N104: Essentials of Nursing Care - Health Safety

N104 Study Guide

Chapter 4 1. C - Although all of the answers are true, the ANA believes that the movement toward optimal functioning is as critical in the definition of health as is the absence of disease. 2. B - The high-level wellness model defines wellness as dependent on the wellness of the family, community, and society. The health belief model assumes that people want to be healthy and are judged to be healthy based on their perceptions of susceptibility, seriousness, and threat. The agent- host-environment model predicts health or illness based on the balance of the agent, host, and environment. 3. C - Stimulus-based models of stress define stress as a disruption in the environment or circumstances that may increase an individual’s susceptibility to illness. Response-based models of stress predict health or illnessbased on the individual’s responses to stress placed on the body. The general adaptation syndrome (GAS) is the response-based model that describes the events that occur in response to stress. 4. A - In the alarm stage, the nervous system releases adrenaline (epinephrine) and cortisone, which produces the “fight or flight response.” In the resistance or adaptation stage, the body attempts to control or limit the stress. In the exhaustion stage, attempts to adapt are not successful and major body systems may begin to fail. The recuperation stage is not part of the GAS. 5. B - Twitching is a physiological response and not a psychological response to stress. 6. C - Mild levels of anxiety produce increased alertness and readiness to learn. With moderate levels of anxiety, the patient may have a decreased attention span and may report some physical symptoms. When anxiety reaches a panic level, the individual will be unable to function and may harm himself or someone else. 7. B - Secondary prevention focuses on early detection of problems. Primary prevention (immunizations, prenatal care, and exercise classes) focuses on preventing illness. Tertiary prevention (rehabilitation efforts) focuses on preventing complications of disease. 8. D - Physiological indicators of anxiety include dilated pupils, moist and clammy skin, and increased pulse rate, respiratory rate, and blood pressure. 9. B - Description of the symptoms should be included in the history of the present illness. A description of diseases of family members is included in the family history. Smoking, drug, and alcohol use should be included in the social history. 10. C - The patient may be reverting to an earlier, safer age and using regression as the defense mechanism. Repression is an unconscious mechanism that prevents stressful thought from entering awareness. Suppression is a conscious attempt to keep threatening thoughts out of consciousness. Rationalization is an intellectual justification of ideas or behaviors.

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