assessment 1 chapter 7
"You can do some things to minimize the effects of this disease on your health."
A client from a low socioeconomic background was diagnosed with a chronic health problem. The client states, "Everyone has to die of something." What is the most appropriate response for the nurse?
Encourage the family to support the client's exercise plan.
A client had a previous myocardial infarction and has been experiencing angina from occluded coronary arteries. What teaching should the nurse provide in the stable phase of the Trajectory Model of Chronic Illness?
The client stops taking some medications due to side effects that are disturbing to the client.
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:
downward
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
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
acknowledges that the client is performing satisfactory
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?
turns off the television
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
"What can I do to assist you in keeping your dog with you?"
A client who is blind and has a guide dog is hospitalized. The nurse states
Opening containers and orienting the client to placement of items on the tray
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
Obtain a sign interpreter.
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
Guide the client's hand to the armrest on the bedside commode prior to the client sitting on the commode.
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
"Follow the prescribed treatment plan."
A client with a chronic condition asks, "What can I do to prevent the disease from getting worse?" Which response will the nurse make to the client?
"It is important to keep current with all health promotion activities."
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?
pain control
A client with end-stage lung cancer has been admitted to hospice care. The hospice team is meeting with the client and her family to establish goals for care. What is likely to be a first priority in goal setting for the client?
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?
alleviate and manage symptoms, validate individual self-worth, validate family functioning
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.
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?
trajectory onset
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?
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?
"Chronic diseases only affect men."
A nurse is caring for a client with a chronic disease. What statement made by the client indicates that additional teaching is necessary?
people-first
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?
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:
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?
Early detection and treatment of diseases
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?
immobility, anemia, increased moisture
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.
acquired disability
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?
pretrajectory
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?
"Chronic conditions are illnesses or diseases that have a prolonged course."
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?
80
Among deaths due to chronic disease, what percentage occurs in low- and middle-income countries?
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
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
provide a list of community resources
An older adult with severe cardiac disease is concerned about the future care of an adult child with intellectual and developmental disabilities. Which action will the nurse take to help the client?
Provide teaching and secure resources and other support systems needed.
Chronic conditions are most acutely experienced by clients and their immediate families. Nurses provide direct care especially during acute episodes. Which of the following is an example of what the nurse can do for a client with a chronic illness?
50
Chronic conditions occur in people of every age group, socioeconomic level, race, and culture. Globally, annual deaths due to chronic disease are expected to increase from 38 million in 2012 to 52 million by 2030. It is predicted that by 2030, what percent of the world's population will have at least one chronic illness?
the management of chronic conditions is a process of discovery, managing chronic conditions must be a collaborative process, chronic illness affects the entire family
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.
developmental disability
Down syndrome is categorized as a(n)
stable
During which phase of the Trajectory Model of chronic illness is the focus of nursing care on reinforcing positive behaviors and offering ongoing monitoring?
developmental
Spina bifida, cerebral palsy, Down syndrome, and muscular dystrophy are all examples of which type of disability?
acquired
Spinal cord injury is an example of which type of disability?
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
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?
COPDer in 216
The instructor provides corrective information to the nursing student when the student refers to the client as the
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?
provide home visits, complete assessments, set goals during hospitilization, coordinate other care providers and services, assess family's ability to provide care in the home
The nurse is anticipating that a client with several chronic conditions will need transitional care. Which actions will the nurse take when planning this care for the client? Select all that apply.
Provide a sign language interpreter.
The nurse is caring for a client who communicates via sign language. What should the nurse do to promote communication?
develop a broad social support system, shock, disbelief, anger, and resentment are all normal reactions, implement family and individual methods of coping with stress, support may come from a combination of family, friends, and community, coping is influenced by events from the individual's past
The nurse is caring for a client with a newly diagnosed chronic illness. Together, the nurse and client identify that the client has adequate financial resources, is accepting of the required lifestyle changes, and has previous experience with illness. Which teaching will the nurse include for this client to promote adequate coping? Select all that apply.
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?
secondary condition
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)
you should aim for 30 minutes of physical activity daily, eat a diet high in fruits and vegetables, limit consumption of sodium and saturated fats
The nurse is concerned that a client with a chronic illness is becoming more debilitated due to increasing body mass index. Which health promotion education will the nurse provide to this client? Select all that apply.
Contact the client to inquire if they have transportation to the appointment.
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?
20
The nurse is planning community education on the prevalence and incidence of disabilities in the United States. The nurse includes that, according to the U.S. Census (2010), what percentage of people are diagnosed with a disability?
have you ever served in the military:
The nurse is preparing to assess a client who had traumatic bilateral lower extremity amputations. Which question will the nurse include in the assessment of this client to help identify the reason for the client's condition?
"The client in Room 412 with left-sided hemiplegia."
The nurse is providing report to the oncoming shift. In which way will the nurse describe a newly admitted client with hemiplegia?
Sitting down in a chair during the teaching.
The nurse is providing teaching for a client in a wheelchair. How will the nurse provide teaching?
End-stage renal disease
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
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.
cerebral palsy
The nurse recognizes which disorder as a developmental disability in a patient?
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.
"I have collaborated with a social worker to assess your needs for after discharge."
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?
Americans with Disabilities Act of 1990
Which act mandates that people with disabilities have access to job opportunities and to the community?
exercise
Which aspect of a healthy lifestyle can the nurse encourage a client to improve that can significantly enhance quality of life with a chronic condition?
Diabetes mellitus
Which chronic illness directly related to an unhealthy lifestyle does the nurse understand is increasing rapidly?
diabetes mellitus
Which chronic illness directly related to an unhealthy lifestyle does the nurse understand is increasing rapidly?
medical
Which model of disability views disability as a problem of the person?
The client is experiencing a critical or life-threatening situation requiring emergency
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.
Which of the following describes the crisis phase of the trajectory model of chronic illness?
comeback
Which phase of the Trajectory Model does the nurse recognize is present when the patient is in remission, after an exacerbation of illness?
Chronic illnesses cannot be prevented.
Which statement is a misconception about chronic disease?
