Brunner - Chapter 9: Chronic Illness and Disability - PrepU
The instructor provides corrective information to the nursing student when the student refers to the client as the - Man with an MI - COPDer in 216 - Woman who has diabetes - Patient who is disabled
- COPDer in 216
The instructor provides corrective information to the nursing student when the student refers to the client as the - Man with an MI - Patient who is disabled - COPDer in 216 - Woman who has diabetes
- COPDer in 216
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 - Developmental - Permanent - Age-related - Acquired
- Acquired
The nurse recognizes which disorder as a developmental disability in a patient? - Spinal cord injury - Stroke - Osteoarthritis - Cerebral palsy
- Cerebral palsy
The nurse is caring for a client with diabetes. Which of the following is a characteristic of chronic illness? - Chronic conditions only involve one aspect of a person's life. - Chronic illness affects the entire family. - One chronic disease never develops into another chronic condition. - Managing chronic conditions must be an individual process.
- Chronic illness affects the entire family.
The nurse is caring for a client with diabetes. Which of the following is a characteristic of chronic illness? - Managing chronic conditions must be an individual process. - Chronic conditions only involve one aspect of a person's life. - Chronic illness affects the entire family. - One chronic disease never develops into another chronic condition.
- Chronic illness affects the entire family.
Which phase of the Trajectory Model does the nurse recognize is present when the patient is in remission, after an exacerbation of illness? - Acute - Downward course - Crisis - Comeback
- Comeback
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 - Acute - Crisis - Stable
- 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 - Shorter lifespans - Lowered stress and increased physical activity lifestyles - An increased mortality rate from infectious diseases
- Early detection and treatment of diseases
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. - Type 2 diabetes mellitus - End-stage renal disease - Coronary artery disease - Carcinoma-in-situ
- End-stage renal disease
Which is a cause related to the increasing number of people with chronic conditions? - An increase in mortality from infectious disease - A tendency for these conditions to develop in younger people - Improved screening and diagnostic procedures - Shorter lifespans
- Improved screening and diagnostic procedures
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 - Continue with the procedure without someone to interpret. - Obtain a sign interpreter. - Talk to the client while also writing messages for the client. - Ask a family member to interpret.
- Obtain a sign interpreter.
A client who is blind is hospitalized for hip surgery. The nurse notices that the containers on the client's lunch tray are unopened, the client is fumbling with items, and food is on the front of the client's gown. The nurse assists the client by - Contacting a family member to assist with feeding the client at meal times - Sitting down in a chair and feeding the client - Opening containers and orienting the client to placement of items on the tray - Obtaining help from a nursing assistant to feed the client
- Opening containers and orienting the client to placement of items on the tray
A patient who is at risk for developing a chronic condition because of genetic factors is said to be in which phase of the Trajectory Model? - Trajectory - Unstable - Pretrajectory - Acute
- Pretrajectory
The nurse is caring for a client who communicates via sign language. What should the nurse do to promote communication? - Direct conversation to a family member. - Communicate only in written format. - Ask a family member to act as interpreter. - Provide a sign language interpreter.
- Provide a sign language interpreter.
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." What is the most apropriate statement the nurse can make in response? - "Smoking cigarettes and drinking alcohol will kill you." - "Yes, you do come from good genes." - "Certain illnesses can be traced to common risk factors and can be prevented." - "It is good that you know your body and your family history so well."
- "Certain illnesses can be traced to common risk factors and can be prevented."
Spinal cord injury is an example of which type of disability? - Acute nontraumatic - Acquired - Developmental - Age-related
- 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? - Chronic disability - Developmental disability - Impaired disability - Acquired disability
- Acquired disability
Down syndrome is categorized as a(n) - acute nontraumatic disorder. - developmental disability. - age-related disability. - acquired disability.
- developmental disability.
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 require short-term management in extended-care facilities." - "Chronic conditions are diseases that come and go." - "Chronic conditions are illnesses or diseases that have a prolonged course." - "Chronic conditions are medical conditions that have disabilities that require hospitalization."
- "Chronic conditions are illnesses or diseases that have a prolonged course."
