Chapter 1 Accessing Your Health

Multiple Choice
1. Which of the following individual choices has a major effect on both current health and projected life expectancy?
A. Genetic tendency toward obesity.
B. Pollution
C. Level of education
D. Smoking
ANS: D
DIF: 2
REF: 3
MSC: Analyzing

2. The medical model of health would most likely focus on which of the following?
A. Controlling air and water pollution
B. Lifestyle interventions to prevent chronic diseases
C. Treating bacterial infections with antibiotics
D. Serving marginalized populations
ANS: C
DIF: 2
REF: 6
MSC: Understanding

3. The number of years a person is anticipated to live based on conditions at the time of birth is
A. life expectancy.
B. population control.
C. mortality.
D. morbidity.
ANS: A
DIF: 2
REF: 4
MSC: Understanding

4. Which of the following were cited by college students in a national survey as major impediments to performing well academically?
A. Pressure from parents and family members
B. Stress, anxiety, and sleep difficulties
C. Repeated strep infections
D. Carrying a too-heavy course load
ANS: B
DIF: 1
REF: 3
MSC: Understanding/Analyzing

5. What is the leading cause of death in the United States across all age groups?
A. Heart disease
B. Cancer
C. Cerebrovascular disease
D. Unintentional injuries
ANS: A
DIF: 1
REF: 4
MSC: Understanding
6. Which of the following describes the rate of deaths within a certain population?
A. Prevalence
B. Life expectancy
C. Mortality
D. Morbidity
ANS: C
DIF: 2
REF: 4
MSC: Understanding

7. Heart disease, cancer, and diabetes are examples of
A. chronic disease.
B. hereditary disease.
C. communicable disease.
D. acute disease.
ANS: A
DIF: 1
REF: 4
MSC: Remembering

8. Since the early 20th century, the life expectancy of Americans has
A. increased by more than 10 years.
B. increased by more than 20 years.
C. increased by more than 30 years.
D. increased by more than 40 years.
ANS: C
DIF: 2
REF: 4
MSC: Understanding

9. Healthy life expectancy refers to the number of years a person can expect to live
A. while covered by Medicare.
B. without chronic pain, disability, or significant illness.
C. without pain or short-term or long-term disability.
D. without cancer or diabetes.
ANS: B
DIF: 2
REF: 5
MSC: Remembering

10) Life expectancy 100 years ago was largely determined by
A. medical history.
B. lifestyle choices.
C. susceptibility to chronic disease.
D. susceptibility to infectious disease.
ANS: D
DIF: 1
REF: 4
MSC: Understanding/Evaluating

11. The term health is often interchangeable with the term
A. adaptability.
B. flexibility.
C. wellness.
D. pain-free.
ANS: C
DIF: 2
REF: 6
MSC: Remembering
12. Jerome eats healthy foods, exercises regularly, gets eight hours of sleep each night, and rarely becomes ill. His ability to ward off illness is related to which dimension of health?
A. Social
B. Intellectual
C. Physical
D. Emotional
ANS: C
DIF: 2
REF: 8
MSC: Applying

13. Jasmine has many friends, is respected by her coworkers, and maintains a great relationship with her boyfriend. Her ability to interact with others exemplifies which dimension of health?
A. Social
B. Intellectual
C. Emotional
D. Physical
ANS: A
DIF: 2
REF: 8
MSC: Applying

14. Rashid volunteers weekly to help pick up trash in his neighborhood. This action contributes to improving which dimension of his health?
A. Intellectual
B. Social
C. Environmental
D. Spiritual
ANS: C
DIF: 2
REF: 9
MSC: Applying

15. Which of the following best describes emotional health?
A. Ability to be self-sufficient
B. Ability to solve problems
C. Ability to express or control feelings
D. Ability to adapt to various social situations
ANS: C
DIF: 2
REF: 9
MSC: Understanding

16. An example of intellectual health is
A. having a sense of meaning and purpose in your life.
B. successfully interacting with others.
C. having low self-efficacy.
D. having a healthy curiosity about life in general.
ANS: D
DIF: 2
REF: 9
MSC: Understanding
17. Which of the following best describes spiritual health?
A. Possessing and expressing a purpose in life
B. Expressing emotions
C. Having satisfying relationships
D. Being able to reason and think objectively
ANS: A
DIF: 1
REF: 9
MSC: Understanding

