Final Exam: NR222 / NR 222 Health & Wellness | Complete
Guide with Questions and Verified Answers| 100% Correct
(New 2024/ 2025 Update) -Chamberlain - 150 Questions
Section 1: Health Promotion and Disease Prevention (Questions 1-13)
1 A community health initiative aims to reduce the incidence of type 2 diabetes in a low-income urban
neighborhood. The program includes free cooking classes, a community garden, and monthly health screenings.
Which level of prevention does this initiative primarily represent?
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Quaternary prevention
Answer: A
Rationale: Primary prevention aims to prevent the onset of disease by addressing risk factors. The initiative targets
healthy behaviors (diet, physical activity) and early detection through screenings, but the focus on lifestyle
modification before disease onset classifies it as primary prevention. Secondary prevention involves early detection
and treatment, while tertiary prevention manages established disease.
2 A nurse is using the Transtheoretical Model to guide a smoking cessation intervention for a client who has been
thinking about quitting but has not yet taken action. According to this model, which intervention strategy is
most appropriate?
A) Provide information about the health risks of smoking.
B) Help the client develop a quit plan and set a quit date.
C) Reinforce the client's decision to quit and explore ambivalence.
D) Encourage the client to engage in relapse prevention strategies.
Answer: C
Rationale: The client is in the contemplation stage, characterized by ambivalence about change. Interventions should
focus on reinforcing the decision to quit and exploring pros and cons. Option A is more appropriate for
precontemplation; option B for preparation; option D for action/maintenance.
3 Which of the following best describes the concept of 'health equity' in the context of disease prevention?
A) Providing the same resources to all individuals regardless of need.
B) Eliminating disparities in health outcomes by addressing social determinants.
C) Ensuring equal access to healthcare services for all populations.
D) Focusing prevention efforts on high-risk groups only.
Answer: B
Rationale: Health equity involves achieving the highest level of health for all people by eliminating disparities, often
through addressing social determinants. Option A describes equality (sameness), not equity. Option C is a
component but incomplete; option D is targeted prevention, not equity.
4 A nurse is evaluating a community-based program that provides free mammograms to women aged 40-64. The
program's goal is to reduce breast cancer mortality. Which type of prevention does this program represent?
A) Primary prevention
B) Secondary prevention
,C) Tertiary prevention
D) Primordial prevention
Answer: B
Rationale: Secondary prevention focuses on early detection of disease through screening, such as mammography, to
reduce mortality. Primary prevention prevents disease onset; tertiary prevention manages established disease;
primordial prevention addresses underlying social conditions.
5 A patient with hypertension is prescribed a low-sodium diet and daily exercise. The nurse also schedules regular
blood pressure checks. Which level of prevention is being implemented?
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Quaternary prevention
Answer: C
Rationale: Tertiary prevention aims to manage established disease and prevent complications. The patient already
has hypertension, so dietary and exercise interventions are part of treatment and monitoring to prevent progression.
Primary prevention would be preventing hypertension; secondary prevention would be early detection.
6 A public health campaign encourages adults to receive the influenza vaccine annually. This is an example of:
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Health promotion only
Answer: A
Rationale: Vaccination is a primary prevention measure because it prevents the onset of influenza infection.
Secondary prevention involves early detection; tertiary prevention manages illness. Health promotion is broader,
but vaccination is a specific primary prevention strategy.
7 Which of the following best illustrates the concept of 'upstream thinking' in disease prevention?
A) Providing smoking cessation classes to individuals who smoke.
B) Advocating for policies that limit tobacco advertising near schools.
C) Screening for lung cancer in high-risk populations.
D) Offering nicotine replacement therapy to smokers.
Answer: B
Rationale: Upstream thinking addresses root causes of health problems at the population level, such as social and
environmental factors. Advocating for policy change is upstream; individual-level interventions (A, C, D) are
downstream.
8 A nurse is implementing a program to prevent childhood obesity. Which intervention addresses a modifiable
risk factor at the community level?
