Details of TESTBANK FOR HEALTH PROMOTION THROUGHOUT THE LIFE SPAN 9TH EDITION BY EDELMANTable of Contents
Chapter 01: Health Defined: Objectives for
... [Show More] Promotion and Prevention ............................................................. 1 Chapter 02: Emerging Populations and Health ................................................................................................ 9 Chapter 03: Health Policy and the Delivery System ....................................................................................... 17 Chapter 04: The Therapeutic Relationship ..................................................................................................... 25 Chapter 05: Ethical Issues Related to Health Promotion ................................................................................ 31 Chapter 05: Ethical Issues Related to Health Promotion ................................................................................ 36 Chapter 06: Health Promotion and the Individual .......................................................................................... 42 Chapter 06: Health Promotion and the Individual .......................................................................................... 50 Chapter 07: Health Promotion and the Family ............................................................................................... 58 Chapter 08: Health Promotion and the Community ........................................................................................ 64 Chapter 09: Screening ................................................................................................................................... 72 Chapter 10: Health Education ....................................................................................................................... 80 Chapter 11: Nutrition Counseling for Health Promotion ................................................................................. 89 Chapter 11: Nutrition Counseling for Health Promotion ................................................................................. 97 Chapter 12: Exercise ................................................................................................................................... 106 Chapter 13: Stress Management .................................................................................................................. 114 Chapter 14: Complementary and Alternative Strategies ............................................................................... 121 Chapter 15: Overview of Growth and Development Framework .................................................................. 129 Chapter 16: The Prenatal Period ................................................................................................................. 134 Chapter 17: Infant ...................................................................................................................................... 144 Chapter 18: Toddler ................................................................................................................................... 154 Chapter 18: Toddler ................................................................................................................................... 162 Chapter 19: Preschool Child ........................................................................................................................ 170 Chapter 20: School-Age Child ...................................................................................................................... 178 Chapter 21: Adolescent ............................................................................................................................... 188 Chapter 22: Young Adult ............................................................................................................................. 196 Chapter 23: Middle-Age Adult ..................................................................................................................... 204 Chapter 24: Older Adult .............................................................................................................................. 212 Chapter 25: Health Promotion in the Twenty-First Century ......................................................................... 221
Chapter 01: Health Defined: Objectives for Promotion and Prevention
MULTIPLE CHOICE 1. Which model of health is most likely used by a person who does not believe in preventive health
1 | P a g ecare?
a. Clinical model
b. Role performance model
c. Adaptive model
d. Eudaimonistic model
ANS: A
The clinical model of health views the absence of signs and symptoms of disease as indicative of
health. People who use this model wait until they are very sick to seek care.
DIF: Cognitive Level: Remember (Knowledge)
REF: p. 3
2. A person with chronic back pain is cared for by her primary care provider as
well as receives acupuncture. Which model of health does this person likely
favor?
a. Clinical model
b. Role performance model
c. Adaptive model
d. Eudaimonistic model
ANS: D
The eudaimonistic model embodies the interaction and interrelationships among physical,
social, psychological, and spiritual aspects of life and the environment in goal attainment and
creating meaning in life. Practitioners who practice the clinical model may not be enough for
someone who believes in the eudaimonistic model. Those who believe in the eudaimonistic
model often look for alternative providers of care.
DIF: Cognitive Level: Apply (Application)
REF:
p. 3
3. A state of physical, mental, spiritual, and social functioning that realizes a person’s
potential and is experienced within a developmental context is known as:
a. growth and development.
b. health.
c. functioning.
d. high-level wellness.
ANS: B
Health is defined as a state of physical, mental, spiritual, and social functioning that realizes a
person’s potential and is experienced within a developmental context.
DIF: Cognitive Level: Remember (Knowledge)
REF: p. 5
4. Which of the following best describes a client who has an illness?
a. Someone who has well-controlled diabetes
b. Someone with hypercholesterolemia
c. Someone with a headache
d. Someone with coronary artery disease
without angina ANS: C
Someone with a headache represents a person with an illness. An illness is made up of the
subjective experience of the individual and the physical manifestation of disease. It can be
described as a response characterized by a mismatch between a person’s needs and the
resources available to meet those needs. A person can have a disease without feeling ill. The
other choices represent disease.
2 | P a g eDIF: Cognitive Level: Analyze (Analysis)
REF: p. 6
5. Which US report is considered a landmark document in creating a global approach to health?
a. The 1990 Health Objectives for the Nation: A Midcourse Review
b. Healthy People 2020
c. Healthy People 2000
d. The U.S. Surgeon General Report
ANS: C
Healthy People 2000 and its Midcourse Review and 1995 Revisions were landmark documents
in which a consortium of people representing national organizations worked with US Public
Health Service officials to create a more global approach to health.
