NUR 3020 Wayne State University -NUR
3020 - Medsurg II Exam 1: Chronic
Disruptions in Daily Living Questions with
Complete Solutions
Course
NUR 3020
1. A 68-year-old with COPD experiences increased shortness of breath, fatigue, and
difficulty showering.
Question: Which nursing interventions best support his ADLs?
Solution:
Pacing and energy conservation: Plan rest periods between tasks.
Use of puff–puff breathing technique during activity.
Adaptive equipment: Shower chair, long-handled sponge.
Oxygen therapy during exertion if prescribed.
This combination optimizes breathing, conserves energy, and maintains independence.
2. A 55-year-old with osteoarthritis struggles with dressing due to joint pain.
Question: What occupational strategies and medications help?
Solution:
OT devices: Button hooks, zipper pulls, long-handled shoehorn.
Warm baths or heat pack before dressing to reduce stiffness.
NSAIDs (e.g., ibuprofen) taken pre-activity.
Educate on joint protection techniques: bending with knees, not spine.
3. A diabetic patient with peripheral neuropathy reports burning feet, preventing nightly
prayer routine sitting on floor.
Question: What steps help restore function and rhythm?
Solution:
Foot care: Inspect, moisturize, wear proper socks/shoes at night.
Pain control: Gabapentin or duloxetine as prescribed.
, Modify ritual: Use a prayer cushion or chair.
Referral: PT or OT to teach alternative positioning.
4. A stroke survivor with left-sided weakness can’t reach toothbrush with right hand only.
Question: Which assistive device and adaptive strategies are appropriate?
Solution:
Universal cuff to hold toothbrush.
Non-slip mat and stable stool to sit at sink.
One-handed techniques: e.g., dressing using a leg lifter.
Setup mirror + lighting to improve coordination.
5. A patient with chronic heart failure has dyspnea on minimal exertion, leading to skipped
meals.
Question: How can nutritional intake be optimized without causing fatigue?
Solution:
Small, frequent high-calorie meals.
Nutritional shakes between meals.
Meal delivery or assistance, use of adaptive utensils.
Monitor daily weights, low-sodium diet, fluid restriction per protocol.
6. A patient with Parkinson’s experiences freezing episodes when initiating walking,
hindering daily function.
Question: What cueing technique and environmental change would you recommend?
Solution:
Auditory cueing: Step in rhythm of metronome or music.
Visual cues: Floor markers or strips to “step to the line.”
Ensure clutter-free walkway, good lighting, sturdy shoes with non-slip soles.
7. A patient with rheumatoid arthritis struggles opening jars and bottles at home.
, Question: Which assistive devices improve independence?
Solution:
Jar opener, rubber-grip mats, non-slip drawer liners.
Ergonomic utensils, electric can opener.
Educate: open cans near the sink to avoid spills, alternate hand use.
8. A patient with visual impairment from diabetic retinopathy can’t manage kitchen safely.
Question: What modifications ensure safe meal prep?
Solution:
High-contrast labeling, tactile stickers on appliances.
Liquid-level indicators, talking kitchen scale or clocks.
Good task lighting, clear floor space without clutter.
9. A patient with chronic rheumatoid spondylitis can’t manage toileting independently.
Question: Which bathroom modifications and safety measures are essential?
Solution:
Raised toilet seat with arm rails.
Grab bars on both sides, non-slip mats.
Use of hand-held bidet or wet wipes, accessible storage nearby.
OT training for safe transfers using weight-bearing on unaffected side.
10. A patient with chronic kidney disease on hemodialysis is too fatigued to shop and cook.
Question: What interprofessional strategies and community resources support daily living?
Solution:
Arrange meal delivery services or grocery drop-off.
Refer to social work for transportation to dialysis and shopping.
Educate family on preparing renal-friendly meals: low potassium/protein.
Coordinate with dietitian to tailor meals and ensure nutrient needs are met.
3020 - Medsurg II Exam 1: Chronic
Disruptions in Daily Living Questions with
Complete Solutions
Course
NUR 3020
1. A 68-year-old with COPD experiences increased shortness of breath, fatigue, and
difficulty showering.
Question: Which nursing interventions best support his ADLs?
Solution:
Pacing and energy conservation: Plan rest periods between tasks.
Use of puff–puff breathing technique during activity.
Adaptive equipment: Shower chair, long-handled sponge.
Oxygen therapy during exertion if prescribed.
This combination optimizes breathing, conserves energy, and maintains independence.
2. A 55-year-old with osteoarthritis struggles with dressing due to joint pain.
Question: What occupational strategies and medications help?
Solution:
OT devices: Button hooks, zipper pulls, long-handled shoehorn.
Warm baths or heat pack before dressing to reduce stiffness.
NSAIDs (e.g., ibuprofen) taken pre-activity.
Educate on joint protection techniques: bending with knees, not spine.
3. A diabetic patient with peripheral neuropathy reports burning feet, preventing nightly
prayer routine sitting on floor.
Question: What steps help restore function and rhythm?
Solution:
Foot care: Inspect, moisturize, wear proper socks/shoes at night.
Pain control: Gabapentin or duloxetine as prescribed.
, Modify ritual: Use a prayer cushion or chair.
Referral: PT or OT to teach alternative positioning.
4. A stroke survivor with left-sided weakness can’t reach toothbrush with right hand only.
Question: Which assistive device and adaptive strategies are appropriate?
Solution:
Universal cuff to hold toothbrush.
Non-slip mat and stable stool to sit at sink.
One-handed techniques: e.g., dressing using a leg lifter.
Setup mirror + lighting to improve coordination.
5. A patient with chronic heart failure has dyspnea on minimal exertion, leading to skipped
meals.
Question: How can nutritional intake be optimized without causing fatigue?
Solution:
Small, frequent high-calorie meals.
Nutritional shakes between meals.
Meal delivery or assistance, use of adaptive utensils.
Monitor daily weights, low-sodium diet, fluid restriction per protocol.
6. A patient with Parkinson’s experiences freezing episodes when initiating walking,
hindering daily function.
Question: What cueing technique and environmental change would you recommend?
Solution:
Auditory cueing: Step in rhythm of metronome or music.
Visual cues: Floor markers or strips to “step to the line.”
Ensure clutter-free walkway, good lighting, sturdy shoes with non-slip soles.
7. A patient with rheumatoid arthritis struggles opening jars and bottles at home.
, Question: Which assistive devices improve independence?
Solution:
Jar opener, rubber-grip mats, non-slip drawer liners.
Ergonomic utensils, electric can opener.
Educate: open cans near the sink to avoid spills, alternate hand use.
8. A patient with visual impairment from diabetic retinopathy can’t manage kitchen safely.
Question: What modifications ensure safe meal prep?
Solution:
High-contrast labeling, tactile stickers on appliances.
Liquid-level indicators, talking kitchen scale or clocks.
Good task lighting, clear floor space without clutter.
9. A patient with chronic rheumatoid spondylitis can’t manage toileting independently.
Question: Which bathroom modifications and safety measures are essential?
Solution:
Raised toilet seat with arm rails.
Grab bars on both sides, non-slip mats.
Use of hand-held bidet or wet wipes, accessible storage nearby.
OT training for safe transfers using weight-bearing on unaffected side.
10. A patient with chronic kidney disease on hemodialysis is too fatigued to shop and cook.
Question: What interprofessional strategies and community resources support daily living?
Solution:
Arrange meal delivery services or grocery drop-off.
Refer to social work for transportation to dialysis and shopping.
Educate family on preparing renal-friendly meals: low potassium/protein.
Coordinate with dietitian to tailor meals and ensure nutrient needs are met.
