CH9 Chronic Illness & Disability

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Models have been developed to explain the issues encountered by people with disabilities. One of these models is the interface model. What does the interface model promote? A) The view that people with disabilities function effectively B) The belief that disabling conditions do not have disabling effects C) The view that those people with disabling conditions function at a level below the "normal" population D) The belief that people with disabling conditions are incapable and irresponsible

Ans: A Feedback: The interface model does not ignore the disabling condition or its disabling effects; instead, it promotes the view that people with disabilities are capable, responsible people who are able to function effectively despite having a disability. Therefore options B, C, and D are incorrect.

What are disabilities commonly found in the elderly called? A) Developmental disabilities B) Acquired disabilities C) Age-related disabilities D) Sensory disabilities

C) Age-related disabilities Feedback: Age-related disabilities are those that occur in the elderly population and are thought to be due to the aging process. Developmental disabilities generally have their origins early in life. Acquired disabilities are those disabilities that can occur as the result of a sudden event. Sensory disabilities include deafness and blindness and are not specifically linked to the elderly population.

12. A patient who is blind is being admitted to the hospital. The patient informs the nurse that she needs to have her guide dog present during her hospitalization. What is the nurse's best response to the patient? A) "Arrangements can be made for your guide dog to be at the hospital with you during your stay." B) "I will need to check with your roommate before that decision can be made." C) "Your guide dog is not allowed to stay in your room during your hospitalization." D) "Your guide dog can stay with you during your hospitalization, but he will need to stay in a cage that you provide."

A) "Arrangements can be made for your guide dog to be at the hospital with you during your stay." Feedback: If patients usually use service animals to assist them with ADLs, it is necessary to make arrangements for the accommodation of these animals. The patient should be moved to a private room, and a cage would prevent the service dog from freely assisting the patient, so it is not necessary.

A patient tells the nurse that her doctor just told her that she had a "chronic condition." She asks the nurse what "chronic condition" means. What would be the nurse's best response? A) "Chronic conditions are defined as health problems that require management of 3 months or longer." B) "Chronic conditions are diseases that come and go." C) "Chronic conditions are medical conditions that have disabilities that require hospitalization." D) "Chronic conditions require short-term management in extended-care facilities."

A) "Chronic conditions are defined as health problems that require management of 3 months or longer." Feedback: Chronic conditions are often defined as medical conditions or health problems with associated symptoms or disabilities that require long-term management (3 months or longer). This makes option D incorrect. Option B is a correct answer, but it is not the best answer to the patient. Option C is incorrect because chronic diseases are usually managed in the home environment.

There are several definitions of a chronic disorder or disability. Which of these definitions may not apply for legal purposes? A) A person can be temporarily disabled but later return to full functioning. B) People who are temporarily disabled can never return to full functioning. C) An injury or acute exacerbation cannot cause a temporary disability. D) Temporary disabilities are not common occurrences.

A) A person can be temporarily disabled but later return to full functioning. Feedback: People can be temporarily disabled because of an injury or acute exacerbation of a chronic disorder but later return to full functioning; this definition of disability may not apply for legal purposes. People who are temporarily disabled can return to full functioning. Injuries or acute exacerbations can cause temporary disabilities. Temporary disabilities are common occurrences.

An individual with a physical disability uses a wheelchair. The individual wants to attend a support group for the parents of autistic children, which is being held in the basement of a church. When the individual arrives at the church, he realizes there are no ramps or elevators to the basement so he will not be able to attend the support group. What type of barrier did this patient experience? A) A structural barrier B) A barrier to health care C) An attitudinal barrier D) A transportation barrier

A) A structural barrier Feedback: Structural barriers make certain facilities inaccessible. Examples of structural barriers include stairs, lack of ramps, narrow doorways that do not permit entry of a wheelchair, and restroom facilities that cannot be used by people with disabilities. This patient experienced no barrier to health care, no attitudinal barrier, and no transportation barrier as they are currently defined.