DIF: Cognitive Level: Remember (Knowledge)
REF: p. 6
6. Which of the following represents a method of primary prevention?
a. Informational session about healthy lifestyles
b. Blood pressure screening
c. Interventional cardiac catheterization
d. Diagnostic cardiac catheterization
ANS: A
Primary prevention precedes disease or dysfunction. It includes health promotion and specific
protection and encourages increased awareness; thus, education about healthy lifestyles fits this
definition. Blood pressure screening does not prevent disease, but instead identifies it.
DIF: Cognitive Level: Apply (Application)
REF:
p. 11
7. Which of the following represents a method of secondary prevention?
a. Self–breast examination education
b. Yearly mammograms
c. Chemotherapy for advanced breast cancer
d. Complete mastectomy for breast cancer
ANS: B
Screening is secondary prevention because the principal goal of screenings is to identify
individuals in an early, detectable stage of the disease process. A mammogram is a screening
tool for breast cancer and thus is considered a method of secondary prevention.
DIF: Cognitive Level: Apply (Application)
REF:
p. 15
8. Which of the following represents a method of tertiary prevention?
a. Drunk driving campaign
b. Road blocks for drunk driving
c. Emergency surgery for head trauma after a motor vehicle accident
d. Physical and occupational therapy after a motor vehicle
accident with head trauma ANS: D
Physical therapy and occupational therapy are considered tertiary prevention. Tertiary
prevention occurs when a defect or disability is permanent and irreversible. It involves
minimizing the effect of disease and disability. The objective of tertiary prevention is to
maximize remaining capacities.
3 | P a g eDIF: Cognitive Level: Apply (Application)
REF:
p. 15
9. In reviewing a person’s medical claims, a nurse realizes that the individual with moderate
persistent asthma has had several emergency department visits and is not on inhaled
steroids as recommended by the NHLBI asthma management guidelines. The nurse discusses
this with the person’s primary care provider. In this scenario, the nurse is acting as a(n):
a. advocate.
b. care manager.
c. consultant.
d. educator.
ANS: B
Care managers act to prevent duplication of service and reduce cost. Care managers base
recommendation on reliable data sources such as evidence-based practices and protocols.
DIF: Cognitive Level: Apply (Application)
REF:
p. 15
10. During a home visit, a nurse assists an individual to complete an application for disability
services. The nurse is acting as a(n):
a. advocate.
b. care manager.
c. consultant.
d. educator.
ANS: A
The advocacy role of the nurse helps individuals obtain what they are entitled to receive
from the health care system, tries to make the system more responsive to individuals’
community needs, and assists individuals in developing skills to advocate for themselves.
DIF: Cognitive Level: Apply (Application)
REF:
p. 15
11. During a home visit, a nurse discusses the dangers of smoking with an individual. In this
scenario the nurse is acting as a(n):
a. advocate.
b. care manager.
c. consultant.
d. educator.
ANS: D
Health education is a primary prevention technique available to avoid major causes of
disease. Teaching can range from a chance remark to a planned lesson.
DIF: Cognitive Level: Apply (Application)
REF:
p. 16
12. A nurse is asked to provide an expert opinion about the development of an
education program for newly diagnosed diabetics. In this scenario, the nurse is
acting as a(n):
a. advocate.
b. care manager.
c. consultant.
d. educator.
ANS: C
Nurses with a specialized area of expertise provide education about health promotion and
disease prevention to individuals and groups as consultants.
DIF: Cognitive Level: Apply (Application)
4 | P a g e
REF:
p. 1613. A nurse is planning to deliver an educational program to individuals with
diabetes. Which of the following should be the initial action taken by the nurse
to ensure the success of the program?
a. Assess the motivation level of the individuals
b. Assess the knowledge level of the individuals
c. Establish teacher-learner goals with the individuals
d. Establish multiple teaching sessions with the individuals
ANS: B
Selection of the methods most likely to succeed involves the establishment of teacher-learner
goals. Thus, the first step by the nurse should be establishment of goals.
DIF: Cognitive Level: Analyze (Analysis)
REF: p. 16
14. The conscientious, explicit, and judicious use of current best evidence in making
decisions about the care of individuals is known as:
a. health-related quality of life.
b. evidence-based practice.
c. a Healthy People 2010 goal.
d. the ecological model of health.
ANS: B
Evidence-based practice is defined as the conscientious, explicit, and judicious use of current
best evidence in making decisions about the care of individuals.
DIF: Cognitive Level: Remember (Knowledge)
REF: p. 16
15. Which research methodology should be used to address the question, “What is the
difference in the infection rates between individuals who receive twice-a-day dressing
changes versus once-a-day dressing changes?”
a. Evidence-based practice research
b. Qualitative research
c. Quantitative research
d. Clinical judgment research
ANS: C
Quantitative research studies describe situations, correlate different variables related to care,
or test causal relationships among variables related to care. Evidence-based practice research
and clinical judgment research are not research methodologies; they are used to answer
clinical questions.
