NR-222 Health and Wellness - Set 1 - Part 1

Correct Answer: "Rehabilitation begins on admission, not at discharge."

Rehabilitation starts the day a client is admitted, focusing from the first shift on preventing complications and preserving function. Waiting for stability or for discharge costs mobility that is very hard to regain. Option b is incorrect because a written order sets specific therapy sessions in motion, not the whole rehabilitative approach. Positioning, range of motion, and early mobility belong to nursing from the first hours. Option c is incorrect because contractures, pressure injuries, and deconditioning develop during exactly the days this answer would spend waiting. By the time the acute phase closes, some of the loss is already permanent. Option d is incorrect because coverage decisions govern where a client receives intensive therapy later. Tying the start of rehabilitation to an approval letter hands a clinical timeline to an administrative process.

Correct Answer: "Exposure is not disease, so this stays primary prevention."

Exposure only means the person met the organism. Rabies has not developed, so the vaccine still aims to keep disease from ever starting, which keeps this action at the primary level. Option a is incorrect because the two are separated by the whole prepathogenesis phase. A person can meet rabies virus and never develop the infection, which is precisely what the vaccine is given to accomplish. Option b is incorrect because timing relative to contact never decides the level. What decides it is whether the disease process has begun in this person, and here nothing has begun. Option c is incorrect because tertiary prevention requires established or irreversible illness. A bite wound is an exposure event, and treating it as rabies confuses the injury with an infection nobody has acquired.

Correct Answer: Wellness and illness coexisting on the continuum

The continuum is dynamic, and wellness and illness are not opposites on it. A client with progressive disease can still move toward high-level wellness through adaptation, meaning, and functional ability within her limits. Option b is incorrect because multiple sclerosis is a chronic condition that persists rather than resolving. Nothing in the scenario suggests the disease has gone away, and adaptation to lasting impairment is not the same as cure. Option c is incorrect because denial shows up as refusing to acknowledge the illness and changing nothing. This client reorganized her home and her routine, which is the opposite of refusing to face what is happening. Option d is incorrect because this description fits the clinical model, where health means no signs or symptoms. Advanced multiple sclerosis involves clear pathology, so calling it an absence of disease misreads the diagnosis.

Correct Answer: Restorative care through a rehabilitation program

Rehabilitation is one of the three components of restorative care and works to return a client to the fullest physical, mental, social, vocational, and economic potential possible through combined therapy services. Option a is incorrect because a nursing center provides intermediate and custodial services around the clock for people with chronic or debilitating conditions. This client is on a recovery trajectory toward going home. Option b is incorrect because community programs work on risk factors in populations through immunization, screening, and education. Therapy after a joint replacement addresses a problem that has already occurred in one person. Option d is incorrect because highly specialized technology intensive services describe intensive care, transplant, and trauma programs. A therapy unit is staffed for function and independence, not for that level of complexity.

Correct Answer: The value and belief pattern

The value and belief pattern records the values, beliefs, spiritual practices, and goals that guide a person's choices and decisions. A faith that governs which treatments are acceptable belongs there. Option b is incorrect because role and relationship data cover family structure, who does what at home, and how illness changes those arrangements. This client is describing what she believes rather than what she does. Option c is incorrect because activity and exercise assesses movement, leisure, and the ability to manage daily living tasks. Religious practice appears there only when it involves physical activity, which is never mentioned. Option d is incorrect because sleep and rest tracks hours slept, perceived adequacy, and anything that interferes with sleeping. No rest problem is raised, so filing a belief statement there would misplace the data.

Correct Answer: State a concern and offer information later

In precontemplation the nurse raises awareness without pushing a plan. Expressing concern non-judgmentally, offering information when he wants it, and preserving the relationship keeps a later conversation possible rather than closing it off. Option a is incorrect because a program referral is an action-stage tool aimed at someone already committed. Offered to a client who refuses the topic, it is the classic mismatch and usually ends the conversation. Option b is incorrect because setting a date belongs in preparation, once the client has decided to change. Asking a man who will not discuss quitting to name a day skips several stages at once. Option d is incorrect because decisional balance work is matched to contemplation, where ambivalence exists to explore. This client reports no ambivalence, so weighing pros and cons has nothing yet to work with.

Correct Answer: Novice, because these situations are unfamiliar

Benner ties skill level to experience with specific clinical situations rather than to years worked. A nurse entering an unfamiliar specialty has no experience with its situations and returns to the novice stage there. Option a is incorrect because time served is the distractor Benner's model was built to defeat. Expertise attaches to a domain, so it does not travel across the hallway with the nurse who earned it elsewhere. Option b is incorrect because much of what she carries over is general rather than obstetric. Perceiving a laboring woman as a whole picture requires cases she has never seen, and her question about the strip shows she lacks them. Option c is incorrect because conscious planning toward long range goals assumes she knows what the goals of this specialty are. She cannot yet predict the course of labor, so that deliberate planning is out of reach.

