Nokea
A patient who is legally blind is being admitted to the hospital. The patient informs the nurse that she needs to have her guide dog present during her hospitalization. What is the nurses best response to the patient?
- A. Arrangements can be made for your guide dog to be at the hospital with you during your stay.
- B. I will need to check with the care team before that decision can be made.
- C. Because of infection control, your guide dog will likely not be allowed to stay in your room during your hospitalization.
- D. Your guide dog can stay with you during your hospitalization, but he will need to stay in a cage or crate that you will need to provide.
Correct Answer: A
Rationale: If patients usually use service animals to assist them with ADLs, it is necessary to make arrangements for the accommodation of these animals. The patient should be moved to a private room, and a cage would prevent the service dog from freely assisting the patient, so it is not necessary.
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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 The nurse finds the man tearful and emotionally withdrawn.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.
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 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.
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 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.