,A man is terminally ill with end-stage prostate cancer. Which is the best statement about
this man's wellness?
a. Wellness can only be achieved with aggressive medical interventions.
b. Wellness is not a real option for this client because he is terminally ill.
c. Wellness is defined as the absence of disease.
d. Nursing interventions can help empower a client to achieve a higher level of wellness
- ANS: D
Nursing interventions can help empower a client to achieve a higher level of wellness; a
nurse can foster wellness in his or her clients. Wellness is defined by the individual and
is multidimensional. It is not just the absence of disease. A wellness perspective is
based on the belief that every person has an optimal level of health independent of his
or her situation or functional level. Even in the presence of chronic illness or while dying,
a movement toward wellness is possible if emphasis of care is placed on the promotion
of well-being in a supportive environment.
In differentiating between health and wellness in health care, which of the following
statements is true?
a. Health is a broad term encompassing attitudes and behaviors.
b. The concept of illness prevention was never considered by previous generations.
c. Wellness and self-actualization develop through learning and growth.
d. Wellness is impossible when one's health is compromised. - ANS: A
Health is a broad term that encompasses attitudes and behaviors; holistically, health
includes wellness, which involves one's whole being. The concept of illness prevention
was never considered by previous generations; throughout history, basic self-care
requirements have been recognized. Wellness and self-actualization develop through
learning and growth—as basic needs are met, higher level needs can be satisfied in
turn, with ever-deepening richness to life. Wellness is possible when one's health is
compromised—even with chronic illness, with multiple disabilities, or in dying,
movement toward a higher level of wellness is possible.
Which racial or ethnic group has the highest life expectancy in the United States?
a. Native Americans
b. African Americans
c. Hispanic Americans
d. Asian and Pacific Island Americans - ANS: C
As shown in Figure 1.4, Hispanic men and women have the highest life expectancy of
all. In 2011, for those of Hispanic origin of any race, the overall life expectancy at 65
years of age was 20.7 more years in 2011 (19.1 years for men and 21.8 years for
women).
,Historical influences that have shaped the lives of the majority of the in-between cohort
in the United States today include which of the following?
a. Influenza epidemic of 1918
b. World War I
c. Child rearing in the Depression
d. World War II - ANS: D
Those who are in the in-between cohort in 2016 were born between 1915 and 1945.
The men were likely to have fought in World War II. The last of the Holocaust survivors
are in this group. A person who survived the influenza epidemic would be at least 98
years old in 2016 and therefore would be considered old-old or a centenarian. Most of
those who are of the in-between cohort had not reached childbearing age by the end of
the Depression. Individuals in the in-between cohort would not have been old enough to
fight in World War II.
According to researchers, which characteristic do most centenarians share?
a. Female
b. Hispanic
c. Living in rural areas
d. Located in the Midwestern states - ANS: A
Based on the U.S. census report of 2010, centenarians were overwhelmingly white,
female, and living in the urban areas of the Southern states.
Which nursing intervention is a holistic approach to an older adult?
a. Performs glucose testing during the weekly worship service
b. Wheels ambulatory adults to exercise when running late
c. Assigns female nurses to older women who are Islamic
d. Allows older adults in a nursing home to eat meals alone - ANS: C
The nurse uses a holistic approach to the care of an older female adult who is Islamic
because the woman and her family are more likely to be willing participants in a
therapeutic regimen that respects a tenet of their culture. Interrupting an older adult's
worship with glucose testing can be interpreted as a lack of respect for spiritual needs.
The nurse can provide for and respect the physical and spiritual aspects of the older
adult's life by testing for glucose before the service begins. In transporting ambulatory
adults to the exercise program in wheelchairs to save time, the nurse disregards the
need for self-esteem and exercise, both important aspects of physical well-being.
Ambulatory adults can walk with assistance, if needed, to exercise programs and can
benefit from the additional activity and independence. The nurse can be tempted to
allow an older adult to eat meals alone in his or her room if this will motivate the person
to eat or if the older adult has dysphasia and is embarrassed. However, although
, focusing on physical needs, the nurse ignores psychosocial and other aspects of health
and well-being.
An older man who resides in a nursing home has a total cholesterol level of 245 mg/dL.
Which nursing intervention is most likely to assist this man in achieving his highest level
of wellness?
a. Instruct him about increasing dietary fiber.
b. Ask the health care provider for a low-fat diet.
c. Schedule a consultation for him with the dietitian.
d. Review a menu with him to choose suitable foods. - ANS: D
The nurse collaborates with the older adult to choose suitable foods, which is likely to
be an effective nursing intervention to help an older adult with hyperlipidemia achieve
optimal health and well-being; it gives him some control over the regimen and thus
engages him in the process of lowering serum cholesterol. Informing the older man
about dietary fiber offers no control to him because he is not part of the decision.
Nursing interventions developed with the older adult's collaboration are most likely to
help the older adult achieve health and wellness. Collaborating with the health care
provider for a low-fat diet is a reasonable approach to help this man with hyperlipidemia
to achieve health and wellness. However, he is more likely to have motivation and
enthusiasm for a therapeutic regimen over which he has had some control. Scheduling
a consultation with a dietitian is a reasonable approach to an older adult with
hyperlipidemia and is a part of a multifaceted approach to optimizing his health.
However, the older adult is more likely to engage in a regimen over which he has input.
Which approach requires the nurse to integrate and balance all aspects of an
individual's life into the plan of care?
a. Holistic nursing
b. Healthy People 2020
c. Maslow's hierarchy of human needs
d. Orem's self-care requirements - ANS: A
Holistic nursing integrates all aspects of an individual's life into the plan of care by
balancing an individual's internal and external environment with psychosocial, spiritual,
cultural, and physical processes. Healthy People 2020, an updated document from
2000 that outlines the goals for achieving health in this country, is a mandate for health
care professionals to follow with 467 objectives in 28 focus areas. Maslow's hierarchy of
human needs provides a basis for understanding individuals in context and for ranking
nursing assessments, diagnoses, goals, and interventions in order of importance.
Dorothea Orem's self-care requirements lists human needs, including the need for air,
fluids, nutrition, hygiene, elimination, activity, comfort, relief from suffering, and skin
integrity. The nurse helps individuals meet these needs to achieve optimal health and
wellness.
