Chapter 19: Illness and Hospitalization Nursing School Test Banks

Chapter 19: Illness and Hospitalization
Test Bank

MULTIPLE CHOICE

1. The abnormal process in which aspects of the social, physical, emotional, or intellectual function of a person are diminished or impaired is called:
a. Health
b. Illness
c. Recovery
d. Homeostasis
ANS: B
Illness is a state of imbalance that is compared with the persons condition prior to development of the present condition. Health is when an individual experiences homeostasis, or a state of balance; recovery refers to improvement after an illness.

DIF: Cognitive Level: Knowledge REF: p. 216 OBJ: 1
TOP: The Nature of Illness KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

2. The client feels unwell. She knows that she would be better off if she rested today, but important matters at work are waiting. She stops at the drugstore on her way to work and purchases several over-the-counter cold remedies. Her behaviors are related to the stage of illness experience called:
a. Symptom experience
b. Medical care contact
c. Assuming the sick role
d. Dependent patient role
ANS: A
The first stage of the illness experience is discovering that something is wrong. The other three options are the other stages: medical care contact is stage three, seeking professional advice; assuming the sick role is stage two, seeking support for the sick role; and dependent patient role is the fourth stage, acceptance of treatment.

DIF: Cognitive Level: Application REF: p. 216 OBJ: 2
TOP: Stages of the Illness Experience KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

3. If illness or hospitalization results in a change in physical appearance, it is likely to have a strong impact on the persons:
a. Attitude
b. Body image
c. Confidence
d. Acceptance of the problem
ANS: B
Threats to body image occur with surgery, extensive diagnostic procedures, and acute and chronic illness. Changes in physical appearance also may affect attitude, confidence, and acceptance of the problem, but not as heavily as they affect body image.

DIF: Cognitive Level: Comprehension REF: p. 217 OBJ: 4
TOP: Impacts of Illness KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

4. For most people, being hospitalized is seen as a(n):
a. Crisis
b. Annoyance
c. Chance to rest
d. Expensive hotel
ANS: A
The crisis of hospitalization involves being removed from ones familiar home environment to be cared for by strangers in an impersonal, uncomfortable setting.

DIF: Cognitive Level: Knowledge REF: p. 218 OBJ: 4
TOP: Situational Crisis KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

5. The client has been admitted to the medical unit for unexplained weight loss and fatigue. He does not speak except to answer questions, and he refuses to interact with other people except when necessary. Which coping mechanism is he using to deal with his hospitalization?
a. Anger
b. Shock
c. Anxiety
d. Withdrawal
ANS: D
Many hospitalized clients withdraw into themselves and interact only when necessary. Clients do this to focus their attention inward and replace the energies that have been drained by illness, crisis, and hospitalization.

DIF: Cognitive Level: Application REF: p. 219 OBJ: 5
TOP: Stages of Hospitalization KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

6. The most important reason for performing a crisis assessment on hospitalized clients is that it allows the care provider to:
a. Implement appropriate care measures.
b. Encourage clients to share their concerns.
c. Identify the requirements for additional supplies and personnel.
d. Identify problems before a crisis develops and plan preventive interventions.
ANS: D
Problems are much easier to address and treat before they become a crisis situation. The other options are not necessarily directly related to a crisis situation.

DIF: Cognitive Level: Application REF: p. 220 OBJ: 6
TOP: Psychosocial Care
KEY: Nursing Process Step: Assessment | Nursing Process Step: Intervention
MSC: Client Needs: Psychosocial Integrity

7. The caregiver is encouraging a mother to participate in bathing her daughter, who is in traction for a fractured femur. The caregiver is recognizing the familys:
a. Physical need to work
b. Social need to stay with the client
c. Intellectual need to control the situation
d. Emotional need to be involved in caring for the client
ANS: D
Clients families have a significant impact on the outcome of the clients illness and provide emotional support.

DIF: Cognitive Level: Comprehension REF: p. 221 OBJ: 7
TOP: Supporting Significant Others KEY: Nursing Process Step: Intervention
MSC: Client Needs: Psychosocial Integrity

8. The process that helps clients cope with illness or surgery after leaving the institution is called:
a. Client education
b. Preventative care
c. Discharge planning
d. Role change planning
ANS: C
Discharge planning should begin on the day of admission. Client education and preventative care are part of discharge planning; role change planning is not.

