Chapter 17 Test Your Knowledge

1.

Which one of the following is an example of the emotional component of

wellness?
A client expresses frustration with her partners substance
Your abuse.
Answer:

Rationale: Frustration is an example of an emotion. The client who

chooses healthy foods (option 1) represents the physical component, taking
parenting classes enhances the intellectual component (option 2), and the
bowling league (option 4) enhances both the physical and social
components.
Cognitive Level: Understanding.
Client Need: Health Promotion and Maintenance.
Nursing Process: Assessment.

Which individual appears to have taken on the sick role?

2.

Correct
Answer:

A mother is ill and says, I wont be able to make your

lunch today.

Rationale: The mother has taken on the sick role by expecting to be

excused from her usual role responsibilities. The sick role states that
persons are not answerable for their illness, contrary to the obese clients
perspective (option 1). In the sick role, the client tries to get better as
opposed to the man who misses his physical therapy appointments (option
3). The older adult is not following the sick role expectation to rely on
competent help (option 4).
Cognitive Level: Applying.
Client Need: Health Promotion/Maintenance and Physiological Adaptation.
Nursing Process: Assessment.

3.

Because a client recently diagnosed with diabetes mellitus is

confident that blood sugar control can be improved with diet and
exercise alone, and recently checked out a video on the

management of diabetes at the HMO education center, the clients

actions are most representative of which model?

Health belief model

correct
Answer:

Rationale: The behavior is most representative of health promotion, which

is the central focus of the health belief model. The clinical model focuses on
relieving signs and symptoms of illness (option 2). The role performance
model emphasizes social activities such as fulfilling a particular role (option
3). The agenthost environment model focuses on predicting illness
(option 4).
Cognitive Level: Analyzing.
Client Need: Health Promotion and Maintenance.
Nursing Process: Analysis.

4.

Because a client with human immunodeficiency virus (HIV) is scheduled to

begin several medications to manage the infection, the nurse will need to
provide client education. Which client characteristics are most likely to
predict adherence with the treatment program? Select all that apply.

A trusting relationship with the health care provider.

Correct
Answers:

An expectation that the medications will be helpful.

Being able to take the medications twice daily instead
of four times daily.

Rationale: Significant evidence exists that a trusting relationship with the

provider, effectiveness of the medication, and simple dosing regime are
important predictors of adherence to a medical regimen. Neither education
nor sex has been shown to be a predictive factor (options 1 and 5).
Cognitive Level: Applying.
Client Need: Health Promotion and Maintenance.
Nursing Process: Planning.
Rationale: Significant evidence exists that a trusting relationship with the
provider, effectiveness of the medication, and simple dosing regime are
important predictors of adherence to a medical regimen. Neither education

nor sex has been shown to be a predictive factor (options 1 and 5).
Cognitive Level: Applying.
Client Need: Health Promotion and Maintenance.
Nursing Process: Planning.

5.

Which one of the following might be the BEST way to measure adherence
to a prescribed medication regime?

Direct observation of medication administration.

Correct
Answer:

Rationale: Although not always practical, direct observation is the best

method to measure adherence (for example, watching heroin addicts
actually take their methadone dose). Because lack of adherence may be life
threatening or damaging to the client as well as others, waiting until the
client displays illness and waiting until laboratory values reflect a lack of
adherence are not the best methods (options 2 and 3). Client report or
recall is not always accurate, even if the client believes he or she is telling
the truth (option 4).
Cognitive Level: Analyzing.
Client Need: Health Promotion and Maintenance.
Nursing Process: Evaluation.

6.

Which of the following is least likely to influence a clients personal

definition of health/wellness?
The medical diagnostic terminology used to describe the
Your clients signs and symptoms.
Answer:

Rationale: The actual term used to describe the diagnosis is less important
because the client may have no frame of reference for it. That is not to say
that the diagnosis is unimportant because clients may be familiar with
common diagnoses such as heart disease or cancer and ascribe historical
meaning to them. Ability to perform usual activities, culture, and
availability of health care will all be strong influences on the clients
definition of health or wellness (options 1, 2, and 3).
Cognitive Level: Analyzing.
Client Need: Health Promotion and Maintenance.

Nursing Process: Assessment.

7.

Which of the following is an internal variable affecting health status, beliefs,

or practices?

Genetics
Correct
Answer:

Rationale: Genetics is an internal variable affecting health. Options 1, 2,

and 3 are all external variables.
Cognitive Level: Remembering.
Client Need: Health Promotion and Maintenance.
Nursing Process: Assessment.

8.

A client recently diagnosed with a chronic illness asks for help in

understanding the term chronic. It would be correct for the nurse to say
which of the following?

Chronic illnesses are considered incurable.

Correct
Answer:

Rationale: By definition, a chronic illness has no known cure, the person

will always have it to some degree. Although acute illnesses may have
severe symptoms, many chronic illnesses also have severe symptoms
(option 1). Although signs and symptoms of chronic illnesses may never go
completely away, they can get better and worse at different times (option
3). Chronic illnesses can be treated, just not cured (option 4).
Cognitive Level: Understanding.
Client Need: Health Promotion and Maintenance.
Nursing Process: Planning.

9.

Although not every client progresses in order through each stage, what is
the usual sequence in Suchmans stages of illness?

Option

Correct Answer

The client makes contact with medical care.

E. Step 3

The client goes into rehabilitation/recovery.

C. Step 5

Signs and symptoms appear.

A. Step 1

The client takes on the dependent role.

D. Step 4

The client takes on the sick role.

B. Step 2

9.1

9.2

9.3

9.4

9.5

10
.

A married mother of three small children has frequent immobilizing

headaches of unknown cause. The nurse anticipates that the woman may
have which of the following possible reactions? Select all that apply.

She feels guilty when unable to perform her usual

Correct activities.
Answers:
She is angry and acting out.
She shifts some responsibilities to the spouse.
She has fewer social interactions with her friends.
Rationale: In the sick role, she would likely feel guilty and some anger but

give up usual roles and accept help from others, and decrease social
interactions. The only reaction that would be unlikely is that the woman
would take on a job to pay expenses. This would be inconsistent with the
sick role.
Cognitive Level: Applying.
Client Need: Health Promotion and Maintenance.
Nursing Process: Planning.
Rationale: In the sick role, she would likely feel guilty and some anger but
give up usual roles and accept help from others, and decrease social
interactions. The only reaction that would be unlikely is that the woman
would take on a job to pay expenses. This would be inconsistent with the
sick role.
Cognitive Level: Applying.
Client Need: Health Promotion and Maintenance.
Nursing Process: Planning.