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Chapter 8 Caring for Patients With Chronic Illness-Fundamentals of Nursing

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Chapter 8 Caring for Patients With Chronic Illness-Fundamentals of Nursing

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Chapter 08: Caring for Hospital client s with ChronicI llness
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MULTIPLE CHOICE ra




1. When considering the Chronic Care Model which intervention demonstrates the nursi
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ng attendant ’s understanding of the nursing role associated with providing care for a ch
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ronically ill hospital client ? ra ra ra ra




a. Sitting quietly with the hospital client ra ra ra ra ra




b. Administering pain medication as prescribed ra ra ra ra




c. Seeking a dietary consult to discuss a therapeutic diet ra ra ra ra ra ra ra ra




d. Suggesting that the hospital client schedule a flu vaccination ra ra ra ra ra ra ra ra




ACCURATE ar



ANSWER:-D
The Chronic Care Model provides a framework to guide hospital client care. The nursing r
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ole in caring for people with chronic diseases encompasses prevention, early detection and
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helping hospital client s identify effective strategies to manage their chronic illnesses.
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DIF:Apply (application) ra



OBJ:Explain the role of a nursing attendant in preventing chronic illness through screenin
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g, education about healthy lifestyle, and public policy. TOPIC:-Implementation MSC:
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Physiological Adaptation ra




2. A nursing attendant is providing followup care for a hospital client newly diagnosed with
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Type 2 diabetes who shares, ―I don’t kn
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ow how I will financially manage the expense of this disease.‖ Which statement by the nu
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r sing attendant demonstrates an understanding of effective diabetes management? a.
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―Let’s discuss how to effectively incorporate diet and exercise into your daily r outine.‖
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b. ―I’ll have the hospital’s Social Services consult with you about community se
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rvices that can help you.‖ ra ra ra ra




c. ―Private insurance is likely to cover most or all of the expense of your medication an ra ra ra ra ra ra ra ra ar ar ra ra ra ra ar




d testing supplies costs.‖
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d. ―I will help you learn to minimize your stress so that your blood sugar remains at a h
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ealthy level.‖ ra




ACCURATE ANSWER:-A ra



People who have diabetes spend an average of 2.3 times more than what people without diab
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etes spend on their health care. Type 2 diabetes is often preventable or can be managed effecti
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vely with lifestyle modifications (e.g., dietary changes, regular exercise) and so the nursing at
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tendant can provide education and support that both improves health and decreases health car
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e costs. Private insurance is likely to provide some but not all financial support for the needed
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medical supplies and medication. The remaining options are appropriate but not focused on i
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mproving health as a way of decreasing health care costs. ra ra ra ra ra ra ra ra ra




DIF:Apply (application) ra



OBJ:Summarize ways to reduce the financial impact of chronic illnesses on individuals and society. ra ra ra ra ra ra ra ra ra ra ra ra ra ar



TOPIC:-Evaluation MSC: Physiological Adaptation ra ra

,3. The nursing attendant will suggest the BRCA1/2 mutation screening for a hospital clie
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nt after identifying what assessment finding? a. Being treated for asthma
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b. First pregnancy at age 18 ra ra ra ra




c. Recent breast reduction surgery ra ra ra




d. Family history of ovarian cancer ra ra ra ra




ACCURATE ANSWER:-D ra



Genetic testing is available for individuals at high risk for developing certain breast and colon c
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ancers. Women with a strong family history of breast, ovarian, tubal, or peritoneal cancer ma
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y benefit from genetic testing for a BRCA1/2 mutation. There is no known association betwee
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n this mutation and any of the other stated situations.
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DIF:Apply (application) ra



OBJ:Identify genetic and environmental factors and their influence on the development of chronic i
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llness.TOP: Implementation MSC: Physiological Adaptation ra ra




4. A cancer survivor is in the intensive care unit (ICU). Some of the hospital client ’s famil
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y is fr
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om out of town and would like to see the hospital client even though it is not ―official‖
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vis
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iting hours. The hospital client is anxious to see family members. The nursing attendan
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t all ows the family to visit. What is the rationale for the nursing attendant ’s actions? a.
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The nursing attendant disagrees with the established time for visiting.
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b. The nursing attendant realizes that the hospital client is dying.
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c. The nursing attendant feels there is no real reason to have limited visiting hours.
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d. The nursing attendant believes that the visit will help relieve psychological stress.
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ACCURATE ANSWER:-D ra