DIF: Cognitive Level: Apply (Application)
REF:
p. 16
16. The question, “What is the experience of teenagers who lose a sibling to cancer?” can
best be answered by using which research methodology?
a. Evidence-based practice research
b. Qualitative research
c. Quantitative research
d. Clinical judgment
research ANS: B
Qualitative research studies describe phenomena or define the historical nature, cultural
relevance, or philosophical basis of aspects of nursing care. Evidence-based practice research
and clinical judgment research are not research methodologies; they are used to answer
5 | P a g eclinical questions.
DIF: Cognitive Level: Apply (Application)
REF:
p. 16
17. A nurse who uses findings from a randomized, controlled trial on the care of Foley catheters to
change practice at an institution is practicing:
a. evidence-based medicine.
b. qualitative research.
c. quantitative research.
d. clinical judgment.
ANS: A
The practice of evidence-based medicine means integrating individual clinical expertise with the
best available external clinical evidence from systematic research.
DIF: Cognitive Level: Apply (Application)
REF:
p. 16
18. Which of the following is most influenced by the social and economic environment of a
community?
a. Social health policies
b. Quality of care
c. Evidence-based practice
d. Practice guidelines
ANS: A
Social policies concerning health are influenced by the social and economic environment of a
population. Analysis of population trends and projections is necessary to help health
professionals determine changing needs.
DIF: Cognitive Level: Remember (Knowledge)
19. A major cause of death in the early twentieth century was:
a. cancer.
b. cerebrovascular disease.
c. heart disease.
d. infections.
ANS: D
Infections and acute disease were the major causes of death in the early part of the
twentieth century. DIF:
Remember (Knowledge)
Cognitive Level:
REF: p. 17
20. A mainstay of therapy for the management of chronic diseases is:
a. lifestyle changes.
b. occupational and physical therapy.
c. medications.
d. surgery.
ANS: A
The application of complex technology is not only costly but contributes minimally to
improvement of health. One needs to focus on the cause of disease. The needs of a person with
chronic disease are related to and affected by the individual’s biochemical functioning,
genetics, environment, and personal choices.
DIF: Cognitive Level: Apply (Application)
6 | P a g e
REF:
p. 17
REF: p. 1721. Which of the following demonstrates a nurse taking action to promote health and prevent
disease?
a. Making a home visit to a person who is recovering from a heart attack
b. Administering medications to a cardiac client in the hospital
c. Providing cardiopulmonary resuscitation during a heart attack
d. Educating a person about the advantages of a heart-healthy diet during a home visit
ANS: D
Solutions for health promotion are focused on individual and government involvement. To
promote health and wellness, an emphasis must be placed on primary prevention. This is often
related to actions such as education that influence lifestyle choices. In the preceding example,
educating a person about the advantages of a heart- healthy diet during a home visit serves to
influence lifestyle choices.
DIF: Cognitive Level: Apply (Application)
REF:
p. 17
22. Which factor may have the most influence in changing the health behavior of a single,
adult woman who smokes and is the care provider for her mother, her own children,
and granddaughter?
a. Education regarding effects of smoking on her health
b. The satisfaction that she will not contribute to secondhand smoke
c. The availability of a weekly support group
d. A gift card for $10 to a local grocery store for every week she is smoke free
ANS: D
Motivational factors play a role in influencing attitudinal changes. A financial incentive is an
example of a motivating factor. For this woman, who is financially responsible for the health
and well-being of other individuals, finances will likely play a significant role in motivating her
actions. Remember that education regarding the benefits of not smoking is not enough. Thus,
the $10 gift card may have the most influence in changing her health behavior.
DIF: Cognitive Level: Analyze (Analysis)
REF: p. 14 (Box 1-6) | p. 18
23. An example of a Hispanic American nurse promoting cultural competency is:
a. providing translation services for all Hispanic Americans.
b. focusing on episodic care of illnesses with Hispanic Americans.
c. taking a class about the Hispanic American culture.
d. providing care for all Hispanic American persons in her clinic.
ANS: C
Nurses must be aware of their beliefs, values, and customs. They should not assume that their
perspective is correct and shared by others. Additionally, they should avoid stereotyping.
Broadening one’s educational base regarding cultural beliefs is a way to develop and thus
promote cultural competency.
DIF: Cognitive Level: Apply (Application)
REF:
p. 17 (Box 1-2)
24. The devaluing of beliefs, values, and customs of others is known as:
a. ethnocentrism.
b. racism.
c. cultural competency.
d. empathy.
ANS: B
Racism is defined as the devaluing of beliefs, values, and customs of others.
DIF: Cognitive Level: Remember (Knowledge)
7 | P a g e
REF: p. 7 (Box 1-2)25. Building a partnership with an obese individual who is trying to lose weight requires the nurse
to:
a. schedule a day to exercise with the individual.
b. go grocery shopping for the individual.
c. learn about the methods of weight loss.
d. give the individual a weight loss goal.
ANS: C
Nurses must work with individuals to determine what they are willing to do to lose weight. To
do this successfully, nurses must know what options are available to the individuals for weight
loss. Once nurses learn about the methods of weight loss, they can then develop goals for
weight loss with the individual.
