Chapter 006

Potter & Perry: Fundamentals of Nursing, 7th Edition
Test Bank
Chapter 6: Health and Wellness
MULTIPLE CHOICE
1. When formulating a definition of health, the nurse should consider that health, within
its current definition, is:
1. The absence of disease
2. A function of the physiological state
3. The ability to pursue activities of daily living
4. A state of well-being involving the whole person
ANS: 4
When formulating a definition of health, a person should consider the total person, as
well as the environment in which the person lives. Health generally implies a state of
well-being that is ultimately defined in terms of the individual.
Health is considered to be more than merely the absence of disease.
The definition of health has broadened beyond the physiological state to include mental,
social, and spiritual well-being.
An individual who has the ability to pursue activities of daily living may not define
himself or herself as being healthy. Life conditions such as environment, diet, and
lifestyle practices may negatively impact ones health long before the person is unable to
perform activities of daily living.
DIF: A
REF: 69
OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Health Promotion and Maintenance
2. Which one of the following is the main, overarching goal for Healthy People 2010?
1. Reduction of health care costs
2. Elimination of health disparities
3. Investigation of substance abuse
4. Determination of acceptable morbidity rates
ANS: 2
Two overarching goals for Healthy People 2010 are (1) to increase quality and years of
healthy life and (2) to eliminate health disparities.
Reducing health care costs was not a goal for Healthy People 2010.
Investigation of substance abuse was not one of the main, overarching goals for Healthy
People 2010.
Determining acceptable morbidity rates was not one of the main, overarching goals for
Healthy People 2010.
DIF: A
REF: 69
OBJ: Comprehension
Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.
Test Bank
6-2
3. A nurse is using a holistic approach when caring for a client. To incorporate all of the
factors that may influence the client, which of the following nursing responses is most
therapeutic?
1. I would like you to perform this exercise once a day.
2. Your physician has left orders that you are to follow.
3. The laboratory tests reveal the need to reduce your daily percentage of fat intake.
4. Adapting to a low-fat diet and increasing your activity will help lower your blood
glucose levels.
ANS: 4
Using a holistic approach involves consideration of all factors that may impact a clients
level of well-being in all dimensions, not just physical health. Factors such as diet and
exercise can influence ones level of health.
Directing the client to exercise does not address the many factors that may impact ones
level of health. This response does not facilitate the client in seeing the connection
between lifestyle choices and well-being.
Directing the client to follow physicians orders, though important, does not describe a
holistic approach of nursing care. A holistic approach may include a discussion of diet
and exercise and the effect these factors have on blood glucose level. The aim is for the
client to take responsibility for their health and choices that may impact their health.
Viewing laboratory test results is a part of the nursing assessment. To approach the client
holistically, the nurse would need to also assess the clients diet and activity level.
DIF: C
REF: 72
OBJ: Analysis
TOP: Nursing Process: Implementation
4. The client states, Heart disease runs in our family. My blood pressure has always been
high. The nurse determines that this is an example of the clients:
1. Risk factors
2. Active strategy
3. Health beliefs
4. Negative health behavior
ANS: 1
Risk factors are anything that increases the vulnerability of an individual or group to an
illness or accident. This client is identifying the physical risk factor of genetic
predisposition to heart disease.
An example of an active strategy would be weight reduction or smoking cessation, where
the client is actively involved in measures to improve their present and future levels of
wellness.
Health beliefs are a persons ideas, convictions, and attitudes about health and illness. An
example of a health belief would be if the client stated, Heart disease runs in our family.
I know I will have heart disease anyway, so why exercise?
A negative health behavior is a behavior that may negatively impact ones health. An
example of a negative health behavior would be consistently drinking alcohol in excess.
Test Bank
6-3
DIF: A
REF: 77
OBJ: Comprehension
5. A client is discharged following a heart attack. In using the Stages of Health Behavior
Change as a guide, the nurse recognizes that the client is most likely to begin to accept
information on diet changes and an exercise program during which stage?
1. Action
2. Preparation
3. Maintenance
4. Contemplation
ANS: 4
During the contemplation stage, the client is considering a change within the next 6
months. The client may be ambivalent initially, but will more likely accept information as
he or she develops more belief in the value of change.
During the action stage, the client is actively engaged in strategies to change behavior.
During the preparation stage, the client is making small changes in preparation for a
change in the next month. At this point, the client believes advantages outweigh
disadvantages in behavior change.