18. A multidimensional concept of health that includes elements of physical, mental, emotional, and social function is
A. physical and emotional health.
B. holistic health care.
C. health-related quality of life.
D. healthy life expectancy.
ANS: C
DIF: 2
REF: 5
MSC: Understanding

19. The first step in modifying your health behavior to achieve overall wellness is to
A. review your medical records and schedule a physical examination by a doctor.
B. become aware of individual behaviors that contribute to or detract from your health.
C. complete a detailed behavior change contract.
D. find a reliable support person or support group.
ANS: B
DIF: 2
REF: 10
MSC: Understanding

20) Holistic wellness involves
A. integrating mind, body, and spiritual components.
B. taking nutritional supplements daily.
C. combining exercise with some form of meditation.
D. consuming organic foods and being treated by a naturopathic doctor.
ANS: A
DIF: 2
REF: 9
MSC: Applying

21. The range of factors that influence a person's health status are known as
A. ethnic or cultural traditions.
B. determinants of health.
C. age-related conditions.
D. genetic influences on health.
ANS: B
DIF: 2
REF: 9
MSC: Understanding

22. Determinants of health include
A. personal, social, economic, and environmental factors.
B. physical, intellectual, spiritual, and cultural factors.
C. nutritional, social, financial, and environmental factors.
D. genetic and lifestyle factors.
ANS: A
DIF: 2
REF: 9
MSC: Understanding
23. Which of the following methods is an example of successful lifestyle change?
A. Making a New Year's resolution to stop smoking again after failing in the past
B. Creating a demanding workout plan in hopes of someday losing weight
C. Beginning a daily walking program and gradually increasing your time and distance
D. Stopping smoking "cold turkey"
ANS: C
DIF: 2
REF: 16
MSC: Applying

24. Jackson made a goal to quit smoking by the end of the year through a lot of hard work and willpower. When he achieved this goal, he bought himself a new car. This is an example of
A. repeated enabling.
B. social reinforcement.
C. positive reinforcement.
D. negative reinforcement.
ANS: C
DIF: 2
REF: 23
MSC: Understanding/Applying

25. Moving from thinking about starting an exercise program to joining a club, working with a trainer to set goals, and showing up for workouts is an example of which model of behavior change?
A. Health belief model
B. Social cognitive model
C. Transtheoretical model
D. Contemplation model
ANS: C
DIF: 3
REF: 16
MSC: Understanding

26. Tasks that are necessary for normal functioning in society are known as
A. activities of daily living.
B. high-level tasks.
C. low-level tasks.
D. vocational activities.
ANS: A
DIF: 2
REF: 8
MSC: Remembering

27. Mark is a junior in college and plans to move to his own apartment before his senior year. He hopes to quit drinking, get more sleep, and spend more time exercising and studying instead of spending so much of his free time on Facebook. The best plan for Mark to succeed is for him to
A. make a chart with an algorithm for coordinating all the changes.
B. try to change all of his bad behaviors at once.
C. select the most important behavior to change and take things one step at a time.
D. worry about changing behaviors later because he'll have plenty of time to change after he finishes college.
ANS: C
DIF: 2
REF: 17-18
MSC: Applying
28. Which of the following factors would be considered a nonmodifiable determinant of health?
A. Sexual behavior
B. Sleep habits
C. Geographic location
D. Genetics
ANS: D
DIF: 2
REF: 10
MSC: Understanding

29. Which of the following is an example of a belief?
A. Disliking the smell of cigarette smoke
B. Thinking that smoking is unhealthy and causes cancer
C. Being happy no one is smoking near you
D. Understanding that smoking has become more prevalent among teenagers
ANS: B
DIF: 2
REF: 14
MSC: Understanding

