Exam 3: NR 222/ NR222 (New 2026/ 2027 Update) Health and Wellness Guide |Questions & Answers| Grade A| (Verified Solutions) 100% Correct - Chamberlain.

Exam 3: NR 222/ NR222 (New 2026/ 2027 Update) Health and Wellness Guide |Questions & Answers| Grade A| (Verified Solutions) 100% Correct - Chamberlain. Q. 1. A nurse is providing education about improving self-awareness to a small group of women who have been victims of domestic violence. The nurse should recommend that clients improve self-awareness by which of the following? ANSWER Listen to oneself and pay attention to emotions, thoughts and reaction. Q. 2. A nurse shares with her client the news she is going to be married soon and tells the client about her wedding plans. The nurse is using which communication technique? ANSWER Self-disclosure Q. 3. What statement would the nurse make to a person seeking care using patient-centered communication? ANSWER When the patient shares that she believes her husband is cheating, the nurse responds by saying, " You think your husband is unfaithful?" Q. 4. "Everyone experiences difficulty sometimes, and a low number on your blood test doesn't matter anyways, why are you even worrying about that since you have much bigger problems?" What is this type of communication? ANSWER Belittling feeling Q. 5. The nurse and patient are involved in a conversation when he leans back against the wall. The nurse simultaneously relaxes against the wall as she talks with him ANSWER Reciprocity Q. 6. The seven-step of valuing process is a method for nurses to clarify values, and it transitions from thoughts to emotions to behaviors. Which is the first step in the valuing process that an individual must make? ANSWER Choosing freely Q. 7. Which statement is correct regarding human growth? ANSWER Growth occurs throughout the lifecycle. Q. 8. Which statement best describes Vygotsky's theory of development? ANSWER Based on experience which creates development and learning. Q. 9. The nurse recognizes that a teenager engaged in which behavior is at risk for not meeting his developmental task of identity? ANSWER Does not admit to being a smoker. Q. 10. Which action should parents take to help their teenagers meet developmental tasks? ANSWER Maintain a friendship with the teenager. Q. 11. A 14-year-old female is being examined for a routine physical exam. Which finding requires further investigation? ANSWER Facial acne Q. 12. A young adult couple has recently divorced. Which of the following conditions is most likely to occur? ANSWER Depression Q. 13. Which circumstance accounts for the leading cause of preventable death in young adults? ANSWER Motor-vehicle accidents Q. 14. The school nurse is conducting an in-service program for teachers that discusses the development of elementary school children. According to Piaget's theoy of cognitive development, which of the following information would the nurse include? ANSWER During this concrete operations phase, children can appreciate the differences between their perspectives and that of their friends. Q. 15. The growth and development of a child is influenced by which factors? (Select all that apply) ANSWER Environment Genetics Parental attitudes Q. 16. A nurse is assigned to provide care for a 96-year-old bedridden man who experiences severe pain from chronic neurological disease. The man asks the nurse to please help him leave this world so that his suffering ends. Which action would be most appropiate for the nurse to take? ANSWER Contact the pain care specialist. Q. 17. The community health and nurse has obtained a grant to offer safe driving education for older adults. Which information should the nurse stress? ANSWER Relearning the art of defensive driving can help reduce the likelihood that an older driver will be involved in motor vehicle accident. Q. 18. Values, clarification, communication, and the helping connection are the core component of what type of relationship? ANSWER Therapeatic Relationship Q. 19. Preparation of a person for an expected development and/or situational crises focuses on which of the following stress management methods. ANSWER Anticipatory guidance Q. 20. Research demonstrates that self-esteem has which compnent? ANSWER Self-esteem is learned from experiences and lessons. Q. 21. An 85-year-old woman who is being discharged from the hospital is oriented to person, place, and time, and her memory is intact. She has occasional forgetfulness without a consistent pattern of memory loss. Which of the following options would be most appropiate for this woman? ANSWER Assisted-living facility Q. 22. A nurse is the process of establishing a therapeautic relationship with a person. What technique should be used by the nurse? ANSWER Show interest in person's concerns. Q. 23. A nurse is educating new parents about normal growth and development for their child. Which items would the nurse NOT include in this discussion? ANSWER Importance of college education Q. 24. A nurse is discussing being a driver as part of a driver's education course. Which recommendation would the nurse exclude in this presentation? ANSWER Carpooling with friends Q. 25. Preventative services recommended for specifically for the older adult include all but which screenings? ANSWER Genome Q. 26. The clinic nurse has seen four people today. Which does the nurse recognize as an example of a 78-year-old person demonstrating a healthy coping pattern? ANSWER Talks about the good times she and her husband had before his illness and death one year ago. Q. 27. A couple in their 60s has assumed responsibiltiy for raising