NUR2502 Multidimensional Care III
Midterm Exam Review
(Questions & Solutions)
2025
©2025
,1. Case Study: A 72‑year‑old man with advanced congestive heart
failure, type II diabetes, and mild cognitive impairment is frequently
non‑adherent with medications. He lives alone and has limited social
support. Which intervention best reflects a multidimensional care
approach?
a) Provide printed medication instructions and discharge him with a
standard follow-up.
b) Arrange regular home health visits with medication reconciliation
while involving a social worker to address isolation.
c) Increase the doses of his medications to compensate for
non‑adherence.
d) Focus on pharmacologic stabilization and schedule a routine clinic
visit.
- Correct ANS: b) Arrange regular home health visits with medication
reconciliation while involving a social worker to address isolation.
- Rationale: This option addresses not only the physical management
(medication and disease control) but also the cognitive and social
dimensions by using home health support and addressing isolation.
2. Case Study: A 65‑year‑old woman with terminal cancer is
experiencing severe pain, depressive symptoms, and spiritual distress as
she nears end‑of‑life. Which intervention best exemplifies
multidimensional care?
a) Intensify opioid pain management only.
b) Initiate a palliative care plan that integrates pain control, mental
health counseling, chaplaincy services, and family meetings.
c) Focus solely on spiritual care by referring her to a chaplain.
d) Continue her current treatment without additional interventions.
- Correct ANS: b) Initiate a palliative care plan that integrates pain
control, mental health counseling, chaplaincy services, and family
meetings.
- Rationale: Multidimensional care in palliative settings must address
physical symptoms, emotional distress, and spiritual needs while
©2025
,involving the family.
3. Case Study: A 68‑year‑old patient with advanced chronic obstructive
pulmonary disease (COPD) struggles with persistent dyspnea, anxiety,
and reports feeling socially isolated. Which intervention best integrates
multidimensional care for this patient?
a) Prescribe bronchodilators and oxygen therapy exclusively.
b) Combine pulmonary rehabilitation with cognitive‑behavioral therapy
for anxiety and coordinate community support services.
c) Advise the patient to avoid strenuous activities to limit dyspnea.
d) Schedule a follow‑up only if the patient’s condition worsens.
- Correct ANS: b) Combine pulmonary rehabilitation with
cognitive‑behavioral therapy for anxiety and coordinate community
support services.
- Rationale: This option simultaneously addresses the physical,
psychological, and social dimensions of the patient’s condition.
4. Case Study: A 55‑year‑old patient post‑major abdominal surgery
reports severe pain, impaired wound healing, and significant anxiety
about recovery. Family conflict is also noted. What is the priority
multidimensional intervention?
a) Increase the patient’s analgesic dose without further evaluation.
b) Implement a comprehensive care plan incorporating pain
management, nutritional support, individualized physical therapy, and
family counseling.
c) Provide educational brochures about self‑care after surgery.
d) Schedule an extended hospital stay solely for wound care.
- Correct ANS: b) Implement a comprehensive care plan incorporating
pain management, nutritional support, individualized physical therapy,
and family counseling.
- Rationale: This intervention demonstrates an integrated approach
that covers physical recovery, nutritional needs, rehabilitation, and
addresses interpersonal (family) dynamics.
5. Case Study: A patient with end‑stage renal disease (ESRD) on dialysis
©2025
, experiences treatment non‑compliance due to depression and financial
challenges. Which multidisciplinary strategy should be included in his
care plan?
a) Focus only on the dialysis schedule and medication adjustments.
b) Develop an interdisciplinary care plan that combines nephrology
management, mental health counseling, and social service/financial
resource referrals.
c) Increase dialysis frequency to compensate for non‑compliance.
d) Provide a standard discharge plan for all dialysis patients.
- Correct ANS: b) Develop an interdisciplinary care plan that combines
nephrology management, mental health counseling, and social
service/financial resource referrals.
- Rationale: Multidimensional care involves addressing medical,
psychological, and socioeconomic factors—all of which influence the
patient’s compliance and overall health outcomes.
6. Case Study: A 50‑year‑old patient with long‑standing schizophrenia
and coexisting cardiovascular disease has difficulty adhering to cardiology
appointments due to his psychiatric symptoms. Which integrated
intervention is most appropriate?
a) Refer the patient solely to a cardiologist for medication adjustments.
b) Develop a collaborative care plan involving both mental health and
cardiology teams with coordinated follow‑ups and case management.
c) Focus on his psychiatric treatment and postpone cardiovascular
care.
d) Increase his psychotropic medications to improve appointment
adherence.
- Correct ANS: b) Develop a collaborative care plan involving both
mental health and cardiology teams with coordinated follow‑ups and
case management.
- Rationale: A true multidimensional approach integrates the
management of both mental and physical health issues through
interdisciplinary collaboration.