The nurse is caring for an adult paraplegic with an ostomy. Which is an appropriate statement for the nurse to make? - "Who changes your pouching system at home?" - "I insist that I empty your ostomy pouch now." - "Do you need assistance managing your ostomy?" - "What type of pouching system do you use, honey?"
- "Do you need assistance managing your ostomy?"
A nurse cares for a client with a chronic illness who has a diagnostic workup for the illness and announces the diagnosis to friends and family. According to the Trajectory Model of Chronic Illness, what phase is the client displaying? - Pretrajectory - Stable - Trajectory onset - Acute
- Trajectory onset
A client who is blind and has a guide dog is hospitalized. The nurse states - "Your dog must stay in a corner of the room." - "Someone needs to stay with you at all times to walk the dog outside." - "You are unable to have your guide dog here." - "What can I do to assist you in keeping your dog with you?"
- "What can I do to assist you in keeping your dog with you?"
The nurse is caring for an adult paraplegic with an ostomy. Which is an appropriate statement for the nurse to make? - "Who changes your pouching system at home?" - "Do you need assistance managing your ostomy?" - "What type of pouching system do you use, honey?" - "I insist that I empty your ostomy pouch now."
- "Do you need assistance managing your ostomy?"
A client is diagnosed with type 2 diabetes mellitus. The client takes metformin and exenatide and reports adhering to a diet. The glycohemoglobin is 5.9%. According to the stable phase of the Trajectory Model of Chronic Illness, how should the nurse respond? - Advises the client that changes must be made to the diet - Acknowledges that the client is performing satisfactorily - Responds, "There are some adjustments to your medications that need to be made" - States, "The glycohemoglobin is too high"
- Acknowledges that the client is performing satisfactorily
An elderly female client who has dizziness and osteoporosis fell at home and fractured her hip. She underwent surgical intervention for repair of the fractured hip and is now being discharged to a subacute care facility. In the comeback phase of the Trajectory Model of Chronic Illness, the nurse - Acknowledges the client's achievement when she walks to the bedside commode with her walker - Assesses postural blood pressures - Teaches the client about osteoporosis - Discontinues the intravenous needle and changes the surgical dressing prior to discharge from the hospital
- Acknowledges the client's achievement when she walks to the bedside commode with her walker
An elderly female client who has dizziness and osteoporosis fell at home and fractured her hip. She underwent surgical intervention for repair of the fractured hip and is now being discharged to a subacute care facility. In the comeback phase of the Trajectory Model of Chronic Illness, the nurse - Assesses postural blood pressures - Discontinues the intravenous needle and changes the surgical dressing prior to discharge from the hospital - Acknowledges the client's achievement when she walks to the bedside commode with her walker - Teaches the client about osteoporosis
- Acknowledges the client's achievement when she walks to the bedside commode with her walker
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 - Age-associated - Developmental - Acquired - Sensory
- 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 - Permanent - Acquired - Developmental - Age-related
- 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? - Developmental disability - Chronic disability - Impaired disability - Acquired disability
- Acquired disability
The client who has the chronic condition of diabetes, reports blurry vision, and admits to non-adherence to the diet and medications. The home health nurse checks the client's fasting blood glucose level, which is 412 mg/dL. What phase of the Trajectory Model of Chronic Illness does the nurse assess this client is in? - Pre-trajectory - Stable - Acute - Comeback
- Acute
The client who has the chronic condition of diabetes, reports blurry vision, and admits to nonadherence to the diet and medications. The home health nurse checks the client's fasting blood glucose level, which is 412 mg/dL. What phase of the Trajectory Model of Chronic Illness does the nurse assess this client is in? - Pretrajectory - Acute - Comeback - Stable
- Acute
A nurse practitioner would be applying the pre-trajectory model of chronic illness when she: - Advised a woman, whose mother has Huntington's chorea, and who is considering pregnancy, to get genetic testing. - Encouraged a post-fracture patient to continue physical therapy. - Suggested home health care to a stroke victim. - Explained the significance of a serum glucose level of 160 mg/dL.