their two grandchildren, ages 9 and 12, because the children's parents died in a car accident. Which is the nursing intervention focuses on cope skills for grandparents? ANSWER Refer them to Grandparents Raising Grandchildren support groups. Q. 28. Which individual is at greatest of injury? ANSWER 80-year-old who does not have air conditioning or fan. Q. 29. A 75-year-old man tells the nurse that he has difficulty staying asleep during the night. Which response should be made by the nurse? ANSWER "Let's talk about your sleep schedule and things that may prevent you from getting a restful night's sleep." Q. 30. The nurse plans a health education workshop focused on developing an individualized lifestyle change program for each participant. Which action should the nurse stress that individals take first? ANSWER Scheduling a complete physical and dental exam. Q. 31. A 63-year-old woman complains to the nurse that she has insomnia and sleeps only 6 hours a night. Which response should be made by the nurse? ANSWER "Do you feel excessively tired during the day?" Q. 32. The occupational health nurse is planning a health fair of employees. Which information about dental health should be included? ANSWER Preventive dental care requires a visit to the dentist every 4 months. Q. 33. A nurse has received a grant to provide a community-based education series for middle-aged adults. The nurse recognizes which topic would make the greatest impact on the health of the members of this age group for helping to proactively address diseases like cancer, heart disease, and stroke? ANSWER Diet and exercise Q. 34. Which type of guidance uses protactive teaching based on developmental milestones to help people successfully manage the stress that arises from the changes during the life span? ANSWER Anticipatory Q. 35. A 35-year-old person asks the nurse working in a dermatology clinic what causes skin to wrinkle. Which statement should be most appropiate way for the nurse to reply? ANSWER "Wrinkles appear for a number of reasons, including lots of fat beneath your skin and too much sun exposure." Q. 36. Which young adult has transmitted successfully to Erikson's intimacy versus isolation and loneliness stage of development? ANSWER A 26-year-old woman who has a long-term relationship with a female companion. 37. A nurse is working in the community to prevent bicycle and motorcycle fatalities. Which measure would be most effective for the nurse to promote? Use of helmets 38. A nurse is discussing optimal activity for young adults as recommended by Healthy People 2020. Which information should be stressed? Amount of time is not important as long as your heart rate increases by 10% while you exercise. 39. The school nurse is working on a campaign to prevent adolescent pregnancies. Which intervention should the nurse implement? Talk to teenagers about sex, including abstinence, contracecption, and sexually transmitted diseases. 40. A mother is concerned because her 13-year-old daughter comes home happy one day and sad the next. The girl also argues with her younger sister more than she did in the past and does not like participating in family activities anymore. Which is the best initial response from the nurse? "The changes during adolesence can be stressful as teens struggle to come to terms with who they are. What other types of behaviors has she been displaying?" 41. A teenager exhibiting which of the following behaviors is a cause for concern? Takes frequent naps and states it is because he is bored. 42. A teenager has a family history of type 2 diabetes mellitus. He asks the nurse what to do to try to prevent developing it himself. Which instructions should the nurse give this client? Tell him to be active and eat a balanced diet. 43. The mother of 13-year-old girl is concerned because her daughter has not started menstruating yet. The girl developed breast buds and started her height spurt at 12 years of age. Which statement would be the most appropiate response from the nurse? "Based on when the breast buds first appeared, she should start menstruating around the age of 14." 44. A high school sophmore engages in risky behavior to fit in with his peers. The nurse recognizes the developmental conflict the student is facing. According to Erikson's theory of human development, which stage of development is the adolescent in? Identity versus role confusion 45. A nurse is teaching parents of a toddler about nutrition. Which statement should the nurse make? "Avoid hot dogs-they cause choking." 46. A nurse is caring for an 85-year-old man with the medical/psychiatric diagnosis of depression related. His nursing diagnosis is "Risk for Suicide." Which of Erikson's developmental stages has not been successfully achieved? Ego Integrity 47. A mother comes to the pediatric clinic and says to the nurse, "I am worried about my 11-month-old baby because he is not crawling yet, and his brother crawled when he was 11 months old. Is something wrong?" Which statement is the appropiate statement made by the nurse? "All babies reach developmental milestones at different rates." 48. The distance between the nurse and the client is at least 6 feet before the nurse begins to ask questions related to the client's health history. This distance is too far for the nurse to build a therapeautic relationship. 