Question 1

Which of the following is most reflective of a life change for managing chronic illness?

Accepted Answer

Chronic illness lasts for a long period of time,usually 6 months or more,and often a lifetime.Chronic illness requires the person to make life changes.These changes might be regular visits to the clinic or hospital,daily medications,or lifestyle modifications such a following a specific diet or smoking cessation.Common chronic illnesses include AIDS,diabetes mellitus,rheumatoid arthritis,and hypertension.Starting on a medication for a tooth extraction or strep throat is a reaction to acute and short-term illnesses.Starting an exercise program at the gym may be an activity that one is beginning as part chronic illness lifestyle change; however,it can also be a healthy lifestyle,health promotion activity.

Question 2

The nursing student is working with a primary nurse on the oncology unit.She says to the nurse,"How can I best help my patients' and to make their hospital stay a better experience?" What is the most appropriate response for the nurse to make? Select all that apply.

Accepted Answer

As a nurse,one can be an instrument of healing in a hurtful world.However,being an instrument of healing does not come automatically with your nursing license.Nor does it allow the luxury of learning just one approach and applying it to every client or patient.It means cultivating a healing presence by listening,being maximally attentive,being aware of one's own gifts and limitations of communication,being willing to learn from those in your care,recognizing and respecting others' was of coping,and enjoying others for who they are.

Question 3

Which of the following situations can lead to family caregiver's feeling(s)of "burnout"? Select all that apply.

Accepted Answer

Everyone has limits.For healthcare providers,too many demands over too long a period of time can lead to "burnout," a feeling of being overwhelmed and demoralized.The same can happen for clients and families.For clients and their families,dealing with the cumulative effect of illness and other life disruptions can break down what might otherwise be excellent coping skills.Therefore,their response many not be typical of what they usually have demonstrated.In this item,the long-term effects of caring for a family member with mental illness such as schizophrenia or Alzheimer's disease are most likely circumstances that can cause burnout.Caring for an infant growing a first tooth and caring for a child with a broken leg are short-term situations with an "end in sight."

Question 4

Which of the following best describes "meaningful work"? Select all that apply.

Accepted Answer

Many people find that work is a healthy way to cope with stressors.People also experience meaningful work as a dimension of wellness.For many people,volunteering,pursuing hobbies,and engaging in pleasurable activities can be forms of meaningful work.For example,some find that singing,playing a musical instrument,or listening to music is particularly healing.Others may enjoy shopping,drawing,or gardening.Additionally,usually in any description of "meaningful" work,salary is not mentioned.

Question 5

The nurse is caring for a patient in his home.After several visits and review of the plan of care,the nurse notices the patient will not follow the diet and exercise regimen.What is the most appropriate action by the nurse?

Accepted Answer

Patients may fail to comply with proposed medical regimens or a plan of care if the plan has no cultural or personal relevance for the patient (or family).The nurse must consider the patient's understanding of the plan,knowledge level,and feasibility in terms of available support,time,energy,and finances.Noncompliance often occurs because the effort,inconvenience,or pain involved with the plan is too much for them to handle.People probably do not refuse to carry out a plan of care simply out of stubbornness,hostility toward healthcare providers,or wanton disregard for their own welfare.The challenge and best action by the nurse is to develop an individualized plan of care in collaboration with the patient,based on mutual goals and respect.If after assessing the problem and revising the plan,the patient continues to refuse to follow the plan,then the physician can be notified and the patient possibly discharged.However,these are not the first and most appropriate actions by the nurse.

Question 6

The nurse is admitting a 70-year-old Hispanic female to the medical floor.Upon her arrival,the nurse notices that the woman speaks very little English and does not appear to understand what the nurse is asking.What is the most appropriate action by the nurse?

Accepted Answer

In admitting this patient,the most appropriate action by the nurse is to activate the hospital translation system or obtain a translator.It is appropriate to contact a family member; however,the assessment cannot be deferred until the family member's arrival because one cannot predict the time of arrival.Hand gestures and facial expressions are commonly used to identify pain when a patent has a language barrier; however,there is much more information that needs to be obtained from this patient as part of the assessment process.Additionally,it is common to check with another staff member who may be able to translate; however,one cannot predict the availability or the language proficiency of the staff member.

Question 7

The nurse is admitting a patient with heart disease to the cardiac unit.When answering questions related to his health history,the patient's responses are lengthy and time consuming.What is the most important action by the nurse?

Accepted Answer

Being maximally attentive is an important factor in facilitating communication.Most people are hungry for someone to listen to them.So often,listeners are so busy thinking about what they want to say that they fail to really listen.The best action is to focus on what the patient or family has to say instead of thinking ahead to what the nurse may want to ask.

Question 8

Having someone physically present during times of illness removes the sense of aloneness during the illness.

Accepted Answer

The sense of "aloneness" or isolation reported by seriously ill clients is related in part to their actual physical separation from loved ones during treatments,hospitalizations,or clinic visits.But it also stems from their feeling that there is no one who is really "in their world." Having someone physically present does not necessarily remove the sense of aloneness a seriously ill client is experiencing.The statement is false.

Question 9

Patients may fail to comply with a proposed healthcare regimen and therefore are perceived to be noncompliant.Identify common reason(s)a patient may be noncompliant with a plan of care? Select all that apply.

Accepted Answer

Patients may fail to comply with proposed medical regimens or a plan of care if the plan has no cultural or personal relevance for the patient (or family).The nurse must consider the patient's understanding of the plan,knowledge level,and feasibility in terms of available support,time,energy,and finances.Noncompliance often occurs because the effort,inconvenience,or pain involved with the plan is too much for them to handle.People probably do not refuse to carry out a plan of care simply out of stubbornness,hostility toward healthcare providers,or wanton disregard for their own welfare.

Question 10

A 30-year-old male patient who has been experiencing joint pain for several months is diagnosed with rheumatoid arthritis.He tells the nurse,"This can't be happening to me.I don't understand this." Which statement below best describes the nurse's primary understanding of the patient statements?

Accepted Answer

Developmental stage influences a person's ability to cope with stressors that tend to move him toward the illness end of the health-illness continuum.For example,infants or children who are ill,frightened,or hurt have a limited repertoire of experiences,communication ability,and understanding to help them in their responses.Age is not the determining factor in one's ability to cope,but developmental stage is.The man at age 30 may not accept his illness at this time because he is not developmentally ready but we do not know this because he has just been informed of the diagnosis.His statements do not provide enough information to infer that he is in denial or that he does not accept his illness.

Question 11

Health is defined as the absence of illness related to mind,body,and spirit.

Accepted Answer

There are many definitions,descriptions,and models of health.There are models of health such as the health-illness continuum,Dunn's Health Grid,Neuman's Continuum.There are also many definitions of health set forth by the World Health Organization (WHO),Florence Nightingale,and Chinese and ancient Indian medicine.What is most significant and accurate is that health is personal to each individual and defined and experienced differently by that individual.The statement is false.

Quiz 11: Experiencing Health Illness