NR 222 -EXAM2 Health & Wellness (Latest 2025/2026 Update) |
Most Tested Questions & Verified Answers - Q&A
Comprehensive Exam Review - 150 Questions
Section 1: Health Promotion and Wellness Models (Questions 1-15)
1 In the Transtheoretical Model, which psychological construct best explains why an individual in the Preparation
stage may regress to Contemplation after a failed attempt to change?
A) Self-efficacy
B) Decisional balance
C) Temptation
D) Processes of change
Answer: B
Rationale: Decisional balance, weighing pros and cons, shifts dramatically after failure; cons of changing increase,
leading to regression. Self-efficacy is more stable; temptation and processes of change are less central to stage
regression.
2 A community health initiative aims to increase physical activity among adults using the Social Ecological
Model. Which intervention strategy best addresses all four levels (individual, interpersonal, organizational,
community/policy)?
A) Distributing pedometers and step-count goal sheets
B) Organizing workplace walking groups with friendly competitions
C) Implementing a city-wide policy for safe sidewalks and bike lanes
D) Launching a media campaign about health benefits of exercise
Answer: C
Rationale: City-wide policy affects built environment (community/policy), while also enabling individual behavior,
interpersonal encouragement, and organizational support. Other options target only one or two levels.
3 A researcher applies the Health Belief Model to predict influenza vaccination uptake. Which combination of
constructs would most strongly predict vaccination behavior?
A) High perceived susceptibility, low perceived severity, high perceived benefits
B) High perceived susceptibility, high perceived severity, high perceived benefits, low perceived barriers
C) Low perceived susceptibility, high perceived severity, high perceived benefits
D) High perceived susceptibility, low perceived severity, low perceived barriers
Answer: B
Rationale: According to the HBM, behavior is most likely when individuals perceive high threat (susceptibility +
severity), believe the action is beneficial, and perceive few barriers. Option B includes all these elements.
4 Which of the following best describes a key criticism of the Theory of Planned Behavior when applied to
long-term health behavior maintenance?
A) It overemphasizes the role of affective attitudes over cognitive attitudes.
B) It assumes that behavioral intention is a sufficient predictor of behavior, ignoring the intention-behavior gap.
C) It fails to account for the influence of subjective norms on behavior.
D) It does not consider past behavior as a predictor of future behavior.
,Answer: B
Rationale: The TPB posits intention as the immediate antecedent of behavior, but research shows a substantial gap
between intention and actual behavior, especially for long-term maintenance. Other options are not primary
criticisms.
5 In the context of Pender's Health Promotion Model, which factor is considered a modifying factor that indirectly
influences health-promoting behavior through its effect on cognitive-perceptual factors?
A) Perceived self-efficacy
B) Perceived benefits of action
C) Interpersonal influences
D) Activity-related affect
Answer: C
Rationale: Interpersonal influences (family, peers) are modifying factors that shape perceptions and affect behavior
indirectly via cognitive-perceptual factors like self-efficacy and benefits. The other options are cognitive-perceptual
factors themselves.
6 A wellness program uses motivational interviewing to help clients resolve ambivalence about smoking
cessation. This approach is most consistent with which stage of the Transtheoretical Model?
A) Precontemplation
B) Contemplation
C) Preparation
D) Action
Answer: B
Rationale: Motivational interviewing is particularly effective in the Contemplation stage, where ambivalence is high
and clients are weighing pros and cons. It helps tip the decisional balance toward change.
7 Which of the following best illustrates the concept of 'reciprocal determinism' as described in Social Cognitive
Theory?
A) A person's belief in their ability to exercise increases after successfully completing a 5K run.
B) A person who values health is more likely to join a gym, and the gym environment reinforces their healthy
behaviors.
C) A person's intention to diet is strongly predicted by their attitude and subjective norms.
D) A person's past failure to quit smoking leads to lower self-efficacy and decreased motivation to try again.
Answer: B
Rationale: Reciprocal determinism involves dynamic interaction between person (values), environment (gym), and
behavior (joining gym). Option B shows person-environment-behavior interplay. Option A is self-efficacy, C is
TPB, D is past behavior influence.
