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 following
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comments made by nurses during a discussion session, which statements would be
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considered a good representation of the WHO definition? Select all that apply.
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A) Interests in keeping the elderly population engaged in such activities as T T T T T T T T T T T
book reviews and word games during social time T T T T T T T
B) Increase in the number of chair aerobics classes provided in the skilled T T T T T T T T T T T T
care facilities T
C) Interventions geared toward keeping the elderly population diagnosed with T T T T T T T T T
diabetes mellitus under tight blood glucose control by providing in-homeT T T T T T T T T T
cooking classes T
D) Providing transportation for renal dialysis patients to and from their T T T T T T T T T T
hemodialysis sessions T
E) Providing handwashing teaching sessions to a group of young T T T T T T T T T
children Ans: A, B, C, E T T T T T
Feedback:
The WHO definition of health is defined as “a state of complete physical, mental,
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and social well-being and not merely the absence of disease and infirmity.”
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Engaging in book reviews facilitates mental and social well-being; chair aerobics
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helps facilitate physical well-being; and assisting with tight control of diabetes helps
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with facilitating physical well-being even though the person has a chronic disease.
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Handwashing is vital in the prevention of disease and spread of germs. T T T T T T T T T T T
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 thereof. The
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nurse is referring to the Healthy People 2020 report from the U.S. Department of
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Health and Human Services as a teaching example. Of the following aspects
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discussed, which would be considered a determinant of health that is outside the
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focus of this report? T T T
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 T T T T T T T T T
effects of stress. T T
B) The client has a family history of cardiovascular disease related to
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hypercholesterolemia and remains noncompliant with the treatment T T T T T T T
regime.
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 access to
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many health care facilities. T T T
Ans: B T
Feedback:
In Healthy People 2020, the focus is to promote good health to all (such as using
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alternative therapies to minimize effects of stress); achieving health equity and
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promoting health for all (which includes having good health care benefits); and
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promoting good health (which includes living in a clean community with good access
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to health care). A client's noncompliance with treatments to control high cholesterol
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levels within the presence of a family history of CV disease does not meet the
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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 large,
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university hospital. The physician is discussing with a colleague the differentiation
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between diseases that are caused by abnormal molecules and diseases that cause
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disease. Which of the following patients most clearly demonstrates the consequences
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of molecules that cause disease?
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A) A 31-year-old woman with sickle cell anemia who is receiving a transfusion
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of packed red blood cells
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B) A 91-year-old woman who has experienced an ischemic stroke resulting
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from familial hypercholesterolemia
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C) A 19-year-old man with exacerbation of his cystic fibrosis requiring
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oxygen therapy and chest physiotherapy T T T T
D) A 30-year-old homeless man who has Pneumocystis carinii pneumonia (PCP)
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and is HIV positive. T T T
Ans: D T
Feedback:
PCP is an example of the effect of a molecule that directly contributes to disease.
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Sickle cell anemia, familial hypercholesterolemia, and cystic fibrosis are all
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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 of
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a number of clients who are under his care in a hospital context. Which of the
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following aspects of clients' situations bN
T esUtR
chSaI
raNctGerTizBe.
s pCaOt hMo g e ne s i s rather than
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etiology?
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 vehicle
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accident Ans: B T T
Feedback:
Pathogenesis refers to the progressive and evolutionary course of disease, such as the
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increasing ammonia levels that accompany liver disease. Bacteria, poisons, and
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traumatic injuries are examples of etiologic factors.
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, 5. A new myocardial infarction patient requiring angioplasty and stent placement has
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arrived to his first cardiac rehabilitation appointment. In this first session, a review
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of the pathogenesis of coronary artery disease is addressed. Which statement by the
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patient verifies to the nurse that he has understood the nurse's teachings about
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coronary artery disease? T T
A) “All I have to do is stop smoking, and then I won't have any more heart attacks.”
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B) “My artery was clogged by fat, so I will need to stop eating fatty foods
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like French fries every day.” T T T T
C) “Sounds like this began because of inflammation inside my artery that made
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it easy to form fatty streaks, which lead to my clogged artery.”
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D) “If I do not exercise regularly to get my heart rate up, blood pools in the
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veins causing a clot that stops blood flow to the muscle, and I will have a heart
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attack.”
Ans: C T
Feedback:
The true etiology/cause of coronary artery disease (CAD) is unknown; however, the
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pathogenesis of the disorder relates to the progression of the inflammatory process
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from a fatty streak to the occlusive vessel lesion seen in people with coronary artery
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disease. Risk factors for CAD revolve around cigarette smoking, diet high in fat,
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and lack of exercise.
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6. A 77-year-old man is a hospital inpatient admitted for exacerbation of his chronic
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obstructive pulmonary disease (COPD), and a respiratory therapist (RT) is assessing
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the client for the first time. WhichNU
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spMects of the patient's current
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state of health would be best characterized as a symptom rather than a sign?
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A) The patient's oxygen saturation is 83% by pulse oxymetry.
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B) The patient notes that he has increased work of breathing when lying supine.
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C) The RT hears diminished breath sounds to the patient's lower lung
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fields bilaterally. T
D) The patient's respiratory rate is 31 T T T T T T
breaths/minute. Ans: B T T
Feedback:
Symptoms are subjective complaints by the person experiencing the health
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problem, such as complaints of breathing difficulty. Oxygen levels, listening to
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breath sounds, and respiratory rate are all objective, observable signs of disease.
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