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Lewis: Medical-Surgical Nursing in Canada, 2nd Edition

Chapter 2: Chronic Illness

Test Bank

MULTIPLE CHOICE

1. Chronic illness accounts for more than 60% of all deaths globally. Which chronic illness accounts for the highest proportion of those deaths in Canada?
a. Cancer
b. Diabetes
c. Cardiovascular disease
d. Chronic respiratory disease

ANS: C
According to the Centre for Chronic Disease Prevention and Control, cardiovascular diseases continue to be the underlying cause of death for one in three Canadians and are responsible for the largest economic impact of all illnesses in Canada.

DIF: Cognitive Level: Comprehension REF: p. 20

2. Which client history indicates multimorbidity?
a. Chronic obstructive pulmonary disease and a urinary tract infection
b. Chronic kidney disease requiring an appendectomy
c. Lung cancer and pneumonia
d. Diabetes with exacerbation of rheumatoid arthritis

ANS: D
Multimorbidity is the simultaneous occurrence of several chronic medical conditions in the same person; therefore, the correct choice is one that has two chronic illnesses, namely, diabetes and rheumatoid arthritis.

DIF: Cognitive Level: Application REF: p. 22

3. Which factor has a major impact on the development of chronic illness?
a. Poverty
b. Social stability
c. Urban dwelling
d. High school diploma

ANS: A
Poverty and socioeconomic disadvantage are recognized to have a major impact on the development of chronic illness, whereas social stability, education, and access to tertiary care facilities do not impact on the development of chronic illness.

DIF: Cognitive Level: Comprehension REF: p. 22

4. Which characteristic reflects nonmodifiable risk factors for chronic illness?
a. Cannot be changed
b. Requires intervention to change
c. Can be altered to benefit health outcomes
d. Can be changed with client perseverance

ANS: A
Behavioural risk factors are considered modifiable, whereas nonmodifiable risk factors (e.g., age, gender, genetic makeup) cannot be changed.

DIF: Cognitive Level: Comprehension REF: p. 22

5. Life expectancy in Canada is estimated to be approximately how many years?
a. 60
b. 70
c. 80
d. 90

ANS: C
According to Statistics Canada (2006), the actual life expectancy in Canada is 80.2 years.

DIF: Cognitive Level: Knowledge REF: p. 23

6. For which type of cancer does evidence exist to support a genetic predisposition to occurrence?
a. Lung
b. Breast
c. Cervical
d. Testicular

ANS: B
Genetic testing has shown an inherited predisposition to several types of cancer, including breast and ovarian cancer, melanoma, and colon cancer.

DIF: Cognitive Level: Knowledge REF: p. 23

7. Viewing disability as directly caused by disease or trauma reflects which model perspective?
a. Social
b. Nursing
c. Medical
d. Collaborative

ANS: C
According to the World Health Organization, two main models have shaped the manner in which we think about disability, namely, the medical model and the social model. The medical model views disability as directly caused by trauma, disease, or another health condition, whereas the social model views disability as a socially created problem and not an inherent attribute of an individual.

DIF: Cognitive Level: Comprehension REF: p. 23

8. Which statement by the client reflects an outcome expectancy?
a. I am not able to exercise.
b. Exercise helps people lose weight.
c. Exercise is too hard on my arthritis.
d. Dietary restrictions work better than exercise to lose weight.

ANS: B
An outcome expectancy is the individual’s belief that a specific behaviour will lead to certain outcomes. For example, the client who tells the nurse that exercising helps people lose weight is voicing an outcome expectancy, whereas the client who tells the nurse that she is not able to exercise is voicing an efficacy expectancy.

DIF: Cognitive Level: Comprehension REF: p. 25

9. Which is the most influential source of self-efficacy?
a. Mastery
b. Affective states
c. Verbal persuasion
d. Vicarious experience

ANS: A
Although all of the choices are sources of self-efficacy, mastery relates to a belief about whether we have what it takes to succeed and is considered the most influential source of self-efficacy.

DIF: Cognitive Level: Knowledge REF: p. 25

10. Which reflects a characteristic of health-related hardiness known as “challenge”?
a. Confidence to appraise a health stressor
b. Ability to modify responses to health stressors
c. Viewing a health stressor as an opportunity for growth
d. Optimal psychosocial adaptation to a health stressor

ANS: C
The three general characteristics of hardy people are control, commitment, and challenge. Challenge is described as the anticipation of change as an exciting challenge to further development. Individuals who cognitively reappraise the health stressor so it is viewed as a stimulating and beneficial opportunity for growth possess the characteristic of challenge.

DIF: Cognitive Level: Comprehension REF: p. 25

11. Which nonpharmacological therapy has the most empirical support for reducing cancer-related fatigue?
a. Bedrest
b. Exercise
c. Relaxation
d. Distraction

ANS: B
Exercise is the nonpharmacological therapy that has the most empirical support from the research literature in treating fatigue.

DIF: Cognitive Level: Knowledge REF: p. 26

12. Which illness trajectory phase has its goal of management as forming an appropriate trajectory projection and scheme?
a. Unstable
b. Downward
c. Pretrajectory
d. Trajectory onset

ANS: D
The trajectory onset phase is the appearance of notable symptoms and includes a period of diagnostic workup as a person begins to discover and cope with the implications of the diagnosis. The goal of management is forming an appropriate trajectory projection and scheme.

DIF: Cognitive Level: Comprehension REF: p. 30

13. Which reflects a reference to symptoms of an acute illness?
a. Blood chemistry analysis
b. Subjective reports from clients
c. Physiological assessment data
d. Objective manifestations of a symptom

ANS: B
Acute illness is typically characterized by a sudden onset with signs and symptoms. Signs are typically manifestations of a condition, whereas symptoms refer to the subjective reports of the client.

DIF: Cognitive Level: Application REF: p. 21

14. Jim was diagnosed with leukemia 4 years ago and is admitted to hospital to help manage his symptoms of an exacerbation. According to the illness trajectory model, which phase of chronic illness is he experiencing?
a. Acute
b. Stable
c. Crisis
d. Unstable

ANS: C
The answer choices all reflect phases of chronic illness according to the trajectory model, but the key characteristic in this question is that he has been admitted to hospital; therefore, he is in the crisis phase. This phase indicates that the client is experiencing a critical or life-threatening situation necessitating emergency treatment or care.

DIF: Cognitive Level: Comprehension REF: p. 30

15. Sally, 25 years old, recently received a diagnosis of type 2 diabetes. She arrives at the clinic and eagerly informs the nurse that she has followed her prescribed dietary and exercise plan for the past month. This statement is reflective of which behaviour?
a. Compliance
b. Adherence
c. Self-management
d. Chronic care maintenance

ANS: B
Adherence implies conformity of the client with the health care recommendations, whereas compliance reflects coercion of the client to engage in particular recommendations.

DIF: Cognitive Level: Application REF: p. 31

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