30) Marissa has tried to quit smoking several times but ultimately failed because she lost motivation and didn't believe she could succeed. Which of the following may have contributed to her failure?
A. She has a strong internal locus of control.
B. She has high self-efficacy.
C. She has a strong external locus of control.
D. She has a strong, positive support group.
ANS: C
DIF: 2
REF: 19-20
MSC: Analyzing

31. Because both of John's parents smoke, John has a higher-than-average chance of being a smoker. This is an example of
A. a reinforcing factor.
B. a predisposing factor.
C. a confirming factor.
D. an enabling factor.
ANS: B
DIF: 3
REF: 17
MSC: Understanding

32. Which of the following best describes an enabling factor?
A. Living near a hiking trail when you want to begin a walking program
B. Nagging your parents because they smoke
C. Encouraging your spouse to go to the fitness club with you
D. Having friends who don't exercise, but you want to start a fitness program
ANS: A
DIF: 2
REF: 17
MSC: Understanding
33. Poor housing, lack of funds for adequate food and clothes, and insecure employment are which type of factors that negatively affect human health?
A. Biological
B. Economic
C. Behavioral
D. Genetic
ANS: B
DIF: 2
REF: 11
MSC: Understanding

34. Carrie grew up in an active family. Now that Carrie lives on her own, her family continues to check in to see if she is making time for exercise. They praise her for joining a fitness club and keeping to a workout schedule. This is an example of
A. a predisposing factor.
B. a confirming factor.
C. a reinforcing factor.
D. an enabling factor.
ANS: C
DIF: 3
REF: 17
MSC: Applying

35. Which model explains why a young woman who smokes is NOT likely to quit because she does not think she will get lung disease, and quitting will result in weight gain?
A. Health belief model
B. Social cognitive model
C. Transtheoretical model
D. Behavior change model
ANS: A
DIF: 3
REF: 14
MSC: Applying

36. Maria's husband has agreed to join her in an exercise program. They've scheduled times to meet to run at a local park. This is an example of
A. reward.
B. social support.
C. enabling.
D. readiness.
ANS: B
DIF: 2
REF: 20-21
MSC: Applying

37. Agents in the physical environment that can be harmful to health include which of the following?
A. Minerals
B. Toxins
C. Water
D. Nutrients
ANS: B
DIF: 2
REF: 11
MSC: Understanding
38. Which of the following groups of actions would most likely reduce a person's risk of premature death?
A. Not smoking, avoiding junk foods, and maintaining a healthy weight
B. Wearing a seat belt only when driving on the freeway and avoiding second-hand smoke
C. Using natural dietary supplements, working the night shift, and spending frugally
D. Avoiding excessive sun exposure and seeing at least two specialists each year
ANS: A
DIF: 2
REF: 5
MSC: Analyzing

39. Setting achievable and incremental goals and rewarding yourself for progress are proven tips for maintaining
A. ongoing support from others.
B. motivation for behavior change.
C. an outstanding academic record.
D. a lower body-mass index.
ANS: B
DIF: 3
REF: 19
MSC: Understanding

40) Selective smoking bans and child restraint laws designed to protect the health of citizens are examples of
A. publicity campaigns.
B. public policies.
C. profiling.
D. public health research.
ANS: B
DIF: 2
REF: 11
MSC: Understanding/Applying

41. The perceived source or cause (internal or external) of events in a person's life is known as his or her
A. locus of control.
B. ability to reason.
C. stages of behavior change.
D. sense of victimization.
ANS: A
DIF: 2
REF: 20
MSC: Understanding

42. Jules is trying to lose weight. When she craves a high-fat treat from the local ice cream shop, she is prepared to allow herself a cup of low-fat frozen yogurt in her favorite flavor. The tactic she is using to avoid eating more calories is
A. rewarding.
B. manipulating.
C. negotiating.
D. countering.
ANS: D
DIF: 2
REF: 22
MSC: Applying

43. An example of shaping is
A. starting with small changes in behavior and gradually increasing the changes.
B. using specific exercises to mold your body to a desired image.
C. trying to influence your younger brother's behavior with rewards.
D. watching a friend's behavior and then trying to mimic him or her.
ANS: A
DIF: 2
REF: 20
MSC: Applying
44. Using rational, positive statements and deliberately blocking negative thoughts are ways to avoid negative
A. influences.
B. actions.
C. self-talk.
D. awareness.
ANS: C
DIF: 2
REF: 22
MSC: Applying

