Chapter 11 Flashcards
Olan is a retired 67-year-old veteran. He has advanced lung disease from years of smoking cigarettes and working in a chemical plant. On a good day, he can walk slowly around the block with minimal oxygen, but on a bad day he can only make it to his recliner chair in front of the television. He is malnourished and lives on his veteran benefits in a small one-bedroom apartment. He has no contact with family. A home care nurse is assigned to his case.
As the nurse working with Olan, which skills are important in developing a professional relationship? Select all that apply.
A - Take time to talk and communicate.
B - Focus on the priorities and concerns of the client.
C - Establish trust.
D - Be caring, respectful, and understanding.
E - Implement the medication plan of care as a priority.
A
B
C
D
After performing an assessment on Olan “on a good day,” where would the nurse place him on the Dunn’s health grid?
A - High-level wellness in a favorable environment
B - Emergent high-level wellness in an unfavorable environment
C - Protected poor health in a favorable environment
D - Poor health in an unfavorable environment
E - None of the categories applies.
B
At the nurse’s next visit with Olan, she finds him “on a bad day.” Where would the nurse place him today on the Dunn’s health grid?
A- High-level wellness in a favorable environment
B - Emergent high-level wellness in an unfavorable environment
C - Protected poor health in a favorable environment
D - Poor health in an unfavorable environment
E - None of the categories applies.
D
As the nurse prepares a plan of care for Olan, which consideration best describes the foundation of the nursing plan?
A- Create a situation of improving health so Olan can begin walking around the block two or three times every day.
B - Focus on his nutritional status, encouraging high-protein meals.
C - Contact his family, including them in the plan of care.
D - Remove Olan from his current location, placing him in a care facility.
E - Determine what Olan feels would be his optimal state of health and create a plan around that.
E
The nurse speaks with Olan about his life growing up in a rural Kentucky community. Which statements contribute to his current health beliefs? Select all that apply.
A - “When we were sick, we had to be half-dead before my parents would get the doctor.”
B - “As a younger man, I was laid off from my job many times and did not have insurance.”
C - “I’ve smoked at least two packs of cigarettes a day since the war. I finally quit a year ago.”
D - “The doctors at the veteran’s health clinic are very welcoming.”
E - “My kids stopped talking to me years ago, when their mother and I divorced.”
A
B
C
D
As the nurse continues to see Olan each week, she begins to see an improvement in his state of health. His “good days” are more frequent and his “bad days” are rare. He has met a neighbor, also a veteran, and they have morning coffee each day, a time for sharing stories. Which statements by Olan demonstrate reasons for this change? Select all that apply.
A - “I went to the clinic and they increased my medications.”
B - “I’m sleeping through the night, only getting up once to go to the bathroom.”
C - “My son contacted me and we have started talking again.”
D - “I’ve found God and recommitted my life to Him.”
E - “Food tastes good and I’ve gained some weight.”
B
C
D
E
The nurse determines that weekly visits are no longer needed for Olan. The goals of the plan of care have been met and exceeded. Which statement is true about Olan’s future?
A - He will continue to live at this highest level of functioning.
B - He will return to his previous level of functioning once the weekly visits stop.
C - His improvement of health was a result of the nurse’s visits.
D - He will fluctuate between health and illness for the rest of his life.
E - His health may deteriorate slightly after the visits end.
D
Which processes did the nurse use while working with Olan that best promoted this therapeutic relationship? Select all that apply.
A - Forced own preferences
B - Took time to communicate
C - Limited visitation time
D - Developed thorough assessment skills
E - Identified the client’s main concerns
B
D
E
A 42-year old client has been laid off from his management job and has several unpaid bills. He is going through a divorce after 17 years of marriage. He has been seeking counseling with his pastor. He does not have a healthcare provider because he rarely gets sick and his parents never took him to a physician when he was a child. Which variables influence the patient’s health practices? Select all that apply.
A - Age of client
B - Family practice of not routinely seeing a healthcare provider
C - Stress from the divorce and the loss of a job
D - Difficulty paying his bills
E - Seeing his pastor for support
B
C
D
E
The nurse is caring for a 72-year-old client with uncontrolled diabetes and hypertension. He lives with family members who prepare healthy meals and encourage him to be active with friends and at the community center, but he disregards their advice and prefers to eat fast food. Where would the nurse place the client on Dunn’s health grid?
A - Poor health in an unfavorable environment
B - High-level wellness in a favorable environment
C - Protected poor health in a favorable environment
D - Emergent high-level wellness in an unfavorable environment
C
A client is speaking with a nurse and says, “I don’t understand, I exercise every day and eat a balanced diet, yet I’m always getting sick. My husband, on the other hand, eats poorly and never exercises and he never gets sick.” What would be the nurse’s best response?
A- “There are many factors that impact health and illness; let’s discuss some.”
B - “Everyone is different, and I guess your husband is just lucky.”
C - “It sounds like you are depressed about being sick.”
D - “It depends on the immune system; yours must not be as strong.”
A
The nurse is honoring the client’s individual health–illness beliefs by using which statement?
A - “You can feel better if you work hard at it. It is obtainable.”
B - “Your weight is below what it should be. I’ll incorporate more calories into your diet.”
C - “You’ll want to reduce the stress in your life, because it’s causing your illness.”
D - “Tell me what it means to you to be in optimal health.”
D
A nurse is concerned about his personal level of wellness. Since beginning a new job on a busy nursing unit, he’s been unable to sleep well and feels stressed all the time. What suggestions could you make for health balance? Select all that apply.
A - Develop a regular exercise program.
B - Eat a balanced diet.
C - Meditate or pray daily.
D - See a healthcare provider for a sedative.
E - Listen to relaxing music on the way to and from work.
A
B
C
E
The nurse is caring for a 65-year-old female client recently diagnosed with breast cancer. According to Betty Neuman’s health–illness continuum, which factors could have contributed to this illness?
A - Age
B - Gender
C - Genetics
D - Comorbidities
E - Level of activity
A
B
C
The nurse is caring for a client admitted with uncontrolled type 2 diabetes mellitus. Which instruction should the nurse provide to the client to move him or her to the health aspect of the health–illness continuum?
A - Take stool softeners twice a day.
B - Include fresh fruits and vegetables in the diet.
C - Include high-calcium foods and a supplement.
D - Incorporate the intake of food high in antioxidants.
B
Which activities would help a client reduce the risk for developing chronic disease?
A - Jogging for 15 minutes most days
B - Walking on a daily basis
C - Gardening for 30 minutes a few days per week
D - Playing video games for an hour every night
E - Obtaining enough sleep on a nightly basis
A
B
C
Which hormone is released during sleep?
A - Oxytocin
B - Melatonin
C - Aldosterone
D - Growth hormone
D
The nurse is educating a group of high school students about the hazards of tobacco use. Which information about tobacco use can the nurse include during this session?
A - Increases risk for cancer
B - Leads to low-birth-weight babies
C - Decreases recovery time from illness
D - Lowers the risk for developing heart disease
E - Causes a decrease in functional relationships
A
B