Survivors who have social and emotional support systems are likely to have less psychologi
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cal distress. Relationships are critical for cancer survivors. The nursing attendant does not n
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ecessarily have problems with the standard visiting hours. Not enough information is provi
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ded to indicate that the hospital client is near death, and not all hospital client s in the ICU
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are dying. ra




DIF:Apply (application) ra



OBJ:Explain the psychosocial effects that living with a chronic illness has on hospital client s and th
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eir
families. TOPIC:-Implementation MSC: Psychosocial Integrity ra ra




5. A nursing attendant is taking a history of a hospital client with a chronic illness.
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Which assessment is priority? a. Fatigue ar ra ra




b. Vision
c. Dehydration
d. Blood pressure ra




ACCURATE ANSWER:-A ra



Fatigue is among the most frequent and distressing complaints of people with a chronic illnes
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s. Vision, dehydration, and blood pressure are not as frequently reported.
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DIF:Apply (application) ra



OBJ:Discuss the physical limitations that hospital client s with chronic illnesses frequently
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experience. TOPIC:-Assessment MSC: Physiological Adaptation ra ra ra

, 6. What statement by the hospital client demonstrates an understanding of the risks invo
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lved ra



when it is determined that the hospital client ’s father carries the gene associated with
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Lync h Syndrome? ar




a. ―I know I’ll develop colon cancer during my lifetime.‖
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b. ―I’m scheduled for genetic screening early next week.‖ ar ra ra ra ra ar ra




c. ―Lynch Syndrome is responsible for trigger a very rare form of cancer.‖ ra ra ra ra ra ra ra ar ra ar ar




d. ―It’s comforting to know that this cancer generally tends to skip a generation.‖
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ACCURATE ANSWER:-B ra



Because Lynch Syndrome is one of the more common hereditary cancer syndromes and because
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early detection improves survival, genetic screening for this type of colon cancer should be offe
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red to firstdegree family members to inform them of the potential risk of developing this cancer. I
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f family
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members screen positive, more frequent screening for this disease increases the chance of early
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detection and early treatment to decrease death from this form of colon cancer. A family history
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of this gene does not confirm that the associated cancer will develop nor is there research to sup
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port a skipping of generations.
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DIF:Apply (application) ra



OBJ:Identify genetic and environmental factors and their influence on the development of chronic i
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llness.TOP: Evaluation MSC: Physiological Adaptation ra ra




7. The nursing attendant is caring for a young woman with breast cancer. The stress between
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th
e woman and spouse is obvious, as is anxiety among the children when she states, ―I can’t
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co
ntinue therapy; it’s asking too much of my family.‖ What is the nursing attendant ’s best acti
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o
n in this situation to help address the hospital client ’s risk for nonadherence to treatment?
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a. Help find or develop an educational program for the hospital client and family.
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b. Encourage the hospital client to continue with the prescribed chemotherapy. ra ra ra ra ra ra ra ra ra




c. Support the spouse and children by acknowledging their stressors. ra ra ra ra ra ra ra ra




d. Suggest that the woman needs to focus on her needs first. ra ra ra ra ra ra ra ra ra ra




ACCURATE ANSWER:-A ra



A hospital client ’s social support from family and friends is an essential component to hospital
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client adherence. It is a nursing attendant ’s responsibility to educate (develop an educational p
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rogram) cancer survivors and their families about the effects of cancer and cancer treatment.
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While the remaining options are relevant, none attempts to meet the needs of the hospital clien
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t as well as her family as does develop an educational program.
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DIF:Apply (application) ra



OBJ:Anticipate the needs of family nursing attendant s who care for hospital client s with ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar



chronic disease. TOPIC:-Implementation MSC: Psychosocial Integrity
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8. The nursing attendant is caring for a hospital client who is undergoing chemotherapy and r
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adiation for cancer. The hospital client asks the nursing attendant about the value of cance
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rs arcreening when therapy is over. What is the nursing attendant ’s best response? a. ra ra ra ra ra ra ra ra ra ra ra ra




―It will allow for early detection of additional cancers.‖
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b. ―It is not something that should be discussed right now.‖
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