8 A health promotion program based on the PRECEDE-PROCEED model identifies that lack of knowledge about
healthy eating is a predisposing factor. Which phase of the model would address this by developing educational
interventions?
A) Phase 1: Social Assessment
B) Phase 3: Educational and Ecological Assessment
C) Phase 4: Administrative and Policy Assessment
D) Phase 5: Implementation
Answer: B
Rationale: Phase 3 (Educational and Ecological Assessment) identifies predisposing, enabling, and reinforcing
,factors. Lack of knowledge is a predisposing factor, and interventions targeting it are designed in this phase. Phase
4 is about resources and policies.
9 In the context of the Wellness-Illness Continuum model, which of the following best describes a person who is
at the 'neutral point' (neither ill nor optimally healthy)?
A) A person with a chronic disease who is managing symptoms but has no acute exacerbation.
B) A person who has no signs or symptoms of disease but engages in risky behaviors like smoking.
C) A person who exercises regularly and eats a balanced diet, but has a family history of heart disease.
D) A person who has just recovered from an acute illness and is gradually resuming normal activities.
Answer: B
Rationale: The neutral point on the continuum represents absence of illness but not optimal health. Engaging in
risky behaviors indicates movement toward illness, but without symptoms, the person is at neutral. Option A is on
the illness side; C and D are moving toward wellness.
10 Which of the following is a major limitation of using the Health Belief Model to design interventions for
culturally diverse populations?
A) The model does not account for the role of self-efficacy.
B) The model assumes that all individuals have equal access to health information.
C) The model emphasizes individual cognitive processes and may undervalue sociocultural and environmental
influences.
D) The model is only applicable to acute illness prevention, not chronic disease management.
Answer: C
Rationale: The HBM focuses on individual perceptions and rational decision-making, often overlooking cultural
norms, social support, and structural barriers that significantly influence health behaviors in diverse populations.
Self-efficacy was added later; B and D are inaccurate.
11 A public health initiative aims to increase community-wide physical activity by redesigning urban
environments to include more parks and bike lanes. This approach most directly aligns with which level of the
ecological model of health behavior?
A) Intrapersonal level
B) Interpersonal level
C) Community level
D) Policy level
Answer: C
Rationale: The ecological model posits multiple levels of influence: intrapersonal (individual), interpersonal (social
networks), community (organizations, neighborhoods), and policy (laws, regulations). Redesigning urban
environments targets the community level by modifying physical and social structures. Policy level would involve
laws or regulations, not direct environmental changes.
12 A nurse is evaluating a wellness program based on the transtheoretical model. Which assessment finding would
indicate that a participant is in the preparation stage, as opposed to contemplation or action?
A) The participant expresses ambivalence about changing their sedentary lifestyle and has no plan to change in
the next six months.
B) The participant has been regularly walking for 30 minutes daily for the past three months.
C) The participant states they intend to start an exercise program within the next 30 days and has purchased
athletic shoes.
D) The participant has not considered changing their diet and does not see it as a problem.
, Answer: C
Rationale: In the transtheoretical model, preparation stage involves intention to take action soon (usually within the
next month) and some behavioral steps, like buying equipment. Contemplation (A) involves ambivalence and no
immediate plan; action (B) involves overt behavior change for less than six months; precontemplation (D) involves
no intention to change.
13 A health educator is designing a program for a culturally diverse urban community with high rates of diabetes.
Using the PEN-3 model, which strategy best addresses the 'Nurturers' dimension?
A) Providing individual counseling sessions tailored to each person's health beliefs.
B) Engaging family members and community elders to support healthy eating practices.
C) Advocating for policy changes to increase access to affordable fresh produce.
D) Developing culturally tailored print materials that explain diabetes prevention.
Answer: B
Rationale: The PEN-3 model's 'Nurturers' dimension refers to family, kin, and community social networks that
influence health behaviors. Engaging family members and elders leverages these nurturers. Individual counseling
targets the 'Person' dimension; policy change addresses 'Environment'; culturally tailored materials may address
multiple dimensions but not specifically nurturers.