A) Offering nutritional counseling to obese children.
B) Advocating for safe parks and playgrounds in the neighborhood.
C) Screening for obesity in school-aged children.
D) Referral to a pediatric weight management clinic.
Answer: B
Rationale: Modifiable risk factors for obesity include physical activity and environment. Advocating for safe parks
promotes physical activity at the community level, addressing a modifiable factor. Options A, C, D are
,individual-level interventions.
9 According to the Health Belief Model, which factor is most likely to predict whether an individual will adopt a
preventive health behavior?
A) Perceived susceptibility to the disease
B) Perceived barriers to action
C) Cues to action
D) Self-efficacy
Answer: D
Rationale: While all components are important, self-efficacy (confidence in one's ability to perform the behavior) is
a strong predictor of behavior adoption, especially for complex behaviors. Perceived susceptibility and barriers
influence motivation, but self-efficacy is critical for initiation and maintenance.
10 A nurse is counseling a client who is overweight and has a family history of diabetes. The client states, 'I don't
think I can lose weight because I've tried before and failed.' Which construct of the Health Belief Model is the
nurse addressing when providing encouragement and setting small goals?
A) Perceived susceptibility
B) Perceived severity
C) Perceived benefits
D) Self-efficacy
Answer: D
Rationale: The client expresses low confidence in ability to lose weight, indicating low self-efficacy. The nurse
addresses this by providing encouragement and setting achievable goals to build self-efficacy. Perceived
susceptibility and severity relate to risk perception; benefits relate to effectiveness of action.
11 A community health initiative aims to reduce cardiovascular disease (CVD) incidence through a multi-level
intervention. Which combination of strategies best aligns with the socio-ecological model for health promotion,
targeting individuals, social networks, organizations, and policy simultaneously?
A) Offering gym memberships, providing dietary counseling, and organizing a 5K run event.
B) Implementing a workplace wellness program with health coaching, creating a farmers' market in a
low-income neighborhood, and advocating for a tax on sugar-sweetened beverages.
C) Distributing educational pamphlets on heart-healthy diets and exercise, and broadcasting public service
announcements on local TV.
D) Conducting health risk appraisals at community health fairs and referring high-risk individuals to primary
care providers.
Answer: B
Rationale: The socio-ecological model emphasizes multiple levels of influence. Option B addresses individual
(health coaching), interpersonal (workplace social norms), organizational (workplace policy), community (farmers'
market access), and policy (sugar tax). Option A is primarily individual and interpersonal. Option C is only
individual and community. Option D is individual-level screening and referral.
12 In the context of the U.S. Preventive Services Task Force (USPSTF) recommendations, which of the following
statements about screening for colorectal cancer in adults aged 50-75 is most accurate?
A) The USPSTF strongly recommends against screening for colorectal cancer using any method due to
insufficient evidence of benefit.
B) The USPSTF recommends screening with high-sensitivity fecal occult blood testing, sigmoidoscopy, or
colonoscopy, but the evidence is insufficient to recommend a specific frequency for each method.
, C) The USPSTF recommends screening with colonoscopy every 10 years, and all other methods are considered
inferior and not recommended.
D) The USPSTF recommends screening with any of several tests, each with a specific recommended interval,
and the choice should be based on patient preference and risk.
Answer: D
Rationale: The USPSTF gives an A recommendation for colorectal cancer screening in adults aged 50–75, endorsing
several strategies (e.g., colonoscopy every 10 years, FIT annually, flexible sigmoidoscopy every 5 years with FIT
every 3 years). Option D accurately reflects that multiple options are recommended with specific intervals and
shared decision-making. Option A is false. Option B incorrectly states insufficient evidence for intervals. Option C
is false because other methods are also recommended.
13 A nurse is designing a community-based health promotion program for young adults (college students). Which
theoretical framework would best guide the development of an intervention to increase physical activity by
addressing both individual motivation and environmental opportunities?
