Chapter 3: Health Education and Health Promotion

1. A nurse has been working with a client whose poorly controlled type 1
diabetes has led to numerous health problems. Over the past several years the
client has had several admissions to the hospital medical unit, and the nurse has
often carried out health promotion interventions. Who is ultimately responsible
for maintaining and promoting this client's health?
A. The medical nurse
B. The community health nurse who has also worked with the client
C. The client's primary care provider
D. The client

ANS: D

Rationale: Society places a great importance on health and the responsibility that
each of us ultimately has to maintain and promote our own health. Even though
the medical nurse, community health nurse, and primary care provider all
actively participate in promoting the client's health, the client must accept
responsibility in order for health promotion to be successful.

PTS: 1 REF: p. 65 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice

2. An 82-year-old client has come to the clinic for a scheduled follow-up

appointment. The nurse learns from the client's child that the client is not
following the instructions the client received upon discharge from the hospital
last month. What is the most likely factor causing the client not to adhere to the
therapeutic regimen?
A. Ethnic background of health care provider
B. Costs of the prescribed regimen
C. Presence of a learning disability
D. Personality of the primary provider

ANS: B

Rationale: Variables that appear to influence the degree of adherence to a

prescribed therapeutic regimen include gender, race, education, illness,
complexity of the regimen, and the cost of treatments. The ethnic background
and personality of the health care provider and the personality of the health care
provider are not considered variables that appear to influence the degree of
adherence to a prescribed therapeutic regimen.

PTS: 1 REF: p. 57 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Remember
NOT: Multiple Choice

3. A gerontologic nurse has observed that clients often fail to adhere to their
therapeutic regimen. What strategy should the nurse adopt to best assist an
older adult in adhering to a therapeutic regimen involving wound care?
A. Demonstrate a dressing change and allow the client to practice.
B. Provide a detailed pamphlet on a dressing change.
C. Verbally instruct how to change a dressing and check for comprehension.
D. Delegate the dressing change to a trusted family member.

ANS: A

Rationale: The nurse must consider that older adults may have deficits in the
ability to draw inferences, apply information, or understand major teaching
points. Demonstration and practice are essential in meeting their learning needs.
The other options are incorrect because providing written instructions is not a
substitute for a comprehensive teaching plan. Verbally teaching how to change a
dressing and then checking for comprehension of the teaching is not as effective
as demonstrating a dressing change and observing the client practicing the
dressing change. Having a family member change the dressing when the client is
capable of doing it impedes self-care and independence.

PTS: 1 REF: p. 58 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
NOT: Multiple Choice

4. A 20-year-old client newly diagnosed with type 1 diabetes needs to learn how
to self-administer insulin. When planning the appropriate educational
interventions and considering variables that will affect the client’s learning, the
nurse should prioritize what factor?
A. Client's expected lifespan
B. Client's gender
C. Client's occupation
D. Client's culture

ANS: D

Rationale: One of the major variables that influence a client's readiness to learn
is the client's culture because it affects how a person learns and what information
is learned. Other variables include illness states, values, emotional readiness,
and physical readiness. Lifespan, occupation, and gender are variables that are
usually less salient.

PTS: 1 REF: p. 59 NAT: Client Needs: Psychosocial Integrity

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level:
Understand
NOT: Multiple Choice
5. The nurse is planning to teach a 75-year-old client with coronary artery
disease about administering the prescribed antiplatelet medication. How can the
nurse best enhance the client's ability to learn?
A. Provide links to websites that contain evidence-based information.
B. Exclude family members from the session to prevent distraction.
C. Use color-coded materials that are succinct and engaging.
D. Make the information directly relevant to the client's condition.

ANS: D

Rationale: Studies have shown that older adults can learn and remember if the
information is paced appropriately, relevant, and followed by appropriate
feedback. Family members should be included in health education. The nurse
should not assume that the client's color vision is intact or that the client
possesses adequate computer skills.

PTS: 1 REF: p. 58 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
NOT: Multiple Choice

6. A nurse is planning care for an older adult who lives with a number of chronic
health problems. Which nursing diagnosis would educate the client and be the
priority intervention?
A. Risk for impaired physical mobility related to joint pain
B. Functional urinary incontinence related decreased mobility
C. Activity intolerance related to contractures
D. Ineffective health maintenance related to nonadherence to therapeutic
regimen

ANS: D

Rationale: For some nursing diagnoses, such as ineffective health maintenance

related to nonadherence to therapeutic regimen, education is a primary nursing
intervention leading to a change in behavior and improved adherence. For the
other nursing diagnoses listed, client education is important, but it is just one of
many other interventions that must be performed to achieve the desired goal.

