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A patient who has recently been diagnosed with chronic heart failure is being taught by the nurse how to live successfully with her chronic condition. Her ability to meet this goal will primarily depend on her ability to do which of the following?
- A. Lower her expectations for quality of life and level of function.
- B. Access community services to eventually cure her disease.
- C. Adapt her lifestyle to accommodate her symptoms.
- D. Establish good rapport with her primary care provider.
Correct Answer: C
Rationale: Successful management of chronic conditions depends largely on the patients ability to adapt in order to accommodate symptoms. However, telling the patient to lower her expectations is a simplistic and negative interpretation of this reality. Rapport is beneficial, but not paramount. A cure is not normally an option.
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In your role as a school nurse, you are presenting at a high school health fair and are promoting the benefits of maintaining a healthy body weight. You should refer to reductions in the risks of what diseases? Select all that apply.
- A. Heart disease
- B. Stroke
- C. Cancer
- D. Diabetes
- E. Hypertension
Correct Answer: A,B,D,E
Rationale: The increasing prevalence of obesity has increased the incidence of heart disease, strokes, diabetes, and hypertension. Obesity is not usually cited as a major risk factor for most types of cancer.
A 39-year-old patient with paraplegia has been admitted to the hospital for the treatment of a sacral ulcer. The nurse is aware that the patient normally lives alone in an apartment and manages his ADLs independently. Before creating the patients plan of care, how should the nurse best identify the level of assistance that the patient will require in the hospital?
- A. Make referrals for assessment to occupational therapy and physical therapy.
- B. Talk with the patient about the type and level of assistance that he desires.
- C. Obtain the patients previous medical record and note what was done during his most recent admission.
- D. Apply a standardized care plan that addresses the needs of a patient with paraplegia.
Correct Answer: B
Rationale: Patients should be asked preferences about approaches to carrying out their ADLs, and assistive devices they require should be readily available. The other listed actions may be necessary in some cases, but the ultimate resource should be the patient himself.
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.
The community nurse is caring for a patient who has paraplegia following a farm accident when he was an adolescent. This patient is now 64 years old and has just been diagnosed with congestive heart failure. The patient states, Im so afraid about what is going to happen to me. What would be the best nursing intervention for this patient?
- A. Assist the patient in making suitable plans for his care.
- B. Take him to visit appropriate long-term care facilities.
- C. Give him pamphlets about available community resources.
- D. Have him visit with other patients who have congestive heart failure.
Correct Answer: A
Rationale: The nurse should recognize the concerns of people with disabilities about their future and encourage them to make suitable plans, which may relieve some of their fears and concerns about what will happen to them as they age. Taking him to visit long-term care facilities may only make him more afraid, especially if he is not ready and/or willing to look at long-term care facilities. Giving him pamphlets about community resources or having him visit with other patients who have congestive heart failure may not do anything to relieve his fears.
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 nurses 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
Correct Answer: D
Rationale: The most important role of the nurse working with patients with chronic illness is to help patients develop the strategies needed to implement their treatment regimens and carry out activities of daily living. The nurse cannot ensure the patient adheres to all treatments. Providing information of treatment options is not the nurses most important role. The nurse does not provide the patient with a detailed plan of ADLs, though promotion of ADLs is a priority.