1. Environmental Barriers 1. Biased language Sets with similar termsA, B, C, E, F (The majority of the population was protected. The emphasis was placed on illness care, because providers received a fee only when a service was rendered, and all costs were reimbursed. Insulated from having to pay for health care, consumers demanded complex and technologically advanced services. These demands were a major force rapidly increasing health care costs because people with insurance felt entitled to care, and, after all, there was a guaranteed payer. Medical orientation was on curing at any cost. The profits of owning or managing an insurance company were not immediately seen.) Populations Affected by Disabilities Terms in this set (24)ANS: D ANS: D ANS: A, D, E, F ANS: B, C, F Sets found in the same folderWhich of the following is an accurate definition of impairment? C. An anatomical, mental, or psychological loss or abnormality A disability, resulting from an impairment, involves a restriction or inability to perform an activity in a normal manner or within the normal range. An anatomical, mental, or psychological loss or abnormality is an impairment. A handicap is a disadvantage resulting from an impairment or disability that prevents fulfillment of an expected role. In a comparison of these concepts, an impairment affects a human organ on a micro level; disability affects a person on an individual level; and a handicap involves society on a macro level of analysis. Which of the following problems depends on the responses of other people and therefore cannot be measured? B. handicap In comparing these concepts, an impairment affects a human organ on a micro level; disability affects a person on an individual level; and a handicap involves society on a macro level of analysis. Table 21-1 points out that both impairment and disability may be objective and measurable, whereas handicap is neither, because it is an experience related to the responses of other people. Which of the following best describes the problem with the viewing disability based on the Nagi model? A. Functional limitations are used to determine if an individual is disabled. The Nagi model uses functional limitations, which have been defined and are measureable, to determine whether an individual is disabled. However, the current paradigm considers the environmental barriers and the perspectives of the onlooker when considering if an individual is disabled. Thus, the other options do not address the limitation of using only functional limitations. Which of the following insights is being stressed by advocacy groups regarding persons with disabilities today? A. Disability results when physical and social barriers in the environment prevent a person from taking equal part in community life. Nearly all definitions identify an individual as disabled on the basis of a physical or mental impairment that limits the person's ability to perform an important activity. The complementary possibility—that the individual is limited by a barrier in society or the environment—is never considered. Advocacy groups are stressing that environment and the reactions of others are as crucial as the actual physical or mental limitation. Which of the following
concerns can a nurse as a citizen help address? A. Advocating for removal of environmental and social barriers to needed services In the National Agenda for the Prevention of Disabilities model, disability occurs when a person's physical or mental limitations, in interaction with physical and social barriers in the environment, prevent the person from taking equal part in the normal life of the community. Confronting environmental and social barriers to needed services can frustrate and exhaust many people with disabilities and their families. The nurse—as a citizen and a concerned professional—can advocate for removal of such barriers. This issue is the most important for the nurse to address, allowing the nurse to partner with clients and families affected by disabilities to remedy barriers that negatively affect quality of life for this population. When a person was brought into the clinic in a wheelchair, the new nurse asked the patient if he felt a need for a priest. Which of the
following best explains why the nurse would ask about spiritual health during the intake assessment? D. Some people perceive disabilities as punishment for sin. There are four models for viewing disability including: (1) the medical model, (2) the rehabilitation model, (3) the socially constructed disability model, and (4) the moral model, which connects disability with sin and shame. The nurse apparently perceived disability as a result of sin not yet repented. A young man rolled his wheelchair up the ramp into the clinic to the desk where the intake nurse greeted him. After welcoming him to the clinic, which of the
following should be the initial question asked by the nurse? D. "What brings you to the clinic today?" The client should be asked what is needed just as any other client would be. A veteran would more probably be at a Veterans Affairs (VA) clinic, and there is nothing in the statement to imply that the clinic is part of the VA medical system. Because the man made it into the clinic, it is doubtful he would need help into the treatment room. Not all persons live with families. The handicap may be unrelated to why he is at the clinic. He may be ill or merely need immunization or other health promotion activity. A young woman rolled her wheelchair up the ramp into the
