Deck 16: Chronic Illness and Rehabilitation

Question 1

The nurse is caring for an older patient who recently immigrated to the United States from Asia.To best address the patient's apparent resistance to the medical and nursing plan of care,the nurse:

A)discusses the patient's behavior with Asian staff members.
B)researches the patient's cultural views on health care.
C)requests a cultural consultation from social services.
D)asks family members to discuss the patient's views on health care.

Answer 1

asks family members to discuss the patient's views on health care.

Question 2

An older patient diagnosed with severe osteoarthritis has recently moved in with his son ecause of a history of falls.The son describes how he and his family have eagerly assumed responsibility for "meeting all Dad's needs." The nurse is most concerned that this environment will result in the patient:

A)developing a sense of powerlessness and possibly a loss of hope.
B)becoming unnecessarily physically and emotionally dependent.
C)losing his will to "get better" and become independent again.
D)becoming resentful and argumentative with his son's family.

Answer 2

developing a sense of powerlessness and possibly a loss of hope.

Question 3

The nurse feels most confident that an older patient is prepared to assume self-management of new type 2 insulin-dependent diabetes when the patient:

A)is heard asking her son to check the insulin's expiration date.
B)is able to identify the symptoms of hypoglycemia.
C)asks why she needs to test her glucose levels so frequently.
D)inquires why she needs to have an A1C test every 3 months.

Answer 3

is heard asking her son to check the insulin's expiration date.

Question 4

When working with older adults with chronic illness and exacerbations,what action by the nurse is most appropriate?

A)Continually assess the patients for adherence to the regime.
B)Assess the patients for ways they can remain in control.
C)Teach the patients about the illness trajectory.
D)Routinely review all medications the patients are taking.

Question 5

A nurse is assessing quality of life (QOL)in older individuals with chronic illnesses who attend a community center.What information is most important to assess?

A)How many days were lost to exacerbations in the last year
B)How good each individual perceives his or her QOL to be
C)How burdensome the patient's treatment regime is daily
D)How often the patient needs to see a health care provider

Question 6

An older patient has been admitted to the nursing unit after a car crash and surgery.When does the nurse begin planning for rehabilitation?

A)On admission
B)When the patient is awake
C)When the patient is stable
D)When the family requests it

Question 7

To best help manage health care costs in older adults,the nurse entrepreneur would do which of the following?

A)Create a telehealth system where nurses could check on patients daily.
B)Provide local transportation services for older people to keep appointments.
C)Create educational videos in multiple languages seen in the community.
D)Build a nurse-run clinic to serve the homeless and underinsured population.

Question 8

The nurse is assessing patients diagnosed with chronic disease processes for the probability of hospitalization because of the exacerbation of related symptoms.The nurse recognizes that the patient with the highest probability is a(n):

A)72-year-old male with congestive heart failure (CHF).
B)82-year-old male with type 2 diabetes.
C)72-year-old female with chronic bronchitis.
D)82-year-old female with osteoporosis.

Question 9

The nurse impacts the trajectory of a patient's type 2 insulin-dependent diabetes best by:

A)evaluating the patient's ability to administer insulin appropriately.
B)providing the patient with a written copy of the treatment plan.
C)explaining to the patient the importance of serum glucose control.
D)providing the patient with research-based nursing care.

Question 10

An older adult has chronic fatigue from several illnesses.The patient is frustrated at this symptom.What action by the nurse is best?

A)Ask the patient to prioritize activities.
B)Have the patient keep a fatigue diary.
C)Encourage the patient to rest in the day.
D)Instruct the patient on good sleep hygiene.

Question 11

A 73-year-old patient has been diagnosed with congested heart failure (CHF).The nurse provides the greatest support for this patient's positive view of self-wellness by presenting information regarding:

A)how to minimize the exacerbation of symptoms.
B)locally available supportive services.
C)the importance of adherence to medical treatment.
D)the need to report symptoms promptly.

Question 12

An older patient has moved into an adult child's home after an extended stay at a rehabilitation facility.The patient complains the child is now "the boss" and the child complains about caregiving duties.What action by the nurse is best?

