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Chapter 15 Promoting Healthful Living in the Primary Care Setting
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Chapter 15 Promoting Healthful Living in the Primary Care Setting
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Chapter 15: Promoting Healthful Living in the Primary Care SettingClaywell: LPN to RN Transitions
MULTIPLE CHOICE
1. A patient admitted with chest pain who is a one pack-a-day smoker tells the nurse, “I am just
not ready to quit smoking yet.” The most appropriate response by the nurse is
a. “This would be a really good time to quit.”
b. “Are you familiar with the nicotine patch?”
c. “Your smoking is the cause of your chest pain.”
d. “What do you think keeps you from quitting?”
ANS: D
Pender and Pender discuss the relationship of situational influences with regard to health
promotion. The nurse’s role is to assist the patient in identifying motivators to quitting. In
addition, the nurse may also ask the patient about roadblocks to quitting. The responses about
this being a good time to quit and naming smoking as the cause of the chest pain express
judgmental feelings by the nurse and are not likely to motivate the patient. Suggesting the use
of medication would be appropriate for the patient only if the patient expressed a desire to quit
smoking.
DIF: Cognitive Level: Application OBJ: Analyze the RN’s role in health promotion.
TOP: Health Promotion MSC: NCLEX: Health Promotion and Maintenance
2. A nurse is caring for a non–English-speaking Asian patient whose cultural practices are not
familiar to the nurse. The nurse is curious about practices regarding communication and eye
contact. The nurse should
N
a. tell the patient that it is cultural practice in the United States to maintain good eye
contact when communicating with someone.
b. observe the behaviors and interactions between the patient and other members of
the culture.
c. avoid all eye contact unless the patient establishes eye contact.
d. use eye contact and communication techniques that are most comfortable for the
nurse.
ANS: B
Telling the patient what US practices are will not be helpful in assessing the patient’s cultural
values regarding eye contact. Avoiding eye contact may not be appropriate for interactions
with some patients. The nurse should attempt to adapt communication to the patient’s
communication style.
DIF: Cognitive Level: Application OBJ: Describe the theoretical basis of self-care.
TOP: Self-Care MSC: NCLEX: Health Promotion and Maintenance
3. After the nurse implements diet instruction with a patient with heart disease, the patient can
explain the information but fails to make the recommended dietary changes. The nurse’s
evaluation is that
a. learning did not occur because the patient’s behavior did not change.
b. the nursing responsibility for helping the patient make dietary changes has been
fulfilled.
, c. choosing not to follow the diet is the behavior that resulted from the learning.
d. the teaching methods were ineffective in helping the patient learn the dietary
information.
ANS: C
Orem assumes that the responsibility of primary health promotion lies with the individual.
Although the patient’s behavior has not changed, the patient’s ability to explain the
information indicates that learning has occurred and the patient is choosing at this time to
continue with the previous diet. The patient may be contemplating or preparing to transition
his behavior. The nurse should reinforce the need for change and continue to provide
information and assistance with planning for change.
DIF: Cognitive Level: Application OBJ: Describe the theoretical basis of self-care.
TOP: Self-Care MSC: NCLEX: Health Promotion and Maintenance
4. A patient is admitted to the hospital with a new diagnosis of diabetes mellitus type 1 and is
scheduled for discharge on the second day after admission. In view of the patient’s 2-day
inpatient stay, the nurse should set realistic goals by planning to
a. teach the patient how to monitor glucose and self-administer insulin.
b. include detailed information about diet and medication use in patient teaching.
c. use every interaction to teach the patient about the details of glucose control.
d. focus on teaching the family instead of the patient about diabetic management.
ANS: A
When time is limited, the nurse should set realistic goals with the patient that will meet
immediate needs. The patient and family will need further teaching about the role of diet,
exercise, medications, and so forth, in controlling glucose, but these topics can be addressed
through planning for appropriaNte referrals.
DIF: Cognitive Level: Application OBJ: Describe the theoretical basis of self-care.
TOP: Self-Care MSC: NCLEX: Health Promotion and Maintenance
5. A nurse recognizes that a homeless patient must walk great distances to obtain food. What
kind of need does this patient demonstrate?
a. Health-deviation need
b. Developmental need
c. Universal need
d. Health continuum need
ANS: C
A universal need is an essential requirement for everyone: food, shelter, air, water, and other
basic needs. A developmental need, such as trust, love, and belonging, changes as a person
moves through each life-cycle period. A health-deviation need is based on an individual’s
genetic or constitutional deviations from normal. A health continuum need is not a true term.
DIF: Cognitive Level: Application OBJ: Describe the theoretical basis of self-care.
TOP: Self-Care MSC: NCLEX: Health Promotion and Maintenance
6. A patient has had no visitors for the 2 weeks he has been on your unit. The patient seems
dejected and insists on having his few belongings in sight at all times. The nurse realizes that
he may be experiencing what kind of need?
a. Health-deviation need
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