Chamberlain Care & Health
Promotion Exam one with
answers
1. A patient discharged a week ago following a stroke is currently
participating in rehabilitation sessions provided by nurses, physical
therapists, and registered dietitians in an outpatient setting. In what level of
prevention is the patient participating?
1. Primary prevention
2. Secondary prevention
3. Tertiary prevention
4. Transtheoretical prevention
1. Answer: 3. Tertiary prevention involves minimizing the effects of long-term
disease or disability by interventions directed at preventing complications
and deterioration. Tertiary prevention activities are directed at rehabilitation
rather than diagnosis and treatment. Care at this level aims to help patients
achieve as high a level of functioning as possible, despite the limitations
caused by illness or impairment. This level of care is called preventive care
because it involves preventing further disability or reduced functioning.
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2. Based on the Transtheoretical Model of Change, what is the most
appropriate response to a patient who states: "Me, stop smoking? I've been
smoking since I was 16!"
1. "That's fine. Some people who smoke live a long life."
2. "OK. I want you to decrease the number of cigarettes you smoke by one
each day, and I'll see you in 1 month."
,3. "What do you think is the greatest reason why stopping smoking would be
challenging for you?"
4. "I'd like you to attend a smoking-cessation class this week and use
nicotine replacement patches as directed."
2. Answer: 3. The patient's response indicates that he is in the
precontemplation stage and not intending to make a change in behavior in
the next 6 months. In this stage the patient is not interested in information
about the behavior and may be defensive when confronted with the
information. Asking an open-ended question about smoking may stimulate
the patient to identify a reason to begin a behavioral change. Nurses are
challenged to motivate and facilitate health behavior change in working with
individuals.
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3. A nurse working on a medical patient care unit states, "I am having
trouble sleeping, and I eat nonstop when I get home. All I can think of when I
get to work is how I can't wait for my shift to be over. I wish I felt happy
again." What are the best responses from the nurse manager? (Select all
that apply.)
1. "I'm sure this is just a phase you are going through. Hang in there. You'll
feel better soon."
2. "I know several nurses who feel this way every now and then. Tell me
about the patients you have cared for recently. Did you find it difficult to
care for them?"
3. "You can take diphenhydramine over the counter to help you sleep at
night."
4. "Describe for me what you do with your time when you are not working."
5. "The hospital just started a group where nurses get together to talk about
their feelings. Would you like for me to e-mail the schedule to you?"
3. Answer: 2, 4, 5. This nurse is experiencing symptoms of compassion
fatigue. The nurse manager needs to establish a therapeutic relationship
with the nurse. Acknowledging personal thoughts and feelings and talking
with other nurses to identify coping strategies can help this nurse work
, through the feelings associated with compassion fatigue. Engaging in
healthy behaviors and establishing a good work-life balance may also help.
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4. A patient has been laid off from his construction job and has many unpaid
bills. He is going through a divorce from his marriage of 15 years and has
been praying daily to help him through this difficult time. He does not have a
primary health care provider because he has never really been sick, and his
parents never took him to a physician when he was a child. Which external
variables influence the patient's health practices? (Select all that apply.)
1. Difficulty paying his bills
2. Praying daily
3. Age of patient (46 years)
4. Stress from the divorce and the loss of a job
5. Family practice of not routinely seeing a health care provider
4. Answer: 1, 5. External factors impacting health practices include family
beliefs and economic impact. The way in which patients' families use health
care services generally affects their health practices. Their perceptions of
the seriousness of diseases and their history of preventive care behaviors (or
lack of them) influence how patients think about health. Economic variables
may affect a patient's level of health by increasing the risk for disease and
influencing how or at what point the patient enters the health care system.
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5. A nurse is conducting a home visit with a new mom and her three
children. While in the home the nurse weighs each family member and
reviews their 3-day food diary. She checks the mom's blood pressure and
encourages the mom to take the children for a 30-minute walk every day.
The nurse is addressing which level of need, according to Maslow's Hierarchy
of Needs?