NR-222 Health and Wellness - Set 5 - Part 2

Correct Answer: Type two diabetes, obesity, and cardiovascular disease

Type two diabetes, obesity, cardiovascular disease, and psychosocial stressors such as anxiety and depression are the named health risks of middle adulthood. A screening clinic for this age band targets them directly. Option b is incorrect because acute confusion, diminished reserve, and skin breakdown are geriatric syndromes that appear after 65. Screening a middle aged crowd for them would return almost nothing useful. Option c is incorrect because restrictive eating, hormone driven skin changes, and pubertal timing concerns belong to the teenage years. None of the three describes what happens to the body after 35. Option d is incorrect because these are reproductive and activity risks concentrated in the twenties and early thirties. Fertility questions do arise later, but they are not what defines this decade of screening.

Correct Answer: Stage of exhaustion with depleted resources

When a stressor outlasts the body's ability to sustain resistance, adaptive resources run out and stress related disease appears. Immunosuppression, infection, and gastrointestinal ulceration are the classic markers of the exhaustion stage. Option a is incorrect because alarm is brief and cannot be sustained for years. It is the immediate fight or flight surge, and this woman is four years past any initial mobilization. Option c is incorrect because during resistance the person still functions, often looking fine to everyone around her. Recurrent infection and a returning ulcer show the adaptation has already broken down. Option d is incorrect because the local syndrome confines itself to one tissue, as inflammation around a splinter does. Her findings are systemic, involving immunity and the gastrointestinal tract at once.

Correct Answer: Sitting with the client during and after meals

Supervising the client at meals and for a period afterward is observation and presence, which fits the assistive role. The nurse keeps assessment, teaching, and any change to the plan of care. Option b is incorrect because patient teaching is a nursing responsibility that cannot be handed off. Explaining why electrolytes shift during refeeding requires the clinical judgment to answer the questions that follow. Option c is incorrect because interpreting laboratory data sits squarely in the nurse's scope. Assistive personnel may transport specimens and relay values they are told to report, but they do not explain meaning. Option d is incorrect because changing a caloric prescription is a provider and dietitian decision carried out by the nurse. Advancing calories too quickly is exactly what triggers a dangerous phosphate shift.

Correct Answer: Assess his willingness to change now

After advising comes assessing, and in this framework assessing means gauging readiness and willingness to change rather than examining the client physically. Only then does the nurse move on to assisting. Option a is incorrect because arranging is the final step, used to set the follow up contact once a plan exists. Booking a return visit before knowing whether he wants to change puts the steps out of order. Option c is incorrect because assisting comes fourth and applies only to a client who is willing. Writing a plan for someone who has not agreed to change produces a document that goes straight in the bin. Option d is incorrect because the first step has already been completed. Repeating the identification question stalls the conversation at the beginning instead of moving it toward readiness and a concrete next move.

Correct Answer: Bulimia nervosa with purging behavior

Russell's sign on the knuckles, eroded enamel, and parotid swelling are the physical marks of self induced vomiting, and bulimia typically occurs at a normal weight. Weight alone never rules it out. Option a is incorrect because anorexia nervosa requires a significantly low body weight, and the restricting subtype by definition excludes regular purging. This client's weight and her oral findings both point away from it. Option b is incorrect because avoidant restrictive food intake disorder involves avoiding foods for sensory reasons or fear of choking. There is no body image concern and no compensatory vomiting to erode teeth. Option c is incorrect because binges without any compensatory behavior produce weight gain over time, not knuckle calluses and parotid swelling. Those marks come from the purging that this diagnosis specifically lacks.

Correct Answer: Do moderate aerobic activity weekly plus strength training

Adults need moderate aerobic activity through the week plus muscle strengthening on at least two days. The strength component is the specific countermeasure for the muscle and bone loss that define midlife. Option a is incorrect because a daily walk covers aerobic work while leaving resistance training out completely. Aerobic activity alone does not slow the loss of muscle mass or protect bone density. Option b is incorrect because tying activity to the absence of aches produces long gaps and eventual inactivity. Guidance is to move more and sit less, adapting the activity rather than waiting for a perfect day. Option d is incorrect because capping activity at brief post meal strolls sets the bar far below what a healthy 52 year old can reach. Some movement beats none, but this teaching understates the target.

Correct Answer: Chronic low back and neck pain

Acupuncture has its best support in chronic pain conditions such as low back pain, neck pain, and knee osteoarthritis, along with headache prevention and chemotherapy induced nausea. Effects are modest but real. Option a is incorrect because resistant hypertension needs a medical workup for secondary causes and drug adjustment. Needle therapy has not been shown to control blood pressure that is failing three agents. Option c is incorrect because asthma is an inflammatory airway disease treated with inhaled controllers. Claims that manual or needle therapies improve it are among the non musculoskeletal claims that evidence does not support. Option d is incorrect because colic and ear infections in infants belong to a list of conditions marketed to parents without credible research behind the claims. Neither responds to needling.