- Advised a woman, whose mother has Huntington's chorea, and who is considering pregnancy, to get genetic testing.
A nurse practitioner would be applying the pre-trajectory model of chronic illness when she: - Encouraged a post-fracture patient to continue physical therapy. - Advised a woman, whose mother has Huntington's chorea, and who is considering pregnancy, to get genetic testing. - Suggested home health care to a stroke victim. - Explained the significance of a serum glucose level of 160 mg/dL.
- Advised a woman, whose mother has Huntington's chorea, and who is considering pregnancy, to get genetic testing.
A client has lung cancer and underwent chemotherapy and radiation treatment. The tumors continue to grow and have metastasized. The nurse assesses the client is in the dying phase of the Trajectory Model of Chronic Illness. The nurse - Assists with arranging hospice care for the client - Discusses rehabilitation with the client and family - Asks the client and family about new treatment and management strategies for cancer - Collaborates with other health care team members to stabilize the client's cancer
- Assists with arranging hospice care for the client
A nurse is assigned to work with a client who has a disability. The nurse believes that all people with disabilities have a poor quality of life and are dependent and nonproductive. What type of barrier will this client experience? - Structural barrier - Transportation barrier - Attitudinal barrier - Barrier to health care
- Attitudinal barrier
A nurse is assigned to work with a client who has a disability. The nurse believes that all people with disabilities have a poor quality of life and are dependent and nonproductive. What type of barrier will this client experience? - Transportation barrier - Structural barrier - Barrier to health care - Attitudinal barrier
- Attitudinal barrier
The nurse provides corrective instruction to the nursing assistant when the assistant refers to the client as the - Man with a stroke - Blind diabetic patient - Person who is disabled - Woman who has multiple sclerosis
- Blind diabetic patient
The nurse recognizes which disorder as a developmental disability in a patient? - Osteoarthritis - Cerebral palsy - Spinal cord injury - Stroke
- Cerebral palsy
Which statement is a misconception about chronic disease? - The major cause of chronic disease is known. - Almost half of chronic deaths occur prematurely in people - Chronic illness typically does not result in sudden death. - Chronic illnesses cannot be prevented.
- Chronic illnesses cannot be prevented.
The nurse is working with a client who has difficulty controlling her blood sugar. The overweight client does not adhere to a low-calorie diet and forgets to take medications and check her blood glucose level. The client's glycohemoglobin is 8.5%. When establishing a goal for the client, the nurse first - Plans the short-term goal as "the client's blood sugar each AM will be less than 110 mg/dL" - Sets the long-term goal as "the client's glycohemoglobin will be 6.9% in 3 months" - Collaborates with the client to establish an agreed-upon goal - Informs the client about what goal the nurse wants the client to achieve
- Collaborates with the client to establish an agreed-upon goal
A client who is blind is admitted for treatment of a small bowel obstruction and has been vomiting for days. Which nursing diagnosis takes highest priority for this client? - Impaired physical mobility - Activity intolerance - Risk for injury - Deficient fluid volume
- Deficient fluid volume
Spina bifida, cerebral palsy, Down syndrome, and muscular dystrophy are all examples of which type of disability? - Acquired - Age-related - Acute nontraumatic disorder - Developmental
- Developmental
This type of disability represents one that occurs any time from birth to 22 years and results in impairment of physical or mental health, cognition, speech, language, or self-care. - Acquired - Acute non-traumatic - Age-related - Developmental
- Developmental
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? - Lowered stress and increased physical activity lifestyles - Shorter lifespans - Early detection and treatment of diseases - An increased mortality rate from infectious diseases
- Early detection and treatment of diseases
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 - Carcinoma-in-situ - Type 2 diabetes mellitus - Coronary artery disease
- End-stage renal disease
Which is a cause related to the increasing number of people with chronic conditions? - Improved screening and diagnostic procedures - An increase in mortality from infectious disease - Shorter lifespans - A tendency for these conditions to develop in younger people
- Improved screening and diagnostic procedures
Which disability model is most appropriate for the nurse to use as a guide for planning care? - Biopsychosocial Model - Social Model - Medical and Rehabilitation Model - Interface Model
- Interface Model
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. - Interventions to manage symptoms - Interventions to prevent complications - Assessment for spontaneous resolution - Assessment for identity changes
- Interventions to manage symptoms - Interventions to prevent complications - Assessment for identity changes
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. - Assess the patient's physical status. - Manage the medication regime. - Provide treatments.
