(Test Bank) United States University FNP 590FNP 590 MIDTERM & FINALS ( ALL ANSWERS AND EXPLANATIONS ARE 100% CORRECT ) 162 PAGES < GUARANTEED GRADES >

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Midterm Ch 1-8 Finals Ch 1-14, 25 CHAPTER 1 Which model of health is most likely used by a person who does not believe in preventive health care? Question options: Clinical model Role performance model Adaptive model Eudaimonistic model The clinical model of health views the absence of signs and symptoms of disease as indicative of health. People who use this model wait until they are very sick to seek care. A person with chronic back pain is cared for by her primary care provider as well as receives acupuncture. Which model of health does this person likely favor? Question options: Clinical model Role performance model Adaptive model Eudaimonistic model The eudaimonistic model embodies the interaction and interrelationships among physical, social, psychological, and spiritual aspects of life and the environment in goal attainment and creating meaning in life. Practitioners who practice the clinical model may not be enough for someone who believes in the eudaimonistic model. Those who believe in the eudaimonistic model often look for alternative providers of care. A state of physical, mental, spiritual, and social functioning that realizes a person’s potential and is experienced within a developmental context is known as: Question options: growth and development. health. functioning. high-level wellness. Health is defined as a state of physical, mental, spiritual, and social functioning that realizes a person’s potential and is experienced within a developmental context. Which US report is considered a landmark document in creating a global approach to health? Question options: The 1990 Health Objectives for the Nation: A Midcourse Review Healthy People 2020 Healthy People 2000 The U.S. Surgeon General Report Healthy People 2000 and its Midcourse Review and 1995 Revisions were landmark documents in which a consortium of people representing national organizations worked with US Public Health Service officials to create a more global approach to health. Which of the following represents a method of primary prevention? Question options: Informational session about healthy lifestyles Blood pressure screening Interventional cardiac catheterization Diagnostic cardiac catheterization Primary prevention precedes disease or dysfunction. It includes health promotion and specific protection and encourages increased awareness; thus, education about healthy lifestyles fits this definition. Blood pressure screening does not prevent disease, but instead identifies it. Which of the following represents a method of secondary prevention? Question options: Self–breast examination education Yearly mammograms Chemotherapy for advanced breast cancer Complete mastectomy for breast cancer Screening is secondary prevention because the principal goal of screenings is to identify individuals in an early, detectable stage of the disease process. A mammogram is a screening tool for breast cancer and thus is considered a method of secondary prevention. In reviewing a person’s medical claims, a nurse realizes that the individual with moderate persistent asthma has had several emergency department visits and is not on inhaled steroids as recommended by the NHLBI asthma management guidelines. The nurse discusses this with the person’s primary care provider. In this scenario, the nurse is acting as a(n): Question options: advocate. care manager. consultant. educator. Care managers act to prevent duplication of service and reduce cost. Care managers base recommendation on reliable data sources such as evidence-based practices and protocols. During a home visit, a nurse assists an individual to complete an application for disability services. The nurse is acting as a(n): Question options: advocate. care manager. consultant. educator. The advocacy role of the nurse helps individuals obtain what they are entitled to receive from the health care system, tries to make the system more responsive to individuals’ community needs, and assists individuals in developing skills to advocate for themselves. During a home visit, a nurse discusses the dangers of smoking with an individual. In this scenario the nurse is acting as a(n): Question options: advocate. care manager. consultant. educator. Health education is a primary prevention technique available to avoid major causes of disease. Teaching can range from a chance remark to a planned lesson. A nurse is asked to provide an expert opinion about the development of an education program for newly diagnosed diabetics. In this scenario, the nurse is acting as a(n): Question options: advocate. care manager. consultant. educator. Nurses with a specialized area of expertise provide education about health promotion and disease prevention to individuals and groups as consultants. A nurse is planning to deliver an educational program to individuals with diabetes. Which of the following should be the initial action taken by the nurse to ensure the success of the program? Question options: Assess the motivation level of the individuals Assess the knowledge level of the individuals Establish teacher-learner goals with the individuals Establish multiple teaching sessions with the individuals Selection of the methods most likely to succeed involves the establishment of teacher-learner goals. Thus, the first step by the nurse should be establishment of goals. A nurse who uses findings from a randomized, controlled trial on the care of Foley catheters to change practice at an institution is practicing: Question options: evidence-based medicine. qualitative research. quantitative research. clinical judgment. