Gero Chapter 29 - Living in Harmony with Chronic Conditions

An older adult client has recently been diagnosed with rheumatoid arthritis that is having a significant impact on the client's daily routines and quality of life. Which response by the nurse best demonstrates understanding about the importance of healing rather than curing the client's condition?

A. "A combination of physical therapy and corticosteroid treatment have a strong chance of mitigating the effects of your arthritis."

B. "The best way for us to foster your overall well-being is to eliminate the symptoms that are most affecting your daily routines."

C. "There are changes that I can help you make that can help you live a full life despite this health problem."

D. "There are lifestyle changes, coupled with promising new therapies, that hold out hope for being free from this problem."

C. "There are changes that I can help you make that can help you live a full life despite this health problem."

The nursing supervisor is reviewing the client's plan of care developed by the homecare nurse. The client recently has been dealing with uncontrolled type 2 diabetes. Which goal identified on the plan of care would the supervisor question?

A. "The client will gain the knowledge and skills necessary to manage his diabetes

independently and effectively within 3 months."

B. "The client will remain free of common complications of diabetes."

C. "The client will maintain a high quality of life despite his diabetes."

D. "The client will regain blood sugar control without medications or diet limitations."

D. "The client will regain blood sugar control without medications or diet limitations."

Despite the fact that a client is now receiving palliative care because of the progression of congestive heart failure (CHF), a nurse views the care that was provided for the client as a success. The nurse arrives at this conclusion based on which information?

A. The client was able to live independently and provide self-care until very late in the progression of the disease.

B. The client maintained an acceptable cardiac output for most of the time that the

client lived with CHF.

C. The client was able to teach other older adults about the experience of living with

CHF and the way it affected life.

D. The client remained largely pain-free from the time of diagnosis until the present

time.

A. The client was able to live independently and provide self-care until very late in the progression of the disease.

A nurse is providing care to an 82-year-old client on the palliative care unit of a hospital. The client has a long-standing diagnosis of diabetes that has manifested in serious cardiac problems. The client is not expected to survive the weekend. Which interpretation would be appropriate regarding the client's chronic care?

A. Death represents the ultimate failure of the provision of care.

B. Dying in comfort and dignity is the final component of high-quality chronic care.

C. The period of death represents the transition from chronic care to acute care.

D. Holistic, chronic care requires limiting the care to psychosocial interventions.

B. Dying in comfort and dignity is the final component of high-quality chronic care.

An older adult who lives alone has hypertension and diabetes but seems to manage both conditions quite well. Three times a week, the client drives to a dialysis center for dialysis. Due to loneliness, the client often has lunch or dinner in restaurants where the client may eat and drink excessively. Which suggestion could a nurse at the dialysis center most likely suggest to assist the client in managing the conditions?

A. "It is important for you to eat at home most of the time."

B. "Take a list of approved foods with you when you go to the restaurants."

C. "Let's find some social activities you might like that do not involve eating."

D. "Check your blood pressure and blood sugar after returning home."

C. "Let's find some social activities you might like that do not involve eating."

A nurse in a cardiac rehabilitation unit is helping an older adult client set health goals for the coming year. The client has had one heart attack and two coronary artery bypass surgeries and can now walk only one city block (1/8 mile) before tiring. Together with the client, the nurse would identify which goal as being reasonable for the client to achieve by the end of the year?

A. Walking 10 blocks every day

B. Jogging 4 blocks every day

C. Walking 24 blocks every day

D. Continuing to walk 1 block every day

A. Walking 10 blocks every day

A nurse is reviewing the medical records of several older adult clients with chronic conditions. Which client would the nurse most likely identify as having the greatest care needs?

A. An 80-year-old client with varicose veins who has just been diagnosed with

osteoarthritis.

B. A 74-year-old client with macular degeneration and long-standing type 1 diabetes.

C. A 77-year-old client with long-standing hypertension and is exhibiting early signs

of chronic renal failure.

D. An 84-year-old client who lives with severe hearing loss and recurrent pleural

effusions.

B. A 74-year-old client with macular degeneration and long-standing type 1 diabetes.

A home health care nurse is providing care to an older adult client with chronic conditions. Which intervention would be most appropriate for the nurse to implement to best ensure proper care for a client when the nurse is not present but can be reached by a telephone or pager?

