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.
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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.
Research has corroborated an experienced nurses observation that the incidence and prevalence of chronic conditions is increasing in the United States. What health promotion initiative most directly addresses the factor that has been shown to contribute to this increase?
- A. A program to link residents with primary care providers
- B. A community-based weight-loss program
- C. A stress management workshop
- D. A cancer screening campaign
Correct Answer: B
Rationale: Lifestyle factors, such as smoking, chronic stress, and sedentary lifestyle, that increase the risk of chronic health problems such rhincrease in the incidence of chronic conditions. Obesity is paramount among these, exceeding the significance of lack of access to primary care, inadequate cancer screening, and inadequate personally significant than lack of access to primary care, inadequate cancer screening, and inadequate stress management.
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 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.
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.
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