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. Which of the following is most influenced by the social and economic environment of a community? Question options: Social health policies Quality of care Evidence-based practice Practice guidelines Social policies concerning health are influenced by the social and economic environment of a population. Analysis of population trends and projections is necessary to help health professionals determine changing needs. A major cause of death in the early twentieth century was: Question options: cancer. cerebrovascular disease. heart disease. infections. Infections and acute disease were the major causes of death in the early part of the twentieth century. Which of the following demonstrates a nurse taking action to promote health and prevent disease? Question options: Making a home visit to a person who is recovering from a heart attack Administering medications to a cardiac client in the hospital Providing cardiopulmonary resuscitation during a heart attack Educating a person about the advantages of a heart-healthy diet during a home visit Solutions for health promotion are focused on individual and government involvement. To promote health and wellness, an emphasis must be placed on primary prevention. This is often related to actions such as education that influence lifestyle choices. In the preceding example, educating a person about the advantages of a heart-healthy diet during a home visit serves to influence lifestyle choices. Which factor may have the most influence in changing the health behavior of a single, adult woman who smokes and is the care provider for her mother, her own children, and granddaughter? Question options: Education regarding effects of smoking on her health The satisfaction that she will not contribute to secondhand smoke The availability of a weekly support group A gift card for $10 to a local grocery store for every week she is smoke free Motivational factors play a role in influencing attitudinal changes. A financial incentive is an example of a motivating factor. For this woman, who is financially responsible for the health and well-being of other individuals, finances will likely play a significant role in motivating her actions. Remember that education regarding the benefits of not smoking is not enough. Thus, the $10 gift card may have the most influence in changing her health behavior. An example of a Hispanic American nurse promoting cultural competency is: Question options: providing translation services for all Hispanic Americans. focusing on episodic care of illnesses with Hispanic Americans. taking a class about the Hispanic American culture. providing care for all Hispanic American persons in her clinic. Nurses must be aware of their beliefs, values, and customs. They should not assume that their perspective is correct and shared by others. Additionally, they should avoid stereotyping. Broadening one’s educational base regarding cultural beliefs is a way to develop and thus promote cultural competency. The devaluing of beliefs, values, and customs of others is known as: Question options: ethnocentrism. racism. cultural competency. empathy. Racism is defined as the devaluing of beliefs, values, and customs of others. Building a partnership with an obese individual who is trying to lose weight requires the nurse to: Question options: schedule a day to exercise with the individual. go grocery shopping for the individual. learn about the methods of weight loss. give the individual a weight loss goal. Nurses must work with individuals to determine what they are willing to do to lose weight. To do this successfully, nurses must know what options are available to the individuals for weight loss. Once nurses learn about the methods of weight loss, they can then develop goals for weight loss with the individual. Assuming that an individual’s own perspective is correct and shared by others is known as: Question options: ethnocentrism. racism. cultural competency. empathy. Assuming that an individual’s own perspective is correct and shared by others is known as ethnocentrism. CHAPTER 2 A person states, “My grandmother is the decision maker in our family.” Which of the following is being described by the person? Question options: Culture Race Ethnicity Values Culture, as an element of ethnicity, refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. The term “ethnicity” encompasses more than a cultural practice, which is what is being described by the person; it focuses on differences in meanings, values, and ways of living. Race is associated with power and indexes the history or ongoing imposition of one’s group’s authority above another. Values are beliefs about the worth of something and serve as standards that influence behavior and thinking. The nurse recommended to a 50-year-old woman that she schedule a routine mammogram. Which of the following would be the most important factor in this woman’s decision to schedule this exam? Question options: Race Ethnicity Cultural values Value orientation Cultural values guide actions and decision-making that facilitates self-worth and self-esteem. They shape human behaviors and determine what individuals will do to maintain their health status, how they will care for themselves, and others who become ill, and where and from whom they will seek health care. Race is associated with power and indexes the history or ongoing imposition of one’s group’s authority above another. Ethnicity focuses on differences in meanings, values, and ways of living. Value orientations reflect the personality type of a particular society. Which of the following actions demonstrates a health care professional providing culturally competent care? Question options: Encouraging the person to take medications as prescribed Asking the person to describe his folk healing methods Demonstrating the proper way to administer an insulin injection Assisting the person with discussing his health problems with the family It is very important for health care providers to be aware of how people interpret their health issues or illnesses to be capable to provide culturally competent care. A culturally competent health care professional should be able to consistently and thoroughly recognize and understand the differences in his or