Nurse 3010 Foundations -- Health Care Systems / Health Care Organizations - ML5

A community-based nurse acts as a case manager for a small town about 60 miles from a major healthcare center. What is the most important factor of community-based nursing for this nurse to be knowledgeable about?

Community resources available to patients.

Two staff nurses on a unit disagree with one another over certain key aspects of providing client care. The nurse manager of the unit arranges a meeting with the charge nurse and the two staff nurses at a mutually agreed-upon time to discuss this situation. This activity is most accurately described as what?

Conflict resolution

A nurse and a client are discussing managed care. The nurse explains that the managed care model was designed for which reason?

Controlling costs while maintaining quality of care.

A client on the medical-surgical unit is scheduled for several diagnostic tests. The nurse is concerned that the tests will be too tiring for the client. What would be the nurse's most appropriate action?

Coordinate with other disciplines to schedule tests with adequate rest for the client.

A nurse is caring for a client who has a PPO health care plan. What is the greatest advantage of this type of plan?

Cost effectiveness.

A nurse is caring for clients at an ambulatory care facility. Which care intervention is least likely to be provided by the nurse in this setting?

Crisis management.

The nurse is working to enhance time management skills and has to administer pain medications to several patients, obtain vital signs, and assist clients with bathing. What should the nurse do next?

Delegate bathing and vital sign tasks.

The Nursing Agenda for Health Care Reform (American Nurses Association (ANA) identifies the recipients of health care. This reform's main focus is on:

Health Promotion.

The nurse is planning discharge of the client who had surgery for a left hip replacement. The client is being discharged from the hospital to the home and requires home medical services. Which item would be provided by home medical services?

High rise toilet seat.

The nurse is planning the discharge of a client who had surgery for a left hip replacement. The client is being discharged from the hospital to the home and requires a walker and high-rise toilet seat. Which type of home health care service does the client require?

Home Medical Services.

A client has had a total knee replacement and will need to walk with crutches for six weeks. The client is being discharged home with a referral for home health care. What will the home care nurse need to assess during the initial assessment?

Home environment.

A nurse is leaving a primary health care system to practice in a tertiary health care system. Which area of nursing would the nurse most likely be entering in this new job?

Hospice Nursing.

A nurse is caring for a client with severe lower back pain. The doctor orders administration of an analgesic as a stat dose. When should the nurse administer the medication?

Immediately. A stat dose is a single order for a medication that must be given immediately.

What intervention should be included in a plan of care to prevent pressure injury development in health care settings?

Implementing an every 2-hours turning schedule.

What nursing function would be most commonly found in an ambulatory care facility?

Providing direct care.

Which statement most accurately reflects the intent of secondary care?

Psychiatric care, same day surgery, and general hospital care.

A nurse recommends palliative care for a client who is being discharged following a diagnosis of cancer. What is the chief focus of this type of care?

Relief from physical, mental, and spiritual distress

The nurse notices a student preparing to enter the room of a client with pulmonary tuberculosis with only gloves on. What is the appropriate nursing intervention?

Remind the student that a fitted N95 respirator is required.

A nurse manager must provide care to the unit's clients and employees under the constraints of the resources. This involves maintaining the financial constraints of the division. What term best describes this scenario?

Resource management.

Which statement by a registered nurse (RN) represents appropriate delegation to a nursing assistant?

"Dispose of the disconnected IV set."

The nurse is evaluating charts of clients who are to be discharged to outside care. Which client would the nurse feel is most appropriate for a referral to hospice care?

A client with terminal pancreatic cancer and loved ones.

Administration Dose

A medication order that is given over a certain number of days.

Which consultation or referral by the nurse is most appropriate for a client who is obese and demonstrates poor wound healing?

A nutritional consult.

A community health nurse provides information to a client with newly diagnosed multiple sclerosis about a support group at the local hospital for clients with the disease and their families. Providing this information is an example of:

A referral. Referring is the process of sending or guiding the client to another source for assistance.

A nurse is caring for a 17-year-old pregnant client who is unable to afford health care. Which resource should the nurse suggest to the client to obtain support?

A social services office to inquire about medicaid benefits.

Which is the most accurate definition of urgent care?

A type of ambulatory care that treats people who walk in with illnesses and minor trauma.

A nurse in a walk-in health care setting provides technical services (e.g., administering medications), determines the priority of care needs, and provides client teaching on all aspects of care. Which term best describes this type of health care setting?

An ambulatory center.

Medicare Part A is

An insurance program that pays a set amount based on the diagnosis and approved care for hospital services.

Which therapist is most likely to focus on teaching a client to hold a toothbrush with an adaptive device and brush the teeth?

An occupational therapist.

The nurse is providing care to several clients on a medical-surgical unit. For which client's plan of care should the nurse include information regarding extended care?