A) Health Belief Model (HBM) focusing on perceived susceptibility to chronic disease and benefits of exercise.
B) Transtheoretical Model (TTM) with stage-matched interventions and processes of change.
C) Social Cognitive Theory (SCT) incorporating self-efficacy, outcome expectations, and observational learning
through peer role models.
D) Pender's Health Promotion Model (HPM) emphasizing individual characteristics, behavior-specific
cognitions, and behavioral outcomes.
Answer: C
Rationale: Social Cognitive Theory explicitly addresses both personal factors (self-efficacy, outcome expectations)
and environmental factors (observational learning, social support, access to facilities), making it ideal for a
multi-level intervention. HBM focuses on perceptions but not environment. TTM focuses on readiness to change
but less on environmental context. HPM includes environment but SCT is more explicit about reciprocal
determinism and observational learning.
Section 2: Theoretical Foundations of Health and Wellness (Questions 14-26)
14 A community health nurse is designing a program to increase physical activity among sedentary office workers.
According to the Transtheoretical Model, which intervention would be most appropriate for individuals who
have been consistently inactive for over a year and express no intention to change?
A) Provide information about the health risks of inactivity and benefits of exercise.
B) Encourage enrollment in a structured group exercise program with scheduled sessions.
C) Assist in setting specific, measurable goals for daily step counts.
D) Discuss strategies to overcome barriers and reinforce progress made.
Answer: A
Rationale: In the Precontemplation stage, individuals have no intention to change. Consciousness-raising through
information about risks and benefits is appropriate. Option B targets Preparation/Action, C targets Action, and D
targets Maintenance.
15 A researcher is evaluating a theory that posits health behavior is determined by the perceived threat of a disease
and the perceived benefits of preventive action, moderated by self-efficacy. Which model is being tested?
A) Health Belief Model (HBM)
B) Theory of Planned Behavior (TPB)
C) Social Cognitive Theory (SCT)
D) Pender's Health Promotion Model (HPM)
Guide with Questions and Verified Answers| 100% Correct
(New 2024/ 2025 Update) -Chamberlain - 150 Questions
Section 1: Health Promotion and Disease Prevention (Questions 1-13)
1 A community health initiative aims to reduce the incidence of type 2 diabetes in a low-income urban
neighborhood. The program includes free cooking classes, a community garden, and monthly health screenings.
Which level of prevention does this initiative primarily represent?
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Quaternary prevention
Answer: A
Rationale: Primary prevention aims to prevent the onset of disease by addressing risk factors. The initiative targets
healthy behaviors (diet, physical activity) and early detection through screenings, but the focus on lifestyle
modification before disease onset classifies it as primary prevention. Secondary prevention involves early detection
and treatment, while tertiary prevention manages established disease.
2 A nurse is using the Transtheoretical Model to guide a smoking cessation intervention for a client who has been
thinking about quitting but has not yet taken action. According to this model, which intervention strategy is
most appropriate?
A) Provide information about the health risks of smoking.
B) Help the client develop a quit plan and set a quit date.
C) Reinforce the client's decision to quit and explore ambivalence.
D) Encourage the client to engage in relapse prevention strategies.
Answer: C
Rationale: The client is in the contemplation stage, characterized by ambivalence about change. Interventions should
focus on reinforcing the decision to quit and exploring pros and cons. Option A is more appropriate for
precontemplation; option B for preparation; option D for action/maintenance.
3 Which of the following best describes the concept of 'health equity' in the context of disease prevention?
A) Providing the same resources to all individuals regardless of need.
B) Eliminating disparities in health outcomes by addressing social determinants.
C) Ensuring equal access to healthcare services for all populations.
D) Focusing prevention efforts on high-risk groups only.
Answer: B
Rationale: Health equity involves achieving the highest level of health for all people by eliminating disparities, often
through addressing social determinants. Option A describes equality (sameness), not equity. Option C is a
component but incomplete; option D is targeted prevention, not equity.
