Nokea
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.
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You are the case manager who oversees the multidisciplinary care of several patients living with chronic conditions. Two of your patients are living with spina bifida. You recognize that the center of care for these two patients typically exists where?
- A. In the hospital
- B. In the physicians office
- C. In the home
- D. In the rehabilitation facility
Correct Answer: C
Rationale: The day-to-day management of illness is largely the responsibility of people with chronic disorders and their families. As a result, the home, rather than the hospital, is the center of care in chronic conditions. Hospitals, rehabilitation facilities, clinics, physicians offices, nursing homes, nursing centers, and community agencies are considered adjuncts or back-up services to daily home management.
The nurse is reviewing the importance of preventative health care with a patient who has a disability. The patient states that she will not have the money to pay for her annual gynecologic exams or mammograms due to the cost of this hospitalization. What information would be appropriate for the nurse to share with the patient?
- A. Limited finances are a common problem for patients with a disability. Since you were hospitalized this year, you can likely forego the gynecologic exam and mammogram.
- B. These are very important health preventative measures, so you will need to borrow the money to pay for the exam and mammogram.
- C. Ill look into federal assistance programs that provide financial assistance for health-related expenses for people with disabling conditions.
- D. These preventative measures should likely be tax deductible, so you should consult with your accountant and then make your appointments.
Correct Answer: C
Rationale: Several federal assistance programs provide financial assistance for health-related expenses for people with some chronic illnesses, acquired disabling acute and chronic diseases, and diseases from childhood. Lack of financial resources, including health insurance, is an important barrier to health care for people with disabilities. Each of the other responses is inappropriate and inaccurate.
You are the nurse caring for a young mother who has a longstanding diagnosis of multiple sclerosis (MS). She was admitted to your unit with a postpartum infection 3 days ago. You are planning to discharge her home when she has finished 5 days of IV antibiotic therapy. With what information would it be most important for you to provide this patient?
- A. A succinct overview of postpartum infections
- B. How the response to infection differs in patients with multiple sclerosis
- C. The same information you would provide to a patient without a chronic condition
- D. Information on effective management of multiple sclerosis in the home setting
Correct Answer: C
Rationale: In general, patients with disabilities are in need of the same information as other patients. Information on home management of MS has likely been already provided to the patient. The immune response does not greatly differ in this patient.
A case manager is responsible for ensuring that patients meet the criteria for diagnoses of chronic conditions in order to ensure their eligibility for federal programs. Which of these definitions may not apply for legal purposes?
- A. A person who is temporarily disabled but later return to full functioning.
- B. A person who is disabled and cannot expect a return to full functioning.
- C. A person whose disability is the result of a developmental disorder.
- D. A person whose disability is the result of a traumatic injury.
Correct Answer: A
Rationale: People can be temporarily disabled because of an injury or acute exacerbation of a chronic disorder, but later return to full functioning; this definition of disability may not apply for legal purposes. Disabilities may result from developmental challenges or trauma.
The nurse is caring for a patient diagnosed with cancer of the liver who has chosen to remain in his home as long as he is able. The nurse reviews the care plan for the patient and notes that it focuses on palliative measures. The nurse also notes that over the last 3 weeks, the patients condition has continued to deteriorate. What is the nurses best response to this clinical information?
- A. Recognize that death will most likely occur in the next week.
- B. Recognize that the patient is in the trajectory phase of chronic illness and should be kept pain-free.
- C. Recognize that the patient is in the downward phase of chronic illness and should be reassessed.
- D. Recognize that the patient should immediately be admitted into the hospital.
Correct Answer: C
Rationale: The downward phase occurs when symptoms of chronic illness worsen despite attempts to control the course through proper regimen management. A downward turn does not necessarily lead to death. A downward trend can be arrested and the trajectory reestablished at any point, depending on the condition and the treatment. A patient who is palliative may not desire hospitalization and aggressive treatment.