- Make referrals for additional care.
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? - Provide treatments. - Assess the patient's physical status. - Manage the medication regime. - Make referrals for additional care.
- Make referrals for additional care.
Clients must contend with chronic illness daily. Nurses relate more effectively to clients when they understand the following as characteristics of chronic illness. Choose all that apply. - Chronic illness involves treating only the medical problems. - Managing chronic conditions must be a collaborative process. - Chronic conditions only involve one phase of a person's life. - Chronic illness affects the entire family. - The management of chronic conditions is a process of discovery.
- Managing chronic conditions must be a collaborative process. - Chronic illness affects the entire family. - The management of chronic conditions is a process of discovery.
A nurse prepares a diabetes prevention health seminar for community residents. Her teaching points should emphasize the most important factor influencing metabolic syndrome (pre-diabetes). What is that factor? - Smoking - Sedentary lifestyle - Obesity - Stress
- Obesity
A nurse prepares a diabetes prevention health seminar for community residents. Her teaching points should emphasize the most important factor influencing metabolic syndrome (pre-diabetes). What is that factor? - Stress - Obesity - Sedentary lifestyle - Smoking
- Obesity
The nurse is working with a coalition that is creating a global strategy to prevent and control diabetes. The nurse suggests which strategies? Select all that apply. - Partnering with the American Diabetes Association - Creating policies for diabetes prevention - Monitoring incidence and prevalence rates - Focusing on healthy lifestyle programming
- Partnering with the American Diabetes Association - Creating policies for diabetes prevention - Monitoring incidence and prevalence rates - Focusing on healthy lifestyle programming
A nurse is talking on the phone with a doctor and states, "I am calling you about Mrs. Nye, my client with cancer in room 213." This is an example of what type of language that is important to all people? - First nation - People-first - Medical jargon - Nursing speak
- People-first
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 - Assist the family in obtaining equipment that would help the client to walk. - Instruct the client what he or she must do. - Refer the client to physical therapy for ambulation exercise two times a week. - Plan with the client how to incorporate the regimen into the client's activities of daily living.
- Plan with the client how to incorporate the regimen into the client's activities of daily living.
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 - Refer the client to physical therapy for ambulation exercise two times a week. - Instruct the client what he or she must do. - Plan with the client how to incorporate the regimen into the client's activities of daily living. - Assist the family in obtaining equipment that would help the client to walk.
- Plan with the client how to incorporate the regimen into the client's activities of daily living.
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 - Wait until past medical records can be obtained. - Chart that the nurse is unable to obtain information. - Repeat back what the client states. - Ask a family member the questions.
- Repeat back what the client states.
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 - Wait until past medical records can be obtained. - Repeat back what the client states. - Chart that the nurse is unable to obtain information. - Ask a family member the questions.
- Repeat back what the client states.
Which of the following would be a characteristic of a chronic illness? - Slow, progressive decline - Requires short-term surveillance. - Reversible pathology - Cure likely
- Slow, progressive decline
A community nurse is working to decrease the incidence of cardiac disease in Nicaragua. The nurse should plan educational health promotion activities around which element? - Birth control - Breastfeeding - Smoking cessation - Vaccinations
- Smoking cessation
A community nurse is working to decrease the incidence of cardiac disease in Nicaragua. The nurse should plan educational health promotion activities around which element? - Vaccinations - Smoking cessation - Breastfeeding - Birth control
- Smoking cessation
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 - Trajectory onset - Unstable - Pretrajectory
- Stable
The nurse is with a client who has a chronic illness and is reinforcing positive behaviors and teaching about health promotion. For which phase of the trajectory model of chronic illness are these nursing actions appropriate? - Stable - Downward - Acute - Comeback
- Stable
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. - The course of the illness and symptoms are under control. - The client may require more diagnostic tests. - The client is in the final days or weeks before death characterized by gradual or rapid shutting down of body processes.
