Name: ______________________ Class: _________________ Date: _________ Chronic Illness & Disability Exam ____ CLASSROOM

Name: ______________________ Class: _________________ Date: _________ Chronic Illness & Disability Exam ____ CLASSROOM 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 “sick role.” D) Chronic illnesses are diagnosed more often in older adults because they have more contact with the health care system. ____ ____ ____ 2. A patient tells the nurse that her doctor just told her that her new diagnosis of rheumatoid arthritis is considered to be a “chronic condition.” She asks the nurse what “chronic condition” means. What would be the nurse's best response? A) “Chronic conditions are defined as health problems that require management of several months or longer.” B) “Chronic conditions are diseases that come and go in a relatively predictable cycle.” C) “Chronic conditions are medical conditions that culminate in disabilities that require hospitalization.” D) “Chronic conditions are those that require short-term management in extended-care facilities.” 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 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 CLASSROOM 1 CLASSROOM CLASSROOM CLASSROOM ID: A CLASSROOM Name: ______________________ ____ CLASSROOM 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 ____ ____ ____ ____ 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 incidence and prevalence of chronic diseases. What has contributed to this decrease in mortality from some acute conditions? A) Improved nutrition B) Integration of alternative health practices C) Stronger international security measures D) Decrease in obesity 7. A 37-year-old woman with multiple sclerosis is married and has three children. The nurse has worked extensively with the woman and her family to plan appropriate care. What is the nurse's most important role with this patient? A) Ensure the patient adheres to all treatments B) Provide the patient with advice on alternative treatment options C) Provide a detailed plan of activities of daily living (ADLs) for the patient D) Help the patient develop strategies to implement treatment regimens 8. A patient has recently been diagnosed with type 2 diabetes. The patient is clinically obese and has a sedentary lifestyle. How can the nurse best begin to help the patient increase his activity level? A) Set up appointment times at a local fitness center for the patient to attend. B) Have a family member ensure the patient follows a suggested exercise plan. C) Construct an exercise program and have the patient follow it. D) Identify barriers with the patient that inhibit his lifestyle change. 9. A home care nurse is making an initial visit to a 68-year-old man. The nurse finds the man tearful and emotionally withdrawn. Even though the man lives alone and has no family, he has been managing well at home until now. What would be the most appropriate action for the nurse to take? A) Reassess the patient's psychosocial status and make the necessary referrals B) Have the patient volunteer in the community for social contact C) Arrange for the patient to be reassessed by his social worker D) Encourage the patient to focus on the positive aspects of his life 2 CLASSROOM CLASSROOM CLASSROOM CLASSROOM ID: A CLASSROOM Name: ______________________ CLASSROOM ____ 10. You are caring for a patient with a history of chronic angina. The patient tells you that after breakfast he usually takes a shower and shaves. It is at this time, the patient says, that he tends to experience chest pain. What might you counsel the patient to do to decrease the likelihood of angina in the morning? A) Shower in the evening and shave before breakfast. B) Skip breakfast and eat an early lunch. C) Take a nitro tab prior to breakfast. D) Shower once a week and shave prior to breakfast. ____ 11. A man with a physical disability uses a wheelchair. The individual wants to attend a support group for the parents of autistic children, which is being held in the basement of a church. When the individual arrives at the church, he realizes there are no ramps or elevators to the basement so he will not be able to attend the support group. What type of barrier did this patient encounter? A) A structural barrier B) A barrier to health care C) An institutional barrier D) A transportation barrier ____ 12. A patient who is legally blind is being admitted to the hospital. The patient informs the nurse that she needs to have her guide dog present during her hospitalization. What is the nurse's best response to the patient? A) “Arrangements can be made for your guide dog to be at the hospital with you during your stay.” B) “I will need to check with the care team before that decision can be made.” C) “Because of infection control, your guide dog will likely not be allowed to stay in your room during your hospitalization.” D) “Your guide dog can stay with you during your hospitalization, but he will need to stay in a cage or crate that you will need to provide.” ____ 13. The staff development nurse is presenting a class on the importance of incorporating “people-first” language into daily practice as well as documentation. What is an example of the use of “people-first” language when giving a verbal report? A) “The schizophrenic” B) “The patient with schizophrenia” C) “The schizophrenic patient” D) “The schizophrenic client” CLASSROOM 3 CLASSROOM CLASSROOM CLASSROOM ID: A CLASSROOM Name: ______________________ CLASSROOM ____ 14. A 19-year-old patient with a diagnosis of Down syndrome is being admitted to your unit for the treatment of community-acquired pneumonia. When planning this patient's care, the nurse recognizes that this patient's disability is categorized as what? A) A sensory disability B) A developmental disability C) An acquired disability D) An age-associated disability ____ 15. The nurse is reviewing the importance of preventative health care with a patient who has a disability. The patient states that she will not have the money to pay for her annual gynecologic exams or mammograms due to the cost of this hospitalization. What information would be appropriate for the nurse to share with the patient? A) “Limited finances are a common problem for patients with a disability. Since you were hospitalized this year, you can likely forego the gynecologic exam and mammogram.” B) “These are very important health preventative measures, so you will need to borrow the money to pay for the exam and mammogram.” C) “I'll look into federal assistance programs that provide financial assistance for health-related expenses for people with disabling conditions.” D) “These preventative measures should likely be tax deductible, so you should consult with your accountant and then make your appointments.” ____ 16. You are the case manager who oversees the multidisciplinary care of several patients living with chronic conditions. Two of your patients are living with spina bifida. You recognize that the center of care for these two patients typically exists where? A) In the hospital B) In the physician's office C) In the home D) In the rehabilitation facility ____ 17. The nurse is caring for a patient diagnosed with cancer of the liver who has chosen to remain in his home as long as he is able. The nurse reviews the care plan for the patient and notes that it focuses on palliative measures. The nurse also notes that over the last 3 weeks, the patient's condition has continued to deteriorate. What is the nurse's best response to this clinical information? A) Recognize that death will most likely occur in the next week. B) Recognize that the patient is in the trajectory phase of chronic illness and should be kept pain-free. C) Recognize that the patient is in the downward phase of chronic illness and should be reassessed. D) Recognize that the patient should immediately be admitted into the hospital