NRS 416 Exam 1 Study Guide With
Complete Solutions
Week 1 Learning Objectives - ANSWER 1. Explore the definition and attributes of
the concept of chronic illness trajectory including SELF-MANAGEMENT, CARE
TRANSITIONS, HEALTH-RELATED QOL, and UNCERTAINTY IN ILLNESS
2. Describe and analyze the trajectory phases of chronic illness based on the
Chronic Illness Trajectory Model
3. Compare and contrast how the nursing process is integrated within the
Chronic Illness Trajectory Model
4. Apply the concept and attributes of chronic illness trajectory within the
chronic illness exemplar
What is a strong first step in prevention of chronic illness - ANSWER preventing
ACEs from occurring
What are the 8 levels in the Chronic Illness Trajectory Model - ANSWER 1. Pre-
trajectory
2. Trajectory Onset
3. Crisis
4. Acute
5. Stable
6. Unstable
7. Downward
8. Dying
Define pre-trajectory in the chronic illness trajectory - ANSWER before the
illness begins; the preventive phase; no s/s present
Define trajectory onset in the chronic illness trajectory - ANSWER s/s are
present; diagnostic period
Define crisis in the chronic illness trajectory - ANSWER life threatening situation;
acute threat to self-identity
Define acute in the chronic illness trajectory - ANSWER active illness or
complications requiring hospitalization
, Define stable in the chronic illness trajectory - ANSWER controlled illness
course/symptoms
Define unstable in the chronic illness trajectory - ANSWER illness
course/symptoms not controlled by regimen but not requiring or desiring
hospitalization
Define downward in the chronic illness trajectory - ANSWER progressive decline
in physical/mental status with increasing disability/signs and symptoms
Define dying in the chronic illness trajectory - ANSWER Immediate
weeks/days/hours preceding death
What can nurses do to help with chronic illness - ANSWER 1. assist clients in
overcoming a plateau by increasing adherence to a regimen so they can reach
the highest level of functional ability possible
2. assist clients in making the attitudinal/lifestyle changes that are needed to
promote heath and prevent disease
3. assist client who is in a downward trajectory to be able to maintain sense of
self and receive expert palliative care
4. assist with advance care planning to assure clients wishes are met
5. assist the client who is in an unstable phase to gain greater control over
symptoms that are interfering with their ability to carry out everyday activities
What are the 4 attributes of chronic illness trajectory - ANSWER -self
management
- health related quality of life
- uncertainty
- care transition
define self management - ANSWER a dynamic process in which individuals
actively manage chronic illness
define health related quality of life - ANSWER pertaining to a life satisfaction and
life concerns; may change overtime; impacted by health and illness; affecting
individual/family
define uncertainty - ANSWER the inability to determine the meaning of illness-
related events; unable to predict outcomes accurately
Define care transitions - ANSWER a proactive plan of care with goals: patient-
family-centered, dynamic, shared with care team
Complete Solutions
Week 1 Learning Objectives - ANSWER 1. Explore the definition and attributes of
the concept of chronic illness trajectory including SELF-MANAGEMENT, CARE
TRANSITIONS, HEALTH-RELATED QOL, and UNCERTAINTY IN ILLNESS
2. Describe and analyze the trajectory phases of chronic illness based on the
Chronic Illness Trajectory Model
3. Compare and contrast how the nursing process is integrated within the
Chronic Illness Trajectory Model
4. Apply the concept and attributes of chronic illness trajectory within the
chronic illness exemplar
What is a strong first step in prevention of chronic illness - ANSWER preventing
ACEs from occurring
What are the 8 levels in the Chronic Illness Trajectory Model - ANSWER 1. Pre-
trajectory
2. Trajectory Onset
3. Crisis
4. Acute
5. Stable
6. Unstable
7. Downward
8. Dying
Define pre-trajectory in the chronic illness trajectory - ANSWER before the
illness begins; the preventive phase; no s/s present
Define trajectory onset in the chronic illness trajectory - ANSWER s/s are
present; diagnostic period
Define crisis in the chronic illness trajectory - ANSWER life threatening situation;
acute threat to self-identity
Define acute in the chronic illness trajectory - ANSWER active illness or
complications requiring hospitalization
, Define stable in the chronic illness trajectory - ANSWER controlled illness
course/symptoms
Define unstable in the chronic illness trajectory - ANSWER illness
course/symptoms not controlled by regimen but not requiring or desiring
hospitalization
Define downward in the chronic illness trajectory - ANSWER progressive decline
in physical/mental status with increasing disability/signs and symptoms
Define dying in the chronic illness trajectory - ANSWER Immediate
weeks/days/hours preceding death
What can nurses do to help with chronic illness - ANSWER 1. assist clients in
overcoming a plateau by increasing adherence to a regimen so they can reach
the highest level of functional ability possible
2. assist clients in making the attitudinal/lifestyle changes that are needed to
promote heath and prevent disease
3. assist client who is in a downward trajectory to be able to maintain sense of
self and receive expert palliative care
4. assist with advance care planning to assure clients wishes are met
5. assist the client who is in an unstable phase to gain greater control over
symptoms that are interfering with their ability to carry out everyday activities
What are the 4 attributes of chronic illness trajectory - ANSWER -self
management
- health related quality of life
- uncertainty
- care transition
define self management - ANSWER a dynamic process in which individuals
actively manage chronic illness
define health related quality of life - ANSWER pertaining to a life satisfaction and
life concerns; may change overtime; impacted by health and illness; affecting
individual/family
define uncertainty - ANSWER the inability to determine the meaning of illness-
related events; unable to predict outcomes accurately
Define care transitions - ANSWER a proactive plan of care with goals: patient-
family-centered, dynamic, shared with care team
