Chapter 7 Disability and Chronic Illness
1. An elderly patient has presented to the clinic with a new diagnosis of osteoarthritis. The
patient's daughter is accompanying him and you have explained why the incidence of chronic
diseases tends to increase with age. What rationale for this phenomenon should you
describe?
A) With age, biologic changes reduce the efficiency of body systems.
B) Older adults often have less support and care from their family, resulting in illness.
C) There is an increased morbidity of peers in this age group, and this leads to the older
adult's desire to also assume the ìsick role.
D) Chronic illnesses are diagnosed more often in older adults because they have
more contact with the health care system. Ans: A
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. Older adults usually have more support and care from their family members.
Assuming the ìsick roleî can be a desire in any age group, not just the elderly.
2. A patient tells the nurse that her doctor just told her that her new diagnosis of rheumatoid
arthritis is considered to be a ìchronic condition.î She asks the nurse what ìchronic conditionî
means. What would be the nurse's best response?
A) ìChronic conditions are defined as health problems that require management of
several months or longer.
B) ìChronic conditions are diseases that come and go in a relatively predictable
cycle.
C) ìChronic conditions are medical conditions that culminate in disabilities that
require hospitalization.
, D) ìChronic conditions are those that require short-term management in extended-
care facilities.
Ans: A
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).
Chronic diseases are usually managed in the home environment. They are not always cyclical
or predictable.
3. A medical-surgical nurse is teaching a patient about the health implications of her
recently diagnosed type 2 diabetes. The nurse should teach the patient to be proactive with
her glycemic control in order to reduce her risk of what health problem?
A) Arthritis
B) Renal failure
C) Pancreatic cancer
D) Asthma Ans: B 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. Diabetes is not often linked to cancer,
arthritis, or asthma.
4. A patient who undergoes hemodialysis three times weekly is on a fluid restriction of
1000 mL/day. The nurse sees the patient drinking a 355-mL (12 ounce) soft drink after the
patient has already reached the maximum intake of fluid for the day. 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 the next dialysis treatment
B) Document the patient's behavior as noncompliant and notify the physician
C) Further 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
Ans: D
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.
5. A patient with end-stage lung cancer has been admitted to hospice care. The hospice
team is meeting with the patient and her family to establish goals for care. What is likely to be
a first priority in goal setting for the patient?
A) Maintenance of activities of daily living
B) Pain control
C) Social interaction
D) Promotion of spirituality
Ans: B
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. This is thus a priority in planning care over the other
listed goals.
6. An international nurse has noted that a trend in developing countries is a decrease in
mortality from some acute conditions. This has corresponded with an increase in the
1. An elderly patient has presented to the clinic with a new diagnosis of osteoarthritis. The
patient's daughter is accompanying him and you have explained why the incidence of chronic
diseases tends to increase with age. What rationale for this phenomenon should you
describe?
A) With age, biologic changes reduce the efficiency of body systems.
B) Older adults often have less support and care from their family, resulting in illness.
C) There is an increased morbidity of peers in this age group, and this leads to the older
adult's desire to also assume the ìsick role.
D) Chronic illnesses are diagnosed more often in older adults because they have
more contact with the health care system. Ans: A
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. Older adults usually have more support and care from their family members.
Assuming the ìsick roleî can be a desire in any age group, not just the elderly.
2. A patient tells the nurse that her doctor just told her that her new diagnosis of rheumatoid
arthritis is considered to be a ìchronic condition.î She asks the nurse what ìchronic conditionî
means. What would be the nurse's best response?
A) ìChronic conditions are defined as health problems that require management of
several months or longer.
B) ìChronic conditions are diseases that come and go in a relatively predictable
cycle.
C) ìChronic conditions are medical conditions that culminate in disabilities that
require hospitalization.
, D) ìChronic conditions are those that require short-term management in extended-
care facilities.
Ans: A
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).
Chronic diseases are usually managed in the home environment. They are not always cyclical
or predictable.
3. A medical-surgical nurse is teaching a patient about the health implications of her
recently diagnosed type 2 diabetes. The nurse should teach the patient to be proactive with
her glycemic control in order to reduce her risk of what health problem?
A) Arthritis
B) Renal failure
C) Pancreatic cancer
D) Asthma Ans: B 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. Diabetes is not often linked to cancer,
arthritis, or asthma.
4. A patient who undergoes hemodialysis three times weekly is on a fluid restriction of
1000 mL/day. The nurse sees the patient drinking a 355-mL (12 ounce) soft drink after the
patient has already reached the maximum intake of fluid for the day. 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 the next dialysis treatment
B) Document the patient's behavior as noncompliant and notify the physician
C) Further 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
Ans: D
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.
5. A patient with end-stage lung cancer has been admitted to hospice care. The hospice
team is meeting with the patient and her family to establish goals for care. What is likely to be
a first priority in goal setting for the patient?
A) Maintenance of activities of daily living
B) Pain control
C) Social interaction
D) Promotion of spirituality
Ans: B
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. This is thus a priority in planning care over the other
listed goals.
6. An international nurse has noted that a trend in developing countries is a decrease in
mortality from some acute conditions. This has corresponded with an increase in the
