Workbook To Accompany Sorrentinos Canadian Textbook For The Support

WORKBOOK TO ACCOMPANY
Sorrentino’s
TEXTBOOK for the

SUPPORT WORKER
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WORKBOOK TO ACCOMPANY
Sorrentino’s
CANADIAN
TEXTBOOK
for the
SUPPORT WORKER
FIFTH EDITION
Mary J. Wilk
RN, GNC(C), BA, BScN, MN
Professor and PSW Program Coordinator
4 Fanshawe College, London, Ontario
Navdeep Sekhon
RN, BSc, BN, MEd
Educator, Bachelor of Nursing Program
Red River College, Winnipeg, Manitoba
US Author
Relda T. Kelly
RN, MSN
Professor Emeritus, Kankakee Community College
Kankakee, Illinois
Parish Nurse, Wesley United Methodist Church
Bradley, Illinois
WORKBOOK TO ACCOMPANY SORRENTINO’S CANADIAN TEXTBOOK FOR THE SUPPORT
WORKER, FIFTH EDITION
ISBN: 978-0-323-71163-0 e
Copyright © 2022 Elsevier Inc. All rights reserved.
Previous edition copyrighted 2018, Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
Adapted from Workbook and Competency Evaluation Review for Mosby’ Textbook for Nursing Assistants, 9th Edition,
prepared by Relda T. Kelly. Copyright © 2017 Elsevier Inc.
(softcover)
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means,
electronic or mechanical, including photocopying, recording, or any information storage and retrieval system,
without permission in writing from the publisher. Reproducing passages from this book without such written
permission is an infringement of copyright law.
Requests for permission to make copies of any part of the work should be mailed to: College Licensing Officer,
access ©, 1 Yonge Street, Suite 1900, Toronto, ON, M5E 1E5. Fax: (416) 868-1621. All other inquiries should be
directed to the publisher, www.elsevier.com/permissions.
Every reasonable effort has been made to acquire permission for copyright material used in this text and to
acknowledge all such indebtedness accurately. Any errors and omissions called to the publisher’s attention will be
corrected in future printings.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other
than as may be noted herein).
NOTICES
The content and procedures in this book are based on information currently available. They were reviewed by
instructors and practising professionals in various regions of Canada. However, agency policies and procedures
may vary from the information and procedures in this book. In addition, standards and guidelines may change
as new information becomes available. Other federal, provincial, and territorial agencies also may issue new
standards and guidelines, as may accrediting agencies and national organizations.
You are responsible for following the policies and procedures of your employer and the most current standards,
practices, and guidelines as they relate to the safety of your work.
To the fullest extent of the law, neither the Publisher nor the authors or editors assume any liability for any
injury and/or damage to persons or property as a matter of products liability, negligence, or otherwise or from
any use or operation of any methods, products, instructions, or ideas contained in the material herein.
The Publisher
We are honoured to have received permission to reproduce the work, “Harmony and the Universe” by Order of
Canada award-winning Indigenous artist, Dr. Daphne Odjig on our textbook cover. Dr. Odjig’s art, which seeks to
open doors and build community between the Indigenous and non-Indigenous community in Canada, reinforces
the valuable message that we are one community in looking out for and caring for one another.
In 2007, Dr. Odjig received the Governor General’s Award in Visual and Media Arts. In 2009, Dr. Odjig was the
first female Indigenous artist to have her own show at the National Gallery of Canada.
“Harmony and the Universe” are copyright © Daphne Odijig, artist, courtesy of Odjig Arts and Stan Somerville
(Odjig); the estate of Daphne Odjig.
VP Education Content: Kevonne Holloway

Content Strategist (Acquisitions, Canada): Roberta A. Spinosa-Millman
Director, Content Development Manager: Laurie Gower
Content Development Specialist: Martina van de Velde
Publishing Services Manager: Shereen Jameel
Senior Project Manager: Umarani Natarajan Working together
Design Direction: Margaret Reid to grow libraries in
Last digit is the print number: 987654321 Reesot developing countries
Ebook ISBN: 978-0-323-71164-7 www.elsevier.com e www.bookaid.org
Contents
The Role and Responsibilities of the Beds and Bed Making 105
Support Worker 1
Skin Care and Prevention of
The Canadian Health Care System 5 Wounds 109
Workplace Settings 9 Promoting Client Comfort, Pain
Management, and Sleep 119
Ethics 13
Measuring Height, Weight, and Vital
BAH
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Legislation: The Client's Rights and
Signs 125
Your Rights 17
Medical Terminology 135
La Health, Wellness, Illness, and
Disability 25 Planning, Reporting, and Recording
Ea
Client Care 143
Caring About Culture and
Diversity 29 Nutrition and Fluids 149
Managing Stress 33 Gl Enteral

Noom™N
BN
NOSS Nutrition and Intravenous
Therapy 157
Interpersonal Communication 37
Urinary Elimination 163
os © Working With Others: Teamwork and
Delegation 43 Bowel Elimination 171
Working With Clients and Their Growth and Development 179

Families 47
Body Structure and Function 187
= =)
== Abuse, Bullying, and Harassment
Common Diseases and Disorders 199
Awareness 51
Hearing and Vision Disorders 211
Starting Your Career 57
Speech and Language Disorders 215
14) Body Mechanics 61
BE
HEV
BO
SO
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OOO
NM
RO
BO
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OO —
MOOR Developmental Disorders and
BwOBN
BR
Exercise and Activity 67
Disabilities 219
Rehabilitation and Restorative Care 73
Mental Health Disorders 225
Personal Hygiene 77
Disorientation, Delirium, and
18) Grooming and Dressing 83 Dementia 231
Preventing Infection 87 eS)

>)
i) Promoting Oxygenation 239
Safety 95 Be
ESHeat and Cold Applications 247
iv Contents
41 Caring for Infants and Their Parents 251 Medication Management 269
Caring for the Young 255 46) Working in Acute Care 273
Caring for Older Persons 259 End-of-Life Care 279
44 Home Management 265

Introduction
This workbook is intended to be used with Sorrentino’s Canadian Textbook for the Support Worker, Fifth
Edition. Additional resources are not required to complete the workbook exercises.
This workbook is designed as a study guide to help you apply what you have learned in each chapter
of the textbook. As a supplement to this workbook, procedure checklists are featured on the Evolve web-
site for Sorrentino’s Canadian Textbook for the Support Worker, Fifth Edition. These checklists are designed
to help you become more skilled at performing procedures to enhance the quality of care. Consult with
your instructor for correct answers to material presented in this workbook and on the Evolve website's
procedure checklists. The Evolve website for Sorrentino’s Canadian Textbook for the Support Worker, Fifth
Edition, can be accessed at http://evolve.elsevier.com/Canada/Sorrentino/Support Worker.
As a support worker, you are an important member of the health care team. Completing the exercises in
this workbook will increase your knowledge and skills. Our goal is to prepare you to provide the best possible
care to your clients and to encourage you to take pride in a job well done.
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CHAPTER
The Role and Responsibilities

| of the Support Worker
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TRUE OR FALSE F Wearing any amount of fragrance

can cause breathing problems for
Circle T for true, or circle F for false. some clients.
ahs Wiles Most adults over the age of 70 years F In long-term care facilities, support
have a disabling illness. workers assist clients with complex
health challenges.
P24 Nea © Support workers are expected to
adapt their work to the setting and
needs of the client. MULTIPLE RESPONSE
3 ANS Unregulated care providers must From the list below, choose all ofthe correct answers.
adhere to their employer’s code of
behaviour at all times. 9. Activities of daily living include:
Bathing
4. T F Discretion means keeping all private Toileting
information to yourself. Feeding
Personal hygiene
sysdh Oy It is okay to discuss your personal Ambulating or transferring
problems with a client you have Ba
Se
(ec
OG) Preparing meals
been working with for a long time.
6 iF The goal of support workers is to

demonstrate true compassionate
care for their clients and families at
all times.
CHAPTER 1_ The Role and Responsibilities of the Support Worker
10. Support workers’ responsibilities can be .« 14. Practices for a professional appearance
grouped into the following categories: include:
A. Personal care Following dress code policies
B. Documenting and reporting any basic Keeping fingernails clean and freshly
assessments, observations, and care polished
C. Financial support Wearing clean stockings or socks
D. Family support Wearing comfortable, clean shoes
E. Legal assistance Ensuring underclothing cannot be seen
EF Social support or detected
G. Support for nurses and other Refraining from wearing makeup
professionals Keeping hair away from the face and off
H. Housekeeping/home management the collar
es
Wearing mildly scented perfumes,
iT. Which statements about support work are colognes, or aftershaves
correct? —. Wearing a clean, well-fitting, modest
A. Support work is a regulated profession. uniform
B. ‘The ultimate goal of support work is to = Wearing an appropriate identification
improve the person's quality of life. badge
C. Support work services provided to
people in their homes help them remain 15. When solving problems, which of the
independent and with their families. following should you consider?
D. Support work makes a difference in Personal desire to solve the problem
people’s lives. Priorities of support work
E. Support work requires showing kindness, Client’s viewpoint
sensitivity, and understanding to clients. Supervisor's viewpoint
Scope of practice
12. The letters in the acronym DI/PPS stand for: eb
OO Whether you will be paid extra for
A. Identification solving the problem
Bie Privacy,
Gy eSincerity 16. Where should you find information about
Deg Preterences your scope of practice?
E. Discretion Clients
FE Personal space Your supervisor
G. Independence Employer’s policies
H. Individualized care Friends and co-workers
I Safety MOOWS
The educational program
J. Dignity
13. To be a true professional, you should

demonstrate:
A. A positive attitude
B. A sense of responsibility
C. A professional appearance
D. Discretion about client information
E. Discretion about personal matters
F Acceptable speech and language
G. ‘That you engage in lifelong learning

CHAPTER 1 The Role and Responsibilities of the Support Worker 3
17. The clients you support can be grouped 21. Support workers can advocate for their
according to their problems, needs, and ages. clients by:
Some of these groups are: A. Never leaving their clients’ side
> Healthy older people who live B. Providing empathetic care
independently C. Acting appropriately at all times
Mothers and newborns D. Speaking or acting on behalf of the
People with disabilities client when necessary
People who are in jail
People with medical problems 22. The ultimate goal of support work is to:
Ow
mioAthletes receiving therapy for sports A. Alleviate the client’s pain
injuries B. Improve the client’s quality of life by
People with mental health problems providing compassionate care
People needing rehabilitation C. Ensure the client is clean and dry at all
Children times
Older people living in a live-in facility D. Perform all assigned duties
ATO People having surgery
23; An example of discretion would be:
A. Using responsible judgement when
MULTIPLE CHOICE speaking about a client
Circle the best answer. B. Refraining from using clients’ names
when talking about them in the
18. A reflective practice review is: lunchroom
A. ‘Thinking about problems that occurred C. Speaking to the client’s family and
with a co-worker friends about the care the client
B. Being discreet when speaking with a receives
client’s family D. Talking to your co-worker about your
C. An honest self-evaluation of all the care private life while you are making beds
you provided to the client
by: Planning client care around staff 24. Amy is a support worker who has just
availability graduated from school. She plans to wear her
engagement ring to work once she is hired.
19. A support worker is considered to be: What should you advise her about this?
A. An unregulated care provider A. She will never get a job if she wears her
B. An unregulated nurse ring.
C. A certified support worker B. She has only a small diamond in her
D. A regulated care provider ring, so it would be okay to wear it.
C. She should not wear it around her
20. A support worker's scope of practice refers supervisor.
to the: D: Her ring can scratch a client and may
A. Skills that the employer wants create an infection control risk, so she
performed should not wear it.
B. Amount of practice that is needed to
perform a skill safely 25. Having concern for a client is:
C. Limit and extent of a health care Awe Gating
worker's role as determined by the B. Sympathy
employer's policies C. Enthusiasm
Amount of time it takes to perform a skill D. Admiration

4 CHAPTER 1 The Role and Responsibilities of the Support Worker
26. A way to preserve the client’s dignity would . 27. Which is an example of an instrumental
be to: activity of daily living (ADL)?
A. Be considerate ee Grooming and dressing
B. Demonstrate empathy B. Management of medication
C. Be respectful of the client’s wishes C. Assisting with meals
D. Maintain a cheerful approach at all times D. Promoting physical comfort
MATCHING
Match each statement in the left column with the correct word in the right column.
28. Supervises LPNs/RPNs and support workers AS Occupational therapist
29: Diagnoses and treats diseases and injuries B. Speech—language pathologist
30. Provides respiratory treatments and therapies Social worker
31. Assesses and plans for nutritional needs Dietitian
Bye Assists people with musculo-skeletal problems 6)

eeePhysician/designated health care provider
35: Assists people with learning or retaining skills Physiotherapist

needed to perform activities of daily living
34. Treats people with speech, voice, hearing, Respiratory therapist

communication, or swallowing disorders
35. Assists people with their spiritual needs Spiritual advisor
36. Helps clients and families with social and Nurse

emotional issues affecting illness and recovery
FILL IN THE BLANKS

Complete the following fill-in-the-blank questions in the space provided.
ove A person receiving care in a hospital is called a sina

live-in facility is called a ; in the community is
called a
38. Professionalism is an approach to work that demonstrates

’ and

CHAPTER
The Canadian Health

Care System
TRUE OR FALSE 7. TF People can lose their medicare

coverage if they are fired from a job.
Circle T for true, or circle F for false.
8. TF Support workers provide most
v1. TF Health care service delivery to support services for home care.
Indigenous peoples is a provincial or
territorial responsibility, only.
MULTIPLE RESPONSE
2. TF The Canadian health care system has From the list below, choose all of the correct
seen a shift in focus from home care aaitiere
to hospital care.
9. The principles of medicare listed in the
3. T F Clients are being sent home sooner Cindi Healy eae
after hospital procedures. A. Public administration
B. Comprehensiveness
4. T F Home care enables some clients Gana ee eee
to maintain their health and D. Universality
independence. E. Transparency
: le ili
5. TF Every province and territory provides G = fas nye
primary, secondary, and tertiary He Aesesiitte P
health care.
6. TF Indigenous health and wellness is

based on a holistic model of health.
6 CHAPTER 2. The Canadian Health Care System _
10. Professional services offered within home , 14. Examples of government policies that
care services include: promote health and prevent illness are:
A. Nursing care A. Prenatal and parenting classes
B. Laundry services B. Immunization programs
C. Physiotherapy C. Same-sex marriage laws
D. Occupational therapy D. Driver's education programs
E. Speech therapy E. Information campaigns (e.g., to reduce
FE Massage therapy drinking during pregnancy, unsafe sex,
G. Cooking and housekeeping services and tobacco use)
H. Nutrition counselling F Age of majority legislation
I. Social work G. Efforts to improve housing, decrease
J. Respiratory therapy poverty, monitor safe drinking water,
and protect the environment
11. Health promotion refers to strategies that:
Ja ms iclient with legal issues when MULTIPLE CHOICE
B. Improve and maintain health and Circle the correct answer.

independence
C. Support prenatal and parenting classes 15. Asa support worker, you contribute to
health promotion by:
12. Disease prevention refers to strategies that: A. Providing medical care and services that
A. Prevent the occurrence of disease or injury can help prevent major health problems
B. Assist clients to improve their overall B. Providing end-of-life care to clients who
health are dying
C. Ensure acute-hospital funding C. Smoking on your work breaks
D. Encourage a lifestyle of healthy eating D. Frequently turning a client who is on
and exercise bed rest
E. Provide war veterans with psychological
services if needed 16. In 2004, Tommy Douglas was voted “the
Greatest Canadian”. His main contribution
13. Home care services today provide support to to Saskatchewan as health minister was to
a large range of clients. These clients include: initiate:
A. Women in labour ate A support worker program
B. Older persons B. A free food program for the people in
C. Families with children Saskatchewan
D. Babies being treated in neonatal critical C. 4 weeks of paid vacation time for
care units everybody
E. People with mental, physical, or D. A medicare system
developmental disabilities
FE People with short-term medical 17. Private health insurance:
conditions A. Is available only to people who are in a
G. People with long-term medical conditions low-income bracket
H. Inmates in a correctional facility B. Is illegal in Canada
I. Clients on telemetry (cardiac C. Must be paid for by either the client or
monitoring) in a coronary care unit the client’s employer
J. People in the recovery stage, D. Is unnecessary because most people’s
rehabilitative stage, or final stage of a provincial or territorial health insurance
life-ending disease pays for all items

CHAPTER 2 The Canadian Health Care System 7
18. Telehealth offers health care services by 20. Factors that challenge and stress the
providing: Canadian health care system include:
A. Phone-in prescription services to a Aging of the baby boomer generation
pharmacies for clients B. An abundance of physicians, nurses,
B. ‘Telephone advice from nurses to people and other health care workers in rural
who call in areas
C. In-home supportive care Canadian residents who have private
D. The telephone numbers of local doctors health insurance plans
who are accepting clients Increasingly shorter wait lists for
medical procedures
19. An example of a health promotion strategy is a:
A. “Stop smoking” advertising campaign
B. Stroke recovery program for people who
have had a stroke
C. Campaign to hire more cancer doctors
in a community
D. Program that provides hearing aids for
seniors
MATCHING
Place the correct year next to each statement below.
a1. Health services for the Indigenous population were transferred to Health Canada. 179
22: Indian Health Policy recognized “the need for community development, strong 1945
relationship between First Nations people, the federal government and the Canadian health
care system.”
23. Canadian government published Gathering Strength: Canadas Aboriginal Action Plan. 1998
24. The Medical Services Branch of government was renamed First Nations and Inuit Health. 2000
FILL IN THE BLANKS

For each of the following, mark P to indicate “professional service” or S to indicate “support service.”
ae Nursing care
26. Physiotherapy
Dapfe Personal care
28. Social work
29: Assistance with activities of daily living
30. | Speech therapy

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CHAPTER
Workplace Settings
TRUE OR FALSE MULTIPLE RESPONSE

Circle T for true, or circle F for false.” From the list below, choose all of the correct
answers.
1. TF Retirement residences are financed
by the government. 8. A chronic illness is an illness that:
A. Is ongoing
2. TF Support workers are responsible for B. May worsen over time
. 80% of the total hours worked by all C. Usually has no cure
home care workers. D. Is always fatal
3. TF Some hospitals hire support workers. 9. An acute illness is described as an illness:

A. ‘That appears suddenly
4. TF Inacommunity day Oa the B. ‘That is recurrent and untreatable
support worker works independently. C. That lasts a short period of time
ae D. That has symptoms that are severe
5. T F Working ina facility requires you to
do many tasks in a limited period of 10. Working in home care presents issues and
chs challenges such as:
ee A. Working on your own
6. TF A lack of privacy can lead to loss o Bo) Talinetditeaionmeorseliderene
self-esteem. professionals
C. Undertaking difficult tasks such as
7. T FE Another term for acute care is
shovelling snow
convalescent care.
Maintaining professional boundaries
Providing for client safety
Providing for your own personal safety
Ammo Working with other team members
10 CHAPTER 3. Workplace Settings
11. What types of services do community day + MULTIPLE CHOICE

programs offer?
Circle the correct answer. Note: There is one
Respite for family members
Rehabilitation correct answer for each.
Counselling for people who have
16. Your client was admitted to a subacute-care
mental impairments
facility. Another name for this is a(n):
Recreational activities
A. Convalescent care
Personal care services such as nail care
B. Hospital
£2; live-in facility provides care to people who: C. Outpatient facility
Are too young to live on their own D. Long-term care facility
Cannot care for themselves at home
. Mrs. Jones receives community-based
Can care for themselves independently
services. This means:
but are too lonely to do so
A. She receives care in her community
eG
CBee
ee
Se Require basic care but not acute
hospital.
medical care
B. She receives care after admission into a
13. The goals of long-term care are to: long-term care facility.
A. Provide care leading to a complete C. Her health care services are supplied
recovery or cure outside of a facility.
B. Maintain the clients’ health and D. She can receive care only in her home.
independence to the greatest extent
18. A support worker can maintain professional
possible
boundaries with clients by:
C. Meet clients’ physical, emotional, social,
A. Refusing to drive a client to a medical
intellectual, and spiritual needs
appointment if asked
14. Examples of a chronic illness include: B. Not discussing personal problems with
Bone fractures clients
Diabetes C. Avoiding eye contact with clients or
Recent urinary tract infection family members
Multiple sclerosis D. Giving out her home telephone number
See
GeeAppendicitis to clients
15. Examples of acute illnesses include: 19. Often, employers will provide a newly hired
A. Pneumonia worker with a written list of expected duties.
B. Alzheimer’s disease Why should you ask for one if you have not
C. Influenza received one?
D. Kidney stone A. So you can find out which agency has
the easiest set of duties.
B. So you can negotiate which duty you
want to eliminate.
C. So you know what your co-workers
should be doing.
D. So you understand which tasks fall
within the job description.

CHAPTER 3 Workplace Settings 11
20. Restoring a client to normal or near-normal 22. In home care, support workers:
function is the aim of which type of care? A. Have a secondary role within home
A. Respite care care.
B. Rehabilitative care B; Are responsible for a wide range of
C. Assisted living home care services.
D. Extended care Are hired on a part-time basis only.
Do not have to take direction from
21. Asa new graduate, you may risk legal others.
action by:
A. Seeking assistance before attempting a
new procedure
B. Performing tasks that are outside of
your role
C. Staying within your scope of practice
D. Avoiding situations with clients that
may be uncomfortable
MATCHING
Match the type of service in the left column with the correct description in the right column.
Z3. Serves people and families living with progressive and A. Respite care
life-threatening illness
“24. Provides services to people who cannot care for themselves at home B. Home care
but do not need hospital care
25. Provides temporary care of a person who needs a high level of support CC. Palliative care
26. Provides services to people with immediate health issues D. Acute care
aT Provides rehabilitation for people recovering from surgery or injury E. Long-term care
28. Provides therapies and education designed to restore or improve a FE Subacute care
person’s independence
29: Provides services for people with mental health disorders Rehabilitation care
30. Provides care to people in their homes H. Mental health care

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CHAPTER
Ethics

Circle T for true, or circle F for false. From the list below, choose all of the correct
answers.
AEP Support workers have a formal code
of ethics. 9. Ethics refers to:
AS Laws that govern our community
2. TF Clients have the right to refuse a B. Beliefs that determine what is good or
2 treatment they do not want. bad
@ Rules of conduct that help us to decide
3. TF Youcan uphold the principle of what is right or wrong
justice by being concerned about 1D), Moral principles or values that guide
all clients. our choices
It is okay to talk about a client in the 10. Which points should be included in a sample
locker room. code of ethics for support workers?
A. Provide high-quality personal care and
There is nothing wrong with
support services
accepting a dinner invitation from
B. Provide compassionate care to paying
a member of a client's family. clients only
Value the dignity of all clients
A support worker is free to discuss
a client’s progress or treatment with
Oo Respect clients’ choices about how they
receive or participate in their care
a close family member.
Se Respect clients’ rights to privacy and
You should not take sides with a confidentiality
client against a family member. Do not misuse the support worker’s
position of trust
Becoming personally involved with Be reliable most of the time
clients or their family members ae Promote and maintain clients’ safety
may prevent you from providing
nonjudgemental care.
14. CHAPTER 4. Ethics.
11. The four basic principles of health care 14. You ask Ms. Burton if she is ready to get
ethics are: dressed. She says, “I would like to wait until
Autonomy after breakfast.” She is exercising her right to:
Honesty A. Privacy
Justice B. Freedom from abuse, mistreatment, and
Beneficence neglect
Maleficence C. Personal choice or autonomy
wp
moO Nonmaleficence D. Be free from restraint
12. Which of the following points will correctly 15. Ms. Burton will not consent to a physical
assist you to decide on a course of action examination. She is exercising her right to:
when faced with an ethical dilemma A. Personal choice
involving a client? B. Privacy
A. Consider the five principles of health C. Quality of life
care ethics D. Refuse treatment
B. Collect as much information about the
situation as possible 16. Ms. Burton continues to refuse to take a
C. Consider a few of your available options shower. Which is true?
D. Determine if the action provides A. ‘The staff can force Ms. Burton to
you with a short-term or long-term shower. .
benefit B. Ms. Burton’s family should force her
E. Consider if the action will treat the to shower.
client justly and fairly C. The staff needs to first find out why
E Decide if the action can cause harm or she refuses to shower.
increase the risk of harm to the client D. ‘The staff should immediately report
G. Consider the client’s wishes and Ms. Burton’s refusal to the supervisor.
preferences before deciding
ive Health care ethics refers to:
A. ‘Trusting others with information
MULTIPLE CHOICE B. Being polite and considerate
Circle the correct answer. C. What is morally right and wrong when
providing health care services
13s Ethics is: D. Right and wrong conduct by yourself
A. Concerned with what is right and and others
wrong behaviour
B. About making bad judgements before 18. An example of just treatment includes:
knowing the facts A. ‘Treating everybody with fairness
C. Deciding whether a situation is right B. ‘Talking about others in the cafeteria
or wrong based on your own life C. Avoiding a client whose lifestyle you
experiences do.not approve of
D. A law telling you what you can and D. Lying about someone to avoid
cannot do embarrassment

CHAPTER 4_ Ethics 15
MATCHING
Match each definition with the correct term.
Ue Seeking to do no harm > Autonomy
20. Doing or promoting good Justice
ya I Abuse Beneficence
yP All people should be treated in a fair manner Intentional harm
23% Accidental injury or negligence BP)

GaNonmaleficence
24. Having free choice Unintentional harm
FILL IN THE BLANKS
25. What do you do if your client’s choice may put him or her at risk for injury?

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CHAPTER
Legislation: The Client’s

Rights and Your Rights
TRUE OR FALSE 6. T F You may refuse to do something

beyond your scope of practice.
7. T F Acommon act of courtesy is one
1. TF Employment standards and way to respect a client’s dignity.
legislation protect you from
harassment. 8. TF Itis okay to open a client’s mail in
case it contains upsetting news.
2. T F_ Libel is making false statements in
print. 9. T F_ Respecting a client’s dignity can
encourage independence.
3. T F The unnecessary use of restraints is
false imprisonment. 10. TF You may encourage the client to
share their private life and personal
4. T F Civil laws deal with relationships information for your interest.
between people.
11. TF Human rights legislation protects
5. TF A designated health care provider against harassment.
can ask you to obtain consent from a
client.
18 CHAPTER 5 _ Legislation: The Client’s Rights and Your Rights
MULTIPLE RESPONSE * 14. How can you show respect to your clients?
From the list below, choose all ofthe correct answers. A. Be courteous
B. Respect the person’s belongings and
92. Basic human rights in Canada include: property
A. The right to equality before and under C. Avoid eye contact
the law, without discrimination based D. Try to do as much as you can for the
on race, ethnic origin, colour, religion, client
sex, age, or disability E. Assist with personal care and grooming
B. Freedom of action whenever—and only if—necessary
C. Freedom of thought, belief, opinion, Be patient
and expression Listen attentively
D. Freedom of peaceful assembly and GeAddress an adult by title and last
association name, unless the person tells you to do
The right to drive otherwise
The right to vote I. Never scold, laugh at, or embarrass the
The right to enter, remain in, and leave person
Canada
ites
clenhera
| ary The right for illegal immigrants to stay 15. Informed consent for a treatment should
in Canada include knowledge about:
I. The right to life, liberty, and security Potential risks and side effects of the
J. Freedom of conscience and religion treatment
The reason for the treatment or service
43. Most long-term care facilities have policies How the treatment will be done
that recognize that residents have the Who will be doing the treatment
following rights: The expected outcomes
A. To be treated with dignity and respect What will be done during the treatment
B. To live in a safe and clean environment Other treatment options
C. To be properly sheltered, clothed, >TOMMOOW
The health care worker's opinions of the
groomed, and cared for treatment
D. To keep and display personal — The likely consequences of not having
possessions, pictures, and furnishings in the treatment
their rooms
E. ‘To have family present 24 hours a day if
MULTIPLE CHOICE
the person is dying
F To have hairdressing and barber services Circle the correct answer.
provided free of charge
G. To be free from abuse 16. If a client has different values or standards
H. To discuss problems or suggest changes from yours, you should:
to any aspect of the services provided to A. Respect the client as an individual
them B. Refuse to care for the client
To privacy and confidentiality C. Firmly tell the client what your values
To give or withhold informed consent are
a To autonomy (the right to make D. Discuss the client’s beliefs with others at
decisions) work or at home

ee CHAPTER’5 Legislation: The Client’s Rights and Your Rights 19
17. If you are asked to obtain a client's signature 21. What action by the support worker protects
on an informed consent form, you should: the client’s right to personal possessions?
A. Make sure the client is mentally A. ‘Throwing away old cards, letters, and
competent magazines to tidy the unit
B. Refuse because this is not a support B. Rearranging personal items so they are
worker's responsibility more decorative
C. Ask a family member to witness the C. Getting the client’s permission to look
signature for an item in the closet
D. Call the doctor to witness the signature D. Taking a piece of candy from the client's
candy dish when he or she is not present
18. I=faclient refuses treatment, what action
should be taken by the health care facility? 22; An advance directive is:
A. Give the treatment as ordered A. ‘The care plan
B. Honour the request and discontinue the B. An order not to resuscitate the client
treatment C. A legal document stating the client's
C. Find out what the client is refusing and wishes about future health care,
why treatment, and personal care
D. Tell the family that the client must be D. A document stating the client’s wishes
removed from the facility about his or her personal belongings
19. Accient tells you he is upset because he 23: A legal right is something that a person:
believes his treatment was done incorrectly A. Must earn by getting a job
yesterday. Your action is based on which of B. Must be a certain age to get
the following? C. Is entitled to in Canada
0 A. He has a right to voice his concerns and D. Can get by applying for it from the
to have the facility try to correct the gover nment
matter.
B. You know the treatment was done 24. When a client complains to you about the
correctly. home care agency's policies, you should:
C. He complains constantly, so everyone A. Defend the agency and the policy
ignores his concerns and questions. B. Check the client’s mental status on the
D. He is confused and forgets what was care plan
done yesterday. C. Inform your supervisor of the complaint
D. Act interested and record it in your
20. What rights do clients have? notepad
A. They have the right to electronic privacy
and confidentiality. 25. A living will addresses the client’s wishes
B. They may take part in social, cultural, about:
religious, and community activities. A. Preferences about the care used to
C. They may receive support and sustain the client's life
reassurance from family members and B. Care and guardianship of the client's
friends. young children
D. AIl of the above Having a tree planted in the client’s name
OO Who will receive the client’s assets and
property once the client has died

20 CHAPTER 5_ Legislation: The Client’s Rights and Your Rights
26. Who is responsible for job safety inalong- « 27. An act is another term for:
term care facility? A. Standard
A. The clients B. Policy
B. ‘The maintenance staff who repair C. Law
broken equipment D. Licence
C. Both employers and employees
D. The provincial minister of health
MATCHING
From the list provided, choose the word that best fills in the blank in each statement.
28. Making a false written statement that hurts the reputation of A. Care; treatment
another is called
29. Discussing a client’s treatment with your best friend invades the B. Privacy
client’s
30. In order to protect the client’s right to privacy, the client’s body C...Libel
must not be needlessly
31. Consent is needed for to D. Negligence

observe the client’s care.
32. The client has the right to and E. Invasion of privacy

mail without interference.
33. Information about the client’s ; FE Others

, and condition is kept
confidential.
34. An individual has failed to act in a reasonable and careful G. Send; receive
manner and caused harm to the person or the person’s property.
This is a tort known as
35. A support worker opens a client’s mail and reads it. This is a tort H. Exposed (or uncovered)
known as

CHAPTER 5__ Legislation: The Client’s Rights and Your Rights pai
36. After her morning care is completed, a client wants to do activities. A. Slander
The support worker does not allow the client to go. This is a tort
known as
37. A living will addresses the client’s wishes about his B. Assault
when he is at a point when he cannot speak for himself.
38. While cleaning a client’s dentures, the support worker drops and C. Documenting
breaks them. This is a tort known as (or recording)
39. Instead of allowing the client a choice, the support worker tells the DD: Private
client that she will get a shower whether or not she wants one. This
is a tort known as
40. An individual makes defamatory statements about another person. Negligence

This is a tort known as
41. A support worker talks to employees from other departments about False imprisonment
a client. This is a tort known as
42. Your best protection against charges of negligence is Care

every procedure.
43. The client is allowed to visit family and friends in lel Invasion of privacy
Pa
44. A client pressed the call bell 20 minutes ago. When no one responds, he A. Invasion of privacy
tries to go to the bathroom alone, slips and falls, and breaks a hip. ‘This
is a tort known as
45. An individual has injured the name and reputation of a person by making ge Intentional
false statements to a third person. This is a tort known as
46. An individual attempts or threatens to touch another person’s body Negligence

without the person’s consent. This is a tort known as
47. An individual touches another person’s body without the person's False
consent. This is a tort known as imprisonment
48. An individual exposes the private affairs of another person to a third Slander
person. This is a tort known as
49. An individual restrains or restricts another person’s freedom of movement Assault

without a designated health care provider's order. This is a tort known
as
50. A worker causing harm to a person deliberately is called an act. Battery
51. A will addresses the client’s wishes about personal Property

2 CHAPTER 5 __ Legislation: The Client's Rights and Your Rights
Match the words and definitions. .

52. What you should or should not do Ae Right
53. Having free choice B. Legislation
54. Legally responsible G Liable
55. Wrongful act committed against a person or a person's property ‘By Negligence
56. A body of laws Je: Ethics
57. Failing to act in a competent manner era] Act
58. Touching a person’s body without consent Autonomy
59. Injuring the reputation of a person by making false statements coBattery

60. Specific law —_— Defamation
61. Something to which a person is justly entitled een) Tort
FILL IN THE BLANKS
62. Informed consent is based on and
63. If a client complains of chest pain and you do not report this to your supervisor, this is a
act.
64. Discussing a person’s treatment with your best friend invades the person’s
65. List the waysys y'you can p protect a client’s right

g to p privacy.y.
0eero
BS
Cx
(>
“one
66. What can cause negligence?

CHAPTER 5 _ Legislation: The Client’s Rights and Your Rights 23
67. What are some of the laws that protect workers?
SOo
Ee
68. Who is responsible for job safety?
69. A will addresses the client’s wishes about , whereas a living

will addresses the client’s wishes about

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CHAPTER
Health, Wellness, Illness,

and Disability

answers.
ve TE A formal group of people who help
each other is called a social support o: Health is defined as a state of:
system. A. Making a lot of money
B. Complete physical, mental, and social
251 FE For some people, spiritual health is well-being
closely linked to religion. C. Well-being in all dimensions of one’s
life
Ait odWeed9 Shamans are believed to use special
D. Not just the absence of disease or
powers to aid in the healing process.
infirmity
4. 1 F Illness is the loss of physical or
10. What are the five dimensions of health?
mental health.
Physical health
oe! AOS Self-image is the individual's Emotional health
perception of himself or herself. Financial health
Social health
Gal OF Choosing athletes for a team shows Cognitive health
discrimination against those not Religious health
chosen. ON
es
Ose
fern
@ Spiritual health
The Ae We It is less stressful for your client if you

make all the decisions on her behalf.
ee ge § Changes in sexual function greatly

affect some people.
26 CHAPTER 6 _ Health, Wellness, Illness, and Disability
11. What factors contribute to physical health? « 15. What are some of the changes and losses
Following a nutritious diet associated with illness and disability?
Having friends and companions Change in routine
Exercising regularly Increase in appetite
Living in a smoke-free environment Change in work life
Practising safe sex at all times Change in family life
Drinking alcohol moderately or not at all Change in sexual function
Having a good night’s sleep Loss of independence
Following safety practices Loss of dignity
WS
MOO
“TAM
Seeking medical attention when needed Change in self-image
mS
maoLoss
STA of intellect
12; How can you promote cognitive health for
your clients?
A. Encourage clients to participate in MULTIPLE CHOICE
games and outings Circle the correct answer.
B. Take clients to religious services
C. Encourage clients to read 16. In the past, ealth was defined as:
D. Help clients to do crossword puzzles or A. A fit, strong body
crafts B. The ability to function in society
E. Talk with clients about community and C. The absence of disease
world events D. A belief in a higher being
FE Encourage clients to toilet themselves
17. A person’s culture can influence health by:
13. What are some of the factors affecting a A. Causing poor working conditions
person’s experience of illness or disability? B. Causing an inherited disease
A. The nature of the illness or condition C. Influencing whom the person seeks
B. Age health care from
C. Level of physical fitness D. Making the person strong and resilient
D. Amount of pain and discomfort to illness
E. The prognosis
FE Emotional, social, cognitive, and 18. Determinants of health should be viewed
spiritual health in relation to each other and not just
G. Personality and ability to cope with individually because:
difficulties A. ‘They are not very important by
H. Culture themselves
I. ‘The presence or absence of emotional, B. ‘They are poorly understood by
social, and financial support themselves
C. Canadians do not practise good health
14. Common reactions to illness or disability are: habits
Joy and happiness D. Each determinant can impact the other
Fear and anxiety determinants
Sadness and grief
Depression
Increased hunger
Loss of bowel or bladder control
Denial
=a@rshehel
ere: Anger

CHAPTER 6 _ Health, Wellness, Illness, and Disability pa
19. Personal health practices and coping skills: 20. Holism:

A. Are not as important as genetics A. Is the consideration of a person’s many
B. Are influenced by society and the dimensions
people one is surrounded by B. Is not appropriate when a person has
C. Usually do not influence a person's physical challenges
ability to survive an illness C. Isa form of prejudice
D. Have never been linked to a healthy D. Is an outdated concept
lifestyle
MATCHING
Match the dimension of health with the correct definition.
21. is achieved through an active, creative mind A. Physical health
22. is achieved when the body is strong, fit, and free of disease B. Social health
235 is achieved through stable and satisfactory relationships C. Cognitive health
24. results when people feel good about themselves D. Spiritual health
25. is achieved through the belief in a purpose greater than the self E. Emotional health

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CHAPTER
Caring About Culture

and Diversity

answers.
Pi
1. TF People of all cultures are comfortable
with physical touch. 11. Culture affects a person’s beliefs and
2. TF In Western cultures, personal space is behaviour in the areas of:
about 120 cm (4 feet). Communication
Receiving wages and earnings
3. TF Silence can be a sign of respect in Family and social organization
some cultures. Religion and worship
4. T F Some children rebel against the
eae
Bs Health care practices and reactions to
illness
culture of their parents.
es) Body shape and intelligence
5. TF You should never try to convert your
clients to your own belief system. 12. Qualities that support workers should possess
include:
6. T F _ All traditional remedies are harmless. A. Being respectful to all others
7. TF Discrimination leads to prejudice. B. Good listening skills
C. Willingness to change people
8. T FE Insome cultures, men do not shake D. Understanding and accepting of other
women’s hands. people's differences
E. Awareness of body language
9. T F Culture is influenced by alarge
number of factors.
10. TF Asking about your client's beliefs

and values will help him or her feel
valued and respected.
30 CHAPTER 7. Caring About Culture and Diversity
13. Many facial expressions that convey emotions 17. When you communicate with people who
are universal; some of these expressions are to don’t speak your language, you should:
ae Convey comfort by the tone of your
voice and with your body language
Speak loudly or shout your message
Surprise Speak slowly and distinctly
Embarrassment Keep messages short and simple
Happiness moOe Be alert for words the client seems to
understand
14. extended family may include: Use gestures and pictures
Parents Repeat the message, using the same
Grandparents words, so they understand you
Neighbours Use slang terms because these are
Friends usually understood
Children Be certain the client understands what
Aunts is going to happen and consents to a
PE
mOOD>
UOP
OAM Cousins procedure before you begin it
Learn a few useful phrases in the client’s
TS: Religions may promote beliefs and practices language
related to:
Daily living habits 18. The acronym LGBTQ? refers to a
Behaviours community of people who identify
Relationships with others themselves as:
Diet Questioning their sexuality
Healing Transgender
Days of worship Transvestite
Birth and birth control Bisexual
Medicine Straight
“TAMMUOWS
Death Gay
Lesbian
16. To be accepting and understanding of others, Blended
you need to understand: oie
hon
Stat
Two-spirited
Everything about other cultures
How your culture has influenced you
How culture influences clients’ MULTIPLE CHOICE
behaviours and attitudes Circle the correct answer.
That all people are the same
=
Ge
LS) That each client is unique, and 19. People of Asian background may conceal
individuals may not follow every belief negative emotions with a:
and practice of their culture or religion we Laugh
b. Smile
Ce Frown
Dy Stare

oa. CHAPTER 7 Caring About Culture and Diversity 31
aa I I IIS TIEN ans ttRSDANN CIE Us DLA oa LI NSA LSM TLRS PSL IA SE TED A PSTN NR NTO
20. Sam and Chris are a couple who share 25. Gayle has refused to take her prescribed
parenting responsibilities for two children. blood pressure medication because of her
Sam is the parent of one of the children, but religious faith. However, her family would
both Sam and Chris are the legal parents like you to “sneak” her pills into her by
of the other child. This is an example of a grinding them and adding them to her food.
family. Your best response to her family would be:
A. Blended A. “Ifyou want me to do this, it'll cost you
B. Nuclear money!
fie
C. Single-parent B. “Are you kidding? I could get fired for

D. Separated this!”
C. “It would be wrong for me to go against
Culture is considered to be more than just a a client’s wishes.”
person’s ethnicity because: D. “Why don’ you do it while I leave the
A. It can refer to characteristics learned room:
ey?
by living in any group (e.g., a group of

college students) . Mrs. Jing, who is a Buddhist, would like to
B. Most Canadians do not have an ethnic pray and has asked if you could pray with
background her. You practise a different faith. What
C. Ethnicity has nothing to do with should you say to her request?
culture A. “Pm not a member of that religion. Let
D. ‘There is no such thing as ethnicity me find someone who is.”
B. “No way. I don’t believe in any of that.”
. Jim is a homosexual man who was recently C. “Tam not allowed to pray with clients.”
beaten up after leaving a gay bar with a D. “Twill support you while you pray as
friend. This is an example of: long as I am able.”
oemeat\acisin
B. Ageism . Sue would like to get a job as a construction
C. Homophobia worker. She was denied because she might
D. Sexism get pregnant and require a maternity leave.
This is an example of:
. Tony’s parents came to Canada from Italy A. Cultural conflict
when Tony was 3 years old. He is expected to B. Sexism
marry someone who is also of Italian descent. CG Racism
However, Tony is seriously dating someone D. Ethnic identity
from an Asian background. This situation is
an example of: . Mr. Jones has asked for a male support worker
A. Cultural stereotyping because according to his religion, it is improper
B. Cultural conflict to be touched by a female other than his wife.
C. Ethnic cleansing There are no male support workers working
D. Ethnic identity that day. How should you handle this situation?
A. Speak to your supervisor about the
. A nuclear family consists of a: situation immediately
A. Mother, father, and children B. ‘Teil Mr. Jones that you are the only one
B. Mother, father, children, and available and that he should be happy
grandparents to get any care at all
C. Mother and children C. Care for him but wear gloves to avoid
D. Father, father, and children skin-to-skin contact
D. Tell him to do his own care