49. An individual reveals to the nurse that he is having an affair with his wife's best friend. Which statement made by the nurse will enhance effective therapeautic communication between him and the nurse? "This affair seems to be troubling you." 50. A woman has just been admitted to the hospital. The nurse is able to determine that the reason for her hospitalization is the result of domestic violence. Which characteristic of the therapeautic relationship will be most useful? Developing trust How does the plan of care change in the older adult? The care needs to be individualized to the patients needs because each older adult varies in their functional abilities. Most older adults are active and are involved in their communities but a smaller number have lost the ability to care for themselves, are confused or withdrawn and unable to make decisions concerning their needs. Most older adults live in NONinstitutional settings. Myths of the older adult include? ill, disabled, physically unattractive, forgetful, confused, rigid, bored, unfriendly, unable to understand ad learn new information, poor, worthless. what are some teaching strategies for the older adult? Therapeutic communication, validation therapy, and reminiscence. Validation therapy is? accepts the description of time and place as stated by the confused older adult. For dementia patients this is the type of therapy used. Nurses do not challenge or argue with statements and behaviors of the confused older adult. Validating or respecting confused older adults feelings in the time an place that is real to them is more important than insisting on the literally correct time and place. Reminiscence is? recalling the past. Older adults enjoy sharing the past experiences. As a therapy, it uses the recollection of the past to bring meaning and understanding to the present and resolve current conflicts. This is a way to express personal identity. What do you do when the Family has concerns about an older adult with an illness or injury? Provide information and answer as many questions as possible for them. What is stochastic theories? It is a biological theory of aging that is views aging as a result of random cellular damage that occurs over time. The accumulated damage leads to the physical changes that are recognized as characteristic of the aging process. What is nonstochastic theories? It is a biological theory of aging that is views aging as the result of genetically programmed physiological mechanisms within the body tat control the process of aging. What are the theories on aging used for? To guide our nursing care Changes in the heart for older adults include? Decreased contractile strength of the myocardium results in decreased cardiac output. Systolic and/or diastolic blood pressures are sometimes abnormally high. Peripheral pulses frequently are weaker, although still palpable, in the lower extremities. Older adults sometimes complain that their lower extremities are cold, particularly at night. Changes in the lungs for older adults include? Lung expansion decreases, and the person is less able to cough deeply. If kyphosis or chronic obstructive lung disease is present, breath sounds become distant. With these changes the older adult is more susceptible to pneumonia and other bacterial or viral infections. Changes in the skin for older adults include? With aging the skin loses resilience and moisture. The epithelial layer thins, and elastic collagen fibers shrink and become rigid. Wrinkles of the face and neck reflect lifelong patterns of muscle activity and facial expressions, the pull of gravity on tissue, and diminished elasticity. Spots and lesions are often present on the skin. Smooth, brown, irregularly shaped spots (age spots or senile lentigo) initially appear on the backs of the hands and on forearms. Small, round, red or brown cherry angiomas occur on the trunk. Seborrheic lesions or keratoses appear as irregular, round or oval, brown, watery lesions. Years of sun exposure contribute to the aging of the skin and lead to premalignant and malignant lesions. Changes in the cognitive status for older adults include? Some structural and physiological changes within the brain are associated with cognitive impairment. Reduction in the number of brain cells, deposition of lipofuscin and amyloid in cells, and changes in neurotransmitter levels occur in older adults both with and without cognitive impairment. Symptoms of cognitive impairment such as disorientation, loss of language skills, loss of the ability to calculate, and poor judgment are not normal aging changes and require you to further assess patients for underlying causes. The three common conditions affecting cognition are delirium, dementia, and depression What are the 3 D's? delirium, dementia, and depression Explain delirium is acute confusional state, is potentially a reversible cognitive impairment that often has a physiological cause. It could be caused by electrolyte imbalances, cerebral anoxia, hypoglycemia, medication effects, tumors, subdural hematomas and cerebrovascular infection, infarction or hemorrhage. In the older adult it is often the presenting symptom for pneumonia or urinary tract infection. Sometimes it can be caused by environmental factors such as sensory deprivation or unfamiliar surroundings or psychosocial facts like emotional stress or pain. Describe delirium S & S sudden/abrupt, can last hours to a month or longer if untreated, worse at night, in darkness or upon awakening, attention level may be considered impaired or disrupted, could be forgetful, need instructions for simple tasks, speech could be slow or very fast, could appear disorganized and hard to understand, sleep may be disturbed and makes numerous errors. Define dementia is a generalized impairment of intellectual functioning that interferes with social