NR-222 Health and Wellness - Set 1 - Part 3

Correct Answer: The patient centered medical home model

The medical home is a way of delivering primary care in which the practice acts as the hub, providing comprehensive, patient centered, coordinated, accessible care and holding itself to quality and safety commitments. Option b is incorrect because that arrangement is a network of hospitals, practices, and post acute providers accepting shared accountability for a population's cost and quality. A single practice is far too small a unit for it. Option c is incorrect because that mechanism pays a set amount for each hospital discharge according to the diagnosis group. It shapes how money flows rather than describing how a practice organizes care. Option d is incorrect because such a committee judges whether admissions and treatments are medically necessary and delivered at the right level. Its work is oversight, and it coordinates nothing for an individual client.

Correct Answer: "I stopped my cholesterol pill because my heart feels fine."

Stopping a lipid lowering drug because symptoms have eased misunderstands why it was started. That medication limits progression of established coronary disease, so the nurse must correct the belief before another event occurs. Option a is incorrect because gradually increasing distance is the whole design of a rehabilitation program. Building endurance under supervision is the outcome the group exists to produce, so the statement is reassuring. Option b is incorrect because taking the drug consistently at a fixed time is precisely the adherence pattern the nurse hopes to hear. Pairing a dose with breakfast is a sensible cue rather than a problem. Option d is incorrect because including a spouse strengthens the support at home and spreads understanding of the regimen. Family involvement helps the plan survive after the program ends, so nothing here needs correcting.

Correct Answer: The neighborhood and built environment domain

Air pollution and substandard housing are physical conditions located in a place, which is exactly what this domain covers. The highest-value intervention is remediating the home triggers, not simply increasing the inhaler dose. Option a is incorrect because nothing in the stem describes income, employment, or the ability to pay for anything. Poverty may well sit behind this housing, but the determinants actually named are physical hazards. Option c is incorrect because that domain covers relational harms such as discrimination, isolation, bullying, and incarceration. Mold and traffic exhaust are not relationships; they are features of the building and the street. Option d is incorrect because access problems look like no insurance, no usual provider, or an appointment nobody can get. This child is already receiving care; what keeps failing is the environment he goes home to.

Correct Answer: "I could never stick a needle into myself, no matter what."

Self-efficacy is the client's confidence in carrying out a specific behavior, and this statement reports none. Without it the insulin will not be given, so the nurse breaks the task into small steps and uses return demonstration. Option b is incorrect because storing the pen in the refrigerator door is a reasonable, workable plan. It shows the client has thought about where the insulin will live, which supports rather than threatens adherence. Option c is incorrect because knowing when to telephone the clinic is exactly what safe self-management sounds like. That statement would reassure the nurse, not prompt an extra teaching session before the client leaves. Option d is incorrect because a written record is a self-monitoring strategy that strengthens the new routine. Clients who build a tracking habit tend to sustain the behavior, so this needs praise rather than intervention.

Correct Answer: "Recommended screening carries no copayment on most plans."

The Affordable Care Act requires most plans to cover recommended preventive services, including cancer screening, with no cost sharing when the service is delivered in network. That fact removes a real barrier here. Option a is incorrect because clinics do price many services, yet a recommended screening covered without cost sharing is not negotiated site by site. Sending this woman out to compare prices leaves the barrier where it stood. Option b is incorrect because deductibles apply to most medical care, which is exactly why the statement sounds right. Recommended preventive services are the carved out exception, and repeating the general rule sends her away unscreened. Option c is incorrect because hardship programs exist for people without insurance, and this client already holds a policy. Routing her through an application for a benefit she is entitled to adds delay rather than access.

Correct Answer: Plan a walk or gum for those moments

He is in action, where relapse risk is highest and substitution works. Counter-conditioning replaces the cigarette with another behavior at the exact trigger points he has already identified for the nurse. Option a is incorrect because reopening the decision undermines a client who has already stopped. Questions about whether to quit belong far earlier, when the person is still weighing the change rather than living it. Option b is incorrect because passive waiting leaves him without a strategy at the moment he most needs one. Cravings after meals are predictable, and predictable triggers deserve a rehearsed response prepared in advance. Option d is incorrect because risk information is consciousness raising, a process used mainly with people who have not yet decided. This client decided three weeks ago and needs practical tools, not more reasons.

Correct Answer: An assisted living community with personal care

Assisted living offers long term care in a home like environment with more resident autonomy and privacy than a nursing facility, while staff assist with activities of daily living and with medications. Option a is incorrect because that setting delivers intermediate and skilled services for people recovering from acute illness or living with heavy care needs. Its structure trades away the privacy this daughter is asking about. Option b is incorrect because a daytime program serves people who live alone or with family and return home each evening. It supplies health and social services during the day but no place to live. Option c is incorrect because that program is family centered care for someone approaching the end of life who is no longer seeking cure. Nothing in the question suggests the mother has a terminal illness.

Correct Answer: Activate the rapid response team for the client

Advocacy means acting to protect the client rather than simply passing a concern along. Calling rapid response escalates a deteriorating picture through a system built for the moment a provider does not respond. Option a is incorrect because a careful chart entry protects the record while the client keeps sliding. Writing down what happened is necessary, yet by itself it leaves the danger exactly where the nurse found it. Option b is incorrect because a second opinion from a peer costs time the client may not have. Confusion with rapid breathing after surgery already justifies escalation without another round of confirmation. Option d is incorrect because rounds run on a schedule that has nothing to do with how fast this client is changing. Waiting hands the decision to the clock instead of to the nurse's own judgment.

Correct Answer: Arrange non-emergency medical transportation for her treatments

Transportation is a built environment determinant and a leading cause of missed care. Many Medicaid plans cover non-emergency medical transportation, so arranging a ride removes the actual obstacle instead of restating the risk. Option b is incorrect because she is not missing treatment out of ignorance. Explaining the danger of skipped dialysis adds knowledge to a client whose problem is that no vehicle reaches the unit. Option c is incorrect because refusal implies a choice she never made. Recording the barrier accurately, rather than a label, is what lets the next clinician and the dialysis unit solve the right problem. Option d is incorrect because handing the search back to the client leaves her with the same gap she already reported. Formal transport programs exist for this situation, and connecting her to one is nursing work.

Correct Answer: The preparation stage

Preparation means commitment plus a concrete plan for roughly the next month, usually with small steps already taken. Buying patches, telling family, and naming a quit day are exactly those steps. Option a is incorrect because contemplation stops short of commitment. A client still weighing whether to change does not purchase aids or announce a date, and those actions mark the shift beyond ambivalence. Option c is incorrect because the behavior itself has not changed yet. She is still smoking today, and action begins only once the overt change has been made and is being actively sustained. Option d is incorrect because termination, where it is taught at all, means complete confidence and zero temptation after years without the behavior. A client who has not yet stopped is nowhere near that endpoint.