An elderly patient has been admitted to your unit with a new diagnosis of osteoarthritis. The daughter who accompanied this patient asks you why the incidence of chronic disease increases with age. What would be your best response? A) Biologic changes reduce the efficiency of body systems. B) The older adult has less support and care from his family members, and this results in illness. C) There is an increased morbidity of friends in this age group, and this leads to the older adult's desire to also assume the "sick role." D) Normal aging increases the circulation of the heart.

A) Biologic changes reduce the efficiency of body systems. Feedback: Causes of the increasing number of people with chronic conditions include the following: longer lifespans because of advances in technology and pharmacology, improved nutrition, safer working conditions, and greater access (for some people) to health care. Also, biologic conditions change in the aged population. These changes reduce the efficiency of the body's systems. Option B is incorrect because older adults usually have more support and care from their family members. Option C is incorrect because assuming the "sick role" can be a desire in any age group, not just the elderly. Option D is incorrect because normal aging does not increase the circulation of the heart.

The community nurse is caring for a patient who is hemiplegic following a sledding accident when he was an adolescent. This patient is now 65 years old and has just been diagnosed with congestive heart failure. The patient states, "I am so afraid about what is going to happen to me." What would be the best nursing intervention for this patient? A) Encouraging him to make suitable plans for his care B) Taking him to visit long-term care facilities C) Giving him pamphlets about community resources D) Having him visit with other patients who have congestive heart failure

A) Encouraging him to make suitable plans for his care Feedback: The nurse should recognize the concerns of people with disabilities about their future and encourage them to make suitable plans, which may relieve some of their fears and concerns about what will happen to them as they age. Options B, C, and D are incorrect because they are not the best nursing intervention for this patient. Taking him to visit long-term care facilities may only make him more afraid, especially if he is not ready and/or willing to look at long-term care facilities. Giving him pamphlets about community resources or having him visit with other patients who have congestive heart failure may not do anything to relieve the fears of this patient.

A trend in developing countries is a decrease in mortality corresponding with an increase in chronic diseases. What has contributed to this decrease in mortality? A) Improved nutrition B) Integration of alternative health practices C) Stronger international security measures D) Decrease in obesity

A) Improved nutrition Feedback: In developing countries, chronic conditions have become the major cause of health-related problems due to improved nutrition, immunizations, and prompt and aggressive management of acute conditions. The integration of alternative health practices has not contributed to a decrease in mortality. Stronger international security measures have not contributed to a decrease in mortality. Obesity has not decreased, even in developing countries.

A home care nurse is making an initial visit to a 68-year-old man. The nurse finds the man tearful and withdrawn. Even though the man lives alone and has no family, he has been managing well at home up until this time. What would be the most appropriate action for the nurse to take? A) Reassess the patient's psychosocial status and make the necessary referrals B) Have the patient volunteer in the community for social contact C) Arrange for him to be reassessed by his physician D) Encourage joining a group that plays cards every week

A) Reassess the patient's psychosocial status and make the necessary referrals Feedback: The patient is exhibiting signs of depression and should be reassessed and a referral made as necessary. Patients with chronic illness are at an increased risk of depression. Options B, C, and D are incorrect because they are not the most appropriate action for the nurse to take.

You are caring for a patient with a history of chronic angina. The patient tells you that after breakfast, he takes a shower and shaves. It is at this time, the patient says, he experiences angina. What might you counsel the patient to do to decrease the likelihood of angina in the morning? A) Shower in the evening and shave before breakfast B) Skip breakfast and eat an early lunch C) Take a nitro tab prior to breakfast D) Shower once a week and shave prior to breakfast

A) Shower in the evening and shave before breakfast Feedback: If the nurse determines that one of the situations most likely to precipitate angina is to shower and shave after breakfast, the nurse might council the patient to break these activities into different times during the day. Skipping breakfast and eating an early lunch would not decrease the likelihood of angina in the morning. Taking a nitro tablet before breakfast is inappropriate because the event requiring the medication has not yet occurred. Also, suggesting that the patient shower once a week and shave prior to breakfast is an incorrect suggestion because showering and shaving can both be done every day if they are spread out over the course of the day.