During the maintenance stage, the client has sustained change over time.
DIF: A
REF: 78
OBJ: Knowledge
TOP: Nursing Process: Planning
6. When assessing the external variables that influence a clients health beliefs and
practices, the nurse must consider his:
1. Income status
2. Religious practices
3. Educational background
4. Reaction to the heart disease
ANS: 1
External variables influencing a persons health beliefs and practices include family
practices, cultural background, and socioeconomic factors, such as income. Economic
variables may affect a clients level of health by increasing the risk for disease and
influencing how or at what point the client enters the health care system. A persons
compliance with the treatment to maintain or improve health is also affected by economic
status.
Religious practices are one way that people exercise spirituality. Spirituality is considered
to be an internal variable.
Educational background is an internal variable that can influence the health beliefs and
practices of a client.
An example of an internal variable that can influence health beliefs and practices of a
client includes emotional factors, such as the reaction to heart disease.
Test Bank
6-4
DIF: A
REF: 74
OBJ: Comprehension
7. A paraplegic client is admitted for an electrolyte imbalance. Based on the levels of
prevention, the client is receiving care at the level of:
1. Health promotion
2. Primary prevention
3. Tertiary prevention
4. Secondary prevention
ANS: 4
The secondary prevention level focuses on early diagnosis and prompt treatment as well
as disability limitations. Adequate treatment for the electrolyte imbalance is sought to
prevent further complications.
Health promotion is a focus of the primary prevention level.
The primary prevention level focuses on health promotion and specific protection
measures such as immunizations and personal hygiene.
The tertiary prevention level focuses on restoration and rehabilitation.
DIF: A
REF: 75
OBJ: Comprehension
8. Which of the following nursing activities is an example of tertiary level caregiving?
1. Teaching a client how to irrigate a new colostomy
2. Providing a class on hygiene for an elementary school class
3. Informing a client that her infant can be immunized at the health department
4. Arranging for a hospice nurse to visit with the family of a client with lung cancer
ANS: 4
Tertiary prevention occurs when a defect or disability is permanent and irreversible. Care
of the hospice nurse at this level aims to help the client and the clients family achieve as
high a level of functioning as possible despite the limitations caused by the cancer.
Teaching a client how to irrigate a new colostomy would be an example of secondary
prevention. If the colostomy is to be permanent, care may later move to the tertiary level
of prevention.
Providing a class on hygiene for an elementary school class would be an example of the
primary level of prevention.
Informing a client about available immunizations would be an example of primary
prevention.
DIF: A
REF: 75-76
OBJ: Comprehension
TOP: Nursing Process: Planning/Implementation
Test Bank
6-5
9. Which one of the following client assessment findings indicates a lifestyle risk factor to
the nurse?
1. Obesity
2. Sunbathing
3. Overcrowded housing
4. Industrial-based occupation
ANS: 2
Excessive sunbathing is a lifestyle risk factor for skin cancer.
Obesity is a physiological risk factor.
Overcrowded housing is an environmental risk factor.
An industrial-based occupation is an environmental risk factor.
DIF: A
REF: 77-78
OBJ: Comprehension
10. In the Health Belief Model, the nurse recognizes that the focus is placed on the:
1. Basic human needs for survival
2. Functioning of the individual in all dimensions
3. Relationship of perceptions and compliance with therapy
4. Multidimensional nature of clients and their interaction with the environment
ANS: 3
In the Health Belief Model, the nurse focuses on the relationship between a persons
beliefs and health behaviors. By focusing on the clients perceptions of health, the nurse
is better able to understand and predict how a client will comply with health care
therapies.
Basic human needs for survival is a component of Maslows hierarchy of needs model.
The nurse who focuses on the functioning of the individual in all dimensions is following
a holistic health model.
In the health promotion model, the nurse focuses on the multidimensional nature of
clients and their interaction with the environment.
DIF: A
REF: 70
OBJ: Comprehension
11. The client who recently received a kidney transplant is worried about her husband since
he has taken over the physical tasks of running their home. The client is in the process of
adapting to a change in:
1. Body image
2. Self-concept
3. Illness behavior
4. Family dynamics
ANS: 4
Test Bank
6-6
The effects of illness on the client and family have created a change in family dynamics.
Family dynamics is the process by which the family functions, makes decisions, gives
support to individual members, and copes with everyday changes and challenges.
