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.
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A nurse knows that patients with invisible disabilities like chronic pain often feel that their chronic conditions are more challenging to deal with than more visible disabilities. Why would they feel this way?
- A. Invisible disabilities create negative attitudes in the health care community.
- B. Despite appearances, invisible disabilities can be as disabling as visible disabilities.
- C. Disabilities, such as chronic pain, are apparent to the general population.
- D. Disabilities. Such as chronic pain, may not be curable, unlike visible disabilities.
Correct Answer: B
Rationale: Many disabilities are visible, but invisible disabilities are often as disabling as those that can be seen. Invisible disabilities are not noted to create negative attitudes among health care workers, though this is a possibility. Disabilities, such as chronic pain, are considered invisible and are not apparent to the general population.
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.
During the care conference for a patient who has multiple chronic conditions, the case manager has alluded to the principles of the interface model of disability. What statement is most characteristic of this model?
- A. This patient should be free to plan his care without our interference.
- B. This patient can be empowered and doesnt have to be dependent.
- C. This patient was a very different person before the emergence of these health problems.
- D. This patients physiological problems are the priority over his psychosocial status.
Correct Answer: B
Rationale: The interface model focuses on care that is empowering rather than care that promotes dependency. The other listed statements are inconsistent with the principles of the interface model.
An initiative has been launched in a large hospital to promote the use of people-first language in formal and informal communication. What is the significance to the patient when the nurse uses people-first language?
- A. The nurse knows more clearly who the patient is.
- B. The person is of more importance to the nurse than the disability.
- C. The patients disability is the defining characteristic of the patients life.
- D. The patients disability is a curable condition.
Correct Answer: B
Rationale: This simple use of language conveys the message that the person, rather than the illness or disability, is of greater importance to the nurse. The other answers are incorrect because no matter what language the nurse uses, the nurse knows who the patient is, that the patients disability is not most important in the patients life, and that the patients disability most likely will never be cured.
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 patients condition has continued to deteriorate. What is the nurses 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.
Correct Answer: C
Rationale: The downward phase occurs when symptoms of chronic illness worsen despite attempts to control the course through proper regimen management. A downward turn does not necessarily lead to death. A downward trend can be arrested and the trajectory reestablished at any point, depending on the condition and the treatment. A patient who is palliative may not desire hospitalization and aggressive treatment.
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