- The client is experiencing a critical or life-threatening situation requiring emergency treatment.
Which of the following describes the crisis phase of the trajectory model of chronic illness? - The client is in the final days or weeks before death characterized by gradual or rapid shutting down of body processes. - The client may require more diagnostic tests. - The client is experiencing a critical or life-threatening situation requiring emergency treatment. - The course of the illness and symptoms are under control.
- The client is experiencing a critical or life-threatening situation requiring emergency treatment.
A client has constant pain and peripheral neuropathy following chemotherapy for cancer. The nurse assesses the following behavior as a common characteristic of a person with a chronic illness: - The client stops taking some medications due to side effects that are disturbing to the client. - The client and family do not allow the chronic illness to be the focal point of their lives. - The client adheres to the prescribed therapeutic regimen. - The client does not believe that the illness threatens self identity and body image.
- The client stops taking some medications due to side effects that are disturbing to the client.
A client with impaired hearing communicates through sign language and has been admitted to the unit before scheduled surgery. The interpreter that the hospital employs is at the bedside. The nurse needs to take what actions into consideration prior to doing preoperative teaching with this client? - An interpreter is not needed. - The nurse should talk to the interpreter while teaching the client. - The interpreter may lag a few words behind--especially if names or technical terms are to be finger-spelled. - A family member would be better to use as the interpreter.
- The interpreter may lag a few words behind--especially if names or technical terms are to be finger-spelled.
A client with impaired hearing communicates through sign language and has been admitted to the unit before scheduled surgery. The interpreter that the hospital employs is at the bedside. The nurse needs to take what actions into consideration prior to doing preoperative teaching with this client? - The nurse should talk to the interpreter while teaching the client. - The interpreter may lag a few words behind--especially if names or technical terms are to be finger-spelled. - A family member would be better to use as the interpreter. - An interpreter is not needed.
- The interpreter may lag a few words behind--especially if names or technical terms are to be finger-spelled.
Clients must contend with chronic illness daily. Nurses relate more effectively to clients when they understand the following as characteristics of chronic illness. Choose all that apply. - The management of chronic conditions is a process of discovery. - Chronic illness involves treating only the medical problems. - Chronic conditions only involve one phase of a person's life. - Managing chronic conditions must be a collaborative process. - Chronic illness affects the entire family.
- The management of chronic conditions is a process of discovery. - Managing chronic conditions must be a collaborative process. - Chronic illness affects the entire family.
The number of people with disabilities is expected to increase over time. What is a major contributor to this prediction? - The decrease in risk factors for early-onset disabilities that are genetic in cause - The ability to cure chronic disorders that are acquired - The survival of people with severe trauma, chronic disorders, and early-onset disabilities - The decrease in the number of people with early-onset disabilities
- The survival of people with severe trauma, chronic disorders, and early-onset disabilities
The number of people with disabilities is expected to increase over time. What is a major contributor to this prediction? - The survival of people with severe trauma, chronic disorders, and early-onset disabilities - The ability to cure chronic disorders that are acquired - The decrease in the number of people with early-onset disabilities - The decrease in risk factors for early-onset disabilities that are genetic in cause
- The survival of people with severe trauma, chronic disorders, and early-onset disabilities
A client with multiple sclerosis is being discharged. The nurse understands that living with chronic conditions imposes many challenges, including the need for which accomplishments? Select all that apply. - Ignore threats to identity - Validate individual self-worth - Validate family functioning - Alleviate and manage symptoms - Return to a better state of health than prior
- Validate individual self-worth - Validate family functioning - Alleviate and manage symptoms
A client with multiple sclerosis is being discharged. The nurse understands that living with chronic conditions imposes many challenges, including the need for which accomplishments? Select all that apply. - Validate individual self-worth - Validate family functioning - Alleviate and manage symptoms - Ignore threats to identity - Return to a better state of health than prior
- Validate individual self-worth - Validate family functioning - Alleviate and manage symptoms
