Chapter 09: Chronic Ilness and Disability
Hinkle: Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 13th Edition
MULTIPLE CHOICE
1. An elderly patient has presented to the clinic with a new diagnosis of
osteoarthritis. The patient's daughter is accompanying him and you have
explained why the incidence of chronic diseases tends to increase with age.
What rationale for this phenomenon should you describe?
A) With age, biologic changes reduce the efficiency of body systems.
B) Older adults often have less support and care from their family, resulting in illness.
C) There is an increased morbidity of peers in this age group, and
this leads to the older adult's desire to also assume the sick role.
D) Chronic illnesses are diagnosed more often in older adults because
they have more contact with the health care system.
ANS: A
Causes of the increasing number of people with chronic conditions include the
following: longer lifespans because of advances in technology and
pharmacology, improved nutrition, safer working conditions, and greater access
(for some people) to health care. Also, biologic conditions change in the aged
population. These changes reduce the efficiency of the body's systems. Older
adults usually have more support and care from their family members.
Assuming the sick role can be a desire in any age group, not just the elderly.
2. A patient tells the nurse that her doctor just told her that her new diagnosis of
rheumatoid arthritis is considered to be a chronic condition. She asks the nurse
what chronic condition means. What would be the nurse's best response?
A) Chronic conditions are defined as health problems that require
management of several months or longer.
, B) Chronic conditions are diseases that come and go in a relatively predictable cycle.
C) Chronic conditions are medical conditions that culminate in
disabilities that require hospitalization.
D) Chronic conditions are those that require short-term
management in extendedcare facilities.
ANS: A
Chronic conditions are often defined as medical conditions or health problems
with associated symptoms or disabilities that require long-term management
(3 months or longer). Chronic diseases are usually managed in the home
environment. They are not always cyclical or predictable.
3. A medical-surgical nurse is teaching a patient about the health implications of
her recently diagnosed type 2 diabetes. The nurse should teach the patient to be
proactive with her glycemic control in order to reduce her risk of what health
problem?
A) Arthritis
B) Renal failure
C) Pancreatic cancer
D) Asthma
ANS: B
One chronic disease can lead to the development of other chronic conditions.
Diabetes, for example, can eventually lead to neurologic and vascular changes
that may result in visual, cardiac, and kidney disease and erectile dysfunction.
Diabetes is not often linked to cancer, arthritis, or asthma.
, 4. A patient who undergoes hemodialysis three times weekly is on a fluid
restriction of 1000 mL/day. The nurse sees the patient drinking a 355-mL (12
ounce) soft drink after the patient has already reached the maximum intake
of fluid for the day. What action should the nurse take?
A) Take the soft drink away from the patient and inform the dialysis
nurse to remove extra fluid from the patient during the next dialysis
treatment
B) Document the patient's behavior as noncompliant and notify the physician
C) Further restrict the patient's fluid for the following day and
communicate this information to the charge nurse
D) Reinforce the importance of the fluid restriction and document the
teaching and the intake of extra fluid
ANS: D
Management of chronic conditions includes learning to live with symptoms or
disabilities and coming to terms with identity changes resulting from having a
chronic condition. It also consists of carrying out the lifestyle changes and
regimens designed to control symptoms and to prevent complications.
Although it may be difficult for nurses and other health care providers to stand by
while patients make unwise decisions about their health, they must accept the fact
that the patient has the right to make his or her own choices and decisions about
lifestyle and health care.
5. A patient with end-stage lung cancer has been admitted to hospice care. The
hospice team is meeting with the patient and her family to establish goals for
care. What is likely to be a first priority in goal setting for the patient?
A) Maintenance of activities of daily living
B) Pain control
C) Social interaction
D) Promotion of spirituality
ANS: B
Hinkle: Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 13th Edition
MULTIPLE CHOICE
1. An elderly patient has presented to the clinic with a new diagnosis of
osteoarthritis. The patient's daughter is accompanying him and you have
explained why the incidence of chronic diseases tends to increase with age.
What rationale for this phenomenon should you describe?
A) With age, biologic changes reduce the efficiency of body systems.
B) Older adults often have less support and care from their family, resulting in illness.
C) There is an increased morbidity of peers in this age group, and
this leads to the older adult's desire to also assume the sick role.
D) Chronic illnesses are diagnosed more often in older adults because
they have more contact with the health care system.
ANS: A
Causes of the increasing number of people with chronic conditions include the
following: longer lifespans because of advances in technology and
pharmacology, improved nutrition, safer working conditions, and greater access
(for some people) to health care. Also, biologic conditions change in the aged
population. These changes reduce the efficiency of the body's systems. Older
adults usually have more support and care from their family members.
Assuming the sick role can be a desire in any age group, not just the elderly.
2. A patient tells the nurse that her doctor just told her that her new diagnosis of
rheumatoid arthritis is considered to be a chronic condition. She asks the nurse
what chronic condition means. What would be the nurse's best response?
A) Chronic conditions are defined as health problems that require
management of several months or longer.
, B) Chronic conditions are diseases that come and go in a relatively predictable cycle.
C) Chronic conditions are medical conditions that culminate in
disabilities that require hospitalization.
D) Chronic conditions are those that require short-term
management in extendedcare facilities.
ANS: A
Chronic conditions are often defined as medical conditions or health problems
with associated symptoms or disabilities that require long-term management
(3 months or longer). Chronic diseases are usually managed in the home
environment. They are not always cyclical or predictable.
3. A medical-surgical nurse is teaching a patient about the health implications of
her recently diagnosed type 2 diabetes. The nurse should teach the patient to be
proactive with her glycemic control in order to reduce her risk of what health
problem?
A) Arthritis
B) Renal failure
C) Pancreatic cancer
D) Asthma
ANS: B
One chronic disease can lead to the development of other chronic conditions.
Diabetes, for example, can eventually lead to neurologic and vascular changes
that may result in visual, cardiac, and kidney disease and erectile dysfunction.
Diabetes is not often linked to cancer, arthritis, or asthma.
, 4. A patient who undergoes hemodialysis three times weekly is on a fluid
restriction of 1000 mL/day. The nurse sees the patient drinking a 355-mL (12
ounce) soft drink after the patient has already reached the maximum intake
of fluid for the day. What action should the nurse take?
A) Take the soft drink away from the patient and inform the dialysis
nurse to remove extra fluid from the patient during the next dialysis
treatment
B) Document the patient's behavior as noncompliant and notify the physician
C) Further restrict the patient's fluid for the following day and
communicate this information to the charge nurse
D) Reinforce the importance of the fluid restriction and document the
teaching and the intake of extra fluid
ANS: D
Management of chronic conditions includes learning to live with symptoms or
disabilities and coming to terms with identity changes resulting from having a
chronic condition. It also consists of carrying out the lifestyle changes and
regimens designed to control symptoms and to prevent complications.
Although it may be difficult for nurses and other health care providers to stand by
while patients make unwise decisions about their health, they must accept the fact
that the patient has the right to make his or her own choices and decisions about
lifestyle and health care.
5. A patient with end-stage lung cancer has been admitted to hospice care. The
hospice team is meeting with the patient and her family to establish goals for
care. What is likely to be a first priority in goal setting for the patient?
A) Maintenance of activities of daily living
B) Pain control
C) Social interaction
D) Promotion of spirituality
ANS: B