DIF: Cognitive Level: Knowledge REF: p. 222 OBJ: 9
TOP: Discharge Planning KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

9. Which is the best way for the nurse to assist clients in managing their pain?
a. By setting mutual goals
b. By focusing on nursing care
c. By administering narcotic analgesics
d. By telling the client to think of something else
ANS: A
Setting mutual goals helps both nurses and clients to set realistic, attainable goals for pain management. Focusing on nursing care is not client centered; administering narcotic analgesics should not be a focus of pain management; and telling the client to think of something else does not address the problem of pain.

DIF: Cognitive Level: Application REF: p. 221 OBJ: 9
TOP: Pain Management KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

10. The stage of hospitalization during which the client reestablishes personal identity and becomes self-centered is the time when the client is:
a. Going to be discharged
b. Feeling overwhelmed
c. Becoming emotionally stabilized
d. Adapting to the environment
ANS: C
During the stabilization stage, the hospitalized person gradually gains the strength to reestablish some personal identity. Some clients become self-centered at this time because they are focusing on their illness. When the client is going to be discharged is not considered a stage of hospitalization; feeling overwhelmed is the first stage, and adapting to the environment is the third stage.

DIF: Cognitive Level: Knowledge REF: p. 219 OBJ: 5
TOP: Stages of Hospitalization KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

11. The nurse begins discharge planning measures with a hospitalized client:
a. Near the time of discharge
b. At the time of admission
c. 3 days into the hospital stay
d. On the day before discharge
ANS: B
Discharge planning should be initiated as soon as possible after the client is admitted so ample time is allowed to make necessary plans for discharge to home or to another facility. The other options will not allow sufficient time for this to occur.

DIF: Cognitive Level: Knowledge REF: p. 222 OBJ: 9
TOP: Discharge Planning KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

12. During a crisis assessment due to the diagnosis of a terminal illness, the nurse is trying to determine what the clients history is with regard to losses. Which question will best assess this area?
a. How easily do you adapt to new situations?
b. What is your understanding of the current situation?
c. Who or what has helped you through crisis situations in the past?
d. How is this situation affecting your family?
ANS: C
This question will help one to determine how this client has dealt with crises in the past. Asking the client about adaptation to new situations assesses for other risk factors; and asking about the clients understanding of the situation or how the situation is affecting the clients family assesses what the illness means to the client.

DIF: Cognitive Level: Application REF: p. 220 OBJ: 4
TOP: Therapeutic Interventions KEY: Nursing Process Step: Intervention
MSC: Client Needs: Psychosocial Integrity

13. A male client has been diagnosed recently with a chronic illness. His family tells the nurse that they have noticed that he has not been attending his weekly card game night with his friends and does not return their calls. What reaction is this client most likely experiencing?
a. Anxiety
b. Withdrawal
c. Shock
d. Anger
ANS: B
Withdrawal is a common response to illness. The individual removes himself from others and refuses to interact. The other options are also common emotional responses to illness: anxiety is described as feelings of uneasiness and apprehension; shock refers to an overwhelmed feeling with inability to process information; and anger is an emotional response that may be directed inward or outward.

DIF: Cognitive Level: Application REF: p. 218 OBJ: 4
TOP: Impacts of Illness KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

14. The nurse is admitting a male client so he can undergo testing for diagnostic purposes. The nurse explains how the equipment in the room works and how to order meals. After the nurse leaves the room, the client yells for the nurse because he cant remember how to use the call light. What emotional response is the client experiencing?
a. Denial
b. Withdrawal
c. Shock
d. Anger
ANS: C
Shock is a common response to illness experienced by clients and their families. The individual experiences an overwhelmed feeling with an inability to process information. The other options are also common emotional responses to illness: denial is described as refusal to acknowledge a situation; withdrawal is characterized by an individuals removing himself or herself from others and refusing to interact; and anger is an emotional response that may be directed inward or outward.