An older adult client who fell at home, and required a hip replacement. Extended care meets the health needs of client's who no longer require acute care, but require rehab, and skilled care.

One of the newest concepts in providing long-term care is called "aging in place." What is the best description of this type of care?

Client's remain at the home of their choice and live their independently with access to health care services as needed provided by the community.

Which is a key resposibility of a home health nurse?

Collaborate with other care providers.

Based on the Patient Protection and Affordable Care Act (ACA), nurses are to assume an important new role in health care. Which is an example of this new role?

Collaborating with all agencies to provide for the client's health needs.

The nurse manager for the psychiatric unit sees that there are major conflicts between the day and night shift staff. The nurse manager suggests that each shift put aside their differences for a time and determine a common major goal. Which conflict resolution style does the nurse manager display?

Collaborating.

The exchange of information among the client, the caregivers, and those responsible for care while the client is in a care setting (and after the client returns home) is key to successful:

Discharge planning.

The nursing student asks the home health nurse what data is required for a Medicare home plan of care. Which item would be incorrect for the nurse to include when responding to the student?

Documented need for a speech pathologist.

The nurse is having an exceptionally busy shift on an obstetrical unit. Which task is the nurse justified in delegating to an unlicensed care provider?

Emptying a client's Foley catheter bag and reporting the volume to the nurse

The community-based nurse is assessing a new client and the home environment. What is a responsibility of the community-based nurse at this initial visit?

Encourage the client and family to contact appropriate community resources.

A nurse has an older adult home care client who lives alone with no family nearby. On a recent visit, the nurse notices that his clothes are very loose, and he has difficulty letting the nurse leave when the visit is ending. After talking with him, the nurse learns that he has not been cooking for himself and he can't get to the grocery store easily. What service could the nurse suggest as an immediate response until a long-term plan can be formed?

Enroll the client on Meals on Wheels.

Nurses are socialized into the:

Healthcare culture.

A nurse is successful in promoting change on the nursing division. This nurse would be considered a:

Leader.

How might one define leadership?

Leadership is the process of guiding, educating, motivating, and directing others.

Which is the largest single source of reimbursement for home health care services?

Medicare

Which is a task that the nurse can delegate to the unlicensed assistive personnel (UAP)?

Obtaining intake and output on a foley catheter.

A client diagnosed with lung cancer has been given a prognosis of 3 to 4 months of life. The nurse discusses hospice care with the client and family. Which aspect of the client's health status indicates that hospice care is appropriate?

The client has a life expectancy of less than 6 months

The nurse is preparing to begin the discharge planning process with a client whose pulmonary embolism has recently resolved. Which factor should the nurse prioritize during this process?

The client's identified needs and goals.

Who provides physicians with the authority to admit and provide care to clients requiring hospitalization?

The health care institution itself.

Hospice nurses provide care in a variety of settings, including clients' homes, long-term-care facilities, and hospice residences. After the client dies, what happens next?

The hospice nurse continues to care for the client's family for up to one year.

Which is the best example of a nurse providing continuity of care?

The nurse collaborating with other members of the health care team in caring for the client.

The registered nurse (RN) wants to delegate a task to an unlicensed assistive personnel (UAP) but is unsure if the task can be delegated. What is the best resource for the RN to use in determining if the task is appropriate?

The nurse practice act or facility's policy and procedures.

A client has suddenly become very ill and needs to be transferred to the intensive care unit (ICU). Which action by the nurse would most ensure continuity of care?

The nurse provides an SBAR report to the nurse in the ICU.

The nurse is met in the staff lounge by the nurse who has been caring for the client team on this shift. The off-going nurse says, "Sorry, but I have to get out of here." The nurse then gives a quick overview of each client on the team and says, "All the rest is in the chart if you need anything." Which essential part of the handoff is missing?

The opportunity for the oncoming nurse to ask questions.

A client is diagnosed with mild dementia while in the hospital. In preparing for discharge, what should the nurse discuss with the family?

The possible need for home care.

The registered nurse (RN) wants to delegate measuring a client's urinary output to an unlicensed assistive personnel (UAP). Which factors should the nurse consider before delegating the task?

The stability of the patient's condition, potential for harm, and complexity of the activity

The nurse knows the term perioperative phase refers to care given to the client:

before, during, and after the operative phase.

Which phrase best describes continuity of care?

Facilitating transition between settings.

A new client arrived on the unit while the nurse was obtaining the end-of-shift report from the night nurse. This client is admitted walking and is here for a cardiac workup; the client is assigned to the nurse. The nursing assistant has settled the client in the room and oriented the client to the surroundings, call system, bathroom, bedside supplies, and where to place clothes. The priority nursing action is to:

Gather information and complete the admission database.

The nurse is caring for a client who would benefit from home health care services. In preparing for discharge, the nurse is aware that home health care can only be initiated if the:

Physician writes an order for home care.