45. Visualizing yourself successfully losing 15 pounds by choosing healthy foods at your favorite restaurant is an example of
A. situational inducement.
B. planned control.
C. imagined rehearsal.
D. modeling.
ANS: C
DIF: 2
REF: 21
MSC: Understanding/Applying

46. Rewarding yourself for reaching your weight loss goal with a trip to Hawaii is an example of which type of reinforcer?
A. Activity
B. Possessional
C. Manipulative
D. Social
ANS: A
DIF: 2
REF: 23
MSC: Understanding/Applying

47. Observing a friend's success at quitting smoking has helped you to quit a few months later, which demonstrates the process of
A. copying.
B. shaping.
C. mirroring.
D. modeling.
ANS: D
DIF: 2
REF: 21
MSC: Applying

48. Carlos wants to avoid overeating and eating unhealthy food. Because of this, he may decline invitations when his friends ask him to join them at a fast food restaurant. Which method is Carlos using to control the risk of overeating?
A. Modeling
B. Imagined rehearsal
C. Consumable reinforcer
D. Situational inducement
ANS: D
DIF: 2
REF: 22
MSC: Applying
49. Which of the following is the best example of a realistic, specific, and attainable goal?
A. I will lose a lot of weight.
B. I will lose 1 pound a week over the next four weeks.
C. I will lose 10 pounds if I start exercising.
D. I will lose 10 pounds if I start exercising and stop eating after 8:00 p.m.
ANS: B
DIF: 2
REF: 20
MSC: Understanding/Applying

50) Lower health insurance rates for nonsmokers serves as which type of reinforcer?
A. Possessional
B. Manipulative
C. Social
D. Activity
ANS: B
DIF: 2
REF: 23
MSC: Understanding/Evaluating

True or False
51. Behavior is a nonmodifiable determinant.
ANS: F
DIF: 2
REF: 10
MSC: Remembering

52. Health disparities are differences in the levels of health and disease among specific population groups, such as the low-income or uninsured.
ANS: T
DIF: 2
REF: 14-15
MSC: Understanding

53. More people across all age groups die from cancer than any other chronic disease.
ANS: F
DIF: 2
REF: 4
MSC: Understanding

54. Daily choices influence an individual's health status and well-being.
ANS: T
DIF: 1
REF: 3
MSC: Understanding

55. The medical model of health focuses on the individual's reaction to his or her social and physical environment.
ANS: F
DIF: 2
REF: 6
MSC: Understanding

56. In the early 1900s, the ecological model or public health model became a major focus of health investigation.
ANS: T
DIF: 2
REF: 6-7
MSC: Remembering

57. Effectively controlling anger demonstrates intellectual health.
ANS: F
DIF: 1
REF: 9
MSC: Applying
58. The primary goal of the Affordable Care Act of 2010 is to provide access to health insurance for millions of uninsured Americans.
ANS: T
DIF: 2
REF: 13
MSC: Understanding

59. Today, quality of life is recognized as being as important as years of life.
ANS: T
DIF: 1
REF: 5
MSC: Understanding

60) According to morbidity and mortality statistics, in the 21st century, a person is more likely to die from an infectious disease rather than from a chronic disease.
ANS: F
DIF: 2
REF: 4
MSC: Understanding

61. Tran is a 47-year-old-male who suffered a knee injury in high school while playing football. This injury is a biological determinant of health.
ANS: T
DIF: 2
REF: 10
MSC: Understanding

62. The average life expectancy for an American child born in 2012 is 78.5 years.
ANS: T
DIF: 1
REF: 4
MSC: Remembering

63. Obesity creates a burden on the overall U.S. economy.
ANS: T
DIF: 1
REF: 5
MSC: Understanding

64. Mortality is defined as the proportion of deaths to the population.
ANS: T
DIF: 1
REF: 4
MSC: Remembering

65. Under the Affordable Care Act, new health plans are banned from imposing deductibles.
ANS: F
DIF: 2
REF: 13
MSC: Understanding

