REL 334 Lecture Notes - Lecture 7: Life Review, Magical Thinking

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23 Jul 2018

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There are financial, personal, social, and psychological costs of life-threatening illness. Life- threatening illness can be seen as obscure in some cultures. This viewpoint can lead to avoidance of people, places, and objects that are associated with the forbidden nature of life- threatening disease. This avoidance then creates a social death for the patient, which is when the friends, family, and caregivers of the patient abandon them because they are avoiding them. This action leads to magical thinking which is the feeling of responsibility for one"s illness, which in turn, places burden on the patient. Patients with a life-threatening illness have to pay for many things, such as, hospitalization, outpatient care, transportation, support services, child-care, and temporary housing. This not only puts a burden on the patient but the patient"s family as well. There are services offered to patients with life- threatening illnesses to help communicate with their friends, family, and caregivers more effectively.

Related Questions

Q37 Research indicates more than 90 % of the deaths occur in older adult 65 and older due to lack of appropriate immunizations on which annual vaccination should the nurse first instruct the patient?

A Pneumonia

B Varicella

C TDAP

D influenza

Q38 which strategies of care would be least likely to enhance the physical function of older adult choose? Choose 2 answers

A weight control

B hearing and vision screening

C smoking cessation

D illness management

E forcing them to attend all activities

Q39 what are common risk factors that contribute to functional decline in the older adult population?

A physical inactivity

B tobacco use

C low sodium dietary intake

D having small families

Q40 what principle is least related to promoting health and preventing certain disabilities in older adults?

A continue activities of daily life (ADLs)

B Maintain as active a lifestyle as possible and desired

C Monitor illnesses through annual health screening ( AHS)

D keep up on assistive and information technology and other tools

Q41 Which focusing on the psychosocial needs of older adults, authorVirginia satir recommends that Healthcare providers get back to the basic communication. whatare the five basic principles satir describes?

A invite

B follow through

C respect personal space

D maximize understanding

E Arrange environment

F maximize attention levels

G trust

H maximize communication

Q42 how do electronic health records facilitate better care coordination? Choose 2 answers

A saving time typing rather than writing

B increasing the accuracy of diagnosis and health outcomes

C preventing an increase in the number of medical errors

D improving communication among health providers

Q43 Rick a 91 year old male, hasa history of chronic otitis media and is experiencing mild hearing loss in hisright ear,what type of assistive technology would Rick use to improve communicative function?

A icon communication board

B behind the ear ( BTE) hearing aid

C Augmentive and alternative communication ( AAC)

D completely in the canal ( CIC) hearing aid

Q 44 An elderly patient has suffered a stroke and is currently in the process of transitioning out of the hospital and into an assisted living facility. The patient's primary diffulty after the stroke is dealing with dysarthria, whichhas limited the patient's ability to speak. whatcommunication technology would appropriately promote an optimal transition of care for the patient?

A an over the ear (OTE) hearing aid

B an augmentation and alternative communication ( AAC) device

C an assistive listening device ( ALD)

D an analog technology to amplify sound

Q45 what must the nurse inform the patient and family or caregivers about assistive devices? Choose 2 answers

A may lessen the importance of ongoing communication with healthcare providers.

B they may result in complete recovery from chronic illness

C they may limit complications of an illness or disability.

D they may enable independent performance and reduce risk of injury.

Q46 An 81 year old Patient has multiple chronic conditions including uncontrolled hypertension and peripheral artery disease and agrees to try assertive devices for monitoring blood pressure and improving circulation provided by a home health agency. Choose 2 answers

A allowing the patient enough time and opportunity for repetition

B only presenting the most relevant content to the patient.

C refraining from suggesting mnemonic devices to Aid the patients use of Technology

D having an outside educator provide several hours of detailed device instructions

Q47 A goal of the National Health Initiative healthy people 2010 is to increase the quality and extend the years of healthy life. What are two ways that this initiative can achieve its goal? Choose 2 answers

A by pressuring older adults who are lonely to move to nursing homes at younger ages

B By encouraging people to have more children so that the children can help their parents as they grow older

C by helping people overcome views of denial and foreboding as old age approaches

D by trying to spread the view that aging is natural and need not include illness and disease

Q48 match each government program with its description. Answer options may be used more than once or not at all

A provide health insurance for low-income families

B bases basic benefits on a workers average indexed monthly earnings in covered employment

C offers a payment system for long-term care ( LTC) foreligible older Americans and persons with disabilities

D is the health insurance program for those 65 or other people with disabilities

Q49 a senior is being cared for by her daughter. The daughter works a full-time job and is only able to care for her mother before she goes to work. On her lunch break, andafter she gets off work. thesenior expresses to a nurse that she gets lonely during the day and sometimes cannot perform tasks by herself.which community resource should the nurse recommend looking into?