7. Case Study: A 47‑year‑old patient with rheumatoid arthritis is
©2025
Midterm Exam Review
(Questions & Solutions)
2025
©2025
,1. Case Study: A 72‑year‑old man with advanced congestive heart
failure, type II diabetes, and mild cognitive impairment is frequently
non‑adherent with medications. He lives alone and has limited social
support. Which intervention best reflects a multidimensional care
approach?
a) Provide printed medication instructions and discharge him with a
standard follow-up.
b) Arrange regular home health visits with medication reconciliation
while involving a social worker to address isolation.
c) Increase the doses of his medications to compensate for
non‑adherence.
d) Focus on pharmacologic stabilization and schedule a routine clinic
visit.
- Correct ANS: b) Arrange regular home health visits with medication
reconciliation while involving a social worker to address isolation.
- Rationale: This option addresses not only the physical management
(medication and disease control) but also the cognitive and social
dimensions by using home health support and addressing isolation.
2. Case Study: A 65‑year‑old woman with terminal cancer is
experiencing severe pain, depressive symptoms, and spiritual distress as
she nears end‑of‑life. Which intervention best exemplifies
multidimensional care?
a) Intensify opioid pain management only.
b) Initiate a palliative care plan that integrates pain control, mental
health counseling, chaplaincy services, and family meetings.
c) Focus solely on spiritual care by referring her to a chaplain.
d) Continue her current treatment without additional interventions.
- Correct ANS: b) Initiate a palliative care plan that integrates pain
control, mental health counseling, chaplaincy services, and family
meetings.
- Rationale: Multidimensional care in palliative settings must address
physical symptoms, emotional distress, and spiritual needs while
©2025
,involving the family.
3. Case Study: A 68‑year‑old patient with advanced chronic obstructive
pulmonary disease (COPD) struggles with persistent dyspnea, anxiety,
and reports feeling socially isolated. Which intervention best integrates
multidimensional care for this patient?
a) Prescribe bronchodilators and oxygen therapy exclusively.
b) Combine pulmonary rehabilitation with cognitive‑behavioral therapy
for anxiety and coordinate community support services.
c) Advise the patient to avoid strenuous activities to limit dyspnea.
d) Schedule a follow‑up only if the patient’s condition worsens.
- Correct ANS: b) Combine pulmonary rehabilitation with
cognitive‑behavioral therapy for anxiety and coordinate community
support services.
- Rationale: This option simultaneously addresses the physical,
psychological, and social dimensions of the patient’s condition.
4. Case Study: A 55‑year‑old patient post‑major abdominal surgery
reports severe pain, impaired wound healing, and significant anxiety
about recovery. Family conflict is also noted. What is the priority
multidimensional intervention?
a) Increase the patient’s analgesic dose without further evaluation.
b) Implement a comprehensive care plan incorporating pain
management, nutritional support, individualized physical therapy, and
family counseling.
c) Provide educational brochures about self‑care after surgery.
d) Schedule an extended hospital stay solely for wound care.
- Correct ANS: b) Implement a comprehensive care plan incorporating
pain management, nutritional support, individualized physical therapy,
and family counseling.
- Rationale: This intervention demonstrates an integrated approach
that covers physical recovery, nutritional needs, rehabilitation, and
addresses interpersonal (family) dynamics.
5. Case Study: A patient with end‑stage renal disease (ESRD) on dialysis
©2025
, experiences treatment non‑compliance due to depression and financial
challenges. Which multidisciplinary strategy should be included in his
care plan?
a) Focus only on the dialysis schedule and medication adjustments.
b) Develop an interdisciplinary care plan that combines nephrology
management, mental health counseling, and social service/financial
resource referrals.
c) Increase dialysis frequency to compensate for non‑compliance.
d) Provide a standard discharge plan for all dialysis patients.
- Correct ANS: b) Develop an interdisciplinary care plan that combines
nephrology management, mental health counseling, and social
service/financial resource referrals.
- Rationale: Multidimensional care involves addressing medical,
psychological, and socioeconomic factors—all of which influence the
patient’s compliance and overall health outcomes.
6. Case Study: A 50‑year‑old patient with long‑standing schizophrenia
and coexisting cardiovascular disease has difficulty adhering to cardiology
appointments due to his psychiatric symptoms. Which integrated
intervention is most appropriate?
a) Refer the patient solely to a cardiologist for medication adjustments.
b) Develop a collaborative care plan involving both mental health and
cardiology teams with coordinated follow‑ups and case management.
c) Focus on his psychiatric treatment and postpone cardiovascular
care.
d) Increase his psychotropic medications to improve appointment
adherence.
- Correct ANS: b) Develop a collaborative care plan involving both
mental health and cardiology teams with coordinated follow‑ups and
case management.
- Rationale: A true multidimensional approach integrates the
management of both mental and physical health issues through
interdisciplinary collaboration.
7. Case Study: A 47‑year‑old patient with rheumatoid arthritis is
©2025