Body image is the subjective concept of physical appearance. The client did not express
concerns regarding body image.
Self-concept is a mental self-image of strengths and weaknesses in all aspects of
personality. The client did not express a change in self-concept.
Illness behavior refers to how people monitor their bodies, define and interpret their
symptoms, take remedial actions, and use the health care system. The client did not
express change in illness behavior.
DIF: A
REF: 81
OBJ: Comprehension
12. Client assessment provides the nurse with necessary information for the development of
an effective plan of care. When determining the influence of an internal variable on the
clients health status, the nurse will specifically look for:
1. Anxiety level present
2. Family remedies used
3. Location and type of occupation
4. Available health insurance coverage
ANS: 1
Emotional factors, such as the clients degree of anxiety, is an internal variable that can
influence the clients health status.
An example of an external variable that can influence the clients health status is the use
of family remedies.
Socioeconomic factors, such as location and type of occupation, are external variables
that can influence the clients health status.
Available health insurance coverage is an example of an external socioeconomic factor
that can influence the clients health status.
DIF: C
REF: 73-74
OBJ: Analysis
13. A nurse understands that illness behavior means:
1. Each distinct illness will cause the client to behave in a specific manner
2. Nursing care provides interventions that are behavior oriented
3. The clients behaviors will have a direct impact on his illness
4. When ill, a clients perception of illness will result in unique behaviors
ANS: 4
Medical sociologists call the reaction to illness, illness behavior. Nurses who understand
how clients react to illness can minimize the effects of illness and assist clients and their
families in maintaining or returning to the highest level of functioning.
Test Bank
6-7
While the other options may be true, they do not define illness behavior.
DIF: A
REF: 79
OBJ: Comprehension
14. A client tells the nurse that his illness is a result of his failure to live a good life. The
nurse recognizes this statement as an example of the clients:
1. Risk factor
2. Health belief
3. Illness behavior
4. Negative health behavior
ANS: 2
Health beliefs are a persons ideas, convictions, and attitudes about health and illness.
A risk factor is any situation, habit, social or environmental condition, physiological or
psychological condition, developmental or intellectual condition, or spiritual or other
variable that increases the vulnerability of an individual or group to an illness or accident.
Illness behavior is the unique manner in which a client reacts to illness.
Negative health behaviors include practices actually or potentially harmful to health, such
as smoking, drug or alcohol abuse, poor diet, and refusal to take necessary medications.
DIF: A
REF: 70
OBJ: Comprehension
15. Which of the following client statements best relates to the third component of the Health
Belief Model?
1. My blood cholesterol is only a little high.
2. No one in my family is susceptible to the flu.
3. Ill just avoid the food that causes the problem.
4. By losing weight my blood pressure may come down.
ANS: 4
The third componentthe likelihood that a person will take preventive actionresults
from the persons perception of the benefits of and barriers to taking action. Preventive
action may include lifestyle changes, increased adherence to medical therapies, or a
search for medical advice or treatment.
The second component is the individuals perception of the seriousness of the illness.
The first component of this model involves the individuals perception of susceptibility to
an illness.
Increased incidence of chronic disease processes.
DIF: C
REF: 70
OBJ: Analysis
Test Bank
6-8
16. The goal of Penders Health Promotion theory is best reflected in which of the following
nursing interventions?
1. Suggesting the client experience a variety of exercise routines before settling on the
one to adapt
2. Arranging for a client to attend a support group for individuals who also have
severe burn scars
3. Playing soft, classical music when a client diagnosed with Alzheimers becomes
physically agitated
4. Providing a client with a history of stress-induced respiratory problems with
detailed explanations regarding her care
ANS: 1
Health-promoting behaviors should result in improved health, enhanced functional
ability, and better quality of life.
According to the Basic Human Needs model, certain human needs are more basic than
others; that is, some needs must be met before other needs (i.e., fulfilling the
physiological needs before the needs of love and belonging). Self-actualization is the
highest expression of ones individual potential and allows for continual discovery of
self. Maslows model takes into account individual experiences, always unique to the
individual.
Nurses using the holistic nursing model recognize the natural healing abilities of the body
and incorporate complementary and alternative interventions, such as music therapy,
reminiscence, relaxation therapy, therapeutic touch, and guided imagery, because they are
effective, economical, noninvasive, nonpharmacological complements to traditional
medical care.
The holistic nursing model considers the emotional and spiritual well-being, as well as
other dimensions of an individual, as important aspects of physical wellness.