32 CHAPTER 7 Caring About Culture and Diversity
MATCHING ;
Match the terms and definitions.
29: Characteristics of a group of people Race
30. An overly simple or exaggerated impression of a person Prejudice
ons The unfair treatment of people based on their group membership Ethnic group
32. The area immediately around one’s body Culture
aoe Groups of people who share similar physical features Personal space
34. Groups of people who share a common history Stereotype
Bee An attitude that judges a person based on his or her membership Discrimination
in a group
36. Trying to convert clients to your own belief system Spiritual abuse
FILL IN THE BLANKS
oss Culture affects a person’s beliefs and behaviour toward

a
b.
8s
d
38. Nonverbal cues can include

a.
b.
e
d
39. How can cultural conflict affect an older person?
40. Adopting the traditions of the larger society is called
41. Actively inviting and creating a space for cultural expression within health care is practising

CHAPTER
TRUE OR FALSE 9. TF Older people are less able to cope

with stress than younger adults.
10. TF All stress is bad for your well-being.
1. TF Stressors over a short period of time
can cause a chronic illness.
MULTIPLE RESPONSE
2. TF You should set weekly goals for
From the list below, choose all of the correct
S yourself.
answers.
3. TF Getting a promotion can cause stress.
11. Which of the following strategies can help
4. T F Achild usually shows different signs you manage stress in your life?
of stress from those of an adult.
Think positively
Develop self-awareness
5. T F Time management is essential to Ask for help and support
reducing stress. Be aggressive
Practise calming exercises
6. TF There is no point in planning your >mmo
OW Practise healthy lifestyle habits
work a day ahead because things
change when you get to work. 12. Which of the following can help you save
time and stay organized in order to reduce
7. TF You dont need to report a conflict stress?
with a client if it is resolved. A. Identify priorities
B. Set goals
8. T F Inahome care setting, you must C. Multi-task
plan your time so you can be on D. Make daily plans
time for the next client. E. Make a weekly plan
34 CHAPTER 8 Managing Stress
13. Which of the following strategies can you use MULTIPLE CHOICE
to manage conflict at work?
Circle the correct answer.
A. Identify and solve problems before they
become major issues.
17. Which of the following defines anxiety?
B. Explain the situation to a co-worker
A. An unconscious reaction that blocks
and ask for advice.
unpleasant feelings
C. Arrange a private meeting with the
B. . A state of exhaustion
person with whom you have a conflict.
C. An event that causes stress
D. Explain the problem to the person,
D. ‘A vague, uneasy feeling
focusing on the facts, not on the person.
E. Listen to the other person’s response 18. Which of the following defines projection?
without interrupting. A. Assigning one’s feelings to someone or
something else
14. Which of the following can be physical signs
B. Acting in a way that is opposite to what
of acute stress?
you feel
Rapid pulse
C. Reverting or moving back to earlier
Rapid respirations
behaviours
Decreased blood pressure
D. Changing an emotion into a physical
Slow speech
reaction
Difficulty swallowing
mimo
o> Difficulty sleeping UP Which of the following is a physical sign of
stress?
15; Emotional and behavioural signs of stress can
A. Forgetfulness
include which of the following?
B. Fear
Anxiety
C. Sweaty palms
Depression
DnAnger
Anger
Increased self-esteem
20. Which strategy will help you manage stress?
Poor concentration
A. Sleeping more
OO
mm Drinking
B. Developing self-awareness
C. ‘Trying to manage everything yourself
16. Which of the following represent the
D. None of the above
acronym SMART when referring to goals?
Specific 213 You may encounter conflict with the client’s
Simple
family members because:
Measurable
A. They are just being difficult
Manageable
B. ‘They want to be in control
Achievable
C. ‘They do not understand the nursing
Reliable
care plan
Realistic
D They do not like you
Timely
eb
aieTeam
ng

CHAPTER 8 Managing Stress 35
MATCHING
Match the term with the definition.
22. ______ A vague, uneasy feeling, often including a sense of impending danger A. Burnout
or harm
23. The emotional, behavioural, or physical response to an event or B. Eustress

situation
24. Symptom state of physical, emotional, and mental exhaustion C. Validate
yay Ongoing stress that can lead to burnout D. Stress
26. To acknowledge, recognize, or confirm the person’s feelings. E. Stressor
DH ip A type of stressor that is healthy and gives one the feeling of fulflment E Anxiety
28. A clash between opposing interests and ideas G. Chronic stress
29. An event or situation that causes stress H. Conflict
FILL IN THE BLANKS
‘30. Problem solving is a process. Describe this process.
31. What are some common stressors you may face?
enone
32. When you realize you have a problem at work, when should you consult your supervisor?
pao
oP

36 CHAPTER 8 _ Managing Stress
33. What steps should be taken to resolve a conflict between two people?
oS=oo
ho
Se

CHAPTER
TRUE OR FALSE Lbbe Assertive communication is the same

as aggressive communication.
12. You can use open-ended questions to
i's dE Be The same word can mean something start a conversation.
different to two different people.
its, Gestures, facial expressions,
a: ler Touch is not a type of communication. posture, body movements, touch,
7 and appearance are ways of
a3. Mhed® When paraphrasing, expand on
communicating without words.
the message and use more words to
ensure you understand. 14. When you hold a client’s hand or
touch the shoulder to convey caring
Thode Nonverbal clues often reflect a
or warmth, you are using verbal
client’s true feelings.
communication.
ipa Most older clients are not aware of
15. A client who denies having pain but
your body language.
protects a body part by lying in a
certain way is using body language
T &E Closed questions can be answered
to communicate.
with “yes” or “no.”
16. When a support worker frowns or
ie as Focusing is useful when a client
wrinkles the nose because the client
rambles.
has body odour, the support worker
dy F Short sentences are more clearly is sending a message through body
understood than long ones. language.
ir 48 It is not important to be at eye level 17, A support worker telling a client

when communicating. “Don't worry” or “Everything will be
okay” may be a barrier to effective
10. ae Using pet names such as “dear” can communication.
improve communication.
38 CHAPTER 9 __ Interpersonal Communication
MULTIPLE RESPONSE . 22. What are some of the barriers to good

communication?
From the list below, choose all of the correct A. Hearing problems
answers. B. Vision problems
GUN tem disord
18. Body ae
ae language includes which of the D. ae a iprivacy
Too much os al
. 8° E. Cultural differences
A. Appearance FE Loud noises
B. Facial expressions Cs MEN crenerions
C. Posture A:
D. Tone ofvoice 23. Nonverbal signs of anger include:
E. “Eye contact A Pacing
F. Gestures B. Clenched fists
C. Red d f: k
19. To effectively communicate with words, you D ees ete:
need to: roe
E. Rapid movements
Choose words carefully
Pretend to understand 24. Clients feel safer and more secure during a
Ask one question at a time procedure if you:
Speak clearly, quickly, and distinctly A. Complete the procedure quickly
Control your volume and tone of voice B. Explain why and how the procedure is
Be brief and concise done
Determine understanding C. Describe sensations or feelings they can
el
saf@)
ese
eecto(@)
Use simple, everyday language expect
D. Explain who will do it
20. When a procedure is performed, which of
the following actions would demonstrate that . Which of the following behaviours can create
the support worker is meeting the client's barriers to effective communication?
safety needs? Interrupting
A. Explains why the procedure needs to be Giving advice
done Answering clients’ questions
B. Describes how the resident in the next Minimizing problems
room handled the procedure Using patronizing language
C. Explains who will do the procedure >OO
Failing to listen
D. Explains how the procedure will be
performed 26. Which of the following are steps in the four-
E. Describes what sensations or feelings to step teaching method used when teaching a
expect client a task?
A. Describe to the client the steps in the
Daiie Guidelines for active listening include: task
A. Making eye contact B. Show the client how to do each task
B. Facing the client C. Have the client try each step
C. Responding to the client D. Review what the client did wrong with
D Leaning toward the client
each step

CHAPTER 9 Interpersonal Communication 39
27. Which of the following are some of the other 30. When you communicate assertively, you
guidelines you can use when you are teaching appear:
tasks to clients? A. Cold or angry
A. Put the client at ease B. Hesitant and timid
B. Start with small, easy steps C. Intimidated
C. Observe and listen D. Confident and calm
D. Make sure you set the pace
E. Allow for time to practise 31. You are teaching Mr. Simpson how to change
his ostomy bag. You would:
28. Which of the following are the guidelines for A. Explain all the steps necessary before
dealing with an angry client? starting the demonstration
A. Ignore the client's feelings B. ‘Teach him the hardest part first
B. ‘Treat the client with dignity and respect C. Use positive statements for
C. Tell the client what you are going to do encouragement
and when D. Seta time limit for him to complete the
D. Stay calm and professional task
E. Argue your point
FE. Listen and use silence 32. You are bathing Mrs. Fox when she suddenly
G. Protect yourself from violent behaviours starts to yell at you for not doing the bath
H. Report the client’s behaviour to your correctly. Which of the following is an
supervisor effective way to communicate with Mrs. Fox?
A. Deny that you are doing it incorrectly
B. Stay calm and professional
MULTIPLE CHOICE C. Tell her you have been doing baths for
Circle the correct answer. many years and know what you are
doing
29. Interpersonal communication is defined as: D. Stop the bath and leave the room
A. Avverbal account of client care and
observations 33. Asking closed questions:
B. A written account of care and A. Invites a client to share thoughts or
observations feelings
C. The use of senses to collect information B. Helps you to make sure you understand
about a client the client’s message
D. The exchange of information between C. Focuses on obtaining specific
two people information
D. Helps you to find out about the client’s
needs

40 CHAPTER 9 __ Interpersonal Communication
MATCHING :
Match the term with the definition.
34. Giving an acceptable reason or excuse for one’s Denial

behaviour or actions
35. Transferring one’s behaviour or emotions from one Displacement

person, place, or thing to another
36. Keeping unpleasant or painful thoughts or Projection

experiences from the conscious mind
Ss Directing emotions toward another person or Regression

thing that seems safe rather than toward the person or thing
that is the source of the emotions
38. Refusing to face or accept something that is unpleasant Rationalization
ied Acting in a way that is opposite to what one truly feels 4 Repression
40. Retreating or moving back to an earlier time or Reaction formation

condition
Match the description with the correct term.

41. Restating someone’s message in your own words Open-ended questions
42. Communicating positively and directly without Nonverbal communication

offending others
43. Questions that invite a client to share thoughts Paraphrasing
44. Paying close attention to a client's verbal and Verbal communication

nonverbal communication
45. Questions that focus on specific information Closed questions
46. Being attentive to a client’s feelings ee) Interpersonal communication
47. Messages sent without words Empathetic listening
48. Limiting the conversation to a certain topic Body language
49. Gestures that send messages to others — Active listening
50. Spoken words ee! Focusing
51. Exchange of information between two people Assertiveness

CHAPTER 9__ Interpersonal Communication 41
FILL IN THE BLANKS
52. The communication process involves the following steps:

a.
b.
c.
d.
53. You can use open-ended questions to

as
b.
54. Ways in which a support worker may display professional communication can include:
cE
Sm
aoe

CHAPTER
Working With Others:

Teamwork and Delegation

answers.
A. TF You can be delegated an authorized
act only if it is allowed within your 8. Which of the following are benefits of
job description and your employer's working on a team?
policy. A. Opportunities for collaboration
B. Opportunities for communication
2. T F_ Registered practical nurses are C. Working with people who have a wide
not allowed to supervise support range of abilities, skills, and perspectives
workers. D. Better decision making and problem
solving
3. TF Itis okay to discuss work problems E. Avoiding conflict
with your client as long as you do
not use proper names.
Which of the following are usually members
4. T F When you agree to perform a task, you of the health care team in a long-term care
are responsible for your own actions. facility?
A. Physician
5. T F You may refuse a delegated task if B. Nurse
you do not want to do the task. C. Dietitian
D, Client
6. T F Delegating is the same as supervising. E. Personal support worker
F Case manager
7. TF Support workers are allowed to G. Volunteer
perform procedures below the skin
surface.
ae CHAPTER 10. Working With Others: Teamwork and Delegation
10. When the nurse delegates a task to you in a. 14. Which of the following is NOT one of the
facility, he or she is required to do which of five rights of delegation?
the following? A. Right directions and communication
AS Monitor you over time to ensure B. Right supervision
you remain able to perform the task C. Right equipment
correctly and safely D. Right circumstances
Assess your base of knowledge
Teach you the task 15. Which of the following is NOT an
lel: Make sure it is within your scope of appropriate reason for a support worker to
practice refuse a task? The support worker:
Ee Assess your performance A. Is not trained to perform the task
safely
11. Which of the following concerns will affect B. Does not know the client or resident
delegation decisions? C. Knows the task will require staying at
AC What is the client’s condition? work late
ie What are the risks involved? D. Does not like the nurse who asked him
Ce: Can the support worker be adequately or her to perform the task
supervised?
Bx Will the support worker be required to 16. Which approach would be effective to use for
perform the task frequently? resolving conflict in the workplace?
le Does the support worker want to A. Tell your co-worker you agree with
perform the task? them that a new policy is unfair.
Je What tasks are included in the support B. Wait and hope that the conflict will
worker's job description? resolve itself.
C. Share with the nurse that you dont like
12. Teams in home care usually include which of to work with another staff member with
the following? whom you disagree.
A. Family members D. Arrange to speak with your co-worker
B: Client in a neutral area to resolve the conflict.
C. Personal support worker
D. Nurse WZ; What are some of the challenges to working
E. Neighbours on a team?
F Case manager A. Making better decisions
G. Social worker B. Having opportunities for
H. Physician communication
C. Working with people who have a wide
array of abilities
MULTIPLE CHOICE D. Recognizing role boundaries
Circle the correct answer. 18. A controlled act is a task that:
A. Must be performed only by those
13. When the nurse delegates a task to a support
authorized to perform it.
worker, who is accountable for the delegated
B. All support workers can do on home
task?
care clients.
A, The nurse
C. All health care team members can
B. The support worker
perform.
Cs The case manager
D. Must be authorized to be performed on
D ‘The doctor
a daily basis.

CHAPTER 10 Working With Others: Teamwork and Delegation 45
MATCHING
Match the terms with the correct definition.
liek To work together toward a common goal Delegation
20. The nurse on duty for that shift Task
21; Person who assesses the client’s needs in the Case manager
community
22; Transfer of function Collaborate
23. A function you perform for the client Iss Charge nurse
24. The legal right F Authority
Match the correct Right of Delegation with the question the support worker should ask himself or
herself before performing an assigned task.
25. Do I have concerns about performing the task? Right task
26. Do I feel competent in performing the task? Right circumstances
27. Is a nurse available if the client’s condition Right person

changes or if problems occur?
28. Was I trained to do the task? Right directions and communication
29. Did I review the task with a nurse? Right supervision and evaluation

we
tors dens
- pnt
\ ; 7.
rie Beh a4
orking With Clients and
eir Families

answers.
“AA. TF Sympathy is the same as empathy.
6. Which of the following represent different
2. TF Independence is the state of not types of families you may work with?
relying on others for control. A. A married couple with or without
children
3. TF A primary caregiver is always a B. An unmarried couple living together,
family member. with or without children
C. A widowed grandparent raising
4. TF Youcan be both a friend and a
grandchildren
professional helper to your client.
A divorced parent living with a partner
5. T F_ Respect is showing acceptance and ae Two women or two men living together
in a same-sex relationship
regard for another person.
FE Older parents, adult children, and
grandchildren living together
7. Which of the following are factors that can

influence psychosocial health?
A. Personality
B. Family background
C. Environment
D> Disease
E. Life circumstances
48 CHAPTER 11. Working With Clients and Their Families
8. Which of the following are elements ofa . 11. Which is an indicator of a professional
professional helping relationship? relationship versus a friendship?
A. ‘There is a defined role within the A. The relationship is not goal-directed.
relationship. B. The helper is nonjudgemental.
B. People involved may not choose the C. Both people may be judgemental.
relationship. ID: Behaviours are based on personal roles.
C. ‘The helper is judgemental.
D. One person takes responsibility for 12. Empathy involves:
helping the other. aN Recognizing and understanding another
E. Both people in the relationship seek to person's emotions
have their needs fulfilled. B. The desire and actions to reduce
problems
Cc. Offering advice and solutions
MULTIPLE CHOICE
1 Desiring to change the person's
Circle the correct answer. behaviour
9. Feeling compassion for or understanding 13. Dependence is the state of:

the difficulties of another person is the ae Relying on others for support
definition for: Be Relying on each other for support
A. Compassion C: Not depending on others
B. Respect D None of the above
C. Empathy
D. Sympathy
10. Being competent means you must:

A. Seek and participate in lifelong learning
B. Be flexible when making decisions
C. Take direction well from your supervisor
D. Act professional at all times
MATCHING
Match the description below to its correct term.
14. Being unable to manage without help Respect
15. Expressions of anger or irritation Self-awareness
16. Not having to rely on others for control Self-esteem
kz. The state of relying on one another Independence
18. The ability to do a job well ge)

Beas
ek
le
2 Conflict
19. Acceptance and regard for another person eo) Interdependence
20. Thinking well of oneself @) Dependence
Zi. Understanding one’s own feelings and moods Competence

CHAPTER 11. Working With Clients and Their Families 49
FILL IN THE BLANKS
22. How can you show your client respect?

a.
b.
(o
d.
23. Describe the difference between a professional helping relationship and a friendship.

CHAPTER
Abuse, Bullying, and

Harassment Awareness
TRUE OR FALSE 9. TF Masturbation may be the result

of urinary problems in a confused
Circle T for true, or circle F for false. client.
A. TF Usually, the time between abusive 10. T FE The best way to handle a client who
events gradually shortens. is masturbating in public is to tell
the client to stop.
2. TF More men than women are abused P
by spouses. 11. TF You are legally responsible to
report child abuse and (in some
3. TF People who are abused often deny
jurisdictions) abuse within facilities.
the abuse.
12. TF Sexual harassment is not considered
4. T F_ Slapping a child is not considered
sexual abuse.
abuse.
13. TF Abuse is usually triggered by an
5. TF Emotional and physical abuse are
event related to the victim.
the most common types of abuse of
older persons. 14. TF People who were abused as children
are not likely to abuse their own
6. TF Ageism is another cause of abuse.
children because they know what it
was like.
7. T F_ Failing to provide privacy is not a
form of abuse. 15. T FE
In most provinces, you do not have
to report abuse of older persons to a
8. T F Changes in mental function can
public authority if it occurs in home
cause someone to become sexually
care settings.
abusive.
52 CHAPTER 12 Abuse, Bullying, and Harassment Awareness
i
16. TF _ Ifyou suspect abuse, you should + 21. Why do abused older persons choose not to
document your findings privately, complain about the abuse?
without making assumptions. Keep A. They do not know they are being
all of your notes for future reference. abused.
B. They would rather find a lawyer and sue
1S oF For suspected child abuse, do not the abuser in court.
rely on your supervisor to report C. They may fear the abuser.
your observations to child protection They may not know where or how to
authorities. .get help.
They may fear being forced to move
into a facility if the abuser is the
MULTIPLE RESPONSE
primary caregiver.
From the list below, choose all of the correct They may have physical or mental
answers. health disabilities that prevent them
from reporting.
18. ‘The three phases in the cycle of abuse are:
Tension-building 22. Examples of how workers might abuse clients
Trust-building in a facility or home are:
Abuse Using restraints inappropriately
Denial Handling the client roughly
Bargaining Isolating the client
>iO
Oe Honeymoon Stealing from the client
Not reviewing the care plan regularly
19. person is more likely to be abusive if he or Not responding to a call for help
es Not checking on the client for long
Holds a responsible job periods of time
Has problems with alcohol or drugs >Oh
oor
1 Leaving the client in soiled linen or
Lives alone clothes
Pee
OOP Has a mental health disorder or severe
personality flaws 23. What are some examples of abuse that a
Was abused as a child support worker may encounter from clients?
min Is going through a period of high stress A. Swearing, name-calling, and using racial
or cultural slurs
20. Certain situations increase the risk of child B. Threats
abuse. They are: C: Denial of meal breaks, drinking water,
Family crisis bathroom use, or handwashing facilities
Nonbiological or temporary caregivers Hitting, pushing, kicking, spitting,
in the home biting, pinching, or other physical
Isolation attacks
Caring for children with special needs Taking too long to eat meals
AeExtremely high or low intelligence Inappropriate touching, sexual assault
or harassment

CHAPTER 12 Abuse, Bullying, and Harassment Awareness 53
24. People at highest risk for abuse include:

MULTIPLE CHOICE
A. Older persons cared for by people with
substance abuse problems Circle the correct answer.
Older persons who are financially stable
7 If you suspect a client is being abused, you
Older persons who are unable to leave
their homes should:
Se
Older persons with disabilities who are
A. Call the police
dependent on their caregivers
B. ‘Talk to the family
E. Older persons with dementia C. Report it to the nurse in charge
D. Talk to the client being abused
25. People at greatest risk for marginalization
28. If you are dealing with an agitated or
include those who:
Work in the sex-trade industry ageressive client, which of these measures
Have a physical or intellectual disability
would be most helpful?
Are assertive in nature
A. ‘Talking to the client in a calm manner
B. Placing your hand on the client’s arm to
Belong to a visible-minority group
prevent injury
Are college graduates
C. Closing the door so that other people
Are substance abusers
are not upset
Cannot speak an official language
TOMMOODS D. Promising the client you will not tell
Have a mental health disorder
anyone else about her behaviour
26. What can you do when a client is being
P43 During the “honeymoon phase” of the cycle
abusive?
of abuse:
A. Stay calm and stand up so as not to be
A. ‘The abuser begins to get moodier and
dominated by the client, but stand far
stressed.
enough away so that the person cannot
B. ‘The abuse can escalate easily even if
reach you.
unprovoked.
B. Position yourself close to a door, and
C. ‘The abuser often blames the victim for
note the location of call bells, alarms,
the abuse.
and other security devices.
D. The abuser is very apologetic for what
C. Keep your hands free, but do not touch
happened.
the client.
D. Listen to the client. Restate what the 30. Mrs. Jones is not allowed to go to the
person says in your own words. bank. Her son insists on handling all of her
E. Raise your voice to show your finances. This is an example of:
dominance and control over the client. A. Neglect
E Tell the client you will get your B. Physical abuse
supervisor to speak to him. If you C. Financial abuse
cannot leave the room, sound the call D Sexual abuse
bell, alarm, or other security device.
G. Ifyou are at a client’s home and think 31. Mts. Jones's son insists on changing his
you are in danger, leave the house mother’s incontinence briefs. This might
immediately. Go to a safe place, and call be a sign of:
your supervisor. A. Neglect
H. Ifyou are at a client’s home, do not B. Physical abuse
leave the client alone. Stay and reason C. Financial abuse
with the client. D Sexual abuse

54 CHAPTER 12 Abuse, Bullying, and Harassment Awareness
S2: Mrs. Verbrugghe cannot speak English. é 36. When a client is angry and demanding, it is
Her son refuses to translate things for her, important to:
especially legal documents, such as the deed A. Walk away and return in 1 hour
to her house. This might be a sign of: B. Ignore the client until her behaviour
A. Neglect improves
B. Physical abuse C. Treat the person with respect and
C. Financial abuse dignity
D. Sexual abuse D. Tell the client how irritating she is to
.the staff
3: You are meeting your home care client, Mrs.
Yil, for the first time in her home. While O75 A term used to describe infants, babies, or
talking to her, you notice that she is very children who are below the norms for body
groggy, slurring her words, and smells of weight, growth, or cognitive development is:
alcohol. What should you do first? oa Neglected
A. Offer her coffee B. Failure to thrive
B. Notify your supervisor and ask what to C. Refusal to grow
do D. Idiopathic weight challenge
C. Inform the client that the nurse will
come to her house to assess her
D. Ask her if you should come back MATCHING
another time when she is more awake Match each example with the letter that corre-
sponds to the abuse type.
34. You have been supporting Mrs. Yil for several A. Neglect
weeks. During that time, you have noticed . Sexual abuse
that she is very quiet whenever her daughter C. Emotional abuse
comes to visit her. You suspect abuse but D. Financial abuse
cannot prove it. What should you do? E. Physical abuse
A. Ignore it. They could just be having a F Bullying
bad day. G. Cyberabuse
B. Ask Mrs. Yil’s daughter if she has
noticed how quiet her mother is. 38. The person has physical injuries
C. Telephone the police and make a (e.g., burns, bumps, cuts, bruises, etc.).
complaint.
D. Discuss this situation with your 39: The person's behaviour changes
supervisor. when the caregiver (i.e., the potential abuser)
leaves or enters the room.
35. Miss Keys scratches and punches when it is
time for her shower. What should you do? 40. Medications are not purchased.
A. Stay calm and protect yourself
B. Refuse to bathe Miss Keys 41. The caregiver insists on being
C. Use silence and ignore her behaviour present or within hearing distance of all
D. Hold her hands until she calms down. conversations.
42. New injuries appear while older

ones are still healing.
43. The person fears opening her text

messages.

CHAPTER 12 Abuse, Bullying, and Harassment Awareness 55
44. The person has an intense fear of 49. ‘The person has many unpaid bills.
bathing or perineal care.
50. ‘The person has signs of poor
45. Personal hygiene is poor (e.g., nutrition and fluid intake (e.g., weight loss,
ingrown nails, untreated sores, matted hair). sunken eyes, dry skin).
46. ‘The person’s living conditions are 51. The person may ask for permission
unsafe, unclean, or inadequate. to write cheques or spend money.
47. The person has irritation or injury a2, The caregiver often complains
of the thighs, perineum, or breasts. about the client.
48. Colleagues at a workplace always Bo. Co-workers continually insult their

exclude the same person from their group peer’s choice of food at lunch.
activities.
Match the correct terms with their definitions.
54. Failure to meet basic needs A. Sexual abuse
55. Misuse of a client's money B. Physical abuse
56. Force or violence that causes injury C. Emotional abuse
D7 Unwanted sexual activity D. Financial abuse
58. Words or actions that inflict mental harm ee Neglect
Match the different forms of client abuse with the appropriate description.
59. Threatening punishment or deprival of needs A. Physical
60. Inflicting punishment on the body B. Violation of rights
61. Kissing, inappropriately touching, or fondling a child CP Sexual
62. Spending a person’s money without consent D. Financial
63. Providing care against a client’s wishes E. Emotional

56 CHAPTER 12. Abuse, Bullying, and Harassment Awareness
FILLIN THE BLANK ;
64. Give three signs/symptoms of each type of abuse.
Physical abuse
a.
b.
(Se
Sexual abuse
a.
b. ee _________ TEE EERE
Cc a
Emotional abuse
a.
b. a
(Se il
Financial abuse
a.
b.
C.
Neglect
a.
b.
Cc
Bullying
a.
b.
Cc.

CHAPTER
TRUE OR FALSE 9. TF Ifyou were fired from a previous

job, it is all right to write on a job
Circle T for true, or circle F for false. application that you resigned.
1. TF The lengthier your resumé, the 10. T F When you are being interviewed for
better it is. a job, it is acceptable to ask about
starting salary and vacation time.
2. T F A letter of application is also called a
a cover letter.
MULTIPLE RESPONSE
3. TF Your cover letter should be at least
two pages long.
answers.
4. T F_ Ifyou email your letter and resumé,
it is a good idea to also deliver a hard 11. Main basic resumé styles include:
A. Chronological resumé: highlights
Ry. employment history, starting with the
5. TF Ifasked, you should tell your most current employment and working
prospective employer if you have backward
been fired from a previous job. B. Functional resumé: highlights skills or
functions and briefly lists positions held
6. T F When filling out an online job C. Achievement resumé: highlights all
application, you may skip parts that successes and awards earned
are unimportant to you.
12. As you write your resumé, which questions
7. T F Asking people you know about should you ask yourself?
possible jobs at their workplace is Is the information relevant?
not the best way to find a job. Have I been completely honest?
Have I expressed myself clearly?
8. T F Anemployer is not as concerned Is my resumé consistent?
about your dependability as he or ae
Ce Is there anything I can leave out?
she may be about your job skills.
58 CHAPTER 13 Starting Your Career
13. Sources to help you in your job search ‘ V7. You can do several things during the
include: interview to help you get the job. Some of
= Employment advertisements on social these are:
media sites Use a firm handshake.
Flyers found on windshields Do not use the interviewer's first name.
The Internet Project a confident image.
College career services Listen carefully.
moO Personal contacts Answer questions rapidly.
Answer questions honestly.
14. Your letter of application should include: Be honest about your previous job even
A. Relevant skills and qualities if it was unpleasant.
B. Accomplishments Use experiences to support opinions.
C. Contests won Ask the right questions.
D. A respectful, capable, and professional Sr
AMmOORE
Thank the interviewer for his or her time.
tone
E. Your mailing address 18. Before accepting a job, find out:
A. If the offer is conditional
15. In an interview, what is the employer looking B. If the job begins with a trial period
for? C. Ifthe pay offered is negotiable
A. Someone with the educational
qualifications for the job 19; You have had a job interview and are now
B. Someone who has the skills necessary to planning to write a thank-you note or email
do the job or who is able to learn these to your interviewer. What points should your
skills note include?
C. Someone to whom clients and co- A. You should express your thanks for the
workers will respond well interview.
D. Someone who is reliable, responsible, B. You should show your interest in the
and motivated position.
E. Someone who is attractive and C. You should sign your name.
personable D. You should state your impressions about
the interviewer.
16. You can prepare for an interview by:
A. Writing possible answers on cue cards
B. Making a good impression—paying MULTIPLE CHOICE
attention to your grooming and Circle the correct answer.
clothing
C. Practising—focusing on listening skills, 20. When going to an interview, it would be
relaxation techniques, and responses to appropriate to:
questions A. Have a glass of wine before arriving to
D. Planning—deciding what you are going relax you.
to wear and the route you will take to B. Wear a sweatsuit and athletic shoes to
get there, and preparing a fresh copy of show that you are physically fit and
your resumé ready to work.
E. Preparing possible questions and C. Avoid wearing heavy perfume or
answers aftershave lotion.
D. Arrive exactly at the time of the
interview so you do not have to wait
around in the reception area.

CHAPTER 13 Starting Your Career 59
21. Mary Saunders has had four jobs in 1 24. Which type of answer is best in an interview?
year. She does not list all four jobs when “Yes” and “no” answers
completing a job application. This is: Honest and positive
Unnecessary information Long explanations
B. Invasion of privacy Se)
OeCount to three and then give a factual
C. Deception by omission answer
D. Ethically correct
25. After a job interview, you should:
22. You are completing a job application. A. Thank the interviewer
How many references should you be B. State that you look forward to hearing
prepared to give? from the interviewer
Dau ne C. Shake the interviewer's hand
B. Two D. Do all of the above
Cy lhree
D. Four 26. Why is having a probationary period
common practice for new hires?
23. You are in the waiting area before your A. So the employer can determine if you
interview. What should you do? are the right fit for the job
A. Text-message your friend on your B. To prevent new hires from using their
cellphone. benefits
B. Talk to the receptionist. C. To reduce your stress and anxiety if you
C. Sit quietly. are let go
D. File your nails so they look groomed. D. So you don’ have to contribute to
Canada Pension Plan

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CHAPTER
Body Mechanics
TRUE OR FALSE The way in which body parts are

aligned with one another is called
Circle T for true, or circle F for false. base ofsupport.
Ie ike as Log-rolling keeps the spine straight. 10. The skin sticking to a surface,
causing the muscles to slide in the
z 3 lee When you lift, move, or carry
direction the body is moving, is
objects, hold them with your arms
called skinning.
extended.
11. Another name for a transfer or safety
When lifting an object from the
belt is a gait belt.
floor, bend from the waist.
12. Turning the client as a unit in
By using two or more people to help
alignment in one motion is called
a heavy, weak, or very old client
body mechanics.
moye up in bed, you protect only
the client from injury. ts. Another name for the back-lying
or dorsal recumbent position is the
In some agencies, a turning pad can
supine posttion.
be an incontinence pad or a folded
sheet. 14. Another name for the side-lying
position is the sideline position.
When transferring a client to a chair,
choose a chair based primarily on 15. The semi-sitting position, with
how comfortable the chair will be. the head of the bed elevated 45 to
60 degrees, is called the Franklin
A client lying in bed or sitting in a position.
chair should be repositioned every 3
to 4 hours. 16. A left-side-lying position in which
the upper leg is sharply flexed is
Rubbing of one surface against
called the Sims’ position.
another is called friction.
62 CHAPTER 14 Body Mechanics :
72 TF Another word for posture is body —* 29. “TA A transfer belt is used on men who
mechanics. have poorly fitting trousers to keep
them from falling down.
18. T F A turning sheet or pad is also called a
transfer sheet or lift pad. 30. Ty cE The seat of the wheelchair is padded
to promote the client’s comfort.
19.77) -F Sitting on the edge of the bed is
called edging. 6 nad bel 2 Mechanical lifts are used when a
client cannot assist with a transfer.
20; 1 EF ‘The position in which the client is
placed on his abdomen with his head Soe bls, ot The number of staff members
turned to one side is called the drone needed to transfer a client from the
position. bed to a chair or wheelchair depends
on the client’s physical abilities and
Zt) A chair used to move clients from condition.
one place to another is called a
wheelchair. eo eed Ge © The Sims position is the right-side-
lying position.
227 tor You can provide a better base of
support for lifting by standing with 34. T F The supine position is a back-lying
your legs and feet apart for a wide position.
base of support.
35.) ak ‘The prone position is difficult for ill
230 TSF Providing a good base of support will clients to maintain.
help to reduce the risk of injury.
36. T F When in the supine position, ankles
24. T F When you move a client up in bed, should be elevated on two pillows.
it is important to protect the skin
from shaving. 37201) 4B ‘The stroke position is also known as
the lateral position.
255 PE You should place the pillow against
the headboard when moving a client 38. T F To correctly lift an object from the
up in bed to prevent her head from floor, you should use muscles in your
hitting the headboard. shoulders, upper arms, hips, and
thighs.
26. T F The level of the bed should be raised
horizontally when the client is being
repositioned to reduce the amount of
MULTIPLE RESPONSE
work the support worker has to do. From the list below, choose all of the correct
answers.
1nd Waneof Two staff members work together
when raising an older client’s head 39. When working together, two co-workers
oe . >
and shoulders to provide more can ensure they move the client at the
support, for clients with fragile same time by:
bones and joints. A. One person communicating directions
when lifting
28. T F A transfer pad is used to keep B. Counting to 10
the bedding neater and to reduce C. Lifting together
wrinkling.

CHAPTER 14 Body Mechanics 63
40. Itis important fora support worker to follow 43. What observations should you make when
the guidelines for good body mechanics. the client is dangling the legs?
These guidelines are: A. Pulse and respirations (if instructed to
a Assess the situation before you begin do so)
lifting B. ‘The length of time the person’s legs
B. Face your work area dangled
C. Bend your back and squat when lifting C. Complaints of dizziness, light-
D. Tighten your stomach muscles and tuck headedness, or difficulty breathing
in your pelvis as you lift D. How well the activity was tolerated
E. Hold objects close to your body when E. ‘The amount of assistance that you wish
lifting, moving, or carrying them you had
F. Avoid unnecessary bending and
reaching 44. Before using a lift, make sure:
G. ‘Turn your whole body in sections A. ‘The client has read the lift policy for
when changing the direction of your your agency
movement B. You are trained to use the lift
C. The lift works
41. How can you provide comfort and safety to a D. The client’s weight does not exceed the
client being lifted or moved in bed? lift’s weight limit
A. Check with your supervisor and the
care plan about limits or restrictions in 45. When you position a client, you should
moving or positioning that client. follow these safety regulations:
While you are moving the client, decide A. Check with the care plan for the best
how to move the client and how much position for the client.
help you need. B. Ask the client when you should
Ask for help before starting the move. reposition her.
ke Communicate
Stent directions with your C. Use good body mechanics.
helper by counting 1—2—3 and then D. Ask for help before beginning the
moving together. process.
Move the client in one large movement. Explain the procedure to the client after
Cover and screen the client for privacy. performing the procedure.
Make sure tubes or drainage containers E Be gentle when moving the client.
connected to the client are not pulled, G. Provide for privacy.
tangled, or pinched during the move. H. Leave the client in good body
H. Position the client in good alignment alignment.
after the move. I. Use pillows as directed in the care plan
I. Make sure linens are wrinkle-free after for comfort and support.
moving the client. J. |Make sure linens are wrinkle-free
by tucking the top sheet under the
42. Log-rolling is used to turn: mattress.
A. Clients with arthritic spines K. In facilities, place the call bell within
B. Clients recovering from hip fractures the client’s reach.
C. Clients with spinal cord injuries
D. Clients with facial injuries
E. Clients recovering from spinal cord
surgery

64 CHAPTER 14 Body Mechanics a
46. What are the benefits of repositioning a 51. Mr. John Dunlop is turned as a unit, with
client frequently? one motion. ‘This is called:
A. Promotes comfort and well-being A. Body mechanics
B. Makes breathing easier B. Log-rolling
C. Keeps linens cleaner and fresher C. Ergonomics
smelling D. The safety roll
D. Helps prevent many complications
(e.g., pressure ulcers and contractures) 52s Mrs. Renee Nadeau has slid down in bed.
Her skin sticks to the bed while her muscles
move down. This is called:
MULTIPLE CHOICE A. Friction
Circle the correct answer. B. Abrasion
C. Tension
47. A transfer sheet or pad is used by placing it D. Shearing
under the client:
A. From the head to above the knees LeP When you are giving bedside care, the bed
B. From the shoulders to the hips should be:
C. From the head to the hips A. At its lowest horizontal level
D. From the shoulders to the knees B. At its highest horizontal level
C. Level with your waist
48. Why should shoes with nonskid soles be D. In Fowler’s position
worn by the client being transferred to a
chair or wheelchair? 54. You need to move a client up in bed. To
A. To provide a good base of support reduce your risk of injury:
B. To make the client more steady on his A. Use a transfer belt
feet B. Raise the head of the bed prior to
C. To prevent the client sliding or slipping moving the client
on the floor C. Instruct the client to place both hands
D. To provide strength on the client's around your neck and shoulders
affected side D. Get assistance from a co-worker
49. When transferring a client to a stretcher: 55. To prevent falls during transfers, you should
A. ‘The client is moved by moving the head ensure that wheelchair or shower chair
first wheels are:
B. A transfer belt is used to lift the client A. Fully inflated
C. The head of the bed is raised before the B. Locked and aligned correctly
transfer C. Removed
D. Three or more staff members are needed D. Positioned sideways and at right angles
to the chair
50. Body alignment is:
A. ‘The way the head, trunk, and legs are 56. Mrs. Arja Gupta has less strength on her
aligned with each other left side. Where should you position the
The same as body mechanics wheelchair?
The base of support A. At the foot of the bed
gor The area on which an object rests B. At the head of the bed
C. Next to the bed on her left side
D. Next to the bed on her right side

CHAPTER 14 Body Mechanics 65
57. When you have to move, turn, or transfer a 59. A no-lift policy means:
client, it is always best to: A. You should not bend over to pick up
A. Use a transfer belt something that fell to the floor
B. Have a co-worker help you B. Mechanical lifts need to be used for
C. Follow the care plan lifting clients
D. Use a mechanical lift C. Only the special lift team is allowed to
lift clients
58. Before moving, turning, transferring, or D. Clients are not allowed to be lifted at
lifting a client, you should always: any time
A. Explain what you are going to do ina
way the client understands
B. Ask a co-worker to help you
C. Apply a transfer belt
D. Use a mechanical lift
FILL IN THE BLANKS
60. The position in which the client is placed on his abdomen with his head turned to one side is called
the position.
61. How can you make sure that you and a co-worker both move the person at the same time when
working together? b
62. When a turning pad or slider sheet is used,

and are reduced, and the person can be
63. Why should you move a person to the side of the bed before turning?
64. Why do you pad the seat of the wheelchair?
65. When are mechanical lifts used?

66 CHAPTER 14 Body Mechanics
FILL IN THE BLANKS P 69. The illustration below shows the
Complete each statement, referring to the illus- position, with thefeet positioned over ___
trations below.
66. The illustration below shows the
position.
position.
position.
71. When lifting correctly as in the images

below, which muscle groups are used?
position, with a pillow placed under the
to prevent
pressure on the toes.

CHAPTER
TRUE OR FALSE 10. TF Plantar flexion and footdrop can be

prevented by using a footboard.
11. TF A trochanter roll can be used to
1. TF Exercise every joint on every client. prevent external rotation of the hips
and legs.
2. TF Support the extremity being exercised.
12. T F A hip abduction wedge keeps the
3. T F_ Exercise the joint to the point of
hips together.
pain.
13. TF Ifaclient is falling, you should try to
4. T F The client should wear soft slippers
stop the fall.
or sandals when using crutches.
14. T F When ambulating, the cane is used
5. TF Loose clothing can hang forward
on the unaffected side.
and block the client’s view of the feet
and crutches. 15. TF A walker gives more support than a
cane.
6. TF A pouch attached to a walker will
always interfere with the client's
ability to ambulate. MULTIPLE RESPONSE
7. T FE When aclient is on bed rest, some
answers.
activities of daily living (ADLs) are
allowed, such as feeding and oral
16. Which of the following are benefits of bed
hygiene. rest?
A. Reduces physical activity
8. TF Strict bed rest means everything is
B. Reduces pain
done for the client.
C. Reduces pressure ulcers
9. T F Bed rest with commode privileges D. Encourages rest
means the client can use the
E. Promotes healing
bathroom for elimination needs.
68 CHAPTER 15__ Exercise and Activity
vein
17. Which of the following is correct when a 21. What is one type of range-of-motion (ROM)
client is using a cane? exercises that a support worker can assist
A. The cane is used on the affected side. with only if allowed by her agency?
B. The client should move the cane A. Hip abduction and adduction
forward 15-25 cm at a time. B. Neck exercises
C. The client should move the unaffected C. Knee exercises
leg forward first. D. Shoulder exercises
22. When you move a joint during ROM

MULTIPLE CHOICE exercises and the client complains of pain,
Circle the correct answer. what should you do?
A. Ask the nurse to give pain medication
18. Which of the following statements correctly before you continue.
describes a type of bed rest? B. Do not force the joint to the point of
A. ‘The client remains in bed but is allowed pain.
to perform some ADLs. C. Stop doing any ROM exercises with the
B. The client can use the bedside client.
commode for elimination needs. D. Push slightly past the point where pain
C. Everything is done for the client; no occurs to restore movement.
ADLs are allowed.
D. All of the above describe bed rest. 23. When ROM exercises are performed, how
often should each exercise be repeated?
19. Which of the following steps would be used A. ‘Once
to prevent orthostatic hypotension? B. Twice
A. Assist the client to lie on the edge of C. Five times or according to the care plan
the bed. D. Until the client complains of being tired
B. Ask the client about weakness,
dizziness, or spots before the eyes. 24. Improperly fitted crutches can cause:
C. Have the client stand up quickly when A. Falls
getting out of bed. B. Back pain and nerve damage
D. Measure blood pressure, pulse, and C. Injuries to the underarms and palms
respirations each time the client changes D. All of the above
position.
25. Which statement about contractures is
20. Which of the following is a complication of correct?
bed rest? A. Contractures are reversible with
A. Urinary retention exercise.
B. Diarrhea B. Contractures can form in as little as 48
C. Blood clots to 72 hours.
D. Diabetes .Contractures cannot form in the neck.
ae Bed cradles prevent contractures.

