Chapter 7

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

COPDer in 216

The nurse is caring for a client with diabetes. Which of the following is a characteristic of chronic illness?

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?

Comeback

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

Diabetes mellitus

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

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

Which is a cause related to the increasing number of people with chronic conditions?

Improved screening and diagnostic procedures

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?

Obesity

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.

The nurse is planning care for an older adult. For which reasons will the nurse consider transitional care for this client? Select all that apply.

Physical limitations Complex therapies Frail physical condition Impaired cognitive status Multiple chronic conditions

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?

Acknowledges that the client is performing satisfactorily

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.

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

The nurse is caring for a client with a long-term chronic condition. Which action will the nurse take when planning teaching for this client?

Assess learning needs before planning instruction.

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 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?

People-first

The nurse is caring for a client who communicates via sign language. What should the nurse do to promote communication?

Provide a sign language interpreter

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

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?

Smoking cessation

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?

Trajectory onset

The nurse is providing report to the oncoming shift. In which way will the nurse describe a newly admitted client with hemiplegia?

"The client in Room 412 with left-sided hemiplegia."

A client with a chronic obstructive pulmonary disease (COPD) says, "I'm glad I don't need to get annual mammograms anymore." Which statement will the nurse make in response to this client?

"It is important to keep current with all health promotion activities."

A client who is blind and has a guide dog is hospitalized. The nurse states

"What can I do to assist you in keeping your dog with you?"

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

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?

Acute

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?

Attitudinal barrier

The nurse is concerned that a client with a disability has missed two follow-up appointments. Which action will the nurse take to support this client?

Contact the client to inquire if they have transportation to the appointment

A nurse is preparing to provide discharge teaching for a hospitalized 19-year-old client who is hearing impaired with functioning hearing aides. The television is on, and several of the client's fraternity brothers are present. What are potential teaching barriers for the nurse? Select all that apply.

Fraternity brothers Television in use

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 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.

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.

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 interpreter may lag a few words behind--especially if names or technical terms are to be finger spelled.

A client with a chronic condition experiences exacerbation of symptoms at the end of every month. On which characteristic of chronic conditions will the nurse focus to identify the reason for the client's symptoms?

Therapeutic regimen


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