A. Encourage that family's questions be filtered through the primary caregiver.

B. Provide detailed written instructions for all procedures.

C. Educate the client once about all procedures.

D. Train all caregivers carefully in all procedures.

B. Provide detailed written instructions for all procedures.

A 77-year-old client has recently been diagnosed with type 2 diabetes. The gerontological nurse providing care to the client has emphasized the need for smart lifestyle choices in managing diabetes. The client says, "Choices! I did not choose to get diabetes and there is not much that I can do about it!" Which statement supports the response that the nurse will provide?

a. Many of the factors that contribute to increased quality of life are within your direct control.

Test Bank - Gerontological Nursing, 10th Edition (Eliopoulos, 2022)

b. You can adopt or reject behaviors that have the potential to cure the disease.

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c. You can identify treatment options in consultation with the health care provider who is providing care.

d. Lifestyle choices exist only if you have strong support networks and sufficient resources.

a. Many of the factors that contribute to increased quality of life are within your direct control.

An older adult client has a serious chronic condition that requires visits to the health care provider several times a year (or more, if hospitalized). The client is considering four health care providers, all of whom are well qualified. Which provider is likely to be her best choice?

A. The top expert in the field who is highly respected at the local hospital

B. A health care provider with an office in the client's neighborhood

C. A health care provider who makes the client feel comfortable

D. A health care provider who communicates well with the client and is in high demand

C. A health care provider who makes the client feel comfortable

76-year-old client's quality of life has been significantly affected by chronic obstructive pulmonary disease.The client has experienced a steady decline in activity tolerance, mobility,and ultimately independence.Considering the apparent ineffectiveness of conventional treatment, the client is eager to forego conventional treatments and explore alternative and complementary treatment options.

A."It is a decision to focus strictly on alternative therapies since most research is conducted on these types of therapies."

B."These are good options to explore,but you need to set aside your health care provider's advice in the short term to get accurate information."

C."Try not to think of your options as choosing conventional treatment or alternative therapies,but rather choosing the best of both."

D."Your care team is probably ignorant of alternative therapies,so you'll have to go elsewhere for any information you need."

C. "Try not to think of your options as choosing either conventional treatment or alternative therapies, but rather choosing the best of both."

An older adult and spouse have lived in their home for 50 years. The client has a diagnosis of heart failure and blindness. The nurse is making a home visit to the client. Which factor would the nurse most likely identify as having the greatest impact on the client's ability to manage the condition?

A. The availability of new treatment options for his disease

B. The financial resources available to the client and spouse

C. The course and progression of the client's disease

D. The openness of the client to complementary and alternative medicine (CAM)

C. The course and progression of the client's disease

The adult child of an 80-year-old client with a diagnosis of severe ischemic heart disease has been the sole caregiver for over one year. The caregiver is tearfully telling the nurse about the onerous burden by struggling to meet the client's ever-increasing needs. Which response by the nurse would be most appropriate?

A. "There are promising new treatments for heart disease that hold a great potential for your parent."

B. "It is very normal for you to feel this way, given how much you do; perhaps we can explore other living options together."

C. "It sounds like it is probably time to think about placing your parent into long- term care."

D. "This must be difficult for you; others in similar circumstances find it useful to remind themselves of how much their parents did for them when they were young."

B. "It is very normal for you to feel this way, given how much you do; perhaps we can explore other living options together."

An older adult client in a nursing home is considered non-compliant by much of the staff because the client refuses to eat some of the food. In addition, the client sometimes skips exercise classes. On the other hand, the client takes all the prescribed medicines, and gets along well with the other clients. When reviewing the client's status, which area would the nurse identify as being successfully met by the client?

a. Diet

b. Assertiveness

c. Exercise

d. Compliance

b. Assertiveness

An older adult client says, "I do not need my medicine for hypertension. It makes me feel weak and I think it sometimes makes me impotent." When the client's spouse tries to remind the client to take the drug, the client becomes irritated. Which action would be appropriate for the nurse to do?