her culture and that of the patient or client, to respect the person’s values and beliefs, and adjust the approach of delivering care to meet each person’s needs and expectations. Asking the person to describe his folk healing methods is the only action that demonstrates the health care professional seeking input from the person into the care that is received. A person reports that she has been seeking care from an acupuncturist to help relieve the chronic pain that she has been experiencing. Which of the following statements would be the most appropriate response from the nurse? Question options: “You should have told me that the current treatments were helping your pain.” “Tell me more about your treatments from the acupuncturist.” “Tell me why you decided to not to continue with your treatment plan.” “You should not be seeing an acupuncturist while receiving professional care.” Through a culturally sensitive assessment process, nurses can determine what specific remedies individuals are using and whether their continued use would interfere with the prescribed method. The nurse asking the person to describe the treatments from the acupuncturist allows the nurse to learn this information. The other responses demonstrate an ethnocentric perspective by the nurse, viewing the treatments from the acupuncturist as inferior to professional care. When providing an educational session about the Arab American population, which of the following information would be included? Question options: The largest group of Arab Americans was refugees in the 1960s. The largest groups of Arab Americans are from Palestine and Iraq. Members of the Arab American population are most likely to live in rural communities. Members of the Arab American population are more likely to have college degrees than Americans at large. Members of the Arab American population are more likely to have college degrees (+45%) than Americans at large (28%). About 94% of Arab Americans live in metropolitan areas. The largest groups of Arab Americans are the Lebanese, Syrians, and Egyptians. Arab Americans came to the United States in three immigration waves; the last occurred in the 1960s and consisted of many professionals, entrepreneurs, and skilled and semiskilled laborers. A health care professional is caring for an Arab American individual. Which of the following cultural practices of this ethnic minority should be considered when planning care? Question options: This ethnic culture tends to be future oriented. Religion plays an important role in this culture. Traditional cultural practices are infrequently used during a health crisis. Members of this culture tend to have smaller families. Religion plays an important part in Arab culture, and there are dietary rules and prescribed rituals for praying and washing. Arab Americans are present oriented and view the future as uncertain. During a health crisis, many Arab Americans seek out their family, community, and traditional values and cultural practices. Arab American families are, on average, larger than non–Arab American families. An Asian American family has recently immigrated to the United States. Which of the following would provide an appropriate rationale when encouraging the family to send their child to school? Question options: The child will get a good education. According to law, all children must go to school. The child can get health care at school. Exposure to different cultures in school will enhance socialization. Exposure to different cultures in school facilitates the adoption of other cultural beliefs and aids in the socialization of the child into a new environment. Which of the following was the fastest-growing minority group in the United States between 2000 and 2010? Question options: Asian American Arab American Hispanic American Native American A 43% increase in the Hispanic population between 2000 and 2010 makes Hispanics the fastest-growing minority group in the United States. The interrelationship of poverty and health care dollars spent by Blacks and other minorities is affected greatly by: Question options: lack of access to preventive health care services low numbers of minority health care providers use of emergency rooms for care increased infant mortality rates in African American populations A decrease in resources for preventive care leads to the use of emergency rooms and other more expensive health care services that are often used as resources when severe illness occurs. A health care provider is working with an African American woman who has recently suffered a stroke and is homebound. She insists that she must get out of the house and attend Sunday worship services. What is the most likely explanation for her insisting that she participate in this cultural practice? Question options: The church is the only place where prayer can be performed. The church serves as a social support for its members. The church is the place where the family meets on a weekly basis. The church serves as a site for folk healing practices. The church is significant support system many African Americans. It serves many purposes beyond worship and formation, including serving as a place to meet where members could pass news, take care of business, and find strength of purpose; providing direct social welfare services; acting as a stabilizing force in the community; facilitating citizenship training and community social action; serving as a transmitter of cultural history; and providing the means for coping and surviving in a hostile world. African Americans often find comfort in the support their religious leader can give them, but it does not have to happen within the church. African Americans believe in the healing power of prayer, but that can happen outside of the church as well. Family is the strongest source of support for African Americans, and most meet more often than weekly at church. Which of the following ethnic groups has a disproportionately high death rate from unintentional injuries and suicide? Question options: American Indian/Alaska Native Americans Asian Americans Latino/Hispanic Americans Black/African Americans American Indian/Alaska Native Americans have disproportionately high death rates from unintentional injuries and suicide. Difficult life situations and stresses of daily life contribute to an array of problems, including feelings of hopelessness, desperation, family dissolution, and substance abuse. A health care professional is offering an educational session about providing culturally congruent care. Which of the following information would be included the presentation? Question options: Hispanic Americans value keeping balance and harmony with the earth. The oldest male is the decision maker in African American families. Native Americans are present oriented, taking one day at a time. The hot and cold concept of disease is part of the Asian American culture. Native Americans are generally present oriented, emphasizing events that are occurring now rather than events that will happen later. They take one day at a time and in times of illness they cope by hoping for improvements the next day. Native Americans value keeping balance and harmony with the earth. The oldest male is the decision maker and spokesperson in Asian American families. The hot and cold concept of disease is part of the Hispanic culture. A family has recently become homeless. Which of the following factors most likely contributed to this situation? Question options: Being from an ethnic minority background Declining rates of poverty Having multiple chronic illnesses Being unable to find affordable housing The inability to find affordable housing, decline in public assistance, poverty, and eroding work opportunities all contribute to homelessness. The increasing prevalence of poverty has caused an increase in the homeless population. Other factors that may affect this situation are lack of affordable health care, domestic violence, mental illness, and addiction disorders. A health care professional is caring for an individual who is homeless. Which of the following considerations should be made? Question options: The prevalence of substance abuse is much lower among the homeless population than the general population. The prevalence of HIV/AIDS is much lower among the homeless population than the general population. The percentage of the population who has health insurance is much lower among the homeless than the general population. The percentage of the population who has limited access to medical care is much lower among the homeless than the general population. Most homeless people do not have health insurance or the ability to pay for needed health care, and many providers refuse to deliver treatments to these people. The prevalence of substance abuse, HIV/AIDS, and mental health disorders is higher among the homeless population than the general population. A health care professional is leading a community action coalition to address the problem of homelessness within the neighborhood. Which of the following statements would most likely be made by health care professional? Question options: Homelessness should be addressed by improving financial assistance programs. Homelessness should be of concern to everyone in the neighborhood. Homelessness should be addressed by encouraging job growth in the area. Homelessness should be of concern to the mental health providers in the area. Homelessness is everyone’s problem, and people can ultimately affect the establishment of priorities to facilitate an improved quality of life. As more people understand homelessness, this will serve as an excellent guide in providing input, taking necessary action, and making the final decision as to what will make a healthy nation. A health care professional is searching for a funding source to develop a colorectal cancer screening program for ethnic and racial minorities in the community. Which of the following federal agencies would most likely be able to assist with this initiative? Question options: The National Institute on Minority Health and Health Disparities The Centers for Disease Control and Prevention The Office of Minority Health The National Institutes of Health The Office of Minority Health improves and protects the health of racial and ethnic minority populations through the development of health policies and programs that concentrate on eliminating health disparities. The National Institute on Minority Health and Health Disparities, The Centers for Disease Control and Prevention, and National Institutes of Health all address health disparities among racial and ethnic minorities, but their priority is not in funding these initiatives. Which of the following best demonstrates the practice of transcultural nursing? Question options: Using previous knowledge about ethnic minority cultures to plan care Adapting nursing care to meet the need of a person from an ethnic minority Requesting an interpreter when caring for a person from an ethnic minority Attending a presentation about cultural diversity Transcultural nursing is defined as an area of nursing study and practice that focuses on discovering and explaining cultural factors that influence the health, well-being, illness, or death of individuals or groups and seeks to provide culturally based appropriate care to people of diverse cultures. Adapting nursing care to meet the needs of a person from an ethnic minority best meets this definition of transcultural nursing. A nurse may initially use previous knowledge about minority cultures to plan care, but then must individualize the care based on individual differences within the culture. Having an interpreter present will not be necessary when working with all persons from ethnic minorities. Attending a presentation about cultural diversity would assist the nurse in becoming more culturally competent, but it is not the best example of practicing transcultural nursing because no nursing care is being provided when attending a presentation. A nurse would like to improve his cultural