Nokea
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 The nurse finds the man tearful and emotionally withdrawn.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.
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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.
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 physicians office
- C. In the home
- D. In the rehabilitation facility
Correct Answer: C
Rationale: The day-to-day management of illness is largely the responsibility of people with chronic disorders and their families. As a result, the home, rather than the hospital, is the center of care in chronic conditions. Hospitals, rehabilitation facilities, clinics, physicians offices, nursing homes, nursing centers, and community agencies are considered adjuncts or back-up services to daily home management.
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
Correct Answer: B
Rationale: 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.
A community health nurse has drafted a program that will address the health promotion needs of members of the community who live with one or more disabilities. Which of the following areas of health promotion education is known to be neglected among adults with disabilities?
- A. Blood pressure screening
- B. Diabetes testing
- C. Nutrition
- D. Sexual health
Correct Answer: D
Rationale: Health promotion interventions addressing sexual health in disabled individuals are necessary but rare. Blood pressure testing, diabetes testing, and nutrition are not known to constitute such a gap in health promotion teaching.
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.