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An elderly female patient has come to the clinic for a scheduled follow-up appointment. The nurse learns from the patients daughter that the patient is not following the instructions she received upon discharge from the hospital last month. What is the most likely factor causing the patient not to adhere to her therapeutic regimen?
- A. Ethnic background of health care provider
- B. Costs of the prescribed regimen
- C. Presence of a learning disability
- D. Personality of the physician
Correct Answer: B
Rationale: Variables that appear to influence the degree of adherence to a prescribed therapeutic regimen include gender, race, education, illness, complexity of the regimen, and the cost of treatments. The ethnic background of the health care provider and the personality of the physician are not considered variables that appear to influence the degree of adherence to a prescribed therapeutic regimen. A learning disability could greatly affect adherence, but cost is a more likely barrier.
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A public health nurse is preparing to hold a series of health-promotion classes for middle-aged adults that will address a variety of topics. Which site would best meet the learning needs of this population?
- A. A well-respected physicians office
- B. A large, local workplace
- C. The local hospital
- D. An ambulatory clinic
Correct Answer: B
Rationale: The workplace has become a center for health-promotion activity. Health-promotion programs can generally be offered almost anywhere in the community, but the workplace is often more convenient for the adult, working population. This makes this option preferable to a hospital, doctors office, or ambulatory clinic.
A gerontologic nurse has observed that patients often fail to adhere to a therapeutic regimen. What strategy should the nurse adopt to best assist an older adult in adhering to a therapeutic regimen involving wound care?
- A. Demonstrate a dressing change and allow the patient to practice.
- B. Provide a detailed pamphlet on a dressing change.
- C. Verbally instruct the patient how to change a dressing and check for comprehension.
- D. Delegate the dressing change to a trusted family member.
Correct Answer: A
Rationale: The nurse must consider that older adults may have deficits in the ability to draw inferences, apply information, or understand major teaching points. Demonstration and practice are essential in meeting their learning needs. The other options are incorrect because the elderly may have problems reading and/or understanding a written pamphlet or verbal instructions. Having a family member change the dressing when the patient is capable of doing it impedes self-care and independence.
A public health nurse understands that health promotion should continue across the lifespan. When planning health promotion initiatives, when in the lifespan should health promotion begin?
- A. Adolescence
- B. School age
- C. Preschool
- D. Before birth
Correct Answer: D
Rationale: Health promotion should begin prior to birth because the health practices of a mother prior to the birth of her child can be influenced positively or negatively. This makes the other options incorrect.
A community health nurse has been asked to participate in a health fair that is being sponsored by the local senior center. The nurse should select educational focuses in the knowledge that older adults benefit most from what kind of activities?
- A. Those that help them eat well
- B. Those that help them maintain independence
- C. Those that preserve their social interactions
- D. Those that promote financial stability
Correct Answer: B
Rationale: Although their chronic illnesses and disabilities cannot be eliminated, the elderly can benefit most from activities that help them maintain independence and achieve an optimal level of health. For many older adults, this is a priority over social interaction, finances, or eating well, even though each of these subjects is important.
As the nurse working in a gerontology clinic, you know that some elderly people do not adhere to therapeutic regimens because of chronic illnesses that require long-term treatment by several health care providers. What is the most important consideration when dealing with this segment of the population?
- A. Health care professionals must know all the dietary supplements the patient is taking.
- B. Health care professionals must work together to provide coordinated care.
- C. Health care professionals may negate the efforts of another health care provider.
- D. Health care professionals must have a peer witness their interactions with the patient.
Correct Answer: B
Rationale: Above all, health care professionals must work together to provide continuous, coordinated care; otherwise, the efforts of one health care professional may be negated by those of another. Interactions do not necessarily need to be witnessed. The care team should be aware of the patients use of supplements, but this is not a priority principle that guides overall care.