A a local Health Clinic

B Day Care Services for Seniors

C a medication assistance program

D Meals on Wheels.

Q50 the Independence at home demonstration was created by the Affordable Care Act. Which statement is true regarding Primary Care teams participating in this initiative?

A the teams are led by a licensed administrator

B the teams must serve at least 500 Medicare beneficiaries.

C the teams be led by a physician.

D the teams can be lead by a nurse practitioner.

Q51 which important facts about Medicare should nurses know? Choose 2 answers

A Medicare requires income assessment in order to qualify for coverage

B Medicare cover assisted living services for Americans in extreme poverty.

C Medicare recipients range from those simply needing Wellness services to those who are profoundly Frail.

D Medicare covers certain disabled Americans who have not reached age eligibility.

Q52 what is a common preventable error that can occur during the transition of care for older adults?

A unhelpful Hospital staff B inaccurate medication reconciliation.

C disorganized dosing schedule

D lost nursing equipment.

Q53 how is communication further facilitated? Choose 2 answers

A through communication to between and among the patients family caregivers and health care providers

B through active engagement of patients and family caregivers with a focus on meeting the patients goals

C through reliance on use of text messages that are less disruptive to the patient and family.

D through Healthcare Providers conversing with the patient and allowing the patient speak with the family.

Q54 what are appropriate evaluation measures related to successful transitions of care? Choose 2 answers

A emotional and social domains of quality of life.

B all clinical indicators related to Chronic conditions.

C functional status

D exclusion of nursing sensitive measures.

Q55 a critical competency in geriatric nursing is the ability to assess family knowledge of the skills necessary in the care of older adults. What Broad caregiver competencies are included in this assessment?

A knowing the science behind the scenes of geriatrics

B allowing the active participation of the patient in all aspects of care.

C balancing the patient autonomy with safety

D knowing how to safely start an IV.

Q56 what Communications techniques promote safe transition of care in patients with aphasia?

A respond in the affirmative when a question is asked

B speak softer so as to never have a harsh tone

C give the patient time to speak

D use non-verbal gestures to communicate.

Q57 what roles of the nurse protect the patient from harm in a care transition?

A symptom manager,educator, collaborator, carecoordinator.

B medication manager screener educator listener

C liasson with Hospital decision maker collaborator coordinator

D decision maker Symptom Manager care coordinator.

Q58 which statements are true regarding health-related quality of life? Choose 2 answers

A cannot be measured in persons with chronic illness

B is measured by and object Observer, basedon the number of times an individual emits both verbal signs of happiness and well-being

C is measured by individuals perceived healthy days per month.

D can be measured by an instrument developed by the center of Disease Control (CDC)

Q59 several options are available as a care approaches to chronic illness care. Which method best describes palliative care?

A care that is only delivered by family or other personal caregivers

B end-of-life care that suspends active treatment

C a combination of active treatment and comfort measures

D a continued focus on here rather than comfort and quality of life.

Q60 A nurse caring for people at the end of their lives knows that Dysnea is relatively common and interferes with patients'comfort and rest. What is the evidence based intervention for shortness of breath?

A liquid morphine at starting dose of 10 mg every 4 hours and titrating dose upward until dyspnea is relieved.

B administer O2 at least 5 liters per minute

C 5 mg of liquid morphine every 4 hours,along with lorazepam 0.5-2.0 mg every 4-6 hours PRN for anxiety and restlessness.

D elevate the head of the bed no more than 20 degrees.

Q61 what do dying persons typically experience grief over?

A loss of bodily function and independence that occurs as illness becomes more prevalent

B loss ability to give and receive love

C loss of basic beliefs,values and faith.

D the feeling that nobody cares that the person is dying.

Q62 which of the following is often the biggest barrier to overcome in crucial conversations to death and dying?

A mistrust of healthcare providers

B lack of energy

C societal attitudes about death

D cost of care

Q63 The End of life Nursing Education consortium (ELNEC) is a resource targeted to nurse providing end of life care that supports evidence based care of dying patients and their families,as well as self care that lessens stress and anxiety and sustains nurse in providing excellent end of life care. Which of the following are self care principles? Choose 2 answers

A maintaining professional boundaries and relationships with patients and families, by tightly controlling feelings and empathy

B. Making good use of the expertise and support of the interprofessional care team

C. Diminishing attention on maintaining an active personal life since end-of-life care is a callings of sorts

D. Developing expertise in symptom management, which not only helps patients and their families, but increases satisfaction and lessens anxiety among professional caregivers

Q64. In addition to a living will, advanced directives may also include a durable power of attorney that encompasses health care related decision making. Which two of the following are accurate so statements regarding the legal instrument known as the durable power of attorney?