DIF: C
REF: 71
OBJ: Analysis
17. The nurse knows that the greatest internal factor to consider when educating an adult
client concerning health promotion activities is the clients:
1. Emotional wellness
2. Developmental stage
3. Professed spirituality
4. Intellectual background
ANS: 4
A persons beliefs about health are shaped in part by the persons knowledge, lack of
knowledge, or incorrect information about body functions and illnesses; educational
background; and past experiences. These variables influence how a client thinks about
health. In addition, cognitive abilities shape the way a person thinks, including the ability
to understand factors involved in illness and to apply knowledge of health and illness to
personal health practices. The clients ability to understand and accept the importance of
the teaching is the primary nursing consideration.
Test Bank
6-9
The clients degree of stress, depression, or fear, for example, can influence health beliefs
and practices. The manner in which a person handles stress throughout each phase of life
will influence the way the person reacts to illness, but this option is not the best choice
available.
A persons thought and behavior patterns change throughout life. The nurse must consider
the clients level of growth and development when using his or her health beliefs and
practices as a basis for planning care, but the client has been identified as being adult and
so the developmental stage has been determined.
Spirituality is reflected in how a person lives his or her life, including the values and
beliefs exercised, the relationships established with family and friends, and the ability to
find hope and meaning in life. However, this is not the best option available.
DIF: C
REF: 23
OBJ: Analysis
18. The nurse is caring for a terminally ill client who recently immigrated to the United
States. To provide quality end-of-life care, the nurse must initially:
1. Make every effort to involve the client and his family in the end-of-life care
2. Understand the clients personal and cultural views regarding death and dying
3. Arrange for end-of-life care to be provided by personnel familiar with the clients
culture
4. Share the clients concerns regarding the dying process with his interdisciplinary
care team
ANS: 2
Differences in beliefs, values, and traditional health care practices are relevant when
planning end-of-life care. It is the nurses responsibility to become familiar with the
clients personal and cultural views so as to provide the most effective and appropriate
end-of-life care.
While this is important, it is not the best available option because understanding the
clients cultural and personal views will facilitate all other offered options.
This may not be either practical or possible.
While this is important, it is not the best available option because understanding the
clients cultural and personal views will facilitate all other offered options.
DIF: C
REF: 74
OBJ: Analysis
19. Which of the following nursing interventions is the best example of a primary care
prevention strategy regarding the flu?
1. Staffing a flu immunization clinic at a senior citizens center
2. Providing flu prevention literature for distribution to visitors
3. Reminding client care personnel of the importance of the flu shot
4. Getting a drug manufacturer to donate flu vaccine for the homeless
Test Bank
6-10
ANS: 4
Primary prevention is true prevention; it precedes disease or dysfunction and is applied to
clients considered physically and emotionally healthy. Primary prevention aimed at
health promotion includes health education programs, immunizations, and physical and
nutritional fitness activities. This option is the best example because it facilitates the
availability of a service to clients to whom it might otherwise be unavailable.
This is a good example of primary care, but it is not the best one available because it
facilitates a service that is already available.
While this is an example of primary care, it is not the best because it does not ensure the
facilitation of the needed service.
While this is an example of primary care, it is not the best because it does not ensure the
facilitation of the needed service.
DIF: C
REF: 75
OBJ: Analysis
20. The nurse can best discuss the impact of a known risk factor on a clients health by
stating:
1. It doesnt mean youll get the disease just that the odds are greater for you.
2. Now you know that the possibility is there, you can take steps to prevent it.
3. The risk factor can be managed by making a change in your lifestyle.
4. Youre lucky because you have the benefit of being able to do something about
it.
ANS: 1
The presence of risk factors does not mean that a disease will develop, but risk factors
increase the chances that the individual will experience a particular disease or
dysfunction.
While this response is not incorrect, it does not address the impact of a risk factor on the
clients health.
This is not always true, and so it is not the best option.
This option minimizes the clients concern and does not address the impact of a risk
factor on the clients health.
DIF: C
REF: 77
OBJ: Analysis
21. When caring for a client with a spouse and two adolescent children, the nurse knows that
the family unit must first:
1. Be viewed as a client
2. Change traditional roles
3. Provide support for the ailing mother
4. Seek help to fulfill day-to-day needs
ANS: 1
Test Bank
6-11
The nurse must view the whole family as a client under stress, planning care to help the
family regain the maximal level of functioning and well-being.
