Ch. 9 Lippincott PrepU

The nurse is caring for a patient who had a stroke and has right-sided hemiparesis. The patient is receiving physical therapy that will continue when discharged through home health care services. After what minimum period of time could this patient's medical condition be termed chronic?

3 months

When providing education to the patient with a chronic illness, what is a priority intervention for the nurse to perform?

Adapt teaching strategies and materials to the individual patient.

A client is a paraplegic, lives alone, and just had a total shoulder arthroplasty. In planning for discharge, the nurse arranges for

Admittance to a rehabilitation unit

The nurse provides corrective instruction to the nursing assistant when the assistant refers to the client as the

Blind diabetic patient

The instructor provides corrective information to the nursing student when the student refers to the client as the

COPDer in 216

Which statement is a misconception about chronic disease?

Chronic illnesses cannot be prevented.

A client who is blind is admitted for treatment of a small bowel obstruction and has been vomitting for days. Which nursing diagnosis takes highest priority for this client?

Deficient fluid volume

Spina bifida, cerebral palsy, Down syndrome, and muscular dystrophy are all examples of which type of disability?

Developmental

Which chronic illness directly related to an unhealthy lifestyle does the nurse understand is increasing rapidly?

Diabetes mellitus

The nurse is caring for a client with chronic obstructive pulmonary disease (COPD). Despite various medication regimes, the client's symptoms are gradually increasing. The nurse realizes that this client is which phase of the Trajectory Model of Chronic Illness?

Downward

A nursing instructor is discussing the causes of the increasing number of people with chronic conditions. Which of the following would the nurse correctly identify as a cause?

Early detection and treatment of diseases

When caring for clients with disabilities, nurses need to understand not only pathophysiological issues but also the concept of disability. Which of the following statements to the client demonstrates that the nurse understands the concept of disability?

"I have collaborated with a social worker to assess your needs for after discharge."

A nursing instructor is preparing a class on pressure ulcers. Which of the following would the instructor most likely include as a possible risk factor? Select all that apply.

Immobility Anemia Increased moisture

Which model of disability is the most appropriate for use by nurses to provide care that empowers clients?

Interface model

Which is a true statement regarding characteristics of chronic conditions?

Managing chronic conditions must be a collaborative process.

Which model of disability views disability as a problem of the person?

Medical

A cause related to the increasing number of people with chronic conditions is

improved screening and diagnostic procedures.

The nurse is caring for a client with muscular dystrophy who is confined to bed. The client develops a pressure ulcer on the sacrum. The nurse documents the pressure ulcer as a(n)

secondary condition.

Which phase of the Trajectory Model of Chronic Illness is characterized by reactivation of an illness?

unstable

The client with blindness is hospitalized following a myocardial infarction. Which of the following care measures would the nurse take with this client? Select all answers that apply.

Identify self when walking into the client's room. State when the nurse is leaving the room. Leave the bathroom door either completely open or closed.

A nurse is caring for a client with multiple chronic conditions and some physical disabilities. The nurse is using "people-first" language with the following statement during end-of-shift report:

"Last evening, Mr. Rudd, a 44-year-old patient with diabetes was admitted to the unit."

The nurse is conducting a community education program on chronic illness. The nurse evaluates that additional education is needed when the participants make which statement?

"Out-of-pocket expenses for chronic illness are low."

A client from a low socioeonomic background was diagnosed with a chronic health problem. The client states, "Everyone has to die of something." The most appropriate response by this nurse is

"There are things you can do to minimize the effects of this disease on your health."

Chronic conditions occur in people of every age group, socioeconomic level, race, and culture. In 2000, an estimated 61 million people (21% of the population) had chronic illnesses. The prediction for 2050 is that what percent of the population will have a chronic illness?

50

A common misconception is that chronic diseases affect mostly high-income countries. In fact, a great percentage of deaths are from chronic diseases in low and middle-income countries. What is the percentage?

