NU 155 FINAL EXAM: MEDICAL-SURGICAL NURSING I 2026 |
Galen College of Nursing | Comprehensive Cumulative
Assessment | Detailed Rationales | Pass Guaranteed - A+
Graded
Section 1: Health Promotion & Illness Models (12 Questions)
Q1: A 45-year-old male smoker tells the nurse, "I know smoking causes lung cancer, but
I don't think it will happen to me because my grandfather smoked until 90." According to
the Health Belief Model, which component is this patient demonstrating?
A. Perceived severity
B. Perceived susceptibility [CORRECT]
C. Perceived benefits
D. Cues to action
Correct Answer: B
Rationale: The patient is demonstrating perceived susceptibility—his subjective belief
about the likelihood of acquiring a specific condition. Despite knowing the risks
(perceived severity), he underestimates his personal vulnerability due to his
grandfather's experience. This cognitive bias (optimism bias) leads to continued
unhealthy behavior. Perceived severity (A) would involve his assessment of how serious
lung cancer would be if it occurred. Perceived benefits (C) would involve beliefs about
the effectiveness of quitting smoking. Cues to action (D) are external triggers like
physician advice or media campaigns. The Health Belief Model predicts that low
perceived susceptibility reduces the likelihood of behavior change, even when severity is
understood.
,Q2: A community health nurse is implementing a program to teach healthy cooking
classes to low-income families. According to the Health Promotion Model, which factor
is being addressed?
A. Individual characteristics and experiences
B. Behavior-specific cognitions and affect
C. Situational influences [CORRECT]
D. Biological factors
Correct Answer: C
Rationale: The Health Promotion Model (Pender) identifies three categories of
influencing factors: individual characteristics/experiences, behavior-specific
cognitions/affect, and situational influences. Teaching cooking classes addresses
situational influences—environmental factors that can facilitate or impede
health-promoting behavior. By providing access to knowledge, skills, and social support
in a community setting, the nurse modifies the environment to enable healthy eating.
Individual characteristics (A) include personal factors like age and personality.
Behavior-specific cognitions (B) include perceived benefits, self-efficacy, and
activity-related affect. Biological factors (D) are not a distinct category in Pender's
model but are considered part of individual characteristics.
Q3: A nurse is caring for a patient who received a mammogram detecting early-stage
breast cancer. Which level of prevention does this represent?
A. Primary prevention
B. Secondary prevention [CORRECT]
C. Tertiary prevention
D. Quaternary prevention
Correct Answer: B
Rationale: Secondary prevention involves early detection and prompt treatment of
disease to prevent progression and complications. Screening tests like mammograms,
Pap smears, colonoscopies, and blood pressure checks are classic secondary
,prevention strategies. Primary prevention (A) aims to prevent disease occurrence
entirely (vaccinations, health education, smoking cessation). Tertiary prevention (C)
focuses on reducing complications and disability from established disease
(rehabilitation after stroke, cardiac rehabilitation). Quaternary prevention (D) is an
emerging concept addressing over-medicalization and iatrogenic harm. Early cancer
detection through screening is the definitive example of secondary prevention, as the
disease exists but is identified before symptoms develop.
Q4: A patient diagnosed with type 2 diabetes six months ago has learned to manage
blood glucose through diet, exercise, and medication. They now focus on preventing
complications like neuropathy and retinopathy. According to the stages of illness
behavior, which stage is this patient demonstrating?
A. Symptom experience
B. Assuming the sick role
C. Medical care contact
D. Dependent/Independent patient role [CORRECT]
Correct Answer: D
Rationale: The patient is in the dependent/independent patient role (also called
"dependent-care" or "recovery/management" stage). Having accepted the diagnosis and
learned self-management, they now focus on long-term disease management and
complication prevention. The symptom experience stage (A) involves recognizing and
interpreting symptoms. Assuming the sick role (B) involves accepting the patient
identity and seeking validation. Medical care contact (C) involves seeking professional
diagnosis and treatment. This stage represents the transition from acute illness
management to chronic disease self-management, emphasizing patient education and
empowerment for long-term health maintenance.
Q5: A nurse is developing a smoking cessation program. Which intervention addresses
"perceived barriers" in the Health Belief Model?
, A. Providing statistics about lung cancer rates
B. Offering free nicotine replacement patches [CORRECT]
C. Sharing success stories of former smokers
D. Sending reminder text messages about quit dates
Correct Answer: B
Rationale: Perceived barriers are the obstacles (financial, physical, psychological) that
prevent action. Offering free nicotine replacement patches directly addresses the cost
barrier to cessation aids. Providing statistics (A) addresses perceived severity. Success
stories (C) address self-efficacy ("if they can do it, so can I"). Reminder texts (D) are
cues to action. The Health Belief Model predicts that even when susceptibility and
severity are high, barriers can prevent behavior change. Removing barriers is often the
most effective intervention for behavior change, as it enables action regardless of
motivation levels.
Q6: Which scenario best exemplifies primary prevention?
A. Administering insulin to a patient with diabetic ketoacidosis
B. Teaching hand hygiene to elementary school children [CORRECT]
C. Performing wound debridement on a pressure injury
D. Administering chemotherapy to a patient with stage III colon cancer
Correct Answer: B
Rationale: Primary prevention prevents disease before it occurs. Teaching hand hygiene
prevents infectious disease transmission. Administering insulin to DKA (A) is tertiary
prevention (managing acute complication of established disease). Wound debridement
(C) is tertiary prevention (treating established injury). Chemotherapy (D) is secondary (if
adjuvant after surgery) or tertiary (treating established cancer). Primary prevention is
the most cost-effective level but often receives less attention because it lacks
immediate, visible outcomes compared to treating existing disease.