DIF: Cognitive Level: Apply (Application)
REF:
p. 8 (Box 1-3)
26. Assuming that an individual’s own perspective is correct and shared by others is known as:
a. ethnocentrism.
b. racism.
c. cultural competency.
d. empathy.
ANS: A
Assuming that an individual’s own perspective is correct and shared by others is known
as ethnocentrism. DIF:
Remember (Knowledge)
MULTIPLE RESPONSE
1. Which of the following “investment” themes has been identified by the National
Institute of Nursing Research? (select all that apply)
a. Interprofessional collaboration
b. Improving quality of life
c. End-of-life care
d. Increasing physical activity among Americans
ANS: B, C
The National Institute of Nursing Research has identified five themes that promote health
and prevent disease, improve quality of life through symptom management, and support
palliative and end-of-life care, innovation, and nurse scientists.
DIF: Cognitive Level: Remember (Knowledge)
REF: p. 16
2. Which interventions address both the National Institute of Nursing Research themes and the
overall goals of the
Healthy People 2020 leading health indicators? (select all that apply)
a. Establishing a new park with a well-lit track
b. Establishing a smoking cessation campaign
c. Providing reduced-cost transportation passes to senior citizens
d. Providing free condoms at all federally
funded health clinics ANS: A, B, D
8 | P a g e
Cognitive Level:
REF: p. 8 (Box 1-2)Establishing a new park with a well-lit track, establishing a smoking cessation campaign, and
providing free condoms at all federally funded health clinics all address the National
Institute of Nursing Research themes and the Healthy People 2020 leading health indicators.
A park, smoking cessation campaign, and free condoms address the themes of promoting
health and preventing disease and the goal of increasing quality and years of healthy life.
Providing reduced-cost transportation passes to senior citizens may indirectly affect the
health of this population; however, it is not directly related to the themes of the National
Institute of Research (promote health and prevent disease, improve quality of life through
symptom management, and support palliative and end-of-life care, innovation, and nurse
scientists) or the overall goals of Healthy People 2020 (increase quality and years of healthy
life and eliminate health disparities).
DIF: Cognitive Level: Analyze (Analysis)
Chapter 02: Emerging
Populations and
Health
MULTIPLE CHOICE
1. Which of the following statements about ethnic minorities in the United States is accurate?
a.
It is estimated that the percentage of ethnic minorities will decrease during the next 30
years.
b. It is estimated that ethnic minorities will increase to one in two by 2050.
c. The increasing population of refugees has been a significant contributor to
the increase in ethnic minorities.
d. The increasing population of ethnic minorities has helped decrease the health
disparities faced by this population.
ANS: B
It is estimated that the number of ethnic minorities will increase to one in two by 2050. In 2010,
it was estimated that 33% of the population was from an ethnic minority. The increasing
population of immigrants has been a significant contributor to the increasing populations of
major ethnic groups. The increasing populations of ethnic groups is one factor that is producing
disparities in health status and access of the health care system.
DIF: Cognitive Level: Understand (Comprehension) REF:
p. 24
2. A person states, “My grandmother is the decision maker in our family.” Which of the
following is being described by the person?
a. Culture
b. Race
c. Ethnicity
d. Values
ANS: A
Culture, as an element of ethnicity, refers to integrated patterns of human behavior that include
the language, thoughts, communications, actions, customs, beliefs, values, and institutions of
racial, ethnic, religious, or social groups. The term “ethnicity” encompasses more than a cultural
practice, which is what is being described by the person; it focuses on differences in meanings,
values, and ways of living. Race is associated with power and indexes the history or ongoing
imposition of one’s group’s authority above another. Values are beliefs about the worth of
something and serve as standards that influence behavior and thinking.
DIF: Cognitive Level: Analyze (Analysis)
REF: p. 24
3. The nurse recommended to a 50-year-old woman that she schedule a routine
9 | P a g e
REF: p. 7 | p. 16mammogram. Which of the following would be the most important factor in this
woman’s decision to schedule this exam?
a. Race
b. Ethnicity
c. Cultural values
d. Value orientation
ANS: C
Cultural values guide actions and decision-making that facilitates self-worth and self-esteem.
They shape human behaviors and determine what individuals will do to maintain their health
status, how they will care for themselves, and others who become ill, and where and from
whom they will seek health care. Race is associated with power and indexes the history or
ongoing imposition of one’s group’s authority above another. Ethnicity focuses on differences
in meanings, values, and ways of living. Value orientations reflect the personality type of a
particular society.
DIF: Cognitive Level: Apply (Application)
REF:
p. 24
4. Which of the following actions demonstrates a health care professional providing culturally
competent care?
a. Encouraging the person to take medications as prescribed
b. Asking the person to describe his folk healing methods
c. Demonstrating the proper way to administer an insulin injection
d. Assisting the person with discussing his health problems with the family
ANS: B
It is very important for health care providers to be aware of how people interpret their health
issues or illnesses to be capable to provide culturally competent care. A culturally competent
health care professional should be able to consistently and thoroughly recognize and
understand the differences in his or her culture and that of the patient or client, to respect the
person’s values and beliefs, and adjust the approach of delivering care to meet each person’s
needs and expectations. Asking the person to describe his folk healing methods is the only
action that demonstrates the health care professional seeking input from the person into the
care that is received.
