Question 1

A patient tells the nurse,"I'll let you do whatever you think is best for me." The patient does very little independently without calling for assistance.The nurses conclude that the patient is demonstrating which personality characteristic?

Accepted Answer

The patient is demonstrating dependence by relying heavily on the nurse to make decisions and perform tasks for them. The statement "I'll let you do whatever you think is best for me" shows a lack of personal agency in decision-making and self-care.

Question 2

Which of the following is an appropriate intervention for the nursing diagnosis of spiritual distress?

Accepted Answer

Considering patients' religious beliefs when planning care is an appropriate intervention for the nursing diagnosis of spiritual distress. This helps to ensure that the patient's spiritual needs are being addressed and that they receive appropriate support in accordance with their beliefs. Providing information about prevalent religious beliefs in the area can also be helpful as it can allow patients to connect with appropriate spiritual resources. However, it is important to avoid any religious practices or beliefs that may be perceived as imposing beliefs on patients or that could be considered offensive or insensitive. Reassuring patients not to blame God for their illness may not be appropriate in all cases as patients may not attribute their illness to God.

Question 3

Which illness has the characteristics of an acute illness?

Accepted Answer

Influenza is an acute illness, meaning that it has a sudden onset and typically lasts for a limited amount of time (usually less than 2 weeks). Exercise-induced asthma and type 2 diabetes are chronic illnesses, meaning that they persist over a long period of time, while cleft palate is a congenital condition that is present from birth.

Question 4

A Caucasian nurse is caring for a Native American after a stroke.The nurse finds the patient sleeping while holding several small feathers bound by a beaded leather thong.The nurse should consider the possibility that this is

Accepted Answer

The feathers bound by a beaded leather thong may be an important item used in native healing practices. It is important for the nurse to be culturally competent and respect the patient's cultural beliefs and practices.

Question 5

What is the primary difference between acute illness and chronic illness?

Accepted Answer

The primary difference between acute illness and chronic illness is that in acute illness, symptoms begin suddenly, progress quickly, and subside quickly. Whereas in chronic illness, symptoms begin gradually, last for an extended period or even a lifetime, and may require ongoing management.

Question 6

A contemporary view of the sick role includes

Accepted Answer

A contemporary view of the sick role includes the patient as a partner with the health care provider, where the patient is actively involved in their healthcare decisions and treatment plan. This approach is based on the belief that patients are experts on their own health and have the right to make informed decisions about their care. This is different from the traditional view of the sick role, where the patient is seen as submissive to the health care provider and expected to comply with their instructions without question. The contemporary approach also recognizes the importance of cultural values in healthcare decisions and seeks to work with patients to incorporate their values and beliefs into their treatment plan. Noncompliance with the health care provider is not seen as a desirable outcome in the contemporary view of the sick role.

Question 7

A patient in whom metastatic cancer is diagnosed tells the nurse,"God has never let me down before.I'll pray for strength." This patient's illness behavior is being influenced by

Accepted Answer

The patient's statement about relying on prayer and their faith in God suggests that their illness behavior is influenced by spirituality. This may be an important coping mechanism for the patient in dealing with their cancer diagnosis.

Question 8

A patient states,"I do not understand why I keep getting these headaches.I have seen a nurse practitioner and two specialists.I have taken several medications,but the headaches keep coming back." In which stage of illness is the patient?

Accepted Answer

The patient is in the stage of attempting to gain control. They have sought medical help and tried various treatments, indicating that they are actively seeking a solution to their problem and trying to take control of their health.

Question 9

A patient states,"There is no hope.They're going to keep me here until I die.Can't you give me my medication more often? I'm going to die anyway." In which stage of illness is this patient?

Accepted Answer

The statement "There is no hope. They're going to keep me here until I die. Can't you give me my medication more often? I'm going to die anyway" indicates that the patient has likely moved past the stages of disbelief and denial, irritability and anger, and attempting to gain control. The patient's resignation and focus on their impending death suggest they are experiencing depression and grief, which is common in the later stages of illness.

Question 10

A patient states,"I am so upset that I need a knee replacement.I should have done those exercises that the physical therapist told me to do years ago." In which stage of illness is the patient?

Accepted Answer

The patient's statement reflects feelings of frustration and regret, which are characteristic of the "Irritability and anger" stage, where individuals may blame themselves or others for their health condition.

Question 11

A patient states,"I have knowledge about my diet and how to do my insulin injections,so I can get on with my life." In which stage of illness is this patient?

Accepted Answer

The patient's statement indicates that they have accepted their illness and are actively participating in their treatment by learning how to manage their diet and insulin injections. This is consistent with the Acceptance and Participation stage of illness.

Question 12

A young girl from a Middle Eastern country is in the process of dying.Her parents ask the nurses to allow her to be prepared for death by being dressed in a specific garment and headdress every day.The parents cannot be there every day to do this and ask the nurses to apply the attire.Which actions by the nurses demonstrate culturally competent care?