4 A nurse is evaluating a community-based program that provides free mammograms to women aged 40-64. The
program's goal is to reduce breast cancer mortality. Which type of prevention does this program represent?
A) Primary prevention
B) Secondary prevention
,C) Tertiary prevention
D) Primordial prevention
Answer: B
Rationale: Secondary prevention focuses on early detection of disease through screening, such as mammography, to
reduce mortality. Primary prevention prevents disease onset; tertiary prevention manages established disease;
primordial prevention addresses underlying social conditions.
5 A patient with hypertension is prescribed a low-sodium diet and daily exercise. The nurse also schedules regular
blood pressure checks. Which level of prevention is being implemented?
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Quaternary prevention
Answer: C
Rationale: Tertiary prevention aims to manage established disease and prevent complications. The patient already
has hypertension, so dietary and exercise interventions are part of treatment and monitoring to prevent progression.
Primary prevention would be preventing hypertension; secondary prevention would be early detection.
6 A public health campaign encourages adults to receive the influenza vaccine annually. This is an example of:
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Health promotion only
Answer: A
Rationale: Vaccination is a primary prevention measure because it prevents the onset of influenza infection.
Secondary prevention involves early detection; tertiary prevention manages illness. Health promotion is broader,
but vaccination is a specific primary prevention strategy.
7 Which of the following best illustrates the concept of 'upstream thinking' in disease prevention?
A) Providing smoking cessation classes to individuals who smoke.
B) Advocating for policies that limit tobacco advertising near schools.
C) Screening for lung cancer in high-risk populations.
D) Offering nicotine replacement therapy to smokers.
Answer: B
Rationale: Upstream thinking addresses root causes of health problems at the population level, such as social and
environmental factors. Advocating for policy change is upstream; individual-level interventions (A, C, D) are
downstream.
8 A nurse is implementing a program to prevent childhood obesity. Which intervention addresses a modifiable
risk factor at the community level?
A) Offering nutritional counseling to obese children.
B) Advocating for safe parks and playgrounds in the neighborhood.
C) Screening for obesity in school-aged children.
D) Referral to a pediatric weight management clinic.
Answer: B
Rationale: Modifiable risk factors for obesity include physical activity and environment. Advocating for safe parks
promotes physical activity at the community level, addressing a modifiable factor. Options A, C, D are
,individual-level interventions.
9 According to the Health Belief Model, which factor is most likely to predict whether an individual will adopt a
preventive health behavior?
A) Perceived susceptibility to the disease
B) Perceived barriers to action
C) Cues to action
D) Self-efficacy
Answer: D
Rationale: While all components are important, self-efficacy (confidence in one's ability to perform the behavior) is
a strong predictor of behavior adoption, especially for complex behaviors. Perceived susceptibility and barriers
influence motivation, but self-efficacy is critical for initiation and maintenance.
10 A nurse is counseling a client who is overweight and has a family history of diabetes. The client states, 'I don't
think I can lose weight because I've tried before and failed.' Which construct of the Health Belief Model is the
nurse addressing when providing encouragement and setting small goals?
A) Perceived susceptibility
B) Perceived severity
C) Perceived benefits
D) Self-efficacy
Answer: D
Rationale: The client expresses low confidence in ability to lose weight, indicating low self-efficacy. The nurse
addresses this by providing encouragement and setting achievable goals to build self-efficacy. Perceived
susceptibility and severity relate to risk perception; benefits relate to effectiveness of action.
11 A community health initiative aims to reduce cardiovascular disease (CVD) incidence through a multi-level
intervention. Which combination of strategies best aligns with the socio-ecological model for health promotion,
targeting individuals, social networks, organizations, and policy simultaneously?
A) Offering gym memberships, providing dietary counseling, and organizing a 5K run event.
B) Implementing a workplace wellness program with health coaching, creating a farmers' market in a
low-income neighborhood, and advocating for a tax on sugar-sweetened beverages.