DIF: Cognitive Level: Analyze (Analysis)
REF: p. 26
5. A person reports that she has been seeking care from an acupuncturist to help relieve the
chronic pain that she has been experiencing. Which of the following statements would be
the most appropriate response from the nurse?
a. “You should have told me that the current treatments were helping your pain.”
b. “Tell me more about your treatments from the acupuncturist.”
c. “Tell me why you decided to not to continue with your treatment plan.”
d. “You should not be seeing an acupuncturist while receiving professional care.”
ANS: B
Through a culturally sensitive assessment process, nurses can determine what specific
remedies individuals are using and whether their continued use would interfere with the
prescribed method. The nurse asking the person to describe the treatments from the
acupuncturist allows the nurse to learn this information. The other responses demonstrate an
ethnocentric perspective by the nurse, viewing the treatments from the acupuncturist as
inferior to professional care.
DIF: Cognitive Level: Analyze (Analysis)
REF: p. 26
6. When providing an educational session about the Arab American population, which
10 | P a g eof the following information would be included?
a. The largest group of Arab Americans was refugees in the 1960s.
b. The largest groups ofArab Americans are from Palestine and Iraq.
c. Members of the Arab American population are most likely to live in rural communities.
d. Members of the Arab American population are more likely to have college
degrees than Americans at large.
ANS: D
Members of the Arab American population are more likely to have college degrees (+45%)
than Americans at large (28%). About 94% of Arab Americans live in metropolitan areas. The
largest groups ofArab Americans are the Lebanese, Syrians, and Egyptians. Arab Americans
came to the United States in three immigration waves; the last occurred in the 1960s and
consisted of many professionals, entrepreneurs, and skilled and semiskilled laborers.
DIF: Cognitive Level: Understand (Comprehension) REF:
p. 27
7. A health care professional is caring for an Arab American individual. Which of the following
cultural practices of this ethnic minority should be considered when planning care?
a. This ethnic culture tends to be future oriented.
b. Religion plays an important role in this culture.
c. Traditional cultural practices are infrequently used during a health crisis.
d. Members of this culture tend to have smaller families.
ANS: B
Religion plays an important part in Arab culture, and there are dietary rules and prescribed
rituals for praying and washing. Arab Americans are present oriented and view the future as
uncertain. During a health crisis, many Arab Americans seek out their family, community, and
traditional values and cultural practices. Arab American families are, on average, larger than
non–Arab American families.
DIF: Cognitive Level: Apply (Application)
REF:
p. 27
8. A health care professional is providing education to the parents of an Asian American
child who has recently been diagnosed with Type I diabetes. Which of the following
actions should be taken by the health care professional?
a. Provide instructions to the child’s father.
b. Encourage the parents to bring other siblings into the clinic for screening.
c. Schedule multiple educational sessions for the child and family.
d. Watch for nonverbal gestures by the adults to indicate understanding.
ANS: A
In Asian American culture, the oldest male family member often is the decision maker and
spokesperson. Maintaining harmony is an important value in Asian cultures, and it is strongly
emphasized to avoid conflict and direct confrontation. As a result of this, Asian Americans may
not show their disagreement with the recommendations of health care professionals. Type I
diabetes is not a common health problem experienced by this minority, so it is probably not
necessary to encourage screening for siblings. Additional educational sessions may be
necessary; however, Asian Americans tend to be more highly educated than any other
population in the United States.
DIF: Cognitive Level: Analyze (Analysis)
REF: p. 29
9. An Asian American family has recently immigrated to the United States. Which of the
following would provide an appropriate rationale when encouraging the family to send
their child to school?
a. The child will get a good education.
11 | P a g eb. According to law, all children must go to school.
c. The child can get health care at school.
d. Exposure to different cultures in school will enhance socialization.
ANS: D
Exposure to different cultures in school facilitates the adoption of other cultural beliefs and
aids in the socialization of the child into a new environment.
DIF: Cognitive Level: Apply (Application)
REF:
p. 29
10. Which of the following was the fastest-growing minority group in the United States between
2000 and 2010?
a. Asian American
b. Arab American
c. Hispanic American
d. Native American
ANS: C
A 43% increase in the Hispanic population between 2000 and 2010 makes Hispanics the
fastest-growing minority group in the United States.
DIF: Cognitive Level: Remember (Knowledge)
REF: p. 31
11. The interrelationship of poverty and health care dollars spent by Blacks and other
minorities is affected greatly by:
a. lack of access to preventive health care services
b. low numbers of minority health care providers
c. use of emergency rooms for care
d. increased infant mortality rates in African American populations
ANS: A
A decrease in resources for preventive care leads to the use of emergency rooms and other more
expensive health care services that are often used as resources when severe illness occurs.