PTS: 1 REF: p. 58
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
NOT: Multiple Choice

7. A class of nursing students has been asked to break into groups of four and
complete a health-promotion teaching project and present a report to their fellow
students. What project most clearly demonstrates the principles of health
promotion teaching?
A. Demonstrating an injection technique to a client for anticoagulant therapy
B. Explaining the side effects of a medication to an adult client
C. Discussing prevention of sexually transmitted infections (STI) to high school
students
D. Instructing an adolescent client how to avoid hypoglycemic episodes

ANS: C

Rationale: Health promotion encourages people to live a healthy lifestyle and to

achieve a high level of wellness. Discussing the importance of STI prevention to a
group of high school students is the best example of a health promotion teaching
project. Teaching a client an injection technique, side effects of medication, and
how to avoid hypoglycemia are interventions to treat disease or illness and not
examples of health promotion.

PTS: 1 REF: p. 63 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
NOT: Multiple Choice

8. Based on current knowledge of health promotion, what factor should the nurse
prioritize in an effort to promote health, longevity, and weight control in clients?
A. Good nutrition
B. Stress reduction
C. Use of vitamins
D. Screening for health risks

ANS: A

Rationale: It has been suggested that good nutrition is the single most significant
factor in determining health status, longevity, and weight control. A balanced diet
that uses few artificial ingredients and is low in fat, caffeine, and sodium
constitutes a healthy diet. Stress reduction and screening for health risks are
correct answers, just not the most significant factors. Vitamin use is not normally
necessary when an individual eats a healthy diet, except in specific
circumstances.

PTS: 1 REF: p. 63 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice

9. The nursing profession and nurses as individuals have a responsibility to

promote activities that foster well-being. What factor has most influenced
nurses' abilities to play this vital role?
A. Nurses are seen as nurturing professionals.
B. Nurses possess a baccalaureate degree as the entry to practice.
C. Nurses possess an authentic desire to help others.
D. Nurses have long-established credibility with the public.

ANS: D
Rationale: Nurses, by virtue of their expertise in health and health care and their
long-established credibility with consumers, play a vital role in health promotion.
Nurses are not necessarily seen as nurturing, and a baccalaureate entry to
practice is not in place in all jurisdictions. Not every nurse has a genuine desire
to help others.

PTS: 1 REF: p. 68 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated
Process: Caring
BLM: Cognitive Level: Understand NOT: Multiple Choice

10. The nurse is teaching a local community group about the importance of
disease prevention. Why is the nurse justified in emphasizing disease prevention
as a component of health promotion?
A. Prevention is emphasized as the link between personal behavior and health.
B. Most individuals die of preventable causes.
C. International organizations emphasize prevention as the main criterion of
health care.
D. The external environment affects the outcome of most disease processes.

ANS: A

Rationale: Most deaths are not classified as being preventable. HMO priorities do
not underlie this emphasis. The external environment affects many disease
processes, but the course of illness is primarily determined by factors intrinsic to
the client.

PTS: 1 REF: p. 63 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice
11. The nurse is preparing discharge teaching for an adult client diagnosed with
urinary retention secondary to multiple sclerosis. The nurse will teach the client
to self-catheterize at home upon discharge. What teaching method is most likely
to be effective for this client?
A. A list of clear instructions written at a sixth-grade level
B. A short video providing useful information and demonstrations
C. An audio-recorded version of discharge instructions that can be accessed at
home
D. A discussion and demonstration between the nurse and the client

ANS: D

Rationale: Demonstration and practice are essential ingredients of a teaching

program, especially when teaching skills. It is best to demonstrate the skill and
then give the learner ample opportunity for practice. When special equipment is
involved, such as urinary catheters, it is important to teach with the same
equipment that will be used in the home setting. A list of instructions, a video,
and an audio recording are effective methods of reinforcing teaching after the
discussion and demonstration have taken place.