14 A community health nurse applies the precede-proceed model to develop an intervention for reducing
childhood obesity. Which activity is most characteristic of the 'Predisposing' factor assessment phase?
A) Surveying parents about their knowledge of nutrition guidelines and attitudes toward physical activity.
B) Mapping the availability of parks and recreational facilities in the neighborhood.
C) Training teachers to implement a new physical education curriculum in schools.
D) Evaluating the effectiveness of a community-wide media campaign after one year.
Answer: A
Rationale: In the precede component, predisposing factors include knowledge, attitudes, beliefs, and values that
motivate behavior. Surveying parents about knowledge and attitudes directly assesses predisposing factors.
Mapping parks assesses enabling factors (availability/resources); training teachers is an intervention; evaluation
occurs in the proceed phase.
15 A researcher uses the health belief model to predict adherence to a new vaccine among young adults. Which
combination of perceptions would most strongly predict uptake?
A) Low perceived susceptibility, high perceived severity, low perceived benefits, high perceived barriers.
B) High perceived susceptibility, high perceived severity, high perceived benefits, low perceived barriers.
C) High perceived susceptibility, low perceived severity, low perceived benefits, high perceived barriers.
D) Low perceived susceptibility, low perceived severity, high perceived benefits, high perceived barriers.
Answer: B
Rationale: The health belief model posits that action is most likely when individuals perceive high susceptibility to a
threat, high severity of the threat, high benefits of the recommended action, and low barriers to taking that action.
Option B aligns with all these conditions. Other combinations include factors that reduce likelihood (e.g., low
benefits, high barriers).
Section 2: Stages of Health Behavior Change (Questions 16-30)
16 A community health initiative aims to reduce sedentary behavior among office workers. Baseline screening
reveals that 40% of participants have no intention to increase physical activity in the next six months.
According to the Transtheoretical Model, which intervention approach is most appropriate for this subgroup?
Most Tested Questions & Verified Answers - Q&A
Comprehensive Exam Review - 150 Questions
Section 1: Health Promotion and Wellness Models (Questions 1-15)
1 In the Transtheoretical Model, which psychological construct best explains why an individual in the Preparation
stage may regress to Contemplation after a failed attempt to change?
A) Self-efficacy
B) Decisional balance
C) Temptation
D) Processes of change
Answer: B
Rationale: Decisional balance, weighing pros and cons, shifts dramatically after failure; cons of changing increase,
leading to regression. Self-efficacy is more stable; temptation and processes of change are less central to stage
regression.
2 A community health initiative aims to increase physical activity among adults using the Social Ecological
Model. Which intervention strategy best addresses all four levels (individual, interpersonal, organizational,
community/policy)?
A) Distributing pedometers and step-count goal sheets
B) Organizing workplace walking groups with friendly competitions
C) Implementing a city-wide policy for safe sidewalks and bike lanes
D) Launching a media campaign about health benefits of exercise
Answer: C
Rationale: City-wide policy affects built environment (community/policy), while also enabling individual behavior,
interpersonal encouragement, and organizational support. Other options target only one or two levels.
3 A researcher applies the Health Belief Model to predict influenza vaccination uptake. Which combination of
constructs would most strongly predict vaccination behavior?
A) High perceived susceptibility, low perceived severity, high perceived benefits
B) High perceived susceptibility, high perceived severity, high perceived benefits, low perceived barriers
C) Low perceived susceptibility, high perceived severity, high perceived benefits
D) High perceived susceptibility, low perceived severity, low perceived barriers
Answer: B
Rationale: According to the HBM, behavior is most likely when individuals perceive high threat (susceptibility +
severity), believe the action is beneficial, and perceive few barriers. Option B includes all these elements.
4 Which of the following best describes a key criticism of the Theory of Planned Behavior when applied to
long-term health behavior maintenance?
A) It overemphasizes the role of affective attitudes over cognitive attitudes.