DIF: Cognitive Level: Understand (Comprehension) REF:
p. 32
12. A health care provider is working with an African American woman who has recently suffered
a stroke and is homebound. She insists that she must get out of the house and attend Sunday
worship services. What is the most likely explanation for her insisting that she participate in
this cultural practice?
a. The church is the only place where prayer can be performed.
b. The church serves as a social support for its members.
c. The church is the place where the family meets on a weekly basis.
d. The church serves as a site for folk healing practices.
ANS: B
The church is significant support system many African Americans. It serves many purposes
beyond worship and formation, including serving as a place to meet where members could pass
news, take care of business, and find strength of purpose; providing direct social welfare
services; acting as a stabilizing force in the community; facilitating citizenship training and
community social action; serving as a transmitter of cultural history; and providing the means
for coping and surviving in a hostile world. African Americans often find comfort in the support
their religious leader can give them, but it does not have to happen within the church. African
Americans believe in the healing power of prayer, but that can happen outside of the church as
well. Family is the strongest source of support for African Americans, and most meet more often
than weekly at church.
12 | P a g eDIF: Cognitive Level: Apply (Application)
REF:
p. 33
13. Which of the following ethnic groups has a disproportionately high death rate from
unintentional injuries and suicide?
a. American Indian/Alaska Native Americans
b. Asian Americans
c. Latino/Hispanic Americans
d. Black/African Americans
ANS: A
American Indian/Alaska Native Americans have disproportionately high death rates from
unintentional injuries and suicide. Difficult life situations and stresses of daily life contribute
to an array of problems, including feelings of hopelessness, desperation, family dissolution,
and substance abuse.
DIF: Cognitive Level: Apply (Application)
REF:
p. 34
14. A health care professional is offering an educational session about providing culturally
congruent care. Which of the following information would be included the presentation?
a. Hispanic Americans value keeping balance and harmony with the earth.
b. The oldest male is the decision maker in African American families.
c. Native Americans are present oriented, taking one day at a time.
d. The hot and cold concept of disease is part of the Asian American culture.
ANS: C
Native Americans are generally present oriented, emphasizing events that are occurring now
rather than events that will happen later. They take one day at a time and in times of illness
they cope by hoping for improvements the next day. Native Americans value keeping balance
and harmony with the earth. The oldest male is the decision maker and spokesperson in Asian
American families. The hot and cold concept of disease is part of the Hispanic culture.
DIF: Cognitive Level: Apply (Application)
REF:
p. 34
15. A family has recently become homeless. Which of the following factors most likely contributed
to this situation?
a. Being from an ethnic minority background
b. Declining rates of poverty
c. Having multiple chronic illnesses
d. Being unable to find affordable housing
ANS: D
The inability to find affordable housing, decline in public assistance, poverty, and eroding work
opportunities all contribute to homelessness. The increasing prevalence of poverty has caused
an increase in the homeless population. Other factors that may affect this situation are lack of
affordable health care, domestic violence, mental illness, and addiction disorders.
DIF: Cognitive Level: Apply (Application)
REF:
p. 35
16. A health care professional is caring for an individual who is homeless. Which of
the following considerations should be made?
a. The prevalence of substance abuse is much lower among the homeless
population than the general population.
b. The prevalence of HIV/AIDS is much lower among the homeless
population than the general population.
c. The percentage of the population who has health insurance is much lower
among the homeless than the general population.
d. The percentage of the population who has limited access to medical care is
13 | P a g emuch lower among the homeless than the general population.
ANS: C
Most homeless people do not have health insurance or the ability to pay for needed health
care, and many providers refuse to deliver treatments to these people. The prevalence of
substance abuse, HIV/AIDS, and mental health disorders is higher among the homeless
population than the general population.
DIF: Cognitive Level: Apply (Application)
REF:
p. 36
17. A health care professional is caring for an individual who is homeless and has recently been
diagnosed with Type II diabetes. Which of the following factors is the most important to
consider when planning care?
a. Considering the cost of the purchasing medications
b. Determining the pharmacy where medications will be obtained
c. Obtaining insurance that will pay for the follow-up care
d. Finding supportive housing for the individual
ANS: D
Research and practice have shown that permanent supportive housing works because
housing is an essential part of treatment; thus, this is the most important factor that should
be considered. If supportive housing is found, the stability will help the homeless individual to
follow the prescribed medical regimen.
DIF: Cognitive Level: Analyze (Analysis)
REF: p. 36
18. A health care professional is leading a community action coalition to address the problem
of homelessness within the neighborhood. Which of the following statements would most
likely be made by health care professional?
a. Homelessness should be addressed by improving financial assistance programs.
b. Homelessness should be of concern to everyone in the neighborhood.
c. Homelessness should be addressed by encouraging job growth in the area.
d. Homelessness should be of concern to the mental health providers in the area.
ANS: B
Homelessness is everyone’s problem, and people can ultimately affect the establishment of
priorities to facilitate an improved quality of life. As more people understand homelessness,
this will serve as an excellent guide in providing input, taking necessary action, and making
the final decision as to what will make a healthy nation.