While the illness of a family member requires role reassignment in order for the family to
continue to function, the initial focus is to be viewed as a unit in need of care.
While the family should provide support to the ailing member, the initial focus is to be
viewed as a unit in need of care.
This may become necessary in order to ensure the continued functioning of the family,
but the initial focus is to be viewed as a unit in need of care.
DIF: C
REF: 81
OBJ: Analysis
22. The nurse observes signs of depression in a client who has been hospitalized for several
weeks because of injuries sustained in an automobile accident. The client confirms his
fears of never, Being able to work and support my family as I did before. The nurses
initial intervention is to:
1. Offer to arrange for him to speak with the facilitys chaplain
2. Assure the client that physical therapy will help him tremendously
3. Revise his care plan to include interventions to assist him with coping
4. Tell his health care provider of his need for antidepressant medication
ANS: 3
In the course of providing care, a nurse is able to observe changes in the clients selfconcept (or in the self-concepts of family members) and develop a care plan to help them
adjust to the changes resulting from the illness.
This option is appropriate only when the client shows an interest in such a referral. The
initial most therapeutic intervention is to revise his care plan to address the issue of
depression and grieving over his current situation.
Although this may be appropriate in some cases, the nurse should not offer false or
unrealistic hope to the client. The initial most therapeutic intervention is to revise his care
plan to address the issue of depression and grieving over his current situation.
Although the health care provider should be informed of the clients signs, the initial
intervention is to revise his care plan to address the issue of depression and grieving over
his current situation.
DIF: C
REF: 81
OBJ: Analysis
23. While discussing discharge plans for a client who recently experienced a stroke that
resulted in right-sided weakness and communication problems, the daughter shares with
the nurse that she has concerns regarding her role as caregiver. The most therapeutic
response by the nurse is to:
1. Agree that her concerns are well-founded
2. Suggest that she consider home health aides
3. Offer to arrange for her to see the facilitys grief counselor
Test Bank
6-12
4. Provide her with information about a caregiver support group

ANS: 3
The client and family often require specific counseling and guidance to assist them in
coping with the role changes.
Although the nurse may agree that the daughters concerns are legitimate, the counselor
is best suited to help the daughter cope with these changes.
While assistance with providing the care may help, the counselor is best suited to help the
daughter cope with these changes.
Although actively participating in a support care could prove helpful, the counselor is
best suited to help the daughter cope with these changes.
DIF: C
REF: 81
OBJ: Analysis
MULTIPLE RESPONSE
1. Which of the following would be considered positive health behaviors for a 40-year-old
client? (Select all that apply.)
1. Eating a low-fat, low-salt diet
2. Getting 6 to 8 hours of sleep nightly
3. Spending quality time with his children
4. Limiting his smoking to 3 cigarettes daily
5. Having his blood pressure checked regularly
6. Walking for 30 minutes several times a week
ANS: 1, 2, 5, 6
Positive health behaviors are activities related to maintaining, attaining, or regaining
good health and preventing illness.
Although spending quality time with his children is an admirable behavior and will
certainly positively affect the parent-child relationship, it is not considered a positive
health behavior.
While limiting nicotine intake to 3 cigarettes daily is a great first step, it would require
smoking cessation to be considered a positive health behavior.
DIF: A
REF: 78
OBJ: Comprehension
2. Which of the following client behaviors are examples of active strategies of health
promotion? (Select all that apply.)
1. Losing 10 pounds
2. Walking 1 mile each evening
3. Drinking vitamin D fortified milk
4. Driving a car equipped with airbags
5. Having regular blood pressure checks
Test Bank
6-13
6. Having a company-required hearing exam

ANS: 1, 2, 5
With active strategies of health promotion, individuals are motivated to adopt specific
health programs. The individual plays an active role in performing tasks or adapting
behaviors that impact their health in a positive manner.
With passive strategies of health promotion, individuals gain from the activities of others
without acting themselves. The fluoridation of municipal drinking water and the
fortification of homogenized milk with vitamin D are examples of passive health
promotion strategies as are driving a car with a manufacturers installed airbag and
accepting a hearing test that is a job requirement.
DIF: C
REF: 78
OBJ: Analysis

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Potter & Perry: Fundamentals of Nursing, 7th Edition

4. Provide her with information about a caregiver support group

6. Having a company-required hearing exam

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