and occupational functioning. it is an umbrella term that includes Alzheimer's disease, Lewy body disease, frontal-temporal dementia and vascular dementia. Cognitive function deterioration leads to a decline in the ability to perform basic ADLs and IADLs. It is a gradual progressive irreversible disease. Describe dementia S & S Insidious/slow and often unrecognized, progressive yet relatively stable over time, pt is alert and has a clear conscious, orientation is normal to person but not to time or place, difficult time with thoughts, judgment impaired, words difficult to find. Define depression Is the most common yet most undetected and untreated impairment in older adulthood. It is treatable and includes medication, psychotherapy or a combinations of both. Approximately one third of older adults experience depressive symptoms. This is NOT a normal part of aging. suicide attempts in older adults are often successful and comprises 20% of all suicides. Describe depression S & S happens with major life changes, often abrupt but can be gradual, typically worse in the morning, rapid or slow onset, last at least 6 weeks to months or even years, consciousness is clear, alert, minimal impairment but easily distracted, intact but with themes of hopelessness, helplessness or self-deprecation, sleep is disturbed, agitation, moody, complains, poor hygiene, neglect of self, little effort, gives up easily, does not care attitude. What are ways to prevent polypharmacy and ensure safe medication use? Check the medications the pt is taking, check the needs of those medications. Have patients and family cargiver be sure that one physician knows all medications that a patient is prescribed. When a patient develops a new behavior or clinical change, consider a possible ADE; consult the physician and a clinical pharmacist, Older adults in long-term settings should have medication reviewed routinely. Truth about older adults They are lifelong learners, have an optimistic outlook on life, have good memories, a broad social contacts and interests and has tolerance for others. What is ageism? discrimination against people because of increasing age. How do most adults assess their health? as excellent or very good. What do therapeutic communication skills do for a nurse? enable you to perceive and respect the older adults uniqueness and health care expectations. Attentive nurses provide care in a timely fashion, meeting a patients expressed or unexpressed needs. A caring nurse expresses attitudes of concern, kindness, and compassion. knowledgeable nurses not only demonstrate procedural competence but recognize needs ad relay information skillfully. Patients accept and respect nurses who meet these expectations and communicate effectively about their welfare. What does touching provide for an older adult? Touching provides sensory stimulation, induces relaxation, provides physical and emotional comfort, orients the person to reality, shows warmth and communicates interest. It is a powerful physical expression of a relationship. Older adults often lack touching if they are separated from family and friends. Those who are isolated, dependent,ill, fears death, has low self-esteem has a greater need for touch. Do not mistake touch as flirtation. Touch should convey respect and sensitivity. Reminiscence provides what information during assessment? provides levels of self esteem, cognitive function, emotional stability, unresolved conflicts, coping ability, and expectations for the future. For example, having a patient talk about a previous loss can give you information on their coping skills. When teaching older adults new information what do you need to do to ensure learning? make sure pt is ready to learn, is the pt physically well enough to learn, sit facing the pt, speak slowly and in a normal voice, present one idea at a time, give the pt enough time to respond, defer teaching if pt is distracted, invite other members of the household to join in, use audio, visual and tactile cues, ask for feedback, use past experiences. Strategies for reducing the risk for an adverse medication effect (polypharmacy) reviewing the medications with the older adult at each visit, examining for potential interactions with food or other medications, simplifying and individualizing the medication regimen, taking every opportunity to inform the older adult and family about all aspects of medication use and encouraging the older adult to question the physician, advanced practice nurse and or pharmacist about all prescribe medications and all over the counter medications. Healthy People Mission and vision to promote, strengthen, and evaluate the nation's efforts to improve the health and well-being of all people Healthy People 2030's vision is to have a society in which all people can achieve their full potential for health and well-being across the lifespan Purpose of Healthy People -eliminate health disparities -address health risks -improve health of our nation -disease prevention Leading Health Indicators -Drug overdose -tobacco use -food insecurity and hunger -exposure to unhealthy air Excessive substance abuse can lead to social, physical, emotional, and job-related problems, as well as death There are several related Healthy People 2030 objectives for drug overdose - reduce the proportion of adults who used drugs in the past month - reduce the proportion of adults who use marijuana daily or almost daily - reduce the proportion of people who misused prescription drugs in the past year - reduce the proportion of people who used heroin in the past year - reduce the proportion of people who started using heroin in the past year signs of substance abuse to pay attention to - agitation - problems thinkings clearly, remembering, or paying attention - poor coordination - seizures or respiratory depression - self-inflicted trauma and suicidal ideation (thinking about or planning suicide) Substance Use Disorder screening TAPS tool and CAGE tool The CAGE tool screening is used for alcohol abuse The TAPS tool is used for The Tobacco, Alcohol, Prescription medication, and other Substance use tool may be self-administered directly by the client or as an interview by the healthcare professional. TAPS tool 1. In the past 12 months, how often have you used tobacco or any other nicotine delivery product? 