Galen College of Nursing | Comprehensive Cumulative
Assessment | Detailed Rationales | Pass Guaranteed - A+
Graded
Section 1: Health Promotion & Illness Models (12 Questions)
Q1: A 45-year-old male smoker tells the nurse, "I know smoking causes lung cancer, but
I don't think it will happen to me because my grandfather smoked until 90." According to
the Health Belief Model, which component is this patient demonstrating?
A. Perceived severity
B. Perceived susceptibility [CORRECT]
C. Perceived benefits
D. Cues to action
Correct Answer: B
Rationale: The patient is demonstrating perceived susceptibility—his subjective belief
about the likelihood of acquiring a specific condition. Despite knowing the risks
(perceived severity), he underestimates his personal vulnerability due to his
grandfather's experience. This cognitive bias (optimism bias) leads to continued
unhealthy behavior. Perceived severity (A) would involve his assessment of how serious
lung cancer would be if it occurred. Perceived benefits (C) would involve beliefs about
the effectiveness of quitting smoking. Cues to action (D) are external triggers like
physician advice or media campaigns. The Health Belief Model predicts that low
perceived susceptibility reduces the likelihood of behavior change, even when severity is
understood.
,Q2: A community health nurse is implementing a program to teach healthy cooking
classes to low-income families. According to the Health Promotion Model, which factor
is being addressed?
A. Individual characteristics and experiences
B. Behavior-specific cognitions and affect
C. Situational influences [CORRECT]
D. Biological factors
Correct Answer: C
Rationale: The Health Promotion Model (Pender) identifies three categories of
influencing factors: individual characteristics/experiences, behavior-specific
cognitions/affect, and situational influences. Teaching cooking classes addresses
situational influences—environmental factors that can facilitate or impede
health-promoting behavior. By providing access to knowledge, skills, and social support
in a community setting, the nurse modifies the environment to enable healthy eating.
Individual characteristics (A) include personal factors like age and personality.
Behavior-specific cognitions (B) include perceived benefits, self-efficacy, and
activity-related affect. Biological factors (D) are not a distinct category in Pender's
model but are considered part of individual characteristics.
Q3: A nurse is caring for a patient who received a mammogram detecting early-stage
breast cancer. Which level of prevention does this represent?
A. Primary prevention
B. Secondary prevention [CORRECT]
C. Tertiary prevention
D. Quaternary prevention
Correct Answer: B
Rationale: Secondary prevention involves early detection and prompt treatment of
disease to prevent progression and complications. Screening tests like mammograms,
Pap smears, colonoscopies, and blood pressure checks are classic secondary
,prevention strategies. Primary prevention (A) aims to prevent disease occurrence
entirely (vaccinations, health education, smoking cessation). Tertiary prevention (C)
focuses on reducing complications and disability from established disease
(rehabilitation after stroke, cardiac rehabilitation). Quaternary prevention (D) is an
emerging concept addressing over-medicalization and iatrogenic harm. Early cancer
detection through screening is the definitive example of secondary prevention, as the
disease exists but is identified before symptoms develop.
Q4: A patient diagnosed with type 2 diabetes six months ago has learned to manage
blood glucose through diet, exercise, and medication. They now focus on preventing
complications like neuropathy and retinopathy. According to the stages of illness
behavior, which stage is this patient demonstrating?
A. Symptom experience
B. Assuming the sick role
C. Medical care contact
D. Dependent/Independent patient role [CORRECT]
Correct Answer: D
Rationale: The patient is in the dependent/independent patient role (also called
"dependent-care" or "recovery/management" stage). Having accepted the diagnosis and
learned self-management, they now focus on long-term disease management and
complication prevention. The symptom experience stage (A) involves recognizing and
interpreting symptoms. Assuming the sick role (B) involves accepting the patient
identity and seeking validation. Medical care contact (C) involves seeking professional
diagnosis and treatment. This stage represents the transition from acute illness
management to chronic disease self-management, emphasizing patient education and
empowerment for long-term health maintenance.
Q5: A nurse is developing a smoking cessation program. Which intervention addresses
"perceived barriers" in the Health Belief Model?
, A. Providing statistics about lung cancer rates
B. Offering free nicotine replacement patches [CORRECT]
C. Sharing success stories of former smokers
D. Sending reminder text messages about quit dates
Correct Answer: B
Rationale: Perceived barriers are the obstacles (financial, physical, psychological) that
prevent action. Offering free nicotine replacement patches directly addresses the cost
barrier to cessation aids. Providing statistics (A) addresses perceived severity. Success
stories (C) address self-efficacy ("if they can do it, so can I"). Reminder texts (D) are
cues to action. The Health Belief Model predicts that even when susceptibility and
severity are high, barriers can prevent behavior change. Removing barriers is often the
most effective intervention for behavior change, as it enables action regardless of
motivation levels.
Q6: Which scenario best exemplifies primary prevention?
A. Administering insulin to a patient with diabetic ketoacidosis
B. Teaching hand hygiene to elementary school children [CORRECT]
C. Performing wound debridement on a pressure injury
D. Administering chemotherapy to a patient with stage III colon cancer
Correct Answer: B
Rationale: Primary prevention prevents disease before it occurs. Teaching hand hygiene
prevents infectious disease transmission. Administering insulin to DKA (A) is tertiary
prevention (managing acute complication of established disease). Wound debridement
(C) is tertiary prevention (treating established injury). Chemotherapy (D) is secondary (if
adjuvant after surgery) or tertiary (treating established cancer). Primary prevention is
the most cost-effective level but often receives less attention because it lacks
immediate, visible outcomes compared to treating existing disease.