DIF: Cognitive Level: Analyze (Analysis)
REF: p. 37
19. What is the main focus of the National Institutes of Health (NIH)?
a. Addressing and reducing health disparities
b. Outlining nationwide health promotion and disease prevention
c. Protecting minority populations through development of health policies
d. Supporting communities in addressing health disparities
ANS: A
The main concern of the National Institutes of Health is addressing and reducing health
disparities involving cancer, diabetes, infant mortality, AIDS, cardiovascular illnesses, and many
other diseases. Healthy People 2020 outlines a comprehensive, nationwide health promotion
and disease prevention agenda. The Office of Minority Health improves and protects the health
of racial and ethnic minority populations through the development of health policies and
programs that concentrate on eliminating health disparities. The Centers for Disease Control
14 | P a g eand Prevention’s Racial and Ethnic Health Disparities Action Institute supports communities
to take action in addressing health disparities.
DIF: Cognitive Level: Remember (Knowledge)
REF: p. 37
20. A health care professional is searching for a funding source to develop a colorectal cancer
screening program for ethnic and racial minorities in the community. Which of the following
federal agencies would most likely be able to assist with this initiative?
a. The National Institute on Minority Health and Health Disparities
b. The Centers for Disease Control and Prevention
c. The Office of Minority Health
d. The National Institutes of Health
ANS: C
The Office of Minority Health improves and protects the health of racial and ethnic minority
populations through the development of health policies and programs that concentrate on
eliminating health disparities. The National Institute on Minority Health and Health Disparities,
The Centers for Disease Control and Prevention, and National Institutes of Health all address
health disparities among racial and ethnic minorities, but their priority is not in funding these
initiatives.
DIF: Cognitive Level: Analyze (Analysis)
REF: p. 37
21. Which of the following best demonstrates the practice of transcultural nursing?
a. Using previous knowledge about ethnic minority cultures to plan care
b. Adapting nursing care to meet the need of a person from an ethnic minority
c. Requesting an interpreter when caring for a person from an ethnic minority
d. Attending a presentation about cultural diversity
ANS: Blm
Transcultural nursing is defined as an area of nursing study and practice that focuses on
discovering and explaining cultural factors that influence the health, well-being, illness, or
death of individuals or groups and seeks to provide culturally based appropriate care to
people of diverse cultures. Adapting nursing care to meet the needs of a person from an
ethnic minority best meets this definition of transcultural nursing. A nurse may initially use
previous knowledge about minority cultures to plan care, but then must individualize the care
based on individual differences within the culture. Having an interpreter present will not be
necessary when working with all persons from ethnic minorities. Attending a presentation
about cultural diversity would assist the nurse in becoming more culturally competent, but it
is not the best example of practicing transcultural nursing because no nursing care is being
provided when attending a presentation.
DIF: Cognitive Level: Analyze (Analysis)
REF: p. 38
22. A nurse would like to improve his cultural competence. Which of the following is the best
strategy to use?
a. Explore complementary and alternative medicine practices used by other cultures.
b. Discuss cultural differences with coworkers.
c. Provide care to diverse populations.
d. Participate in continuing education programs about cultural diversity.
ANS: D
Salman et al. (2007) assessed cultural awareness and cultural competence levels among staff
nurses who participated in a continuing education program aimed at increasing knowledge of
culturally competent care of geriatric populations. Staff nurses who participated in this
training program had higher cultural competence levels as compared with those who did not
join this training program. Exploring complementary and alternative medicine practices used
by other cultures will assist if a nurse is using these practices; however, depending on whom
15 | P a g ethe nurse is caring for, this information may have limited usefulness. Discussing cultural
differences with coworkers may help the nurse learn about other cultures, but it may not
provide the best source of information. Providing care to diverse populations may not help the
nurse to become more culturally competent without having some baseline knowledge about
cultural diversity.
DIF: Cognitive Level: Apply (Application)
REF:
p. 26 (Box 2-3)
23. A nurse is told by a colleague that an Asian American individual on home care is using
complementary and alternative medicine (CAM). Which of the following conclusions can
accurately be drawn from this statement?
a. The client will have adverse complications from using this form of medicine.
b. The client may be using meditation, acupuncture, or another therapy.
c. The client will soon be returning to his or her native country for further treatment.
d. The client does not agree with the current professional care medication regimen.
ANS: B
Examples of complementary and alternative medicine (CAM) include acupuncture, feedback,
relaxation, music therapy, massage, art, music, and dance therapy. Persons who do not
experience relief from chronic conditions often resort to complementary alternative medicine.
It is important the nurse learn more about the CAM that the person is using so that any
potential interactions between the use of CAM and professional care can be addressed.
Complementary and alternative medicine can be used in conjunction with the use of
professional care.