A. Allow the client to vent these frustrations.

B. Insist that the client force oneself to take the medicine.

C. Advise the client's spouse to supervise the client.

D. Pressure the client repeatedly about the need for the medicine to treat hypertension.

A. Allow the client to vent these frustrations.

An older adult client has lived with the son and his family for about 10 years. The client's daughter-in-law is the primary caregiver, and has begun to feel resentful about having retired from her job to take on this role. Recently, the family hired a part-time home care worker to help, which gives the daughter-in- law more freedom but adds to the financial burden. Which guidance will the nurse provide?

A. Set firmer boundaries with the client

B. Arrange for additional in-home care

C. Consider finding an assisted-living facility

D. Make their own decisions without outside input

C. Consider finding an assisted-living facility

A home health care nurse is making a home visit to an older adult client with a chronic condition. The client has a chronic care coach. During the visit, the nurse observes the coach praise the client for the positive results on the current blood test. The nurse interprets this as which step?

A. Contact

B. Affirm

C. Observe

D. Help

B. Affirm

An older adult is dying of cancer and a hospice nurse comes to the home every day to oversee the client's care and comfort. Which intervention would be most important for the nurse to provide?

A. Providing stress management

B. Helping with tasks

C. Assuring support

D. Helping with basic needs

C. Assuring support

An older adult, who has no serious health problems and eats healthfully, often feels fatigued. After medical problems have been ruled out, the nurse will recommend which action as an option improve the client's fatigue?

A. Limit intake of red meat.

B. Begin meditative practices.

C. Increase exercise.

D. Sleep 8 to 10 hours per night.

C. Increase exercise.

A 70-year-old independent client is receiving dialysis. An old friend has invited the client to travel across the country and to spend a week in the friend's home. Which response by the client's dialysis nurse would be appropriate?

A. Discourage the idea, as the client is likely to eat and drink too much on vacation.

B. Discourage the idea but provide as much helpful information as possible.

C. Provide as much emotional support as possible.

D. Encourage the idea but only if the client travels with a caregiver.

C. Provide as much emotional support as possible.

A nurse is preparing a presentation about chronic conditions in older adults. The nurse identifies the need to address the high incidence and prevalence of these conditions among this population. Which phenomenon(s) would the nurse most likely include as contributing to the high incidence? Select all that apply.

A. Longevity is increasing.

B. Many previously fatal diseases are now treatable.

C. Increasing numbers of older adults can afford medical care.

D. Older adults have increased expectations for treatment.

E. New chronic conditions are being identified by medical researchers.

A. Longevity is increasing.

B. Many previously fatal diseases are now treatable.

A nurse is developing a plan of care for an older adult client with several chronic conditions. Which information would be important for the nurse to integrate into the plan when identifying goals for the client? Select all that apply.

A. Chronic illnesses can be cured with proper and persistent treatment.

B. Healing requires the mobilization of the body, mind, and spirit.

C. Appropriate care measures focus on helping clients live in harmony with chronic

disease.

D. Controlling symptoms, promoting a sense of well-being, and enhancing the quality of life is important in chronic diseases.

E. The success of interventions should be judged on how quickly and totally the

clients can recover.

B. Healing requires the mobilization of the body, mind, and spirit.

C. Appropriate care measures focus on helping clients live in harmony with chronic

disease.

D. Controlling symptoms, promoting a sense of well-being, and enhancing the quality of life is important in chronic diseases.

An older adult client has heart disease and the client's spouse asks for help to learn about the cooking methods and recipes that can be used. Which suggestion(s) will the nurse include? Select all that apply.

A. joining a cardiac support group

B. visiting a dietitian

C. referencing meat-focused cookbooks for ideas

D. looking up recipes on the Eating Well website

E. avoiding meat and eat shellfish

A. joining a cardiac support group

B. visiting a dietitian

D. looking up recipes on the Eating Well website

A nurse, who is planning a health workshop for senior citizens, wants to provide discussion topics that will interest everyone. In a typical group of seniors, which disorder(s) would the nurse most likely identify as common chronic conditions among older adults? Select all that apply.

A. Hypertension

B. Dementia

C. Heart failure

D. Arthritis

E. Depression

A. Hypertension

B. Dementia

C. Heart failure

D. Arthritis

E. Depression