A)Help the older patient find another place to live.
B)Suggest that it is time for assisted living.
C)Mediate a family meeting to discuss roles.
D)Listen empathetically but let them work it out.

Question 13

Nurses should evaluate health programs based on what data?

A)Effect on quality of life
B)Cost-benefit ratio of service
C)Adherence statistics
D)Ease of following through

Question 14

A nurse assesses a newly admitted patient to a nursing home using the Functional Independence Measure (FIM)and rates the patient at 20.What action by the nurse is best?

A)Arrange admission to a rehabilitation center.
B)Plan care for a nearly dependent person.
C)Plan care for a nearly independent person.
D)Tells the family the patient is cognitively impaired.

Question 15

A student learning about the early AIDS epidemic wonders why the patients were stigmatized.What response by the nurse was best?

A)Fear of the unknown etiology
B)Expense required government assistance
C)Patients being ashamed of their illness
D)Younger patients not having accomplishments

Question 16

A home health care nurse is conducting a functional assessment on an older woman who lives alone.What assessment question is likely to get the best information?

A)How do you manage all your medications?
B)Who shops and cleans your house for you?
C)Can you show me how you prepare a meal?
D)What parts of your body can't you wash?

Question 17

An older patient has developed moderate muscle weakness on the left side as a result of a cerebral vascular accident (CVA,stroke).The nurse determines the patient possesses the healthiest view of self-wellness when heard stating:

A)"I'll certainly miss hiking,but I guess I'll find something else to do outdoors."
B)"I was getting too old to safely practice karate."
C)"I've decided to take up oil painting because it's difficult for me to knit."
D)"It was getting difficult to work in the garden anyway."

Question 18

The nurse is preparing an older widowed patient with several chronic illnesses for discharge to home.The nurse addresses the primary nursing outcome for this patient when:

A)assuring the patient that social services will arrange for help with medical expenses.
B)arranging for in-home assistance in areas of activities of daily living (ADLs)and nursing care as needed.
C)educating the patient regarding the safety risks caused by these conditions.
D)identifying barriers to ensure adherence to the prescribed drug therapies.

Question 19

To best assist an older adult patient to cope with a new diagnosis of chronic renal failure,the nurse:

A)asks the patient to describe her usual coping strategies.
B)provides the patient with descriptions of new coping strategies.
C)initiates discussions with the patient to explain the disease.
D)offers to arrange a meeting with another patient with the diagnosis.

Question 20

A nurse is working with a patient who was diagnosed with type 2 diabetes 4 months ago.The patient's blood sugars have stayed under control.What action by the nurse is best?

A)Ask the patient what barriers to wellness still exist.
B)Remind the patient about the A1C in 2 months.
C)Review side effects of medications with the patient.
D)Ask the patient how she or he feels about diabetes.

Question 21

The nurse understands what about the Americans with Disabilities Act? (Select all that apply. )

A)It outlaws discrimination on the job because of disabilities.
B)It requires state governments to fund disability services.
C)It prohibits discrimination in government services to the disabled.
D)It requires all buildings to be retrofitted to allow access.
E)It provides funding for barrier-free buildings and parks.

Question 22

Adherence to prescribed health care treatments by a patient with a chronic disease is best facilitated when the nurse does which of the following? (Select all that apply. )

A)Provides the patient with information regarding his disease
B)Assesses the patient's ability to understand his disease
C)Defines "health and wellness" for the patient
D)Helps the patient identify barriers to his personal wellness
E)Coordinates support services to facilitate the patient's discharge

Question 23

The student learning about chronic disease and illness in the older population learns which facts about this situation? (Select all that apply. )

A)One in two adults,or more than 133,000 Americans,has a chronic condition.
B)Chronic disease is the leading cause of death in those over 65.
C)About 75% of medical costs each year are spent on managing chronic disease.
D)Formerly acute conditions are now manageable chronic diseases..
E)The focus of America's health care services is now on chronic illness