DIF: Cognitive Level: Apply (Application)
REF:
p. 30 (Box 2-4)
24. A woman reports that she has strong spiritual practices. Which of the following is she most
likely to experience?
a. Improved coping skills and social support
b. Increased understanding of religious differences
c. Decreased pain and improved healing
d. Decreased use of Western medicine
ANS: A
Spiritual practices are likely to improve coping skills and social support, promote feelings of
optimism and home, encourage healthy behavior, decrease feelings of depression and
anxiety, and support a sense of relaxation.
DIF: Cognitive Level: Apply (Application)
MULTIPLE RESPONSE
1. Which of the following individuals will most likely experience a disparity in health and
health care? (select all that apply)
a. African American man
b. Unemployed woman
c. White middle-aged man
d. Single white woman
ANS: A, B, D
Health disparities adversely affect groups of people who have systematically experienced
greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status;
gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or
gender identity; geographic location; or other characteristics historically linked to
discrimination or exclusion. A white middle-aged man is the only individual who does not meet
that definition.
16 | P a g e
REF:
p. 39 (Box 2-5)DIF: Cognitive Level: Apply (Application)
REF:
p. 23
2. A health care professional is providing culturally competent care. Which of the
following actions is being performed by the professional? (select all that apply)
a. Recognizing and accepting cultural diversity
b. Respecting the patient’s values, beliefs, and expectations
c. Understanding the pathophysiology of disease processes
d. Providing health care services that are respectful of the individual’s cultural beliefs
ANS: B, D
A culturally competent health care professional should be able to consistently and thoroughly
recognize and understand the differences in his or her culture and that of the patient or
client; respect the individual’s values and beliefs; and adjust the approach of delivering care to
meet each individual’s needs and expectations. Simply recognizing and accepting cultural
diversity and understanding the pathophysiology of disease processes are insufficient
measures to reach cultural competency in health care.
DIF: Cognitive Level: Apply (Application)
REF:
p. 26
3. A health care provider is discussing the importance of receiving routine preventive care with
a Hispanic family who has recently immigrated to the United States. Which of the following
would best describe why they may be disinterested in receiving professional care? (select all
that apply)
a. Lack of folk remedies
b. Lack of interpreter services
c. Lack of health insurance
d. Lack of family support
ANS: B, C
Barriers experienced by Hispanic Americans in receiving appropriate health care services
include lack of racial and ethnic diversity in the leadership and workforce of the health care
system, lack of interpreter services for Spanish-speaking people, lack of health insurance,
and lack of or inadequate culturally appropriate health care resources. They may not readily
seek care because of their continued reliance on their folk system of healing. The family is
the most important source of support for Hispanic Americans.
DIF: Cognitive Level: Apply (Application)
REF:
p. 31
4. A nurse is developing a continuing education program about strategies to work with
culturally diverse populations for health care professionals in the community. Which of the
following organizations would provide information that could be included in this
presentation? (select all that apply)
a. The American Nurses Association
b. Sigma Theta Tau International
c. The National League for Nursing
d. The American Association of Colleges of Nursing
ANS: A, C, D
Major organizations, such as the American Nurses Association (ANA), the National League for
Nursing (NLN), and the American Association of Colleges of Nursing (AACN), publish culturally
relevant materials to guide students, clinicians, and educators.
DIF: Cognitive Level: Apply (Application)
Chapter 03: Health
Policy and the
Delivery System
17 | P a g e
REF:
p. 38MULTIPLE CHOICE
1. Which addition to a community best demonstrates the concept of the Healthy People 2020
report?
a. New cardiothoracic intensive care unit at a major hospital
b. New rehabilitation center
c. New recreational health center
d. New children’s hospital
ANS: C
The Healthy People 2020 report promotes health care, not illness care. A hospital, ICU, and
rehabilitation center emphasize episodic care after an illness. The recreation health center
serves to preserve health in the community and helps meet the goals of the Healthy People
2020 report.
DIF: Cognitive Level: Apply (Application)
REF:
2. Which nurse is at risk of making a medical error?
a. Working overtime
b. Works in a hospital that advocates multidisciplinary care
c. Caring for four clients during the shift
d. Attends regular continuing education programs
ANS: A
Health care systems are the basic cause of medical errors. Organizational and workforce
management, work design, and organizational culture are problem areas that contribute to
medical errors. Poor management leads to increased nurse turnover, the need for increased
client-to-nurse ratios, increased need for overtime, and decreased number of nurses, all of
which can lead to medical errors. A nurse working overtime is at risk of making a medical
error.
DIF: Cognitive Level: Apply (Application)
REF:
p. 50
3. What is the most effective policy a staff nurse can implement to help decrease medical errors on
the unit?
a. Forgo opportunities for continuing education so the unit is never understaffed.
b. Foster a collaborative working environment on the unit.
c. Check all medications a minimum of three times before administering them.
d. Develop a policy that mandates the firing of any nurse who commits an error.
ANS: B
Health care systems are the basic cause of medical errors. Organizational and workforce
management, work design, and organizational culture are problem areas that contribute to
medical errors. Creating a collaborative working environment helps improve organizational
culture, thereby reducing the chance of medical errors.
DIF: Cognitive Level: Apply (Application)
REF: [Show Less]