Question 1

Which one of the following describes the nurse's role for an older patient with a chronic illness?&#10;A) Implement an individualized therapeutic regimen that brings about a cure.&#10;B) Provide caring to help the patient live at the optimal level of health and wellness.&#10;C) Suggest that the patient accept eventual death to reduce burdens on the patient's family.&#10;D) Encourage the patient to minimize the utilization of services to control costs.

Accepted Answer

The nurse's role for an older patient with a chronic illness would be to provide caring to help the patient live at the optimal level of health and wellness. It is unrealistic to expect a cure for a chronic illness, and suggesting that the patient accept eventual death is not within the nurse's scope of practice. Furthermore, encouraging the patient to minimize utilization of services to control costs is not appropriate, as the patient may require additional services to manage their chronic condition.

Question 2

An older male adult who is right-handed works as a carpenter, but he has been left with a flaccid right arm after a thrombus occluded a cerebral artery. Which is the most important goal for the plan of care to help this man achieve his optimal state of health and wellness?

A) Maintain skin integrity of the right arm.
B) Collaborate with occupational therapy.
C) Promote plaque-reversing strategies.
D) Support effective coping mechanisms.

Accepted Answer

Collaborating with occupational therapy is the most important goal for the plan of care in order to help the man achieve his optimal state of health and wellness. With the flaccid right arm, he will need assistance in relearning how to perform activities of daily living and work-related tasks. Occupational therapy can provide the necessary interventions and training to promote independence and improve quality of life. The other options, while still important, are not as critical as occupational therapy in this situation.

Question 3

Which statement is true about rehabilitation and restorative care for older adults?&#10;A) The purpose is to regain specific abilities lost because of a condition.&#10;B) Rehabilitation consists primarily of regular physiotherapy sessions.&#10;C) A person can learn skills and gain abilities that enable functioning.&#10;D) The patient's capabilities are recognized at the time of admission.

Accepted Answer

Rehabilitation and restorative care for older adults aim to help individuals learn new skills and regain lost abilities in order to improve overall functioning. This involves a range of therapies and interventions, not just physiotherapy, and focuses on improving the person's capabilities over time. Upon admission, a comprehensive assessment is typically conducted to determine the person's abilities and needs to develop an individualized plan of care.

Question 4

Which statement is the most suitable for establishing goals when teaching an older adult with a chronic illness about potential changes in the health maintenance regimen?&#10;A) Management of the patient's chronic disease rests on the patient and caregiver, so goals should be set collaboratively.&#10;B) The patient will be able to make needed changes in his life if you provide accurate, written instructions.&#10;C) Psychological functioning is usually impaired only to a small extent in a patient with a chronic illness.&#10;D) The patient's values, culture, and beliefs will have little to do with the types of changes he will be able to make.

Accepted Answer

Collaborative goal setting is important for patients with chronic illnesses, as it allows for a better understanding of the patient's values, beliefs, and preferences. This helps in tailoring the health maintenance regimen to the patient's individual needs and abilities. Option B is not suitable as it assumes that written instructions alone will enable the patient to make changes. Option C is incorrect as psychological functioning can be significantly impacted by chronic illness. Option D is also incorrect as a patient's values, culture, and beliefs play a significant role in their willingness and ability to make changes to their health maintenance regimen.

Question 5

An older female adult has diabetes mellitus. Which of the following validates the nurse's conclusion that this patient's illness is in the foreground perspective of the Shifting Perspectives Model of Chronic Illness?

A) The older adult has an amputation of two toes.
B) The older adult lives at home with her husband.
C) The older adult self-checks blood sugar frequently.
D) The older adult changes the battery in her glucometer.

Accepted Answer

The amputation of two toes is a complication of diabetes mellitus that can significantly impact daily life and requires ongoing management, putting the illness in the foreground perspective of the Shifting Perspectives Model of Chronic Illness. Choices B, C, and D are related to the patient's management of diabetes but do not necessarily indicate the foreground perspective.

