Chapter 21: Living Well with Chronic Illness Touhy: Ebersole & Hess' Toward Healthy Aging, 9th Edition MULTIPLE CHOICE 1. A nurse is caring for an older adult who is in the pre-trajectory phase of the Chronic Illness
Trajectory. The nurse knows that this phase is characterized by which of the following: The absence of signs or symptoms of the illness Diagnostic testing being conducted A progressive decline in physical and or mental status A period of temporary remission from the crisis
a. b. c. d.
ANS: A
The pre-trajectory phase is characterized by the absence of signs or symptoms of the illness. The trajectory onset includes the diagnostic period. The downward phase is characterized by a progressive decline in physical/mental status, characterized by increasing disability/symptoms. The comeback phase is characterized as a period of temporary remission from the crisis. DIF: Cognitive Level: Remembering REF: p. 280, Table 21-1 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Physiological Adaptation 2. A major difference in the diagnosis of chronic disease between younger adults and older
adults is that: a. chronic disease is often diagnosed earlier in younger adults and measures can be implemented to prevent later problems. b. chronic disease is often diagnosed earlier in older adults since they are more likely to seek medical care. c. chronic disease is usually not identified in older adults because of the many age-related changes. d. chronic illness is uncommon in younger adults. ANS: A
In a younger adult, the early signs of a pending chronic disease may be identified early enough to prevent later problems (e.g., a finding of an elevated cholesterol level). In older adults, a chronic disease may not be diagnosed until some amount of “end organ damage” has already occurred. For example, diabetic retinopathy may be found during an annual eye examination indicating that the diabetes has been present for some time. Although there are many age-related changes in the older adult, it is still possible to identify chronic illness. Chronic illness is common in younger adults, although it is more common in older adults. DIF: Cognitive Level: Applying REF: p. 278 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Physiological Adaptation 3. An older man who is a smoker is hospitalized for orthopedic surgery. A nurse takes the
opportunity to provide smoking cessation education. The patient asks the nurse: “I have been smoking for most of my life, and I am an old man. Why are you wasting your time telling me to stop smoking? Isn’t it too late?” The nurse bases the response on the knowledge that: a. smoking cessation as late as age 75 can reduce premature death by up to 50%.