18. The definition of chronic conditions can be complex. Which factor(s) would you expect to be included in the definition of chronic conditions? (Select all that apply.) A) Diseases that resolve spontaneously B) Diseases where complete cures are rare C) Diseases that have a short course D) Diseases that do not resolve spontaneously E) Diseases that have a prolonged course

Ans: B, D, E B) Diseases where complete cures are rare D) Diseases that do not resolve spontaneously E) Diseases that have a prolonged course Feedback: Chronic conditions can also be defined as illnesses or diseases that have a prolonged course, that do not resolve spontaneously, and for which complete cures are unlikely or rare. Therefore, options A and C are incorrect.

13. The staff development nurse is presenting a class on the importance of incorporating "people-first" language into daily practice. What is an example of the use of "people-first" language when giving nursing report? A) "The diabetic" B) "The patient with diabetes" C) "The diabetic patient" D) "The diabetic client"

B) "The patient with diabetes" Feedback: Using "people-first" language means referring to the person first: "the patient with diabetes" rather than "the diabetic," "the diabetic patient," or "the diabetic client." Therefore, options A, C, and D are incorrect.

14. A 19 year-old patient with a history of Down syndrome is being admitted to your unit with a diagnosis of pneumonia. This nurse recognizes that this patient's disability is categorized as what? A) A sensory disability B) A developmental disability C) An acquired disability D) An age-associated disability

B) A developmental disability Feedback: Developmental disabilities are those that occur any time from birth to 22 years of age and result in impairment of physical or mental health, cognition, speech, language, or self-care. Examples of developmental disabilities are spina bifida, cerebral palsy, Down syndrome, and muscular dystrophy. Acquired disabilities may occur as a result of an acute and sudden injury, acute nontraumatic disorders, or progression of a chronic disorder. Age-related disabilities are those that occur in the elderly population and are thought to be due to the aging process. A sensory disability is a type of a disability and not a category.

Patients with disabilities like multiple sclerosis (MS) often feel that their chronic conditions are harder to deal with than disabilities like physical deformities. Why would they feel this way? A) Invisible disabilities create negative attitudes in the health care community. B) Invisible disabilities can be as disabling as visible disabilities. C) Disabilities like MS are apparent to the general population. D) Disabilities like MS steal your life in an instant.

B) Invisible disabilities can be as disabling as visible disabilities. Feedback: Many disabilities are visible, but invisible disabilities are often as disabling as those that can be seen. Invisible disabilities create no more negative attitudes than do visible disabilities. Disabilities like MS are considered invisible and are not apparent to the general population. Disabilities like MS do not create apparent disabilities in an instant; it is more like stealing your life by inches.

Research has shown that the incidence of chronic conditions is increasing. Which lifestyle factor has been shown to contribute to this increase? A) Exercise B) Obesity C) Eustress D) Gastrointestinal disease

B) Obesity Feedback: Lifestyle factors, such as smoking, chronic stress, and sedentary lifestyle, that increase the risk of chronic health problems such as respiratory disease, hypertension, cardiovascular disease, and obesity are all thought to be factors for the increasing incidence of chronic conditions. Although signs and symptoms of chronic illness often first appear during older age, risks may begin earlier, even during fetal development. Exercise, eustress, and gastrointestinal disease have not been shown to be factors that have contributed to the increase in chronic conditions.

A patient with terminal cancer has been admitted to hospice care. The hospice team is meeting to establish goals for this patient. What is likely to be a first priority in goal setting for the patient? A) Morning care B) Pain control C) Clean living space D) Meal preparation

B) Pain control Feedback: Once the phase of illness has been identified for a specific patient, along with the specific medical problems and related social and psychological problems, the nurse helps prioritize problems and establish the goals of care. Identification of goals must be a collaborative effort, with the patient, family, and nurse working together, and the goals must be consistent with the abilities, desires, motivations, and resources of those involved. Pain control is essential for patients who have a terminal illness. If pain control is not achieved, all activities of daily living are unattainable. Options A, C, and D are not considered a first priority in goal setting for a terminal patient.