Correct Answer: Compassion satisfaction, which buffers against fatigue

Compassion satisfaction is the fulfillment that comes from doing the work well and finding meaning in it. High levels buffer a nurse against compassion fatigue and burnout, so building it deliberately is protective. Option b is incorrect because compassion discomfort names a transient unease that clears with rest, an early point on the road toward fatigue. This nurse reports fulfillment, not unease she has slept off. Option c is incorrect because reaction formation would have her acting warmly toward patients she secretly resents. Reading genuine meaning as a disguise for hidden hostility invents a conflict the stem never mentions. Option d is incorrect because denial refuses to acknowledge a painful reality. She acknowledges that admissions are difficult and still finds the work worthwhile, which is the opposite of shutting reality out.

Correct Answer: Meditation, music therapy, reminiscence, and guided imagery

Meditation, music therapy, reminiscence, relaxation therapy, therapeutic touch, and guided imagery are the holistic interventions the holistic model names, and they can be offered at every stage of health and illness. Option a is incorrect because those are physical nursing tasks aimed at tissue integrity. They are necessary care, but they address one body system rather than the person's mind, spirit, and environment. Option b is incorrect because monitoring vital signs and laboratory values gathers data. Surveillance tells the nurse how the resident is doing without doing anything to engage the resident in their own healing. Option d is incorrect because rehabilitation activities restore function and mobility, which is valuable but narrow. The holistic list the model names works through the mind and the emotions rather than through gait.

Correct Answer: Arrange immediate evaluation for cardiac instability

Bradycardia, orthostatic change, and low body temperature mark medical instability, and an adolescent can look well while the heart is at risk. These findings are the reason for admission rather than clinic follow up. Option a is incorrect because meal planning education matters later, once the client is medically stable. Teaching a client whose heart rate is dangerously slow does nothing about the problem in front of the nurse. Option b is incorrect because a counseling appointment days from now assumes the client is safe to go home. Vital signs this abnormal call for evaluation today, not a slot on next week's schedule. Option c is incorrect because weight and growth plotting are useful data that change nothing about the immediate danger. Gathering more measurements while the pulse stays this low simply delays the referral.

Correct Answer: Diversity, since each family is unique

Diversity means each family unit is unique. Two households reach the same clinical outcome by entirely different routes, which is why the nurse assesses this family rather than importing a template. Option a is incorrect because durability would be demonstrated by a connection surviving divorce, remarriage, or a move across the country. Neither family in this comparison has undergone a structural change. Option b is incorrect because coping with a sudden stressor is not what the stem measures. Both families are managing a chronic condition steadily, and no crisis has arrived for either of them to absorb. Option d is incorrect because the dynamic attribute describes interactions being altered inside one family when something changes. What stands out here is the contrast between two households, not change within either.

Correct Answer: It has not been clearly shown to work, but it is harmless.

The honest statement is that biofield practices have not been clearly shown to be effective for any purpose, while causing no physical harm. Comfort probably comes from presence, attention, and relaxation. Option b is incorrect because no scientific evidence supports the existence of the energy field these practices assume. Describing it as measurable overstates what is known and misleads a grieving family. Option c is incorrect because comparing a low quality body of research to opioid analgesia invents a finding that does not exist. Pain at the end of life still needs pharmacological management. Option d is incorrect because substitution is where the danger lies. A dying client who finds comfort in therapeutic touch is not harmed, but one who gives up symptom control for it is.

Correct Answer: Resiliency in coping with a stressor

Resiliency is the family's ability to cope with expected and unexpected stressors. The observable marker is role flexibility, and here two members picked up the tasks the injured father can no longer perform. Option a is incorrect because durability points to a bond that outlasts a change in structure, as when divorce and remarriage rearrange who lives where. Nobody has entered or left this household. Option c is incorrect because diversity is about how one family differs from another, not about how a single family handles a crisis. There is no comparison group anywhere in this stem. Option d is incorrect because the dynamic attribute would fit if the item stressed that communication and relationships were altered without saying whether it went well. This stem says plainly that the family managed.

Correct Answer: I will set boundaries and check in on myself.

