Test 1: Breakdown of Questions
Test 1 has 50 questions. Most items are multiple choice, but a few items may be multiple answer (select all
that apply). The time limit is 75 minutes.
*Please note this is not an all-inclusive list of test items.
*Partial credit is not awarded for select all that apply items.
*Generic names and pharmacotherapeutic class will be provided for medications
Unit 1: Adult Health Promotion
Adult Health Promotion: 2 questions
o Focus on primary, secondary, and tertiary prevention and know examples
Primary: PREVENTION
Measures to prevent the occurrence of a disease
No disease
Includes: VACCINES
Secondary: DETECTION
Taking actions aimed @ early detection of disease that can lead to interventions
to prevent it
Subclinical disease
Includes: SCREENINGS (BREAST CANCER, PAPSMEAR)
Tertiary: REHAB
Diagnosed disease
o ALREADY HAVE THE DISEASE
Activities on does that LIMIT disease progression or return the patient to optimal
functioning
Includes: REHAB, PHYSICAL THERAPY
Health disparities are differences in the incidence (new cases), prevalence (all cases), mortality rate,
and burden of disease they exist among specific population groups.
o Examples:
Ethnicity and Race
Geographic Location
Education
Socioeconomic Status: insurance
Sexual Identity
Gender
age
Teaching and Learning: 6 questions
o Transtheoretical model (be able to identify different stages and associated nursing
interventions)
Represents a person’s readiness to change
Discovering where a person is helps determine what they need
Person can EXIT and RE-ENETER at ANY stage
STAGES
Precontemplation
o Person is not worried about use
o Not interested in stopping
o Person not intending to take action in foreseeable future (6 mos.)
o NURSE INTERVENTIONS:
, Validate lack of readiness
Clarify that it is THEIR DECISION
Provide support
Increase awareness of condition
Describe benefits of change and risks of not changing
Contemplation
o Still enjoy using
o Start to notice problems from use
o Start weighing out what changing means for them
o Person is intending to make a change in the next 6 months
o Ambivalence is common
Patient understands the behavior is a problem and change is
necessary BUT they believe it is challenging and the behaviors are
not worth the risk
o NURSE INTERVENTIONS:
Introduce what is involved in changing the behavior
Encourage evaluation of PROS & CONS
Reinforce need to change
Identify new and promote positive outcomes
Preparation
o Not-good things outweigh the things they enjoy
o Prepare to make a change
o Person is planning to take action in the immediate future (1 mos.)
o NURSE INTERVENTIONS:
Reinforce positive outcomes of change
Identify and assist in problem solving obstacles
Help identify social support
Encourage small initial steps
Give information and encouragement
Help set goals and develop a plan with high priorities
Action
o Start to make a change
o Person is making specific modifications to lifestyle (last around 6 months)
o NURSE INTERVENTIONS:
Focus on restricting cues and social support
Combat feelings of loss
Reiterate long-term benefits
Reinforce behavior with reward
Discuss choices to help minimize relapse
Maintenance
o Maintaining this change
o Keep here long enough, maintain goal
o Person is working to prevent relapse; increasing confidence (6 mos. To 5
years)
o NURSE INTERVENTIONS:
Plan for follow-up support
Reinforce internal rewards
Provide more teaching on the need to maintain the change
, Termination
o Person has no temptation and 100 % self-efficacy (difficult to achieve)
o NURSE INTERVENTION:
Evaluate effectiveness of the new behavior
Relapse
o Relapse: Return back to use
o Lapse: slip up
Doesn’t not lead to relapse
o NURSE INTERVENTION
Evaluate trigger for relapse
Reassess motivation and barriers
Plan stronger coping strategies
o Review motivational interviewing
Uses nonconfrontational interpersonal communication techniques
Guiding style
Allows clinician to put control in the patient
Listen to them rather than tell
Adjust to patient resistance
Express empathy through reflective listening
Focus on patient strength
Avoid arguments and direct confrontation
Help patient recognize “gap”
o Teaching/learning process, evaluation of learning
Observe patient or caregiver directly
Ex. Ask patient to show you how to change a dressing directly
Observe verbal and nonverbal cues
Ex. Asks you to repeat instructions; loses eye contact
Ask open-ended questions (“teach back”)
Ex. “How often do you need to change the dressing?”
Talk with caregiver (“teach back”)
Ex. “What medications is she taking?”
Seek the patient’s self-evaluation of progress
Ex. Ask patient about his or her progress
If goals are not met,
Reassess the patient and revise teaching plan accordingly
o Goals of Patient Teaching:
Health promotion: need to understand the risk
Disease prevention
Illness management
Selection and use of appropriate treatment options
o “Teach back” vs. “Show back”
Teach Back helps check for understanding
Patient should be able to summarize what was said
Advantages
Helps patients remember and understand more information
Raises patient satisfaction and helps patients feel more relaxed
Helps gain the patients’ trust
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