The nursing instructor is discussing chronic conditions and their effects on the body with her medical-surgical class. What would the nursing instructor explain to her students that a patient with diabetes is at risk for? A) Arthritis B) Renal failure C) Cancer D) Asthma

B) Renal Failure Feedback: One chronic disease can lead to the development of other chronic conditions. Diabetes, for example, can eventually lead to neurologic and vascular changes that may result in visual, cardiac, and kidney disease and erectile dysfunction. Options A, C, and D are incorrect because they are not risk factors caused by diabetes.

What is the significance to the patient when the nurse uses "people-first" language? A) That the nurse knows who the patient is B) That the person is of more importance to the nurse than the disability C) That the patient's disability is most important in the patient's life D) That the nurse knows that the patient's disability is a curable chronic condition

B) That the person is of more importance to the nurse than the disability Feedback: This simple use of language conveys the message that the person, rather than the illness or disability, is of greater importance to the nurse. The other answers are incorrect because no matter what language the nurse uses, the nurse knows who the patient is, that the patient's disability is not most important in the patient's life, and that the patient's disability most likely will never be cured.

The role of nurses as advocates for the removal of barriers to health care can have its' basis in what? A) The trajectory model B) The interface model C) The phase model D) The nursing process

B) The interface model Feedback: The interface model can serve as a basis for the role of nurses as advocates for removal of barriers to health care and for examination of how society and health care professionals contribute to discrimination by viewing disability as an abnormal state. The trajectory model, the phase model, and the nursing process are not the basis for the role of nurses as advocates for the removal of barriers to health care.

15. You are preparing to discharge a patient with a physical disability related to an automobile accident. You are reviewing the importance of preventative health care when the patient informs you that she will not have the money to pay for her annual gynecologic exams or mammograms due to the cost of this hospitalization. What information would be appropriate for you to share with the patient? A) "Limited finances are a common problem for patients with a disability. Since you were hospitalized this year, you can miss the gynecologic exam and mammogram." B) "These are very important health preventative measures, so you will need to borrow the money to pay for the exam and mammogram." C) "Federal assistance programs may be available to provide financial assistance for health-related expenses for people with disabling conditions." D) "These preventative measures should be a tax deduction, so you should consult with your accountant and then make your appointments."

C) "Federal assistance programs may be available to provide financial assistance for health-related expenses for people with disabling conditions." Feedback: Several federal assistance programs provide financial assistance for health-related expenses for people with some chronic illnesses, acquired disabling acute and chronic diseases, and diseases from childhood. Lack of financial resources, including health insurance, is an important barrier to health care for people with disabilities. Option A is incorrect because the nurse would not recommend that the patient miss her gynecologic exam and mammogram. Option B is incorrect because the nurse would not encourage the patient to borrow money to pay for medical bills. Option D is incorrect because decisions about health care are not made with an accountant on the basis of whether the health care expense would be a tax deduction.

You are presenting patient teaching to a 48-year-old male who was just diagnosed with type 2 diabetes mellitus. The patient has a BMI of 35 and leads a sedentary lifestyle. You give the patient information on the risk factors for his diagnosis and talk with him about changing the behaviors of diet and exercise. You know that further patient teaching is necessary when your patient tells you what? A) "I need to start slow on an exercise program approved by my doctor." B) "Over 80% of type 2 diabetes could be prevented if the risk factors were eliminated." C) "There is nothing that can be done anyway; chronic diseases cannot be prevented." D) D "The major causes of chronic diseases are known."