PTS: 1 REF: p. 59 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
NOT: Multiple Choice

12. The nurse is planning to teach tracheostomy care to a client who will be
discharged home following a spinal cord injury. When preparing to teach, which
component of the teaching plan should the nurse prioritize?
A. Citing the evidence that underlies each of the teaching points
B. Alleviating the client's guilt associated with not knowing appropriate self-care
C. Determining the client's readiness to learn new information
D. Including several nursing colleagues in the planning process
ANS: C

Rationale: Assessment in the teaching–learning process is directed toward the

systematic collection of data about the person and family's learning needs and
readiness to learn. Client readiness is critical to accepting and integrating new
information. Unless the client is ready to accept new information, client teaching
will be ineffective. Citing the evidence base will not likely enhance learning. Client
guilt cannot be alleviated until the client understands the intricacies of the
condition and their physiologic response to the disease. Inclusion of colleagues
can be beneficial, but this does not determine the success or failure of teaching.

PTS: 1 REF: p. 59 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
NOT: Multiple Choice

13. The occupational health nurse is preparing health promotion programs for the
workplace. Which program is the occupational health nurse most likely to
develop to promote wellness?
A. Self-care for diabetes
B. Cholesterol screening
C. Body-building
D. Working efficiently

ANS: B

Rationale: Health promotion includes health screenings, counseling,

immunizations, and preventative medications. Health promotion programs in the
workplace typically offer health screenings, such as cholesterol screenings. While
a health promotion program may screen for glucose levels, workplace programs
are typically not focused on self-care for a particular disease. Health promotion
programs may also offer physical fitness programs to improve and maintain
health; however, bodybuilding is not part of physical fitness for health promotion
in the workplace. Working more efficiently may help to reduce stress, but this
type of program is not likely to be developed by the occupational health nurse.

PTS: 1 REF: p. 68 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
NOT: Multiple Choice

14. A nurse is teaching a community program about the association between

stress levels and negative health outcomes. The nurse should include the cause-
and-effect relationship that stress has with which type of condition?
A. Congenital defects
B. Infectious diseases
C. Traumatic injuries
D. Chronic illnesses
E. Genetic disorders

ANS: B, C, D

Rationale: Studies suggest the negative effects of stress on health and a cause-
and-effect relationship between stress and infectious diseases, traumatic injuries
(e.g., motor vehicle crashes), and some chronic illnesses. Congenital defects,
such as spina bifida and cleft lip, occur during pregnancy or birth due to
hereditary conditions or environmental factors and are not linked to stress.
Genetic disorders likewise typically result from genetic mutations due to inherited
disorders or environmental factors occurring before birth, and are not associated
with stress.

PTS: 1 REF: p. 65 NAT: Client Needs: Psychosocial Integrity

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Understand
NOT: Multiple Response
15. A public health nurse understands that health promotion should continue
across the lifespan. When planning health promotion initiatives, when in the
lifespan should health promotion begin?
A. Adolescence
B. School age
C. Preschool
D. Before birth

ANS: D

Rationale: Health promotion should begin prior to birth because the health
practices of a mother prior to the birth of her child can be influenced positively or
negatively. This makes the other options incorrect.

PTS: 1 REF: p. 66 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Understand
NOT: Multiple Choice

16. A nurse is working with a client who was recently diagnosed with asthma.
During the current session, the nurse taught the client how to administer the
bronchodilator by metered-dose inhaler. How should the nurse best evaluate the
teaching–learning process?
A. Ask the client specific questions about the medication.
B. Ask whether the client now understands how to use the inhaler.
C. Directly observe the client using the inhaler to self-administer a dose.
D. Assess the client’s respiratory health at the next scheduled visit.

ANS: C

Rationale: Demonstration and practice are essential ingredients of a teaching

program, especially when teaching skills. It is best to demonstrate the skill and
then give the learner ample opportunity for practice. By observing the client
using the inhaler, the nurse may identify what learning needs to be enhanced or
reinforced. Asking questions is not an accurate gauge of learning. Respiratory
assessment is a relevant, but indirect, indicator of learning. Delaying the
appraisal of the client's technique until a later clinic visit is inappropriate because
health problems could occur in the interval.

PTS: 1 REF: p. 63
NAT: Client Needs: Physiological Integrity: Pharmacological and Parenteral
Therapies
TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
NOT: Multiple Choice

17. A team of public health nurses is doing a strategic plan and discussing health
promotion activities for the next year. What initiative best demonstrates the
principles of health promotion?
A. A seminar on antiterrorism
B. A family planning clinic at a community center
C. An immunization clinic at the largest local mall
D. A meeting about leadership styles

ANS: B

Rationale: Health promotion may be defined as those activities that assist people
in developing resources that maintain or enhance well-being and improve their
quality of life. A family planning clinic meets these criteria most closely. An anti-
terrorism seminar is not about health improvement. The immunization clinic will
fall under the category of primary and secondary prevention. A leadership styles
meeting is informational, but not about health promotion.

