Exam 2: NR222 / NR 222 (Latest Update 2024/ 2025) Health & Wellness Review| Complete Guide with Questions and Verified Answers| 100% Correct -Chamberlain
Exam 2: NR222 / NR 222 (Latest Update
2024/ 2025) Health & Wellness Review|
Complete Guide with Questions and Verified
Answers| 100% Correct -Chamberlain
Q: Health Promotion Model
Answer:
Extends the health belief model to include determinants of health promoting behaviour and
includes self-efficacy theory
Pender
Q: Transtheoretical Model
Answer:
six stages in the change process: precontemplation, contemplation, preparation, action,
maintenance, and termination
Q: Health Belief
Answer:
likelihood of engaging in health-promoting behavior
-Suggests that an individual’s decision to adopt healthy behaviors is based upon their perception
of susceptibility to an illness (& severity of illness
Q: Basic Human Needs
Answer:
The fundamental needs of people for adequate food, shelter, health care, sanitation, and
education. Meeting such needs may be thought of as both a moral imperative and a form of
investment in “human capital” essential for economic growth.
Q: Holistic Health Model
Answer:
Attempts to create conditions that promote optimal health, and consider clients the ultimate
expert on their own health.
Q: Self-Determination and Advance Directives
Answer:
The Patient Self-Determination Act guarantees that all competent adults have the right to
complete an Advance Directive (living will) to state whether or not they want treatment, how
they want to treat end-of-life choices, and who they want to make their decisions
Q: The Patient Self-Determination Act (PSDA)
Answer:
- an attempt to ensure that people’s rights were honored
- to improve communication related to end-of-life care issues
- to improve preferences among individuals, health care providers and proxies
Q: Advanced Directives
Answer: - a way for people to ensure that the treatment and care matches their wishes when they become
incapacitated
Q: Loved Ones
Answer:
potentially to relieve
them the strain as they strive to
make the “right” treatment choices
for a friend or relative
Q: Healthcare Professionals
Answer:
will be guided in their decision making
regarding the person in question
Q: Type of Advanced Derivative: Instructional
Answer:
written document; can be very specific or tailored to
order or may be a form document that can be downloaded from the
internet. Types:
Living will
Terminal Care document
Q: Type of Advanced Derivative: Health care proxy
Answer:
allows a competent person to designate a
decision maker in the event of incapacity.
Durable Power of Attorney
Q: Best advance directive:
Answer:
combination of proxy and written directions.
Q: Least advanced directive:
Answer:
living will
Q: Proxy Decision making
Answer:
must take into account what is known about the person
and must follow a path of action that is most likely to respect that individual’s goals and values.
Q: Minimal capacities needed for competent
decision-making
Answer:
- Possession of a set of values and goals;
- The ability to communicate and to
understand information; - The ability to reason and deliberate
about one’s choice
Q: Health Literacy Skills
Answer:
are skills related to a person’s ability to obtain, process and act on basic health information.
Q: Nursing codes of ethics and standards of
practice:
Answer:
provide guidance about the nature
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Autonomy The ethical tenet that the physician has the responsibility to respect patients’ choices about their own healthcare.Right to choose, self freedom
Confidentiality protection of privacy without diminishing access to quality careA legal and ethical concept that establishes the healthcare provider’s responsibility for protecting health records and other personal and private information from unauthorized use or disclosure
Veracity Adherence to the truth; truthfulness
Fidelity Faithfulness; loyalty
Nonmaleficence Avoid causing harm or pain as much as possible when giving treatments. Principle of avoiding harm
Beneficence The ethical tenet that the physician has a responsibility to act in the patient’s best interest.
Watson Theory Human caring Theory- caring to meet human needsWatson sees caring as central to nursing and only able to be demonstrated interpersonally. Caring depends on certain factors that satisfy human needs. Effective caring promotes health and growth.Show unconditional acceptance. Use a holistic treatment approach—one that includes treating the mind, soul, and spirit as well as the body). Spend uninterrupted time with patients – something Watson calls “caring moments.” Promote health through knowledge and intervention
Leininger’s Theory Transcultural nursing focuses on the analyses of different cultures in the world regarding their caring behavior, nursing care, health-illness values, with the goal of developing a scientific and humanistic body of knowledge from which to derive culture-specific and culture universal nursing care practices.Madeleine Leininger involves knowing and understanding different cultures with respect to nursing and health-illness caring practices, beliefs and values with the goal to provide meaningful and efficacious nursing care services to people according to their culture beliefs.