DIF: Cognitive Level: Application REF: p. 218 OBJ: 4
TOP: Impacts of Illness KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

15. A female client admitted to a mental health facility for depression is frequently asking for help in deciding on what foods to choose for her meals, as well as which activities she should participate in. Which stage of illness is she experiencing?
a. Dependency
b. Symptoms
c. Recovery and rehabilitation
d. Sick role
ANS: A
Dependency is stage 4 of the stages of illness and is characterized by relying on and accepting the attention of others. The appearance of symptoms is the first stage of illness and refers to notice of an undesirable change and awareness that something is not right; recovery and rehabilitation constitute stage 5 of illness; and the sick role is the second stage of illness, in which an individual accepts the illness and focuses on treatment and/or recovery.

DIF: Cognitive Level: Application REF: p. 217 OBJ: 2
TOP: Stages of Illness Experience KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

16. The nurse is talking with a male client recently admitted to a mental health facility. He is very anxious to begin his treatment for alcohol and drug addiction because he states that he really wants to get well this time. Which stage of illness is the client experiencing?
a. Dependency
b. Symptoms
c. Recovery and rehabilitation
d. Sick role
ANS: D
The sick role is the stage of illness in which an individual accepts the illness and focuses on treatment and/or recovery. Dependency is stage 4 of illness and is characterized by relying on and accepting the attention of others. The appearance of symptoms is the first stage of illness and refers to notice of an undesirable change and awareness that something is not right; recovery and rehabilitation constitute stage 5 of illness.

DIF: Cognitive Level: Application REF: p. 216 OBJ: 2
TOP: Stages of Illness Experience KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

17. An individual notices that he is experiencing periods of feeling very depressed followed by periods of elation and increased energy. He knows that something is wrong and talks with his family about what he should do. This is an example of the stage of illness called:
a. Dependency
b. Symptoms
c. Recovery and rehabilitation
d. Sick role
ANS: B
During stage 1 of illness, the individual notices an undesirable change, is aware that something is not right, and seeks the advice of others. Dependency is stage 4 of illness and is characterized by relying on and accepting the attention of others. Recovery and rehabilitation is stage 5 of illness; and assuming the sick role is the stage of illness in which an individual accepts the illness and focuses on treatment and/or recovery.

DIF: Cognitive Level: Application REF: p. 216 OBJ: 2
TOP: Stages of Illness Experience KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

18. A business owner is hospitalized after suffering a heart attack. The staff finds him very demanding and angry toward all personnel and noncompliant in his therapy and treatment plan. What is the best strategy for the nurse to employ with this patient?
a. Give him an ultimatum to cooperate or face a longer recovery period.
b. Allow him to continue this behavior due to his role outside the hospital.
c. Provide him with necessary information to actively participate in goal setting.
d. Request that a health care provider with a stronger personality take care of him.
ANS: C
Loss of control and dependence on health care providers are feelings shared by hospitalized clients. Providing necessary information to make decisions in his own care allows the client some control over the hospitalization.

DIF: Cognitive Level: Application REF: p. 218 OBJ: 4
TOP: Situational Crisis KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

19. A 72-year-old woman from the Dominican Republic is hospitalized after fainting while visiting her daughter. The staff has voiced complaints regarding the family ignoring hospital rules regarding visiting hours and number of visitors allowed in the room. In addition, the daughter brings food to the mother from home that is not a part of the clients prescribed diet. How can the staff deal with these issues in a professional manner?
a. Meet with the patient and family to determine how to provide support for cultural practices.
b. Have security remove the family and focus on the clients care and needs.
c. Accept the food from the family and throw it out without informing them.
d. Allow family presence to take priority over treatments and therapies.
ANS: A
An individuals family is an important group in ones life. Family members should be included and consulted for details about the clients care. In this case the family is also in crisis and needs support and the satisfaction that their loved one is receiving good care. All other options seek to exclude the family from this support.

