Nokea
A patient who is recovering from a stroke expresses frustration about his care to the nurse, stating, It seems like everyone sees me as just a problem that needs fixing. This patients statement is suggestive of what model of disability?
- A. Biopsychosocial model
- B. Social model
- C. Rehabilitation model
- D. Interface model
Correct Answer: C
Rationale: The rehabilitation model regards disability as a deficiency that requires a rehabilitation specialist or other helping professional to fix the problem. This is not characteristic of the biopsychosocial, social, or interface models.
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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 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.
A major cause of health-related problems is the increase in the incidence of chronic conditions. This is the case not only in developed countries like the United States but also in developing countries. What factor has contributed to the increased incidence of chronic diseases in developing countries?
- A. Developing countries are experiencing an increase in average life span.
- B. Increasing amounts of health research are taking place in developing countries.
- C. Developing countries lack the health infrastructure to manage illness.
- D. Developing countries are simultaneously coping with emerging infectious diseases.
Correct Answer: D
Rationale: Chronic conditions have become the major cause of health-related problems in developed countries as well as in the developing countries, which are also trying to cope with new and emerging infectious diseases. There is indeed a lack of health infrastructure in many countries, but this is not cited as the cause of the increased incidence of chronic diseases. In many countries, increased life span and health research are not occurring.
A patient has recently been diagnosed with type 2 diabetes. The patient is clinically obese and has a sedentary lifestyle. How can the nurse best begin to help the patient increase his activity level?
- A. Set up appointment times at a local fitness center for the patient to attend.
- B. Have a family member ensure the patient follows a suggested exercise plan.
- C. Construct an exercise program and have the patient follow it.
- D. Identify barriers with the patient that inhibit his lifestyle change.
Correct Answer: D
Rationale: Nurses cannot expect that sedentary patients are going to develop a sudden passion for exercise and that they will easily rearrange their day to accommodate time-consuming exercise plans. The patient may not be ready or willing to accept this lifestyle change. This is why it is important that the nurse and patient identify barriers to change.
A patient with end-stage lung cancer has been admitted to hospice care. The hospice team is meeting with the patient and her family to establish goals for care. What is likely to be a first priority in goal setting for the patient?
- A. Maintenance of activities of daily living
- B. Pain control
- C. Social interaction
- D. Promotion of spirituality
Correct Answer: B
Rationale: Once the phase of illness has been identified for a specific patient, along with the specific medical problems and related social and psychological problems, the nurse helps prioritize problems and establish the goals of care. Identification of goals must be a collaborative effort, with the patient, family, and nurse working together, and the goals must be consistent with the abilities, desires, motivations, and resources of those involved. Pain control is essential for patients who have a terminal illness. If pain control is not achieved, all activities of daily living are unattainable. This is thus a priority in planning care over the other listed goals.