Orems Theory patient should do what they can independently, we ASSIT and SUPPORT patient where they have trouble
Health Promotion Model Extends the health belief model to include determinants of health promoting behaviour and includes self-efficacy theoryPender
Transtheoretical Model six stages in the change process: precontemplation, contemplation, preparation, action, maintenance, and termination
Health Belief likelihood of engaging in health-promoting behavior-Suggests that an individual’s decision to adopt healthy behaviors is based upon their perception of susceptibility to an illness (& severity of illness
Basic Human Needs The fundamental needs of people for adequate food, shelter, health care, sanitation, and education. Meeting such needs may be thought of as both a moral imperative and a form of investment in “human capital” essential for economic growth.
Holistic Health Model Attempts to create conditions that promote optimal health, and consider clients the ultimate expert on their own health.
Self-Determination and Advance Directives The Patient Self-Determination Act guarantees that all competent adults have the right to complete an Advance Directive (living will) to state whether or not they want treatment, how they want to treat end-of-life choices, and who they want to make their decisions
The Patient Self-Determination Act (PSDA) – an attempt to ensure that people’s rights were honored- to improve communication related to end-of-life care issues- to improve preferences among individuals, health care providers and proxies
Advanced Directives – a way for people to ensure that the treatment and care matches their wishes when they become incapacitated
Loved Ones potentially to relievethem the strain as they strive tomake the “right” treatment choicesfor a friend or relative
Healthcare Professionals will be guided in their decision makingregarding the person in question
Type of Advanced Derivative: Instructional written document; can be very specific or tailored toorder or may be a form document that can be downloaded from theinternet. Types: Living will Terminal Care document
Type of Advanced Derivative: Health care proxy allows a competent person to designate adecision maker in the event of incapacity. Durable Power of Attorney
Best advance directive: combination of proxy and written directions.
Least advanced directive: living will
Proxy Decision making must take into account what is known about the personand must follow a path of action that is most likely to respect that individual’s goals and values.
Minimal capacities needed for competentdecision-making • Possession of a set of values and goals;• The ability to communicate and tounderstand information;• The ability to reason and deliberateabout one’s choice
Health Literacy Skills are skills related to a person’s ability to obtain, process and act on basic health information.
Nursing codes of ethics and standards ofpractice: provide guidance about the natureof practice and the manner in which serviceswill be provided
Complementary Medicine/ Integrative Traditional + therapy health care practices and products used together with conventional medicinetherapies used in addition to or together with conventional treatment recommended by a person’s health care provider
Allopathy medical practice that tries to combat disease through modern or conventional means (ex. drugs, surgery).
Alternative Medicine health care practices and products used in place of conventional medicinetherapy same as complementary therapies but they become the primary treatment.
Complementary and Integrative Therapies Massage, yoga, reflexology
Complementary therapy A patient with back pain says “my nurse practitioner told me acupuncture may enhance the effect of the medications and physical therapy prescribed.” What type of therapy is being recommended?
Integrative Therapy Any therapy that draws from more than one current of psychotherapeutic theory and technique.
Relaxation Therapy a technique for reducing tension by consciously relaxing muscles of the body
Homeopathic Medicine remedies that feature a small dose of an illness-inducing substances to activate the body’s own natural defenses
Biofeedback a system for electronically recording, amplifying, and feeding back information regarding a subtle psychological state, such as blood pressure or muscle tension
Acupuncture a system of complementary medicine that involves pricking the skin or tissues with needles, used to alleviate pain and to treat various physical, mental, and emotional conditions. Originating in ancient China, acupuncture is now widely practiced in the West.manipulates life energy by stimulating precisely mapped points on skin surface
Acupressure a massage that applies pressure to specific acupuncture-like points n the body; pressure enourages the flow of vital energy (qi) along the meridian pathways. It is used to control chronic pain, migraine headaches, and backaches.