PTS: 1 REF: p. 64 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
NOT: Multiple Choice

18. The nurse is caring for a client with chronic obstructive pulmonary disease
(COPD) who has just received a new diagnosis of diabetes. Which client behavior
demonstrates to the nurse the client’s emotional readiness to learn?
A. The client is asking questions about diabetes management.
B. The client is no longer experiencing shortness of breath.
C. The client describes a sibling with well-controlled diabetes.
D. The client successfully follows a complex COPD regimen.

ANS: A

Rationale: Seeking information about diabetes shows an emotional readiness and

motivation to learn. No longer experiencing shortness of breath is an example of
physical readiness to learn. Experiential readiness relates to previous experiences
that may influence an individual's ability to learn. Having a sibling with well-
controlled diabetes and being able to follow a complex regimen for COPD are
examples of experiential readiness.

PTS: 1 REF: p. 59 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Analyze
NOT: Multiple Choice

19. A nurse is planning an educational event for a local group of citizens who live
with a variety of physical and cognitive disabilities. What variable should the
nurse prioritize when planning this event?
A. Health-promotion needs of the group
B. Relationships between participants and caregivers
C. Wellness state of each individual
D. Learning needs of caregivers

ANS: A
Rationale: The nurse must be aware of the participants' specific health promotion
needs when teaching specific groups of people with physical and mental
disabilities. This is a priority over the relationships between participants and
caregivers, each person's wellness state, or caregivers' learning needs.

PTS: 1 REF: p. 57 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
NOT: Multiple Choice

20. A public health nurse is planning educational interventions that are based on
Becker's Health Belief Model. When identifying the variables that affect local
residents' health promotion behaviors, what question should the nurse seek to
answer?
A. "Do residents believe that they have ready access to health promotion
resources?"
B. "Why have previous attempts at health promotion failed?"
C. "How much funding is available for health promotion in the community?"
D. "Who is available to provide health promotion education in the local area?"

ANS: A

Rationale: Barriers, Becker's second variable, are defined as factors leading to

unavailability or difficulty in gaining access to a specific health promotion
alternative. The other listed questions do not directly relate to the four variables
that Becker specified.

PTS: 1 REF: p. 64 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
NOT: Multiple Choice
21. How should the nurse best define health?
A. Health is the effort to systematically maximize wellness.
B. Health is a state that is characterized by a lack of disease.
C. Health is a condition that enables people to function at their optimal potential.
D. Health is a deliberate attempt to mitigate the effects of disease.

ANS: C

Rationale: Health is viewed as a dynamic, ever-changing condition that enables

people to function at an optimal potential at any given time. Health does not
necessarily denote the absence of disease, an effort to maximize wellness, or
mitigate the effects of disease.

PTS: 1 REF: p. 64 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Communication and Documentation BLM: Cognitive
Level: Understand
NOT: Multiple Choice

22. A parish nurse is describing the relationship between health and physical
fitness to a group of older adults who all attend the same church. What potential
benefits of a regular exercise program should the nurse describe? Select all that
apply.
A. Decreased cholesterol levels
B. Delayed degenerative changes
C. Improved sensory function
D. Improved overall muscle strength
E. Increased blood sugar levels

ANS: A, B, D

Rationale: Clinicians and researchers who have examined the relationship

between health and physical fitness have found that a regular exercise program
can promote health in the following ways: by decreasing cholesterol and low-
density lipoprotein levels; delaying degenerative changes, such as osteoporosis;
and improving flexibility and overall muscle strength and endurance. Physical
fitness does not directly improve the senses, and it tends to decrease blood
sugar.

PTS: 1 REF: p. 65 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Response

23. A nurse is discussing health promotion strategies with a client with elevated
lipid levels. Which client response best indicates to the nurse that the client is
exhibiting self-responsibility?
A. “Teach my spouse about diet since I do not do the cooking.”
B. “I do not need to exercise since I am on my feet all day at work.”
C. “My father had high cholesterol levels, and he is in good health.”
D. “I will need to learn to read food labels when food shopping.”

