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A nurse is providing care for a client who has had a hip replacement and is going to be discharged in 2 days. The nurse has provided the client instructions for care after discharge. Which instruction would be considered accessing tertiary care?
- A. Begin physical therapy in 1 week.'
- B. Follow up with your primary health care provider in 2 days to discuss laboratory results.'
- C. Go to the outpatient laboratory for blood studies in 3 days.'
- D. Report to the emergency department for signs of infection, shortness of breath, or chest pain.'
Correct Answer: A
Rationale: Starting physical therapy, a type of rehabilitation, is a form of tertiary care. Tertiary care focuses on complex medical and surgical interventions, and specialized services such as cancer care and rehabilitative services. Encouraging the client to see a family health care provider would be promoting primary care. Sending the client for lab studies or instructing them to go to the emergency department would be directing the client to seek secondary care, which includes additional testing and emergency care.
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A 17-year-old client is having protected sex one to two times a week in a monogamous relationship. What is the client participating in?
- A. Health promotion
- B. Health maintenance
- C. Illness prevention
- D. Wellness
Correct Answer: B
Rationale: Protecting one's current level of health by practicing safe sex to prevent illness is an example of a health maintenance activity. Health promotion strategies are used to enhance health, such as eating a diet high in fiber. Illness prevention includes identifying risk factors such as hypertension. Wellness is the balance of total well-being.
The nurse is providing a program at the local YMCA about stress-reduction techniques combined with a 1-mile walk around the indoor track once a week. What does this type of program address for the community?
- A. Health promotion
- B. Health maintenance
- C. Illness prevention
- D. Early detection of illness
Correct Answer: A
Rationale: Health promotion refers to engaging in strategies to enhance health such as eating a diet high in grains and complex carbohydrates, exercising regularly, balancing work with leisure activities, and practicing stress-reduction techniques. Illness prevention involves identifying risk factors such as a family history of hypertension or diabetes and reducing the effects of risk factors on one's health. Early detection uses screening diagnostic tests and procedures to identify a disease process earlier, so that treatment may be initiated earlier and be more effective. Health maintenance refers to protecting one's current level of health by preventing illness or deterioration, such as by complying with medication regimens, being screened for diseases such as breast and colon cancers, or practicing safe sex.
A client undergoing a surgical procedure at the hospital died related to complications during the procedure. The nurse is required to collect data about the event so that a cause can be determined. What type of quality indicators would be used in this incident?
- A. Prevention QIs
- B. Inpatient QIs
- C. Client safety QIs
- D. Pediatric QIs
Correct Answer: B
Rationale: Inpatient QIs reflect quality of care inside hospitals, including inpatient mortality for medical conditions and surgical procedures. Prevention QIs identify hospital admissions that could be avoided through high-quality outpatient care. Client safety QIs also reflect quality of care within hospitals but focus on potentially avoidable complications and adverse events. Pediatric QIs reflect quality of care inside hospitals and identify potentially avoidable hospitalization among children.
A client with chronic obstructive pulmonary disease visits a local long-term care facility once a week to lead a bingo game for the residents. How does the nurse determine that this client is achieving a high level of wellness?
- A. The client enjoys the activity that the nurse provides to the clients.
- B. The client finds satisfaction in socialization with the residents.
- C. The client is achieving a high quality of life within the limits of the illness.
- D. The client needs to feel a part of a group setting.
Correct Answer: C
Rationale: Clients with chronic illness can achieve a high level of wellness if they can experience a high quality of life within the limits of that illness. By engaging in a personal and social activity weekly, this client would be considered healthy. Although the client may enjoy the activity, find satisfaction in socialization, or need to feel a part of a group, choosing to take part in an activity that promotes a high quality of life within the limits of the client's illness is what demonstrates wellness to the nurse.
The nurse is assisting with the development of a program to administer flu shots to a group of senior citizens. What type of prevention does this program reflect?
- A. Primary prevention
- B. Secondary prevention
- C. Tertiary prevention
- D. Prevalence
Correct Answer: A
Rationale: Primary prevention is prevention of the development of disease in a susceptible or potentially susceptible population and includes health promotion and immunization. Secondary prevention is the early diagnosis and treatment to shorten duration and severity of an illness, reduce contagion, and limit complications. Tertiary prevention is healthcare to limit the degree of disability or promote rehabilitation in chronic, irreversible diseases. Prevalence is the number of cases of a disease in a specific population during a specific period.