80

The nurse is performing an initial assessment of a client with a disability. The nurse should assess for which condition? Select all that apply.

Abuse Depression

A 65-year-old client was diagnosed with multiple sclerosis 10 years ago. The client has difficulty ambulating and is seeking a prescription for a wheelchair. The nurse assesses the type of disability the client has is

Acquired

An elderly male client was in an automobile accident 2 weeks ago and incurred a spinal cord injury with resulting paralysis. The nurse assesses this disability as

Acquired

A patient has had a traumatic amputation of the left leg above the knee following an industrial accident. What type of disability does this patient have?

Acquired disability

A client with multiple sclerosis is being discharged. The nurse understands that living with chronic conditions imposes many challenges, including the need to accomplish the following. Select all that apply.

Alleviate and manage symptoms Validate individual self-worth Validate family functioning

A client who will undergo emergency surgery suffers from chronic depression. The nurse is performing client teaching prior to the surgery. To make the client more comfortable, which of the following actions should the nurse take? Select all answers that apply.

Allow extra time for this client. Face the client when speaking to the client. Address the client by title and last name. Wait for the client to complete speaking even when answers are slow.

A client had a previous myocardial infarction and has been experiencing angina from occluded coronary arteries. He received rehabilitative therapy following the myocardial infarction. In the unstable phase of the Trajectory Model of Chronic Illness, the nurse

Encourages the client to quit smoking

The nurse practitioner has four patients with chronic illness that require consistent medical and nursing management. Select the condition that is the best example of a "chronically critical and progressively ill" condition.

End-stage renal disease

A nursing instructor is lecturing to the junior students about common misconceptions of chronic illness. The instructor asks the students to write down and share some misconceptions with one another. Which of the following are common misconceptions? Select all that apply.

Everyone has to die of something and so chronic illness should not be treated. Chronic diseases cannot be prevented. Chronic diseases mainly affect people who are rich.

Which aspect of a healthy lifestyle can the nurse encourage a patient to improve that can significantly enhance quality of life with a chronic condition?

Exercise

A client who is legally blind had orthopedic surgery 3 days ago and wants to urinate. She is using a walker for ambulation. It would be best for the nurse to

Guide the client's hand to the armrest on the bedside commode prior to the client sitting on the commode.

The nurse is planning a community education program on disabilities. The nurse plans to include which statement?

People with disabilities are most likely to work part time.

The most important health-promoting behavior that can prevent chronic illness or significantly improve the quality of life for those with a chronic condition is:

Physical exercise.

A client has lost mobility following a stroke. The nurse has established interventions that include providing direct care to the client, teaching, making referrals, and managing the case, to meet the goal. The next step is to

Plan with the client how to incorporate the regimen into the client's activities of daily living.

A nursing student shares that he read that chronic conditions are costly to people, families, and society, and that one of the major goals of nursing today should be the prevention of chronic conditions and the care of people with them. The student asks the instructor what can nurses do to help. Which of the following is a correct answer given by the instructor?

Promote wearing seat belts.

The client had a cerebrovascular accident with drooping of the face. Speech is slurred. The nurse is obtaining the admission assessment data. It would be best for the nurse to

Repeat back what the client states.

Which of the following would be a characteristic of a chronic illness?

Slow, progressive decline

During which phase of the Trajectory Model of chronic illness is the focus of nursing care on reinforcing positive behaviors and offering ongoing monitoring?

Stable

The nurse is preparing to provide discharge teaching for a hospitalized 19-year-old client who has had asthma for most of his life. The television is on, and several of the client's fraternity brothers are present. The client needs to have his intravenous catheter discontinued. The nurse determines that barriers to learning exist. Which of the following represent potential barriers? Select all answers that apply.

Television in use Fraternity brothers

Which of the following describes the crisis phase of the trajectory model of chronic illness?

The client is experiencing a critical or life-threatening situation requiring emergency treatment

Chronic illness can be monitored using the Trajectory Model. In what phase can the nurse's nursing diagnosis help in care planning?

