Exam 18: Chronic Illness and the Aprn

The nurse practitioner is conducting a health of older adults in-service with a group of older adults at a community center.The first concept she presents is a definition of chronic illness. Which of the following is the best definition?

The U.S.health-care system functions by managing and paying for illness by focusing on one problem at a time.The nurse practitioner analyzes this system and concludes it is ineffective because:

Mrs.Morrison is 85 years old and on Medicare with supplemental insurance.She is obese and has diabetes and heart failure.The nurse practitioner collaborates with a social worker and with a representative from Medicare about the cost of her treatment choices.The nurse practitioner analyzes treatment burden and the costs of care to develop a practical and cost-effective plan of care.Which of the following puts Mrs.Morrison at risk for a financial burden for health care? Select all that apply.

The nurse practitioner has conducted a thorough health assessment for Mr.York, who is 83 years old.As the nurse practitioner synthesizes the information and creates the discharge instructions, consideration must be given to which of the following? Select all that apply.

The nurse practitioner is speaking to a group of student nurses about the causes of death of older adults.Which of the following statements is true regarding mortality and morbidity of people older than 65 years?

While teaching a family about the risks of chronic illness for James, who is 69 years old and the patriarch of the family, the nurse practitioner includes which of the following information?

Mrs.Kesler, 91 years old, is considered frail and yet she is active and lives alone with supervision from her daughter.Her frailty is based on which of the following? Select all that apply.

The nurse practitioner is conducting an initial history and physical examination, along with a health assessment on a new patient.Mr.Carter is African American and 68 years old.He presents with complaints of dizziness, unstable gait, and polyuria.This combination of symptoms is blamed for his frequent falling at home.The nurse practitioner analyzes the findings of the examination and suggests which of the following diagnostics? Select all that apply.

Mrs.Jones, 80 years old, comes to the clinic for management of heart failure, diabetes, and depression.The nurse practitioner assesses that this patient is not compliant with the medication plan and has missed a couple of recent appointments.The nurse practitioner analyzes this information and concludes that perhaps Mrs.Jones is experiencing treatment burden because:

Mrs.Koslowski, 95 years old, comes to the nurse practitioner with her daughter to discuss her medical regime.She complains that she thinks some of the therapies are doing more harm than good.Mrs.Koslowski wants to discontinue some of the medical orders.The nurse practitioner reviews her medical plan and discusses a new model of care called minimally disruptive medicine (MDM).She explains to the daughter and to Mrs.Koslowski that this model does which of the following? Select all that apply.

The family of Mr.Moore, 90 years old, meets with the nurse practitioner to discuss a change in the care of Mr.Moore.He appears to be less comfortable, more irritable, and has less appetite.He has diabetes, chronic obstructive pulmonary disease (COPD), kidney disease, and chronic colitis.The family and practitioner agree that Mr.Moore is not near end of life, and yet there is not an apparent cure for his conditions.The nurse practitioner discusses palliative care for Mr.Moore.Why might palliative care be a good option? Select all that apply.

Mr.Smith, 82 years old, is seen by a nurse practitioner and is potentially diagnosed with treatment burden.The nurse practitioner recommends the Chronic Disease Self-Management Program (CDSMP).This program addresses which of the following skills? Select all that apply.

The nurse practitioner whose practice consists of geriatric-aged patients must consider which of the following when working with patients who experience multiple chronic illnesses?

Mrs.Hupp, 91 years old, lives with her daughter, Kim.Kim loves her mother and does everything she can to assist in providing a good quality life for her mother.Recently, Kim has been telling her nurse practitioner that she is experiencing lack of sleep, higher blood sugars, and anxiety.The nurse practitioner discusses which of the following with Kim? Select all that apply.