clinic to the desk where the intake nurse greeted her. Which of the following should be the nurse's first response? D. Sit so the nurse is on eye level with the young woman Nurses who demonstrate understanding of the issues confronting people with disabilities should approach them on an eye-to-eye level, listening to understand. Moving to eye level should be the first action that the nurse takes before beginning a conversation with the client. Which of the following best describes the proportion of the U.S. population that is made up of persons with a long-lasting condition or disability? D. The proportion is almost 20% and increasing. In 2010, approximately 56.7 million (18.7%) of the 303.9 million civilian noninstitutionalized population aged 5 years and older had a long-lasting condition or disability. Further, it is important for health care policy makers and health care providers to recognize that the prevalence of disability is increasing. Which of the following best describes how many households with at least one child with a disabling condition would a school nurse working in an elementary school expect to see? C. About 15% About 15.1% of households with children have at least one child with a special health care need (disabling condition). The
mother confided in the nurse, "I don't think my child is improving." Which of the following statements would be the best response by the nurse? D. What is causing your concern? Nurses should pay attention, particularly when parents intuitively whisper, "Something is not right." A well-meaning health care provider may attempt to reassure a concerned mother. However, this kind of response may create silence and delay further questions by the parent. Rather than decrease parental concern, it may increase anxiety. The nurse can serve as an intermediary, working among the family and the health care team, to address parental concerns and client goals. Which
of the following describes the most important need of every school-aged child with a disability? D. An IEP A child should have all of the above items, an advocate in the school nurse, a teacher who understands, an assessment including comparison with developmental milestones, as all of these are components of an IEP with goals, cooperatively developed with the parents, to help the child succeed in school. The IEP describes the goals, as well as any special support needed to help achieve them. The IEP is the most comprehensive answer. Which of the following best describes the current perspective on how communities should treat persons with disabilities (PWDs)? B. Maximize opportunities for PWDs to work and otherwise contribute to community life Contemporary disability policy minimizes disadvantages and maximizes opportunities for PWDs to live productively in their communities. Early American public policy viewed PWDs as "deserving poor" who required governmental protection and provision, with little capacity for self-support or independence. A professional strongly encouraged institutionalization so the parents could focus on care of their other family members. Which of the following suggestions would be appropriate for the nurse to make to the parents? B. The child has a right to an education in the least-restrictive setting. It is a given that it is the parents' choice. As an advocate for the child, you can explain that children have a legal right to an appropriate public education based on the child's needs in the least-restrictive setting. A man came for follow-up care to the free clinic, explaining that he had applied for a job based on his education and years of previous work experience, but, being in a wheelchair, he was turned down. Which of the following responses would be most appropriate for the nurse? A. "If you know you can do the job, go to the free legal aid clinic for assistance. The employer may not know the law." The Americans with Disabilities Act (ADA) became law in 1990. This landmark civil rights legislation prohibits discrimination toward people with disabilities in everyday activities. The ADA guarantees equal opportunities for people with disabilities related to employment, transportation, public accommodations, public services, and telecommunications. A qualified individual with a disability must meet legitimate skill, experience, education, or other requirements of an employment position. The person must be able to perform the essential functions of the job. Which of the following problems was the Ticket to Work and Work Incentives Improvement Act (TWWIIA) designed to address? D. Persons with disabilities not seeking employment for fear of losing their health care and other governmental supports Typically, people with disabilities could qualify for such benefits as health care, income assistance programs, and personal care attendant services only if they chose not to work. To address employment and benefit issues for persons with disabilities, in December 1999, the TWWIIA was signed into law. The TWWIIA reduced people with disabilities' disincentives to work by increasing access to vocational services and provided new methods for retaining health insurance after returning to work. Which of the following was the result of the passage of the American