The four prevention strategies are establishing professional boundaries, practicing self care, becoming self aware, and learning about compassion fatigue. Setting limits and monitoring her own state covers two of them directly. Option a is incorrect because picking up extra shifts is the boundary failure this condition feeds on. Nurses losing empathy often give more, not less, and from the outside it looks like dedication. Option b is incorrect because silence is exactly what lets the problem grow. Talking with colleagues, debriefing after hard cases, and accepting feedback from people who know her are protective, not indulgent. Option c is incorrect because education about the phenomenon is itself one of the four strategies. A nurse who does not know it exists reads her own symptoms as weakness and hides them.

Correct Answer: St John's wort with a transplant immunosuppressant

As a potent enzyme inducer St John's wort drives immunosuppressant levels down, and subtherapeutic levels lead to graft rejection. That outcome is irreversible, which puts this pairing ahead of the bleeding and glucose risks. Option b is incorrect because ginkgo plus aspirin does raise bleeding risk and belongs in the report. It is a monitoring concern with warning signs the nurse can watch for, not a silent path to organ loss. Option c is incorrect because ginger and ibuprofen add to each other's antiplatelet effect, a caution rather than an emergency. Gastric protection and bruising checks handle it, and no prescribed therapy stops working. Option d is incorrect because ginseng may lower blood glucose alongside the oral agent, which the team manages with closer monitoring. Hypoglycemia is detectable and treatable within minutes at the bedside.

Correct Answer: "What you say stays between us unless someone is being hurt."

Confidentiality is stated proactively and paired with its limits, harm to self, harm to others, and abuse. Naming the exception up front lets the teenager disclose knowing exactly what could be shared. Option a is incorrect because promising blanket privacy is a promise the nurse cannot keep. Disclosure of abuse or a suicide plan requires action, and breaking that promise destroys trust in health care for years. Option c is incorrect because announcing that the mother will hear everything guarantees an edited history. The adolescent will simply withhold the substance use, mood, and sexual health information the visit exists to uncover. Option d is incorrect because leaving the rules vague puts the teenager in the position of guessing. Teens who cannot predict what will be repeated tend to say very little, which is the outcome this approach produces.

Correct Answer: Menstrual periods that stopped three months ago

Amenorrhea in an adolescent athlete points to energy intake that is not covering training demands, a pattern seen in restrictive eating. It also threatens bone density during the years peak bone mass is built. Option a is incorrect because hunger after heavy training is the body asking for fuel and matching intake to output. That is the response the nurse hopes to see in a growing athlete. Option b is incorrect because modest weight gain during adolescence reflects the growth spurt and added lean mass. Loss, not gain, is the direction that raises concern in a teenager who is still growing. Option d is incorrect because delayed soreness follows unaccustomed exercise in anyone and resolves on its own. It carries no information about restriction, purging, or how this runner views her body.

Correct Answer: A single parent household

The single parent form arises two ways, through loss of a parent by death, divorce, or desertion, or when a single person decides to have or adopt a child. This is the second route. Option a is incorrect because alternative would apply to an unpartnered adult living alone with no child in her care. The presence of a child she parents moves this household into a different category. Option b is incorrect because two adults are required for the nuclear pattern. This mother has no partner in the home, so the count of adults rules the option out immediately. Option c is incorrect because extended households add aunts, uncles, grandparents, or cousins to a nuclear family. No relatives beyond this mother and her adopted daughter share the dwelling.

Correct Answer: Emotion focused strategies such as a bereavement group

Death cannot be undone, so relentless problem solving against it produces frustration and exhaustion. Emotion focused strategies such as support groups, journaling, and meaning making fit an uncontrollable stressor and are what he needs now. Option a is incorrect because more of the same is exactly what has not worked. Problem focused effort belongs with stressors that can be changed, and no amount of research alters the fact of her death. Option b is incorrect because encouraging a defense mechanism is not a nursing intervention. Refusing to acknowledge the loss would postpone grief work and leave him in the same place a year from now. Option d is incorrect because a dispute over billing is another controllable task he can throw himself into. It channels the same avoidance into a fresh target while the underlying sorrow stays untouched.

Correct Answer: Impaired decision making that reduces care quality

The professional category of compassion fatigue signs is the one that reaches patients. Impaired decision making, reduced quality of care, and errors put people at risk right now, so it outranks the personal signs. Option b is incorrect because lengthening breaks belongs under absenteeism, one of the six sign categories. It signals the problem and deserves attention, but no patient is harmed while she is off the floor. Option c is incorrect because emotional numbness is a genuine marker and often the first one relatives spot. Feelings alone do not endanger anyone, and the charge nurse is weighing immediate risk. Option d is incorrect because pulling back from friendships sits in the relationships category and describes damage to the nurse's own life. Serious as that is, it happens off duty and threatens no one under her care.