NR-222 Health and Wellness - Set 5 - Part 1

Correct Answer: Personalize the risk and offer to talk later

He is in precontemplation, so the matched intervention raises awareness with information personalized to him and keeps the door open. The goal at this stage is movement toward contemplation, not an action plan. Option a is incorrect because handing over a prescription for behavior he has not agreed to is the classic stage mismatch. He will discard it, and he will also learn that this nurse does not listen. Option b is incorrect because goal setting suits a client in preparation who has already decided to act. Pressing for a commitment from someone still unconvinced hardens resistance rather than softening it. Option d is incorrect because abandoning the topic permanently forfeits the cumulative effect of brief conversations. Each contact nudges a person along the change continuum even when nothing shifts on the day.

Correct Answer: Assess for hypoxia, infection, and medication effects

Delirium is a symptom of an acute physiologic derangement, so the first move is finding the cause. Oxygenation, worsening infection, drugs, electrolytes, pain, and retention all belong in that search. Option b is incorrect because reorientation is a supportive measure that treats nothing. It is worth doing, but a client who is hypoxic or septic will drift again within minutes of the reminder. Option c is incorrect because environmental modification helps agitation and belongs in the plan, yet it postpones the physiologic search. A quiet room does not correct the derangement producing the confusion. Option d is incorrect because restraints worsen delirium, raise injury risk, and are reserved for imminent danger. This client is safe, supervised, and in no need of physical restriction right now.

Correct Answer: "Thank you for telling me. That was not your fault."

Validating the disclosure and countering self blame comes first, followed by an assessment of current safety. The nurse does not need the narrative to deliver care that recognizes what happened. Option a is incorrect because pressing for the full account is interrogation, and repeated questioning re traumatizes. The nurse gathers only what safety and any reporting duty require, then refers for trauma specific treatment. Option b is incorrect because turning her disclosure into a clinical explanation makes her a case study rather than a person. She has just taken a risk, and analysis is not what meets that moment. Option d is incorrect because redirecting to happier memories tells her the topic is unwelcome. Suggesting that a survivor look on the bright side is a way of closing a conversation she just opened.

Correct Answer: Seven or more hours every night

The recommendation for adults aged eighteen through sixty is seven or more hours per night. It is stated as a floor because habitual short sleep raises risk of obesity, diabetes, hypertension, and cardiovascular disease. Option a is incorrect because feeling fine is a poor gauge of sleep sufficiency. People adapt to their own impairment, and measured performance after chronic restriction falls even when the person reports no problem. Option b is incorrect because the lower end of that range endorses six hours, which sits in the zone linked to cardiometabolic, cognitive, and mortality risk. Older sources carry that figure, current guidance does not. Option c is incorrect because ten hours belongs to school aged children rather than to working adults. Pushing an adult toward that total misreads a pediatric figure, and no evidence supports it for him.

Correct Answer: Offering earplugs and dimming the room lights

Offering earplugs, an eye mask, and lower lighting is a standardized comfort measure with a predictable outcome, so it fits within assistive personnel's scope. The nurse keeps the judgment, teaching, and evaluation steps. Option b is incorrect because deciding to omit an assessment requires weighing the client's stability. That is nursing judgment, and it usually requires a conversation with the prescriber before any overnight check is dropped. Option c is incorrect because client education cannot be handed off. Teaching a relaxation technique means assessing readiness, coaching the steps, and confirming understanding, all of which stay with the licensed nurse. Option d is incorrect because evaluation closes the nursing process and belongs to the nurse alone. Judging whether an intervention worked calls for comparing outcomes against the plan, which is beyond an assistant's role.

Correct Answer: Compassion fatigue from continuous exposure to suffering

Compassion fatigue is declining empathy that results from continuous exposure to sickness and suffering. The loss of the capacity to feel for patients, in a setting dense with death, is its defining mark. Option a is incorrect because moral distress arises when a nurse knows the right action and is blocked from taking it. Nothing here describes a barrier standing between her and what she believes is right. Option b is incorrect because vicarious trauma shows up as changed core beliefs about safety, trust, and the goodness of people. Her beliefs are intact; what has drained away is feeling. Option d is incorrect because compassion satisfaction is the pleasure a nurse takes in doing the work well. It protects against this picture rather than describing it, and she reports the opposite experience.

Correct Answer: Safety plan with her and offer advocacy resources

For a competent adult experiencing partner violence, the default is respecting autonomy. The nurse assesses safety, builds a safety plan, offers advocacy and hotline resources, documents objectively, and lets the client decide. Option a is incorrect because reporting a competent adult's abuse against her wishes is not universally mandated and can raise her danger. A child at risk in the home would change that calculation. Option b is incorrect because the period around separation is the most dangerous stretch for a survivor. Pushing an unplanned departure trades her judgment for the nurse's and removes the preparation that keeps her alive. Option c is incorrect because charting alone leaves her with nothing she can use. Respecting a decision is not the same as withholding help, and resources plus a plan are exactly what she can accept now.