C) "There is nothing that can be done anyway; chronic diseases cannot be prevented." Feedback: The major causes of chronic diseases are known, and if these risk factors were eliminated, at least over 80% of heart disease, stroke, and Type 2 diabetes would be prevented. In addition, over 40% of cancers would be prevented. Options A, B, and D are all correct and would not indicate the need for further patient teaching.

20. What is true of chronic conditions? A) Chronic conditions are only found in the lower socioeconomic strata. B) Chronic conditions are only found in the elderly. C) Chronic conditions occur in every race and culture. D) Chronic conditions are decreasing.

C) Chronic conditions occur in every race and culture. Feedback: Chronic conditions occur in people of every age group, socioeconomic level, race, and culture. Therefore options A, B, and D are incorrect.

16. You are the case manager of a group of patients with a diagnosis of spina bifida. You recognize that the center of care for these patients occurs where? A) In the hospital B) In the physician's office C) In the home D) In the rehabilitation facility

C) In the home Feedback: The day-to-day management of illness is largely the responsibility of people with chronic disorders and their families. As a result, the home, rather than the hospital, is the center of care in chronic conditions. Hospitals, clinics, physician's offices, nursing homes, nursing centers, and community agencies are considered adjuncts or back-up services to daily home management.

The nurse is caring for a young adult male with a disability caused by a motor vehicle accident when he was an adolescent. Where does the nurse often provide care for patients like this young adult? A) Rehabilitation facilities B) Step-down units C) Medical-surgical units D) Pediatric units

C) Medical-surgical units Feedback: Patients with preexisting disabilities due to conditions that have been present from birth or due to illnesses or injuries experienced as an adolescent or young adult often require health care and nursing care in medical-surgical settings. Option A is incorrect because rehabilitation facilities are utilized once the patient has been discharged from the acute care setting. Step-down units provide care between the ICU setting and the regular units. Pediatric units provide care for patients aged 19 and younger.

17. The nurse is caring for a patient diagnosed with cancer of the liver. The nurse reviews the care plan for the patient and learns the plan of care focuses on palliative measures. The nurse also notes that over the last 3 weeks, the patient's condition has continued to deteriorate and the nurse recognizes what? A) Death will occur in the next week. B) The patient is in the trajectory phase of chronic illness. C) The patient is in the downward phase of chronic illness and should be reassessed. D) The patient should immediately be admitted into the hospital.

C) The patient is in the downward phase of chronic illness and should be reassessed. Feedback: The downward phase occurs when symptoms of chronic illness worsen despite attempts to control the course through proper regimen management. A downward turn does not necessarily lead to death. A downward trend can be arrested and the trajectory reestablished at any point depending on the condition and the treatment. A patient who is palliative may not desire hospitalization and aggressive treatment.

You are the nurse caring for a young mother who has multiple sclerosis. She was admitted to your unit with a postpartum infection 3 days ago. You are planning to discharge her home when she has finished 5 days of IV antibiotic therapy. What information would it be important for you to provide this patient with? A) The information pertaining to a postpartum infection and multiple sclerosis B) How the inflammatory process differs in patients with multiple sclerosis C) The same information you would provide to a patient without a chronic condition D) Information on how IV antibiotics affect multiple sclerosis

C) The same information you would provide to a patient without a chronic condition Feedback: Patients with disabilities are in need of the same information as other patients; however, they often require large print, Braille, audiotapes, or the assistance of a sign interpreter. In this instance, option A is incorrect because postpartum infections do not occur because the mother has multiple sclerosis so there would be no specific information that would be necessary to give to this patient. A postpartum infection is not an inflammatory process, it is an infectious process. IV antibiotics affect people with multiple sclerosis the same as they affect other patients.

What have the models of disability been used for? A) To define a medical framework for the care of the disabled B) To create a forum for improving rehabilitative care C) To address issues encountered by patients with disabilities D) To formulate care plans for the disabled population

C) To address issues encountered by patients with disabilities Feedback: Several models of disability have been used to address or explain the issues encountered by people with disabilities (Smeltzer, 2007a). These include the medical and rehabilitation models, the social model, the biopsychosocial model, and the interface model. These models do not define a medical framework in the care of the disabled, do not create a forum for improving rehabilitative care, and do not formulate care plans for use with the disabled.