ANS: D

Rationale: Taking responsibility for oneself is the key to successful health

promotion. By taking the initiative to learn to read food labels, the client is
demonstrating self-responsibility. Requesting that the spouse be taught about
nutrition is not taking responsibility for one's health. By denying the benefits of
regular exercise or that elevated lipids levels can lead to cardiovascular disease,
the client is not demonstrating self-responsibility.

PTS: 1 REF: p. 65 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
24. The nurse is assessing the nutritional awareness of a client who is
overweight. What outcome most clearly demonstrates that the client possesses
nutritional awareness?
A. The client avoids processed foods.
B. The client uses vitamins and supplements to meet daily nutritional
requirements.
C. The client consumes store-bought, low-calorie cakes for snacks.
D. The client chooses foods high in trans fat.

ANS: A

Rationale: Nutritional awareness involves an understanding of the importance of

a healthy diet that supplies nutrients through unprocessed foods. With healthy
eating, vitamins and supplements should not be necessary to meet daily
nutritional needs. Store-bought cakes, even low-calorie ones, are processed and
refined and should be avoided. The client with nutritional awareness would
choose a healthier unsaturated fat food rather than one with trans fats.

PTS: 1 REF: p. 65 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice

25. A nurse has planned a teaching–learning interaction that is aimed at middle-

school–aged students. To foster successful health education, the nurse's planning
should prioritize what component?
A. Pretesting
B. Social and cultural patterns
C. Client awareness
D. Measurable interventions

ANS: B
Rationale: A client's social and cultural patterns must be appropriately
incorporated into the teaching–learning interaction. Pretesting may or may not
be used; client awareness is a phrase that has many meanings, none of which
make the teaching–learning interaction successful. Interventions are not
measured; goals and outcomes are.

PTS: 1 REF: p. 59 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Apply
NOT: Multiple Choice

26. Positive client outcomes are the ultimate goal of nurse–client interactions,
regardless of the particular setting. Which of the following factors has the most
direct influence on positive health outcomes?
A. Client's age
B. Client's ethnic heritage
C. Health education
D. Outcome evaluation

ANS: C

Rationale: Health education is an influential factor directly related to positive

client care outcomes. The other options are incorrect because ethnicity, the
client's age, and outcome evaluation are less influential factors related to positive
client care outcomes, though each factor should be considered when planning
care. Outcomes should be evaluated, but this does not cause them to be
successful, but rather identifies if they were achieved.

PTS: 1 REF: p. 56 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Understand
NOT: Multiple Choice
27. A school nurse is facilitating a health screening program among middle school
students. What purpose of health screening should the nurse prioritize when
planning this program?
A. To provide education to treat chronic diseases
B. To evaluate the treatment of current health problems
C. To identify the presence of infectious diseases
D. To promote positive health practices

ANS: D

Rationale: One purpose of health screening in the adolescent population is to

promote positive health practices early in life. The purpose of a health screening
is not to provide education to treat chronic illnesses, evaluate how current health
problems are being treated, or to detect infectious diseases.

PTS: 1 REF: p. 66 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice

28. A nurse recognizes that individuals of different ages have specific health
promotion needs. When planning to promote health among young adults, what
subject is most likely to meet the learning needs of the demographic group?
A. Family planning
B. Management of risky behaviors
C. Chronic illness management
D. Relationship skills training

ANS: A

Rationale: Because of the nationwide emphasis on health during the reproductive

years, young adults actively seek programs that address prenatal health,
parenting, family planning, and women's health issues. The other options are
incorrect because they are not health promotion classes typically sought out by
young adults.

PTS: 1 REF: p. 67 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Teaching/Learning | Integrated Process: Nursing
Process
BLM: Cognitive Level: Apply NOT: Multiple Choice

29. Middle-aged adults are part of an age group that is known to be interested in
health and health promotion, and the nurse is planning health promotion
activities accordingly. To what suggestions do members of this age group usually
respond with enthusiasm? Select all that apply.
A. Lifestyle practices that can improve health
B. Healthier eating practices
C. Life benefits of exercise
D. Strategies for adhering to prescribed therapy
E. Exercise for the aging

ANS: A, B, C

Rationale: Young and middle-aged adults represent an age group that not only
expresses an interest in health and health promotion but also responds
enthusiastically to suggestions that show how lifestyle practices can improve
health; these lifestyle practices include nutrition and exercise. Middle-aged adults
may not respond positively to teaching aimed at "the aging." Adherence is not
noted to be a desired focus in this age group.