Correct Answer: Alternative therapy replacing the prescribed drug

The metformin has been abandoned and the capsules put in its place, which is substitution. A non mainstream approach used instead of conventional medicine is alternative, and this pattern carries the risk of untreated disease. Option b is incorrect because complementary means the prescription continues while something is added beside it. Nothing was added here; the metformin was dropped, which changes the classification entirely. Option c is incorrect because integrative care requires conventional and non mainstream treatment to run together under one documented plan. This client acted alone and no clinician is monitoring the herbal capsules. Option d is incorrect because holistic refers to how a nurse frames care, attending to body, mind, and spirit at once. The question here is what happened to the prescribed medication.

Correct Answer: Slight slowing that is expected at this age

Cognitive decline is rare in middle adulthood. Reaction time and performance speed slow slightly while memory stays intact, and preserved management of finances and household confirms that function is not impaired. Option a is incorrect because a dementia picture involves losing ground on daily tasks, and family members usually raise the alarm before the person does. Here the client is the worried one and function is intact. Option b is incorrect because nothing in the scenario describes low mood, anhedonia, sleep change, or withdrawal. Depression can certainly blunt concentration, but the nurse would need those findings before naming it. Option c is incorrect because ordinary misplaced keys do not meet any threshold for emergency neuroimaging. Sudden deficits, disorientation, or lost calculation ability would change that, and none of them appear here.

Correct Answer: Delirium from an acute underlying cause

Acute onset over hours, a fluctuating course, inattention, and a shifting level of consciousness are the delirium picture. The baseline a week earlier was intact, which rules out a slow degenerative process. Option a is incorrect because dementia creeps in over months to years and families cannot date its beginning. This daughter can, and alertness in dementia stays normal until the disease is far advanced. Option b is incorrect because a depressed older adult is slowed and discouraged but stays oriented and can attend when engaged. Answers tend toward I do not know rather than agitation and line pulling. Option d is incorrect because nothing about postoperative recovery includes waxing and waning confusion. Treating this as expected delays the hunt for infection, pain, hypoxia, medication effect, or retained urine.

Correct Answer: Vicarious trauma with transformed core beliefs

Vicarious trauma is the cumulative transformation of the helper's inner world, changing what she believes about safety, trust, and control. The shift is in worldview and identity rather than in symptoms alone. Option a is incorrect because that condition empties out feeling for patients. This nurse still cares deeply, so much that her fear has followed her home into decisions about her own family. Option c is incorrect because a sudden onset after a single case is the marker of that syndrome, along with nightmares and hyperarousal. Six years of accumulation points somewhere else entirely. Option d is incorrect because burnout traces to workload, control, reward, and fairness on the job. Her locks and her children have nothing to do with staffing, and detachment is not what she describes.

Correct Answer: Conventional and complementary care are combined in one coordinated plan.

Integrative health brings conventional and complementary approaches together deliberately, in a single plan that the whole team knows about and monitors. Coordination is what separates it from a client adding something privately. Option a is incorrect because swapping herbal products for standard protocols is substitution, the definition of alternative use. An integrative program keeps the evidence based treatment running and adds to it. Option b is incorrect because integrative care does not wait for conventional treatment to fail. The two run alongside each other from the start, chosen together for symptoms such as nausea or anxiety. Option d is incorrect because leaving the medical team out defeats the whole point of the model. Undocumented therapies are invisible to the pharmacist and the prescriber, which is exactly the gap integration closes.

Correct Answer: Risky health behavior, chronic disease, and early death

Higher ACE counts are associated with risky health behavior, chronic health problems, low life potential, and early death, along with more suicide attempts, alcohol misuse, drug use, absenteeism, depression, and smoking. Option b is incorrect because it reverses the direction of the relationship. Adversity in childhood predicts worse adult health and reduced earning and educational attainment, which is the cluster described as low life potential. Option c is incorrect because smoking, heavy drinking, and work absenteeism all become more likely, not less. Substances that calm an over activated stress system are among the commonest coping strategies survivors use. Option d is incorrect because deterministic wording misstates what the evidence shows. These findings raise population level risk, and any option promising a certain outcome for an individual should be rejected.