Healing touch – uses gentle touch directly on or close to body to bring back balance/ homeostasis- needs to be certified to perform
Therapeutic Touch – practitioner’s hands lay on or close to a patient’s body- no need to be certified to perform/ integrated in learning
Traditional Chinese Medicine Is a system of ancient Chinese medicinal treatments including acupuncture diet herbal theraphy meditation physical exercise and massage to prevent diagnose and treat disease
Integrative Nursing Roles AwarenessSkillsKnowledgeEncountersDesires
Guided Imagery Is a type of treatment in which a patient follows verbal prompts to envision a specific peaceful location in detail distancing him- or herself from any pain or stress the patient is currently experiencing
Nursing Accessible Therapies relaxation therapy, meditation and breathing, imagery
Relaxation Therapy – is the state of generalized decreased cognitive, physiological, and/or behavioral arousal- also involves arousal reduction.- decreases activity of the brain
Distributive justice concerns the nature of a socially just allocation of goods in a society. A society in which incidental inequalities in outcome do not arise would be considered a society guided by the principles of distributive justice
Primary legislation and enforcement to ban or control the use of hazardous products (e.g. asbestos) or to mandate safe and healthy practices (e.g. use of seatbelts and bike helmets)education about healthy and safe habits (e.g. eating well, exercising regularly, not smoking)immunization against infectious diseases.
Secondary regular exams and screening tests to detect disease in its earliest stages (e.g. mammograms to detect breast cancer)daily, low-dose aspirins and/or diet and exercise programs to prevent further heart attacks or strokessuitably modified work so injured or ill workers can return safely to their jobs.
Tertiary cardiac or stroke rehabilitation programs, chronic disease management programs (e.g. for diabetes, arthritis, depression, etc.)support groups that allow members to share strategies for living wellvocational rehabilitation programs to retrain workers for new jobs when they have recovered as much as possible.
Culture associated with norms, values, and traditions passed down through generationssame as ethnicity, race, nationality and languageBeliefs, customs, and traditions of a specific group of people. as an element of ethnicity, refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups
Intersectionality an analytic framework for assessing how factors such as race, gender, and class interact to shape individual life chances and societal patterns of stratificationWe all belong simultaneously to multiple social groups within changing social and political contexts
Opression Formal or informal system of advantages and disadvantages tied to our membership in social groups
Marginalization Groups lacking desirable traits are excluded from society. These groups include poor, uneducated, undesirable color and language. These groups will stay on the margin of acceptance by society unless there is social intervention.
Social Location Ones place in society is based on membership in a social groupthe group memberships that people have because of their location in history and society
Matrix of Domination important to understand race, gender and other forms of identity as a larger system of power and privilege that permeates society
Ethnicity vs Race People of the same race share genetically transmitted physical characteristics. People of the same ethnicity share cultural, linguistic, religious, and often racial characteristics. (So ethnicity is more specific than race. ex:race = black, white, asian; ex: ethnicity = hispanic, Japanese, etc)
Leininger Transcultural Nursing comparitive study of cultures to understand their similarities and their differences
Culturally Competent Care care that fits a persons life patterns, values and system of meaningslearning patients schedule for taking their medicationscare delivered with an awareness of the aspects of the patient’s culture
Cultural Competency one of the major elements in eliminating health disparities; it starts with an honest desire to disregard personal biases and to treat every person with respect. enabling of health care providers to deliver services that are respectful of diversityAbility to understand, communicate, and interact effectively with people from different cultures. Four components: -Awareness of one’s own cultural worldview-attitude towards cultural differences-knowledge of different cultural practices and worldviews –cross-cultural skills
Cultural Congruency the application of evidence based practice in respect to someones culture
Cultural Awareness self examination of your backgroundrecognizes biases and prejudices1st step of patient centered careAn in-depth self-examination of one’s own background, recognizing biases, prejudices, and assumptions about other people
Cultural Knowledge comparative knowledge of diverse groupsworld viewhow people perceive othersThe nurse who is scheduled to work in a clinic in a Hispanic neighborhood takes time to research Hispanic cultural norms to better provide culturally competent care to people at work. This behavior is an example of which of the following cultural components?