PTS: 1 REF: p. 67 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Response
30. A community health nurse has been asked to participate in a health fair that
is being sponsored by the local senior center. Which principle of health promotion
for older adults should the nurse use when developing educational activities?
A. Older adults are not likely to perform health promotion activities.
B. Older adults benefit from practices that help them maintain independence.
C. Older adults with chronic illnesses are not likely to benefit from health
promotion activities.
D. Older adults are no longer in need of health promotion activities.

ANS: B

Rationale: Although their chronic illnesses and disabilities cannot be eliminated,

the older adult can benefit from activities that help them maintain independence
and achieve an optimal level of health. Moreover, older adults, even those with
chronic illness, are health conscious, view their health positively, and are likely to
engage in health promotion activities.

PTS: 1 REF: p. 68 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
NOT: Multiple Choice

31. Which concept should the nurse use when performing health teaching?
A. The primary goal of health teaching is to prevent illness.
B. Health teaching requires a prescription from the client’s primary care provider.
C. Health teaching is an independent nursing function.
D. The nurse must provide health teaching, even if the client refuses.

ANS: C

Rationale: Health teaching and client education are included in each state’s nurse
practice act and are essential independent functions of the nurse that do not
require a provider's order. Preventing illness is only one goal of health teaching.
Other goals include promoting, maintaining, and restoring health, as well as
helping clients adapt to illness. Although health teaching is a key responsibility of
the nurse, nurses also need to recognize that each client has the right to accept
or refuse education.

PTS: 1 REF: p. 57 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice

32. A nurse who provides care at the campus medical clinic of a large university
puts much effort into health promotion. What purpose of health promotion should
guide the nurse's efforts?
A. To teach people how to act within the limitations of their health
B. To teach people how to grow in a holistic manner
C. To change the environment in ways that enhance cultural expectations
D. To influence people's behaviors in ways that reduce risks

ANS: D

Rationale: The purpose of health promotion is to focus on the person's potential

for wellness and to encourage appropriate alterations in personal habits, lifestyle,
and environment in ways that reduce risks and enhance health and well-being.
The other options are incorrect because the purpose of health promotion is not to
teach people how to "grow in a holistic manner," to accommodate their
limitations, or to change the environment in ways that enhance cultural
expectations. Growth is much broader than health and a focus on limitations
does not promote health.

PTS: 1 REF: p. 56 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice

33. Which of the following factors has most influenced the growing emphasis on
health promotion in nursing?
A. A changing definition of health
B. An awareness that wellness exists
C. An expanded definition of chronic illness
D. A belief that disease is preventable

ANS: A

Rationale: The concept of health promotion has evolved because of a changing

definition of health and an awareness that wellness exists at many levels of
functioning. The other options are incorrect because health promotion has not
evolved because we know that wellness exists or a belief that disease is
preventable. No expanded definition of chronic illness has caused the concept of
health promotion to evolve.

PTS: 1 REF: p. 64 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice

34. A nurse is working with a client who has recently received a diagnosis of
human immunodeficiency virus (HIV). When performing client education during
discharge planning, what goal should the nurse prioritize?
A. Encourage the client to exercise within the client’s limitations.
B. Encourage the client to adhere to the client’s therapeutic regimen.
C. Appraise the client's level of nutritional awareness.
D. Encourage a disease-free state.

ANS: B
Rationale: One of the goals of client education is to encourage people to adhere
to the therapeutic regimen. This is a very important goal because it is necessary
if clients are to attain their optimal level of wellness. In this client's
circumstances, this is likely a priority over exercise or nutrition, though these are
important considerations. A disease-free state is not obtainable.

PTS: 1 REF: p. 57 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice

35. A client with a recent diagnosis of which condition would most likely benefit
from health education that emphasizes adherence?
A. Colonization with methicillin-resistant Staphylococcus aureus (MRSA)
B. Small bowel obstruction
C. Multiple sclerosis
D. A fractured humerus

ANS: C
Rationale: Many people do not adhere to their prescribed regimens; rates of
adherence are especially low (and thus health education is especially needed)
when the regimens are complex or of long duration (e.g., therapy for
tuberculosis, multiple sclerosis, and HIV infection, and hemodialysis). On the
other hand, clients with more acute, short-term conditions (e.g., MRSA, a bowel
obstruction, or an arm fracture), which have treatment regimens that are simpler
and of shorter duration, would be less likely to benefit from health education that
emphasizes adherence.

