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 patients care, the nurse recognizes that this patients disability is categorized as what?
- A. A sensory disability
- B. A developmental disability
- C. An acquired disability
- D. An age-associated disability
Correct Answer: B
Rationale: Developmental disabilities are those that occur any time from birth to 22 years of age and result in impairment of physical or mental health, cognition, speech, language, or self-care. Examples of developmental disabilities are spina bifida, cerebral palsy, Down syndrome, and muscular dystrophy. Acquired disabilities may occur as a result of an acute and sudden injury, acute nontraumatic disorders, or progression of a chronic disorder. Age-related disabilities are those that occur in the elderly population and are thought to be due to the aging process. A sensory disability is a type of a disability and not a category.
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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 The nurse finds the man tearful and emotionally withdrawn.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 patients 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
Correct Answer: A
Rationale: The patient is exhibiting signs of depression and should be reassessed and a referral made as necessary. Patients with chronic illness are at an increased risk of depression. It would be simplistic to arrange for him to volunteer or focus on the positive. Social work may or may not be needed; assessment should precede such a referral.
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
Correct Answer: A
Rationale: Structural barriers make certain facilities inaccessible. Examples of structural barriers include stairs, lack of ramps, narrow doorways that do not permit entry of a wheelchair, and restroom facilities that cannot be used by people with disabilities. This individual did not experience a barrier to health care, an institutional barrier, or a transportation barrier.
An elderly patient has presented to the clinic with a new diagnosis of osteoarthritis. The patients 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 adults 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.
Correct Answer: A
Rationale: 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 bodys systems. Older adults usually have more support and care from their family members. Assuming the sick role can be a desire in any age group, not just the elderly.
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
Correct Answer: A
Rationale: In developing countries, chronic conditions have become the major cause of health-related problems due to improved nutrition, immunizations, and prompt and aggressive management of acute conditions. The integration of alternative health practices has not contributed to a decrease in mortality. Stronger international security measures have not contributed to a decrease in mortality. Obesity has not decreased, even in developing countries.
A case manager is responsible for ensuring that patients meet the criteria for diagnoses of chronic conditions in order to ensure their eligibility for federal programs. Which of these definitions may not apply for legal purposes?
- A. A person who is temporarily disabled but later return to full functioning.
- B. A person who is disabled and cannot expect a return to full functioning.
- C. A person whose disability is the result of a developmental disorder.
- D. A person whose disability is the result of a traumatic injury.
Correct Answer: A
Rationale: People can be temporarily disabled because of an injury or acute exacerbation of a chronic disorder, but later return to full functioning; this definition of disability may not apply for legal purposes. Disabilities may result from developmental challenges or trauma.
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