B) It assumes that behavioral intention is a sufficient predictor of behavior, ignoring the intention-behavior gap.
C) It fails to account for the influence of subjective norms on behavior.
D) It does not consider past behavior as a predictor of future behavior.
,Answer: B
Rationale: The TPB posits intention as the immediate antecedent of behavior, but research shows a substantial gap
between intention and actual behavior, especially for long-term maintenance. Other options are not primary
criticisms.
5 In the context of Pender's Health Promotion Model, which factor is considered a modifying factor that indirectly
influences health-promoting behavior through its effect on cognitive-perceptual factors?
A) Perceived self-efficacy
B) Perceived benefits of action
C) Interpersonal influences
D) Activity-related affect
Answer: C
Rationale: Interpersonal influences (family, peers) are modifying factors that shape perceptions and affect behavior
indirectly via cognitive-perceptual factors like self-efficacy and benefits. The other options are cognitive-perceptual
factors themselves.
6 A wellness program uses motivational interviewing to help clients resolve ambivalence about smoking
cessation. This approach is most consistent with which stage of the Transtheoretical Model?
A) Precontemplation
B) Contemplation
C) Preparation
D) Action
Answer: B
Rationale: Motivational interviewing is particularly effective in the Contemplation stage, where ambivalence is high
and clients are weighing pros and cons. It helps tip the decisional balance toward change.
7 Which of the following best illustrates the concept of 'reciprocal determinism' as described in Social Cognitive
Theory?
A) A person's belief in their ability to exercise increases after successfully completing a 5K run.
B) A person who values health is more likely to join a gym, and the gym environment reinforces their healthy
behaviors.
C) A person's intention to diet is strongly predicted by their attitude and subjective norms.
D) A person's past failure to quit smoking leads to lower self-efficacy and decreased motivation to try again.
Answer: B
Rationale: Reciprocal determinism involves dynamic interaction between person (values), environment (gym), and
behavior (joining gym). Option B shows person-environment-behavior interplay. Option A is self-efficacy, C is
TPB, D is past behavior influence.
8 A health promotion program based on the PRECEDE-PROCEED model identifies that lack of knowledge about
healthy eating is a predisposing factor. Which phase of the model would address this by developing educational
interventions?
A) Phase 1: Social Assessment
B) Phase 3: Educational and Ecological Assessment
C) Phase 4: Administrative and Policy Assessment
D) Phase 5: Implementation
Answer: B
Rationale: Phase 3 (Educational and Ecological Assessment) identifies predisposing, enabling, and reinforcing
,factors. Lack of knowledge is a predisposing factor, and interventions targeting it are designed in this phase. Phase
4 is about resources and policies.
9 In the context of the Wellness-Illness Continuum model, which of the following best describes a person who is
at the 'neutral point' (neither ill nor optimally healthy)?
A) A person with a chronic disease who is managing symptoms but has no acute exacerbation.
B) A person who has no signs or symptoms of disease but engages in risky behaviors like smoking.
C) A person who exercises regularly and eats a balanced diet, but has a family history of heart disease.
D) A person who has just recovered from an acute illness and is gradually resuming normal activities.
Answer: B
Rationale: The neutral point on the continuum represents absence of illness but not optimal health. Engaging in
risky behaviors indicates movement toward illness, but without symptoms, the person is at neutral. Option A is on
the illness side; C and D are moving toward wellness.
10 Which of the following is a major limitation of using the Health Belief Model to design interventions for
culturally diverse populations?
A) The model does not account for the role of self-efficacy.
B) The model assumes that all individuals have equal access to health information.
C) The model emphasizes individual cognitive processes and may undervalue sociocultural and environmental
influences.
D) The model is only applicable to acute illness prevention, not chronic disease management.
Answer: C
Rationale: The HBM focuses on individual perceptions and rational decision-making, often overlooking cultural
norms, social support, and structural barriers that significantly influence health behaviors in diverse populations.
Self-efficacy was added later; B and D are inaccurate.