2. In the past 12 months, how often have you had 5 or more drinks (men)/4 or more drinks (women) containing alcohol in one day? 3. In the past 12 months, how often have you used any prescription medications just for the feeling, more than prescribed, or that were not prescribed for you? 4. In the past 12 months, how often have you used any drugs [substances], including marijuana, cocaine or crack, heroin, methamphetamine (crystal meth), hallucinogens, ecstasy/MDMA? CAGE tool 1. Have you ever felt you should cut down on your drinking? (C) 2. Have people annoyed you by criticizing your drinking? (A) 3. Have you ever felt bad or guilty about your drinking? (G) 4. Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (eye-opener)? (E) Factors that increase adolescent smoking -Mother smoked during pregnancy -Parents smoke -Peer pressure -Depression -Dieting to lose weight -Stressful home situations Food Insecurity a lack of consistent access to enough food or lack of financial resources Food desert limited access to affordable and nutritious foods Food Assistance Programs include - Women, Infants, and Children (WIC) - Supplemental Nutrition Assistance Program (SNAP) - Child Nutrition Programs Women, Infants, and Children (WIC) -Income eligibility requirements -Available for pregnant women, postpartum & breastfeeding, infants & children up to 5 yrs Supplemental Nutrition Assistance Program (SNAP) -Low income families -Supplements food budgets -Largest federal nutrition assistant program Child Nutrition Programs -School breakfast programs -School lunch programs Healthcare costs are increasing annually in the US due to -Advanced technology -Prescription drug development -Innovations in healthcare -Emergency room care (when unnecessary) -Longer hospital stays About ____ in ____ people in the United States do not have health insurance 1; 10 The Affordable Care Act objectives -Reform the private insurance market. -Expand Medicaid to the working poor with income up to 138% of the federal poverty level. -Change the way medical decisions are made to lower the cost of healthcare -make health insurance available to more people Affordable Care Act Programs include: -Hospital value-based purchasing -Bundled payments for care improvements -Hospital Acquired Conditions Reduction Program -Hospital Readmissions Reduction Program Hospital Value-Based Purchasing Program Part of Medicare is tied to patients satisfaction; a standard data collection tool is used; ties a portion of medicare reimbursements for inpatient acute care to performance in quality measures Bundled payments for care improvements Program Single payment received for all services reduced during a single care visit Hospital Acquired Conditions Reduction Program The hospital receives no reimbursement for hospital-associated infections (CAUTI)- catheter-associated urinary infections and central line-associated bloodstream infections Hospital Readmissions Reduction Program will not get reimbursed for readmission with the same condition within 30 days Which location is associated with the care provided? Hospice end of life comfort care Which location is associated with the care provided? Rehabilitation goal is to regain maximum functioning Which location is associated with the care provided? Adult day care center Break for caregivers during business hours Which location is associated with the care provided? Long term care center 24 hour nursing care Complementary and Alternative Therapies examples - yoga -aromatherapy -hypnosis -homeopathy -herbal medicine mediation -chromo therapy -massage therapy - diet therapy - acupuncture -reiki complementary and alternative medicine (CAM) used to describe holistic approaches that are not part of traditional/conventional medical treatment Complementary and Alternative therapies - Complementary therapies are used in conjunction (together) with traditional medical approaches. - Alternative therapies are used instead of traditional medical approaches. Integrative Healthcare brings conventional and complementary approaches together in a coordinated way. Holistic Nursing Takes into consideration all aspects of a person's life including environment, social interactions, and emotional responses to health and wellness In holistic nursing the practitioners seek to - Support a person's natural healing - Consider the whole person - Consider the environment - Connect the client's spirit, thoughts, & body Therapies that do not require specialized training -Relaxation therapy -Meditation and Breathwork -Imagery Therapies that require training -Traditional Chinese medicine (TCM) -Acupuncture -Touch Therapies -Spinal Manipulation -Biofeedback Herbal Therapies Natural products Dietary supplements Vitamins Minerals Oils Probiotics Self Care Environment Sleep Exercise Communication Nutrition Herbs Aromatherapy Love and Healing