What ethical dilemma exists?

Who are the stakeholders and what gains or losses do each have?

What strategies should the hospice nurse take to resolve the ethical dilemma?

QUESTION 4:

Chapter 4, Health Education and Health Promotion

he community health nurse is planning a health promotion workshop for a high school PTSO (Parent-Teacher-Student Organization). The choice of topics was suggested by the high school’s registered nurse who has observed a gradual increase in student obesity. The two nurses have collaborated to develop this workshop to provide parents, students, and teachers with information about the importance of health promotion. (Learning Objectives 6, 8, and 9)

a. Describe the importance of a focus on health promotion.

b. According to the health promotion model developed by Becker (1993), what four variables influence the selection and use of health promotion behaviors?

c.       Describe four components of health promotion.

QUESTION 5: Chapter 5, Adult Health and Nutritional Assessment

The registered nurse prepares to conduct a nutritional assessment on Mrs. Varner, a 52-year-old Caucasian female who describes herself as “overweight most of my adult life.” The client states that her health is good. She works part time as a receptionist and volunteers about 10 hours per week in her church. The nurse obtains Mrs. Varner’s height as 64 inches and her weight as 165 pounds. (Learning Objective 8)

a. What is the rationale for computing body mass index? What is Mrs. Varner’s BMI?

b. Calculate her ideal body weight. What is your assessment of her BMI and weight?

c. Based on Mrs. Varner’s BMI and weight, the nurse measures her waist circumference. Describe the proper procedure for this assessment.

d. Mrs. Varner’s waist circumference is 38 inches. What is your assessment?

e. What laboratory values would the nurse review to evaluate Mrs. Varner’s protein levels?

QUESTION 6: Chapter 6, Individual and Family Homeostasis, Stress, and Adaptation

Mary Turner stepped on a nail 5 days ago and sustained a puncture about 1 inch deep. She immediately cleaned the area with soap and water and hydrogen peroxide, and applied triple antibiotic ointment to the site. Today she comes to the clinic with complaints of increased pain and swelling in her foot. On assessment, the nurse notes that the puncture site is red and edematous, and has a moderate amount of yellowish drainage. (Learning Objective 9)

a. Describe the sequence of events that caused the local inflammation seen in Mary’s foot.

b. What is the role of histamine and kinins in the inflammatory process?

c. Which of the five cardinal signs of inflammation does Mary exhibit?

d. Because Mary’s injury occurred 5 days ago, the nurse should assess for what systemic effects?

QUESTION 7:

Chapter 7, Overview of Transcultural Nursing

The nurse manager of an ambulatory care clinic has noted an increased number of visits by patients from different countries and cultures, including patients from Mexico and other Latin American countries. Concerned about meeting the needs of this culturally diverse population, the nurse manager convenes a staff meeting to discuss this change in patient demographics, and to query the staff about any learning needs they have related to the care of these patients. (Learning Objective 3)

a. What strategy to avoid stereotyping clients from other cultures should the nurse include in this meeting?

b. Identify culturally sensitive issues to be discussed in the staff meeting.

c. One technician on the staff complains that some patients never make eye contact, and this makes it difficult for him to complete his work. How should the nurse respond?

QUESTION 8: Chapter 8, Overview of Genetics and Genomics in Nursing

Mr. Wayne is a 38-year-old man with a significant family history of elevated cholesterol levels. His father died at age 42 from a massive heart attack secondary to elevated cholesterol and triglycerides, and two of his older siblings are currently taking medications to lower their cholesterol levels. Mr. Wayne makes an appointment to discuss his risk for hypercholesterolemia. The nurse recognizes that Mr. Wayne is at risk for familial hypercholesterolemia because this is an autosomal dominant inherited condition. (Learning Objective 2)

a. Describe the pattern of autosomal dominant inheritance.

b. Mr. Wayne asks what chance his children have of developing familial hypercholesterolemia. How should the nurse respond?

c. Explain the phenomenon of penetrance observed in autosomal dominant inheritance.

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