CHAPTER 15 Exercise and Activity 69
MATCHING
Match the following statements with the correct terms related to exercise and activity.
26. Support placed to prevent external rotation of hips and legs A. Footboard
ed Swinging bar on overbed frame that allows the client to B Contracture

move in bed
28. Decrease in size or wasting away of tissue Atrophy

Zo. Turning downward Bed board
30. Device placed to keep soles of feet flush against it with Plantar flexion
feet in flexed position
a Abnormal shortening of a muscle 74 Trochanter roll
a2. Sections of plywood used to prevent mattress from sagging ‘Trapeze

33. Footdrop ROM exercises
34. Exercise of all joints of the body ee

Pronation
Match each movement with the correct description.
35. Turn head from side to side Abduction
36. Turn hand so palm is down Adduction
37. Turn hand toward thumb Flexion
38. Bend arm so that same-side shoulder is touched Internal rotation
39. Pull foot forward and push down on heel at same time Extension
40. Move straight arm away from side of body Hyperextension
41. Turn foot down or point the toes Rotation
42. Move head to the right and to the left sep

aur
ters
el
ey
eezlercrd
Lateral flexion
43. Touch each fingertip to thumb — External rotation
44, Turn hand toward little finger Pronation
45. Move forearm toward head Supination
46. Move leg toward the other leg Opposition
47. Straighten fingers so fingers, hand, and wrist are straight Plantar flexion
48. Bend the hand back Dorsiflexion
49. Turn inside of foot up and outside down Radial flexion
50. Turn leg inward ae

28
SCUlnar flexion

70 CHAPTER 15__ Exercise and Activity
Match the following types of range-of-motion exercises with the correct definition.
Someone moves the client’s joints through ROM exercises A. Active
The client does the exercises with the help of another person _B. Passive
The client does the exercises by himself C. Active-assisted
FILL IN THE BLANKS
54. Describe the following types of bed rest:

a. Bed rest
b. Strict bed rest
c. Bed rest with commode privileges
d. Bed rest with bathroom privileges
Doe What problem can be prevented by using a footboard?
56. Depending on the child’s activity limits, almost any play activity promotes
in children.
Bis What device is used to safely transfer or ambulate the person?
58. Why do you ease a client who is falling onto the floor instead of trying to stop the fall?
59. A client using a cane should follow these steps:

aye otep ek
b. Step B
Can step.

CHAPTER 15_ Exercise and Activity 71
CROSSWORD
YO
eco ie eg le [es | otA

Sed AgGs ed|
ra
a | |
Across Down
4. Decrease in size or a wasting away of tissue 1 Foot falls down at the ankle (permanent
5. Turning downward plantar flexion)
6. Lack of joint mobility caused by abnormal yar Moving a body part toward the midline of
shortening of a muscle the body
7. Turning the joint . Excessive straightening of a body part
ies)
9. Straightening of a body part . Moving a body part away from the midline
10. Movement of a joint to the extent possible of the body
without causing pain (3 words) 11. Bending a body part
12. Turning upward
13. Bending the toes and foot up at the ankles
14. Brief loss of consciousness; fainting

WE SOZG 9 WA iid gt a J ca
: | sale pan) 7 oe
a
CHAPTER
Rehabilitation and
Restorative Care
TRUE OR FALSE 6. The goal of using a prosthesis is that

it should be like the missing body
Circle T for true, or circle F for false. part in function, appearance, or
both.
14 tae © A disability does not affect the
client’s psychological well-being. It is 7 Rehabilitation can occur in the
only a physical problem. community as well as in long-term
care settings.
Pd Oe Rehabilitation and restorative care
begins by preventing complications. 8 Good skin care is important in
rehabilitation as it can prevent
So.) 1) F Rehabilitation and restorative care
further disability and illness.
often takes less time for older clients
than for clients in other age groups. 9. An electric toothbrush may make
brushing the teeth more difficult
Ce ie Health care workers as well as the
for a client who has limited arm
client and family members are part
movement.
of the rehabilitation and restorative
care team. 10. The home is assessed by the
rehabilitation team after a client
onl ek Restorative care is usually provided
goes home.
by the family physician.
74 CHAPTER 16 Rehabilitation and Restorative Care
MULTIPLE RESPONSE MULTIPLE CHOICE

From the list below, choose all of the correct Circle the correct answer.
answers.
15. An orthotic is:
11. Which of the following are goals of A. An artificial replacement for missing
rehabilitation and restorative care? body parts
A. To restore function as much as possible B. The process of correcting a deformity
for each client C. An apparatus worn for support
B. To improve a client’s functional abilities D. ‘The process of restoring a client to the
C. To cure diseases highest level of functioning possible
D. To teach clients new skills
E. To prevent further disability and illness 16. Rehabilitation:
A. Is often slow and frustrating
2: Examples of orthotics include which of the B. Occurs quickly
following? C. Is carried out only in a hospital
A. Splints D. Does not involve the family
B. Foot support
C. Transfer belt WE Occupational therapists on the rehabilitation
D. Knee and back braces team:
A. Lead and coordinate rehabilitation
13. Common health problems requiring B. Assess the performance of activities of
rehabilitation and restorative care include daily living
which of the following? C. Test speech
A. Acquired brain injury D. Coordinate home care
B. Alcoholism
C. Amputation 18. Social workers on the rehabilitation team:
D. Brain tumour A. Provide counselling
E. Poor nutrition B. Help with physiotherapy
FE Cerebral palsy C. Coordinate and provide care at every
G. Chronic obstructive pulmonary disease stage
D. Evaluate strength
14. How can you improve the quality of life for a
client with a disability? 19% Which member of the rehabilitation team
A. Allow the client to practise skills in assesses the client’s performance of activities
private. of daily living?
Se Share information about a client’s A. ‘The physiotherapist
progress with other clients. B. ‘The occupational therapist
C. Allow for personal choice whenever C. ‘The case manager
possible. D. ‘The speech—language pathologist
D. Focus on the positive.
E. Offer praise only when goals are met.
FE Never force clients to do more than
they are able.
G. Perform activities of daily living for the
client as much as possible.

CHAPTER 16. Rehabilitation and Restorative Care 75
MATCHING
Match the following words with the correct definitions.
20. ______ Process of restoring a person to the highest possible level A. Activities of daily living
of function
21. ____Self-care activities performed to remain independence B. Independence
22. _____ Helps a person regain health and strength C. Rehabilitation
FILL IN THE BLANKS
23. Rehabilitation can occur in different settings. List some of the settings.
a.
b.
C
d.
24. Describe the difference between rehabilitation and restorative care.
Copyright © 2022 Elsevier Inc. Alll rights reserved.

Wa. 20.7 SY
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CRAPTER
TRUE OR FALSE Cold water should not be used to

clean or store dentures because it
Circle T for true, or circle F for false. ° may cause them to warp.
ibsnl tana2 Soap dries the skin, especially in 10. T When you are giving mouth care
older clients. to an unconscious client, it is
important to position the client on
Zoe Eh ‘The support worker decides what
his or her back to avoid aspiration.
skin care products to use when
giving a client a bath. isa If an older client with dementia
resists your effort to assist with
bimelieds Plain water may be used for the bath
hygiene, you may find ways to work
when the skin is very dry.
with the client in the care plan.
4. T F Bath oils and lotions are used to
2a Older clients with dementia
clean the skin.
sometimes become agitated
and combative during bathing
ool EF Adjust the water temperature and
procedures as they do not
pressure before the client gets in the
understand what is happening or
shower.
why.
6. T F Illness and disease can cause a bad
13, 7 The tub or shower should be cleaned
taste in the mouth.
before using to prevent the spread of
ThA OM Some medications and diseases can microbes and infection.
cause a white coating on the tongue.
14. T The cleanest part of the perineal area
& T F Children should learn to brush their is the anal region.
teeth at about age 5.
78 CHAPTER 17 _ Personal Hygiene
MULTIPLE RESPONSE es 19. When giving a tub bath or shower, what

safety measures will help to prevent falls?
From the list below, choose all of the correct A. Dry the bathroom or shower room
answers. floor.
B. Check handrails, grab bars, hydraulic
15. When should oral hygiene be performed? lifts, and other safety aids to ensure they
Upon awakening
are in working order.
After each meal
C. Place a bath mat inside tubs or showers
Every other day
without a nonskid surface.
At bedtime
D. Place needed items out of the client's
ole Before meals (if the client wishes)
feo)
es
reach.
E. Place the call bell within the client’s
16. When giving oral care, what observations or
assessments should you report to the nurse? reach.
ne Dry, cracked, swollen, or blistered lips
FE Have the client use towel bars when
B. Redness, swelling, irritation, sores, or
getting in and out of the tub or shower.
white patches in the mouth or on the
G. Do not use bath oils because they make
tongue
surfaces slippery.
Cc Bleeding, swelling, or redness of the H. Keep bar soap in the dish to prevent the
gums
client from slipping on it.
1B, Loose teeth
I. Do not leave weak or unsteady clients
r Rough, sharp, or chipped areas on
unattended.
dentures
J. Stay within hearing distance if the client
can be left alone.
E: Complaints of pain or discomfort
17. What are reasons for bathing a client?

20. What observations should you make and
As To clean the skin and mucous
report when you give a client a bath?
membranes of the genital and anal areas
ie The colour of the skin, lips, nail beds,
Be To remove microbes, dead skin,
and sclera
perspiration, and excess oils The location and description of rashes
G. To refresh and relax the client
Normal skin
by. To stimulate circulation and exercise Bruises or open skin areas
body parts Pale or reddened areas, particularly over
bony parts
18. How can the support worker assist the client aSia Drainage or bleeding from wounds or
with dementia to tolerate a bath? body openings
ie Not rushing the client Swelling of the feet and legs
B. Using a loud, firm voice Corns or calluses on the feet
C. Diverting the client’s attention Skin temperature
D Calming the client and, if the client HO Complaints of pain or discomfort
resists, trying again later

CHAPTER 17 Personal Hygiene 72
21. What areas are bathed when giving a partial 26. Why should you avoid using bath oils when
bath? giving a tub bath or shower?
A. Face They make the tub or floor slippery.
Ba sHands They may be irritating to the skin.
C. Underarms They will cause dryness of the skin.
D. Feet FON They may collect in skin folds and cause
Ee Back skin breakdown.
FE Buttocks
G. Perineal area 27; Before being given a bath, the client should
be assisted to the bathroom or offered the
22. What are reasons a complete bed bath may commode, bedpan, or urinal because:
be ordered? A. This will prevent incontinence during
A. The client is conscious. the bath
B. ‘The client is paralyzed. B. Bathing stimulates urination
C. The client is in a cast or traction. C. It will prevent skin breakdown during
D. The client is weak from illness or the bath
surgery. D. It will prevent soiling after the bath
23. Back massages should not be given’

to clients 28. About how long should a back massage last?
with: A. 1 to 2 minutes
A. Certain heart diseases B. 3 to 5 minutes
B. Back injuries C. 6 to 8 minutes
C. Back surgeries D. At least 10 minutes
D. Skin diseases
E. Some lung disorders 29. What is one reason to provide perineal care
at least once a day?
A. To prevent the growth of microbes that
MULTIPLE CHOICE can cause infection
Circle the correct answer. B. To prevent incontinence
C. ‘To prevent pain
24. When giving oral care, why should you wear D. To provide exercise
gloves?
A. You will have contact with the mucous 30. Which of the following is the correct way to
membranes. wash the perineal area?
B. ‘The gums may bleed. A. Wash from the anal area toward the
C. There may be harmful bacteria urethra.
(pathogens) in the mouth. B. Wash ina circular motion from the
D. All of the above are correct. outside to the inside.
C. Wash from the urethra to the anal area.
25. How often should mouth care be given to an D. Wash back and forth over the entire
unconscious client? area several times.
A. Once a day
B. Once each shift
C. After every meal
D. Every 2 hours

80 CHAPTER 17 _ Personal Hygiene
31. When should the bathwater be changed, 37. Dentures are stored in
during a complete bed bath?
A. After washing the chest and abdomen if 38. When giving mouth care to an unconscious
the water is soapy or cool client, it is important to turn the person
B. Before washing the feet and legs to
C. After giving perineal care prevent
D. Only if it is soapy or cool
BSF Why are the following rules important when
32: Which of these steps is not correct when bathing a client?
giving perineal care to a male client? a. Keep soap in dish between lathering
A. Retract the foreskin of the
uncircumcised male. b. Rinse the skin
B. Wash the tip of the penis starting at the
urethral opening and working outward. c. Pat the skin dry
C. Clean the shaft of the penis with firm,
downward strokes. d. Bathe the skin whenever urine and feces
D. Leave the foreskin retracted at the end are present
of the procedure.
40. How can you provide for warmth during a

FILL IN THE BLANKS bath?
Ss
33. What causes these problems in the oral b.
cavity?
a. Bad taste 41. Lower water temperature for bathing is
important for because they
b. White coating on tongue have
42. Why is the water temperature for a bed bath

c. Redness and swelling of tongue and
43.3° to 46.1°C (110°F to 115°F)?
mouth
d. Dry mouth 43. When washing and drying the chest during
a bed bath, what steps are taken to avoid
exposing the client?
34. When you are cleaning dentures, why do you
a.
fill the sink or basin with water and line it
with a towel? b.
(G
35. Hot water should not be used to clean or

store dentures because it may cause them to
36. What are the reasons the teeth should be

flossed?
a.
b.

CHAPTER 17 _ Personal Hygiene 81
44. ‘The cleanest area in the perineal area is the 47. Using an arrow, show the direction used to
and clean the eyes while giving a bed bath.
the dirtiest area is the
45. When giving perineal care, what observations

should be reported to the nurse?
a.
b.
Ce
LABELLING
46. Using arrows, show the directions in which

the teeth should be brushed.
48. Draw lines with arrows to show the direction

your hands move when giving a backrub.

_>
Fer Rese, sep et 2 not 3

etaleaptdesctmayrenineldie.» ate ici
i}
7
CHAPTER 78
TRUE OR FALSE F Brushing and combing are

important to prevent tangles in
Circle T for true, or circle F for false. long hair.
it EF How the hair looks has no effect on 10. F Garbage bags can be used to make
the client’s well-being. a plastic trough to wash the hair of
a client in bed at home.
ae le oe When brushing hair, start at the
scalp and brush to the hair ends. 11. F When you are giving foot care, you
should treat corns and blisters.
al EF If hair is tangled and matted, first
start to brush at the scalp and brush 12: F Poor circulation to feet and toes
to the ends. can be caused by diabetes or
vascular disease.
4. T F When caring for adolescents, style
hair in a manner that pleases the 13. F Gangrene and amputation are
client and parents. serious complications of foot
injuries.
Bal oF Older clients need to shampoo more
frequently because of decreased oil F The best time to clean and trim
gland secretion. fingernails is right after they have
been soaked or immediately after
Gale A female client may want you to a client has been bathed.
shave coarse facial hair.
13: F Shampooing at the sink or ona
Zale OE When you are shaving the face, the stretcher is difficult for people
client’s skin should be loose. with limited range of motion in
their legs and hips.
GEE Fingernails should be trimmed with
scissors.
84 CHAPTER 18 Grooming and Dressing
iin
16. T F Standard Practices should always , 2A If nicks or cuts occur when shaving a client,
be followed when shaving a client you should:
to prevent contact with their blood A. Apply direct pressure to the nick or cut
from a nick or cut. B. Apply pressure around the nick or cut
but never apply pressure directly to the
17. T F An adolescent may need frequent cut itself
shampooing because oil gland C. Report the nick or cut to your
secretion decreases during puberty, supervisor at once
resulting in hair that is drier than
normal. papa Observations that should be reported to the
nurse during foot care include:
18. TF You can soften the skin before A. Soft, pink, intact skin
shaving by applying a warm towel to B. Very dry skin
the face for a few minutes. C. Foot odours
D. Cracks or breaks in the skin, especially
between the toes
MULTIPLE RESPONSE
E. Ingrown nails
From the list below, choose all ofthe correct answers. F. Loose nails
G. Reddened, irritated, or calloused areas
19. What specific measures are needed to comb on the feet, heels, or ankles
curly, coarse, or dry hair? H. No drainage or bleeding
A. Use a wide-tooth comb. J. Change in colour or texture of nails,
B. Wet the hair or use cooking oil to make especially black, thick, or brittle nails
combing easier. J. Corns, bunions, or blisters
C. Begin at the neckline and comb upward,
lifting and fluffing hair outward. 23% When the client requests a shampoo, you
should:
20. How can client safety and comfort be A. Shampoo the client’s hair while she is in
achieved with different methods of bed to avoid tiring her out
shampooing? B. Follow the client’s care plan
A. During a shower or bath, support the C. Explain that shampooing is not your
back of the client’s head with a pillow job
while shampooing the client's hair. D. Wear gloves if the client has scalp
B. If the client must lean forward, have him lesions or head lice
place a folded washcloth over his eyes,
and support his forehead with one hand 24. Support workers should NOT cut or trim the
as you shampoo with the other hand. nails of the following clients:
C. If the client is in a wheelchair, have her A. Clients who have diabetes
lean back over the sink. Place a folded B. Clients who are on medications that
towel over the sink edge to protect her affect blood clotting
neck. C. Clients who are cooperative and assist
D. If the client is in a wheelchair, make in the process of trimming and cutting
sure it is securely locked in place. their nails
E. If the client is on a stretcher, his hair D. Clients who have nails that are thick
should not be shampooed. and/or ingrown
F If the client is in bed, place a shampoo E. Clients with good circulation to the legs
tray under her head to protect the and feet
linens and mattress.

CHAPTER 18 Grooming and Dressing 85
MULTIPLE CHOICE 28. Which of these should you wear when you
are shaving a client?
A. Gown
B. Gloves
25. Microbes (or bacteria) can be found on dirty:
C. Mask
A. Shoes
D. Gown, gloves, and mask
B. Socks
C. Feet
J Which of these statements is correct about
D. All of the above
dressing or undressing a client?
A. Remove clothing from the affected side
26. Aclient has long hair. Which procedure Erst
:
aoe aah i bj B. Put clothing on the affected side first.
B. are epee ie ee C. Put clothing on the unaffected side first.
C Gar zs teas eae D. Remove clothing from the side farthest
oats 8 away from you first.
D. Braiding or styling 30. Which of these steps is correct when you

27. A female client in a long-term care facility pee seen detente
has her hair done weekly at the beauty shop. by
heuer Sea cheuld A. Remove the gown from the arm with
, you should:
A. Wash her hair as usual CANES:
ah bel B. Gather up the sleeve of the arm with the
B. Protect her hair with a shower cap TV Anittclidene cece el venreeaun
C. Be careful not to get water on her hair CT, eae S
D. Wrap a towel around her head to ae ka ee errr er ee
i P fee. temporarily while changing the gown.
2hDead D. Put the gown on the arm without the
IV first.
MATCHING
Match each of the following descriptions to the correct term related to personal care.
31. Excessive body hair A. Cutting

oz. Infestation with lice in the pubic area B. Pediculosis pubis
ERY Hair loss C. Hirsutism
34. An infestation with lice D. Pediculosis capitis
35. You may groom hair in this manner with the person’s permission =.E. Dandruff
36. Excessive amounts of dry, white flakes from the scalp E Pediculosis
37. Parasites that can live on different parts of the body G. Alopecia
38. You must never do this to matted or tangled hair H. Pediculosis corporis
39. Infestation of the scalp with lice eee ice
40. Infestation of the body with lice J. Braiding

86 CHAPTER 18 Grooming and Dressing
Match each of the following descriptions to the correct term related to undressing or dressing the client.
41. When undressing a client, start with removing a pullover garment from the A. Exposure
side.
42. Prevent by covering the client with a sheet. B. Bad
43. You should always refrain from calling the affected side the side. C. Unaffected
44. Acronym for undressing the client is DROP
45. The position is the easiest for removing clothing in bed. Es schE
46. An acronym that refers to anti-embolic stockings is E Supine
FILL IN THE BLANKS
47. What should you do if the person asks to have his or her hair washed?
48. When making a plastic trough to wash hair in the bed at home, you should not use
49. How do the following factors help to cause foot injury, infection, or odours?
a. Dirty feet, socks, stockings
b. Shoes and socks
c. Poorly fitted shoes
d. Poor circulation
e. Diabetes, vascular diseases
f. Trimming or cutting toenails

CHAPTER
Preventing Infection
TRUE OR FALSE Microbes exist in six different forms.
Circle T for true, or circle F for false. Animals are common reservoirs for
microbes.
[and ae S Microbes cannot survive in
reservoirs. 11. The environment must be warm and
bright for microbes to survive.
eek: ak Microbes are destroyed by a warm,
dark environment. 12; Hands should be held up
throughout the handwashing
Sage ne. Items can be sterilized in the home procedure.
with boiling water.
13. Paper towels are used to turn off
4. T F If you must transport a client with hand-operated water faucets to avoid
an infection that requires droplet contaminating the hands.
or airborne precautions out of his
or her room, the client must wear a 14. Mr. Fox has an infection caused by
disposable gown. a wound on his leg. ‘This infection
can exit Mr. Fox’s body through his
Syd hay When you remove gloves, the inside wound.
is considered clean.
LS, Pathogens from Mr. Fox’s infection
6. T F If a sterile item touches a clean item, cannot enter another person’s body
the sterile item is contaminated. through a portal of entry.
Fis AR te If a clean item touches a 16. Portals of entry can include mucous
sterile item, the clean item is membranes.
contaminated.
7. The easiest and most important way
8. Tr &F If a sterile item is above your waist, to prevent the spread of infection is
it is contaminated. by eating well and staying fit.
88 CHAPTER 19 Preventing Infection
18. T F A gown is contaminated when wet , 29. TF Gloves should be changed between
and should be removed. tasks (procedures) on the same
client.
192700 .F Nosocomial or health care—
associated infections (HAIs) are 30. T EF When you enter the room of a client
acquired after a person’s release from with contact precautions, you should
a health care facility. never wear gloves.
20. T F ‘The respiratory tract is one of the 31. T F When providing care for multiple
most common sites for nosocomial ‘clients, you should plan care for
or HAIs. the ones who are diagnosed with
a methicillin-resistant organism
yy ae tee When cleaning equipment, the (MRO) first.
support worker should rinse the item
in cold water first. 32. T EF When providing care for a client
in the community who has been
109deg AY Chemical disinfectants are used to diagnosed with an MRO, it is okay
clean reusable items. to enter the home if there is no
personal protective equipment (PPE)
23. 1 E An effective and cheap disinfectant available for you to put on.
for home use may be made by
mixing 1 cup of bleach with 3 cups
of water. MULTIPLE RESPONSE
24. T F After preparing the effective and
answers.
cheap disinfectant solution from
question #23, it should be labelled 33. Signs and symptoms of a systemic infection
toxic cleaner.
<4 . »”»
include:
= Behavioural changes (especially in older
25201: FE A simple way to sterilize items in the
persons)
home is to pour boiling water over
Swelling and redness of the area
them.
Presence of dandruff and itchy scalp
26, 1 -F If an item is sitting on the floor, it is
Low body temperature
considered to be contaminated.
Chills
Decreased pulse
27 TE When you are finished using a sharp Increased respiratory rate
object (such as a razor), after giving Fatigue and loss of energy
care, you should place it in the Increased appetite
garbage. roOmmoOp
TS Discharge from the infected area that
may have a foul odour
28. T F After a mask has been worn, the
outside part is considered to be
contaminated.

; CHAPTER 19 _ Preventing Infection 89
34. Nancy is a support worker caring for a client 37. You should allow a client to see your face
in the home. When should she wash her before you put on personal protective
hands? equipment:
A. Approximately one half hour before and A. Because children may be afraid if they
after giving care cannot see your face
ley Only when the hands are visibly soiled B. Because clients with confusion or
G After contact with her own or another’s dementia may be afraid if they cannot
blood, body fluids, secretions, or see your face
excretions C. To avoid clients thinking you are there
After touching objects that are to rob them
contaminated (e.g., soiled linens,
garbage bags) 38. Aseptic measures the support worker can
Before and after preparing and handling use in the health care facility to control the
only foods that must be heated transmission of infection include:
F Before feeding the client A. Assisting clients with handwashing as
G. While wearing gloves necessary
H After personal body functions (e.g., Bb: Washing hands properly morning,
going to the bathroom, sneezing) afternoon, and evening
(Gs Cleaning, disinfecting, and sterilizing
35. What guidelines should be followed when equipment, as appropriate
cleaning equipment? Maintaining personal hygiene
A. Wear PPE when cleaning items that Keeping vaccinations up to date
may be contaminated with blood, body Keeping tables, countertops, wheelchair
fluids, secretions, or excretions. trays, and other surfaces clean and dry
Wash the item with soap and bleach. Washing contaminated areas with tap
Scrub the item thoroughly. water
SONS:
After cleaning, rinse the item in cold Go Providing for the client’s skin care and
water. oral hygiene, according to the care plan
lee Dry the item. — Covering nose and mouth with a mask
when coughing or sneezing
36. Standard Practices are guidelines used to nae Ensuring clients have their own care
prevent the spread of infection from: equipment, and not sharing items
Blood among clients
Only people who live high-risk lifestyles Taking equipment and supplies from
All body fluids, secretions, and one client’s room and using with
excretions another client to reduce expenses
All hair and skin products Holding equipment and linens close to
Nonintact skin (skin with open breaks) the body
ae
eSMucous membranes Covering bedpans and commodes with
a lid when transporting
Avoiding sitting on a client’s bed
§
OZNot using items that have touched the
floor for 5 seconds or more
ro Disinfecting tubs, showers, shower
chairs, bedpans, urinals, and commodes
after each use

90 CHAPTER 19 _ Preventing Infection
39. When you are assigned to care foraclient . 43. Which of these statements reflects the use of
in isolation, you should tell the nurse if you proper aseptic technique?
have Toke Take clean, unused equipment from
A. Tattoos under your uniform one person’s room to another room.
B. Broken skin on your face, arms, or legs B. Clean from the dirtiest area to the
Cx Fever cleanest area.
D. Vomiting Wear personal protective equipment as
E. Diarrhea needed.
F. Sore throat Keep tables and other surfaces clean
G Asthma by wiping them down with the client's
facecloth:
40. Types of sharps containers that may be used
in home care include: 44. Here is a list of common aseptic practices
A. Containers according to employer that you should use. Which one is the most
policy important for preventing the spread of
B. Containers that you can easily open to infection?
om A. Bathing, washing hair, and brushing
C. Containers that are puncture-resistant teeth regularly
D. Containers that are leak-proof B. Washing cooking utensils with soap and
water .
41. When you care for a client with an infection, C. Covering nose and mouth when
what precautions should be used when coughing or sneezing
handling contaminated laundry? D. Washing hands immediately before and
A. Sort or rinse linen only in client care after client care as necessary
ates:
B. Hold soiled linens away from your 45. ‘Transmission-Based Precautions are used:
uniform. Wear gloves. 1% When caring for all clients
C. Remove soiled linens by folding them B. When caring for clients with open
with the cleanest areas in the centre. wounds
D. Linen contaminated with blood, body Cc. Depending on how the pathogen is
fluids, secretions, or excretions must be spread
placed in a sturdy, leak-proof laundry Oy Only when caring for clients with a
bag labelled with the biohazard symbol. respiratory infection
E. Bag soiled linen in the room where it
was used. 46. When you are caring for a client who is in
isolation, what should you do if you drop
clean linens on the floor?
MULTIPLE CHOICE A. Pick them up and return them to the
Circle the correct answer. stack of clean linens.
B. They are contaminated and should be
42. When your hands are contaminated while thrown in the trash.
working in a health care facility, you should They are contaminated and should be
wash them for at least: placed in the dirty linen container.
A. 3 to 5 minutes Use them immediately so they are
B. 2 minutes mixed with clean linens.
C. 15 to 20 seconds
D. 1 minute

CHAPTER 19 Preventing Infection 91
47. Paper towels are used in isolation: 53. Which, if any, of these gloves can be reused
A. ‘To handle contaminated items after cleaning?
B. Under clean items or objects A. Sterile gloves
C. To turn faucets on and off B. Disposable gloves
D. For all of the above C. Utility gloves
D. None of the above
48. Standard Practices should be used:
A. Only when you think a person has an 54. Which of the following statements about
infection wearing gloves is correct?
B. Only when you are changing soiled A. Remove and discard torn or punctured
linens gloves immediately.
C. Only when you have open skin wounds B. Wear the same gloves when giving care
D. When caring for all persons at all times to both people in a semi-private room.
C. Practise hand hygiene while wearing
49. When you are removing gloves after giving your gloves.
care, which part is considered “clean”? D. Hand hygiene is not necessary if you
A. The inside wear gloves.
B. ‘The outside
C. Both sides aS. When is double-bagging of biohazardous
D. Neither side waste necessary?
A. Any time contaminated items are
50. When transporting a client who is in removed from the client’s room
isolation, the client should wear a mask: B. When the client has contact precautions
A. Atall times C. When materials are contaminated with
B. Until he or she reaches the destination body fluids
C. Ifhe or she is on airborne or droplet D. When the outside of the biohazard bag
precautions has been contaminated
D. Only while in an elevator
56. When putting on sterile gloves, which of the
51. Which of the following aseptic measures will following steps is correct?
control the portal of entry? A. Lift the second glove by touching only
A. Make sure all clients have their own the inside of the glove.
personal care equipment. B. Pick up the second glove by reaching
B. Make sure drainage tubes are correctly under the cuff with your hand.
connected. C. Hold the thumb of your first gloved
C. Cover your nose and mouth when hand away from your second hand as
coughing or sneezing. you put on the glove.
D. Keep drainage containers below D. Place the glove package below waist
drainage sites. height.
D2: If a container is labelled “biohazard,” it D7. How can you help to prevent a client’s decrease
contains materials that are: in self-esteem when the client is in isolation?
A. Sterile A. Discourage visits by family and friends
B. Radioactive B. Maintain distance between you and the
C. Contaminated client
D. Poisonous C. Arrange to spend time to visit with the
client
D. Remain in the room only for a short time

92 CHAPTER 19 Preventing Infection
FILL IN THE BLANK :
58. What do the following statements describe?

e They exist in five different forms.
¢ They can live in a person, a plant, an animal, soil, food, water, or other material.
e They need water, nourishment, and oxygen to live.
¢ They all need a warm, dark environment to live and may be destroyed by heat and light.
59. Common reservoirs for microbes are ‘ : 5 ee

of eer
VA
60. The environment must be and

for microbes to survive. They also need to live.
61. Why do you hold your hands down throughout the handwashing procedure?
62. Why do you turn off the water by using a paper towel to touch the hand-operated faucets?
63. What is the easiest and most important

p way ytop
to prevent the spread
p of a p person’s infection?
64. The most common sites for nosocomial or health care—associated infections (HAIs) are
a
b.
Cs
d
65. Utility or rubber household gloves should be worn when using a chemical disinfectant because it can
66. When using Standard Practices, masks, eye protection, and face shields are worn during
67. What are some of the rules to follow when caring for a client under Transmission-Based Precautions?
rR
ono

CHAPTER 19 Preventing Infection 93
DIAGRAMS 70. Identify the part of the sterile field (shown

below) that is considered contaminated by
shading in the area with a pencil in the image
68. Identify the parts of the hands that are
below.
frequently missed during handwashing by
shading them in with a pencil in the image
below.
69. Identify the part of the gown that is

considered contaminated after use by
shading in the contaminated area with a
pencil in the image below.

Tara GAG, Ber, Pca Or sigan.
bey seca) a Gs (> fe
qh Yessiiiea sven.
wt iay eb vhs 2 fi 2 ‘
ai
Ne
iL,
1 ae
ye.
}
. wip <
25 ~
wn +.ch
» Sy Sey Ger why vileeied -
resutestte Lestat =
=
+B 2a
ols ot tise ; oa
ee
-
usu dealing
~
>
i:
CHAPTER
TRUE OR FALSE 8. TF Check the material safety data sheet

(MSDS) after cleaning up a leak
Circle T for true, or circle F for false. ~ or spill or disposing of a hazardous
substance.
Polat & An electrical plug not being
grounded may cause a fire. 9. T F When using restraints, the most
restrictive device is used.
Pdi WEA Visitors need to be reminded not to
smoke in a room with supplemental 10. T F Apply a restraint only after receiving
oxygen, even if the facility has a “No instructions about its proper use.
Smoking” policy.
11. TF Always follow manufacturers’
Beak. To prevent sparks, you must turn instructions when using restraints.
off electrical equipment before
unplugging it. 12. TF Sheets, towels, or other items can be
used to position and stabilize a client
4. T F You should attempt to put out a fire on the toilet.
before sounding a fire alarm.
Bon bear All fire extinguishers are effective for MULTIPLE RESPONSE
any fire. From the list below, choose all of the correct
answers.
Gate EF Disinfectants and cleaning solutions
are hazardous substances.
13. What physical changes in some older persons
place them at risk for accidents?
hed Cad Warnings, words, pictures, and
Stiff joints and weakened muscle groups
symbols on hazardous substances
Improved balance and coordination
may be removed after opening the
Increased sensitivity to heat, smell,
container.
taste, and touch
Diminished vision and hearing
ar
PO)Memory problems
”
96 CHAPTER 20 Safety
14. Why should you avoid calling a client by 17, Under the occupational health and safety
name as a method of identifying the client? - (OH&S) legislation, what must your
A. Some clients may be confused and employer do to ensure your safety?
unaware of their name. A. Have written safety policies
B. Some clients who are disoriented may B. ‘Train and educate employees about
answer to any name. these safety policies
C. Some clients with hearing difficulties C. Create a health and safety committee
may not hear you correctly. to identify workplace hazards and
investigate accidents
15. The support worker can prevent falls when Respond to reports of workplace hazards
giving care by: mo Warn employees about safety hazards and
A. ‘Taping cords and wires near the wall correcting these hazards whenever possible
and away from the path for walking EF Make sure that all necessary equipment
B. Using high-gloss floor wax to prevent is available and in good working order
tripping
C. Cleaning up water and other spills 18. OH&S legislation states the employee's
immediately responsibilities are:
D. Keeping lights on low dimmers to A. Follow all safety policies and procedures
decrease glare B. Use all recommended protective
E. Reporting frayed, torn, or bumpy rugs equipment and clothing
and carpets C. Decide which concerns should be
FE Rearranging the client’s furniture to a addressed to the supervisor or the health
better arrangement and safety committee
G. Using nonslip rubber bath mats or D. Complete an incident report after an
nonslip strips in bathtubs and showers accident in the specified time
H. Making sure that the client’s footwear
and clothing fit properly 19. Safety measures aimed at preventing burns
I. Ensuring the client’s shoes and slippers include:
are nonskid A. Telling clients about the dangers of wear-
ing tight-fitting clothing while cooking
16. Injury prevention measures include: B. Keeping clients who smoke a designated
A. Encouraging the client to wear reading distance away from the doors of the facility
glasses when up and about C. Following safety guidelines and the care
B. Ensuring crutches, canes, and walkers plan when applying heat and cold
have nonskid tips D. ‘Testing the temperature of food by
C. Checking the client carefully and often, dipping a clean spoon into the food and
especially a client with risk factors touching the inner aspect of your lower
D. Using pillows, wedge pads, or seats arm with it
to position the client as the care plan E. ‘Testing the water in the tub, shower, or
directs basin with your hand before bathing an
E. Keeping wheelchair wheels unlocked adult or helping an adult bathe
when stationary RF. Checking for “hot spots” in the bath
water, and mix the water well by
moving your hand back and forth in it
G. Relying on the client to check the tem-
perature of the bathwater before bathing
H. Allowing the client to eat or drink food
that is only warm and not hot

CHAPTER 20 _ Safety 97
20. Incident reports are used by employers and 24. Restraints may be used only:
health and safety committees to: A. When absolutely necessary
A. Identify recurring problems B. When the client is in imminent danger
B. Determine who is following health and of harming others
safety policies C. When a client is refusing to eat
C. Determine which steps were followed D. When a client actively threatens to
after the injury or incident occurred harm himself
D. Justify cost-saving measures E. Asa last resort and after less-restrictive
measures have failed
2h. What safety information should the support
worker know and use when handling 25% Which of the following statements are true
hazardous substances? in regard to restraints?
How to safely handle the product A. A restraint is any device that restricts or
The cost of the product limits movement.
How to safely use the product B. Support workers are responsible for
How to safely freeze the product determining who should have a restraint
Set
he
Sg First aid measures required in case of an applied.
accident or emergency C. Restraints can cause emotional harm
74 Instructions for disposing of the and physical injury.
product D. Unnecessary restraint is false
imprisonment.
2. Call bells: E. Restraints are used to discipline certain
A. Can be ignored if the client is known to clients.
call needlessly
B. Should always be placed within the 26. What alternatives to restraints can be used by
client’s reach on her strong or dominant a support worker when giving care?
side A. Use diversions, such as TV or music, to
C. Enable the client to call for assistance calm and distract the client.
D. Can be removed from a client’s bedside B. Avoid following routines and habits
if the staff are frequently alerted since they obviously do not work.
C. Provide attention and companionship.
22. What information about hazardous materials D. ‘Turn up the volume of the TV or radio
can be found on the Workplace Hazardous so the client will hear it.
Materials Information System (WHMIS) es Avoid explaining procedures and care
label? measures to reduce confusion.
A. Risk phrases that describe the health Closely supervise the client.
hazard Allow the client to wander in a safe area.
Supplier information Promote uninterrupted sleep.
Hazard symbol Meet food, fluid, and elimination needs
Cost of the product promptly.
moO Precautionary statements that describe — If ordered, help the client use padded
safety measures to take when using the hip protectors, pillows, wedge cushions,
product and posture and positioning aids.
E First aid measures in case of accident or K. Follow safety precautions to prevent
emergency falls; if ordered, use floor cushions and
G. Reference to the material safety data roll guards.
sheet (MSDS) L. ‘Take away call bells, as they are a safety
hazard.

98 CHAPTER 20 _ Safety
27 How can you meet a restrained client's : MULTIPLE CHOICE

psychological needs?
A. Treat the person with kindness, caring, Circle the response that correctly completes the
sentence.
respect, and dignity.
B. Toilet the client every 6 hours.
30. A chemical restraint is a
C. Visit the person often.
used to control behaviour or movement.
D. Offer repeated explanations and
ie Belt
reassurance.
B. Jacket
E. Bea good listener.
Cc. Food
28. What information should be reported to the b; Medication
nurse when you are caring for a restrained client?
31. Which of the following statements about
A. ‘The type of restraint applied
restraint use is true?
B. The reason for the restraint
A. Most facilities have limited policies
C. Safety measures taken, as listed in the
about the use of restraints.
care plan, such as whether bed rails are
B. Restraints cannot be used without prior
padded or raised
informed consent given.
D. The time the restraint was applied
A wheelchair belt is not considered to
E. ‘The time the restraint was removed
be a restraint.
F The care given when the restraint was
Ly: Items such as bedsheets can be used to
removed
restrain a client.
Skin colour and condition
The pulse felt in the restrained part 32. When a client is restrained, the support
aaa Complaints of a tight restraint; difficulty worker must check the client at least every
breathing; and pain, numbness, or
tingling in the restrained part 15% 5 minutes
B. 15 minutes
29. What are some measures that you can take to
(Oe Hour
prevent suffocation in children?
1D) 2 hours
A. Supervise children when they are eating.
B. Allow children to play with small 33. Which of these statements is correct
marbles, coins, and paper clips. regarding restraints?
C. Do not allow children to play with iN Certain drugs may be a form of
blow-up balloons. restraint.
D. Place garbage bags within easy reach B. Restraints may be used for staff
of children. convenience.
E. Do not allow children to wear Restraints are never used to protect a
necklaces, strings, cords, or other items client from harming himself or herself
around their necks. or others.
F. Position infants on their backs for sleeping. 1D: The staff determines who should be
G. Make sure that crib mattresses fit snugly restrained.
in the crib and are firm.
H. Do not place pillows around infants to 34. Restraints that are too big or loose can
prevent them from falling off the bed or increase the risk for
furniture. Cuts
I. Keep the toilet seat raised. Bruises
Do not leave children unattended in a Strangulation
vehicle. Fas
OS Suffocation

35. When a client’s clothing is on fire, you 40. Which of the following sets of factors puts a
should the client and cover him client at increased risk for falls?
or her with a or Coat to A. Confusion, disorientation, and memory
smother the flames. problems
A. Roll, blanket B. Increased joint mobility and muscle
B. Hug, curtain strength
C. Hug, blanket C. Visual impairment, strange
D. Roll, curtain surroundings, and improved reaction
time
36. It is important to exercise personal safety D. Regular exercise and diet habits, proper
measures at all times to avoid injury. If use of medications
visiting a client in the home, one safety
precaution would be to: 41. In a facility, falls are most likely to occur:
A. Position yourself in the corner of the A. During shift changes
room B. During meal times
B. Remove shoes or boots and throw them C. When visitors are present
at the client if the client is being abusive D. While care is being given
C. Try to reason with the client or family
member who is abusive or making 42. Which factor increases a client’s risk of
sexual demands falling?
D. Be cautious in hallways, elevators, and A. Awareness of surroundings
stairwells B. A history of falls
C. Well-fitting footwear
o/s Which is a good personal safety measure to D. Muscle coordination
take when driving to and from work?
A. Always use a seat belt. 43. Which client is most at risk for falls?
B. Never park near people; choose remote, A. A toddler on the stairs who is just
empty areas. learning to walk
C. Do not take your keys out until you are B. A pregnant woman
at your car. C. A school-age child who plays soccer
D. Never carry cash with you at any time. D. A 40-year-old man who is bicycling
38. If someone tries to force you into a vehicle, 44. A client who has balance problems is:
you should: A. At risk for memory problems
A. Cry softly B. Suffering from impaired hearing
B. Push your thumbs into the attacker's C. At risk of falling
eyes D. Taking medication
C. Avoid resisting and go into the vehicle
D. Crouch in a fetal position 45. Which of the following can help to prevent
falls?
Bo; Accident risk factors include: A. Spills on the floor
A. Natural disasters B. Scatter rugs
B. Impaired vision and hearing C. Night lights
C. Suffocation D. Clutter
D. Sleeping

46. A person has a chair alarm. Which is true? * 51. When an accident or error occurs, it is
A. It serves the same purpose as a night correct to:
light. A. Report the accident or error
B. You need to respond immediately to the immediately to your supervisor
alarm. B. Report the incident only if a client is
C. Alarms are used only at night. injured
D. Alarms reduce the need to watch the C. Call the family immediately
client. D. Call the doctor or ambulance
47. Bed rails are padded to: ops If your car breaks down, a good safety
A. Prevent the person from getting caught practice would be to:
between the rails and the mattress A. Stay in the car and call police if you
B. Provide privacy for the person have a cellphone
C. Prevent the person from climbing out B. Ask for a ride to a police station if
of bed someone stops to help
D. Decrease agitation C. Walk to the nearest place where you can
get help
48. What should you do if you find that a smoke D. Get out of the car and try to flag down
detector does not work in a home where you a ride for help
are giving care?
Replace the battery. 53. If you feel uncomfortable or threatened in a
Call the fire department. home setting, you should first:
Notify the nurse and the family. A. Speak to the person who is threatening
i
eo
BG)This is not your responsibility; do not you
get involved. B. Go toa safe place immediately and call
your supervisor
49. If a fire occurs, which of these steps should C. Resign from your job
be done first? D. Call a co-worker to come to the home
A. Usea fire extinguisher to put out the to assist you
fire.
B. Close all doors and windows. 54. Which of the following would be a threat to
C. Announce “Fire” in a loud voice. your safety in home care?
D. Move people who are in danger to a safe A. Denial of meal breaks, drinking water,
place. or bathroom use
B. Inadequate heat or ventilation
50. Suffocation can occur because: C. Being subject to name-calling or
A. Aperson chokes on a piece of food obscene language
B. A person is given a tub bath D. All of the above
C. Restraints are applied correctly
D. Dentures fit properly

CHAPTER20 Safety 101
MATCHING
Match the description or example with the correct restraint.
55. A drug is given that is not required to treat the client’s medical Chemical restraint
symptoms.
56. An attached tray keeps the client from getting up. Mitt restraint
“We Hands are covered to prevent the client from removing the dressing. Geriatric chair
Match the safety measure used with the correct risk factor.
58. Measure the temperature of bath water. Burns
cee Keep the client’s room free of clutter. Suffocation
60. Open doors and windows if you notice gas odours. Falls
61. Store cleaners, medicines, and hazardous substances in the original Poisoning
containers.
Match the safety measure used with the correct risk factor.
62. Do not allow smoking in bed. Burns
63. Do not prop up a baby bottle with a rolled-up towel or blanket. Suffocation
64. Use nonslip strips on the floor next to the bed and in the Falls
bathroom.
Match the accident risk factor with the possible outcome or injury.
65. Can harm herself or others because she cannot understand what is Impaired awareness
happening of surroundings
66. May take wrong medication or dosage or poison himself because Impaired vision
cannot read labels
Impaired hearing
67. Has problems smelling smoke or gas, so is unaware of fire
Altered sense of
68. Cannot hear fire alarms or sirens, so cannot move to safety smell or touch
69. Has not learned the difference between safety and danger, so is Paralysis
unaware of hazardous situations
70. May be aware of danger but is unable to move to safety Developmental

stage or age

Match the accident risk factor with the possible outcome or injury.
71. Injury resulting from being unaware that certain people, A. Impaired awareness of
places, or things may be safety hazards surroundings
De Movements slower and less steady; balance affected B. Impaired vision
Tigo Can trip on toys, rugs, furniture, electrical cords C. Impaired hearing
74. Easily burned because of problems sensing heat and’cold D. Altered sense of touch
hee Cannot hear explanation or instructions, so may take E. Paralysis

wrong medication or dosage
76. May develop pressure sores from lack of movement E Medications
Tle Unaware that mixing these without proper guidance G. Developmental stage or age
can cause illness or death
FILL IN THE BLANKS
78. Where would you find information about a hazardous substance found in the workplace?
TihsJ What are some behaviours that would allow for the use of restraints?
a.
b.
(S
80. If the support worker applies a restraint unnecessarily, he or she could face
81. The client or substitute decision maker must give for the use of
restraints. The support worker (can or cannot) provide the information about
restraints and obtain the signed consent.
82. When a person is restrained, the support worker must make sure basic needs are met by doing the
following:
a. ‘The person must be checked at least
b. Meet the person’s needs for '
, and
83. Several staff members may be needed to apply restraints because

84. Why can confusion increase when a person is restrained?

ee ee OF
85. When applying restraints, the person should be positioned in , and

any bony areas and skin should be to prevent
and
86. Restraints that are too small cause

a
ee
87. What personal safety measures can you take to reduce your risk for assaults?
2
b.
e
d.
2.
2
88. How can you use your car keys as a weapon?
89. How can you use your body as a weapon if you are attacked?
a
b.
es
LABELLING
90. What are two safety problems with the plug in the figure?

