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, Chapter 1- Concepts of Health and Disease
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1. At an international nursing conference, many discussions and breakout sessions
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focused on the World Health Organization (WHO) views on health. Of the
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following comments made by nurses during a discussion session, which
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statements would be considered a good representation of the WHO definition?
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Select all that apply.
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A) Interests in keeping the elderly population engaged in suchnn nn nn nn nn nn nn nn
activities as book reviews and word games during social time
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B) Increase in the number of chair aerobics classes provided in the
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skilled care facilities
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C) Interventions geared toward keeping the elderly population diagnosed nn nn nn nn nn nn nn
with diabetes mellitus under tight blood glucose control by providing
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in-home cooking classes
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D) Providing transportation for renal dialysis patients to and fromnn nn nn nn nn nn nn nn
their hemodialysis sessions
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E) Providing handwashing teaching sessions to a group of young nn nn nn nn nn nn nn nn
children Ans: A, B, C, E
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Feedback:
The WHO definition of health is defined as ―a state of complete physical,
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mental, and social well-being and not merely the absence of disease and
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infirmity.‖ Engaging in book reviews facilitates mental and social well-being;
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chair aerobics helps facilitate physical well-being; and assisting with tight control
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of diabetes helps with facilitating physical well-being even though the person has
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a chronic disease. Handwashing is vital in the prevention of disease and
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spread of germs.
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2. A community health nurse is teaching a group of recent graduates about the
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large variety of factors that influence an individual's health or lack
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nnthereof. The nurse is referring to the Healthy People 2020 report from the
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nnU.S. Department of Health and Human Services as a teaching example. Of
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the following aspects discussed, which would be considered a determinant
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nnof health that is outside the focus of this report?
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A) The client has a diverse background by being of Asian and Native
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American descent and practices various alternative therapies to minimize
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effects of stress.
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B) The client has a family history of cardiovascular disease related
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to hypercholesterolemia and remains noncompliant with the
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treatment regime.
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C) The client has a good career with exceptional preventative health care benefits.
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D) The client lives in an affluent, clean, suburban community with
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access to many health care facilities.
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Ans: B
Feedback:
In Healthy People 2020, the focus is to promote good health to all (such as
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using alternative therapies to minimize effects of stress); achieving health equity
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and promoting health for all (which includes having good health care benefits);
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and promoting good health (which includes living in a clean community with
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good access to health care). A client's noncompliance with treatments to control
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high cholesterol levels within the presence of a family history of CV
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nndisease does not meet the nn nn nn nn
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,―attaining lives free of preventable disease and premature death‖ determinant.
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, 3. A physician is providing care for a number of patients on a medical unit of a
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large, university hospital. The physician is discussing with a colleague the
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differentiation between diseases that are caused by abnormal molecules and
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diseases that cause disease. Which of the following patients most clearly
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demonstrates the consequences of molecules that cause disease?
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A) A 31-year-old woman with sickle cell anemia who is receiving a
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transfusion of packed red blood cells
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B) A 91-year-old woman who has experienced an ischemic stroke
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resulting from familial hypercholesterolemia
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C) A 19-year-old man with exacerbation of his cystic fibrosis
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requiring oxygen therapy and chest physiotherapy
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D) A 30-year-old homeless man who has Pneumocystis carinii pneumonia
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(PCP) and is HIV positive.
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Ans: D
Feedback:
PCP is an example of the effect of a molecule that directly contributes to
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disease. Sickle cell anemia, familial hypercholesterolemia, and cystic fibrosis
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are all examples of the effects of abnormal molecules.
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4. A member of the health care team is researching the etiology and pathogenesis
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of a number of clients who are under his care in a hospital context. Which of
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the following aspects of clients' situations best characterizes pathogenesis rather
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than etiology?
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A) A client who has been exposed to the Mycobacterium tuberculosis bacterium
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B) A client who has increasing serum ammonia levels due to liver cirrhosis
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C) A client who was admitted with the effects of methyl alcohol poisoning
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D) A client with multiple skeletal injuries secondary to a motor
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vehicle accident Ans: B
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Feedback:
Pathogenesis refers to the progressive and evolutionary course of disease, such as
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the increasing ammonia levels that accompany liver disease. Bacteria, poisons,
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and traumatic injuries are examples of etiologic factors.
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