Question 6

An older male adult who has osteoarthritis tells the nurse that he has experienced fatigue for the past two weeks. Which nursing intervention should the nurse implement to help him manage fatigue?&#10;A) Recommend an antidepressant.&#10;B) Help him plan exercise and rest.&#10;C) Plan two or three naps every day.&#10;D) Tell him the fatigue is due to osteoarthritis.

Accepted Answer

Planning exercise and rest can help manage fatigue in an older adult with osteoarthritis. The nurse can work with the patient to develop a plan that includes appropriate amounts of rest and exercise, and encourages the patient to pace activities throughout the day. Antidepressants may not be appropriate for managing fatigue in this patient given that fatigue is a common symptom of osteoarthritis. Planning two to three naps per day may not be feasible or effective for this patient's lifestyle. Telling the patient that the fatigue is due to osteoarthritis without offering additional interventions does not provide effective management of the symptom.

Question 7

Which of the following qualities does the nurse need to provide caring?&#10;A) Sensitivity to the needs of other nurses&#10;B) Longing to help others live a healthy life&#10;C) Desire to have a stable career and income&#10;D) Ability to create a trusting environment

Accepted Answer

Along with competence,compassion,conscience,and a commitment to provide caring,the nurse must be able to inspire confidence in the nursing care.The nurse with compassion has sensitivity to the needs of others in general.The desire to help others lead a healthy life is admirable; however,to provide caring,the nurse should not impose personal beliefs on patients.Nurses can provide caring by dedicating themselves to nursing as a lifelong commitment and not solely as a means to provide a living.

Question 8

An older female adult has gastritis, occasional migraine headaches and severe osteoporosis in the long bones, with impaired mobility and chronic pain. In the trajectory phase, what health teaching should the nurse offer to the older adult?

A) Regular exercise (at least 30 minutes daily) will increase bone density.
B) Daily intake of vitamin C 500 mg will reverse osteoporosis over time.
C) Rest periods of one to two hours throughout the day will prevent osteoporotic pain in long bones.
D) Taking nonsteroidal anti-inflammatory agents (NSAIDs) every two hours will reduce pain.

Accepted Answer

Regular exercise has been proven to increase bone density and reduce osteoporosis. It also helps with maintaining a healthy weight, improving mobility, reducing pain, and preventing falls. Vitamin C and rest periods may have some benefits, but they are not as effective as regular exercise. Taking NSAIDs every two hours is not safe, and it can lead to adverse effects such as gastrointestinal bleeding and kidney damage. The nurse should avoid recommending this option.

Question 9

Which one of the following descriptors represents a phase of the chronic illness trajectory (CIT)?&#10;A) Caring&#10;B) Stable&#10;C) Bargaining&#10;D) Rehabilitation

Accepted Answer

The chronic illness trajectory (CIT) framework includes a "stable" phase, where the illness symptoms are controlled and daily life activities continue with minimal disruption.

Question 10

An older female adult is diagnosed with a chronic illness. Which principle should the nurse apply when answering her questions?&#10;A) The most prevalent form of disease in Canada is acute illness.&#10;B) Usually, chronic disease has a negligible impact on the family.&#10;C) Chronic illness is unending, and coping can be influenced by the perception of uncertainty.&#10;D) Older adults cope successfully with chronic disease by learning about the disease.

Accepted Answer

Chronic illness is unending, and coping can be influenced by the perception of uncertainty. This is important for the nurse to keep in mind when addressing the older female adult's questions and concerns about her chronic illness. It is important to provide clear and accurate information while also acknowledging the uncertainty that comes with living with a chronic illness. Option A is incorrect as it is not relevant to the question being asked. Option B is false as chronic disease can have a significant impact on both the individual and their family. Option D may be true for some older adults, but it is not a universal coping mechanism for all.

Deck 15: Living With Chronic Illness