7
oComaipan Wag) at AS
a ae rv di ta |
-¢ = aa piss = aed ~e
~X
——
—=
=
CHAPTER

answers.
1. TF In long-term care, an open bed is
made because most clients are out 8. Which bed-making steps follow Standard
of bed all day. Practices?
Hold linens away from your body.
2. T F Clients in long-term care facilities Roll up the soiled linen away from you.
may use their own linens. Wear gloves when handling soiled linen.
Sete
Very soiled linens should be placed
3. T F_ Ifaclient receiving home care on the floor to avoid further
refuses to have his linens changed, contamination.
you should follow the client’s
wishes. 9. When you are making an occupied bed,
which of the following are concerns you
4. T F The space between the mattress should have about the client in the bed?
and crib sides should be no more A. Ensure the client is in good body
than 5 cm (2 in.). alignment.
B. Know about restrictions or limitations
5. T F_ A surgical bed is made by fan- concerning the client’s movement or
folding the linens to the side of the
positioning.
bed closest to the door.
C. Ensure the garbage is removed from the
room.
6. TF Shaking bed linens spreads
D. Each step of the procedure should be
microbes.
explained to the client.
7. TF Making one side of the bed before
going to the other saves the
support worker time and energy.
106 CHAPTER 21. Beds and Bed Making
10. Identify the correct basic bed positions: ‘ 3; Why do you raise the level of the bed when
A. Fowler’s position you are changing linens?
B. Reverse Fowler’s position A. So that you can use good body
C. Trendelenburg position mechanics to prevent injury
D. Reverse Trendelenburg position B. To prevent injury to the client in bed
E. Semi-Trendelenburg position C. To allow space under the bed for
FE Semi-Fowler’s position cleaning
G. — Flat D. So that you can keep the client in good
body alignment
MULTIPLE CHOICE rr . The high-Fowler’s position is used in order
Circle the correct answer. to:
A. Decrease the client’s rate of breathing
LU When changing bed linens, when should you B. Reduce the risk of choking while eating
wear gloves? C. Promote the client’s renal function
A. Ifyou have not performed hand D. Reduce the client’s ankle swelling
hygiene
B. When linens are soiled with blood, 15. An alternating pressure mattress:
body fluids, or body secretions or A. Cannot be placed in a high-Fowler’s
excretions position.
C. When you are handling the clean linens B. Requires that all sheets be tightly tucked
D. Before the client has had a bath under the mattress.
C. Requires the use of an incontinence pad
t2; Which statement is true when you are at all times.
making an occupied bed? D. Is used for clients who are prone to skin
A. Remove all soiled linens before starting. breakdown.
B. Position the client on the side of the bed
opposite to the side you are making.
C. The top linens are folded so that a client
can be transferred from a stretcher to
the bed easily.
D. If used, the clean incontinence pad is
placed directly onto the mattress.
MATCHING
Match each term with the correct statement.
16. ____ Closed bed A. ‘Top linens are folded for transferring the client to or from a stretcher
17 Open bed B. Can be raised horizontally to give care
18. _____ Occupied bed = C. A bed made with the client in it
19; ——_ Hospital-bed D. ‘Top linens are pulled up and the bedspread is pulled neatly over the pillow
20. Bottom sheet E. .Must be wrinkle free to prevent skin irritation

CHAPTER 21. Bedsand Bed Making 107
FILL IN THE BLANKS
21. Why is an incontinence pad used on the bed?
22. What is the disadvantage of using an incontinence pad?
23. When making an occupied bed, the client should be covered with a bath blanket to provide
and
24. What are the safety rules about using bumper pads on a crib?
a.
b.
es
d.
LABELLING
25. Arrange, in order, the steps used to make a mitred corner, by writing the letters “A” through “D” on
the line below.

one a
a 7)
CHAPTER 2?
Skin Care and

of Wounds
TRUE OR FALSE When changing a dressing, you

should make sure that the client
Circle T for true, or circle F for false. looks at his or her wound.
4. T F When giving a back massage, 3. When changing a dressing, you
massage the bony areas need to wear gloves only if there is
thoroughly. drainage.
2. T F Clients sitting in a chair should be 9. You should never apply lotion to a

reminded to shift their weight every Bree
hour.
10. A venous ulcer is caused by poor
3. T F When bathing or drying the client, blood return through the veins.
rub vigorously.
11; A skin tear is a very deep cut in the
4. T F To prevent pressure injuries, you een
must frequently check clients who
are incontinent to ensure they are 12. Skin tears commonly occur in the
not lying on wet linens. head and chest.
5. TF When applied, adhesive tape should 13: When oxygen and nutrients get into
circle the entire body part to prevent the cells, skin, and tissues, pressure
swelling. ulcers will occur.
6. T F Make sure you collect all equipment 14. When a client slides down in a bed
needed before you begin to change a or chair, shearing occurs. Blood
nonsterile dressing. vessels and tissues are damaged.
110 CHAPTER 22 Skin Care and Prevention of Wounds
Tbe 71 F In obese clients, pressure injuries can MULTIPLE RESPONSE

. er) . e
develop where skin surfaces press

against each other, causing a decrease
in blood flow. answers.
16. T F Heel protectors reduce pressure on 22. Strategies for preventing skin tears include:
the heels by lowering them. A. Keeping the skin dry and avoiding all
moisturizers or skin softeners
LAs 8 A flotation pad or cushion is placed B. . Offering fluids
in a pillowcase so the pad does not C. Dressing and undressing the client
touch the skin. carefully
D. Dressing the client in soft clothing with
18. T F You should check with the nurse long sleeves and long pants
before using soap on a client who is E. Keeping your fingernails short and
at risk for pressure injuries because smoothly filed
soap can moisturize the skin. es Keeping the client’s fingernails short
and smoothly filed
jie ad eo Skin should be kept clean and dry Not wearing rings with raised or large
and free of moisture from urine, stones
stool, perspiration, and wound coFollowing safety guidelines when lifting
drainage. and transferring clients
— Preventing friction and shearing during
20. -T F When very small amounts of lifting, moving, transferring, and
drainage are expected, a drain is repositioning (e.g., using a transfer
applied to enable the drainage to sheet or pad)
leave the wound. J. Avoiding the use of pillows to support
arms and legs
Py odNe Scabs and scars are complications
K. Being patient and calm when the client
of wound healing that are surgical
resists care
emergencies.
L. Padding bed rails and wheelchair arms,
footrests, and leg supports
M. Providing good lighting to help prevent
the client from bumping into furniture
or walls
23. What are common causes of skin breakdown

and pressure injuries?
A. Pressure
B. Age
C. Friction
D. Shearing

CHAPTER 22 Skin Care and Prevention of Wounds 111
24. You can prevent shearing and friction by: 29. What are the risk factors for the development
A. Using proper lifting, positioning, and of arterial ulcers?
transferring procedures A. High blood pressure
B. Applying a thin layer of powder to the B. Diabetes
bottom sheets C. Poor diet
C. Never raising the head of the bed more D. Aging
than 30 degrees E. Smoking
D. Use a turning pad (or sheet) to move F Osteoporosis
and turn the client in bed
30. When observing a wound’s appearance, what
ZS; Clients at risk for pressure injuries are those should you continue to monitor?
who: A. Ifthe wound is red and swollen
A. Are confined to a bed or chair B. If the area around the wound is warm
B. Require moderate to complete help in to the touch
moving G If sutures, staples, or clips are intact or
Have loss of bowel or bladder control broken
Have fair to good nutrition ID: If wound edges are closed or separated,
Have altered mental awareness’ or if the wound has broken open
Have problems sensing pain or pressure lee If the client has complained of the
Have circulatory problems wound getting itchy at times
Are younger
moO
“TO
Are obese or very thin 31. What are the functions of wound dressings?
A. ‘They protect wounds from injury and
26. Why are pillows and blankets used to prevent microbes.
pressure injuries? B. ‘They absorb drainage.
A. To prevent skin from being in contact C. ‘They remove dead tissue.
with skin D. ‘They promote comfort.
B. To reduce moisture and friction E. They keep the wound warm.
between skin surfaces FE They cover unsightly wounds.
C. To keep the client well hydrated G. They provide a moist environment for
wound healing.
27. Signs that a pressure injury is beginning and H. When bleeding is a problem, pressure
that therefore should be reported include: dressings help control bleeding.
A. Shivering and a drop in body
temperature 32. How should tape be applied to secure a
B. An increase in blood pressure dressing?
C. Pale skin A. Apply tape to the top, middle, and
D. A warm, reddened area bottom of the dressing.
B. Extend the tape several centimetres
28. Common sites for venous ulcers are: beyond each side of the dressing.
A. Lower legs C. Place one piece of adhesive tape across
B. Upper arms the iniddle of the dressing.
me beet
D. Face and neck 33. What types of tape do not cause allergic
reactions?
A. Paper tape
B. Plastic tape

112 CHAPTER 22. Skin Care and Prevention of Wounds
34. If a client has a draining wound, you can 38. Which of the following practices are
help improve the client’s appetite by: intended to prevent skin tears in clients?
A. Covering the wound with an airtight A. Taking daily baths
dressing B. Keeping your fingernails short and
Using room deodorizers as directed smoothly filed
Keeping drainage containers out of the C. Wearing jewellery with large stones
client’s sight D. Wearing a clean uniform daily
OF
U Offering foods that are strongly scented
to mask any odour of wound drainage 39. To prevent pressure injuries, the health care
ee Removing soiled dressings promptly team may place the client on a surface such
from the room as:
A. A firm mattress
3D: How should you remove tape and old B. A foam, air, alternating air, or gel
dressings from a wound? mattress
A. Hold the skin down and gently pull C. Plastic or rubber material
the tape toward the wound. Remove D. Abed board
adhesive from the skin.
B. Lift the dressing very gently, and keep 40. Which of the following measures is helpful
the soiled side of the dressing out of the in preventing pressure injuries?
client’s sight. Position the client at a 45-degree angle.
C. Pull the dressing off as quickly as you B. Reposition the client every 6 hours.
can. C. Massage around bony and reddened
areas.
36. You can assist a client with a wound by: D. Keep the client’s heels on the bed.
A. Allowing pain medications to take effect
before giving care 41. Which of the following measures would help
B. Ensuring the client stays on complete to prevent venous ulcers?
bed rest until the wound is fully healed A. Making sure the client’s clothing fits
C. Carefully observing the wound and tightly
reporting any signs or symptoms of B. Having the client wear elastic stockings
infection immediately as ordered by the doctor
D. Implementing Standard Practices C. Massaging any reddened area over
during all client care pressure points
D. Having the client trim his own toenails
weekly
MULTIPLE CHOICE
Circle the correct answer. 42. Why may pain medication be given before a
dressing change?
OF. Which of the following is a cause of skin To reduce discomfort during the
breakdown? dressing change
A. Good nutrition and hydration B. To prevent the client from looking at
B. Decreased mobility the wound
—C. Increased circulation C. To prevent the client from seeing your
D. A regular exercise program nonverbal responses
D. ‘To prevent contamination of the wound

CHAPTER 22. Skin Care and Prevention of Wounds 113
43. When you are removing an old dressing, it 46. Clients who are in pain are at greater risk for
should be: developing pressure injuries because:
A. Shown to the client They may be more likely to eat and
B. Removed quickly from the wound with drink well
a quick pull B. ‘They cry more and require more
C. Removed so that the soiled side is emotional support
turned away from the client’s sight C. They are less likely to require pain
D. Placed in the client’s garbage can medication
D. They are less likely to move and
44. Movement and ambulation can contribute to reposition themselves
wound healing by:
A. Ensuring the wound dressing stays in 47. Clients with infected and draining wounds
place will require more of which two nutrients?
B. Keeping the client’s skin clean and dry A. Calcium and iron
C. Encouraging better oxygenation of B. Protein and vitamin C
tissue cells C. Potassium and phosphorus
D. Preventing discoloration of the wound D. Vitamins A and D
scar :
45. Which practice is intended to prevent

pressure injuries in the client’s coccyx area?
A. Never trimming the client’s toenails if
the client has diabetes
sm
B. Brushing the client's teeth, flossing
gently, and inspecting the mouth for
food particles
Washing bony prominences with gentle
soap, rinsing, and drying well
Encouraging deep breathing and
helping the client to cough up phlegm

114 CHAPTER 22. Skin Care and Prevention of Wounds
ee inn anna an ARN NOAA A ADD
MATCHING
Match the type of wound with the correct description.
48. Wound containing large amounts of bacteria A. Chronic wound
49. Wound that does not heal easily B. Clean wound
50. Wound created for therapy C. Clean-contaminated wound
ST. Wound resulting from trauma D. Closed wound
aye Wound occurring from surgical entry of the urinary, E. Contaminated wound
reproductive, respiratory, or gastro-intestinal system
53. Wound that is not infected; microbes have not entered FE Dirty (infected) wound
wound
54. Wound in which dermis, epidermis, and subcutaneous G. Full-thickness wound

tissue are penetrated; muscle and bone may be involved
55. Wound with high risk of infection H. Intentional wound
56. Wound in which tissues are injured, but the skin isnot I. Open wound
broken
573 Wound in which skin or mucous membrane is broken ‘J. ~_—Partial-thickness wound
58. Wound in which dermis and epidermis of the skin are | K. Unintentional wound
broken
Match the type of wound drainage with the correct description.
59. Thin, watery drainage that is blood tinged A. Purulent drainage
60. Thick green, yellow, or brown drainage B. Sanguineous drainage
61. Bloody drainage C. Serosanguineous drainage
62. Clear, watery fluid D. Serous drainage
Match the stage of a pressure injury with the correct description.
63. The skin is gone, and underlying tissues are exposed. A. Stage l
64. The skin cracks, blisters, and peels. B. Stage 2
65. Drainage is likely. Ge Stages
66. The colour does not return to the skin when pressure is D. Stage 4
relieved.

Match the stage of a pressure injury with the correct description.
67. Muscle and bone are exposed and damaged. Ae Stage |
68. ‘The skin is red. Bawstage 2
69. There may be a shallow crater. CS Stage3
70. The exposed tissue is damaged. D. Stage 4
Match the phase of wound healing with the correct statement.
a1. Tissue cells multiply to repair the wound. A. Inflammatory phase
2. The scar eventually becomes thin and pale. B. Proliferative phase
a3. Blood supply to the wound increases. C. Maturation phase
FILL IN THE BLANKS
74. What is the purpose of heel elevators?
75. What is the purpose of a drain placed in a wound?
76. Why should you be careful to control nonverbal communication when changing a dressing?
77. How can you assist a person with a wound with the following concerns?
a. Pain and discomfort
b. Nutrition
c. Infection

116 CHAPTER 22 Skin Care and Prevention of Wounds.
LABELLING ° 81. Place an X on four areas where pressure

injuries may form on a person in the sitting
position.
78. Place an X on six areas where pressure
injuries may form on a person lying in the
lateral position.
79. Place an X on six areas where pressure

prone position.
80. Place an X on three areas where pressure

Fowler’s position.

82. Identify the stages of pressure injuries by writing the letter beside each stage number in the correct
order. Describe the tissue damage in each one.
(Courtesy Laurel Wiersma-Bryant, RN, MSN, Clinical Nurse Specialist, Barnes-Jewish Hospital, St. Louis.)
aaeotace,
Deocave mee aoe
x Sets
ab Seow

118 CHAPTER 22 Skin Care and Prevention of Wounds
CROSSWORD PUZZLE
ea
Aeee ie
Aes
ae
el is) ace
ual
|
eB
I 2)
ale
coe
thee
PR hase
a
ee |Tees
Across Down
DB: Pressure injury, bedsore (2 words) 1. Open wound with torn tissues and jagged edges
7s Thick green, yellow, or brown discharge 2 Partial-thickness wound caused by scraping

away or rubbing of the skin
8. Clear, watery drainage
Open wound caused by poor blood return to
3; Disorder that results when there is not the heart from the legs and feet (2 words)
enough blood supply to organs and tissues . Excessive loss of blood in a short period of time
11. Disorder in which there is death of tissue . Separation of wound layers
We Thin, blood-tinged, watery drainage Break in the skin or mucous membranes
Closed wound caused by blow to the body

14. Accident or violent act that injures the skin,
mucous membranes, bones, and internal - Open wound with clean, straight edges;
organs usually intentionally produced with a sharp
instrument
16. Separation of wound along with protrusion
of abdominal organs 13. Break or rip in skin that separates the epidermis
from the underlying tissues (2 words)
15. Collection of blood under the skin and tissues

romoting Client Comfort,
ain Management, and Slee
TRUE OR FALSE F Crying, fussing, and changes in

behaviour are normal in infants
Circle T for true, or circle F for false. and young children.
ee *F Personal items in a client’s space
F Clients from birth to 1 year and
are arranged as the individual clients aged 65 years and over
prefers. will probably need lower room
temperatures.
vi Nee The support worker may throw
away any items in the client’s space
that are in the way. MULTIPLE RESPONSE
Soil’ —F Make sure the client can reach the
telephone, television, and light
answers for each question.
controls.
9. Which of the following are factors that affect
pain:
4.T F Moving furniture or belongings
A Past experience
may be a safety hazard for a client
B. Anxiety
with poor vision.
Ce Nurse pain assessment
Dewle Ff Distraction involves creating an D Support from others
image in the mind. Ey Culture
Is Age
Gaeta EF Older clients are at greater risk
for undetected disease or injury
because they have decreased pain
sensations.
120 CHAPTER 23 Promoting Client Comfort, Pain Management, and Sleep
SASL aANESGH ReS NCMNLeSe eS INL RENATGIRE ME AL UNE RAT LE CIEL GSS ES CT IS DSSUSY OSU IDLSSR Les eS DDSI EOTL SURI ITI AELH A oT ee a eae
10. The nurse needs certain information to assess 15. How long should you wait to perform
the client’s pain. Which of the following procedures after pain medications are given?
questions could you ask to help gather this A. 5 minutes
information for the nurse? B. 10 minutes
A. Where is the pain? C. 30 minutes
B. How bad is the pain on a scale of 1-30? D. 60 minutes
C. When did the pain start?
D. Describe the pain. 16. What should you do if a client expresses an
intention to leave the facility without the
11. Which of the following are safety measures doctor’s permission?
used when the client is receiving strong pain A. Try to talk the client out of it
medication? B. Tell the nurse immediately
A. Keep hospital beds in the lowest C. Call the doctor to get permission
position D. Let the client leave as it is his or her choice
B. Provide assistance when the client is
ambulating 17. If you wish to locate an item in a client's
C. Keep bed rails up closet, you should:
D. Check on the client every 10 to 15 A. Wait until the client is out of the room
minutes to search for it
E. Provide a calm, quiet, darkened B. Tell the client that you must find the
environment item and begin to search
C. Ask the client for permission to look for
12, Which of the following body responses may the item
be signs and symptoms of pain? D. Inform the nurse and have her look for
A. Nausea the item
B. Increased pulse, respirations, and blood
pressure 18. You are admitting a new client. Which of
C. Dry skin these situations should be reported to the
D. Sweating nurse immediately?
E. Vomiting A. ‘The client complains of pain and
appears to be in distress.
B. ‘The client cries and expresses a desire to
MULTIPLE CHOICE go home.
Circle the correct answer. C. The client has difficulty hearing you.
D. Both A and B.
ts The call bell should always be positioned:
A. On the bed rail 19. Mrs. Smith is being admitted to a facility. She
B. Attached to the pillow wants a family member to stay with her during
C. Within the client’s reach the admission process. What should you do?
D. On the arm of the chair A. Tell the family member he or she must
leave
14. What type of pain is felt suddenly from B. Tell the nurse
injury, disease, trauma, or surgery? C. Understand that this is a critical and
A. Chronic pain emotional time for Mrs. Smith and her
B. Severe pain family and let the family member stay
C. Acute pain D. Address all questions to the family
D. Mild pain member because he or she can answer
more quickly than Mrs. Smith can

CHAPTER 23 Promoting Client Comfort, Pain Management, and Sleep 121
20. Which of the following tasks is a support 23. What type of pain occurs when a client
worker's responsibility when a client is being with an amputated leg still feels pain in the
discharged? missing limb?
A. Packing the client’s belongings A. Acute
B. Teaching the client about a new diet B. Chronic
C. Making an appointment with the C. Radiating
doctor for the client D. Phantom
D. ‘Teaching the client about dressing
changes 24. If a client is unable to fall asleep, is unable
to stay asleep, or awakens easily and cannot
21. Which of the following statements about fall back to sleep, the client has which of the
pain is true? following conditions?
A. Pain is easy to measure with objective A. Sleep deprivation
assessments. B. Insomnia
B. Pain is different for each client. C. Sleepwalking
C. Pain means there is no damage to body D Emotional problems
tissue.
D. Moaning signifies severe pain. -
22. Which of the following statements describes

chronic pain?
A. Pain that lasts less than 6 months.
B. Pain that may be constant or occur off
and on
C. Pain that eventually disappears at night
D. Pain that is easily treated with
medication
MATCHING
Match the definition to the term.
Zp. Absence of mental or physical stress A. Guided imagery
26. Directing the client’s attention away from pain B. Distraction
D7 Creating an image in the mind and focusing on it C. Relaxation
Match the comfort factors with the actions that the support worker can take to control these factors.
28. Adjusting the thermostat in the room A. ‘Temperature
PAL) Turning lights down during rest periods Ventilation
30. Emptying bedpans and urinals promptly Noise
31. Opening windows and doors and turning on fans as the client desires Odours
a2, Talking quietly to staff members @)

Sis
Lighting

Match the type ofpain with the correct description.
33. ____ Pain is felt at the site of tissue damage and in nearby areas. A. Acute pain
34. ____ Pain is felt suddenly and lasts a short time. B. Chronic pain
35. ____ Pain is felt in a body part that is no longer there. C. Radiating pain
36. ____ Pain lasts longer than 6 months. D. Phantom pain
Match the average sleep requirements with the correct age group.
37. _____ Newborns (birth to 4 weeks) A. 11-12 hrs
38. ____ Infants (4 weeks to 1 year) B. 10-11 his
59 - loddlers/ipresehoolers (Lito 6 years) C. 7-8 hrs
40. ____ Middle/late childhood (6 to 12 years) D. 14-18 hrs
41. ____ Adolescents (12 to 18 years) E. <7-hes
42. _____—~-Young adults (18 to 40 years) FE 8—9 hts
43. _____ Middle-aged adults (40 to 65 years) G. 5-7 hrs
44. ____ Late adulthood (65 years and older) H. 12-14 hrs
FILLIN THE BLANK

Indicate whether each of the words below is:
A. A behaviour that is a sign or symptom of pain
B. A descriptive word related to pain
AS Aching
ee
46. _____ Throbbing
47. ____ Groaning

48. ___ Restlessness
49 eases Squeezing
50. ____—sWKnnifelike
bt. 2
Dull
52, se eitcitabiliry,
D3. ae
2 Ouietness

CHAPTER 23 Promoting Client Comfort, Pain Management, and Sleep 123
FILL IN THE BLANKS
54. What type of pain is felt suddenly from injury, disease, trauma, or surgery?
55. How do these factors affect pain?

Past experience
Anxiety
Rest and sleep
Attention
Value or meaning of pain
Support from others
Culture
op
ao
mo
roa Age
56. The nurse needs certain information to assess the client’s pain. What are important observations you
should make or questions you can ask that would best assist the nurse?
a. Location
b. Onset and duration
c. Intensity
d. Description
e. Factors causing pain
f. Vital signs
g. Other signs and symptoms
57. Why are older clients at greater risk for undetected disease or injury?
58. The nurse asks you to assist with these measures to control pain. What is done with each one?
a. Distraction
b. Relaxation
c. Guided imagery

59. When a client experiences pain, it cannot be*seen, heard, felt, or smelled. How can you know the
client has pain?
60. What are some ways you may be able to tell that an infant or young child has pain?
61. Ill or injured clients need to rest more often. How can you help them to get the rest needed?
62. What foods or liquids can help a person fall sleep?
63. How do the following factors affect sleep?

a. Illness
b. Nutrition
c. Exercise at bedtime
d. Environment
e. Medications and alcohol
f. Changes and stress
g. Emotional problems
64. What can you do to the client’s room to promote sleep?

a.
b.
e
d.
65. What drinks should be avoided before going to bed?

a
b.
66. List ways that a homelike environment can be provided in a long-term care facility.
ay
b.
e
d.
67. Higher room temperatures will probably be needed by clients in these age groups.
a
b.
68. Why are toilets in some health care facilities higher than standard toilets?
a;
b.

CHAPTER D4
Measuring Height, Weight,

and Vital Signs
TRUE OR FALSE An axillary temperature taken with

a thermometer can take up to 2
Circle T for true, or circle F for false. minutes to register accurately.
le 1s A handheld electronic thermometer 10. The earpieces and diaphragm on a

is stored in a storage box. stethoscope should never be cleaned
with alcohol wipes.
iets Systole is the period of time when
the heart muscle is relaxed. 1M Rhythm and force are characteristics
of a pulse.
LF Bradycardia is a rapid heart rate.
12, You should avoid using your thumb
T oF Blood pressure is normally measured to take a pulse because you could
in the brachial artery. mistake the pulse in your thumb for
the client’s pulse.
T F If you are unsure you have taken an
accurate blood pressure reading, you 13. Blood pressure increases with age, up
should take off the cuff and try again to adulthood.
in 30 to 60 seconds.
14. Women usually have higher blood
ESE The systolic pressure is the lower pressures than men.
pressure.
15. The lower the blood volume, the
iF Respiratory rates vary with age. lower the blood pressure.
(LE A tympanic membrane thermometer 16. Stress decreases blood pressure.

is inserted into the ear to measure
body temperature. We Blood pressure is higher in
overweight people.
126 CHAPTER 24 Measuring Height, Weight, and Vital Signs
18. TF Blood pressure tends to be lower 24. Which of the following factors can affect the
among people of South Asian, pulse rate?
Indigenous, and African descent. Elevated body temperature
Exercise
19. T EF Smoking increases blood pressure. Pain
Position change
20. T F Normal newborn respirations are Caffeine
30-60 respirations/minute. e2)
yada
Sole
2B Medications
21. T EF 25-32 respirations/minute is normal 25. When you are taking a client’s blood
for a healthy adult. pressure, which of the following guidelines
should you follow?
MULTIPLE RESPONSE iN Take blood pressure on an arm with an
IV infusion, cast, or dialysis access site;
From the list below, choose all of the correct an injured arm; or on the side where the
answers. client has had breast surgery.
Let the client rest for 10 to 20 minutes
22. When would you expect vital signs to be
first.
measured? Measure blood pressure with the client
During physical examinations
standing.
When a person is admitted to a facility
Use the correct-sized blood pressure
Once a day for hospital patients
cuff.
Before and after surgery
Apply the cuff over the shirt sleeve.
Before a fall or other injury
Make sure the cuff is snug.
aG)
eer
BE When medications are taken that affect Place the diaphragm of the stethoscope
the respiratory or circulatory system
firmly over the artery.
G. Whenever the client complains of pain,
Have the manometer clearly visible.
dizziness, light-headedness, shortness of
The first sound is the diastolic pressure.
breath, rapid heart rate, or not feeling
well ae
Phy
ie
et Wait 5—10 seconds before repeating the
measurement.
H. As stated in the care plan (usually daily
or weekly)
MULTIPLE CHOICE
23. The temperature should not be taken orally if
the client:
A. Is conscious
26. Why is it important to keep a record of
B. Has had surgery or an injury to the
previous vital signs?
face, neck, nose, or mouth
A. The support worker can prove that they
C. Has a nasogastric tube
were taken.
D. Is delirious, restless, confused, or
B: The doctor or nurse can compare each
disoriented
measurement.
Is paralyzed on one side of the body
Ce The client’s family can check to see if
Has a sore mouth
the care is being given.
Has a convulsive disorder
The support worker can see if the
ays
Is receiving oxygen therapy
readings obtained are accurate
compared with others.

CHAPTER 24 Measuring Height, Weight, and Vital Signs 127
27. When you take the vital signs and they have os When assessing the client’s pulse, which of
changed from a previous measurement, what the following pulse rates should be reported
should you do? to the nurse immediately?
A. Record the results promptly in the Bore
client’s record. Bana0
B. Circle the changes in red. ou
C. Report the changes to the nurse D298
promptly.
D. ‘Take them again in 15 minutes. 32. You are assigned to take the blood pressure of
several clients. Which of these measurements
28. Which of these statements about electronic should you report immediately?
thermometers is not true? A. 140/80
Be The temperature display is easily read. B. 138/90
B. If the probe is broken, the client could Ca ts0/110
swallow mercury. Di 96/70
C. The temperature is rapidly measured.
D. Disposable covers reduce the possibility 33. What best describes a pulse oximeter? It is a
of spreading infection. device that:
A: Measures the client’s pulse and blood
29. If the client is smoking and you need to take pressure
an oral temperature, what should you do? B. Measures the oxygen level in the blood
AS Provide oral hygiene first. and pulse
B Wait 15 minutes to take the Assesses the client’s response to pain
temperature. Measures the pH level of the client's
ee Take a rectal temperature instead. blood
1: Wait 45 minutes to take the
temperature.
30. For how long should you take an irregular

pulse?
A. 30 seconds
B. 2 minutes
C. 5 minutes
D. 1 full minute

MATCHING
Match the parts of the stethoscope as indicated in the diagram.
34. Diaphragm ST. Binaurals
35. Bell 38. Rubber or plastic tubing
36. Earpieces 39. Chest piece

Match the site of the temperature to the normal range for that site.
40. Oral Perens tI, G
41. Axillary Baa tO age
42. Tympanic membrane (G. VoD rsigsente) oohbE
Match the name of the pulse site to where you would find the pulse on the body.
43. Temporal A. Inside the elbows
44. Carotid B. Ankles
45. Brachial C. Top of inner thighs
46. Radial Dee chese
47. Femoral E. Sides of the neck
48. Popliteal Eom tices

K
49. Dorsalis pedis G. Sides of the head
50. Apical H. Wrists

Match the normal pulse ranges with the correct age group.
51. 120 to 160 A. School-age child
52. 75 to 100 B. Toddler
53. 90 to 140 C. Birth to 1 year
54. 60 to 100 D. Adolescent

130 CHAPTER 24 Measuring Height, Weight, and Vital Signs a
PLES Na LLIN NOLAN LAME ata RELENTLESS Ee TI ENS AA TOLD AE LE a OE I eee
Match the definition with the correct term.
55. ‘Taking the apical and radial pulses at the same time A. Respiration
56. Amount of force exerted against the walls of an artery by the blood B. ‘Tachycardia
57. Disorder in which the systolic blood pressure is below 90 mm Hg and C. Apical radial pulse
the diastolic pressure is below 60 mm Hg
58. Instrument used to listen to the sounds produced by the heart, lungs, D. Diastole
and other body organs
59. A slow heart rate; rate is less than 60 beats per minute E. Hypertension
60. Act of breathing air into and out of the lungs E_ Blood pressure
61. Persistent blood pressure measurements above the normal systolic G. Bradycardia
62. Rapid heart rate; rate is over 100 beats per minute H. Systole
63. Period of heart muscle relaxation I. - Hypotension
64. Beat of the heart felt at an artery as a wave of blood passes through J. Pulse
the artery
65. Instrument used to measure blood pressure K. Vital signs
66. Temperature, pulse, respirations, and blood pressure (two words) L. Stethoscope
67. Period of heart muscle contraction M. Sphygmomanometer

FILL IN THE BLANKS

Identify whether the following words are used when discussing:
A. Pulse
B. Blood pressure
68. __—s——séRRadial
69. __—_—s Brradycardia
70. Hypertension
Fl =.
2 Systole
72. ______ Hypotension
Psa. 8?
OF oDiastole
74. ___—_—s Apical
75. Tachycardia
76. For how long is an axillary temperature taken with a thermometer?
77. Why are the earpieces and diaphragm on a stethoscope cleaned with alcohol wipes before and after use?
78. How can you prevent noise when you are using a stethoscope?
79. When you are measuring the pulse, what two characteristics of the pulse should be noted in addition
to the rate?
80. Why do you keep your fingers or stethoscope in place after you count the pulse and while you count
the respirations?

81. How do these factors affect the blood pressure?

Age
Gender
Blood volume
Stress
Pain
Exercise
Weight
Ethnicity
Diet
Medications
Position
aseck
aris
Wont
amie Smoking
5 Alcohol
82. Ifaclient cannot stand up to have his or her height measured, what procedure will help you to gather
this information?
83. Why do you ensure your client has voided before you weigh them?
84. The height or length of a young child is taken from the

to the
85. What is the normal respiratory rate for the following ages?
a. Newborn
b. 10 years
c. 2 years
d. Healthy adult
86. What are some guidelines to follow when measuring a client’s blood pressure?
eo
ao
Pp

LABELLING
87. Fill in the following drawings so that the dials show the correct blood pressures.
a. 168/102
b. 104/68
88. Fill in the following drawings so that the mercury columns show the correct blood pressure.
aa 2/80
b. 198/110
120
110
100
80
60
40

CROSSWORD
Popols ale ae a ee a
he
bed
= are
Se te tee eee
eet aE
Across 12. Persistent blood pressure measurements

above the normal systolic (140 mm Hg) or
2. Taking the apical and radial pulses at the diastolic (90 mm Hg) pressures
same time (3 words) 13. Rapid heart rate; heart rate is over 100 beats
5. Amount of force exerted against the walls of per minute
an artery by the blood (2 words)
6. Disorder in which the systolic blood pressure Down
is below 90 mm Hg and the diastolic
pressure is below 60 mm Hg 1. Period of heart muscle relaxation
8. Instrument used to listen to the sounds 3. Beat of the heart felt at an artery as a wave of
produced by the heart, lungs, and other body blood passes through the artery
organs 4. Instrument used to measure blood pressure
9. A slow heart rate; rate is less than 60 beats 7. ‘Temperature, pulse, respirations, and blood
per minute pressure (2 words)
10. Act of breathing air into and out of the lungs 11. Period of heart muscle contraction

CHAPTER
MULTIPLE CHOICE 5. Blue colour or condition:

; , A. Cyonosis
Circle the word in each group that is spelled B. Cyinosis
correctly. C. Cyanosis
1. Slow heart rate: D. Cianosys
A. Bradecardia 6. Opening into the trachea:
Y B. Bradycardia A. ‘Tracheastomy
C. Bradacordia B. Trachiostomy
D. Bradicardia C. Tracheostome
2. Difficulty urinating: eit OUy)

A. Dysuria 7. Pain in a nerve:
B. Dysurya A. Neuralgia
Gr Dysuira B. Neuroalgia
D. Disuria C. Nourealgia
D. Neurilegi
Sele
3. Paralysis on one side of the body:
A. Hemyplegia 8. Examination of a joint with a scope:
B. Hemaplegia A. Arthoscope
C. Hemoplega B. Arthroscopy
D. Hemiplegia C. Arethroscopy
; D. Artheroscope
4. Opening into the ileum:
A. Illeostomy 9. Rapid breathing:
B. Ileostomy A. ‘Tachepnea
C. Ileastoma B. Tachypinea
D. Illiostomy C. ‘Tachypnea
D. ‘Tachypnia
136 CHAPTER 25 Medical Terminology
10. Removal of the gallbladder: ‘

A. Cholecystectomy
B. Cholcystectomy
C. Cholicystetomy
D. Cholecistectomy
MATCHING
Match the word with the correct definition.
11. Neuralgia A. Painful or difficult urination
12. Gastrostomy B. Inflammation of the kidneys
13. Cholecystectomy C. Bluish colour
14. Dysuria D. Caused by bacteria
15. Gastritis E. Study of the skin
16. Enteritis F Incision into large intestine
17. Bacteriogenic G. Instrument used to examine bronchi
18. Glossitis H. Inflammation of the tongue
19. Cyanotic I. Nerve pain
20. Dermatology Examination of the rectum with an instrument
21. Oophorectomy Excision (removal) of the gallbladder
22. Colostomy L. Excision (removal) of an ovary
23. Nephritis M. Incision into the stomach
24. Bronchoscope N. Inflammation of the stomach
25. Proctoscopy O. Inflammation of the intestine

i CHAPTER 25. Medical Terminology 137
Match the prefix with the definition.
20: ___—_ auto- A. Around
of. -*
_ brady: B. White
28. circum- Ce Self
29. ____—dys- D. Large
BO... _—_ecto- E. Outer, outside
ae lenk- FE Slow
Bo; Smacro- G. Above, over
ao.“ neo- sk (Osi
34. ____supra- I. New
o5.6.— uni- J. Difficult, abnormal
Match each root word with the correct definition.
36. ___aden(o) A. Bronchus, bronchi
Be eenpi(c) Jeevan
38. —_ bronch(o) C. Women
39. ____crani(o) D. Spinal cord, bone marro
40. ____ duoden(o) E. Pus
A1..« = énter(o) E Gland
42. ___ gynec(o) G. Mammary gland, breast
43. ___ mast(o) H. Intestines
44, ___ myel(o) I. Skull
45. ___py(o) tee Vessel

Match each suffix with the correct definition.
46. ___-asis A. ‘Tumour
47. ____-genic B. Falling, sagging, dropping, down
48. ___—-ism C. Enlargement
49. _____—-oma D. Paralysis
50, 22) -phasia E, Examination using a scope
51. ____-ptosis FE Condition, usually abnormal
2.) = .-plegia G. Maintenance, maintaining a constant level
53. ____-megaly H. A disorder
54. ____-scopy I. Speaking
Die =stasis J. Producing, causing
Match the following phrases or terms with the correct abbreviation.
56. ____ Abdomen Naben ts
ba ee Dctore: meals Ba dic
58. ____ After meals C. OB
Doe ee With De= pe
60. _—S— Cancer E. ROM
61. ___ Discontinue ECs
62. _____ Lower left quadrant G. abd
63. ____ Every day EVSLLO
64. ____ Range of motion EPesc

CHAPTER 25 Medical Terminology 139
Match the following abbreviations with the correct word.
2S i Weight
nas 2) =. ain, D: Twice a day
67.5 HO US Nothing by mouth
Gd. swt 1): Height
Bon. a ht iB Three times a day
70. _' » wie es) Complete bed res
mies —* \stat Wheelchair
as sO, coWithout
eau C — Centigrade
75. __i.
__ bid Every night at bedtime
fae we CBR Cardiopulmonary resuscitation
aoe NPO Morning
77. pares = pir When necessary
pt heals
8 Right lower quadrant
7920. ROM SOA

eeAt once, immediately
30.) = RLO ro Four times a day
Ghee te SOB Left lower quadrant
Bee ee tid ©
oeWater
S35 3 gid Shortness of breath
Gane CPR Oxygen
iy a HO) Vital signs
86. VS aSaat
Range of motion

140 CHAPTER 25. Medical Terminology.
Match the following terms with the correct defthition.
87. ___ Hepatomegaly aX Incision into the abdomen
88. ____ Hemiplegia B. Disease of the nervous system
89. Cholecystectomy Excessive urination
90. Laparotomy Deficiency of red blood cells
91. ___ Bradycardia ae. Slow

Sa heart rate
92. ____ Neuropathy 7 Enlarged live
93. ____ Tachypnea Excision (removal) of the gallbladder
94. ____ Polyuria White blood cell
95. ____ Pyorrhea — A disease of the brai
96. ____Erythrocytopenia Discharge of pus
97. ie Leukocyte Paralysis of one side of the body
98. ____ Bronchoscopy Rapid breathing
99. ____ Encephalopathy M. Inflammation of the mouth
100. Stomatitis Examination of the bronchi using a scope

CHAPTER 25 Medical Terminology 141
WORD SEARCH
For questions 101 to 113, write the correct term 112. abd
next to each abbreviation given. For questions
114 to 125, write the correct abbreviation next to a Pe post op
the term given. Then find the answers (words and
abbreviations) in the following word search puzzle. 114. Twice a day
101. S iALbe Complete bed rest
- am 116. Nothing by mouth
17: When necessary
118. Every night at bedtime
119. Range of motion
120. Right lower quadrant
124. Shortness of breath
122; Three times a day
123. Four times a day
124. Left lower quadrant
125. Vital signs
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@) Po A
OO ts
he
Ce ae I Wy les
®)
Oe
lente
ah
olen
Amelies!
ev me
oO
aon
eS
See
Oe
< Zi
Fda
GARG)
tte

USING WORD ELEMENTS

The following words are made up ofprefixes, root words, and suffixes. Identify each ofthe word elements
using one of these methods:
Circle the prefixes in black, the root words in red, and the suffixes in blue.
OR
Highlight the prefixes in yellow, the root words in pink, and the suffixes in blue.
In the space following each word, define the word.
126. Hepatomegaly
W227. Hemiplegia
128. Cholecystectomy
129. Laparotomy
130. Bradycardia
131. Neuropathy
132. Tachypnea
133. Polyuria
134. Pyorrhea
135. Dysphagia
136. Erythrocytopenia
137. Leukocyte
138. Bronchoscopy
139. Encephalopathy
140. Stomatitis

CHAPTER 26
Planning, Reporting, and

Recording Client Care
TRUE OR FALSE Document what you or others did or

observed.
The following statements apply to rules for
recording. Circle Tfor true, or circle F for false. Document all care and treatments
early in the shift before beginning
1. TF Document in pencil. work.
2. TF Include the date whenever a new 11. Document your observations,

entry is made. interpretations, and judgements.
3. TF Inwritten notes, all writing must be 2s Document in a logical and
legible and neat. sequential manner.
4. T F Use any abbreviations needed to 13. Avoid terms with more than one
shorten an entry. meaning.
5. TF Use correct spelling, grammar, and 14. Paraphrase the client’s words to make
punctuation. the meaning more understandable.
6. T F_ For written documentation, use an ier Document any changes from normal
eraser or correction fluid if you make or changes in the client’s condition.
an error.
16. Repeated complaints of pain can be
7. TF Sign all entries with your name and omitted when documenting.
title as required by your agency.
17. Document safety measures used in
8. TF Skip lines between recorded entries. caring for the client.
144 CHAPTER 26 _ Planning, Reporting, and Recording Client Care
(Herd e F Objective data are things a client 24. What observations and assessments will help
reports that you cannot observe or to determine whether a client is moving
gather by using your senses. appropriately?
A. The client can squeeze your fingers with
19s eE F Subjective data are pieces of each hand.
information you can obtain about a B. The client can move his or her arms and
client by using your senses. legs.
C. The client’s movements are shaky or
20. T F When you document in the chart, jerky.
you sign your name and write your D. The client can ambulate without
title as per agency policy after each assistance.
entry.
pes What observations and assessments should
be made about a client’s respirations?
MULTIPLE RESPONSE
A. Do both sides of the client's chest rise
From the list below, choose all of the correct and fall with respirations?
answers. B. Is the client’s breathing noisy?
C. Does the client complain of difficulty
21. What are the four senses you use to obtain breathing?
information about a client? D. Does the client complain of gas?
Smell E. What is the amount and colour of
Hearing sputum?
Touch E What is the frequency of the client's
Instinct cough? Is it dry or productive?
ae
SOSight
26. What observations and assessments should
22. Which of the following basic observations be made about the skin?
will give you information about a client? Is the skin pale or flushed?
ADLs Is the skin moist or dry?
Appetite Is the skin intact?
Pain Are bruises present? Where?
Respirations Is the abdomen firm or soft?
Skin condition >amo
Ow Does the client complain of itching?
mm
OO Ability to respond
Lhe What observations and assessments are
23. What basic observations and assessments can important for determining how the bowels
you make to determine a client’s ability to and bladder are functioning?
respond? ie Amount, colour, and consistency of
1G The client can state his or her name, the stool
time, and the location. Colour of the lips and nail beds
The client can speak clearly. Frequency of bowel movements
The client can follow directions. Pain or difficulty urinating
The family can answer questions. Client’s control of the passage of urine
The client is easy to rouse. ommo Frequency of urination
mmo The client responds correctly to
questions.