3 dimensions of Cultural Competency building relationshipworking outside the usual frameworkreinventing practice in action
Emic View insider’s view of nurse: not being aware of Korean culture about seaweed soup being the first meal after giving birth
Etic View Outsider viewKorean patient’s view of American professional postpartum care: assumes that seaweed soup is available in the hospital
Linguistic Competency ability of organization to communicate and convey information that is easily understood by diverse audience
Teach back helps you confirm that you have explained what a patient needs to knowask open ended questions
Cultural encounters direct interaction of the nurse to diverse populationCross cultural conflictengaging in face-to-face cultural interactions with persons from diverse backgrounds, and learning to modify one’s existing beliefs and prevent possible stereotyping
Cultural desire motivation of health care professional to want to not have to engage in process of becoming culturally competent
Title VI of Civil Rights Act of 1964 Limited English Proficiency (LEP)Prohibits discrimination based on race, color and national origin if they receive federal fundingIt is vital that interpreters be present who not onlyserve to verbally translate the conversation but whoalso can describe to you the clinical aspects andmeanings of the person’s situation.
Heritage Consistency degree to which persons lifestyle reflects traditional heritage
value orientation learned and shared through socialization and reflect the personality type of particular societyKluckhohns model: value oreitnations incorporates themes regarding basic human nature and relationshipsReflects the extent to which and individual focuses on either the task and technical concerns or people and social concerns when making decisions
cultural competency major element in eliminating health disparityhonest desire to disregard personal biases and treat everyone with respect
3 components of healing systems Folk HealingSelf CareProfessional Care Systems
Folk Healing mix of traditional healing practices and beliefs that involve herbal medicine, spirituality, manual therapies/exercises to diagnose and treat illness
Self Care performing behaviors that promote health, prevent disease, and minimize reliance on the formal medical system.
Professional Care Systems Systems for provision of health care, characterized by specialized education and knowledge, and responsibility for care and expectation of remuneration for services rendered by the health care provider
emerging populations ethnic minorities and homelessEthnic minorities, persons who are homeless, and those persons afflicted with HIV/AIDS.
ethnicitiy – social group within the social system that claims to possessvariable traits, e.g. geographic origin, religion, race, traditions, etc.A group of people who share a common social and cultural heritage based on shared traditions, national origin, physical and biologic characteristics ethnicity is a dynamic set of historically derived and institutionalized ideas and practices that allows people to identify or to be identified with groupings of people on the basis of presumed (and usually claimed) commonalities including language, history, nation or region of origin, customs, ways of being, religion, names, physical appearance, and/or genealogy or ancestry; can be a source of meaning, action, and identity; and confers a sense of belonging, pride, and motivation”
race a dynamic set of historically derived and institutionalized ideas and practices that: sorts people into ethnic groups according to perceived physical and behavioral human characteristics; associates differential value, power, and privilege with these characteristics and establishes a social status ranking among the different groups is associated with power and indexes the history or ongoing imposition of one group’s authority above another.
Values belief about the worth of somethingBeliefs of a person or social group in which they have an emotional investment (either for or against something). shape human behaviors and determine what individuals will do to maintain their health status, how they will care for themselves, and others who become ill, and where and from whom they will seek health care
minority group A subordinate group whose members have significantly less control or power over their own lives than do the members of a dominant or majority group.
Religion belief in a divine or superhuman power or powers to be obeyed and worshipedbelief in a divine or superhuman power or powers to be obeyed and worshipped as the creator(s) or ruler(s) of the universe.
spirituality includes belief or system other than religion borne out of each persons unique life experience A person’s system of beliefs and values, feelings of connectedness to self and others, and experience of finding meaning and purpose in life.
Socialization the general process of acquiring culture as you grow up in a society and acquire the characteristics of that group
Aculturation process of adapting to and acquiring another cultureadopting new cultural traits while maintaining some of the former ones
assimilation process by which a person develops new cultural identity and becomes like the members of the dominant cultureAdopting the traits of another culture. Often happens over time when one immigrates into a new country.
biculturalism dual pattern of identification and often of divided loyaltyis when minority members adopt characteristics of majority cultures in order to succeed.
health disparity refers to gaps in the quality of health care across racial, ethnic, & socioeconomic groupsadversly affects groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic groupa particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage,” and “health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion”
health equity accomplishment of the highest level of health for all people
ethnocentrism views other ways as inferior Belief in the superiority of one’s nation or ethnic group.