. You are a public health nurse who is presenting an educational event on chronic diseases to a local community group. One of the people attending this event asks you if the priority of low- and middle-income countries shouldn't be the control of infectious diseases. What would be your best response? A) "At the present time, there is a rapidly growing problem with chronic conditions in low-and middle-income countries." B) "Infectious diseases are a very real issue in low- and middle-income countries." C) "The rise in risk factors for chronic conditions in low- and middle-income countries has increased the number of deaths caused by these conditions." D) "Infectious diseases are an issue in low- and middle-income countries. A bigger issue at the present time is the rapid increase in the risk factors for chronic conditions and the deaths these conditions are causing."

D) "Infectious diseases are an issue in low- and middle-income countries. A bigger issue at the present time is the rapid increase in the risk factors for chronic conditions and the deaths these conditions are causing." Feedback: Although infectious diseases are an issue, low- and middle-income countries are experiencing a rapid increase in chronic-disease risk factors and deaths, especially in urban settings. Option A, B, and C are all correct, but they are not the best answer the nurse can give.

A major cause of health-related problems is the increase in chronic conditions. This is especially true in developing countries because of what? A) Developing countries have the resources to deal with chronic conditions. B) Developing countries are not finding new infectious diseases. C) Developing countries are the only place chronic conditions are found. D) Developing countries are also trying to cope with emerging infectious diseases.

D) Developing countries are also trying to cope with emerging infectious diseases. Feedback: Chronic conditions have become the major cause of health-related problems in developed countries as well as in the developing countries, which are also trying to cope with new and emerging infectious diseases. Options A, B, and C are incorrect because developing countries do not have the resources to deal with chronic conditions, they are finding new infectious diseases, and developing countries are not the only place chronic conditions are found.

A 37-year-old woman with multiple sclerosis is married and has three children. What is the nurse's most important role with this patient? A) Ensure the patient is compliant with all treatments B) Provide the patient with advice on treatment options C) Provide a detailed plan of activities of daily living for the patient D) Help the patient develop strategies to implement treatment regimens

D) Help the patient develop strategies to implement treatment regimens Feedback: The most important role of the nurse working with patients with chronic illness is to help patients develop the strategies needed to implement their treatment regimens and carry out activities of daily living. Option A is incorrect because the nurse cannot ensure the patient is compliant with all treatments. Option B is incorrect because providing information of treatment options is not the nurse's most important role. Option C is incorrect because the nurse does not provide the patient with a detailed plan of ADLs.

You are caring for a young woman who has a diagnosis of congestive heart failure. This young woman has a history of Down syndrome. What is important for you to consider in the treatment of this patient? A) That she is attitudinally disabled B) That patients with Down syndrome are very oppositional C) How the disability affects the patient D) How the congestive heart failure affects the disability

D) How the congestive heart failure affects the disability Feedback: It is important to consider how the health issue or treatment regimen affects the disability. The other options are incorrect because a patient with Down syndrome is not attitudinally disabled, it is not important to consider that patients with Down syndrome are very oppositional because they are not, and patients with Down syndrome do not consider themselves disabled so their disabilities generally do not affect the patient.

A patient has recently been diagnosed with diabetes. The patient is clinically obese and is sedentary. How can the nurse best ensure potential success to increase activity in this patient? A) Set up appointment times at a local fitness center for the patient to attend B) Have a family member ensure the patient follows a suggested exercise plan C) Construct an exercise program and have the patient follow it D) Identify barriers with the patient that will inhibit change

D) Identify barriers with the patient that will inhibit change Feedback: Nurses cannot expect that sedentary patients are going to develop a sudden passion for exercise and that they will easily rearrange their day to accommodate time-consuming exercise plans. The patient may not be ready or willing to accept this lifestyle change. This is why it is important that the nurse and patient identify barriers to change.