PTS: 1 REF: p. 57 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
36. The nurse is providing client education to a client who was diagnosed 6
months ago with type 1 diabetes. The client’s hemoglobin A1c results suggest the
client has not been adhering to the prescribed treatment regimen. To help this
client better adhere to the treatment regimen, the nurse should assess variables
that affect the client’s ability to perform which tasks? Select all that apply.
A. Obtain resources.
B. Teach friends about diabetes.
C. Cure the disease.
D. Maintain a healthy social environment.
E. Adopt specific behaviors.

ANS: A, D, E

Rationale: Nurses' success with health education is determined by ongoing

assessment of the variables that affect a client's ability to adopt specific
behaviors, obtain resources, and maintain a healthy social environment. The
client's ability to teach friends about the condition is not a variable that the nurse
would likely assess when educating the client about the treatment regimen. Type
1 diabetes is not curable.

PTS: 1 REF: p. 57 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Response

37. The nurse is working with a 15-year-old client who has diabetes and who is
struggling with the necessary behavioral changes. Which of the following
motivators is most likely to be effective?
A. A learning contract
B. A star chart
C. A point system
D. A food reward system
ANS: A

Rationale: Using a learning contract or agreement can also be a motivator for

learning. Such a contract is based on assessment of client needs; health care
data; and specific, measurable goals. Young adults would not respond well to the
use of star charts, point systems, or food as reward for behavioral change. These
types of motivators would work better with children.

PTS: 1 REF: p. 58
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice

38. A nurse working in a gerontology clinic as a member of a health care team

recognizes that some older adults do not adhere to therapeutic regimens because
of chronic illnesses that require long-term treatment by several health care
providers. Which responsibility of the nurse is most important in this situation?
A. Knowing all the dietary supplements the client is taking
B. Working collaboratively with other team members to provide coordinated care
C. Identifying all potential side effects of a medication the client is taking
D. Having a peer witness their interactions with the client

ANS: B

Rationale: Above all, health care professionals must work together to provide
continuous, coordinated care; otherwise, the efforts of one health care
professional may be negated by those of another. Interactions do not necessarily
need to be witnessed. The care team should be aware of the client's use of
supplements and familiar with potential side effects of a medication the client is
taking, but these are not priority principles that guide overall care.
PTS: 1 REF: p. 60
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice

39. A client will be receiving outpatient intravenous antibiotic therapy for the
treatment of endocarditis. The nurse is preparing health education to promote
the client's adherence to the course of treatment. What cultural consideration
should the nurse use when developing a teaching plan for the client?
A. Apply general knowledge of the client’s culture to the teaching plan.
B. Acknowledge that culture does not affect the client’s readiness to learn.
C. Explain to the client that cultural health practices will interfere with antibiotic
therapy.
D. Perform an individual cultural assessment with the client.

ANS: D

Rationale: Before beginning health teaching, nurses must conduct an individual

cultural assessment instead of relying only on generalized assumptions about a
particular culture. Consequences of ignoring the effects of a client’s cultural
practices can lead to misunderstanding, a lack of adherence to treatment, and
poor health outcomes. The nurse should assess whether there are any cultural
practices that may affect health outcomes and work with the client to develop an
acceptable plan.

PTS: 1 REF: p. 58 NAT: Client Needs: Health Promotion and Maintenance

TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Apply
NOT: Multiple Choice
40. The nurse is working with a client who has diagnoses of coronary artery
disease and angina pectoris. During a clinic visit, the nurse learns that the client
has only been taking the prescribed antiplatelet medication when the client
experiences chest pain and fatigue. What nursing diagnosis is most relevant to
this assessment finding?
A. Acute pain related to myocardial ischemia
B. Confusion related to mismanagement of drug regimen
C. Ineffective health maintenance related to inappropriate medication use
D. Ineffective role performance related to inability to manage medications

ANS: C

Rationale: This client's action suggests that by taking medications incorrectly the
client is not adequately maintaining their health. Role performance is not directly
applicable to the client's actions and confusion suggests a cognitive deficit. Pain
is not central to the essence of the problem.

PTS: 1 REF: p. 66
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 3: Health Education and Health Promotion
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice