A. Concept of Man, Health & Illness (25 pts.

Case Scenario: Both Jerry and Joe have had heart attacks. Jerry, upon advice from his doctor, started
exercising, changed his dietary intake, entered stress reduction classes, and returned to work 6 weeks
after his heart attack. He has a positive outlook, is doing well, and talks about being “well”. Joe also
changed his dietary habits and started exercising. However, Joe has been unable to quit smoking even
though he wants to and has been advised to do so. Joe is frequently depressed, is very fearful of
having another heart attack, has not yet returned to work, and frequently talks about being “ill”.
1. How does Jerry’s psychological or mental dimension of health status or wellness differ from
Joe’s?
Answer: Jerry's mental health is more positive compared to Joe's. While Jerry actively engages in health-
improving activities like exercising and stress reduction, Joe struggles with depression and fear, hindering his
ability to fully participate in such activities.

2. Both Jerry and Joe have heart disease. Jerry considers himself “well” whereas Joe considers
himself “ill”. Why do they have a different perception regarding their health?
Answer: Jerry views himself as "well" due to his positive attitude and proactive approach to health, while Joe
perceives himself as "ill" because of his depressive tendencies and lack of engagement in health-promoting
behaviors.

3. What factors may have influenced Jerry’s decision to implement positive health behaviors?
Answer: Jerry's decision to adopt positive health behaviors may be influenced by factors such as his optimistic
outlook, motivation to improve, support from healthcare providers, access to resources like stress reduction
classes, and a supportive social network.

4. What factors may have prevented Joe from developing the same positive outlook and actions
that Jerry was able to take regarding his illness?
Answer: Conversely, Joe's inability to develop a positive outlook and take proactive measures may be attributed
to his depressive mindset, fear of another heart attack, poor stress coping skills, limited social support, and
potential underlying psychological issues.

5. What nursing interventions or actions would be most beneficial to Joe concerning his
smoking problem?
Answer: Nursing interventions for Joe's smoking problem could involve providing counseling and support
services tailored to smoking cessation, linking him with relevant programs or support groups, investigating the
root causes of his struggle to quit (e.g., stressors), and collaborating with other healthcare professionals to
address his mental health concerns and fears related to his heart condition.
B. Nursing as a Profession (Roles of a Professional Nurse)

Case Scenario:

Christina, a registered nurse, arrives for work on the day shift in an acute medical unit and receives 5
medical patients for her care. After receiving the endorsement, she made her rounds, made a head-
to-toe assessment of each, listed each patient’s problems, set patient goals, and plans their care for
the day. During the shift, Christina administers the medications to all 5 patients, and asks the
unlicensed assistive personnel (nursing aide) to bathe 2 of the patients who need assistance; she
assists a patient with ambulation; provides education to a patient who will be discharged; evaluates
the plan of care, with updates as necessary, and notifies the physician of critically abnormal blood
results of 2 patients.

One patient’s friend came to visit and stopped Christina in the hallway to ask detailed questions about
the patient’s condition. Christina states that patient information is protected and cannot be
shared without the consent of the patient.

At a recent continuing education conference, Christina learned new information on giving

intramuscular injections to patients where aspirating the syringe after the needle is inserted is no
longer recommended. Christina believes that self-care maintains wholeness, and meets the patient’s
self-care needs by doing for, guiding, teaching, supporting, or providing the environment to promote
self-care activities.

• Which roles are exhibited by Christina and when are they exhibited? Cite at least 5 situations
in the case and identify the role that was exhibited by Christina. Use the template below. (10
pts.)

Situation in the Case Role of a Profession Nurse

(exhibited by Christina)

Example: In a continuing education conference, Research Consumer

Christina learned a new information on giving
intramuscular injections to patients where
aspirating the syringe after the needle is inserted is
no longer recommended.
Christina receives 5 medical patients for care, Care Coordinator/ Planner
conducts assessments, sets patient goals, and plans
care for the day.
Christina administers medications to all 5 patients. Medication Administrator
Christina asks unlicensed assistive personnel to bathe Team Leader/ Supervisor
2 patients who need assistance and assists a patient
with ambulation.
Christina provides education to a patient who will be Educator
discharged.
Christina evaluates the plan of care, updates as Care Evaluator/Communicator
necessary, and notifies the physician of critically
abnormal blood results of 2 patients.
C. Nursing as an Art (Caring, Communication & Teaching) (25 pts)

Case Application:

You are the nursing student assigned to care for Mr. Rogers, a 45-year-old man who will be returning
from the recovery room after undergoing the removal of a mass from his abdomen. While you are
preparing his room for his return, the staff nurse and the physician arrive to talk with Mrs. Rogers
about her husband’s surgery. The physician explained that the mass was malignant and invasive. Mr.
Rogers is a candidate for chemotherapy, but his prognosis is guarded because of the extent of the
tumor growth. Mrs. Rogers looks away, closes her eyes, and only nods her head “yes”.

As the physician leaves, the nurse approaches Mrs. Rogers, sits next to her, and puts her arm around
Mrs. Rogers, who begins to cry. The nurse uses a soothing voice to tell Mrs. Rogers that it is okay to
cry and assures her she will remain with her. The two of them sit in silence until Mrs. Rogers can
express her feelings. The nurse listens attentively.

Later the nurse offers to get a cup of coffee for Mrs. Rogers and asks if there is anything she can do to
assist Mrs. Rogers at this difficult time.

1. Interpret Mrs. Rogers’ non-verbal behavior in response to the news about her husband’s surgery.
Answer: Mrs. Rogers' non-verbal behavior, like looking away, closing her eyes, and nodding while crying, suggests
she's in shock and emotional distress upon hearing about her husband's surgery and prognosis.

2. Evaluate the nurse’s response toward Mrs. Rogers based on the concept of caring and
comforting.
Answer: The nurse's response to Mrs. Rogers shows genuine care and comfort. By sitting close, offering a
comforting touch, and speaking soothingly, the nurse creates a safe space for Mrs. Rogers to express her feelings.

3. Why is it important for the nurse to effectively communicate with Mrs. Rogers at this time?
Answer: Effective communication with Mrs. Rogers is crucial now to provide emotional support and clarify any
doubts or concerns she may have. It helps build trust and reduces her anxiety during this difficult time.

4. The nurse was described as listening attentively to Mrs. Rogers. Cite actions that portray
attentive listening.
Answer: The nurse's attentive listening is evident as she sits quietly, maintains eye contact, nods
understandingly, and refrains from interrupting, showing empathy and support.

5. Cite therapeutic communication techniques used by the health care providers in dealing with
Mrs. Rogers and how these were manifested in the scenario. Are these effective? Why or why
not?
Answer: Therapeutic communication techniques used include active listening, empathy, and offering emotional
support. The nurse's empathetic response and offer of assistance validate Mrs. Rogers' feelings, showing
effective communication.

6. Mr. Rogers is about to be discharged, and the nurse discusses with Mrs. Rogers the importance
of rehabilitation, struct drug compliance, lifestyle changes, and the care of the wound. Before
giving the proper instructions to Mr. and Mrs. Rogers, what will be considered first? What
important areas (the focus of health teaching) will be discussed for the continuity of care at
home. Cite 3 and why are these important.
Answer: Before giving instructions, the nurse should assess Mr. and Mrs. Rogers' readiness, emotional state, and
any language or cultural barriers. Important topics for home care include rehabilitation, medication compliance,
and lifestyle changes to ensure Mr. Rogers' continued recovery and well-being.

Rehabilitation: It's important to talk about sticking to the rehab plan, which includes doing physical therapy
exercises. This helps in getting better and building up strength.

Structured drug compliance: We need to stress how important it is to take medicines exactly as the doctor
prescribed them. This includes chemotherapy, if that's part of the treatment, to make sure it works well and
helps manage any symptoms.

Lifestyle changes: We'll go over things like changing your diet, starting an exercise routine, and ways to manage
stress. These changes are important for staying healthy overall and reducing the chances of the disease coming
back or causing other problems.

Passed By: Tabafa, Nyen G.

BSN1-O