The interface model of disability may be the most appropriate for use by nurses. Why would this be? A) It fosters dependency. B) It encourages the provision of care that is based on the disability. C) It promotes interactions with patients focused on the cause of the disability. D) It allows for the provision of care that is empowering.

D) It allows for the provision of care that is empowering. Feedback: The interface model (Goodall, 1995) may be the most appropriate for use by nurses to provide care that is empowering rather than care that promotes dependency. The interface model does not foster dependency, does not encourage giving care based on the patient's disability, and does not encourage or promote interactions with patients that are focused on the cause of the disability.

A patient scheduled for dialysis is on a fluid restriction of 1000 mL/day. The nurse sees the patient drinking a 55 mL soft drink after the patient has already reached the maximum intake of fluid for the day. The nurse has instructed the patient on the risks of fluid overload. What action should the nurse take? A) Take the soft drink away from the patient and inform the dialysis nurse to remove extra fluid from the patient during their next dialysis treatment. B) Document the patient's behavior as noncompliant and notify the physician. C) Restrict the patient's fluid for the following day and communicate this information to the charge nurse. D) Reinforce the importance of the fluid restriction, and document the teaching and the intake of extra fluid.

D) Reinforce the importance of the fluid restriction, and document the teaching and the intake of extra fluid. Feedback: Management of chronic conditions includes learning to live with symptoms or disabilities and coming to terms with identity changes resulting from having a chronic condition. It also consists of carrying out the lifestyle changes and regimens designed to control symptoms and to prevent complications. Although it may be difficult for nurses and other health care providers to stand by while patients make unwise decisions about their health, they must accept the fact that the patient has the right to make his or her own choices and decisions about lifestyle and health care.

What is considered to be a major factor in the increase in people with disabilities over time? A) The decrease in the number of people with early-onset disabilities B) The ability to cure chronic disorders that are acquired C) The decrease in risk factors for early-onset disabilities that are genetic in cause D) The survival of people with severe trauma

D) The survival of people with severe trauma Feedback: The number of people with disabilities is expected to increase over time as people with early-onset disabilities, chronic disorders, and severe trauma survive and have normal or near-normal lifespans. There has not been a decrease in the number of people with early-onset disabilities. Acquired chronic disorders still cannot be cured. Genetic risk factors for early-onset disabilities have not decreased.

During the prime employable years, 77% of those with a nonsevere disability are employed. What has research shown about this employed population? A) Their salaries are commensurate with their experience. B) They earn more money than those who have no disabilities. C) More people who are disabled than people who are not disabled are employed. D) They earn less money than people without disabilities.

D) They earn less money than people without disabilities. Feedback: Employed people with a disability earn less money than people without disabilities; this makes option A incorrect. Option B is incorrect because they do not earn more money than those who have no disability. Eighty-two percent of those without a disability are employed as compared to 77% of those with a nonsevere disability.

You have admitted a new patient to your unit with a diagnosis of Stage IV breast cancer. This woman has a comorbidity of myasthenia gravis. While you are doing the initial assessment, the patient tells you that she felt the lump in her breast about 9 months ago. You ask the patient why she did not see her health care provider when she first found the lump in her breast. What would be a factor that would influence the patient in seeking health care services? A) Positive attitudes among health care providers B) Lack of knowledge by the patient C) Overly sensitive patient reactions to health care services D) Unfavorable interactions with health care providers

D) Unfavorable interactions with health care providers Feedback: Because of unfavorable interactions with health care providers, including negative attitudes, insensitivity, and lack of knowledge, people with disabilities may avoid seeking medical intervention or health care services. Therefore option A is incorrect. Lack of knowledge by health care providers about the patient who is disabled is an influencing factor in people with disabilities seeking health care. The population of people who are disabled is not overly sensitive to the reactions of those providing health care services.


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