Correct Answer: Build the plan around the client's stated goal

Health is a state people define through their own values, personality, and lifestyle. A plan anchored to what this client cares about will hold, while one built only on the nurse's criteria usually fails. Option b is incorrect because a laboratory target is the nurse's definition of success rather than the client's. Numbers still matter clinically, but leading with them substitutes professional values for the ones driving this client. Option c is incorrect because dismissing the goal as unmeasurable damages the partnership the teaching depends on. Walking down an aisle is in fact measurable through endurance, glycemic stability, and preserved sensation in the feet. Option d is incorrect because delay wastes the strongest motivation this client will ever have. Readiness is high right now, and postponing until the event is over removes the very reason she wants to manage her diabetes.

Correct Answer: Clinical nurse specialist first, clinical nurse leader second

The clinical nurse specialist works through three spheres of influence and is one of the four advanced practice roles. The clinical nurse leader is a master's prepared generalist at the point of care and is not. Option a is incorrect because a faculty member or staff development specialist teaches learners and designs curriculum. Neither half of the student's description mentions teaching programs, so this pairing misses on the first term. Option b is incorrect because it reverses the order and misnames the second role. The generalist described belongs in the second slot, and a practitioner diagnoses and manages conditions rather than overseeing a cohort's care. Option c is incorrect because a practitioner assesses, orders tests, prescribes, and manages acute and chronic conditions, often as a primary care provider. That work does not match the three spheres described first.

Correct Answer: Cardiac rehabilitation is tertiary prevention in restorative care

Cardiac rehabilitation restores function after established heart disease, which makes it tertiary prevention, and it reaches clients through restorative services aimed at recovery. Both labels apply because they come from separate systems. Option a is incorrect because the two adjectives happen to match, which is the trap. Screening is indeed secondary prevention, yet it is usually delivered in a primary care office rather than by a specialist. Option b is incorrect because a unit like that is tertiary care, a statement about complexity and setting. Much of what happens there is treatment of acute illness that fits no prevention level whatsoever. Option d is incorrect because an immunization clinic sits in the preventive layer, the broad base of the pyramid, not in first contact practice. Only the prevention half of the pairing survives inspection.

Correct Answer: Tertiary care, providing highly specialized services

Burn units concentrate technology and specialized expertise for complex injuries and accept referrals from less specialized hospitals. That combination of complexity and specialization defines tertiary care in the health services pyramid. Option a is incorrect because first contact care is the broad entry point for any new complaint, delivered close to home and continued over years. Nobody walks into a burn unit as their usual source of care. Option c is incorrect because recovery focused services come later, once the acute injury is survived. Rehabilitation and home health rebuild function, whereas the burn unit exists to keep the client alive through the critical phase. Option d is incorrect because ongoing services for dependent or terminally ill people run over indefinite periods in nursing centers, assisted living, and hospice. A burn unit admission is intense and time limited instead.

Correct Answer: Coach both nurses about the at-risk behavior

Just culture matches the response to the behavior rather than to the outcome. Both nurses drifted into the same at-risk shortcut, so both receive coaching along with removal of whatever made the shortcut attractive. Option b is incorrect because it lets the roll of the dice decide who is punished. Identical choices produced different results by chance, and grading the response by damage rewards luck rather than changing behavior. Option c is incorrect because consoling is the answer to an inadvertent slip or lapse that the person never intended. Skipping a scanning step is a chosen shortcut, and treating it as an accident leaves the drift in place. Option d is incorrect because punishment is reserved for conscious disregard of a substantial and unjustifiable risk. Neither nurse recognized the danger, and a punitive answer here drives future reporting underground.

Correct Answer: Assisting the client with a bed bath

Bathing is a routine activity of daily living with a predictable outcome and requires no nursing judgment, which makes it delegable. The nurse still directs the aide and stays accountable for the result. Option a is incorrect because instructing a spouse means gauging what he already understands and correcting his technique as he practices. That responsiveness is nursing judgment, and instruction cannot be handed to an aide. Option b is incorrect because judging whether the program is working compares progress against the outcome the nurse wrote. Evaluation stays with the registered nurse in every setting, home health included. Option d is incorrect because checking swallowing after a stroke protects the airway, and a wrong call ends in aspiration. Screening of that kind falls far outside an aide's scope no matter how experienced she is.