11 A public health initiative aims to increase community-wide physical activity by redesigning urban
environments to include more parks and bike lanes. This approach most directly aligns with which level of the
ecological model of health behavior?
A) Intrapersonal level
B) Interpersonal level
C) Community level
D) Policy level
Answer: C
Rationale: The ecological model posits multiple levels of influence: intrapersonal (individual), interpersonal (social
networks), community (organizations, neighborhoods), and policy (laws, regulations). Redesigning urban
environments targets the community level by modifying physical and social structures. Policy level would involve
laws or regulations, not direct environmental changes.
12 A nurse is evaluating a wellness program based on the transtheoretical model. Which assessment finding would
indicate that a participant is in the preparation stage, as opposed to contemplation or action?
A) The participant expresses ambivalence about changing their sedentary lifestyle and has no plan to change in
the next six months.
B) The participant has been regularly walking for 30 minutes daily for the past three months.
C) The participant states they intend to start an exercise program within the next 30 days and has purchased
athletic shoes.
D) The participant has not considered changing their diet and does not see it as a problem.
, Answer: C
Rationale: In the transtheoretical model, preparation stage involves intention to take action soon (usually within the
next month) and some behavioral steps, like buying equipment. Contemplation (A) involves ambivalence and no
immediate plan; action (B) involves overt behavior change for less than six months; precontemplation (D) involves
no intention to change.
13 A health educator is designing a program for a culturally diverse urban community with high rates of diabetes.
Using the PEN-3 model, which strategy best addresses the 'Nurturers' dimension?
A) Providing individual counseling sessions tailored to each person's health beliefs.
B) Engaging family members and community elders to support healthy eating practices.
C) Advocating for policy changes to increase access to affordable fresh produce.
D) Developing culturally tailored print materials that explain diabetes prevention.
Answer: B
Rationale: The PEN-3 model's 'Nurturers' dimension refers to family, kin, and community social networks that
influence health behaviors. Engaging family members and elders leverages these nurturers. Individual counseling
targets the 'Person' dimension; policy change addresses 'Environment'; culturally tailored materials may address
multiple dimensions but not specifically nurturers.
14 A community health nurse applies the precede-proceed model to develop an intervention for reducing
childhood obesity. Which activity is most characteristic of the 'Predisposing' factor assessment phase?
A) Surveying parents about their knowledge of nutrition guidelines and attitudes toward physical activity.
B) Mapping the availability of parks and recreational facilities in the neighborhood.
C) Training teachers to implement a new physical education curriculum in schools.
D) Evaluating the effectiveness of a community-wide media campaign after one year.
Answer: A
Rationale: In the precede component, predisposing factors include knowledge, attitudes, beliefs, and values that
motivate behavior. Surveying parents about knowledge and attitudes directly assesses predisposing factors.
Mapping parks assesses enabling factors (availability/resources); training teachers is an intervention; evaluation
occurs in the proceed phase.
15 A researcher uses the health belief model to predict adherence to a new vaccine among young adults. Which
combination of perceptions would most strongly predict uptake?
A) Low perceived susceptibility, high perceived severity, low perceived benefits, high perceived barriers.
B) High perceived susceptibility, high perceived severity, high perceived benefits, low perceived barriers.
C) High perceived susceptibility, low perceived severity, low perceived benefits, high perceived barriers.
D) Low perceived susceptibility, low perceived severity, high perceived benefits, high perceived barriers.
Answer: B
Rationale: The health belief model posits that action is most likely when individuals perceive high susceptibility to a
threat, high severity of the threat, high benefits of the recommended action, and low barriers to taking that action.
Option B aligns with all these conditions. Other combinations include factors that reduce likelihood (e.g., low
benefits, high barriers).
Section 2: Stages of Health Behavior Change (Questions 16-30)
16 A community health initiative aims to reduce sedentary behavior among office workers. Baseline screening
reveals that 40% of participants have no intention to increase physical activity in the next six months.
According to the Transtheoretical Model, which intervention approach is most appropriate for this subgroup?