66. Life expectancy may decline in coming years due to the prevalence of obesity and sedentary lifestyles.
ANS: T
DIF: 2
REF: 5
MSC: Understanding

67. Today, the concept of adaptability is a key element in the overall definition of health.
ANS: T
DIF: 1
REF: 7-8
MSC: Understanding
68. Believing that you will be able to run two mile miles without stopping by the end of the semester demonstrates self-efficacy.
ANS: T
DIF: 1
REF: 19
MSC: Applying

69. A person who has the attitude, knowledge, skills, and resources to make change possible possesses ambition.
ANS: F
DIF: 1
REF: 19
MSC: Understanding

70) Learning communication and relationship skills can enhance the social dimension of health.
ANS: T
DIF: 2
REF: 8-9
MSC: Applying

71. Having high self-esteem always improves the intellectual dimension of health.
ANS: F
DIF: 2
REF: 9
MSC: Understanding

72. Losing your temper because someone said something that made you angry demonstrates an external locus of control.
ANS: T
DIF: 1
REF: 20
MSC: Applying

73. Developing better problem-solving and decision-making skills enhances the emotional dimension of health.
ANS: F
DIF: 2
REF: 9
MSC: Understanding

74. Positive reinforcers are punishments for not accomplishing goals.
ANS: F
DIF: 2
REF: 23
MSC: Understanding

75. Actions taken or changes in behavior designed to treat an existing illness are part of disease prevention.
ANS: F
DIF: 2
REF: 7
MSC: Understanding

76. Spiritual health encompasses more than simply religious beliefs.
ANS: T
DIF: 1
REF: 9
MSC: Understanding

77. Attaining the optimal level of well-being for your unique limitations and strengths is known as wellness.
ANS: T
DIF: 2
REF: 9
MSC: Understanding
78. Adolescent teens having access to cigarette vending machines is an example of a positive reinforcing factor that can influence smoking behavior.
ANS: F
DIF: 1
REF: 23
MSC: Applying

79. Healthy People 2020 is the Surgeon General's health promotion plan to improve the quality of life and years of life for all Americans.
ANS: T
DIF: 2
REF: 9
MSC: Understanding

80) Global warming, decreased water supplies, and toxic chemicals are serious health threats with far-reaching effects worldwide.
ANS: T
DIF: 2
REF: 11
MSC: Understanding

81. Risk behaviors are those actions that increase the likelihood of negative health outcomes.
ANS: T
DIF: 2
REF: 7
MSC: Understanding

82. The Summary Plan Description (SPD) explains covered services, benefits, deductibles, copays, and network rules under a specific health insurance plan.
ANS: T
DIF: 2
REF: 12
MSC: Understanding

83. A reinforcing factor of your weight management program would be having your clothes fit better.
ANS: T
DIF: 1
REF: 16
MSC: Applying

84. Locus of control may be internal or external.
ANS: T
DIF: 2
REF: 19-20
MSC: Understanding

85. Asking your doctor to help you obtain the lowest-cost care is inappropriate.
ANS: F
DIF: 2
REF: 12
MSC: Applying

86. A consumable reinforcer could be a healthy edible item that you enjoy.
ANS: T
DIF: 2
REF: 23
MSC: Understanding

87. The three components of the social cognitive model of behavior change are thoughts, behavior, and genetics.
ANS: F
DIF: 2
REF: 15
MSC: Understanding
88. When a person who wants to eat healthier and lose weight clears out unhealthy foods from the refrigerator and pantry, this is an example of situational inducement.
ANS: T
DIF: 2
REF: 22
MSC: Understanding

89. Economic status and geographic location have very little influence on a person's health status.
ANS: F
DIF: 2
REF: 15
MSC: Understanding

90) Obesity, sedentary lifestyles, smoking, excessive alcohol consumption, and illegal drug use result in direct and indirect costs to society.
ANS: T
DIF: 2
REF: 5-6
MSC: Evaluating