A. The alternative decision maker must be a close relative of a dying persons in order to understand his or her wishes.

B. It allows for an alternative decision maker in the event that the dying persons is incapacitated and no longer able to make health care decision

C. The living will remains a useful tool in providing direction to the alternate decision maker.

D. A durable power of attorney for health care decision also enables the alternative decision maker to also handle finances and other legal matters.

PLEASE ANSWER ALL THESE QUESTIONS I REALLY NEED THEM.

25. What is the most important discussion of the interdisciplinary team at regularly scheduled meetings.

A. Care access issues

B. Standard dized testing resulting

C. Risk reduction assessment

D. Complaince issues

26. What should be the nurse's primary consideration while allowing for patient autonomy and reducing risk when dealing with end of life care ?

A.stage of illness

B. Cognitive impairment

C. Weight

D. Age

27. Whicn statement from a nurse would indicate good judgment when considering common myths regarding physical restraint use ?

A. Alternatively to physical restraints are unavailable

B. Inadequate staffing causes the need for physical restraint use.

C. Failure to restrain puts individuals at risk for legal liability

D. Risk of falls exists when restraints are used.

28. A 66 year- old patient lives alone and has a BMI of 32, as well as diabetes. As the nurse begins to encourage the patient to increase current levels of physical activity, the nurse should recognize common barriers identified by the elderly. Which barrier to physical activity is least common for the elderly?

A. Finding safe area to walk

B. Swelling of ankles

C. Having pain from arthritis

D. Experience fatigue

29. An 81-year-old patient is a new resident in Hill Side Nursing Home. Upon admission the patient had a Braden score of 17. Which statement would indicate that the RN on duty lacks understanding that the patient is at risk for pressure ulcers?

A. The primary risk factor is immobility.

B. The primary risk factor is a BMI < 24

C. The primary risk factor is polypharmacy

D. The primary risk factor is malnutrition

30. Harriett is a 92-year-old who lives in assisted living; she recently fell and broke her hip. Harriet and her family would like to keep Harriet safe and at the highest level of independence on her return to her accommodations from the hospital. Which action should the nurse take to help Harriet and her family ?

A. Counsel about home safely assessments

B. Tell Harriet to become active in the local Tai Chi program

C. Discuss the rate of unintentional injuries for older aldults

D. Have Harriet and her family request a daily room check by staff

31. Sharron is a 90- year-old female who lived in Asia for most of her life and is a nonnative English speaker. She recently had emergency gallbladder surgery. Which nursing action would be best to do before discharging Sharron back to her accommodations?

A. Explore her use of alternative medicines

B. Explore English as a second language lessons

C. Explore aromatherapy for relaxation purposes

D. Explore counciling for depression options.

32. Agnes is a 77 year old who lost her husband last year and has congestive heart failure. She has a move in with her son Alex. She has been brought to the ER by Alex who says she is short of breath. He doesn't know how long she has been in the state, nor does he know the medication she should be on. What is the nursing priority?

A. Admit and stabilize the patient

B. Call Agne's daughter

C. Contact social services

D. Ask the son if he is overwhelmed

33. Duke is a 90 year old male with Alzheimer's Dementia living in a nursing home. Recently he has been experiencing sun downing. Which solutions should the nurse consider?

A. Restraining the patient in a chair in lobby area where he can see people.

B. Putting the patient in a room by himself with low light and a closed door

C. Giving the patient nonpharmacologic treatments such as putting the patient in a well lit room

D. Giving the patient Alprazolam to calm him down.

34. Ruth is a 75 year old residing in an assisted living facility and is at risk for fluid volume deficit. Which nursing action would ensure the most accurate monitoring of Ruth's fluid status in a co-created plan of care? Choose 2 answer

A. Measure and record fluid intake and output.

B. Check for crackles in the lungs every shift

C. Ask Ruth to weight each day at the same time

D. Take the vital signs assessed every 4 hours.

35. Which activity would be helpful for older adult to engage in to prevent or interrupt the course of frailty?

A. maintaining social relationships

B. Taking a medication for each chronic disease/ disorder

C. Avoiding travel D. Sleeping greater than 10 hours daily.

Q36 What

should the nurse first instruct the older adult to do when the older adult is beginning an exercise program

A Purchase new gym shoes

B work out until you sweat

C Purchase membership at nearby gym D proceed with low intensity and moderat

1. According to a WSJ article, in Britain, drug companies are paying for nurses to study patient charts to identify people with chronic illnesses. "The nurses then recommend which patients should be called in for a check-up and perhaps prescribe new treatment. The work is part of what the industry calls "disease management programs," which the companies say improve care for people with illnesses like diabetes, asthma, or heart disease." Source: Jeanne Whalen, "Drug Makers Finance Nurses for U.K. Doctors." Wall Street Journal, 30 May 2007, Page B1. Which of the following best explains the actions of the drug companies? Select one:

a. Drug companies see this program as a way of educating patients about the various drug choices available to them

b. The companies see this program as a way to market their own products

c. The companies are committed to improving patient care in Britain

d. The companies are doing their part to ease the health care crisis in Britain

2. According to the economic way of thinking, Select one:

a. The value of a good is determined by the cost of the resources used to produce that good

b. A nation's wealth can be increased by shifting the production possibilities frontier inward.

c. Innovation makes it possible to produce good without giving up the production of another good

d. Costs are incurred when scarce resources are used to produce goods.