DIF: Cognitive Level: Application REF: p. 221 OBJ: 7
TOP: Supporting Significant Others KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

20. A woman arrives at the hospital to deliver her first child. She has no previous history of hospitalization or serious illness. During her stay, the client is highly anxious and demands to be informed of all information documented on her medical record. The clients husband informs the nurse that the clients mother died in the hospital 10 months ago after a brief battle with lung cancer. he most probable reason for the clients current reaction is:
a. An obsessive fear of dying
b. Reluctance in becoming a mother
c. Symbolic meaning of the hospital
d. Ambivalence regarding the sick role
ANS: C
The clients reaction is due to the symbolic meaning this hospital has for her.

DIF: Cognitive Level: Application REF: p. 221 OBJ: 7
TOP: Supporting Significant Others KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

21. The client being transferred to a rehabilitation center following hospitalization for surgical repair of a fractured hip is portrayed by the nurse in the hospital setting as being very involved and making good progress in his physical therapy sessions. However, the nurse in the rehabilitation facility observes that the client is withdrawn, and often asks to defer his physical therapy sessions. Which statement best describes the change in patient behavior?
a. The patient is suffering from delirium due to the unfamiliar surroundings.
b. The patient has adapted to the recovery role and does not need rehabilitation.
c. The patient enjoyed the dependency role in the hospital setting.
d. The patient is adjusting to a new environment and is in a vulnerable position.
ANS: D
In dealing with his hospitalization the client has regained personal identity and adapts, however for persons transferred to another institution, the crisis begins again. This does not indicate that the patient does not require rehabilitation. His behavior in the hospital was not reflective of a dependency. This client is not exhibiting behaviors indicative of delirium.

DIF: Cognitive Level: Application REF: p. 219 OBJ: 5
TOP: Stages of Hospitalization KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

MULTIPLE RESPONSE

22. How does the experience of entering a psychiatric treatment facility differ from hospitalization for physical reasons? (Select all that apply.)
a. The client may fear other clients behaviors.
b. The client receives a negative diagnostic label.
c. The client can enjoy the attention of caregivers.
d. The client must cope with the stigma of mental illness.
e. The client must cope with the stigma of physical illness.
f. Insurance companies may deny payment for treatment.
g. Insurance companies never deny payment for treatment.
ANS: A, B, D, F
Because of stereotyping of mental illness, clients often fear mental health facilities and the stigma of being in one. In addition, some insurance companies have not added mental health treatment to their plans or have limited treatment coverage.

DIF: Cognitive Level: Application REF: p. 219 OBJ: 6
TOP: Psychiatric Hospitalization KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

23. Which natural remedies may the nurse use to assist clients in alleviating pain? (Select all that apply.)
a. Distraction
b. Pain patches
c. Massage
d. Visualization
e. PCA pumps
ANS: A, C, D
Natural remedies are less invasive and should be attempted prior to administration of medication, such as pain patches and PCA pumps.

DIF: Cognitive Level: Knowledge REF: p. 220 OBJ: 8
TOP: Psychosocial Care KEY: Nursing Process Step: Assessment
MSC: Client Needs: Physiological Integrity

24. Which functions of a person are diminished or impaired during illness? (Select all that apply.)
a. Social
b. Medical
c. Emotional
d. Physical
e. Intellectual
ANS: A, C, D, E
Illness is defined as an abnormal process in which aspects of the social, physical, emotional, or intellectual condition and function are diminished or impaired. Medical is not a human function.

DIF: Cognitive Level: Knowledge REF: p. 216 OBJ: 1
TOP: The Nature of Illness KEY: Nursing Process Step: Assessment
MSC: Client Needs: Physiological Integrity

COMPLETION

25. __________ is a continually changing state of well-being that encompasses an individuals physical, social, and mental well-being.

ANS:
Health
Health also comprises the absence of disease or abnormal conditions.

DIF: Cognitive Level: Knowledge REF: p. 216 OBJ: 1
TOP: Illness and Hospitalization KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

26. A psychological defense mechanism that allows a person to block painful feelings associated with a problem is known as __________.

ANS:
denial
This defense mechanism allows an individual time to collect his or her thoughts, make plans, and restore himself or herself to a more comfortable state of functioning.

DIF: Cognitive Level: Knowledge REF: p. 218 OBJ: 3
TOP: Impacts of Illness KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

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