Trajectory

The nurse forms a nursing diagnosis during which phase of the trajectory model of chronic illness?

Trajectory onset

A client is hospitalized with a traumatic brain injury following an automobile accident. The client has difficulty processing information and needs information to be repeated. A consulting physician enters the room. The nurse

Turns off the television

Which phase in the trajectory model of chronic illness is characterized by the reactivation of an illness in remission?

Unstable

A client experiencing a manic phase of bipolar disorder sustained cuts on the body from falling through a store window. The nurse is preparing to start an intravenous needle insertion and explains the procedure to the client

Using clear and simple terms

Evidence-based medical and nursing research (2009) has identified cardiovascular disease as the most prevalent chronic disease in the United States. Under this classification, one condition is the most common. Using this information, a nurse practitioner, treating a 50-year-old man, would do which of the following?

Write a prescription for a serum cholesterol level.

A client who is hearing impaired and communicates through sign language only is scheduled for an endoscopy. She does not read lips. It would be best for the nurse to

Obtain a sign interpreter.

A client has a tentative diagnosis of lung cancer following computed tomography (CT) scanning. He is scheduled for a fiberoptic bronchoscopy with biopsy. In the trajectory phase of the Trajectory Model of Chronic Illness, the nurse

Answers the client's questions about the bronchoscopy procedure

A client has been hospitalized with heart failure multiple times. The home health nurse is visiting the client with the overall goal of decreasing the frequency of hospitalizations. Using the nursing process, outline the steps the nurse would do in the correct order from 1 to 5.

Assesses the client's weight as 88 kg, 117% of ideal body weight Establishes the nursing diagnosis as Excess Fluid Volume Identifies a goal for the client to weigh 86 kg within 1 week Intervenes by teaching the client about weighing self every day Evaluates the client's weight as 86 kg 1 week later

The nurse is working with a client with a chronic condition. The nurse includes which elements in the plan of care? Select all that apply.

Assessment for identity changes Interventions to manage symptoms Interventions to prevent complications

A graduate nurse is assigned to care for a client with an acute exacerbation of chronic obstructive pulmonary disease. The client also has Down syndrome. During the shift, the nurse discovers that the client lives alone and holds a full-time job. Which type of disability would the nurse state the client has?

Developmental

A client has had multiple admissions for heart failure. The client is now on continuous oxygen, bedridden, and provided care by his family. The nurse discusses end-of-life preferences with the client. The nurse assesses the client is in the phase of the Trajectory Model of Chronic Illness known as

Downward

Which disability model is most appropriate for the nurse to use as a guide for planning care?

Interface Model

Nursing care of patients with chronic illness is varied and occurs in a variety of settings. Care must be direct and supportive. To provide supportive care, a nurse would do which of the following?

Make referrals for additional care.

A young female client smokes two packs of cigarettes and drinks a six-pack of beer each day. The nurse is attempting to teach the client about smoking cessation and decreasing alcohol intake. The client states, "My grandmother lived to be in her 90s, and she smoked and drank. I come from good genes." The most apropriate statement by the nurse is

"Certain illnesses can be traced to common risk factors and can be prevented."

A student nurse approaches a nursing instructor and states that a client was just told that she had a "chronic condition." The student asks the instructor what "chronic condition" means. What would be the instructor's best response?

"Chronic conditions are illnesses or diseases that have a prolonged course."

A client has chronic obstructive pulmonary disease (COPD). He researches information on the internet about COPD, seeking out new treatments and medications. The client frequently asks his physician and nurse about the new ways of treating his disease. This type of client behavior is seen in which type of model of disability?

Interface model

Among deaths due to chronic disease, what percentage occurs in low- and middle-income countries?

Most people with chronic conditions do not consider themselves sick or ill.

Which statement provides accurate information related to chronic illness?

Most people with chronic conditions do not consider themselves sick or ill.