Correct Answer: Health belief model, then health promotion model

The Health Belief Model is threat based and explains why people act to avoid disease. Pender's model is not fear based; it targets well-being through enjoyment of the activity and interpersonal support. Option a is incorrect because the order is reversed. Describing how disabling a stroke would be raises perceived severity, which is threat work, while finding an enjoyable class with a companion is approach motivated. Option b is incorrect because nothing in the first scenario identifies where the client sits in a sequence of readiness. Stages of change would require language about intention and timing, which the stem never supplies. Option c is incorrect because its second half misnames the model. A needs model would rank oxygen, food, and safety by urgency, whereas activity-related affect and interpersonal influence are Pender's signature variables.

Correct Answer: Respectful and Equitable Practice, showing cultural humility

This standard covers practicing with cultural humility and inclusiveness, and securing a qualified interpreter instead of leaning on a family member is the example the standard is written around. Option a is incorrect because that standard addresses how effectively the nurse conveys information in professional practice generally. The point of the scene is equity of access to care, not the mechanics of getting a message across. Option c is incorrect because stewardship concerns choosing safe and effective services without waste. Bringing in a paid interpreter costs money the nurse spends willingly, so cost containment is not the value on display. Option d is incorrect because working with stakeholders means partnering with the client, family, and other disciplines on the plan. Booking an interpreter enables that partnership rather than being an instance of it.

Correct Answer: Advanced beginner during the first year

New graduates sit at the advanced beginner stage for roughly the first year. They have enough real experience to recognize recurring aspects of a situation, yet they stay task focused and need support to set priorities. Option b is incorrect because the entry stage belongs to students and to nurses meeting a specialty for the very first time. Three months of practice has already given this graduate patterns a true beginner would not hold. Option c is incorrect because mastery of that kind arrives after two or three years in the same role. A nurse who cannot yet order the morning's tasks has not reached the deliberate planning that stage requires. Option d is incorrect because reading a situation as a whole and sensing when it deviates from the expected takes several more years of varied cases. Nothing in this description shows that kind of pattern sense.

Correct Answer: Quality of Practice, contributing to nursing quality

Measuring how a unit process performs and testing an improvement is professional role behavior rather than care of one client. This standard covers a nurse's contribution to the quality of nursing practice. Option a is incorrect because that standard means collecting data pertinent to one person's health or situation. Wait times across a whole unit describe a process, and no individual is being assessed anywhere in the story. Option b is incorrect because carrying out a plan means performing interventions, coordinating, and teaching for the client that plan was written for. Redesigning a workflow reaches far beyond any single plan of care. Option c is incorrect because judging progress compares one client's result against the outcome written for that client. Here the nurse weighs a system's performance over weeks, which the practice standards were not built to describe.

Correct Answer: Fourth-grade reading proficiency among local children

Fourth-grade reading proficiency is one of the twenty-three Leading Health Indicators, chosen because it is measurable, modifiable, and upstream. Several indicators are social rather than clinical, which is exactly the point the framework makes. Option a is incorrect because an objective missing reliable baseline data is developmental. Every indicator is drawn from the core set, since a measure with no data cannot be tracked toward a target. Option b is incorrect because that describes a research objective, where the evidence for what works is the gap. Indicators must be modifiable through interventions that have already been shown to succeed. Option d is incorrect because a locally written question has no national baseline behind it. The value of using an indicator is that the committee can compare its county against published national numbers and targets.

Correct Answer: An employee has a newly positive tuberculin test

A newly positive tuberculin test means infection is already present and silent. Secondary prevention pays off only when an abnormal result moves quickly to evaluation and treatment, so this worker needs attention now. Option b is incorrect because refusing influenza vaccine costs an opportunity for specific protection and nothing more. The nurse should revisit the offer, yet no illness is developing that demands action today. Option c is incorrect because curiosity about a cessation class is an opening for health promotion, not a clinical finding. It can be answered any time this week without any risk to the employee. Option d is incorrect because supplying hearing protection is routine primary prevention that any staff member can arrange. Damage has not begun, so the request never competes for the nurse's first attention.

Correct Answer: Palliative care alongside ongoing cancer treatment

Palliative care manages symptoms and suffering at any stage of serious illness and may run concurrently with treatment aimed at cure or control. Nothing about it requires this client to stop chemotherapy. Option a is incorrect because that program serves people near the end of life who have set curative treatment aside. Enrolling would mean giving up the chemotherapy this client is still receiving, which she has not chosen to do. Option c is incorrect because short term relief is arranged for the benefit of a family member worn down by caregiving. The client is asking about her own symptoms, and no exhausted caregiver appears in the scenario. Option d is incorrect because intermediate facility services bridge hospital and home for someone who cannot yet manage independently. This woman wants symptom relief where she lives, not a change of address.