CHAPTER 26 _ Planning, Reporting, and Recording Client Care 145
28. When reporting to the nurse, you should do 31. Which of these is a question about an
which of the following? activity of daily living?
A. Report what you observed and did A. Can the client perform personal care
yourself without help?
B. Report what other support workers did B. How much food on the tray did the
C. Report any changes in the client’s client eat?
condition. C. What is the frequency of the client’s
D. Report promptly, thoroughly, and bowel movements?
accurately D. Can the client move his or her arms and
E. Report only at the end of your shift legs?
32. When should the support worker contact the

MULTIPLE CHOICE supervisor?
Circle the correct answer. A. When the pharmacy delivers the client’s
medications to the house
29. What information is included on the graphic B. When you believe the client’s safety is at
sheet? risk
A. Bowel sounds C. ‘The support worker should provide the
B. Temperature, pulse, and respirations supervisor with hourly updates
C. Complaints of pain D. After completion of a procedure
D. Amount of food consumed
30. What statement about electronic

, documentation is correct?
A. You are able to use all types of
abbreviations.
B. All spelling errors are automatically
corrected.
In general, staff can take electronic
tablets home to document on their own
time.
It requires individual entries using a
personal identification number (PIN) or
code.

MATCHING
Match the following descriptions with one of the key terms related to communication.
33. Identification of a disease or condition by a doctor A. Client care plan
34. Determining whether the goals in the care plan have been met _—B. ~—-Nursing diagnosis
35. Description of a health problem that can be treated by nursing C. Nursing intervention
measures
36. Written guide that gives direction about the care and services _D. Care planning process
a client should receive
ze Method used by nurses to plan and deliver nursing care E. Medical diagnosis
38. Action taken by a nursing team member to help the client FE Evaluation
reach a goal

CHAPTER 26 Planning, Reporting, and Recording Client Care 147
Match the following time with the corresponding time using the 24-hour clock.
NO.) ee 8-45.41. A. 0030h
40. ss 4:00 p.m. B. 2400 or 0000 hr
41. ___si11:59 p.m. @ B2200hr
2 es 12230 a.m. D. 0630hr
Sees) 0'p.m. E1930:
44, ____—smidnight Pee 530shc
Ayo 6:50 a.m. G. 0845 hr
46. ____—s«i10:00 p.m. ee 3oi
a7 8 l230'p.m: I. 1445 hr
48. 750 p.m. J2) 1530ehe
AD te 23:30 p.m. Ke -2:150-hr
eee 241). L. 1600 hr

FILL IN THE BLANKS

The following words or phrases are either subjective (S) or objective (O) data. Fill in the blank with
either an S or an O.
Dees Sleepy,
2] 2 Chest pain
bo. = \Cool’skin
54. ___ Bruises
55. ______ Difficulty breathing
56, _2 Gas pain
57. ______ Pain when urinating
58. ___ Productive cough
59. ___ Breath has a fruity odour
60. ____ Rapid pulse and shallow breathing
61. _____ Mr. Khan states that he is cold
62. __ Mary has red hair
63. _____ Mrs. Smith says she has pain in her right shoulder
64. ______—s Temperature 37.6°C (99.6°F), pulse 72, respirations 16
65. _____ Mr. Kallio ate all of his breakfast
66. _____ Mrs. Foster says she is anxious about having surgery
67. Identify the meaning of each word in the SMART acronym for use when setting goals:
S=

CHAPTER
TRUE OR FALSE There are four calories in 1 g of

carbohydrate.
10. One gram of fat contains nine
1. TF the body becomes swollen if too calories.
much sugar is retained.
Ts One gram of protein contains five
2, T F Whena healthy client eats more calories.
sodium than the body needs, it will
be excreted. 12. Chopped foods may be added to an
infant’s diet at about 5 months of
3. T F Aclient with diabetes will retain salt age.
in the body.
13; Clients from India generally do not
4. T F When a client has diabetes, sugar eat beef.
builds up in the bloodstream.
14. Clients who must eat in bed
5. T F When aclient is placed on a diabetic should be positioned in the supine
diet, only three meals each day are position.
allowed.
15. A decrease in saliva may cause
6. T F_ Aclient ona clear-liquid diet difficulty swallowing.
is allowed water, gelatin, and
popsicles. 16. Decreased peristalsis results in
slower emptying of the stomach
7. TF Acdlient who has constipation may and colon, causing flatulence and
be helped by a high-fibre diet. constipation.
8. T F Many special diets involve a7, Cooked fruits and vegetables may be
between-meal nourishments such eaten to prevent constipation.
as crackers and milk.
150 CHAPTER 27. Nutrition and Fluids
18. F Too much sodium in the diet causes MULTIPLE RESPONSE

° . . Ld
the body to retain more water.

19. F When aclient is on a sodium- answers.
restricted diet, the only food group

without restrictions is fruits and 29; Which of the following dietary guidelines are
vegetables.
recommended for healthy eating?
A. Select dietary choices only from one
20. F Clients with diabetes must eat at food group.
regular times to maintain their B. Emphasize cereals, breads, other grain
cholesterol levels. products, vegetables, and fruit.
CG. Choose higher-fat dairy products, leaner
Zt. F When a client has dysphagia, the meats, and foods prepared with little or
care plan might indicate that he is on no fat.
a puréed diet. 1D, Participate in regular physical activity
and healthy eating.
22. F The daily minimum amount of Is Limit salt, alcohol, and caffeine.
water required for an adult to survive
is 800 mL. 30. In what ways, other than positioning, can
you help clients to get ready for meals?
aS. F To maintain normal fluid balance, a AN Assist with elimination and hand
client needs 2000—2500 mL of fluids hygiene.
each day. B. Change clothing and provide clean
linens if necessary.
24. F An older client should increase @. Be sure dentures, eyeglasses, and
calorie intake, as more calories are hearing aids are in place.
needed as we age. D. Decide their menu choices.
Be Make the setting attractive.
23. F An older client should increase fluid
intake to aid in digestion, kidney BAe Which of the following actions are important
function, chewing, and swallowing. for safety and comfort when feeding a client?
Provide a relaxed mood.
26. F_ An older client should increase
Provide time and privacy to pray.
protein intake for tissue growth and
Use a fork to feed the client.
repair.
Offer larger portions.
Offer fluids during the meal.
LT F An older client should decrease soft
Engage the client in conversation.
bulk to prevent constipation.
Stand while you are feeding the client.
28. F An older client should decrease Op
mmo
Te Encourage the client to feed herself.
intake of fried, fatty foods as these
are hard to digest.

CHAPTER 27 _ Nutrition and Fluids 151
a me ht NN AN nN MS Me SAOE AON ADSL LLE AN SALSA LEONE EEE LEAL TLE
a2. Which of the following are common causes 37. Which of these foods would be included as
of dehydration? liquid intake?
Adequate fluid intake A. Spaghetti sauce
Vomiting B. Yogurt
Diarrhea C. Cottage cheese
Bleeding D. Beef stew
Excess sweating
le
plho
yet. Decreased urine production 38. Which of the following statements describes
assistive dining?
33. Which of the following food categories is A. One client is fed by one support worker
included in the plate snapshot of the 2019 to reduce stimulation.
Canada’s Dietary Guidelines? B. Food is placed on platters or dishes, and
A. Fibre products the clients serve themselves.
B. Vegetables and fruit C. Clients are served food at the table as in
C. Sugar and other sweets a restaurant.
D. Milk products D. Four clients are seated at a horseshoe-
E. Meat and alternatives shaped table and are fed by one support
worker.
MULTIPLE CHOICE Use the following conversion table to answer

Circle the correct answer. questions 39 to 46.
loz = 30mL (cc)
34. Why are carbohydrates important in the 1 cup = 250mL (cc)
diet? 1 quart = 1 000mL (cc) or 1 litre
A. ‘They supply products for tissue growth lce = 1mL
and repair.
B. ‘They provide energy and bulk for bowel 39. A 6-oz cup of coffee = how many mL?
elimination. A. 160mL
C. They provide energy and flavour. B. 180mL
D. They supply vitamins that are needed Creal 0 mE
daily. D200 mE
35. What can you give a client who has an order 40. 80z of milk = how many mL?
for NPO? A. 200mL
A. Unlimited fluids B. 260mL
B. No food or fluids Gy 240 mi
C. Small amounts of fluids D230 mE
D. Only clear liquids
41. 1 quart of water = how many mL?
What effect may cultural and religious beliefs A L000 mE
36.
have on nutrition? B. 900mL
A. Certain types of food may be restricted. Ca 0207nk
B. Methods of preparation may be part of De LOL0mL
beliefs.
42. 2 cups of tea = how many mL?
C. Certain foods are eaten, and others are
A. 400mL
avoided. B. 440mL
D. All of the above may be part of
C. 460mL
beliefs. D. 500mL

43. 40z of gelatin = how many mL? 45. 120z of broth = how many mL?
Ao LOO A. 340mL
Bee 20 me B. 380mL
Ce 130ml Cc. 360mE
D. 140mL Ds. 320mL
44. 5oz of orange juice = how many mL? 46. A half-cup of sherbet = how many mL?
ees 5 Omr A. 100mL
Dae toms B. 110mL
C21 70mbE Gei12amb
D. 140mL Dy. 130 mE
MATCHING
Match the nutrient with the reason it is important to good health.
47. Needed for tooth and bone formation A. Protein
48. Needed for tissue growth and repair B. Carbohydrates
49. Provides energy and adds flavour CP alate
50. Provides energy and fibre for elimination D. Vitamins
BA; Does not provide calories but is needed for E. Minerals

certain body functions

CHAPTER 27 Nutrition and Fluids 153
Match the correct vitamin with its major function.
Py Healthy eyes, healthy skin and mucous membranes, protein Vitamin A

and carbohydrate metabolism
53. Formation of substances that hold tissues together Thiamine
54. Formation of red blood cells, nervous system functioning Riboflavin
55. Blood clotting Niacin
56. Normal reproduction Vitamin By,
D7. Growth, vision, healthy hair and skin es) Folic acid
58. Muscle tone, nerve function, digestion Ascorbic acid
Bo. Protein, fat, and carbohydrate metabolism cfVitamin D
60. Formation of red blood cells, functioning of intestine — Vitamin E
61. Absorption and metabolism of calcium and phosphorus, Vitamin K

healthy bones
Match the correct mineral with its major function.
62. Formation of bone and teeth; use of protein, fats, and Calcium
carbohydrates
63. Thyroid gland function, growth, metabolism Phosphorus
64. Fluid balance, nerve function, muscle function Iron
65. Formation of bone and teeth, blood clotting, muscle Iodine

contraction
66. Enabling red blood cells to carry oxygen Sodium
67. Nerve function, muscle contraction, heart function Potassium

Match each of the following situations with the appropriate special diet.
68. ______ First diet most clients can tolerate after surgery A. High-protein
69. _____ Constipation and colon disorders B. Fat-controlled/low-cholesterol
70. _____ Weight gain and certain thyroid imbalances C. Clear-liquid
71. _____ Heart disease, gallbladder disease D. High-calorie
72. _____ Burns, high fever, infection E. |High-fibre
Match each of the following food items to the correct food group.
Toa ee a Grackers A. Vegetables and fruit
74. ____ Kidney beans B. Grain products
73 2 Potatoes C. Meat and alternatives
76. ____ Ice milk D. Milk products
Temes” Chocolate bar E. Other foods
Match each of the following food items to the correct food group.
78. _____ Pineapple chunks A. Vegetables and fruit
79 Ss Peanut butter B. Grain products
80. __—— Oatmeal C. Meat and alternatives
81. __ Butter tart D. Milk products
O22) 2 Sour-cteam E. Other foods
FILL IN THE BLANKS
83. According to Canadas Dietary Guidelines, what proportion of the plate is recommended to make up
the protein component of each meal?
84. Ifan older client must avoid high-fibre foods, what foods may be eaten to prevent constipation?

CHAPTER 27. NutritionandFluids 155
85. Why are the following actions important for safety and comfort when feeding a client?
a. Provide a relaxed mood
b. Provide time and privacy to pray
c. Use spoon to feed
d. Offer small portions (spoon that is 1/3 tsp full)
e. Offer fluids during meal
f. Engage in conversation
g. Sit so you face client
h. Encourage the client to feed himself or herself
86. Should an older client increase or decrease these dietary elements? Why?
a. Calories
Why?
b. Fluids
Why?
c. Protein
Why?
d. Soft bulk
Why?
e. Fried, fatty foods
Why?

156 CHAPTER 27_ Nutrition and Fluids
LABELLING
87. Label the following plate with numbers so that you could describe the location of food to a client
who is blind.
a. Where would you tell the client to find the meat

b. Where would you tell the client to find the baked potato?

CHAPTER
Enteral Nutrition and

Intravenous Therapy
TRUE OR FALSE yf You should clean the client’s nose

and nostrils around the feeding tube
Circle T for true, or circle F for false. every 4 to 8hours.
1. T F Duringa scheduled tube feeding, 8. Support workers are responsible for

400 mL (13.5 fluid oz) is usually maintaining IV therapy.
given over 20 minutes.
: Notify your supervisor immediately
2. TF Formula for feeding tubes should be if there is any leaking of fluid from
heated. the IV site.
3. TF The risk of regurgitation is less with 10. Clients should be sitting or in the
nasointestinal tubes than with other semi-Fowler’s position during tube
types of tubes. feedings.
4. T F Mouth care is not important when 11. Scheduled enteral feedings are
clients are NPO. usually given four times a day.
5. T F An intravenous (IV) site on the back 12: Continuous enteral feedings require
of the hand is in a central venous an electric feeding pump.
site.
13. When a client is receiving an enteral
6. T F Support workers should check the feeding, he or she is in a supine
placement of the feeding tube before position for at least 1-2 hours.
each feeding.
158 CHAPTER 28 _ Enteral Nutrition and Intravenous Therapy
ae en SN Se edn GO TCT ae nn
sien
14. TF Frequent oral care can help a client 19. What should be reported to the nurse if the
with a feeding tube feel more client is receiving a tube feeding?
comfortable. Nausea or vomiting
Discomfort during the tube feeding
15. T FE The left-side-lying position Diarrhea
should be avoided when a client is Distended abdomen
receiving enteral nutrition as this Coughing
position prevents the stomach from Complaints of indigestion or heartburn
emptying. Redness, swelling, drainage, odour, or
pain at the ostomy site
Normal temperature
MULTIPLE RESPONSE
clare
siren)
eG) Signs and symptoms of respiratory
From the list below, choose all of the correct distress
answers. iP Complaints of flatulence
16. What conditions may require a client to have 20. A client may receive IV therapy to:
a feeding tube? Receive fluids
A. Cancers of the head, neck, and Receive minerals and vitamins
esophagus Receive sugar for energy
B. Coma Receive blood
C. Dysphagia caused by paralysis Receive oral medications
D. ‘Trauma or surgery to the face, head, Receive hyperalimentation (a solution
mouth, or neck highly concentrated with nutrients)
E. Dementia
Z1; What safety measures must be followed when
17. What can cause the feeding tube to move? the client has an IV?
Coughing 70 Follow Standard Practices.
Sneezing D. Move the needle or catheter if the IV is
Vomiting not running.
Talking & Follow the safety measures for restraints
Suctioning if the nurse restrains the extremity to
ee
viel
te)
splice
Poor positioning prevent the needle or catheter from
moving.
18. When you care for a client with a feeding Protect the IV bag, tubing, and needle
tube at home, which of the following is the or catheter when ambulating the client.
support worker allowed to do? Assist the client with turning and
Insert feeding tubes repositioning.
Test the position of the tube Move the bag to the side of the bed
Give the first dose of a tube feeding on which the client is lying, allowing
Pour formula into a feeding bag enough slack in the tubing.
>mAOOWStart feed after placement of tube has Notify your supervisor immediately if
been verified by the nurse bleeding occurs from the insertion site.
Notify your supervisor immediately
if you notice signs or symptoms of
complications.

CHAPTER 28 Enteral Nutrition and Intravenous Therapy 159
Z2. What signs and symptoms indicate that there 2. What responsibility does the support worker
is a problem with an IV site? have if a client is being fed through a tube?
A. Bleeding A. Removing the tube after each feeding
B. Puffiness or swelling B. Giving clear liquids by mouth
C. Pale or reddened skin C. Assisting the nurse in giving feedings
D. Complaints of pain at or above the IV D. Avoiding giving mouth care
site
E. Hot or cold skin near the site 26. Clients who cannot chew or swallow often
receive nutrition by:
5% What signs and symptoms indicate that there A. Enteral nutrition
is a systemic problem with an IV? B. IV feedings
Fever C. A liquid diet
Itching D. A puréed diet
Drop in blood pressure
Bradycardia His Support workers are responsible for:
Regular pulse A. Inserting feeding tubes
Pink skin B. ‘Testing the position of the tube
Changes in mental function C. Giving the first dose of a tube feeding
Loss of consciousness D. Providing personal care to the client
Difficulty breathing
Increasing urine output 28. Physicians order IV therapy to:
Chest pain A. Replace minerals and vitamins lost due
ess Nausea
s)
ciel
alin
Pabst to illness
B. Administer medications
C. Administer blood
MULTIPLE CHOICE D. Do all of the above
ys A sign of an IV therapy complication is:
24. Which of the following describes a A. Vomiting
gastrostomy tube? B. Swelling around the site
A. A tube is inserted through a surgical C. Indigestion
opening into the stomach. D. Diarrhea
B. A tube is inserted through the nose and
into the stomach.
C. An opening is made into the middle
part of the small intestine.
D. A tube is inserted through the nose and
into the duodenum.

160 CHAPTER 28_ Enteral Nutrition and Intravenous Therapy
MATCHING
Match the type offeeding tube with the correct gastrointestinal tract route.
30. _ Gastrostomy tube A. ‘Through the nose into the stomach
ots Percutaneous endoscopic gastrostomy B. Through the nose into the small intestine
(PEG) tube
o2; Jejunostomy tube C. Into the stomach through a surgically created

opening
33. Nasointestinal tube D. Into the intestines through a surgically created

opening
34. Nasogastric tube E. Into the stomach through a surgically created

opening; an endoscope is fed through the
mouth and into the stomach
You may care for clients who have IVs in different sites. Match the site where each of these IVs would be
inserted.
35. Peripheral A. In the subclavian vein or the internal jugular

vein
36. Scalp B. In the cephalic or basilic veins in the arm
B76 Central venous sites C. On the back of the hand, in the forearm, or in
the crease of the elbow
38. Peripherally inserted central catheter D. On the head

(PICC)
FILL IN THE BLANKS
39. How do these measures help clients with feeding tubes feel more comfortable?
a. Hard candy or gum
b. Lubricant for lips
c. Cleaning of nose and nostrils every 4 to 8 hours
d. Frequent oral hygiene

CHAPTER 28 _ Enteral Nutrition and Intravenous Therapy 161
40. What are four signs of aspiration in a client that need to be attended to immediately?
a
b
G
d

ben
ae I .a
- - 1S
;
aed
i
viltata
_
Marais patties 0Leleseny enc:

|
iid
=o -@
eS ie
7 ir ee
~
|
—_ ae
bs seg vhs
CHAPTER
Urinary Elimination
TRUE OR FALSE Fig When you collect a urine specimen,

? ou should tell the client not to have
Circle T for true, or circle F forfalse. ;bowel movement or place toilet
1. T F When assisting with normal BSMp: hh ligageiatngn
elimination, you should practise 8. The specimen container and
surgical asepsis and Standard requisition slip are taken to the
. Practices. laboratory in a plastic cup.
2. TF Normal elimination is easier if a 9. An adult normally produces
man can stand or a woman can sit or 2 500 mL of urine every day.
squat.
10. A urinal has a hooked handle so it
3. TF Ifaclient has osteoporosis, pain in can be passed easily to the client.
the joints from arthritis, or a hip
replacement, a regular bedpan will 11. When you leave a client alone to
be the most comfortable. void, you should place the call bell
and toilet tissue within reach.
4. TF Incontinence is a common reason
for seeking long-term care for a 12: After a client has voided, you should
family member. provide perineal care as needed
and have the client wash his or her
5. T F When collecting a specimen to check Ponda
for a urine infection, you can use any
nonsterile container. 13. You wear gloves when emptying a
bedpan or urinal to avoid contact
6. T F A specimen container must be with utineorstool.
labelled with the client’s initials,
room, date, and time. 14. If a urinary drainage bag is lower
than the bladder, urine can flow
back into the client’s bladder and an
infection can develop.
164 CHAPTER 29 _ Urinary Elimination
15. Adhesive tape should never be 23. How can you promote relaxation and not
used to secure a condom catheter rush a client who is voiding?
because this type of tape does not v3 Have the client practise meditation
stretch and may cause restricted while voiding
blood flow to the penis. B. Talk to the client to provide some
diversion
16. Another name for urinary stones is G Offer the person something to read
calculi. 1B), Allow the person enough time to void
17. The goal of bladder training is 24. What measures can you take to help clients
voluntary control of urination. with urinary incontinence?
way Answer all calls for assistance promptly
18. When collecting a midstream urine Be Encourage urination at scheduled
specimen, you pass the specimen intervals
container into the urine stream (or G. Follow the client’s bladder training
flow) at any point during urination. program
Encourage the client to wear clothing
19. To prevent the growth of
with zippers and laces
microorganisms, place a 24-hour
Encourage the client to do pelvic
urine specimen on ice or ina
muscle exercises, as directed by the care
refrigerator. plan
Decrease fluid intake before bedtime
20. Urine is strained to see if it contains
Provide good skin care once a day
crystals.
Provide dry garments and linens
Observe for signs of skin breakdown.
MULTIPLE RESPONSE ashesUse incontinence products as directed
Sohne
by the care plan.
answers.
25. Urinary tract infections can sometimes be
21. Who may use a fracture (bed) pan? prevented by:

A. Providing adequate food for the client
A. Clients in casts
to eat
B. Clients who do not like to walk to the
B. Encouraging the client to add bath oil
toilet
to the tub bath
C. Clients with casts on their ankles
C. Instructing the client to wear cotton
D. Clients with limited back movement
E. Clients with fragile bones or painful
undergarments
joints D. Providing perineal care as needed
F Clients who have recently fractured a hip
26, What disorders and other conditions may
cause urinary incontinence?
DPA If a client is embarrassed about voiding with
others close by, what can be done to mask Urinary tract infections
the sounds? Menopause
A. Run some water in a nearby tap Nervous system disorders
B. Move the client to another floor or Bladder cancer
ward Diabetes
C. Flush the toilet OO
Hearing impairment
D. Play music nearby

CHAPTER 29 Urinary Elimination 165
27. Causes of urinary incontinence include: 31. The urinary drainage bag should be:
A. A weakened pelvic floor A. Secured to a bed rail
B. An enlarged prostate B. Positioned below the level of the
C. Some medications bladder at all times
D. Immobility C. Placed carefully to drain on the floor
E. The use of restraints D. Disinfected daily using bleach
F Unanswered calls for help
G. Confusion 2. When a client is having a 24-hour urine
H. Certain surgeries specimen collected, what should you do with
the first voiding?
28. What complications can occur when a client A. Discard it
has incontinence? B. Send it to the laboratory
A. Skin irritation C. Place it in the large container used for
B. Confusion saving the urine
C. Skin breakdown D. Test it for sugar and ketones
D. Infection
33. Which of these actions would be most
MULTIPLE CHOICE helpful in getting a client to void?
Circle the correct answer. Offering to hold the urinal for the client
while he is voiding
29. Why is voiding in a bedside commode easier B. Running water in the sink while the
than voiding in a bedpan? client is sitting on the toilet
A. It allows for a more normal position for C. Standing next to the bed and talking
elimination. quietly to the client who is urinating
B. It provides more privacy. D. Providing a glass of cold water to drink
C. It is more comfortable. while the client is trying to void
D. It allows the bladder to empty
completely. 34. When emptying a urinary drainage bag, you
maintain medical asepsis by:
30. Which of the following correctly describes A. Using sterile gloves
catheter care? B. Placing the measuring container on a
A. Wash the perineal area and avoid paper towel
touching the catheter C. Placing the measuring container on the
B. Clean the meatus and the catheter with overbed table and stooping to read it
an alcohol swab accurately
C. Clean the catheter from the meatus and D. Doing all of the above
down the catheter about 10cm (4 in.)
with soap and water 35. When straining urine, what should you do if
D. Clean the catheter with soap and water, you see particles in the strainer?
starting about 10cm (4 in.) below the A. Place the strainer in the container and
meatus and washing toward the perineal send it to the laboratory
area B. Show it to the nurse and then discard it
C. Send the urine and strainer to the
laboratory
D. Keep the strainer in the client’s room
until the doctor arrives

166 CHAPTER 29 Urinary Elimination
36. When using a reagent strip to test urine, the”

support worker should:
A. Send the specimen and reagent strip to
the laboratory
B. Ask the nurse to read the strip
C. Follow the manufacturer's instructions
on the container
D. Teach the client to read the strips
MATCHING
Match each group of words with the effect that it has on urine.
37. ____ Coffee, tea, alcohol A. Cause(s) bright yellow urine
38. ____ Diet high in salt B. Cause(s) a change in urine odour
39. ____ Beets, blackberries C. Increase(s) urine production
40. ____ Carrots, sweet potatoes D. Cause(s) red-coloured urine
41. ____ Asparagus E. Decrease(s) urine production
Match each word with its meaning.
42. ______ Painful or difficult urination A. Polyuria
43. _____ Blood in the urine B. Ureterostomy
44. ____ Production of abnormally large amounts of urine C. Oliguria
45. ____ Scant amount of urine (less than 500 mL D. Dysuria

in 24 hours)
46. _____ Frequent urination at night E. Hematuria
47. _____ An artificial opening between the ureter and the FE Nocturia
abdomen
FILL IN THE BLANKS
48. When do most people usually void during the day? (Normal voiding routine)
a
b.
(e
49. Explain the two basic methods of bladder training.

a
b.

The next five fill-in-the-blank exercises (questions 50 through 54) each describe a common urinary
problem. Identify the problem and list the causes of each problem.
50. Painful or difficult urination is called

Causes:
a.
b.
Cc
51. Blood in the urine is called

Causes:
a.
b.
Gy
a2. Predueneurinatronuariiont is.called <n

@.
Causes:
a.
b.
Cc
53. Scant amount of urine (less than 500 mL in 24 hours) is called

Causes:
oe
pao
54. Production of abnormally large amounts of urine is called
Causes:
a
b.
s
d.
oer, A ureterostomy is
NN

168 CHAPTER 29 Urinary Elimination.
Answer questions 57 through 59 using the

LABELLING
following illustration.
56. Draw an arrow to show the direction to clean

the catheter.
by: Name the parts of the urinary drainage

system indicated.
a.
List observations you make that need to

e
be reported to the nurse when caring for a
person with an in-dwelling catheter. es
a.
b. 58. Why is the tubing coiled on the bed?

(Ga Aa a
d. a ee
59. Why is the catheter taped to the man’s

abdomen?

CROSSWORD
ine}
BeAr
et een er
oa a Se es
2
eae at Hoe] = scaler

es
eetieeeca
Across 14. A compound that appears in the urine

because of rapid breakdown of fat for energy;
4. Sugar in the urine
ketone body
6. Production of abnormally large amounts of
urine Down
ihe Scant amount of urine; usually less than

7. ‘Tube used to drain or inject fluid through a 500 mL in 24 hours
body opening
Frequent urination at night
9. Voiding at frequent intervals
Process of inserting a catheter
10. Blood in the urine
Urination or micturition
11. Painful or difficult urination
ee
Need to void immediately
13. Process of emptying urine from the bladder;
urination or voiding 12. Process of emptying urine from bladder;
micturition or voiding

a 5 ~ — i4 a
,
i = =~ ; = 7 ‘ 7 a ee
Que ’ ‘ : eau pee a A.

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; = me . ~ ae = ; 7
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7
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aS a
CHAPTER
TRUE OR FALSE Vie lek Feces become hard and dry when
fluid intake is poor.
12 lee The support worker may help
1. TF Feces move through the intestine by to prevent fecal incontinence by
a process called defecation. promptly responding to all requests
for help using the bathroom,
2. TF Constipation is a condition in which
bedpan, or commode.
c bowel movements are less frequent
than usual. 1320 lr One of two goals of bowel training
is to develop a regular pattern of
3. TF Support workers are not responsible
elimination, thus preventing fecal
for the promotion of a normal bowel
impaction, constipation, and fecal
routine for clients.
incontinence.
4. T F Fewer than 10 wet diapers per
14. T F When you are helping a client
day from an infant may indicate
with bowel training, the client is
dehydration.
usually encouraged to use the toilet,
5. TF Enemas can be dangerous. commode, or bedpan before a meal.
6. F A support worker is allowed to insert Wieme 1h) Fe A suppository is used to stimulate

rectal tubes to relieve flatulence. defecation when bowel training is
being done.
rie F A stoma is painful when touched.
16; 0" 4F Giving an enema is a controlled act.
8. F Aclient with an ostomy pouch can
wear normal clothes.
Wie de ae Enemas may be ordered by the
designated health care provider to
9. T F When internal bleeding is suspected, prepare the client for certain X-ray
feces are checked for blood. procedures.
10. T EF Acommercial enema stimulates and teh de Ly ‘The volume of saline enema varies
distends the rectum. according to a child’s size and age.
172 CHAPTER 30. Bowel Elimination
19. TF The purpose of an ostomy pouch is : 26. What are common causes of constipation?
to collect feces and flatus. A. A high-fibre diet
B. Ignoring the urge to defecate
20 T F An ostomy bag is changed every day C. Decreased fluid intake
and whenever it leaks. D. Activity
E. Medications
21 T F An ostomy pouch can be removed E Aging
and changed when peristalsis is less Gx SGerednediseases
active. The best time is usually after
breakfast. 27. Which of the following comfort and safety
measures can the support worker use when
22 T F Fore from oe ileostomy is especially assisting a client with fecal elimination?
irritating to the skin because the A. Assist the client to the toilet or
small intestine contains digestive commode, or provide the bedpan, as
juices that are very irritating. soon as requested.
B. Provide fe i k visitors to leave
23. TF Occult blood is bright red blood that fevice (oe eee et eae
‘ ; the room, close doors, pull privacy
can be easily observed in the stool. ; :
curtains, and close window curtains,
blinds, or shades).
MULTIPLE RESPONSE C. Make sure the bedpan is cold.
; D. Position the client in a side-lying position.
From the list below, choose all of the correct B. Allow enough ameter tetesicn sida
answers.
not rush the client.
24. What should you observe and report when a F Place the call bell and toilet tissue
within reach.
client has a bowel movement? eH3. .
wee. G. Leave the room if the client is weak or
A. Abnormalities in colour 4
B. Abnormalities in amount SS
saan ; H. Provide oral care.
C. Abnormalities in consistency :
D.
bash
Abnormalities in odour
I. Dispose of stool
;
promptly.
Da Droeralines crac iE fo the client with hand hygiene after
FE. Abnormalities in size baa uae ae
. Phautel a Heavens 28. What symptoms may occur if flatulence is
H. Complaints of pain :
not relieved?
25. What are some signs of fecal impaction? A. Abdominal cramping or pain
? ‘ B. Shortness of breath
A. Abdominal discomfort and swelling
B./ Cramping C. Decreased level of consciousness
C. A feeling of fullness or pain in the D. Swollen abdomen, or “bloating
rectum ae ,
29. Which of the following are reasons that
D. Nausea or vomiting ene
enemas are given?
Eg) Hever
Ny A. To remove feces
FE Increased need or decreased ability to ; mde
B. ‘To relieve constipation or fecal impaction
urinate ;
G. Liquid feces seeping from the anus Cailtlo sn coutsecieteutos
Spee Pins D. To clean the bowel of feces before
H. Regular bowel movements é
certain surgeries or X-ray procedures
E. To relieve flatulence and intestinal
distension

CHAPTER 30. Bowel Elimination 173
30. How can odour associated with an ostomy 34. Which of these may kill normal flora in the
pouch be prevented? intestine?
A. By providing good hygiene A. Antibiotics
B. Instructing the client to cover it with a B. Laxatives
plastic bag C. Pain medications
C. By encouraging the client to avoid gas- D. Enemas
forming foods
D. By putting deodorants into the pouch, 35. What instruction will the nurse likely give if
according to the care plan a client has diarrhea or loose stools?
A. Withhold all fluids
B. Give the client plenty to drink
MULTIPLE CHOICE C. Encourage the client to eat as little as
Circle the correct answer. possible
D. Give the client foods with plenty of
31. Which of the following will not assist fecal fibre
elimination?
A. Drinking a hot beverage 36. What would be an effective nursing action to
B. Using a bedside commode in a relieve flatulence?
semiprivate room A. Giving an enema
C. Taking a walk B. Making sure the diet is high in
D. Reading a book or newspaper vegetables
C. Having the client lie flat in bed
32. Which of these foods would be most likely to D. Ambulating the client or placing the
- stimulate fecal elimination? client in the side-lying position
A. Pudding and gelatin
B. Whole-grain cereals and fruit 7. When the nurse or support worker
C. Meat and fish (where allowed by agency policy) inserts
D. Pretzels and potato chips a suppository into a client’s rectum to
stimulate defecation, how soon would you
33. Mr. Leroux, 85, usually has a bowel expect results?
movement after breakfast. About 45 minutes A. In about 30 minutes
after having a bowel movement, he wants to B. Immediately
go to the bathroom again. The most likely Cieeln2aos bouts
reason for this is: D. In the morning
A. Older persons lose control over
defecation. 38. Which position is best when giving an
B. Complete emptying of the rectum does enema?
not always occur with older persons. A. Sims’ position
C. He may have a tumour or other B. Right position
disorder. C. Semi-Fowler’s position
D. He is concerned about becoming D. Prone position
constipated.

39. Which of the following statements about f 42. What is the purpose of a rectal tube?
stool specimens is correct? A. Relief of constipation
A. Stool specimens are best obtained at the B. ‘Treatment of fecal impaction
end of the day. C. Prevention of diarrhea
B. Urine will contaminate the stool D. Relief of flatulence and distension
specimen.
C. Stool specimens should be sent to the 43. What is the consistency of the stool if
lab by the end of each shift. a colostomy is near the end of the large
D. Stool specimens that contain blood intestine?
have been contaminated and should not A. Liquid
be accepted. B. Soft
C. Formed
40. You should wear gloves when testing a stool D. Hard and dry
for occult blood to:
A. Prevent contact with body fluids and 44, Which of these methods would help to
substances prevent skin breakdown around the stoma?
B. Prevent contaminating the specimen A. Clean with alcohol wipes
C. Maintain a sterile specimen B. Use an antiseptic lotion or petroleum
D. Prevent contact with chemicals used in jelly on the skin
the test C. Clean the area with water and mild
soap as directed by the nurse
41. The term melena describes stool that: D. Wipe with tissues until clean
A. Is black and tarry
B. Contains unseen blood
C. Hard and pebble-shaped
D. Contains visible parasites
MATCHING
Match each of the corresponding factors that can cause the stool to change colours to the correct colour.
45. Bleeding in the stomach A. Green
46. Bleeding in the lower colon or rectum; also, beets B. Black
47. A diet high in green vegetables Gun Red

CHAPTER 30. BowelElimination 175
Match each definition to the correct word.
48. Semi-solid mass of waste products in the colon A. Defecation
49. Introduction of fluid into the rectum and lower colon B. Suppository
50. ___ Artificial opening between the ileum and abdomen C. Diarrhea
“ae Bowel movement D. Peristalsis
ye Alternating contraction and relaxation of intestinal muscles Ey eeces
53. Surgical creation of an artificial opening E Ostomy
54. Cone-shaped medication that is inserted into a body opening G. Enema
Boe Gas or air in the stomach or intestines Eiee Cyne
56. Feces that have been excreted I. Flatus
a7« Frequent passage of liquid stools J. Stoma
58. Partially digested food and fluids that pass from the stomach to K. Stool
the small intestine
Enh The opening of a colostomy or ileostomy L. Tleostomy
FILL IN THE BLANKS
60. What effect does normal bacterial action in the large intestine have on the stool?
61. What are the risks if you do not give good skin care to a client who has loose stools or diarrhea?
a.
b:
Cc.
62. How would you mix the solution for a saline enema?
63. How does a commercial enema, which contains only 120 mL of solution, stimulate defecation?
64. When you are giving “enemas until clear,” how will you know that you have given enough?

oniiyinieienscuinsencsinealWitotimnorasn
ineEABNEAHOEREOAAINER
65. How warm is the solution in a cleansing enema? ee
66. Only a enema may be given to children.
67. What instructions should you give to a client who is going to expel an enema in the toilet?
68. What will happen if you release pressure on a commercial enema container while giving an enema?
69. What is the purpose of an ostomy pouch?
70. You should empty or open an ostomy pouch when or when the
bag
lee An ostomy bag is changed every days.
Tea An ostomy pouch can be removed and changed when peristalsis is less active. The best time is usually
Hgos Why are certain stool specimens taken directly to the laboratory?
Refer to the figure when answering Questions

74-76:
74. a. How high above the anus should the bag

hang? emma ns
b. How high above the mattress should bag
hang?
75. How far should the tube be inserted into the

rectum?
76. Identify the position of the person.