3. All of the statements are true about markets except Select one:

a. Markets excel at wealth creation because they often provide incentives for self-interested individuals to take socially beneficial actions

b. Markets function even without an administrator to coordinate the consumption and production plans of buyers and suppliers, respectively

c. The most equitable way to distribute goods and services is through markets

d. Markets are generally an efficient way to facilitate the exchange of goods, services, and resources

4. An institutional arrangement that provides people with opportunities and procedures for exchanging goods, services, and resources is called: Select one:

a. Barter

b. A social economy

c. Traded.

d. A market

5. Concerned that California's high-occupancy vehicle (HOV) lanes were not operating at full capacity and therefore not easing congestion as much as they could. In 2006, California lawmakers authorized the state's Department of Motor Vehicles to distribute 85,000 stickers to owners of gasoline-electric hybrid cars. Which of the following are the consequences of this policy?

(i) The stickers increased the demand for hybrid vehicles that qualified for stickers. (ii) The price of hybrid vehicles increased. (iii) The HOV lanes became clogged with hybrid vehicles which further aggravated congestion. Select one:

a. (i) and (ii) only b. (i), (ii) and (iii) c. (ii) and (iii) only d. (i) only

6. Consider the following policy: To make sure that poor people receive emergency treatment, the U.S. government forces emergency rooms to offer free care to poor patients. Which of the following is a consequence of this policy? Select one:

a. Hospitals in poor neighborhoods are likely to close their emergency rooms because of the high cost of providing free treatment to poor patients

b. Hospitals will have to offer higher salaries to doctors and nurses to induce them to work in poor neighborhoods

c. More hospitals are likely to open emergency care facilities in poor neighborhoods because of increased demand

d. The wait time in emergency rooms will fall.

7. Consider the following three statements: (i) The slump in the housing market has led to an increase in unemployment in the housing construction market. (ii) The Federal Reserve decided to keep interest rates unchanged, motivated by the slump in the housing market. (iii) The California Air Resources Board passed a regulation requiring that 10% of all large automobiles sold in California from 2008 onward be zero-emissions vehicles: cars powered by electricity or alternative fuels like hydrogen. Which of the statements is a macroeconomics issue? Select one:

a. (ii) only b. (i), (ii) and (iii) c. (i) and (ii) only d. (ii) and (iii) only

8. Consider the following three statements: (i) The slump in the housing market has led to an increase in unemployment in the housing construction market. (ii) The Federal Reserve decided to keep interest rates unchanged, motivated by the slump in the housing market. (iii) The California Air Resources Board passed a regulation requiring that 10% of all large automobiles sold in California from 2008 onward be zero-emissions vehicles: cars powered by electricity or alternative fuels like hydrogen. Which of the statements is largely a microeconomics issue? Select one:

a. (i) and (iii) only b. None of the above statements is a microeconomics issue c. (iii) only d. (i) only

9. Consider the following two medical procedures for a particular chronic illness. Procedure X has a very high patient survival rate, but patients are likely to suffer significant brain damage that greatly diminishes one's quality of life. Procedure Y has a much lower survival rate, but if a patient survives she is able to lead a full and normal life. If surgeons are compensated only if their patients survive, how will this policy affect the treatment for this illness?

Select one:

a. More of procedure X will be performed although patients are likely to suffer significant brain damage

b. Surgeons have no incentive to treat this illness

c. More of procedure Y will be performed because patients will able to lead full and normal lives

d. Patients have no incentive to seek treatment for this illness

10. Daikin, Possner, and Zoe are discussing what it means to say that people respond to incentives. Here is an extract from their conversation. Daikin: It means that people are required to behave in a cooperative fashion so that the citizens of a nation can coexist peacefully. Possner: It means that people act in ways that society approves. No rational person will do business with immoral characters. Zoe: It means that people undertake certain actions if they know that doing so will result in some form of material reward that they will not otherwise receive. Whose view accords with the economic way of thinking? Select one:

a. Only the views of Daikin and Zoe exhibit the economic way of thinking.

b. Possner's view is the only one that exhibits the economic way of thinking.

c. All three of their views exhibit an economic way of thinking.

d. Zoe's view is the only one that exhibits the economic way of thinking.

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REL 334 Lecture Notes - Lecture 7: Life Review, Magical Thinking

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