Nokea
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.
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A 37-year-old woman with multiple sclerosis is married and has three children. The nurse has worked extensively with the woman and her family to plan appropriate care. What is the nurses most important role with this patient?
- A. Ensure the patient adheres to all treatments
- B. Provide the patient with advice on alternative treatment options
- C. Provide a detailed plan of activities of daily living (ADLs) for the patient
- D. Help the patient develop strategies to implement treatment regimens
Correct Answer: D
Rationale: The most important role of the nurse working with patients with chronic illness is to help patients develop the strategies needed to implement their treatment regimens and carry out activities of daily living. The nurse cannot ensure the patient adheres to all treatments. Providing information of treatment options is not the nurses most important role. The nurse does not provide the patient with a detailed plan of ADLs, though promotion of ADLs is a priority.
A nurse knows that patients with invisible disabilities like chronic pain often feel that their chronic conditions are more challenging to deal with than more visible disabilities. Why would they feel this way?
- A. Invisible disabilities create negative attitudes in the health care community.
- B. Despite appearances, invisible disabilities can be as disabling as visible disabilities.
- C. Disabilities, such as chronic pain, are apparent to the general population.
- D. Disabilities. Such as chronic pain, may not be curable, unlike visible disabilities.
Correct Answer: B
Rationale: Many disabilities are visible, but invisible disabilities are often as disabling as those that can be seen. Invisible disabilities are not noted to create negative attitudes among health care workers, though this is a possibility. Disabilities, such as chronic pain, are considered invisible and are not apparent to the general population.
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.
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.
A nurse is aware that the number of people in the United States who are living with disabilities is expected to continue increasing. What is considered to be one of the factors contributing to this increase?
- A. The decrease in the number of people with early-onset disabilities
- B. The increased inability to cure chronic disorders
- C. Changes in infection patterns resulting from antibiotic resistance
- D. Increased survival rates among people who experience trauma
Correct Answer: D
Rationale: The number of people with disabilities is expected to increase over time as people with early-onset disabilities, chronic disorders, and severe trauma survive and have normal or near-normal lifespans. There has not been a decrease in the number of people with early-onset disabilities. Acquired chronic disorders still cannot be cured.