CHAPTER 30 Bowel Elimination 177.
WORD SEARCH 83. Cone-shaped

medication that is inserted into a body
Write the correct word next to each definition opening
below. Then find those words in the Word Search
and circle or highlight them in the word search 84. Gas or air in the
puzzle. stomach or intestines
re Semi-solid mass of 85. Feces that have

waste products in the colon been excreted
78. Introduction of 86. Frequent passage of

fluid into the rectum and lower colon liquid stools
79. Artificial opening 87. Partially digested

between the ileum and abdomen food and fluids that pass from the stomach
to the small intestine
80. Bowel movement
88. The opening of a
81. Alternating contraction colostomy or ileostomy
and relaxation of intestinal muscles
82. Surgical creation of

an artificial opening
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LN
TRUE OR FALSE Development is a change

in psychological and social
Circle T for true, or circle F for false. ° functioning.
ional 28 Three-month-old infants can raise Children should develop at the

their heads and shoulders when same rate.
lying on their stomachs.
A 4-year-old child has a strong
Toilet training is usually completed preference for the parent of the
by the age of 1% years. same sex.
Sole Three-year-olds are able to play At 8 years of age, peer-group

with other children. activities and opinions are
important to the child.
4. T F Young adulthood is the time when
partners spend more time alone 11. Puberty begins when reproductive
together. organs begin to function.
5: al. Adolescents begin to think about tz. During young adulthood, hobbies
careers and what to do after high and pastimes can be pursued since
school graduation. more free time is available.
The term growth refers to the
physical changes that can be
measured and that occur in a
steady and organized manner.
180 CHAPTER 31. Growth and Development
MULTIPLE RESPONSE 7 17. A toddler should be able to:

A. Use a spoon and cup
From the list below, choose all the correct answers. B. Ride a bicycle
13. Which of these are among the six basic = eae body
principles of growth and development?
A. Growth and development occur from 18. During which stage do children begin
the moment of birth until death. playing with other children?
B. ‘The process is from simple to complex. A. Infancy
C. Growth and development occur from B. The toddler years
head to foot and from the centre of the C. The preschool years
body outward. D. Middle childhood
D. Growth and development occur in a
sequence, order, and pattern; each stage 19. Reproductive organs begin to function and
lays the foundation for the next stage. secondary sex characteristics appear during
E. Growth and development occur from which stage?
the moment of fertilization until death. A. Late childhood
F Growth and development occur at a set B. Preadolescence
pace. C. Puberty
G. Each stage of growth and development D. Early adulthood
has its own characteristics and
developmental tasks. 20. Middle adulthood is the period from about:
A. 25 to 35 years of age
B. 30 to 40 years of age
MULTIPLE CHOICE C. 40 to 50 years of age
Circle the correct answer. D. 40 to 65 years of age
14. The stage of infancy is the first: 21. Middle adulthood is usually a time when:
A. 4 weeks of life A. Families are started
B. 3 months of life B. People learn to live with a partner
C. 6 months of life C. Children are grown and leave home
D. Year of life D. People need to prepare for death
15. Which reflexes does the infant need for 22. What stage of growth and development
feeding? includes the following developmental tasks: a
A. The Moro and startle reflexes time of rapid growth, and psychological and
B. ‘The rooting and sucking reflexes social maturity?
C. ‘The grasping and Moro reflexes A. Late adulthood
D. The rooting and grasping reflexes B. Young adulthood
C. Adolescence
16. At what age are solid foods usually D. ‘The toddler years
introduced to an infant?
A. At5 to 7 months of age
B. At 8 months of age
C. At 9 or 10 months of age
D. At 11 or 12 months of age

CHAPTER 31. Growthand Development 181
23. What stage of growth and development

includes the following developmental tasks:
increasing the ability to communicate with
and understand others; performing self-care
activities; learning the physical differences
between the sexes; learning right from wrong
and good from bad; learning to play with
others; and developing family relationships?
A. Puberty
B. Young adulthood
C. Preschool
D. Newborn
MATCHING
Match the correct age at which a child is expected to develop each of the following skills.
24. Speaks in short sentences A. 2 months

25. Usually protective of younger brothers and sisters B. 3 months
26. Learn to tell time C. 5 months
pe Smiles and follows objects with the eyes D. 6 months
28. Can eat table food E. 8 months
29. Can hold a rattle Ea livear
30. Reacts to the word “no” G. 3 years
ods Begins to bite and chew finger foods Hi. > years
a2. Plays with the toes I ¥.yeats

182 CHAPTER 31. Growth and Development
Match the behaviour or physical change with the correct age.
33. Do not like being teased or criticized and are A. Birth—4 weeks
sensitive about how others treat them
34. Temper tantrums and saying “no” are common B. 8 months
3D. In girls, pelvis becomes broader, fat appears on C., 2 years

hips and chest, and budding of breasts occurs
36. Movements are uncoordinated and lack purpose D. 2% years
Bee Select partner and learn to live together; develop E. 3 years

intimate relationships
38. May be able to stand when holding on to E™ ©5 years

something
Bee Bowel training usually is complete G. 6 years
40. Awkward movements occur because of rapid H. 7 years

growth in height and weight
41. Recognize that male and female bodies are I. 8 years

different
42. More permanent teeth appear; movements are J. 10-14 years

faster and more graceful
43. Weight control becomes a problem as metabolism K. Adolescence

and physical activity slow down
44. May cheat to win, but they like rules and try to L. Young adulthood
follow them
45. Baby teeth are lost, and replacement with M. Middle adulthood
permanent teeth begins

CHAPTER 31. GrowthandDevelopment 183
Match the following statements with the correct reflex of an infant.
46. Produced by touching the cheeks A. Moro (startle) reflex
47. When cheek is touched, baby turns head 132 Rooting reflex
in the direction of touch
48. A loud noise causes infant to throw arms Sucking reflex

apart and extend legs
49. When palm of hand is touched, baby D. Grasping reflex

closes fingers around object
Match the developmental task with the correct age group.
50. Accepting the changes in body and A. Infancy (birth to 1 year)

appearance
51, Developing leisure-time activities Toddler (1 to 3 years)
52. Gaining control of bowel and bladder Preschooler (3 to 6 years)

functions
D3. Becoming independent from parents Middle childhood (6 to 8 years)

and adults
54. Learning to eat solid foods Late childhood (9 to 12 years)
55. Developing a conscience and morals Adolescence (12 to 18 years)
56. Learning to get along with peers Young adulthood (18 to 40 years)
57. Developing a satisfactory sex life sais

ae Middle adulthood (40 to 65 years)
Match the developmental task with the correct age group.
58. Developing new friends and keeping tas Infancy (birth to 1 year)
friendships with peers
59. Using words to communicate with others Toddler (1 to 3 years)
60. Learning to live with a partner Preschooler (3 to 6 years)
61. Developing a good feeling and attitude Middle childhood (6 to 8 years)

about self
62. Developing stable sleep and feeding Late childhood (9 to 12 years)

patterns
63. Performing self-care activities Adolescence (12 to 18 years)
64. Tend to confide and seek advice from peers Young adulthood (18 to 40 years)

184 CHAPTER 31 Growth and Development
Match the psychosocial task as described by Erikson’s theory with the age range during which it occurs.
65. ___sGenerativity versus stagnation Av=6 toil? yeats
66. ___ Initiative versus guilt B. 1 to 3 years
67. _____ Identity versus role confusion C. 20 to 40 years
68. ___ Integrity versus despair D. 12 to 20 years
69. _____ Trust versus mistrust E a3 Ae years
70. ______ Competence versus inferiority it leone years
71. _____ Intimacy versus isolation G. 40 to 65 years
Tipa8 Autonomy versus doubt H. 0 to f year
Match each type of basic need identified in Maslow’s hierarchy of needs with the correct word or phrase
(need) in the left column.
ideo = Clothing A. Physical needs
74, _. tavCloseniess B. Safety needs
75. _______ Experiencing one’s potential C. Love and belonging needs
76. _____ Opinion of self D. Self-esteem needs
77. _______ Protection from harm E. Self-actualization needs
FILL IN THE BLANKS

According to your textbook, at what age is a child expected to develop each of the following skills?
78. ______ Child learns to write rather than print
79. ______ Capable of bladder control during the day
80. ______—~ Knows male and female bodies are different
81. A is a baby in the first 4 weeks after birth.

CHAPTER 31. Growthand Development 185
LABELLING
Label each section of the pyramid with the basic need according to Maslow.
Match each section of the pyramid with the basic need according to Maslow.
82. ___ Self-esteem
$3. _ = Jove and belonging
84. Physical
85. ___ Sel f-actualization
BG. Salety

$ : ‘ J
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at
Ci
a
if a
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oe
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ah
CHAPTER
Body Structure and

Function
TRUE OR FALSE A function of the muscular system is

to provide the body with heat.
The function of the urinary system is
in Le FE The skin is the body’s first line of to remove waste products from the
defence against disease. blood.
ele eh ‘The optic nerve is found in the ear. 11. The process of cell division is called
mitosis.
og le or The immune system is made up of
red blood cells. We The ball-and-socket joint allows
movement in all directions.
4. T F The tympanic membrane is found in
the ear. 13. The hinge joint allows turning from
side to side.
Bek Fingernails and toenails are part of
the integumentary system. 14. The pivot joint allows movement in
one direction.
6. T F The peripheral nervous system is
made up of the brain and spinal 15. ‘The pathways that conduct messages
cord. to and from the brain are contained
in the spinal cord.
75 AKAN The parasympathetic nervous system
is responsible for flight, fright, or 16. The small bones in the middle ear
fight. are called the malleus, incus, and
anvil.
So lek Bones are dead.
188 CHAPTER 32 _ Body Structure and Function ie } hy ees ote
17. TF The function of the lungs is to allows 28. Specialized connective tissue includes:
respiration. A. Blood
B. “Bone
18. TF Urine is made up of waste products C. Muscle
filtered out of the liver. D. Adipose
E. Dense fibrous
19. TF The master gland of the endocrine Eu aNierve
system is the pituitary gland.
; 29. The purpose of adipose tissue includes:
20. T F The major function of the thyroid A. Supplies energy to surrounding cells
gland is to regulate calcium. B. Assists in draining internal fluids
(Omer. hion to the bod
21. T F Glucocorticoids regulate the ee
ae ee D. Supports surrounding structures
Pee ee cnet ees E. Transports hormones to target organs
22. TF Passive immunity is a natural process E waedsiin Body tem peraruse reomlaay
2nue antibodies within the BO. ype of bares inelnde.
ad A. Flat bones
23. T F Cartilage is connective tissue that B. Short bones
C. Irregular bones
prevents bone ends from rubbing
suns: D. Cartilage
E. Long bones
24. T F Capillaries are the largest diameter F. Spinal bones
bléca vessels: G. Sesamoid bones
25. T EF Chemical digestion is the act of MULTIPLE CHOICE

chewing food.
MULTIPLE RESPONSE 31. What is the name of the body function that
From the list below, choose all of the correct burns food for heat and energy?
answer's. A. Metabolism
B. Digestion
26. What are the basic structures of the cell? C. Peristalsis
A. Cell membrane D. Urination
B. Nucleus
C. Pleura 32. The urinary system consists of:
D. Cytoplasm A. 2 kidneys, 2 ureters, 2 urethras,
E. Synovial fluid . 2 bladders
B. 2 kidneys, 1 bladder, 1 ureter, 1 urethra
27. Which of the following are the structures C. Urethra and bladder only
that make up the circulatory system? D. 2 kidneys, 2 ureters, 1 bladder, 1 urethra
A. Blood
B. Kidney 33. Each system of the body is composed of:
C. Heart A. Cells, tissues, and bones
D. Vessels B. Tissues, organs, and muscles
E. Spinal cord C. Bones, muscles, and tissues
D. Cells, tissues, and organs

CHAPTER 32 Body Structure and Function 189
34. Smooth muscles may be found in the: 40. What type of blood vessel carries blood away
A. Arms and legs from the heart?
B. Body track AS Attery
C. Digestive tract B. Vein
D. Head and neck C. Vena cava
D. Capillary
35. Which statement is true about cardiac
muscle? 41. The cerebellum:
A. Itis classified as voluntary muscle A. Is also called the brain stem
B. Is found only in the heart B. Controls the body’s senses
C. It is used to create body heat C. Regulates and controls body movement
D. It is found in the dorsal cavity D. Is considered the largest part of the
brain
36. Which statement about the integumentary
system is true? 42. The highest functions of the brain take place
A. Consists of all four types of tissues in the:
working together A. Cerebral cortex
B. ‘The epidermis is the innermost layer of B. Medulla
the skin C. Brain stem
C. ‘The epidermis contains a vast supply of D. Spinal nerve
blood vessels
D. Dead cells of the epidermis contain 43. The endocrine glands secrete substances
pigment called:
A. Hormones
37. The middle layer of the skin is called the: B. Mucus
A. Epidermis CG Semen
Bae Dermis D. Insulin
C. Subcutaneous
De Fat 44. What is the major function of the thyroid
gland?
38. An example of a hinge joint is the: A. Regulates growth
A. Shoulder B. Prevents excessive loss of fluids
B. Knuckles at the base of the fingers C. Regulates metabolism
C. Wrist D. Regulates calcium use by the body
D> ‘Knee
45. Besides serving as the organ of hearing, the
Boe Tendons connect: ear is involved with:
A. Muscles to muscles A. Balance
B. Nerve cells to muscles B. Regulating body movements
C. Bone to bone C. Controlling involuntary muscles
D. Muscles to bones D. Smoothness of body movements

190 CHAPTER 32 Body Structure and Function
MATCHING :
Match the following statements with the correct terms.
46. Blood vessel that carries blood away A Artery

from the heart
47. Blood vessel that carries blood back to B. Capillary

the heart
48. Tiny blood vessel that allows food, for Cell

oxygen, and other substances to pass to
the cells
49. Basic unit of body structure D. Digestion
50. Group of cells with the same function EE. Metabolism
51. Group of tissues with the same function F. Organ
52. Organs that work together to perform _—G. Peristalsis

special functions
53. Process of physically and chemically Ei System

breaking down food so it can be
absorbed for use by the cells of the body
54. Muscle contractions in the digestive E Tissue

system that move food through the
alimentary canal
55. Burning of food by the cells to produce J. Vein

heat and energy
Match the four basic types of tissue with their functions.
56. Epithelial tissue A. Anchors, connects, and supports other body

tissues
57. ______ Connective tissue B. Relays information to and from the brain and
throughout the body
58. ____ Muscle tissue Ce Allows the.body to move by stretching and

contracting
59. ___ Nerve tissue D. Covers internal and external body surfaces

CHAPTER 32 Body Structureand Function 191
Match the bone with the correct description of what the bone does.
60. _____ Long bones A. Allow skill and ease in movement
61. __—_—__—sdShorrt bones B. Protect the organs
622 slat bones C. Bear the weight of the body
63. ____sIrregular bones D. Allow various degrees of movement and flexibility
Match the following statements with one of the terms related to the digestive and urinary systems.
64. Structure that adds digestive juices A. Bladder

to chyme
65. Semi-liquid food mixture formed B. Chyme

in stomach
66. Portion of the gastrointestinal Ge Colon

tract that absorbs food
67. Portion of the gastrointestinal D. Duodenum

tract that absorbs water
68. Produces digestive juices E. Jejunum
69. Produces bile E Kidney
70. Basic working unit of the kidney G. Liver
71; Hollow muscular sac that stores H. Meatus

urine
7f) Structure that allows urine to pass I. Nephron

from the bladder
73: Opening from the bladder at the \eeeePancreas

end of the urethra
74. Bean-shaped structure that K. Urethra

produces urine
75. Moistens food particles in the L. Saliva

mouth

192 CHAPTER 32 _ Body Structure and Function
Match the correct pituitary hormone with the effect it has on the body.
76. Growth hormone a Enables thyroid gland function
ids Thyroid-stimulating hormone (TSH) B. Prevents the kidneys from excreting

excessive amounts of water
78. Adrenocorticotropic hormone (ACTH) Causes the uterine muscles to contract

during childbirth
79; Antidiuretic hormone (ADH) D. Causes growth of muscles, bones, and

other organs
80. Oxytocin ley Stimulates the adrenal gland
Match the action of the hormone with the correct hormone.
81. Released by pancreas and regulates sugar in 7s\e Epinephrine

blood
82. Sex hormone secreted by testes ow Estrogen
83. Sex hormone secreted by ovaries Insulin
84. Regulates metabolism aeParathyroid hormone

85. Regulates calcium levels in body So ‘Testosterone
86. Stimulates body to produce energy during iF Thyroxine

emergencies
Match the special cells or substances in the immune system to their function in protecting the body.
87. Antibodies Ay Cause the body to produce antibodies
88. Antigens Bi Produce antibodies
89. Phagocytes Cause the production of antibodies

that circulate in the plasma
90. Lymphocytes Destroy invading cells or attract other

cells that destroy invading cells
ot B lymphocytes (B cells) Attack and destroy abnormal or

unwanted substances
SZ, T lymphocytes (T cells) Digest and destroy microorganisms

and other unwanted substances

FILL IN THE BLANKS
whe Skeletal muscles are attached to and cause

of body parts.
94. What is the function of the nervous system?
OD: What are the five senses?

a.
b.
c
d.
e.
96. Three small bones in the middle ear the sound and transmit it to the
. The small bones in the middle ear are called the
ee ee ee Oe aad
97. Describe the function of the digestive system.
98. The undigested portion of food that passes from the body through the rectum and anus is called
sey Urine is made up of waste products filtered out of the
100. What are the functions of the ovaries?

a.
b.
101. What effects do mineralocorticoid hormones have on the body?
102. What are three functions of the lymphatic system?

as
b.
Cc

LABELLING ° 105. Name the structure and function of the six

main parts of the heart indicated on the
drawing.
103. Identify the type of joint and the body's
location for each joint shown in the
drawings below.
A.
B.
a.
104. Label the parts of the brain indicated on b
the drawing. :
os
d.
e.

106. Name the structures of the respiratory 107. Name the structures of the digestive system
system indicated on the drawing. indicated on the drawing.
oa
hant
Trace
mt
D:
ce
d.
eS
fe
g.
Go
7
Pee.

108. Name the structures of the urinary system * 109. Name the structures of the parts of the
indicated on the drawing. male reproductive system indicated on the
drawing.
ooeetS
ihe
ooo)
=
a,
b.
@
d.

110. Name the structures of the external female

genitalia indicated on the drawing.
aoe
mmo

CROSSWORD
Across Down
2: Blood vessel that carries blood back to the Lk Burning of food for heat and energy by the
heart cells
4. Involuntary muscle contractions in the 3. Process in which the lining of the uterus
digestive system that move food through the breaks up and is discharged from the body
alimentary canal through the vagina
Substance in red blood cells that carries Tiny blood vessel; food, oxygen, and other
oxygen and gives blood its colour substances pass from the capillaries to the
Blood vessel that carries blood away from the cells
heart Process.of physically and chemically breaking
Group of cells with the same function down food so that it can be absorbed for use
(2, Basic unit of body structure by the cells
(ee Protection against a disease or infection; Chemical substance secreted by the glands
the person will not get or be affected by the into the bloodstream
disease Group of tissues with the same function
Organs that work together to perform special
functions

CHAPTER
Common D iseases and

Disorders
TRUE OR FALSE Osteoporosis causes the cartilage that

occupies the joints of the body to
Circle T for true, or circle F for false. deteriorate.
ANSE Kalla§ People who have osteoarthritis An infant who has a fracture may be
experience joint stiffness with a victim of child abuse.
activity and range-of-motion
exercises. Phantom limb pains can occur when
a client has had an amputation.
Pa ad Rheumatoid arthritis affects only the
large weight-bearing joints. A stroke occurs when brain cells
get too much oxygen and too many
8 iolba Rheumatoid arthritis in children can nutrients.
affect growth and development.
11. All clients with Parkinson’s disease
4. T F Arthroplasty is done to cure arthritis. have impaired mental function.
Sole E People can help to prevent 2% Multiple sclerosis is a short-term,
osteoporosis by taking calcium acute disease.
supplements and having a regular
exercise program. 13; A client with chronic obstructive
pulmonary disease (COPD) is at risk
G21, FB When turning and repositioning a for respiratory infections.
client with osteoporosis, you should
move him or her quickly to prevent 14. The use of condoms is one way to
fractures. reduce the spread of tuberculosis.
200 CHAPTER 33 Common Diseases and Disorders ee
ae
to.41. F Clients with tuberculosis have 28. T F Shingles are caused by an allergic
an overproduction of thyroxin reaction.
hormone.
29.3 ak A client with emphysema can
16. T F Angina pectoris occurs when vessels breathe more easily if he or she is
narrow and the heart pumps with allowed to sit upright and slightly
mote force. forward.
U7 oF Activity will usually relieve angina 30. T F, Exercise and physiotherapy can
pain in 3 to 15 minutes. help a client with Parkinson's
disease to improve or maintain
18. T F A common term for a myocardial strength, posture, balance, and
infarction is heart attack. mobility.
19. TF The goal of cardiac rehabilitation ol. fF Repeated asthma attacks can damage
after a myocardial infarction is to the respiratory system.
prevent another attack.
O20 Tok Scabies appear as white circular
20. T F When a client has renal calculi, you patches on the lower legs and back
should strain the urine. areas.
Pl
A Ua When a client has persistent renal oon Pee The term furuncle is used to describe
failure, only the renal system is a skin tag.
affected.
34. T F An aneurysm is caused from the
220 OE You need to follow Standard presence of excessive acid in the
Practices when disposing of vomitus. digestive tract.
23.°T" F A client who has human 5s. k er Hypertension is more common

immunodeficiency virus (HIV) but among Canadians of South Asian,
has not developed acquired immune Aboriginal, and African descent.
deficiency syndrome (AIDS) cannot
infect others with the virus. 36. T F The risk of hypertension increases
if excess weight is stored around the
24. T F Elevated toilet seats are helpful to a abdomen.
client with osteoarthritis when the
client has limited range of motion in Ved ba Good skin care and regular position
the hips and knees. changes can help to prevent skin
breakdown.
Zz, bE Juvenile rheumatoid arthritis occurs
in children. o0. LF With persistent renal failure,
the nephrons of the kidneys are
26. T F Preventing deformities is one of destroyed.
the goals in treating rheumatoid
arthritis. Bb Be ose Clients with persistent renal
failure have dialysis to remove
27 1 FE When a client has osteoporosis, a wastes and excess water from the
fracture can occur because the bones blood.
are very brittle.

CHAPTER)33 Common Diseases and Disorders 201
40. TF The most important way to 45. A child falls and has signs and symptoms of
prevent the spread of hepatitis is by a fracture. These would include which of the
practising Standard Practices. following?
A. Limb looks bent or out of position
41. T F AIDS reduces the client’s ability to B. )Pain
fight infections. C. Swelling
D. Unlimited movement of limb
42. TF The use of condoms will help E. Bruising and colour changes in the skin
prevent the spread of sexually at the fracture site
transmitted infections (STIs). Bleeding (internal or external)
MULTIPLE RESPONSE 46. What treatments are used to relieve pain and
stiffness in a client who has osteoarthritis?
From the list below, choose all of the correct A. Designated health care providers may
answers. order aspirin for pain.
B: Heat or cold applications may be
43. Which of the following are early warning ordered.
signs of cancer? : CG Obese clients may be advised to gain
A. Acough that goes on for more than two weight.
days By A low-fat, low-calorie diet may be
B. Blood in the stool ordered.
C. Indigestion that continues more than an Pe A cane or walker may be used for
hour support.
D. Unexplained aches and pains that go on
for more than two weeks 47. Which of the following are rules you should
E. Difficulty urinating or blood in the follow when caring for a client with a cast?
urine 1 Make sure to cover the cast with
FE Bleeding after a cut blankets, plastic, or other material.
G. Any lump or mass Bh Turn the client as directed by the care
H. A sore that does not heal plan.
I. Anew growth on the skin Place a wet cast on a hard surface.
J. Patches of skin that bleed, itch, or are Support a wet cast with your palms
red when turning and positioning the
client.
44. What side effects of radiation therapy cause Protect the client from rough cast edges.
clients with cancer to have special care needs? Keep a plaster cast dry.
Discomfort Do not allow the client to insert
Nausea and vomiting anything under the cast.
Increased appetite Elevate a casted arm or leg on pillows.
Fatigue Ome
or Have enough help when turning and
Diarrhea repositioning the client.
eae
Ora Skin breakdown Position the client as directed by your
supervisor and the care plan.

202 CHAPTER 33. Common Diseases and Disorders
48. When you care for a client who has a hip 50. What measures would be helpful to use
fracture, what measures are important for when you care for a client who has had a
you to follow? stroke?
A. Meet basic needs if the client A. Complete all activities of daily living for
is confined to bed, and prevent the client.
complications of bed rest. B. Encourage the client to do as little as
ee Transfer, turn, and reposition the possible.
person as directed. C. Meet basic needs if the client is
Keep the operated leg adducted at all confined to bed; prevent complications
times. of bed rest.
Encourage external rotation of the hip. D. Assist with bladder or bowel training
oO
me Provide range-of-motion exercises as programs.
directed. E. Assist with range-of-motion exercises.
FE Provide a straight-backed chair with F. Provide emotional support and
armrests. encouragement.
G. Prevent the client’s leg from bending at G. Report any changes in the person's
the hip. mood or behaviour.
H. Do not let the client stand on the
affected leg unless allowed by the 51. Infants and children may suffer brain damage
designated health care provider. from acquired brain injuries caused by:
I. Support and elevate the leg as directed A. Conditions during birth
when the client is in a chair. B. Being shaken
J. Apply elastic stockings as directed. C. Childhood diseases
K. Remind the client that it is okay to D. Accidents
cross the legs while seated.
52. How can you help the client with
49. If you are caring for a client who has had a pneumonia to breathe more easily and be
stroke, you might observe effects such as: more comfortable?
Hemiplegia A. Limit fluid intake.
Weakness on both sides of the body B. Position the client in high-Fowler’s or
Loss of muscle control of the face semi-Fowler’s position.
Changing emotions C. Assist with oxygen therapy, as needed.
Difficulty swallowing
Dimmed vision or loss of vision 53. What damage can hypertension do to body
Improved ability to speak or understand organs?
others ‘The heart may enlarge.
AMMOO>
T Changes in sight, touch, movement, B. Blood vessels in the brain may burst
and thought and cause a stroke.
Improved memory C. Blood vessels in the eyes may be
SSS Urinary frequency, urgency, or damaged.
incontinence D. Blood vessels in the kidneys (and other
organs) may be damaged.

CHAPTER 33 Common Diseases and Disorders 203
54. Which risk factors of coronary artery disease 57. How is pain from angina relieved or avoided?
can be changed by the client through lifestyle Elective bypass surgery
changes? Resting when the pain begins
Lack of exercise Avoiding stress
Excessive weight oh
ee
GBsAvoiding other triggers (extreme cold or
Smoking heat, heavy meals, alcohol, smoking)
Excessive alcohol E. Taking nitroglycerin
Stress FE Reducing physical exertion
>mmo
Ow Genetic link
58. When you are caring for a client with acute
55. What signs and symptoms would tell you a renal failure, the care plan is likely to include
client is experiencing angina pectoris? which of the following instructions?
A. Pain on the right side that may travel A. Strain the urine every six hours
(radiate) to the jaw, neck, shoulders, B. Measure and record intake and urinary
back, and arms catheter output every hour
Shortness of breath C. Increase fluid intake
Nausea D. Weigh the client daily using a different
Dry skin scale
Dizziness or light-headedness E. Provide frequent oral hygiene
Fatigue FE Meet basic needs if the client is
DAmmo
Palpitations confined to bed; prevent complications
of bed rest
56. Ifa client is having a myocardial infarction, G. Prevent infections
the signs and symptoms may include:
A. Sudden, severe chest pain, usually on . What are the signs and symptoms of
the right side hepatitis?
B. Pain described as crushing, stabbing, or Nausea, vomiting, and abdominal pain
squeezing Light-coloured urine
Pain that radiates to the neck and jaw, Jaundice
and down the arm or to the sides Dark-coloured stools
®
Oe Pain that is more severe and lasts longer Muscle pain
than angina Increased energy
oS Pain that is relieved by rest and Irritability
nitroglycerin Itching
Indigestion Diarrhea
Shortness of breath >TF
OOD
TOmm General aching in the joints,
Nausea or vomiting accompanied by redness and swelling
Dizziness
Perspiration 60. Some complications of diabetes mellitus
Cyanosis include:
Cold and clammy skin Blindness
Low blood pressure Kidney disease
cer
21S
aie Weak and irregular pulse Nerve damage
Sexual dysfunction
Circulatory disorders
Stroke and heart attack
OmmMOOR>
Improved wound healing

61. AIDS is spread by: 65. When caring for a client who had a recent
A. Protected intercourse with an HIV- hip replacement, which of these activities can
infected person cause the hip joint to dislocate?
B. Needle-sharing among IV drug users A. Abducting the affected leg
C. HIV-infected mothers to their babies at B. Using an abductor splint or pillow
birth or during breastfeeding between the legs when in bed
D. Infected body fluids (not including C. Any activity that bends the hip joint by
saliva, tears, urine, or sweat) coming more than 90 degrees
into direct contact with broken skin D. Using a shower chair for bathing
E. Needle stick injuries
E Casual contact such as hugging 66. Gangrene can occur because of:
A. Joint immobility and inflammation
62. What signs and symptoms may occur with B. Infection, injuries, and decreased
both hypoglycemia and hyperglycemia? circulation
. Hunger C. Poor body alignment and positioning
Vision changes D. Porous, brittle bones
Headache
Slow pulse 67. A transient ischemic attack (TIA):
High blood pressure A. Is another name for a stroke
Confusion B. Occurs when blood supply to the brain
Convulsions is disrupted for a short period
>TO
0 Loss of consciousness C. Occurs when blood pressure is elevated
D. Occurs when there is high sugar in the
blood
MULTIPLE CHOICE
Circle the correct answer. 68. When caring for a client with a spinal cord
injury, you would:
63. What is a helpful suggestion that you can A. Encourage the use of heating pads on
give to a client who has pain associated with the client’s paralyzed limbs
rheumatoid arthritis? B. Follow bowel and bladder training
A. Refrain from doing range-of-motion programs with the client
exercises. C. Limit the client’s visitors
B. Refrain from drinking citrus juices. D. Recommend a puréed diet for the client
C. Follow your designated health care
provider’s recommendations in regard 69. You are caring for a client who has angina,
to heat and cold applications. and you find a bottle of tablets marked
D. Encourage the client to follow a “Nitroglycerine” at the bedside. You should:
diabetic diet. = Place them in a locked cabinet
B. Tell the nurse
64. Which of the following is a cause of C. Give them to the family to take home
osteoporosis? D. Make sure they remain where the client
A. Excessive number of leukocytes in the put them
blood
B. Lack of dietary calcium
C. Lack of testosterone production
D. Running marathon races

CHAPTER 33 Common Diseases and Disorders 205
70. Which of these measures would be included 74. Which disease do the following signs and
in the treatment of a client with congestive symptoms describe?
heart failure? Sudden weakness or numbness on one side of
A. Measuring the client’s weight daily the body, impaired vision or loss of vision, loss
before breakfast. ofspeech or trouble talking, loss of control of
B. Ensuring the client eats a diet high in facial muscles, unexplained dizziness
salt A. Stroke
C. Encouraging the client to exercise B. Parkinson’s disease
vigorously C. Multiple sclerosis
D. Encouraging the client to maintain a D. Emphysema
low-Fowler’s position
72. Which disease do the following signs and
a Childhood communicable diseases are most symptoms describe?
commonly transmitted by: Enlarged alveoli, loss of elasticity in the walls of
A. Airborne spread of or direct contact the alveoli, air remaining trapped in the alveoli
with respiratory secretions during expiration, shortness of breath and
B. Direct contact with feces ‘smoker's cough,” barrel chest
C. Direct contact with skin lesions A. Stroke
D. Contact with a carrier B. Parkinson’s disease
C. Multiple sclerosis
72. Which disease do the following signs and D. Emphysema
symptoms describe?
Unusual mass or swelling, unexplained paleness 76. Which disease do the following signs and
or loss of energy, sudden tendency to bruise, symptoms describe?
persistent localized pain, or frequent headaches, Mask-like facial expression, tremors, pill-
especially with vomiting rolling movements of the fingers, shuffling gait,
A. Stroke impaired balance, stooped posture, stiff muscles,
B. Emphysema slurred or monotone speech, drooling
Cx *Cancet A. Cancer
D. Parkinson’s disease B. Parkinson’s disease
C. Multiple sclerosis
US Which disease do the following signs and D. Emphysema
symptoms describe?
Blurred or double vision, numbness and TS Which area of the body would be paralyzed
tingling, muscle weakness, difficulty speaking, if the client had a cervical spine injury?
dizziness, poor coordination, bladder problems A. From the neck down
A. Stroke B. One side of the body
B. Parkinson's disease C. From the chest down
C. Multiple sclerosis D. From the waist down
D. Emphysema
78. Spinal cord injuries at the thoracic level
(chest area) or lower may cause:
A. Quadriplegia
B. Paralysis on one side of the body
C. Paraplegia
D. Paralysis of one limb

saa aee A OS a a ise atl Oe eh A Se ee
79. An acquired brain injury (ABI) is defined as: ‘

A. An inability to cope with stress and
anxiety
B. The effects from long-term excessive
alcohol abuse
C. Any lasting traumatic emotional
experience
D. Any type of sudden injury that causes
brain damage
MATCHING
Match the disease process to the symptom or physical effect listed below:
A. Chronic bronchitis
B. Emphysema
80. Person develops barrel chest
81. Mucus and inflamed breathing passages obstruct airflow
82. Walls of alveoli are less elastic
Match the correct term to the symptom or physical effect listed below:
A. Hypoglycemia
B. Hyperglycemia
83. a» Trembling
84. ______—_— Nausea and vomiting
85. Ss Cold, clammy skin
86. _____—Filushed face
87. ____— Tiredness and fatigue
88. _s«dDiizziness
89. Ss Dry skin
90. _ Sweating
91. ____ Slow, laboured breathing

CHAPTER 33. Common Diseases and Disorders 207
Match the type of diabetes mellitus with the age or situation when each type usually occurs.
92. Type 1 diabetes A. Develops during pregnancy
93: Type 2 diabetes B. Occurs most often in children and young adults
94. Gestational diabetes C. Usually develops in adulthood
FILL IN THE BLANKS
95. Why does a client with osteoarthritis have more pain when standing and walking?
96. What type of arthritis occurs in children?
97. What are the goals in treating rheumatoid arthritis?

a.
b.
(Se
98. For each of these signs and symptoms that should be reported immediately if they occur to a client
with a cast, explain the possible cause.
dar ain
b. Swelling/tight cast
c. Pale skin
d. Cyanosis
e. Odour
f, Inability to move toes or fingers
g. Numbness
h. Temperature changes
i. Drainage on or under cast
j. Chills, fever, nausea, vomiting

sin cin nani rn SN SAN SA AA AL AAD ADDL AADOD AAD DODO AAA
99. When an extremity must be amputated because of gangrene, what areas of the client’s life may be
affected?
a
b.
c
100. Why are older clients at higher risk for serious problems after a hip fracture?
a:
b.
101. A client with Parkinson’s disease may need assistance with:
oP
ao
102. A client with chronic obstructive pulmonary disease (COPD) must stop
103. How can you help a client with pneumonia to breathe more easily and be more comfortable?
a:
b.
&
104. How are tuberculosis bacteria spread?
105. What precautions to prevent infection should be used when caring for a client with tuberculosis?
a.
b.
106. When caring for a client with tuberculosis, how should you dispose of tissues?
a. In the home
b. Ina health care facility
107. How do these risk factors affect hypertension?

a. Age
b. Ethnicity
c. Family history
d. Obesity
e. Stress
f. Smoking
g. Alcohol

CHAPTER 33. Common Diseases and Disorders 209
108. What measures could you use when caring for a client with heart failure?
Pp
7
ono
109. Why are older clients with heart failure at risk for skin breakdown?
110. Ifyou are caring for a client who has renal calculi, you should encourage the client to drink about
per day.
111. With acute renal failure, recovery may take
112. With chronic renal failure, the nephrons of the kidneys are
113. Dialysis is done with chronic renal failure to remove
114. What measures are used to care for a client in chronic renal failure?
hoe
m@
op
a9
115. Why is good foot care very important for a person with diabetes?
116. To protect yourself from contracting hepatitis, you use
117. Signs and symptoms of AIDS related to the following include:

a. Skin
b. Mouth and neck
c. Mental status
d. Digestive system
118. Why does a client with AIDS often develop other diseases?

119. Sexually transmitted infections (STIs) may « 121. Colour the area that would be paralyzed if
enter the body through many body areas the person had a lumbar spine injury.
such as the
LABELLING
120. Colour the area that would be paralyzed if

the person had a cervical spine injury.

CHAPTER
Hearing and Vision

Disorders
TRUE OR FALSE 6. TF Clients with hearing problems may

avoid social situations because they
cannot follow conversations.
J. TF Presbyopia is an age-related change ve ets Clients with hearing problems

that takes place in the eye. sometimes control conversations
because they cannot hear if
2. TF Clients with a hearing impairment
someone else has something to say.
understand what you are saying if
you exaggerate your words. 8. TF Clients with hearing problems may
get frustrated or irritable as they
3. T EF Age-related macular degeneration
are under continual stress, trying
is damage to blood vessels in the
to compensate for their hearing
retina as a result of diabetes.
impairment.
4, ision impairment affects a
Yok Bare io ee ae 9. T F_ Ifyou see a client with a guide dog
client’s physical, social, intellectual,
ne or a white cane with a red tip, you
and spiritual health.
should recognize that the client is
Dogs can be specially trained blind.

5. TF
to work with clients who have
hearing impairment.
212 CHAPTER 34 _ Hearing and Vision Disorders
MULTIPLE RESPONSE ‘ 12. Which are the correct steps to clean an

artificial eye?
From the list below, choose all of the correct De Wash the eye with mild soap and warm
answers. water. Rinse well.
B. Line a container with a tissue or with
10. Which of the following guidelines will help
toilet paper.
you to communicate better with a client with Fill the container with any cleaning
a hearing impairment?
solution.
A. Alert the client to your presence.
Label the container with the client's
B. Adjust the lighting so the client can see
name and room number (if in a
your face for lip reading.
facility).
C. Increase background noise. Place the container in the drawer in the
D. Focus your attention on the client;
bedside stand or in another safe place as
if the client hears from only one ear,
directed by the client.
stand or sit on the side of the unaffected
Wash the eye socket with hot soapy
ear, and do not do other tasks while
water. Use a washcloth or gauze square.
speaking to the client.
Wash the eyelid with mild soap and
E. Speak in a loud voice; do not shout, and
warm water. Clean from the outer to
do not cover your mouth when talking.
the inner part of the eye.
FE Check communication aids; make sure
the client is wearing hearing aids and 13. Which of the following will assist you to care
eyeglasses, if used. for a client with vision impairment?
G. Adjust your language; state the topic A. Adjust the lighting to avoid glare; stand
of conversation clearly, and use simple or sit in good light.
words and short sentences; say things B. Alert the client to your presence;
in a different way if the client does not identify yourself when you enter the
understand you. room, and tell the person when you are
H. Use other communication methods leaving the room.
(e.g., use body language or write key Focus your attention on the client; do
words on paper). not turn or walk away while talking,
I. Watch for signs of fatigue; avoid tiring and do not do other tasks while talking.
the client. Speak in a loud voice; speak slowly and
clearly.
11. What should you do if a hearing aid does not
Assist with walking.
seem to work properly?
Assist with eating.
si Check if the hearing aid is on
Keep walkways clear and free of clutter.
B. Check the battery position
C. Insert a new battery if needed
Ons Keep doors partially opened.
D. Clean the hearing aid with hot soapy 14. Which of these is a responsibility of a
water support worker?
Checking the battery position in a
hearing aid
Cleaning eyeglasses with warm water
Assisting a client to remove an artificial
eye
Removing wax from a client's ear canal

CHAPTER 34 _ Hearing and Vision Disorders 215
MULTIPLE CHOICE 20. What disease do the following statements

describe?
Circle the correct answers.
© Pressure within the eye is increased.
15. Which disorder may cause vertigo? © It has a gradual or sudden onset.
© The signs and symptoms include tunnel
A. Glaucoma
vision, blurred vision, and blue-green halos
B. Otitis media
around lights.
C. Méniére’s disease
© With a sudden onset, there also is severe eye
[IOP Cataracts
pain, nausea, and vomiting.
16. Which of these actions by a client indicate A. Méniére’s disease
that the client has a hearing impairment? B. Glaucoma
Speaking very softly Cry .Cataract
Asking for words to be repeated D. Brain tumour
Pronouncing words very clearly
ya ie What disease do the following statements
Oe
Answering questions appropriately
describe?
while watching television
© Involves increased fluid in the inner ear.
17. What is the most common cause of blindness © Symptoms are vertigo, tinnitus, and hearing
in clients over 50?
impairment.
A. Méniére’s disease
Pym PC ataracts
B. Glaucoma
B. Age-related macular degeneration
Cy Cataract
C. Vertigo
D. Brain tumour
D. Otitis media
18. Symptoms of retinal detachment include:

22. What disorder do the following statements
A. Yellow liquid discharge from the describe?
affected eye
© The lens becomes opaque.
B. A reported loss of central vision © A gradual blurring and dimming of vision
C. Reports of seeing yellow halos around
occurs.
© It can occur in one or both eyes.
people
© Aging is the most common cause.
D. Flashing lights in the corner of the
A. Méniére’s disease
affected eye
B. Glaucoma
19; When a client is legally blind, she: Ce" Cataract
A. Cannot sense light and has no usable D. Brain tumour
vision
B. Can sense some light but has no usable
vision
C. Has some usable vision but cannot read
newsprint
D. Sees at 6 metres what a person with
normal vision sees at 60 metres

214 CHAPTER 34 _ Hearing and Vision Disorders
MATCHING
Match the term related to hearing and vision problems with the correct definition.
Do ee Dizziness A. Otitis media
24. ____ Ringing in the ears B. Tinnitus
25. _______— Method of writing using raised dots C. Vertigo
26. _____Infection of the middle ear by: Braille
FILL IN THE BLANKS
27. Explain why the following behaviours may occur in clients with hearing problems.
a. Avoids social situations
b. Controls conversations
c. Fatigue, frustration, irritability
28. What should you do to clean and store eyeglasses?

a. Cleaning
b. Storage
29. Ifyou see a client with a guide dog or a white cane with a red tip, you should recognize that the client
is
30. List five ways in which you can provide support to a client who uses a service dog?
Coe
Oe

CHAPTER
Speech and Language

isorders
TRUE OR FALSE 8. TF Itisa help to the client to finish

words for him.
9. T F Use positive statements rather than
A. TF Most older people have apraxia. negative statements.
2. T EF Some people with aphasia cannot 10. T F Aphasia is seldom permanent.
understand the message.
3. T F Clients with expressive aphasia are MULTIPLE RESPONSE

not aware of their mistakes when
speaking.
answers.
4. T F Dysarthria is caused by weakness in
11. What can cause speech and language
the muscles used for speech. challenges?
5. T F_ Relationships between family A. Genetic problems or conditions present
at birth
members are not affected when
B. Poor eating habits
someone has a speech disorder.
C. Brain injury, which may be caused by
6. TF Shopping and cooking are not accident, infection, drug abuse, stroke,
affected when someone has a and so on
communication problem. D. Disease
E. Hearing impairment
7. T F Because you do not need to spend EK Brain tumours
time on communication, you can G. Stress incontinence
take less time giving care to someone H. Problems involving the structures used
who cannot speak. for speech
“A
216 CHAPTER 35 Speech and Language Disorders
12. ‘The basic types of aphasia (and their ‘ 15. How do you provide compassionate care
meanings) include: to clients who have speech or language
A. Receptive aphasia: difficulty speaking or disorders?
writing A. Address questions and comments to the
B. Receptive aphasia: difficulty client, not to others who are present.
understanding written or spoken words B. Do not force a client to talk in front of
C. Expressive aphasia: difficulty speaking others.
or writing C. Never show impatience, frustration, or
D. Motor aphasia: difficulty moving limbs worry when a client is having problems
E. Expressive-receptive aphasia (also speaking or understanding.
known as global aphasia): difficulty D. Discourage communication. It will only
speaking and understanding language make the client upset and frustrated.
E. Limit the number of choices to help the
13. Which points describe dysarthria? client express preferences.
A. Clients have difficulty speaking clearly
because of weakness or paralysis in the 16. How can support workers show their respect
muscles used to speak. for clients with speech or language disorders?
B. Clients usually have slurred, slow, and A. By being encouraging and supportive
soft speech. B. By keeping private information
C. Clients often have problems forming confidential
words, spacing their words, and C. By learning to be comfortable with
breathing while speaking. silence
D. Clients cannot move the muscles used D. By taking extra time to explain
to speak. procedures and not explaining all the
steps at once
14. What are some of the emotions that clients E. By speaking slowly and clearly
with speech and language disorders may EF By being alert to signs the client has not
experience? understood you
A. Frustration
B. Depression
© vAnger
D. Low self-esteem
E. Excitement
FE Shame
G. Guilt

CHAPTER 35 Speech and Language Disorders 217
17. Some guidelines to effective communication 19. After asking Mrs. Ekove a question, the
with clients with speech or language support worker should:
disorders are: A. Allow time for her to process the
A. Minimize distractions by keeping the question
client alone as much as possible. B. Expect an answer in a short time
B. Adjust the lighting; make sure the client C. Repeat the question again immediately
can see your face clearly and that you D. Ask if she is going to answer the
can see the client's. question
C. Give the client your full attention; sit
next to the client and speak into his ear. 20. To ensure that Mr. Ross understands what
D. Ask the client questions to which you you have said, you should:
know the answer; this helps you become A. Always have a witness when you speak
familiar with the client's speech. to him
E. Determine the subject being discussed; B. Ask questions to see if he understood
look for nonverbal clues. you
ia Follow the client’s lead; change your C. Ask him to take notes while you speak
communication method as needed. D. Not bother to speak; instead, write
Speak slowly, clearly, and in a normal things down and give him the note
tone of voice.
Give the client time to respond; do not 21. Mrs. Faubert cannot speak. To communicate
answer your own questions. with her, you should:
Pit
e. Use simple words and short sentences; A. Use body language
focus mainly on action words and B. Shout slowly and distinctly
words for people, places, and things. C. Use sign language
Be patient; repeat yourself as needed. D. Follow the care plan
Use positive statements.
Which of the following is true in regard to
migheUse appropriate questioning and 22.
electronic communication?
paraphrasing techniques; ask questions
A. These devices are not useful for assisting
that require only a short answer or shake
older people to communicate.
of the head, and summarize in your own
B. ‘They are not recommended for clients
words what the client has said.
with verbal-expression communication
M. Try to speak without the use of gestures
disorders.
or pointing.
C. A male or female voice can be generated
N. Try other communication methods;
from the electronic aid.
follow the care plan and use writing and
D. These are helpful only for clients with
communication boards as needed.
good eyesight.
MULTIPLE CHOICE
18. Mrs. Ekove can understand others but

cannot speak. Which type of aphasia is she
likely to have?
A. Expressive aphasia
B. Receptive aphasia
C. Expressive-receptive aphasia
D. Hemiplegia

218 CHAPTER 35 _ Speech and Language Disorders
- ‘ Be
FILL IN THE BLANKS . 24. Dysarthria means

People with this disorder
23. Apraxia of speech means
People with this disorder

CHAPTER 36
~Developmental Disorders
and Disabilities
TRUE OR FALSE 8. TF Autism can be cured with

appropriate therapies.
Circle T for true, or circle F for false. ce B
9. T F Children with myelomeningocele
A. TF People with a mild intellectual may learn to walk using braces or
disability are slow to learn in school. crutches.
2. TF People with developmental 10. TF Ifachild has hydrocephalus,

disabilities do not have sexual urges. creedLPSeerel WsReelEe
neurological damage will occur
3. T F_ All people with a developmental
without treatment.
disability have the same amount of
impairment. 11. TF Ifa mother develops rubella
(German measles) during pregnancy,
4. T F Down syndrome causes some
the baby may have an intellectual
degree of intellectual disability in all
disability.
affected people.
12. TF Shaking a baby can cause intellectual
5. TF Cerebral palsy results from brain Teh
damage that occurs during birth.
6. TF Spastic cerebral palsy affects posture,

balance, and movement.
7. TF Autism begins in early childhood.