C) Distributing educational pamphlets on heart-healthy diets and exercise, and broadcasting public service
announcements on local TV.
D) Conducting health risk appraisals at community health fairs and referring high-risk individuals to primary
care providers.
Answer: B
Rationale: The socio-ecological model emphasizes multiple levels of influence. Option B addresses individual
(health coaching), interpersonal (workplace social norms), organizational (workplace policy), community (farmers'
market access), and policy (sugar tax). Option A is primarily individual and interpersonal. Option C is only
individual and community. Option D is individual-level screening and referral.
12 In the context of the U.S. Preventive Services Task Force (USPSTF) recommendations, which of the following
statements about screening for colorectal cancer in adults aged 50-75 is most accurate?
A) The USPSTF strongly recommends against screening for colorectal cancer using any method due to
insufficient evidence of benefit.
B) The USPSTF recommends screening with high-sensitivity fecal occult blood testing, sigmoidoscopy, or
colonoscopy, but the evidence is insufficient to recommend a specific frequency for each method.
, C) The USPSTF recommends screening with colonoscopy every 10 years, and all other methods are considered
inferior and not recommended.
D) The USPSTF recommends screening with any of several tests, each with a specific recommended interval,
and the choice should be based on patient preference and risk.
Answer: D
Rationale: The USPSTF gives an A recommendation for colorectal cancer screening in adults aged 50–75, endorsing
several strategies (e.g., colonoscopy every 10 years, FIT annually, flexible sigmoidoscopy every 5 years with FIT
every 3 years). Option D accurately reflects that multiple options are recommended with specific intervals and
shared decision-making. Option A is false. Option B incorrectly states insufficient evidence for intervals. Option C
is false because other methods are also recommended.
13 A nurse is designing a community-based health promotion program for young adults (college students). Which
theoretical framework would best guide the development of an intervention to increase physical activity by
addressing both individual motivation and environmental opportunities?
A) Health Belief Model (HBM) focusing on perceived susceptibility to chronic disease and benefits of exercise.
B) Transtheoretical Model (TTM) with stage-matched interventions and processes of change.
C) Social Cognitive Theory (SCT) incorporating self-efficacy, outcome expectations, and observational learning
through peer role models.
D) Pender's Health Promotion Model (HPM) emphasizing individual characteristics, behavior-specific
cognitions, and behavioral outcomes.
Answer: C
Rationale: Social Cognitive Theory explicitly addresses both personal factors (self-efficacy, outcome expectations)
and environmental factors (observational learning, social support, access to facilities), making it ideal for a
multi-level intervention. HBM focuses on perceptions but not environment. TTM focuses on readiness to change
but less on environmental context. HPM includes environment but SCT is more explicit about reciprocal
determinism and observational learning.
Section 2: Theoretical Foundations of Health and Wellness (Questions 14-26)
14 A community health nurse is designing a program to increase physical activity among sedentary office workers.
According to the Transtheoretical Model, which intervention would be most appropriate for individuals who
have been consistently inactive for over a year and express no intention to change?
A) Provide information about the health risks of inactivity and benefits of exercise.
B) Encourage enrollment in a structured group exercise program with scheduled sessions.
C) Assist in setting specific, measurable goals for daily step counts.
D) Discuss strategies to overcome barriers and reinforce progress made.
Answer: A
Rationale: In the Precontemplation stage, individuals have no intention to change. Consciousness-raising through
information about risks and benefits is appropriate. Option B targets Preparation/Action, C targets Action, and D
targets Maintenance.
15 A researcher is evaluating a theory that posits health behavior is determined by the perceived threat of a disease
and the perceived benefits of preventive action, moderated by self-efficacy. Which model is being tested?
A) Health Belief Model (HBM)
B) Theory of Planned Behavior (TPB)
C) Social Cognitive Theory (SCT)
D) Pender's Health Promotion Model (HPM)