Taosim philosophical foundation of Chinese medicine balancingacupuncture, holisitic, herbalism, meditiationThe philosophical and theoretical foundation of Chinese medicine. A doctrine that states that humans are microcosms within the universe, and achieving harmony between the two is essential because the energies of both intertwine.
Chi energy that flows through your body
emerging population Ethnic minorities, persons who are homeless, and those persons afflicted with HIV/AIDS.
imagery therapy where person relaxes and focuses attention on images chosen and presented
active listening conscious, empathetic, non judgemental Providing the speaker with feedback that indicates the message is being received and is understood.
Five interrelated components ofculturally competent nurse ASKED Communication Awareness: being awareSkills: ability/accessKnowledge: scientific factsEncounter: be there for patientDesire: commitment, motivation
LEARN Communication Listen with empathyExplain your perceptions of the problemAcknowledge and discuss cultural similarities and differencesRecommend treatment (involve patient)Negotiate agreement
RESPECT Communication Rapport (connect, their point of view, suspend judgment)Empathy (they came for help, legitimize their feelings)Support (help overcome barriers, be available) Partnership (flexibility, negotiate, work together)Explanations (check for understanding)Cultural Competence (respect, understand, be aware)Trust (earn trust)
Steps to Cultural Competency/RolesR.E.S.P.E.C.T R ealize you MUST know and understand yourheritage and your patient.E xamine the patient within the context of his or hercultural HEALTH and ILLNESS practices.S elect questions that are not complex; do not ask questions rapidly.P ace questions throughout the physical examination.E ncourage the patient to discuss the meanings of health and illness with you.C heck for the patient’s understanding and acceptance of recommendations, andbuild on cultural HEALTH practices when indicated.T ouch the patient within the cultural boundaries of his or her heritage – mannersare a vital component of the nurse-patient relationship.
CLARA Calm downListen to patient/ family perspectiveAffirmRespondAdd (educate)
Standard 8 culturally congruent practiceestablish a set of guidelines to initiate global discussion for the practice of culturally competent nursing care in clinical practice education administration research
Provision 8.3 obligation to advance health and human rightsnurses collaborate to change social inequalities and disparities-educate the public-identify condititions and circumstances-address health barriers recognize that health care is provided to culturally divers populations in each country and across the globe
Rec 1 Remove scope of practice barriers ONE great barrier wall around China
Rec 2 expand opportunities for nurses to lead and diffuse collaborative imporovement efforts2= collaborate with 2 people
Rec 3 implement nurse residency programsresidency is 3 years
Rec 4 increase nurses with a Bacc degree 80% by 2020 Bacc degree is 4 years
Rec 5 double the number of nurses with a doctorate by 20205 times 4 is 20
Rec 6 ensure that nurses engage in lifelong learningSix=sex, lifelong marriage
Rec 7 prepare and enable nurses to take lead change in advanced healthseven: heaven take lead change of your life to go to heaven
Rec 8 build an infrastructure for collection of healthcare data Date someone who creates infrastructures Date:8
Yang A force that is masculine, positive, light, warm.
Yin A force that is feminine, negative, dark, cold.
Which 2 medicines are biologically based therapys? Dietary SupplementHerbal
What 2 touches are energy therapys HealingTheraputic
Which 2 therapies are manipulative in body based methods? Massage therapyAcupressure
Which 5 works are mind body interventions? biofeedbackbreathworkguided imagerymeditationmusic therapytai chi
what 2 therapies are movement therapys dance therapypilates
which 2 methods are whole medical systems homeopathic medicinenative american traditional healing
which 3 works are training specific therapies biofeedbackaccupuncturetheraputic touch
Family Systems Theory a theory that views the family as a system of interacting parts whose interactions exhibit consistent patterns and unstated rules
Bowen’s Family Systems Theory emotional system exists within a family and this system influences the degree of separateness and togetherness, major goal is to develop differentiation or independence among family members
Duvall and Miller Theory of family development tasks based on Erikson’s theory ofpsychosocial development* Identified stages of the familylife cycle and critical familydevelopmental tasks* presents family pattern
Family Structure – family composition, roles and relationships
Family Function consists of processes within systems as information and energy exchange occurs between families and their environment.