The nurse is delegating care to an unlicensed assistive personnel (UAP). Which intervention would be most important for the nurse to perform independently?

Assess difficulty breathing.

Which is the primary goal of continuity of care?

Ensuring a smooth and safe transition between different health care settings.

Which refers to a person's ability to find and to receive care from a health care provider?

Access to health care.

During the entry phase of a home visit, the nurse is most likely to perform which task?

Establish nursing diagnoses based on the client's needs.

The home health nurse is making a home visit for an older adult client recently discharged from the hospital after suffering a stroke. Which finding would most concern the nurse?

Area rugs are present in multiple areas throughout the house.

A client informs the nurse about leaving the health care facility because the client is not satisfied with the treatment. The nurse knows that the client's treatment is incomplete and further testing and evaluations are scheduled. Which action by the nurse would be most appropriate to prevent false imprisonment?

Ask the client to sign a release without medical approval.

An Indian client is admitted to a facility for treatment of pneumonia. Since admission, she has been unwilling to participate in care offered by the nursing staff but is too weak to provide her own care. The nurse is planning care for this client with a diagnosis of Bathing/Hygiene: Self-Care Deficit. What would the priority nursing intervention be?

Assess the client's cultural views regarding hygiene and self-care.

The older client tells the nurse that the client needs to use the restroom. Which safety intervention must the nurse perform first?

Assess the need for assistance with ambulation.

The registered nurse on a busy telemetry floor is delegating tasks to an unlicensed assistive person (UAP). Which task is appropriate for the UAP to complete?

Bathing a combative client.

Which type of health problem requires both physician- and nurse-prescribed actions to address?

Collaborative health problems.

The initial step in discharge planning is:

Collecting and organizing data about the patient.

A nurse strives to establish trusting interpersonal relationships with clients, peers, subordinates, and superiors to facilitate goal achievement and personal growth of all participants. Which type of skill is this nurse demonstrating?

Communication Skills.

A client is having an increasing amount of difficulty caring for oneself in the home alone. The client states to the nurse, "I need more help. What am I going to do?" Which action would be the most appropriate for the nurse to take?

Have the social worker visit the client to discuss care options.

A client is diagnosed with a terminal illness. Who is usually responsible for deciding what, when, and how the client should be told?

Health Care Provider.

A nurse is caring for a client with pneumonia. Which task is most appropriate for the nurse to delegate to an experienced unlicensed assistive personnel (UAP)?

Obtaining vital signs every 4 hours

A nurse is researching health care in rural areas. Based on a 2013 U.S. Subcommittee on Primary Health and Aging, which statement regarding access to primary health care is correct?

One in five americans live in areas without adequate access to primary health care due to a shortage of primary care providers.

Which two areas of knowledge are most important when providing nursing care to clients in the home?

Physical assessment and infection control

What is the priority nursing responsibility when transferring a client from one unit in the hospital to another?

Provide a verbal report of the client's status to the admitting nurse.

What role will the nurse play in transferring a client to a long-term care facility?

Provide a verbal report to the nurse at the long-term care facility on the client, the hospital care, and the client's current condition.

The nurse is providing care for a client who is ordered nothing by mouth (n.p.o.). What is an important nursing intervention?

Provide frequent mouth care.

Public health nursing is the branch of nursing that:

Provides healthcare to the community.

The nurse understands that planning for discharge actually begins at admission to the facility. The purpose of discharge planning is best described as:

Providing continuity of care that is goal directed.

The nurse is a member of the multidisciplinary team in a large primary healthcare setting. The nurse understands that which healthcare team member is responsible for a client's swallow evaluation following a cerebral vascular accident?

Speech Pathologist/Therapist.

A hospitalized client asks the nurse for "some aspirin for my headache." There is no order for aspirin for this client. What will the nurse do?

State that an order from the doctor is legally required and check with the doctor.

Which type of skills is not needed for nursing leadership?

Technical skills

A new unlicensed assistive personnel (UAP) is preparing to ambulate an obese client. The registered nurse (RN) is concerned about the UAP's ability to safely ambulate the client. Which would be the nurse's most appropriate action?

Tell the UAP that the RN will assist the UAP with the client's ambulation.

Which Organization audits charts regularly?

The Joint Commission.

The procedural physician has initiated performance of a time-out in the operating room before surgery. The student nurse asks the operating room nurse why this is important. What is the operating room nurse's best response?

The time-out checks to be sure that we have the right client, and the right procedure.

Why are quality-assurance programs important in nursing?

They enable nursing to be accountable for the quality of care.

What is the rationale for conducting discharge planning?

To ensure patient and family needs are consistently met.

Which is the major goal of ambulatory care facilities?

To provide care for clients capable of self-care at home.

A new graduate is working at a first job. Which statement is most important for the new nurse to follow?

Use abbreviations approved by the facility.