competence. Which of the following is the best strategy to use? Question options: Explore complementary and alternative medicine practices used by other cultures. Discuss cultural differences with coworkers. Provide care to diverse populations. Participate in continuing education programs about cultural diversity. Salman et al. (2007) assessed cultural awareness and cultural competence levels among staff nurses who participated in a continuing education program aimed at increasing knowledge of culturally competent care of geriatric populations. Staff nurses who participated in this training program had higher cultural competence levels as compared with those who did not join this training program. Exploring complementary and alternative medicine practices used by other cultures will assist if a nurse is using these practices; however, depending on whom the nurse is caring for, this information may have limited usefulness. Discussing cultural differences with coworkers may help the nurse learn about other cultures, but it may not provide the best source of information. Providing care to diverse populations may not help the nurse to become more culturally competent without having some baseline knowledge about cultural diversity. A nurse is told by a colleague that an Asian American individual on home care is using complementary and alternative medicine (CAM). Which of the following conclusions can accurately be drawn from this statement? Question options: The client will have adverse complications from using this form of medicine. The client may be using meditation, acupuncture, or another therapy. The client will soon be returning to his or her native country for further treatment. The client does not agree with the current professional care medication regimen. Examples of complementary and alternative medicine (CAM) include acupuncture, feedback, relaxation, music therapy, massage, art, music, and dance therapy. Persons who do not experience relief from chronic conditions often resort to complementary alternative medicine. It is important the nurse learn more about the CAM that the person is using so that any potential interactions between the use of CAM and professional care can be addressed. Complementary and alternative medicine can be used in conjunction with the use of professional care. A woman reports that she has strong spiritual practices. Which of the following is she most likely to experience? Question options: Improved coping skills and social support Increased understanding of religious differences Decreased pain and improved healing Decreased use of Western medicine Spiritual practices are likely to improve coping skills and social support, promote feelings of optimism and home, encourage healthy behavior, decrease feelings of depression and anxiety, and support a sense of relaxation. CHAPTER 3 Which addition to a community best demonstrates the concept of the Healthy People 2020 report? Question options: New cardiothoracic intensive care unit at a major hospital New rehabilitation center New recreational health center New children’s hospital The Healthy People 2020 report promotes health care, not illness care. A hospital, ICU, and rehabilitation center emphasize episodic care after an illness. The recreation health center serves to preserve health in the community and helps meet the goals of the Healthy People 2020 report. Which nurse is at risk of making a medical error? Question options: Working overtime Works in a hospital that advocates multidisciplinary care Caring for four clients during the shift Attends regular continuing education programs Health care systems are the basic cause of medical errors. Organizational and workforce management, work design, and organizational culture are problem areas that contribute to medical errors. Poor management leads to increased nurse turnover, the need for increased client-to-nurse ratios, increased need for overtime, and decreased number of nurses, all of which can lead to medical errors. A nurse working overtime is at risk of making a medical error. What is the most effective policy a staff nurse can implement to help decrease medical errors on the unit? Question options: Forgo opportunities for continuing education so the unit is never understaffed. Foster a collaborative working environment on the unit. Check all medications a minimum of three times before administering them. Develop a policy that mandates the firing of any nurse who commits an error. Health care systems are the basic cause of medical errors. Organizational and workforce management, work design, and organizational culture are problem areas that contribute to medical errors. Creating a collaborative working environment helps improve organizational culture, thereby reducing the chance of medical errors. The person known as the father of British and American public health is: Question options: Lillian Wald. Edwin Chadwick. Lemuel Shattuck. Paul Ehrlich. A community planning committee is working on the development of a community nursing center. Which of the following essential components should be included in this center? Question options: Physician as medical director Interdisciplinary staff Nurse as chief manager Partnership with an academic institution The essential components of a community nursing center include a nurse as chief manager, a nursing staff that is accountable and responsible for care and professional practice, and nurses as the primary providers of care. Considering the provider and client perspective, which of the following is the most autonomous form of insurance? Question options: Fee-for-service plan Health maintenance organization (HMO) Preferred provider organization (PPO) Independent practice association (IPA) In the fee-for-service plan, a provider provides a service and bills the individual’s insurance company. The individual is also allowed to choose his or her provider. Which health care provider represents a primary care provider? Question options: Psychiatric advanced practice nurse Clinical nurse specialist