Arab Americans Arab Americans suffer from chronic health problems such as diabetes and coronary artery disease. Several factors place Arab Americans at high risk for developing adult-onset diabetes and cardiovascular disease including obesity, age, gender, and low employment rates.mental health and the role of acculturation tobacco consumption
Asian Americans/Pacific Islanders Some Asian American immigrants have carried diseases from their home countries, and they may now experience new diseases because of their new lifestyle and living conditions. However, AAPIs are more likely to be healthier than Whites and other ethnic groups. Asian American women have the highest life expectancy (85.8 years) among all ethnic groups in the United StatesCancer, heart disease, stroke, unintentional injuries, and diabetes are the top five leading causes of death among AAPIshigh prevalence and risk factors for chronic obstructive pulmonary disease, hepatitis B, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), smoking, tuberculosis, and liver disease
Latino/Hispanic Americans The leading causes of illness and death among Hispanics include heart disease, cancer, HIV/AIDS, stroke, and diabetes. Hispanic men and women have higher incidence and mortality rates for stomach cancerasthma, chronic obstructive pulmonary disease, HIV/AIDS, obesity, suicide, and liver disease.
hot and cold concept of disease LHAs attribute the origins of disease and illness to spiritual or natural punishments, hot and cold imbalances, magic, dislocation of internal organs, natural diseases, and emotional and mental issues This concept of hot and cold guides Hispanics when they categorize illnesses and select appropriate treatments. For example, an elevated body temperature is managed by giving the person a cool drink to lower the fever. For a person who has a cold, drinking warm fluids would be considered therapeutic
Blacks/African Americans high rates of infant mortality and maternal mortality.cancer, HIV/AIDS, obesity, diabetes, heart disease, and hypertensionSevere high blood pressure
American Indians/Alaska Natives heart disease, cancer, unintentional injuries (accidents), diabetes, and stroke. mental health and suicide, obesity, substance abuse, sudden infant death syndrome (SIDS), teenage pregnancy, liver disease, and hepatitis
Transcultural Nursing Goal: provide culturally congruent care Culturally congruent careclient centered, integration of culture into all aspects of nursing care, care to clients with different backgrounds
Cultural competency – patientcenteredcare Universal skills for healthcareproviders Five interrelated components ofculturally competent nurse: ASKED Three Dimensions of CulturalCompetence
ASKED Awareness: being awareSkills: ability/accessKnowledge: scientific factsEncounter: be there for patientDesire: commitment, motivation
Three dimensions of cultural competency building relationshipworking outside the usual frameworkreinventing practice in action
Health care disparities differences in presence of illnesses, health outcomes, or access to care within a population (gaps in quality of life)
Cultural awareness 1st step towards patient-centered care- self-aware about self bias andattitude about human behavior
Cultural knowledge World view – the way people tend tolook out upon the world or theiruniverse to form a picture or valuestance about life or the world aroundthemdetermines how people perceive others,how they interact and relate to reality, andhow they process information
Communication Techniques • Open-ended versus close-ended• Focused• Contrasted Questions• Ethnohistory• Sexual Orientation and Gender Identity• Social Organization• Socio-economic status• Bicultural ecology and health risks• Language and communication• Caring beliefs and practices
Linguistic Competence health care services that are respectful of and responsive to a person’s linguistic needs, is one small part of cultural competence.
Health Literacy Teach BackUse open-ended questionNurse to test own communicationTeach back methods – process ofclosing the loop• Plan your approach• Use handouts, pictures and models• Clarify• Practice
Cultural Encounter – Direct interaction of the nurse todiverse population- Cross cultural conflict
Cultural Desire motivation of a health care professionalto “want to”—not “have to”—engagein the process of becoming culturallycompetent