Short Answer
91. List and briefly explain the six steps of the transtheoretical (stages of change) model of behavior change.
ANS: 1. Precontemplation - no current intention to change.
2. Contemplation - recognizing there is a problem but not yet planning to change.
3. Preparation - coming up with a plan for change.
4. Action - taking real steps to achieve goals.
5. Maintenance - continues to make changes a permanent part of life.
6. Termination - new behavior has become part of daily living, so ongoing vigilance may not be needed.
DIF: 3
REF: 16
MSC: Understanding/Applying

92. Explain the purpose of a behavior change contract and how it can help you make a positive change.
ANS: A behavior change contract functions as a promise to yourself, a public declaration of your intentions, an organized plan for change, a way to identify barriers to change and determine how to overcome them, a list of sources of support, and a reminder of the benefits of sticking to your plan.
DIF: 2
REF: 21
MSC: Understanding/Applying

93. Compare and contrast the medical model and public health models of health.
ANS: The medical model focuses on the individual, his or her tissues and organs, and the diagnosis and treatment of disease. The public health model (also known as the ecological model) views diseases and negative health events as resulting from an individual interacting with his or her social and physical environment.
DIF: 2
REF: 6-7
MSC: Analyzing

94. Explain the nature of SMART goals.
ANS: SMART goals are:
Specific - with a defined outcome
Measurable - can be objectively observed and measured
Action-oriented - involve specific tasks or actions
Realistic - are likely to be accomplished
Time-oriented - involve the commitment of a specific amount of time
DIF: 2
REF: 20
MSC: Remembering
95. When analyzing your behavior prior to making a change, which factors must you examine before making your plan?
ANS: You should examine your current health habit and patterns, including:
How long has the behavior been going on?
How frequently does the behavior occur?
How serious are the short-term and long-term consequences of this behavior?
Why have you continued this problematic behavior?
What kinds of situations trigger the behavior?
Are other people involved? If yes, how do they influence your behavior?
DIF: 2
REF: 16
MSC: Understanding/Applying

96. What is self-efficacy, and why is it important in making a behavior change?
ANS: Self-efficacy is an individual's belief that he or she is capable of performing a task successfully and of achieving specific goals. If an individual approaches a behavior change with a high level of self-efficacy, his or her chances of success will be much greater.
DIF: 2
REF: 19
MSC: Understanding/Applying

97. Differentiate between the health belief model, social cognitive model, and transtheoretical (stages of change) model of behavior change.
ANS: 1. The health belief model addresses three factors that must exist before a person can make a change: the perceived seriousness of the potential health problem; the perceived susceptibility to the problem, and cues to action, alerts or reminders to take preventive action.
2. The social cognitive model is based on the concept that three elements interact to motivate and enable change: a person's thoughts, behaviors, and the social environment.
3. The transtheoretical model views change in six stages: precontemplation, contemplation, preparation, action, maintenance, and termination.
DIF: 3
REF: 14-16
MSC: Analyzing

98. You want to improve your health by initiating an exercise program. Describe at least three ways you can maintain your motivation for regular exercise.
ANS: Any three of the following:
Pick one specific behavior to change and assess that behavior.
Set achievable, incremental goals.
Reward yourself for achieving goals.
Anticipate and avoid barriers and temptations.
Remind yourself why you want to change.
Enlist help and support from others.
Don't be discouraged by relapses, just get back on track.
DIF: 3
REF: 19
MSC: Applying

99. List at least three common barriers to behavior change.
ANS: Any three of the following:
Setting overambitious goals
Holding on to self-defeating beliefs and attitudes
Not accurately assessing your current state of wellness or fitness
Not having adequate support or guidance
Allowing negative emotions to sabotage your efforts
DIF: 2
REF: 20
MSC: Understanding
100) Define self-talk and explain how you can use it to help your efforts toward change.
ANS: Self-talk is your usual manner of thinking and talking to yourself (the voice in your head) that can affect your self-image and behavior. Deliberately changing your self-talk can have a big influence on behavior change by:
Using rational, positive statements
Blocking or stopping negative thoughts when they occur
Not dwelling on negative thoughts or images and focusing on more positive, uplifting, and encouraging thoughts
DIF: 2
REF: 22-23
MSC: Understanding/Applying