Correct Answer: Dynamic quality of family interactions

Dynamic means family interactions are affected by configuration, structure, function, problem solving, and coping capacity. Illness in one member has altered function, communication, and roles, with no claim that the family is managing well. Option a is incorrect because durability turns on a bond that outlives changes to the family's makeup, such as divorce, remarriage, or distance. Membership in this household has not changed at all. Option b is incorrect because resiliency requires evidence that the family absorbed the stressor and kept functioning, usually with someone stepping into a vacated role. Here nobody has picked up the chores. Option c is incorrect because diversity is the observation that every family unit is unique, illustrated by comparing households that organize themselves differently. The stem describes one family and one event.

Correct Answer: Ringing in the ears after each shift

Tinnitus after shifts signals noise exposure that is already damaging hearing, and the damage does not reverse. Hearing conservation, protection, and audiometry are the follow up this occupational finding demands. Option b is incorrect because seven hours meets the adult sleep target. Shift work does disrupt circadian rhythm, but this client is reaching the recommended amount, so it is not the finding to chase first. Option c is incorrect because spending the shift on foot is activity, and activity is protective. The nurse would ask about footwear and back strain, yet nothing here suggests an injury has occurred. Option d is incorrect because bringing food from home usually improves diet quality compared with vending machines. It is a habit worth reinforcing, not a red flag that pulls the nurse away from a hazard.

Correct Answer: I quit my pain pills and see only my chiropractor now.

Stopping the prescribed analgesic and relying on spinal manipulation alone is substitution, which defines alternative use. The same chiropractic visits would be complementary if the pain medication had continued alongside them. Option a is incorrect because heat is layered onto a drug regimen that continues unchanged. Adding something on top of conventional treatment is the textbook picture of a complementary approach. Option c is incorrect because shared documentation between the acupuncturist and the provider signals a coordinated plan. That arrangement, with one record and one team, is what integrative health means. Option d is incorrect because the muscle relaxant is still being swallowed every day. Meditation sits beside the prescription instead of replacing it, so no conventional therapy has been given up.

Correct Answer: Substance use, unplanned pregnancy, and work injury

Substance use disorder, unplanned pregnancy, sexually transmitted infections, job related stress, and work related injuries or exposures are the named risks of young adulthood. A worksite session should target exactly those. Option a is incorrect because falls, medication burden, and skin breakdown are geriatric syndromes tied to reduced reserve and multiple prescriptions. Workers in their twenties rarely carry any of those exposures. Option b is incorrect because loss of near vision, muscle mass, and bone density begin to show in the middle adult years. A 25 year old is at the physical peak rather than the start of decline. Option d is incorrect because the menopausal transition, children leaving home, and caring for aging parents cluster between roughly 35 and 65. Aiming a session there would miss what this workforce is facing.

Correct Answer: Fish oil and vitamin E capsules

Fish oil and vitamin E both have antiplatelet activity, so they add to surgical bleeding risk. Products like these are commonly stopped one to two weeks before surgery on the surgeon's direction. Option a is incorrect because calcium with vitamin D supports bone mineralization and carries no bleeding or anesthetic interaction. It stays on the medication list but raises no perioperative alarm. Option b is incorrect because a nightly cup of chamomile is a mild sedative beverage in ordinary amounts. Documenting it is enough; nothing about it changes the operative plan or the anesthetic. Option c is incorrect because a standard multivitamin delivers nutrients at ordinary daily value amounts. The problems come from concentrated single ingredient products, and this one supplies none of them.

Correct Answer: Explain it may be given after a shared decision

HPV vaccine is routinely recommended through age 26 for those not adequately vaccinated, and for adults from 27 through 45 it may be given by shared clinical decision making with the provider. Option a is incorrect because the vaccine is licensed and available well past 26. It stops being a routine recommendation at that point, which is not the same thing as being barred. Option b is incorrect because no waiting period applies and delay only extends the window of susceptibility. Telling a client to hold off leaves her unprotected while an available option sits unused. Option d is incorrect because most adults have met some strains but rarely all of them. Assuming universal prior exposure would write off benefit that a discussion with her provider is meant to weigh.

Correct Answer: Assess the household's concrete needs and supports

Assessment precedes intervention, and this household carries stacked risks, bereavement, adversity in the children, caregiving strain, and limited income. Finding out what they need and who helps drives every referral that follows. Option a is incorrect because reciting a demographic trend does nothing for a family in front of the nurse. Normalizing has its place after the nurse knows what this grandmother is actually up against. Option b is incorrect because a referral chosen before assessment often lands on the wrong problem. Grief support may well help, but transportation, food, and housing may be the barriers that decide whether anyone attends. Option c is incorrect because joint protection teaching addresses one chronic condition while the household's stability is unexamined. Her arthritis matters, though it is not the reason this family was referred for a visit.