Recovery and Reinvestment Act of 2009? D. Little change has occurred. Employers willing to hire PWDs may receive monies provided through the American Recovery and Reinvestment Act (2009). However, little improvement in employment levels has been seen. Which of the following was suggested by the National Healthcare Disparities Report of 2008 (NHDR) as one reason that there are such disparities in health care outcomes inside the health care system? A. Care provider bias and poor communication exist. The NHDR explains that, within the scope of health care delivery, disparities are due to differences in access to care, provider biases, poor provider-patient communication, poor health literacy, and other factors. This report did not address that there is inadequate funding to provide appropriate care, that people seek care too late, or that there is a national shortage of providers. A nurse came limping into work with a huge cast on her right leg and asked to have an assignment for a week or two that did not require driving. The nurse said, "I never realized how difficult it is to get some places without two good legs. Now I know how persons with disabilities must feel!" Which of the following would be the most appropriate response from the nursing
supervisor? B. "Not really; you'll be out of that cast in a few weeks." Those who have a temporary disability have a very different experience than those who are permanently disabled. Although they may experience frustrations, they view it as a temporary problem and a temporary setback. The other responses address this temporary disability as if it is similar to a permanent disability, which it clearly is not. A family has recently learned that their child will be permanently disabled. The parents do not deny the disability,
but do not fully realize its impact. Which of the following levels of adjustment are the parents experiencing? C. Ostrich phase Ulrich and Bauer (2003) propose that the adjustment to disability experience occurs in four levels as parents gradually become aware of the impact of their child's disability. These levels include: (1) the ostrich phase, where parents do not deny a disability, but do not fully realize its impact; (2) special designation, when parents begin to realize their child has a special need and seek help; (3) normalization, when parents try to make the differences between their child and children without disabilities less apparent, and may actually request a decrease in services; and (4) self-actualization, when parents do not view being different as better or worse, just different, and support their child in learning about his or her disability, along with how to be a self-advocate. A nurse eagerly explained to a long-term disabled male client the most recent relevant research related to his care. The client, rather than express appreciation, said, "I prefer to have my care given this way." The nurse explained that research suggested an alternative approach was more clinically effective, but the client said, "I am more comfortable during the day if my care is given
this way." Which of the following actions should be taken by the nurse? A. Accept that the client knows what works best A person who lives with a disability commonly becomes an expert at knowing what works best for his or her body. The nurse must ask the client what works best for him or her and what goals the client is pursuing. Research is based on probabilities of effectiveness with large groups, but individuals may have a different unique reaction to any intervention. Which of the following best describes why some advocacy groups have taken a strong stand against physician-assisted
suicide? C. Fear that some persons may be "encouraged" to accept an early death merely because they are not valued by society for their contributions Because people have previously been killed because they had a disability, some advocacy groups, such as Not Dead Yet, have taken a strong stance against physician-assisted suicide, fearing it will lead to the early or forced death of people with disability. Ethical and personal beliefs and emphasizing the hope for a new treatment have not been stands taken by advocacy groups against physician-assisted suicide. Which of the following guiding rules or principles would most likely be followed by a nurse caring for persons with disabilities? (Select all that apply.) A, D, E, F Data from interviews conducted with nurses who provide care to persons with disabilities revealed principles such as do not assume anything; adopt the client's perspective; listen and learn from the client; gather data from the perspective of the client and family; care for the client and the family, not the disability; be well informed about community resources; and become an advocate by letting clients choose. Which
of the following would be good rules to use when interacting with a person with disabilities? (Select all that apply.) C, F Rules include do not offer expert advice or assistance based on what you think the person needs or can do; do not grab the arm of a person who is blind but let the person take your arm so the person does not lose his or her balance; do not pet a working dog; do seek out similarities and shared interests; do inform the person who is present; say goodbye when leaving; and treat the person very much like an able-bodied person. |