220 CHAPTER 36. Developmental Disorders and Disabilities
MULTIPLE RESPONSE . 16. What are the physical characteristics of

Down syndrome?
From the list below, choose all the correct answers. Large head
Oval-shaped eyes that slant upward
13. What are some kinds of developmental
Flat face
disabilities?
Short, wide neck
A. Intellectual disabilities
Small tongue
B. Down syndrome
Wide, flat nose
C. Autism
Large ears
D. Cerebral palsy
Short stature
E. Chronic fatigue syndrome
Short, wide hands with stubby fingers
FR Spina bifida
G. Fetal alcohol syndrome oO Good muscle tone
a
eo
ee
17. What therapies will probably be needed
14. What are some of the causes of intellectual
for children and adults who have Down
disability?
syndrome?
A. Abnormal genes inherited from one or
A. Speech therapy
both parents
B. Language therapy
Missing or extra chromosomes
C. Physiotherapy
Illness of mother during pregnancy
D. Occupational therapy
Premature birth
Alcohol or drug use during pregnancy 18. Infants at risk for cerebral palsy include those
Adequate nutrition who:
a
pieiisslw
Ole: Acquired brain injury A. Have a high birth weight
B. Do not cry in the first 5 minutes after
15. The Canadian Association for Community
birth
Living believes the following:
C. Need mechanical ventilation
A. Children with an intellectual disability
D. Have bleeding in the brain
should live with families and be
E. Have heart, kidney, or spinal cord
integrated into regular schools whenever
abnormalities
possible.
E Have blood problems
B. Children with an intellectual disability
G. Have seizures
should learn and play with others who
do not have disabilities. JiSk What impairments may occur with cerebral
C. Adults with an intellectual disability palsy?
should control their own lives to the Intellectual disability
fullest extent possible. Learning disability
D. Adults with an intellectual disability Hearing impairments
should live in a long-term care facility Speech impairments
or have choices and decisions about Vision impairments
their care made by others. Bowel and bladder control problems
E. People with an intellectual disability Seizures
have the right to privacy and to love Attention-deficit hyperactivity disorder
and be loved. ot
ee)
GyeBreathing problems
FE People with an intellectual disability
should learn about sex, sexual abuse,
and sexuality issues.

CHAPTER 36 Developmental Disorders and Disabilities 221
20. Symptoms of attention-deficit hyperactivity MULTIPLE CHOICE

disorder (ADHD) can include:
Becoming easily flustered and tense Circle the correct answer.
A tendency toward addictive behaviours
23. A client who has epilepsy:
Difficulty structuring time and setting
priorities
A. Can never drive a car
B. May be able to function normally with
Breath-holding and pouting behaviour
GaSe
PRC Difficulty completing tasks medication
C. Can never get a job
2A. What behaviours would you expect to see D. Is intellectually disabled
in a client with autism spectrum disorder
24. Hydrocephalus is treated by:
(ASD)?
A. Medication
Poor speaking skills
B. Closing the sac or pouch
Repeating words or phrases
C. Placing a shunt in the brain
Starting or maintaining conversation
D. Physiotherapy and occupational therapy
Repeating body movements
Spending time with others 25. Certain body movements and body parts
Showing little reaction to pain are affected by cerebral palsy (CP). Identify
Overreacting to noise and touch the correct term used to describe the loss of
Liking cuddling ability to move corresponding parts on both
oa
eee)
Having frequent tantrums for no sides of the body.
apparent reason A. Diplegia
— Forming strong attachment to a single B. Monoplegia
item, idea, activity, or person C. Hemiplegia
Needing routines D. Quadriplegia
Fearing danger
Responding to others 26. A client with cerebral palsy may have:
4
ZeDisplaying aggressive or violent A. A large tongue
behaviour B. Short, wide hands
C. Involuntary movements
22:3 What therapies are used to help the client D. Asmall head
with autism spectrum disorder (ASD)?
Behaviour modification 27. A client with autism spectrum disorder
Speech and language therapy (ASD) may:
Music, auditory, recreation, and sensory A. Show little reaction to pain
therapies B. Have speech impairments
Occupational therapy C. Have seizures
Surgical modification D: >)Drool
Medication therapy
OPP
ammo Diet therapy

222 CHAPTER 36 _ Developmental Disorders and Disabilities
MATCHING :
Match the types of spina bifida with the correct description.
28. Part of the spinal column is contained inasac A. Spina bifida occulta
29. Spinal cord and nerves are usually normal; B. Spina bifida cystica
corrected with surgery
30. Defect in vertebrae closure but cannot C: Meningocele

be seen on outside of body
31. Pouch contains nerves and spinal cord; loss of | D. Myelomeningocele

function
Match the three types of cerebral palsy to the correct description of muscle movements.
52. Spastic A. Muscle tone is weak, and coordinating

movement is difficult.
33. Athetoid B. Movement is stiff and jerky, affecting

one or both sides of the body.
34. Ataxic C. Movement is involuntary and

involves constant, slow weaving or
withering motions in the trunk,
arms, hands, legs, and feet.
FILL IN THE BLANKS
35. What physical disorders or problems often affect children with Down syndrome?
ae
b.
c. At risk for
36. Lack of oxygen in early childhood can also cause cerebral palsy. The lack of oxygen can occur from
a
bs
G
d.
37. What activities of daily living are affected because of spastic movements with cerebral palsy?

CHAPTER 36 Developmental Disorders and Disabilities 223
38. What functions are impaired with autism spectrum disorder?

a
b.
Cc.
39. What kind of impairment can occur with these disorders?

a. Spina bifida occulta
b. Meningocele
c. Myelomeningocele
40. Ifthe pressure inside the head of a child with hydrocephalus is not treated, what kinds of problems
can result?
a
b.
(S,

CHAPTER 3/
TRUE OR FALSE FA phobia involves intense fear of an

object or situation.
F Selective mutism is an inability
ela ak A mental health disorder can affect or extreme reluctance to speak in
all dimensions of a person's life. certain social situations.
ie T F Depressive disorders are usually MMs F In the manic phase of bipolar

mild in nature. disorder, the person feels depressed
and worthless.
otiogd Dea S ‘The onset of most mental health
12; F Depression in the older person is
disorders occurs in mid- to late-life.
rarely overlooked.
4.T F Anxiety disorders are the least i; F Major depression can occur at any
common of all mental health issues. age.
ee er Communication is important
14. F Psychosis is a mental disorder in
when caring for persons with
which the perception of reality is
impaired.
mental health disorders.
15. F Delusion is the uncontrollable urge
Ga tea EL Panic disorders are more common to perform an act.
in women.
16. F The term hallucination is another
fet E A panic attack occurs suddenly word for sleepwalking.
with no obvious reason.
bes F Schizophrenia affects one’s ability
to function in all aspects of life.
ial Ba When a panic attack occurs, the
client may experience racing heart 18. F Someone who has schizophrenia
and even chest pain. has a split personality.
226 CHAPTER 37. Mental Health Disorders
N94; 1, F Without treatment, the person « oes TF For optimal mental health
who has schizophrenia has functioning, teenagers should get 5
problems knowing what is real and to Ghours of sleep each night.
what is not.
20. T People with depression might have MULTIPLE RESPONSE

as a symptom the belief that others From the list below, choose all of the correct
are betraying them. answers.
205-1 A compulsion is an unwillingness to
33. What are some of the causes of mental health
accept reality.
disorders?
729 A Vi An obsession is resentfulness toward A. Biological factors
others. B. Extreme intelligence
C. Childhood trauma or conflict
232-7 People fixated with the idea that D. Social and cultural factors (e.g., poverty,
germs are on their hands will often discrimination, social isolation)
wash their hands repeatedly. E. Stressful life events (e.g., death of a
24.7 If a person believes he or she is loved one, divorce)
the prime minister of Canada, 23 Poor physical health or disability
that person is having a delusion of
34. ‘The various forms of psychotherapy include:
grandeur.
Psychoanalysis
25. 1. Bipolar affective disorders are easy Behaviour therapy
to diagnose in children. Group therapy
Diet therapy
26. T An older client with fatigue, slow >MOOR Family therapy
or unreliable memory, agitation,
and thoughts of death may be 35. A person who is suffering from schizophrenia
suffering from depression. may exhibit the following behaviours:
A. Psychosis
2¢.. L. A client with anorexia nervosa
B. Delusions
craves food; after eating, the person
C. Increased need for sleeping
induces vomiting.
D. Hallucinations
28. T Some people who are bulimic take E. Paranoia
diuretics to lose weight.
ZOS ST. A client with schizophrenia
may experience delusions and
hallucinations.
S055E A person with anxiety experiences
vague, uneasy feelings and feels a
sense of danger or harm.
lis. Gl To support a client with a

disruptive, impulse-control, and
conduct disorder, you should try to
hug the client.

CHAPTER 37. Mental Health Disorders 227
a in NR MI EIDE UG UML ES LM EL SL ESM AAU ATEN LVL TR UA eT Ned ENE
36. Signs and symptoms of depression include: 40. Which of the following is an example of an
Bloating and flatulence unhealthy coping response to stress?
Feeling sad, “blue,” or hopeless A. Going for a walk
Itchy skin and hives B. Exercising
Irritability C. Chain smoking
Reduced interest in almost all activities D. Having a piece of cake with a meal
OO Significant weight gain or loss, without
dieting 41. An older person may not be diagnosed with
Insomnia or too much sleep depression because:
Too much or too little motor activity A. It rarely occurs in an older person
Fatigue or loss of energy B. ‘Treatment of physical problems is more
Feelings of worthlessness or guilt important in an older person
Strong desire to eat a nonfood substance C. ‘The older person may be thought to
Increased ability to concentrate or think have dementia
Difficulties making decisions D. Depression in older persons is usually
ATE
IO
ZrRecurrent thoughts of death
mild and does not require treatment
Bra Which of these factors may contribute to a
mental health disorder? 42. Which of these experiences would be present
A. Poor physical health and lifestyle in someone with delusions of persecution?
B. Loving and satisfying relationships A. Seeing, hearing, or feeling something
C. Inability to cope with stressful life events that is not there
D. Family members with a mental health B. Not sleeping or taking time to tend to
disorder self-care needs
E. Ability to handle challenging situations C. Believing that one is mistreated, abused,
E Traumatic past life experiences or harassed
D. Having poor judgement and morals and
38. Which are common risk factors for suicidal lacking ethics
intent in an older person?
Loss of independence 43. When a person has anorexia nervosa, which
Ability to adapt to change of these behaviours is likely to be displayed?
Unable to manage finances without A. Dieting even though the person
assistance becomes emaciated
Ability to obtain groceries B. Withdrawing from the world and
Extreme losses in friends and family showing no interest in others
OD
mooChronic pain that interferes with sleep C. Regressing to the behaviour of a
younger child
MULMPLE CHOICE D. Having delusions or hallucinations
Circle the correct answer. 44. Which of these substances can be abused?
A. Legal drugs
oo. Self-harm is defined as: B. Illegal drugs
A. The misuse of and inability to stop the C. Alcohol
abuse of illegal drugs D. All of the above
B. A disorder that involves recurrent
thoughts about ending one’s own life
C. Inflicting harm on oneself in order to
deal with feelings of anxiety, depression,
or loss of control
D. Burying unpleasant or painful thoughts

228 CHAPTER 37. Mental Health Disorders
45. Which of the following statements about 48. Mr. Wong becomes very angry and states
post-traumatic stress disorder (PTSD) is that someone has been in his room and has
true? taken his razor. He is swearing and yelling at
A. People with PTSD will often the staff. Your best response is:
voluntarily share their experiences. A. “I don’t blame you for being angry.”
B. PTSD occurs only in adults. B. “That doesn’t make any sense. I don’t
C. Survivors with PTSD will most likely know who would want your razor.”
improve without counselling. C. “This happens all the time” and begin
D. PTSD is a trauma- or stress-related to look in his bedside unit.
disorder. D. “This is very upsetting. Can you show
me where you usually keep your razor?”
46. What is the best response to use when caring
for a client who is depressed? 49. Which statement in regard to suicide is
A. “Let me tell you a funny story.” correct?
B. “You seem down today.” A. Suicidal intent is a sign of a serious
C. “Cheer up and don’t look so sad.” physical health problem.
D. “Dont worry; everything will be all B. More women die by suicide than men.
right.” C. Men use less violent means than women
to die by suicide.
47. When caring for a client who has a D. Suicide is a common cause of death
substance-related and addictive disorder, you among adolescents.
should:
A. Confront the client in a professional 50. You suspect a client has suicidal intent. What
manner if you suspect the client is should you do?
abusing alcohol. A. Quietly collect all the client’s pills and
B. Discuss suspicions of alcohol abuse only place them in a paper bag.
with your supervisor. B. Stay with the client but inform your
C. Say nothing to anybody to respect the supervisor immediately.
client’s right to confidentiality. C. Tell the person that “everyone has those
D. Locate the alcohol and discretely pour it thoughts.”
down the drain. D. Recommend that the client take
another anxiety pill with her tea.
FILL IN THE BLANKS 55. An older person has the following symptoms:
fatigue, slow or unreliable memory, agitation,
51. An obsession is and thoughts of death. It may be that he or
she is suffering from
2. A compulsion is
56. A person with
53. Why does a person act on an obsessive idea? craves food. After eating, the person induces
54. Ifa person believes he or she is the prime 97. Why does a person with bulimia take diuretics?
minister of Canada, what type of false belief
is present?

CHAPTER 37. Mental Health Disorders 229
58. What do the following statements describe? 60. What do the following statements describe?
¢ Thinking and behaviour are disturbed. e The person may have extreme mood
e Delusions and hallucinations are swings.
present. e At times, the person may feel very sad,
e ‘The individual has difficulty relating to lonely, worthless.
others and the world. ¢ Tends to run in families.
e At times, the person may have much
energy and be excited.
59. What do the following statements describe?
¢ ‘The individual has vague, uneasy feelings.
e ‘The person feels a sense of danger or 61. What do the following statements describe?
harm. Abusive
¢ Occurs in response to stress. Paranoid
e ‘The person is unaware of the source of the Distrusts others
uneasy feeling. Irresponsible

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CHAPTER 38
Disorientation, Delirium,
and Dementia
TRUE OR FALSE 7. People with Alzheimer’s disease

can control their behaviours
Circle T for true, or circle F for false. of forgetfulness, incontinence,
agitation, or rudeness if they are
feet iE Never tell a disoriented client the
shown how.
date and time.
Alzheimer’s disease progresses slowly
AE 9) When caring for disoriented
at a predictable rate in all people.
clients, you should provide
newspapers and magazines and 9. It is important to reason with a
access to television and radio. client who is cognitively impaired
as a first step when the client is
oo oF It is all right to rearrange the
behaving in an aggressive manner.
furniture or belongings of a
disoriented client. 10. Individuals who have a cognitive
impairment are not likely to be
4. T F Delirium is a permanent state of
physically abused.
mental disorientation.
Always approach a cognitively
bee Loe uk Delirium is an emergency. impaired client in an assertive and
controlling manner.
Gb ir Repetitive behaviours that are
harmless may cause no problems 12. Delirium is the same as dementia.
to the client.
13. ‘The average age of people with
Alzheimer’s disease and related
dementias is 42 years.
232 CHAPTER 38 __ Disorientation, Delirium, and Dementia
14. TF A client with dementia is in dangeg MULTIPLE RESPONSE

of having accidents because the
client does not recognize safety
hazards. answers.
15. TF A catastrophic reaction refers to 24. Early warning signs of dementia may
; include:
cheohicaall Eases A. Memory loss that affects daily activities
B. Disorientation
16. T F Aoarding is intentionally obtaining C. Problems finding the right words or
information about a client. following conversations
D. Poor judgement
17. T EF When caring for a disoriented E. Urinary urgency
client, face the client and speak E Problems with common tasks
clearly and slowly. G. Changes in mood, behaviour, or
personality
18. TF You should maintain a disoriented H. Loss of interest in activities or hobbies
client’s routine by following a
schedule for meals, bathing, 25. Some of the behaviours associated with early-
exercise, IV, and other activities. stage dementia include:
A. Increase in spontaneity—more outgoing
19. TF \ Cueing at mealtime is an or interested in things
important way to assist a client B. Problems finishing thoughts, following
who has middle-stage dementia. directions, and remembering names
C. Poor judgement
20. TF The sandwich generation refers to D. Blaming others for mistakes,
adult children who care for their forgetfulness, and other problems
own children and their parents. Irritability or defensiveness
21. T FEF Sundowning refers to the way
mabs Problems performing everyday tasks
daylight can cause an anxiety 26. Ways that caregivers can help to calm a
reaction in some clients. person with dementia who screams include:
A. Providing a calm, quiet settin
22. TF A disoriented client can become : 8 oe : 8
darian ; B. Using touch to calm the client
more disoriented if not wearing ; ‘
C. Playing soft music
asses. : ‘ ; :
8 D. Discouraging the client from wearing
roe ; > hearing aids to reduce noise
23. TF _ Disorientation, delirium, and FE Lavi 8 Eamil b f ;
; ; ! aving a family member or
dementia are all considered to be 8 ‘ Oh aa
F
normal aspects of aging. 8
caregiver comfort and calm the e client
cli

CHAPTER 38 Disorientation, Delirium, and Dementia 233
ke What should you do when a client with 31. Which of the following actions may increase
Alzheimer’s disease fondles her genital area? a client’s disorientation?
A. Check to see if the client is wet or A. Stating your name and showing your
soiled. name tag
B. Provide for privacy and safety for the B. Giving the client very detailed instructions
client. prior to performing a procedure
C. Notify your supervisor if this is a C. Calling the client by name each time
frequent behaviour. you are in contact with him
D. Ask the client’s family to bring in sex D. Encouraging the client to wear his
magazines so the client can look at glasses and hearing aid if needed
them.
32. Which of these measures is helpful when a
28. What are some reasons a family may decide client with Alzheimer’s disease is agitated?
to place a person with Alzheimer’s disease in A. Approach the client in a slow, unhurried
a long-term care facility? manner
A. Clients with Alzheimer’s disease are not B. ‘Turn the volume of the TV up to get
allowed to be in a private home. the client’s attention
B. Family members cannot meet the C. Gently begin massaging the client’s back
person's needs. D. Place the client in a darkened room and
C. Family members have their own health shut the door
problems.
D. The person's behaviours present a aoe What should you do if the client repeatedly
danger to herself or to others. tries to go outside and wander?
A. Make sure the client receives medication
to calm him or her down.
MULTIPLE CHOICE B. Restrain the client to prevent wandering.
Circle the correct answer. C. If allowed, escort the client outside and
stay with him or her.
zo. How can you maintain the day—night cycle D. Tell the client he or she is not allowed
for a disoriented client? outside.
A. Keep the room well lit all day and at
night 34. How can you incorporate principles of
B. Keep the curtains closed in the client's validation therapy when caring for a client
room all day who thinks that “kitty cats” are in her closet?
C. Encourage the person to wear regular A. Ask her to describe the cats
clothes during the day, not sleepwear B. Distract her by showing her pictures on
D. Do not allow the client to be toileted her dresser
during the night C. Tell her that there are no cats in that
facility
30. Which statement is true concerning clients D. Ask her if she is hungry
with Alzheimer’s disease and sundowning?
A. The client may be frightened by poor 35. Vascular dementia is:
light or shadows. The least common form of dementia
B. Sundowning occurs only on clear nights Is also called Creutzfeldt-Jakob disease
when the moon is visible. Is the result of a series of strokes
C. The client can be talked out of his fears. ee
BNO)
Is caused by a lack of vitamin D in the
D. There is no treatment for sundowning. diet

234 CHAPTER 38 Disorientation, Delirium, and Dementia
36. A broad term describing a progressive 39. What is a classic sign of Alzheimer’s disease?
deterioration of intellectual function is: Problems finding one’s car keys
Ac) Dementia Repeatedly saying the same statement
B. Mental health disorder Engaging in reckless behaviour
G.- Senility ee
Forgetting how to perform long
D. Schizophrenia division
BYhe Which of the following is a reversible form 40. What is apraxia?

of dementia? A. A sudden increase in cursing or
A. Parkinson’s disease swearing
B. Brain tumour B. Temporary mental disorientation
C. Normal pressure hydrocephalus C. The loss of being able to perform
D. Multiple sclerosis learned skills
D. A sudden loss of hair
38. Pseudo-dementia occurs when:
A. Pathogens destroy nerve cells in the 41. Apathy can be described as:
brain A. Extreme mood swings within a short
B. ‘Thiamine is in high levels in the body time period
C. The cells multiply, forming a brain B. A defence mechanism when
tumour communicating
D. When severe depression causes C. An absence of emotional feeling
cognitive changes, mimicking dementia D. A display of increased anxiety
MATCHING
Match the area of concern for people with dementia with its correct care strategy.
42. Follow facility policy for locking doors A. Loss of short-term memory
and windows.
43. Provide plastic eating and drinking B. Forgetting a person, place, or time
utensils.
44. Tell the client that you will provide C. Risk for injury
protection from harm.
45. Give consistent responses. D, Wandering
46. Provide for the client’s food and fluid E. Sundowning

needs.
47. Play music and show movies from the FE. Hallucinations and delusions
client’s past.
48. Make sure the client has eaten, because G. Reduced ability to meet one’s own basic needs
hunger can increase restlessness.

CHAPTER 38 __ Disorientation, Delirium,and Dementia 235
Match the area of concern for people with dementia with a strategy to give care to address that concern.
49. ‘Try bathing the client when he or she Tat Disorientation to place and time
is calm.
50. Make sure the client wears an ID Displays of aggressive behaviour if startled
bracelet at all times.
va Approach the client in a calm, quiet Easily distracted during meals

manner.
oye Provide a quiet and calm eating Wandering

environment. Cue chewing behaviours
as needed.
53. Ensure the client’s eyeglasses and hearing Hallucinations and delusions
aids are clean and in good repair. Keep
area well-lit and play soft music.
54. Keep a calendar and clock where the Fear of personal care
client can see them.
FILL IN THE BLANKS

Match the signs and symptoms below with the following conditions:
A. Disorientation
B. Dementia
5D. Loss of ability to recognize own reflection in a mirror
56. Can occur after surgery
7 Anger, restlessness, depression, and irritability may occur
58. May be caused by losses of hearing and sight
59. Progressive loss of cognitive and social functions
Place the letter of the stage of dementia next to the symptom that best describes it:
A. Stage 1
B. Stage2
C. Stage3
60. Restlessness that increases during evening hours
61. Cannot walk or sit

236 CHAPTER 38 _ Disorientation, Delirium, and Dementia
62. Forgets recent events 5
63. Does not recognize family members
64. May say the same thing over and over again
65. Cannot tell the difference between hot and cold
66. Totally incontinent of urine and feces
67. Disoriented to time and place
68. Cannot communicate
69. Has difficulty following directions
70. Delirium is common in with

illnesses.
71. The risk of Alzheimer’s disease increases after the age of
72. Describe each of the following problems that occur with dementia or the behaviour that is displayed
with the problem.
a. Catastrophic reactions
b. Agitation and restlessness
c. Aggression and combativeness
d. Screaming
e. Abnormal sexual behaviour
f. Repetitive behaviours
73. What actions by a caregiver can cause agitation and restlessness?
74. How can you help someone with Alzheimer’s disease who displays abnormal sexual behaviour?

CHAPTER 38 __ Disorientation, Delirium,
and Dementia 237
75. What are reasons why sundowning may occur in a person with Alzheimer’s disease?
ahs
b.
Cy
76. What response may occur if a person with Alzheimer’s disease receives too many stimuli at one time?
77. Complete these statements that relate to providing care for a confused client.
a. Face the person and
b. Explain what
c. Give short, simple
d. Keep calendars and clocks with
e. Allow the person to place
far Ask questions. Allow enough time
g. Maintain atmosphere.
78. Why are locks placed at the top or bottom of a door to prevent wandering?
79. Why is it ineffective to argue or try to reason with a person with Alzheimer’s disease?

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TRUE OR FALSE FA cover is placed over the

tracheostomy opening when the
Circle T for true, or circle F for false.’ client is outside to prevent dust,
insects, and other small particles
ober or The sensor for the pulse oximeter is
from entering the stoma.
used only on the fingers.
10. T F Suctioning the upper airway may
(2g ee The doctor or nurse practitioner
be done through the mouth and
must order oxygen because oxygen
pharynx or the nose and pharynx.
is considered a drug.
HS ge F Suctioning should only be
Seal beady The support worker is responsible
performed daily.
for setting up a client’s oxygen.
tee k F Aclean (not sterile) catheter is used
4.T F The type of device used to deliver
for oro-pharyngeal suctioning.
oxygen is decided by the nurse.
haa F Support workers may change the
ol Need 9 A thoracentesis is a procedure in
settings on a mechanical ventilator
which lung tissue is removed.
as needed.
6, eve E A pulmonary function test 14. T F When a client has chest tubes, the
measures the amount of oxygen in
drainage system is kept above the
the client’s blood. level of the client’s chest.
Vendy, Fi Frequent oral hygiene should be 15. 7 F Petrolatum gauze is kept at the
given when the client is receiving
bedside to cover the insertion site
oxygen therapy. if a chest tube comes out.
hyd ee Tracheostomy tubes usually consist

of three parts.
240 CHAPTER 39 Promoting Oxygenation
F In the blood, hemoglobin 25. What signs and symptoms would tell you the
contained within the red blood client has hypoxia?
cells picks up oxygen in the lungs Restlessness
and carries it to the cells. Constipation
Dizziness
17, F If the client is wearing dark nail Disorientation
polish, you should remove it when Confusion
you want to use the pulse oximeter. Behaviour and personality changes
Increased ability to concentrate and
18. F Gloves are worn to prevent the follow directions
spread of infection when collecting Apprehension
a sputum specimen because Anxiety
sputum is a bodily fluid. Fatigue
19s F If you observe that the oxygen Agitation
rate is not set at the rate the
Decreased pulse rate
nurse stated, you need to adjust it
Decreased rate and depth of respirations
immediately. Often leaning forward when in a sitting
position
20. F Signs of irritation are evident on Cyanosis
the client’s arms when he or she is a
AS
ee
Ze
eo
wo
Ge Dyspnea
wearing an oxygen cannula or mask.
26. When a pulse oximeter is used, what should
Zits FA humidifier is often used in oxygen be reported and recorded?
administration to humidify the A. If you think the machine is not working
oxygen so it will not dry the mucous B. What the client was doing at the time
membranes in the client's airway. of the measurement
Cc Oxygen flow rate and the device used
ye F Coughing and deep-breathing D. Reason for the measurement (routine or
exercises help to prevent change in the client’s condition)
hyperventilation. 1S Other observations
23. F Chest percussion involves listening to yay How is the client instructed to exhale during
the lungs for abnormal lung sounds. coughing and deep-breathing exercises?
“Exhale slowly through pursed lips.”
MULTIPLE RESPONSE “Exhale in short, forceful puffs.”
“Exhale until you feel light-headed.”
From the list below, choose all of the correct i“Exhale until your ribs move as far
answers. down as possible.”
24. What processes are involved in the function
of the respiratory system?
A. Air moves into and out of the lungs.
B. Carbon dioxide is absorbed into the
bloodstream from the lungs.
‘Sc Oxygen (O,) and carbon dioxide (CO)
are exchanged at the alveoli.
The blood transports O, to the cells and
removes CO, from them.

CHAPTER 39 Promoting Oxygenation 241
28. What rules should you follow when handling 32. When you are caring for a client with a
the tubing for oxygen administration? tracheostomy, you should call the nurse if:
A. Secure connecting tubing (i.e., nasal ‘The client shows signs and symptoms of
cannula) in place. hypoxia
B. Make sure there are no kinks in the B. ‘The client shows signs of respiratory
tubing. distress
C. ‘Tape or pin the tubing to the client’s C. ‘The outer cannula comes out
garment according to employer policy. D. ‘The client must urinate
D. Make sure the client does not lie on any
part of the tubing. 33. What measures are implemented to prevent
E. Never handle the tubing without gloves. aspiration in a client with a tracheostomy?
A. Make sure dressings do not have loose
oe What fire safety rules should be followed if gauze or lint.
oxygen is in use? B. Instruct the client to breathe through
A. Place “No Smoking” signs in the room his nose.
and on the room door. Make sure the stoma is not covered with
B. Remove materials from the room that plastic, leather, or similar materials.
ignite easily. Instruct the client to take only showers.
C. Turn off electrical items before aOeMake sure the client is helped with
unplugging them. shampooing so that water does not
D. Use electrical equipment that is in good enter the stoma.
repair. F Instruct the client that swimming is not
E. Do not use materials that cause static allowed.
electricity (wool and synthetic fabrics). G. Make sure the client wears medical alert
E Know the location of fire extinguishers jewellery and carries a medical alert ID
and how to use them. card.
G. Ifa fire occurs, turn off the oxygen.
Then get the client to safety. 34. What observations should you report to a
H. Remind the client and family members nurse when assisting with suctioning a client?
about oxygen safety. Report safety A. An increase in pulse rate
hazards immediately. B. Irregular cardiac rhythms
C. A drop or rise in blood pressure
30. How can you assist the nurse in caring for D. Respiratory distress
clients with artificial airways?
A. By checking vital signs 35. What is the role of the respiratory therapist
B. By observing the client for signs of as part of the patient care team?
hypoxia and other respiratory problems = Prescribing oxygen therapy for a client
C. By reporting if an artificial airway B. Setting up the oxygen device for a client
comes out or is dislodged C. ‘Taking a leadership role in providing
D. By providing oral hygiene twice a day respiratory therapy
D Evaluating, treating, and maintaining
St: What are the parts of a tracheostomy tube? heart and lung function to help clients
A. Outer cannula keep breathing
B. Middle cannula E. Performing chest percussions on a
C. Inner cannula client, if needed
D. Obturator
E. Respirator

36. When caring for a client with chest tubes, , 40. When is the best time to collect a sputum
what information should be observed and specimen:
reported to the nurse? A. At mealtime
A. Changes in vital signs B. Early in the morning
B. Signs and symptoms of hypoxia and C. At bedtime
respiratory distress D. After using mouthwash
C. Complaints of pain or difficulty
breathing 41. What position is often preferred by clients
D. A decrease in chest drainage with difficulty breathing?
E. Bubbling in the drainage system A. Lying on one side
increasing, decreasing, or stopping B: Supine position
FE Any part of the system being loose or C. Orthopneic position
disconnected D. Prone position
G. Achest tube coming out
42. Which of these statements is true about
Wi While caring for a client with chest tubes, administering oxygen with a face mask?
one of the chest tubes falls out. After you call 740, The mask can irritate the throat.
for help, what should you do next? B. You need to listen carefully when the
A. Cover the insertion site with sterile client who is wearing a mask is trying to
petrolatum gauze speak.
B. Ask the client to hold his or her breath The client may eat and drink while the
C. Keep the client in a supine position mask is in place.
D. Stay with the client, and then follow the Oral hygiene is not necessary when a
nurse’s directions client is receiving oxygen through a
mask.
MULTIPLE CHOICE 43. The acronym “SOBOE?” stands for:

Circle the correct answer. A. Suction once by oxygen employee
B. Sputum obtained by obturator
38. A pulse oximeter is used to measure: extension
A. ‘The oxygen concentration in arterial (Ce Sudden oxygen bradypnea outpatient
blood emergency
B. ‘The pulse rate D. Short of breath on exertion
C. The oxygen concentration in the lungs
D. ‘The amount of oxygen in the blood 44. When the nurse is giving tracheostomy care,
the support worker may be asked to assist
39. Which of these procedures may be done by a when the ties are removed by:
support worker? A, Holding the inner cannula in place
A. Administering oxygen therapy B. Cleaning the outer cannula
B. Suctioning CG Cleaning the stoma
C. Collecting a sputum specimen By Suctioning the tracheostomy
D. Performing tracheostomy care

45. Which of the following would be the 47. Which physical condition may most
responsibility of the support worker with a likely contribute to Mrs. Tleen’s difficulty
client on a mechanical ventilator? breathing?
A. Resetting the alarm if it rings A. Diabetes
B. Performing suctioning whenever the B. Epilepsy
breathing tube is plugged C. Emphysema
C. Carefully changing the oxygen tubing D. Glaucoma
D. Using established hand or eye signals
for “yes” and “no” 48. Narcotic pain medication can affect
breathing by causing:
46. Mrs. Doronsulic’s respiration rate is 34 A. ‘The respiration rate to increase
breaths per minute. This is called: B. ‘Thickened mucus in the lungs
A. Eupnea C. Nasal congestion and sinus problems
B. Bradypnea D. A suppressed respiration rate and
C. ‘Tachypnea breathing that is shallower than normal
D. Apnea
MATCHING
Match the name of each type of artificial airway with the correct description.
49. An artificial airway inserted through the mouth and into the A. ‘Tracheostomy tube
pharynx
50. An artificial airway inserted through a nostril and into the B. Endotracheal tube
pharynx
51. An artificial airway inserted through the mouth or nose and C. Naso-pharyngeal airway
into the trachea
52. An artificial airway inserted through a surgical incision into D. Oro-pharyngeal airway
the trachea
Match each test with the correct description.
53. Measures the amount of air moving in and out of the A. Chest X-ray
lungs
54. Allows the doctor to inspect the trachea and bronchi B. Lung scan
55. Punctures and aspirates air or fluid from the pleura C. Bronchoscopy
56. Evaluates changes in the lungs D. ‘Thoracentesis
ores Radioactive gas is inhaled, allowing the physician to see = E. Pulmonary function tests
what areas are not getting air or blood
58. Laboratory test that measures the amount of oxygen in FE Arterial blood gases
the blood

FILL IN THE BLANKS :
59. Explain how these factors affect oxygen needs.

a. Respiratory system
Cardiovascular system
Red blood cell count
Nervous system
Aging
Exercise
Fever
Pain
Drugs
Smoking
Allergies
Pollutant exposure
Nutrition
Alcohol
60. Coughing and deep-breathing exercises help to prevent and
61. Describe each of these oxygen sources.

eb Wall outlet bse Tinea ieee RE RN Fn
b. Oxygen tank
Cc. Oxygen concentrator

62. Describe the following devices used to deliver oxygen.

a. Simple face mask
b. Partial-rebreather mask
c. Non-rebreather mask
d. Venturi mask
63. What should you do if the oxygen humidifier is bubbling?
64. Where should the support worker check for signs of irritation from the oxygen cannula or mask?
65. How can the person with an artificial airway communicate with you?
66. When assisting with suctioning, the support worker may check the person's pulse, respirations, and
pulse oximeter ; , and
the procedure.
67. When the support worker is assisting with suctioning, the following should be reported to the nurse:
oP
ono
68. An Ambu bag is used to before to

prevent or treat hypoxia.
69. Why is it important to keep the call bell within reach and answer it promptly when you are caring for
a person with mechanical ventilation?

CROSSWORD
es
fd ss a a Pl elipalaed
ipa
SRE RS ee as
PapC[aMbsefiet
isshies ||
eer
=aoO
ASE peaees
eee ae
el sa abe [al]
Across 15. Being able to breathe deeply and comfortably

only while sitting or standing
Zz Rapid breathing; respirations are usually
more than 24 per minute 17. Difficult, laboured, or painful breathing
Respirations that are rapid and deeper than Down

normal 1. Collection of air in the pleural space
Process of withdrawing or sucking up fluids
3. Escape and collection of fluid in the pleural
(secretions)
space (2 words)
Slow breathing; respirations are fewer than 4. Collection of blood in the pleural space
12 per minute
5. Respirations that are slow, shallow, and
. Expectorated mucus
sometimes irregular
Below the normal level of oxygen in the
6. Bloody sputum
blood
8. Process of inserting an artificial airway
13. Lack or absence of breathing
16. Sensitivity to a substance that causes the
14. Harmful chemical or substance in the air or
body to react with signs and symptoms
water

CHAPTER GO
Heat and Cold Applications
TRUE OR FALSE 10. TF You should check the skin every

15 minutes when moist heat or cold
compresses are in place.
1. TF Bags that contain beans or wheat 11. T FE A sitz bath is a type of soak used to
should always be shaken thoroughly clean and soothe perineal or anal
before being heated. wounds.
2. TF Applying cold to a body area will 12. TF Never apply a heat pack without
constrict blood flow to that area. covering the pack first.
3. TF Ifthe skin is pink, it would be

described as being “cyanotic.” MULTIPLE RESPONSE
4. T F A sitz bath is a warm soak for sore
answers.
hands and wrists.
13. How does dilation of the blood vessels to an

5. TF Support workers can generally apply
heat and cold packs to clients. area help in healing?
A. More blood flows through the vessels
6. T F Moist heat usually penetrates more and therefore tissues have more oxygen
deeply than dry heat. and nutrients for healing.
B. ‘The dilated blood vessels aid in
7. T F Applying a cold pack for too long can digestion and make the client feel more
cause the underlying skin to burn. relaxed.
C. Excess fluid and wastes are removed
8. TF Short-term heat applications affect from the area faster, helping to reduce
blood vessels by making them pain and swelling and helping the
constrict (or become narrow). muscles to relax.
9. T F Heat or cold should be applied at

25-minute intervals.
248 CHAPTER 40_ Heat and Cold Applications
14. Heat applications are used to: 18. What guidelines should be followed for
Improve muscle tension applying heat or cold?
Promote healing A. Apply only when ordered by a
Relieve pain professional, allowed by your employer,
Reduce tissue swelling and assigned to do so.
Increase joint stiffness Know how to use the equipment.
Oe
ie Improve muscle strength and endurance Measure the temperature of moist
applications after applying.
15. Which people or groups of people are at risk Follow employer policies for safe
for burns from heat applications? temperature ranges.
People with metal implants Do not apply hot applications above
Young children 49 1G.
Older people Ask your supervisor what the
Dark-skinned people temperature of the application should
People who have decreased sensation be.
(e.g., people with diabetes, spinal cord Know the precise site for the
injuries, or stroke) application.
People with dementia or confusion Before applying moist heat or cold
Infants applications, cover them with a flannel
or terrycloth cover, towel, or pillowcase.
16. When working in home care, what can you Leave at-risk clients unattended only for
use to apply ice? short periods of time.
A. Ice bag Observe the skin for signs of
B: Ice collar complications. If any signs are observed,
css Ice cube tray immediately remove the application and
Dy, Ice glove report to your supervisor.
Observe for changes in the client’s
U7. What are the signs of complications when
behaviour that may indicate sleepiness.
applying heat or cold?
Remind the client not to change the
As Complaints of discomfort, pain,
temperature of the application.
numbness, or burning
Prevent chills. Cover the client with a
Excessive redness
blanket or robe. Control room drafts.
Blisters
Ask your supervisor how long to leave
Pink skin
the application in place. Carefully
Cyanosis
watch the time.
mmo
Shivering
Applications are left on for no more
than 25 minutes.
Follow Standard Practices.

CHAPTER 40 HeatandColdApplications 249
MULTIPLE CHOICE 23. Why are people with thin skin at

increased risk for burns with heat and cold
applications?
A. They have better circulation than people
19. Which of these factors may make a client
with thicker skin.
more susceptible to burns?
They lack enough of a protective
A. Respiratory disorders BI
adipose layer.
B. Dehydration C
They usually have taken better care of
C. Circulatory disorders
their skin.
D. Infections D
They lack feeling to their skin.
20. Heat should not be applied to which of these
24. Heat and cold applications must be covered
areas?
before being applied to a client’s skin. Which
A. Metal hip and knee replacements
is the best explanation for why this is done?
B. Joints A
It protects the heat and cold pack from
C. Soft tissues
wear and tear.
D. Old fractures B
It keeps the heat and cold pack cleaner
21. A sitz bath may cause the client to feel weak and free of germs.
or faint because: © It helps to prevent contact burns on the
A. The bath increases pain in the area. 5 client’s skin.
B. Blood flow increases in the pelvic area, It prevents skin irritation from the
and less blood flows to other body surface of the pack.
parts.
C. Blood flow decreases in the pelvic area,
and more blood flows to other body
parts.
D. The client becomes chilled.
22. You applied a commercial cold pack to Jane's

ankle as instructed in her care plan. After
3 minutes, she complains of extreme pain to
the area. What should you do first?
A. Check it after another 2 minutes
B. Notify your supervisor
C. Take her pulse in that area
D. Remove the cold pack

250 CHAPTER 40 _ Heat and Cold Applications
MATCHING ‘
Match the types of heat applications with the correct descriptions or statements. The same answer may
be used more than once.
25. ______ A moistened soft pad applied over a body area A. Dry heat
26. _____ Does not penetrate deeply B. Moist heat
27. ______ Temperature must be lower to prevent injury C. Compresses
28. ______—~ A warm, moist application that involves immersing a body D. Soaks
part in heated water
29. _____ The higher temperature needed means burns are still a risk
30. ______— Moist heat is applied to a small area
31. _____ The water temperature should be hot (36.6° to 41.1°C [97.8° to 105.9°F])
32. _____ The tub may be used for applying moist heat to a large area
FILL IN THE BLANKS
33. What happens to blood vessels and blood flow when heat is applied for a long time?