Accepted Answer

Culturally competent care requires nurses to understand and respect the traditions and beliefs of their patients. Learning how to apply the garment and headdress properly demonstrates an effort to accommodate the wishes of the family and show respect for their culture. Option A is also acceptable if the parents are present to dress the patient themselves. Consulting the chaplain may provide additional insight, but it is not necessary for the nurses to fulfill the family's request. Option C is not an appropriate response as it disregards the family's cultural beliefs.

Question 13

A patient with diabetes who refuses to change eating patterns may be in which stage of adjustment?

Accepted Answer

Refusing to change eating patterns is a sign of denial which is a normal stage of adjustment in the process of chronic illness.

Question 14

Which statement about acute illness is true?

Accepted Answer

Acute illness is a short-term illness that usually has a sudden onset and is often severe. Most people with acute illness return to their previous level of wellness with appropriate treatment and self-care measures. The majority of people with acute illness do not develop chronic illness as a result. Not all people with acute illness require medical care, as some may resolve on their own or with minor interventions. Acute illnesses can range from minor illnesses, such as the common cold, to more serious conditions, but they are not inherently catastrophic in nature.

Question 15

A patient in whom cancer has just been diagnosed tells the nurse,"Just get out of here and leave me alone! Let me suffer alone.God is punishing me." The nurse determines that the most appropriate nursing diagnosis for this patient is

Accepted Answer

The patient's statement about God punishing them suggests a spiritual distress related to the cancer diagnosis. The patient may benefit from spiritual support and counseling to address these beliefs and feelings. Option A (risk for loneliness) may also be applicable, but it is not the most appropriate diagnosis given the patient's expressed desire to be alone. Option B (powerlessness) may be more appropriate if the patient's statement was related to a sense of loss of control over their life and health. Option C (dysfunctional grieving) would not be appropriate as the patient has just received the diagnosis and has not yet had time to process or grieve the situation.

Question 16

A patient diagnosed with breast cancer responded by gathering information about treatment options and becoming involved in a self-help group.The nurse assesses that the patient is demonstrating which personality characteristic?

Accepted Answer

Hardiness refers to a personality characteristic that reflects a combination of resilience, challenge, and control. Individuals who are hardy are better able to adapt and cope with difficult situations, such as a diagnosis of breast cancer. They are more likely to seek out information and support, and to become actively involved in their own care. This is consistent with the patient's behavior of gathering information about treatment options and joining a self-help group. Independence, self-control, and tolerance may also be important personality characteristics, but they are not specifically demonstrated by this patient's behavior.

Question 17

An English-speaking nurse gave a non-English-speaking Asian patient instructions about preparing an abdominal surgical site.The nurse showed the patient how the bottle of povidone-iodine was to be used in cleansing the area.The patient smiled and nodded throughout the instructions.The patient did not respond when asked if he had any questions.When the nurse left the room,the patient promptly drank the bottle of povidone-iodine.Which action would be most effective in preventing this error?

Accepted Answer

Since the patient did not understand the nurse's instructions and did not ask any questions, it is important to use a medical interpreter who can accurately communicate the instructions in the patient's language. Giving written instructions, having the patient sign a statement, or using illustrations may not be effective if the patient is illiterate or unable to read and understand the language. A medical interpreter can also provide an opportunity for the patient to ask questions and clarify any misunderstandings.

Question 18

A patient was diagnosed with ovarian cancer 5 years ago.She underwent chemotherapy and radiotherapy,but cancer returned 2 years ago with metastases to the bone and possibly the lung.She says the cancer is "no longer curable,but treatable." During this time the patient's daughter was critically injured in a car accident and now lives with a traumatic brain injury,needing round-the-clock care.Her husband had an affair.She continues to work and volunteers with various community groups.Which phenomenon is the patient demonstrating?

Accepted Answer

The patient is demonstrating resilience, which is the ability to adapt and cope in the face of adversity or difficult situations. Despite the cancer returning and the various challenges in her personal life, she continues to work and volunteer, indicating a strong ability to persevere and overcome obstacles.

Question 19

Which illness has the characteristics of a chronic illness?

Accepted Answer

Lupus is a chronic autoimmune disease that causes inflammation and damage to various body tissues and organs. It is long-lasting and may cause symptoms that can last for a lifetime.

Answer: B) Bronchitis 
 Bronchitis is an acute illness that causes inflammation in the bronchial tubes, which carry air to the lungs. Although it can last for several weeks, it is not considered a chronic illness.

Answer: D) Gastroenteritis 
 Gastroenteritis is an acute illness that causes inflammation of the stomach and intestines. It is typically caused by a viral or bacterial infection and usually goes away on its own within a few days. It is not considered a chronic illness.

Therefore, the best choice is A) Lupus.

Question 20

A patient is in the intensive care unit after a myocardial infarction and refuses to stay in bed,saying,"I have to be up and walking around.When I stayed in bed after having my babies 40 years ago,I got so weak I could hardly move." This patient's illness behavior is being influenced by

Accepted Answer

The patient's past experience of feeling weak after staying in bed after childbirth is influencing their current illness behavior of wanting to be up and walking around after a myocardial infarction.

Quiz 13: Nurses,patients Families: Caring at the Intersection of Health,Illness Culture