CHAPTER
Caring for Infants

and Their Parents
TRUE OR FALSE 8. The diaper is applied loosely while

the circumcision is healing.
2: It is important to respond to the
1 Wie ® Never leave ; baby unattended, or cries of the baby or to feed the baby
with a sibling, in a tub of water. when he or she is hungry in order to
2. TF Formula may be heated safely in a lb, SaG Dabyaieel Serute ana Ovce
microwave. 10. If a baby is “fed on demand,” the
3. TF _ Extra bottles of formula can be payoisdec Cn aiteeuia creda:
stored in the refrigerator and used 11. To reduce the chance of infection,
within 24 hours. thoroughly rinse bottles and other
4. T F Disposable diapers are changed SUNS Mk ae
only when the baby has a bowel ze If the baby has had a large bowel
OSA ee movement or has a rash, the genital
5. T F All disposable diapers can be flushed eas Ripe Geeta ee
down the toilet when soiled. :
13. When diapering a boy, the cloth
6. TF Thecord stump dries up and falls off
diaper is folded in front. For
in 7 to 10 days.
diapering girls, the diaper is folded
in back.
7. TF Cord stump care is given every time
a bath is given.
252 = =CHAPTER 41 Caring for Infants and Their Parents
14.
T F It is important to plan well when , 22. What signs and symptoms would tell you
bathing a baby because once you that an infant may be ill?
start, you cannot leave the baby ia, Jaundice
unattended. B. Redness or drainage around the cord
stump or circumcision
15. F When you are giving the baby a Normal temperature
sponge bath, the head is washed at Limpness and slowness to respond
the end of the bath. Occasional screaming or crying
Flushed or pale skin
16. F It is important to keep babies’ Heavy perspiration
nails short to prevent them from Rash
scratching themselves. Soft, rhythmic respirations
Coughing or sneezing
NZ. F It is best to trim a baby’s nails when Reddened or irritated eyes
he or she is awake so the baby is not
or
Ee
eeeTurning head to one side or putting a
frightened. hand to one ear (signs of an ear infection)
Very hungry; eating
18. F The mother will have an abdominal
Vomiting most of the feeding or
incision if her baby is delivered by
between feedings
Caesarean section.
Soft stools
Uk F Diarrhea can quickly upset the baby’s Stiff neck
water balance and harm the baby. ae
LO, Signs of dehydration (i.e., fewer than
six wet diapers a day, dark yellow urine,
decreased saliva and tears, dry lips, dry
MULTIPLE RESPONSE and wrinkled skin, sunken eyes and top
From the list below, choose all ofthe correct answers. of head)
Frequent watery, green, mucusy, or
20. When changing a baby on a table or sofa, foul-smelling stools
you can prevent injury by:
Exe Wrapping a belt around the baby and 23, What ways would be helpful to assist a
table top to keep the baby secure mother with breastfeeding?
B. Keeping one hand on the baby at all times FS Wash your hands and remind the
C. Gathering all supplies before beginning mother to wash hers
the diaper change B. Tell the mother to assume a comfortable
I@). Placing a baby monitor nearby and position
listening for sounds if you must leave Change the baby’s diaper if necessary
the baby unattended Bring the baby to the mother
Tell the mother to cover the baby and
DAK Which health reasons or personal beliefs herself with a blanket
would most likely influence parents to Help the mother burp the baby
choose to have their son circumcised? Change the baby’s diaper after the
oN Better hygiene of the genital area feeding if necessary
sy To possibly prevent certain cancers =oF Lay the baby in the mother’s bed if the
C. To prevent the foreskin from getting baby is asleep
caught in trouser zippers in the future —. Record what time the baby nursed and
D Male circumcision is a religious practice how long on each side, and report any
of the parents problems or concerns

CHAPTER 41 Caring for Infants and Their Parents 253
24. To what types of baby formula must you add 28. What safety measures should be followed
water? when bathing a baby?
A. Ready-to-feed formula A. Never leave the baby alone on a table or
B. Powdered formula in the bathtub.
C. Concentrated formula B. Hold the baby securely throughout the
bath.
25. What measures are important to follow for C. Keep room temperature between 18
bottle-feeding a baby? and 20°C.
AS Place the bottle in the microwave to D. Water temperature must be between
warm up the formula. 37.8 and 40.6°C. Measure bath
B. Tilt the bottle to check the flow of temperature with a thermometer or test
formula dripping out of the nipple. with the inside of your wrist.
Assume a comfortable position for
feeding. 29. Signs and symptoms of postpartum
Hold the baby close to you. complications include:
Tilt the bottle so that the neck of the ie Fever of 38°C or higher
bottle and the nipple are always filled. B. Chills, poor appetite, fatigue, nausea, or
7 Lay the baby down comfortably and vomiting
prop up the bottle for the feeding. Lochia that soaks a sanitary pad within
Burp the baby after about half the 1 hour of application
formula and at the end of the feeding. Foul-smelling lochia
coKeep feeding the baby until all the Large number of clots in the lochia
formula is finished. Painful, burning, or difficult urination
Place remaining formula in the Mild abdominal or perineal pain
eyy
nepali
Te Bleeding,
—
refrigerator. redness, swelling, or drainage

= Wash the bottle, cap, and nipple after from a Caesarean-section incision
the feeding. Leg pain, tenderness, or swelling
Breast pain, warmth, tenderness, or
26. What are good methods for burping a baby? swelling
tek Hold the baby over your shoulder and Ke Feelings of severe depression
gently pat or rub the baby’s back.
B. Support the baby in a sitting position
on your lap. Gently pat or rub the MULTIPLE CHOICE
baby’s back. Circle the correct answer.
C. If the baby is under 3 months, bounce
the baby gently. 30. Which of these statements is true about cloth
diapers?
ZT Cord care includes: A. When soiled, they are placed in the
n't Keeping the cord moist at all times garbage.
B. Washing your hands before and after B. ‘They can be easily composted.
contact with the umbilical area C. ‘They are cheaper to use than disposable
CF Keeping the cord clean by gently wiping diapers.
around the base of the cord with a clean D. Cloth diapers are never washed in hot
cloth moistened with warm water water.
Keeping the top of the diaper below the
cord
Reporting any signs of infection (e.g.,
redness, odour, drainage from the cord)

254 CHAPTER 41 Caring for Infants and Their Parents ©
31. How do you remove formula from bottle -« 36. What part of the body is cleaned with cotton
nipples? swabs during a sponge bath?
A. Place them in the sterilizer A. Nostrils
B. Squeeze hot, soapy water through the B. Eyes
nipples Ge Bats
C. Clean them with a bottle brush D. No part of the body
D. Wash them with cool, clean water fe
Which of the following indicates a vaginal or
BZ. Which of the following concerns should the uterine infection in a postpartum woman?
mother discuss immediately with her doctor A. Dark red discharge 3 to 4 days after
Or nurse practitioner? delivery
A. ‘The baby “spits up” during burping. B. An increase in lochia flow with activity
B. The baby’s bowel movement consists of C. A foul-smelling lochia
hard, formed stool. D. Lochia alba that continues for 2 to 6
C. ‘The baby’s cord stump is dry. weeks after delivery
D. The baby stops crying when she is
picked up and cuddled.
FILL IN THE BLANKS
33. A sign of infection in the cord stump would
be: 38. Explain how you would prepare each of the
A. A dried, blackened piece of tissue following forms of baby formula:
B. Redness or odour at the site a. Ready-to-feed formula
C. Slight bleeding when the stump
falls off b. Powdered formula
D. Softening around the base of the cord
c. Concentrated formula
34. When a baby boy is circumcised, which of
the following is true?
A. The penis will look red, swollen, and 39. What should you do if a baby has diarrhea?
sore.
B. Urination will be difficult until it is
Why?
healed.
C. The area will completely heal in 4 to 6
days. 40. List four safety tips to consider when
D. Circumcision results in shortening the swaddling a baby:
length of the penis.
35. When the area of the circumcision is cleaned,

what may be applied to prevent the penis
from sticking to the diaper?
ae Alcohol
B. Soap and water
‘Sy Powder
D Cream or ointment

CHAPTER
Caring for the Young

answers.
ETS. B It is important to protect the
privacy of children in your care. 9. Which of the statements below are true for
helping a child eat well?
7A
WO § Television during mealtime relaxes oe Encourage family members to eat at
4
the child and stimulates appetite. different times to avoid conflict.
De Problem solving and difficult
Sl) EF It is not your duty to provide a discussions should be done away from
stable, secure, or safe atmosphere meal times.
for the family. Adults should model good table
manners and respectful behaviour.
You should try to develop positive
Let the child decide when they are full.
relationships with all family
Check children’s weight after each meal.
members.
mo
9 Parents should avoid comments that
may lead to power struggles.
You should punish the
Pressure children to try new foods so
misbehaving child the way the
that they will have a balanced diet.
parents would.
cfAvoid giving into children’s demands at
Bedtime rituals should be meals.
eliminated if the child is ill.
It is dangerous to leave any child

unsupervised in the home.
Touching the child to provide

comfort should depend on the
child’s culture.
256 CHAPTER 42. Caring for the Young
10. Ways to support a child who displays go FS. Children are vaccinated to
challenging behaviors include which of the certain contagious infections.
following? A. Prevent them from developing
A. Be specific about expectations. (catching)
B. Let them choose how the day will B. Cure them of
go. This will help them make good C. Reduce the symptoms of
decisions. D. Infect them with
C. Use positive reinforcement to help
encourage desired behaviour. 14. Which of the following statements about
D. Be knowledgeable about the child’s vaccinating children is true?
concerns and difficulties. A. If vaccinations were to be discontinued,
E. Follow through on consequences the rate of disease would go down.
consistently. B. Children need to be vaccinated against
EF Yell back at the child so they can hear viral meningitis.
you if they are upset. C. Vaccines can be given to infants only.
G. Practise forgiveness and patience D. Vaccinations prevent the spread of a
certain variety of pathogens.
11. What are the most common reasons for why
children are absent from school? 15. Asa general rule, children should stay home
A. Upper respiratory infections from school or day care if:
B. Stomach flu A. They drink normally but pick at their
Gy, Ulcers food
D. Ear infections B. ‘They have a temperature of 37.5°C
E. Brain infections (99.5°F) and sleep soundly at night
FE Conjunctivitis C. ‘They have a temperature over 38°C
G. Sore throat (100.4°F), diarrhea, and vomiting
D. They have been on antibiotics for
36 hours
MULTIPLE CHOICE
Circle the correct answer. 16. Reye's syndrome is:
A. A rare congenital condition caused by
12. What is a common reason for why children nuclear radiation
may display challenging behaviours? B. A rare but often fatal illness linked
Px Their parents have always set limits in to taking aspirin to treat influenza or
place to help with behaviour. chicken pox
B. They may be faced with many changes C. Acondition caused by an allergy to
in their lives. acetaminophen (Tylenol)
C. They live with a family where their D. Acommon congenital condition caused
opinion is considered in decisions. by a mother drinking alcohol while
D. They are getting along well with their pregnant
friends at school.

CHAPTER 42 Caringforthe Young 257
17. One of the five most common reasons 19. Which of the following statements about
children stay home from school or day care is vaccination is true?
that they: A. Vaccination can cause autism.
A. Do not wish to go to school B. The risk of not being vaccinated is
B. Ate too many hot dogs at a birthday greater than any risk from vaccination.
patty C. Inthe case of an outbreak, no child can
C. Have test anxiety be prevented from attending class.
D. Have conjunctivitis D. There is no legislation in Canada that
requires a child to be vaccinated.
18. One of the main principles in supporting
children with challenging behaviours is to:
A. Sternly punish bad behaviours
B. Encourage and reinforce good
behaviours
C. Yell at them to let them know who is
the boss
D. Never give in to their demands
FILL IN THE BLANKS
20. Children are a population that we must protect. Which kinds of family situations would need to be
reported because they may put a child at risk?
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CHAPTER 43
Caring for Older Persons
TRUE OR FALSE 10. Men usually live longer than

women.
Circle T ifthe statement promotes a client’s rights,
and circle F if it does not. 11. Clients who do not speak English
have a greater risk of suffering from
1. TF _ Encourage the client to wear a lonelincseand cote
hospital gown at all times.
12. The skin of an older person is fragile
2. TF Protect the client’s right to privacy. and easily injured.
3. T F Encourage the client oes 13; The older person may have decreased
counselling if the client's sexual mobility, which would decrease the
attitudes are different from yours. HieEEdHe
4. TF Knock before you enter a room. 14. Activity and diet can slow the loss of
b | h.
5. TF Older clients have the right to be Snead rate be
sexual. 15. Decreased kidney function
6. T F_ Discourage single older clients from eee urine aanemo's
developing new relationships. :
16. M have difficulty urinati
7. TF Couples in a long-term care facility ay aor i ae
should be allowed to share the same cei eae
room.
7s The support worker can help the
8. T EF Same-sex couples should not be ateserien, RUSS Veg RP
allowed to share a room. infections by providing extra fluids.
9. TF Separation from children can cause
loneliness in an older client.
260 CHAPTER 43 Caring for Older Persons 3 a eS ae 2:
MULTIPLE RESPONSE ‘ Zo Which of the following physical changes is

most likely to cause confusion or behavioural
From the list below, choose all of the correct changes in an older client?
answers. A. Respiratory infections
B. Lack of exercise
18. How can the support worker facilitate C. Reduced blood flow to the brain
breathing in the older client? D. Poor fluid intake
A. Avoid the use of heavy bed linens over
the client’s chest. 23. Which,of the following is true in regard to
B. ‘Turn and reposition the client at least depression in older persons?
every 4hours. A. Depression is an inevitable part of the
C. Encourage deep breathing. aging process.
D. If the client is on bed rest, keep the B. Older persons are more likely to report
head of the bed flat. their depression than younger adults.
E. Encourage activity. C. Depression in older persons may go
unrecognized.
19. What are some ways in which older persons
D. Depression in older persons must be
may express closeness and intimacy without treated with medication.
having intercourse?
A. Holding hands 24. Why should older persons avoid using
B. Touching heating pads?
C. Caressing A. Their skin has overactive oil glands and
D Embracing may burn easily.
B. ‘They will not be able to manage the
MULTIPLE CHOICE heating controls.
C. Heating pads can impair circulation.
Circle the correct answer. D. Decreased sensitivity to heat may
increase the risk of burns.
20. Which of these statements about sexuality
for older persons is true? 25. Older persons often complain that food has
A. Love, affection, and intimacy are an no taste. This happens because:
important part of life at any age. A. Memory is shorter in older persons.
B. Older persons are unable to masturbate. B. ‘The number of taste buds decreases
C. It is not normal for older persons to be with age.
sexual. C. ‘The ability to feel heat and cold
D. A decline in the female hormone decreases.
estrogen increases sexual desire. D. A progressive loss of brain cells occurs.
21. Which statement is true about sexuality and
the older person?
A. After menopause, women are no longer
interested in having sexual relations.
B. Aman cannot have an erection when he
gets older.
C. Sexual relationships are psychologically and
physically important to the older person.
D. Orgasm may be less intense and longer
in duration than in younger adults.

CHAPTER 43 _ Caring for Older Persons 261
MATCHING
Match the statement about physical changes in the older person with the body system affected.
26. Decrease in bone strength bake Integumentary

ie Change in sleeping patterns Musculo-skeletal
28. Less blood flows through narrowed arteries Nervous
a Fe Folds, lines, and wrinkles appear Cardiovascular
30. Lung tissue becomes less elastic Respiratory
al. Decreased appetite Digestive
ee Urine becomes concentrated el

Ola
tert.
Urinary
Match the body system to the correct care measures described.
33. Performing range-of-motion exercises Integumentary
34. Providing a sweater and a lap blanket for a client who is cold Nervous
35. Allowing the older client to rest or nap more during the day Musculo-skeletal
36. Placing the client in a semi-Fowler’s position @!

a
rei
Bele Respiratory
FILL IN THE BLANKS

Indicate whether the examples given are:
A. A benefit of working
B. A benefit of retirement
C. A negative aspect of retirement
27, Time to travel
38. More leisure time
39. Poor health and aging
40. Increased medical bills with less income
41. Personal fulfillment and usefulness
42. Friendships formed with coworkers

43. Reduced income forces lifestyle changes
44. Time to do as you wish
45. Meeting basic needs of love, belonging, and self-esteem
46. Reward for a lifetime of work

7962 CH APTER 43 Caring for Older Persons |
Indicate whether each of the effects of aging ‘

listed is:
A. Physical
B. Psychological
C. Social
47. ____—sGrreying hair
48. Preparing for one’s own death
49. Death of a partner
50. Slower movements
51. Retirement
52. What are two common causes of loneliness in older clients?
;
53. What happens to the roles of children and parents as the parent ages?
54. What are some ways loneliness in older people can be prevented?
b
Ss
55. Why are there usually more widows than widowers?
56. When a partner dies, how is the other partner affected?

ae Serious and problems may
occur.
b. May lose or attempt
57. In Canada, older clients who do not speak English or French often have greater loneliness and
isolation than others. What are some of the reasons for this?
a. Relatives and friends who share cultural values may
b. Clients may not have anyone and may not

CHAPTER 43 _ Caring for Older Persons 263
58. How do these physical changes affect the safety of older persons?
Diinistravieand easily injured
Fewer nerve endings
Pectcasinm strengty ancemusclea@ttopny. =e
=
Bones become brittle
Reduced sense of touch and pain
GQ»
©)
(ox
lor
an) Reduced blood flow to brain; loss of brain cells
hE Older clients often complain of feeling cold. What are some ways you can safely provide warmth?
a
b.
Cc.
60. How can loss of bone and muscle strength be slowed?
61. Touch and sensitivity to | and

are reduced with aging.
62. Urine may be more concentrated because of and
63. Urinary frequency or urgency may occur because weaken

and decreases.
64. Why should you make sure that an older person reduces their fluid intake after 5 p.m.?

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CHAPTER
Home Management

Circle Tfor true, or circle F for false. From the list below, choose all of the correct
answers.
1. T EF Work from dirtiest to cleanest.
12. ‘To complete home management tasks, you
2. TF Dust from higher surfaces to lower need to use your time wisely. Identify the
surfaces. points below that will help you.
3. T F The use of gloves is not required a sean erg
Pee egies : stablish a routine.
TRIS Ger HE ag annotate C. Use your time well—start with tasks
4. T F _ Itis safe to use any cleaner in the that have a waiting period or run
eed koh automatically, and then go on to other
tasks.
5. T F Aclient recovering from surgery D. Finish tasks, and put items away.
may need extra cleaning done in the E. Set time limits for each task.
Berhroon FE If one task takes too long, switch tasks.
Watch the clock.
6. F Baking soda will remove stains. G. Put the client’s needs first.
Be F Any type of liquid soap can be used 13. To remove urine stains, you should:
in the dishwasher. A. Rinse the stained item in hot water
B. Soak the item in a solution of 1 L warm
8. F Sort clothing by colour before washing. water, 2mL liquid handwashing soap,
9. F Stained items should be soaked in and - cu bleach for 30 minutes

bleach for 10 minutes before washing. C. Rinse the item in cool water
D. Soak the item in a solution of 1 L warm
10. T F Some cleaners can scratch surfaces so water and 15 mL vinegar for 1 hour
read product labels carefully. E. With permission, machine-wash
the item with chlorine bleach and
11. TF Itis safe to mix chlorine bleach and detergent. Dry as usual.
ammonia to make a stronger cleaner.
CHAPTER 44 Home Management
14. Your goal when doing laundry is: 17. Cleaning products can cause harm if not
A. To clean items used properly. Remember to:
B. Not to damage items A. Read all labels carefully
C. To entertain the client B. Never mix cleaning products
C. Wear latex gloves
15. When cleaning kitchens, you should D. Never use products in unlabelled
remember the following: containers
A. Pour dirty or contaminated liquids ms Store products in their original
down the kitchen sink only. containers
B. Use one cloth for counters, another for F. Keep cleaning products away from food
wiping floors, and another for dishes. G. Keep cleaning products out of reach of
C. Use dishcloths to dry your hands. children and adults with dementia
D. Change cloths daily as needed. Wash in H Use products only for their intended
bleach and hot water. purpose
E. Use paper towels for all tasks when I. Keep aerosol cans away from heat
possible. sources
FE Clean outside the microwave after every J. Ask the client before using a strong
use. cleaner on a surface
G. Do not put soiled diapers into the K. Rinse away strong, abrasive cleaners
kitchen garbage. immediately after use
L. Scrub vigorously when cleaning
16. What can you do to decrease microbes in the
bathroom? 18. What are some general cleaning guidelines?
A. Remove and dispose of hair from the Clear away clutter.
sink, tub, or shower. Work from lower to higher.
B. Flush the toilet with the seat down to Work from near to far.
prevent splashing. Work from dry to wet.
C. Rinse the sink after it has been used for Work from dirtiest to cleanest.
washing, shaving, or oral hygiene. Change cloths and water frequently.
D. Hang damp towels and bath mats up to Use a dry cloth for dusting.
dry. Spread them out. Rinse and dry washed surfaces.
E. Wash bath mats, the wastebasket, and >re
ee
ilo
at Avoid soiling a clean area.
the laundry hamper every week.
E Close shower doors.
G. Let the bathtub or shower drip dry after MULTIPLE CHOICE
use. Circle the correct answer.
H. Flush dirty or contaminated liquids
down the toilet only. 19. 19. When should spills and splashes be
cleaned up?
A. After meals
B. Weekly
C. Before you leave for the day
D. Immediately

CHAPTER 44 HomeManagement 267
20. Which statement about laundry care is true? 22, Why should cleaning products never be
A. All clothing should be ironed. mixed together?
B. All whites should be washed together. A. Mixing chemicals reduces their cleaning
C. All whites are washed in hot water. effect.
D. Care label instructions should be B. Cleaners may become toxic if mixed.
followed. C. Mixed chemicals can stain your hands.
D. Mixing chemicals might make the
21. You notice the client’s clothing is missing article dirtier.
care labels. What should you do?
A. Ask the client for washing guidance. . Which statement on food handling is true?
B. Guess how each article should be A. Always wear gloves while cooking.
washed. B. Garbage should be disposed of weekly.
C. Wash everything by hand. C. Leftover food should be refrigerated
D. Wash everything in cold water. immediately.
D. Season the client’s food to your taste.
MATCHING
Match each laundry symbol to its meaning.
24. Dry clean
25. Handwash gently in cool water
26. Machine-wash in hot water
27. Use chlorine bleach with care
28. Do not iron or press
Dee J Hang to dry after removing excess water

FILL IN THE BLANKS :
30. List five safety guidelines for providing care to a client who is receiving cytotoxic drugs.

TRUE OR FALSE 9. TF You may purchase over-the-counter
medications for your client if
Circle T for true, or circle F for false. requested to do so because these are
not prescription drugs.
1
eg An elixir is medication dissolved in a
concentrated sugar solution. 10. TF Dispensing medications is beyond
your scope of practice.
BAA It is your responsibility to ensure
that your clients know about the side
effects that can occur when they take MULTIPLE RESPONSE
their medications. From the list below, choose all of the correct
answers.
a. ly F Part of your responsibility is to fill
your client’s pillbox each week. 11. Your role in assisting with medications may
involve:
4. T F To make a suppository more A. Reminding the client to take a
comfortable for insertion, apply medication
petroleum jelly to it before handing B. Bringing medication containers to the
it to the client. client
C. Bringing prepoured medications, prefilled
Seode Me A lozenge is a form of medication.
syringes, or pillboxes to the client
D. Reading the prescription label to the client
6 17 F Some medications have to be taken
E. Loosening or removing container lids or
on an empty stomach.
opening blister packs
UeAW AS You must follow your agency's F Checking the dosage against the
policies in regard to signing medication label
medication administration records G. Providing water or other fluids as needed
(MARs). H. Phoning the client's family doctor for
prescription refills
8. T F Medication on transdermal discs is I. Supervising the client as she pours the
absorbed over 24 hours. medication into her hand, measuring
spoon, or cup
270 CHAPTER 45 Medication Management 3 i aa Sey eee
Rs oss UR LP eS SON AEB RDP ESA SA SoePDP SRO ES TN FN DUST STONED ACSC SNS Ua SO NSE Ova OE SLSS cece
12. A side effect of a medication: a Wigs If the medication is to dissolve under the
A. Isa response that occurs along with the client’s tongue, you should:
main desired response to the medication A. Place the medication under the tongue
B. May be predictable or unpredictable with your fingers
C. Is usually insignificant so you will not B. Ask the client to close his or her mouth
have to look for side effects and let the medication dissolve
C. Remind the client not to chew or
13. Which information is contained in most swallow the medication
MARs? D. Provide warm food or fluids to assist in
A. The client’s name dissolving the medication
B. The client’s medication allergies
C. The name, dose, and administration 18. What information is included on a
instructions for each medication prescription label?
D Why the client is taking the medication A. Pharmacy name
and what the side effects are B. Date filled
E. A place to sign or initial after C. Prescription warning labels
administering the medication D. Cost of the medication
E. Physician’s name
14. Medications should be stored: FE Number of times the prescription can
A. Ina special place just for the person’s be refilled
medications G. Drug name and dose
B. Inawarm place, such as in a cupboard H. Side effects of the medication
over the stove I. Client’s name
C. Out of reach of children and adults J. Client’s address
with dementia
D. In the original labelled container, with
the lid tightly closed
MULTIPLE CHOICE
E. According to any special storage Circle the correct answer.
instructions
19. Mrs. Smythe, one of your clients, is taking
15. Some of the “rights” of assisting with an antihistamine and drinking alcohol. What
medications include: should you do first?
A. The right reasons for taking the A. Discuss the situation with your
medication supervisor
The right medication B. ‘Throw away the rest of your client’s
The right dose alcohol
The right route C. Ask your client if she wants to die by
The right time zone suicide
The right documentation D. Observe the client for any more
The right expiration date drinking
app
ie:
eriledelic
The right prescriber
20. You have been assigned to apply Mrs.
16. Medication particles suspended in air or gas Smythe’s prescription ointment for a rash on
and inhaled through the lungs is called a: her back. What should you do first?
A. Puffer A. Provide privacy for the client
B. Suspension B. Put on a disposable glove
C. Inhaler C. Wash her skin well and dry it
D. Aerosol D. Check the MAR for all of the rights

CHAPTER 45 Medication Management 271
21. What is true about transdermal patches? 24. A dosette is meant to:
AS They have medication that is absorbed IX Remind clients when to take their
through mucous membranes. medications
B. They can leak easily, so they need to be oe Prevent the medication from going stale
covered up with a bandage. Cs Protect the medication from exposure
ie One must be removed before another to heat
one can be applied. D. Keep the medication clean and germ-
1@) They must be rubbed between your free
hands to activate the medication.
25. A sublingual medication is:
22. What is true about medication suspensions? A. Digested in the client’s small intestine
They: ey Dissolved in the client’s rectum
LN, Are always taken orally CG Absorbed in the client’s skin
B: Need to be shaken well before being D. Dissolved under the client’s tongue
poured
G: Usually are dissolved in alcohol 26. A metered-dose inhaler is used for:
bp: Must be absorbed under the client’s Ne Medications that are narcotics and
tongue under lock and key
B. Children’s medications
23. Your client cannot open the jar of her aspirin Cc. Medications that must be inhaled into
bottle and asks you to do it for her. Which is the lungs
the most appropriate action to take? 1 Drug addicts who might overdose easily
AS You open her bottle as requested and
give it to her. ya ie When working in home care, what should
Pg B. Tell her that support workers are not the support worker do with the MAR?
allowed to do this. A. Keep it in her car
Check with your supervisor first if you B. Keep it in the client’s record at the
are allowed. client's home
Check the client’s medication Cc Keep it with the support worker's
administration records (MARs) as well employer
as her care plan first. Dy Discard it at the end of each day

Ble CHAPTER 45. Medication Management _
MATCHING :
Match the abbreviation with the meaning.
28. By mouth bid
29. Per rectum
30. Every hour
31. Twice a day
32s Every 2 hours
33. Four times a day
34. Sublingual
35. Nothing by mouth cm

36. Hours of sleep
37. Every day
Match the medication route with its description.
38. Taken by mouth and swallowed ares

eee
>es) Oral
39. Applied to the skin or mucous membranes Sublingual
40. Breathed in through the mouth or nose Parenteral
41. Placed under the tongue and absorbed into the body &
eee
Inhalant
42. Injected by a needle into a muscle, a vein, or under the skin Topical
FILL IN THE BLANKS
43. Medications come in many forms. List three forms and give an example of each.
a.

CHAPTER
TRUE OR FALSE 9. TF A thrombus can form in the deep leg

veins.
10. TF Elastic stockings help prevent thrombi.
1. TF A nasal speculum is used to examine
the inside of the nose.
MULTIPLE RESPONSE
2. TF the lithotomy position is used to
examine a client's breasts.
answers.
3. TF You should always weigh your client
11. A hospital unit consists of which of the
before an examination.
following rooms:
4. T F Sims’ position is sometimes used to
Clean utility room
Nursing station
examine the rectum or vagina.
Pantry (or kitchenette)
5. TF The examiner (either the doctor or the Pharmacy
nurse) will take all of the specimens to Soiled (dirty) utility room
the laboratory. Apparatus room
Oxygen room
6. TF The preoperative period may be TOmMMOORD
Client rooms
many days or just a few minutes.
12. What should you explain to the client about
7. T EF Abdominal surgeries do not usually the position used during the examination?
require a preoperative enema. Why the position is needed
How to assume the position
8. TF The support worker is responsible How the body is draped for warmth
for ensuring that the client’s chart is and privacy
in order before the client goes to the What the examiner is looking for
operating room. ee
ae)
1G)
coh How long the client will stay in the
position
oO 274 CHAPTER 46 Working in Acute Care
13. Which of the following can you do to assist. 16. What valuables should be removed from the
in the psychological care of the surgical client and placed in safekeeping while the
client? client undergoes surgery, if the client has no
A. Listen to the client voice his or her fears one to give it to?
or concerns about surgery. Dentures
B. Answer any questions about the surgery. Glasses
C. Explain to the client procedures you Contact lenses
will perform and why they are being Lottery tickets
done. Hearing aid
D. Report to your supervisor any verbal Cash
and nonverbal signs of client fear and Jewellery .
anxiety. >TODA
OOWArtificial eyes and prostheses
E. Report to your supervisor the client's
request to see a spiritual advisor. We How can the support worker protect the
client from injury after a preoperative
14. Which of the following are typical support medication has been given?
worker responsibilities in supporting clients Have the client walk to the bathroom to
who are having day surgery? void.
A. Accompanying the client to the day- Raise bed rails as per hospital policy.
surgery room. Place a lap belt across the client.
B. Familiarizing the client with where the =SO?Make sure the call bell is within the
bathroom is located. client’s reach.
G Telling the client where they can go Sy Place a glass of water next to the client
to get their hospital gown for the so the client doesn’t have to get up.
procedure.
Holding on to the client’s valuables 18. How is the client’s room prepared for the
(including dentures) for them while client’s return from surgery?
they are in surgery, for safekeeping Make the bed as a closed bed.
Ensuring the client has voided prior to Place a jug of water at the bedside.
going to the operating room. Place a kidney basin and tissues at the
bedside.
15. Which of the following are fears that the Have the bed in a high-Fowler’s position.
client may have about surgery? =
Oe
a Place an IV pole next to the client’s bed.
Disfigurement and scarring
Disability 19; Which postoperative observations are
Nausea or vomiting important to report to the nurse?
Pain during and after surgery Choking
Dying during surgery A drop or rise in blood pressure
Anaesthesia and its effects Bright red blood from the incision,
Severe pain or discomfort after surgery drainage tubes, or suction tubes
eo
TA
emsTubes, needles, and other equipment ae
SG A pulse rate of more than between 80
used for care and 100 beats per minute
A rise or drop in body temperature
Hypoxia
Eupnea
Cold, moist, clammy, or pale skin
ergy
The client would like a coffee

CHAPTER 46 Workingin Acute Care 275
20. Which complications can be prevented with 25. Why is a catheter ordered for some surgeries?
early ambulation? A. To keep the bladder empty during
A. Thrombi surgery
B. Pneumonia B. ‘To prevent bladder infections
C. Atelectasis postoperatively
D. Wound pain C. To prevent incontinence
E. Constipation D. So that the client does not have to get
Ee Emesis out of bed to go to the bathroom
G. Dehydration
26. Why are postoperative leg exercises
21. Why is it important for the client to be important for the client to practise?
encouraged to deep-breathe and cough after A. They help to decrease venous blood flow
surgery? to the leg.
A. It may prevent pneumonia. B. ‘They help to prevent the formation of a
B. It reduces postoperative pain. thrombus in the leg.
C. It reduces the risk of vomiting. C. Exercises reduce hypoxia to the
D. It promotes urine production. lower leg.
E. It reduces the likelihood of lung D. They assist with stabilizing
complications. postoperative blood pressure.
27. A general anaesthesia produces:

MULTIPLE CHOICE A. A loss of sensation or feeling in a large
Circle the correct answer. area of the body
B. Unconsciousness and the loss of feeling
22. A tuning fork is used to: or sensation
A. Examine the mouth C. Loss of sensation in a small area
B. Examine the inside of the nose D. A partial loss of memory and sensation
C. Examine the internal structures of
the eye 28. When a client first returns from the recovery
D. Test hearing room, how often should vital signs be taken?
A. Every 15 minutes for the first hour
23. The position the client is usually in for an B. Every 30 minutes
examination of the abdomen is the: C. Every hour for 4hours
A. Lithotomy position D Every 4 hours
B. Knee-—chest position
C. Sims’ position
D. Supine position
24. The lithotomy position is used to

examine the:
A. Vagina and perineum
B. Abdomen
C. Prostate gland
D. Chest

276 CHAPTER 46 Workingin Acute Care
MATCHING :
Match each description with the correct position.
29. _____ Hips down to edge of table, knees flexed, feet in stirrups A. Supine
30. ____ Lying on side with upper leg flexed B. Lithotomy
31. _____ Lying on back with legs together or knees flexed C. Knee—chest
32. ______ Kneeling with body supported on knees and chest D. Sims’
Match the descriptions or examples given with the correct type ofsurgery. The same answer may be used
more than once.
33. _____ Done immediately to save the client's life A. Elective surgery
34. ______~ Done when the coronary arteries are blocked B. Emergency surgery
35. _____ Done for the client’s well-being C. Urgent surgery
36. ____ Needed after an accident
37. ______ Must be done soon to prevent further damage or disease
38. ______—~ Cosmetic surgery is an example of this type of surgery
Determine when each of these events occurs in relation to the surgical process.
39. Chest X-ray, CBC, and ECG Preoperatively
40. Coughing and deep-breathing exercises as ordered Postoperatively
41. Operative consent must be signed

CHAPTER 46 _ Working in Acute Care 2/7
LABELLING
42. Label each of the examination instruments below.
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CHAPTER
End-of-Life Care
TRUE OR-FALSE - TF Oral hygiene should be given less

frequently as death approaches.
11. T EF When death is near, circulation
Weel oF Many people fear death. fails and the pulse is fast, weak, and
irregular.
26 Took During the bargaining stage of grief,
the client is usually angry. 2 T F The goal of palliative care is to
relieve pain and suffering while
3 Tink The client has the right to refuse
finding a cure.
treatments.
13. T F An advance directive is an informal

4. T F As death approaches, the client will
document in which a person states
need more blankets.
their wishes about future health care,
Seyth Ade Advance directives allow clients to treatment, and personal care.
control their future health care.
14. T F Mucus collecting in the airway that
5 Lar Religious beliefs may help when
causes wet gurgling sounds is known
someone is dying because they can as the death rattle.
provide comfort.
MULTIPLE RESPONSE
Hel E Children younger than 3 years have
no concept of death. From the list below, choose all ofthe correct answers.
Ds Ady Children 3-5 years of age know that 1; How can the support worker help to
death is final but may not think that promote comfort when the dying client has
it will happen to them. severe pain?
Provide skin care and personal hygiene.
skeetihSAe Listening is an important method of Offer back massages.
communication when dealing with a Assist with relaxation techniques.
dying client. Encourage physical activity.
MOORS
Keep the person in good body alignment.
_ CHAPTER 47 End-of-Life Care
16. What rights are protected in the Dying MULTIPLE CHOICE

Person's Bill of Rights?
A. To be treated as a living human being
until death
19. Which of these beliefs about death is
B. To maintain a sense of hopefulness
common among young adults?
C. To be cared for by those who can
A. They may blame themselves when
maintain a sense of hopefulness
someone dies.
D. To express feelings and emotions about
B. ‘They see death as a reunion with those
one’s approaching death
who have died before them.
E. To have decisions about one’s care made
C. They worry about who will care for and
by others
support those left behind.
FE To be free of pain
D. They welcome death as freedom from
G. To die in peace and dignity
pain, suffering, and disability.
he Some signs of death include the following:
20. Which of the following statements about
A. Movement, muscle tone, and sensation
providing physical care for a dying client is
are lost.
true?
B. Peristalsis and other digestive functions
A. Sims’ position is the best to promote
slow.
breathing.
Cheyne-—Stokes respirations are
B. The need for repositioning is decreased.
common.
C. Nutritional needs increase.
Pain increases.
©AoE
The client usually refuses to eat or
D. Urinary retention and constipation are
common.
drink.
21. Which of these actions would be helpful to
18. Which of the following criteria are necessary
the family of a dying client?
for a person to be eligible for medical
A. Stay in the room with the family and
assistance in dying?
client as much as possible.
A. The person is eligible for government
Allow family members to give care.
funding of health care.
Ask the family to leave when visiting
B. ‘The person is a visitor to Canada at
hours are over.
time of request for medical assistance in
dying.
yao Ask your clergy member to visit them.
C. The person is 26 years old and mentally Pap HS Which of a client’s rights is violated if a
competent.
health care worker avoids the dying client?
D. The person independently and A. Right to privacy
voluntarily makes the request for
B. Right to confidentiality
medical assistance in dying.
C. Right to be free from abuse,
E. ‘The person does not have a fatal disease
mistreatment, and neglect
or illness.
D. Right to protection of personal
F. The person is able to give informed
possessions
consent to receive assistance with dying.
G. ‘The person has a remediable condition.

CHAPTER 47. End-of-LifeCare 281
23. Ifa client has a “do not resuscitate” order, 26. Which is one of the last functions lost?
what action is appropriate when the client A. Taste
dies? B. Smell
A. Begin CPR immediately. Cr earings:
B. ‘The nurse in charge decides if a code D. Sight
should be called.
C. ‘The support worker may begin CPR if 27. Postmortem care includes:
her own beliefs are opposed to taking A. Repositioning the body
no action. B. Bathing the body
D. No attempt will be made to resuscitate C. Removing tubes after permission is
the client. given
D. All of the above
24. What is a sign that death is near?
A. The respiratory system fails. 28. A hospice provides:
B. ‘The body temperature falls. A. Palliative care
C. The pulse rate slows. B. Active medical care
D. Pain increases. C. Care postoperatively
D. Preoperative care
25. Which group of clients has fewer fears about
death?
A. Younger adults
B. Children
C. Older persons
D. Middle-aged adults
MATCHING
Match the correct stage ofgrief with each statement. Note: Answers may be used more than once.
29. The client cannot deal with any problem or decision about his illness. | A. Denial
30. The client may wish to talk about people and things that will be left B. Anger
behind. ae
C. Bargaining
31. The client may blame others and be difficult to care for. D. . D Depression
325 This stage is done privately and on a spiritual level. E. Acceptance
33. The client takes care of unfinished business.
34. The client is sad and mourns things that have been lost.
35. The client refuses to believe death is close.
36. The client may carry on this stage in private
B/. The client may blame others for problems.
38. The client begins to move forward with their life.

282 CHAPTER 47_ End-of-Life Care
FILL IN THE BLANKS ‘

Recall the British Columbia Residents’ Bill of Rights (Box 5-2 in Chapter 5), and match the rights of
dying clients in long-term care related to the following actions:
A. Commitment to care
B. Rights to health, safety, and dignity
C. Rights to participation and freedom of expression
D. Rights to transparency and accountability
39. Restraints are used only if ordered by a doctor.
40. Do not expose the client unnecessarily.
41. Try to keep equipment and supplies out of sight.
42. Some people avoid a dying person because of superstitions and religious beliefs.
43. The client may refuse treatment.
44. The client may want certain photographs and religious items nearby.
45. The client’s final moments and cause of death are kept confidential.
46. The health care team needs to respect the client’s choices to refuse treatment and not to
prolong life.
47. The client’s personal property is protected from loss or damage before and after death.

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VP Education Content: Kevonne Holloway

Managing Stress 33 Gl Enteral

Working With Clients and Their Growth and Development 179

Preventing Infection 87 eS)

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ae Laneyttl Sol dey a PR eas ott oud 390 Qi a iala peciey hh

The Role and Responsibilities

TRUE OR FALSE F Wearing any amount of fragrance

6 iF The goal of support workers is to

13. To be a true professional, you should

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Copyright © 2022 Elsevier Inc. All rights reserved.

29: Diagnoses and treats diseases and injuries B. Speech—language pathologist

30. Provides respiratory treatments and therapies Social worker

31. Assesses and plans for nutritional needs Dietitian

Bye Assists people with musculo-skeletal problems 6)

35: Assists people with learning or retaining skills Physiotherapist

34. Treats people with speech, voice, hearing, Respiratory therapist

35. Assists people with their spiritual needs Spiritual advisor

36. Helps clients and families with social and Nurse

FILL IN THE BLANKS

ove A person receiving care in a hospital is called a sina

38. Professionalism is an approach to work that demonstrates

Copyright © 2022 Elsevier Inc. All rights reserved.

The Canadian Health

TRUE OR FALSE 7. TF People can lose their medicare

6. TF Indigenous health and wellness is

B. Improve and maintain health and Circle the correct answer.

Copyright © 2022 Elsevier Inc. All rights reserved.

FILL IN THE BLANKS

Dapfe Personal care

28. Social work

29: Assistance with activities of daily living

30. | Speech therapy

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TRUE OR FALSE MULTIPLE RESPONSE

3. TF Some hospitals hire support workers. 9. An acute illness is described as an illness:

11. What types of services do community day + MULTIPLE CHOICE

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30. Provides care to people in their homes H. Mental health care

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TRUE OR FALSE MULTIPLE RESPONSE

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20. Doing or promoting good Justice

yP All people should be treated in a fair manner Intentional harm

23% Accidental injury or negligence BP)

FILL IN THE BLANKS

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Legislation: The Client’s