PrepU Chapter 2: MEDICAL-SURGICAL NURSING

The goal of OSHA is

to ensure safe work conditions.

A client with multiple sclerosis is unable to independently complete activities of daily living. Which recommendation will the nurse make when the spouse refuses to participate in providing the client's personal care?

"A personal caregiver might be a good idea.

A nurse is evaluating a client's discharge collaboration between the referring agency and the home care agency. What response by the client would indicate an understanding of the discharge planning process?

"The nurse helped me make a list of my needs and goals for recovery and shared them with the home care team"

The home care nurse is finishing a visit with a client. What teaching points should the nurse cover with the client and client's family member prior to leaving? Select all that apply.

-Teach back instruction on new procedures or medication administration -Positive findings during the visit in order to provide encouragement -A review of the teaching plan with written instructions

An urban, community-based nurse is looking for community resources for a client who has complex rehabilitation needs and several comorbid, chronic health conditions. Where is the best place for the nurse to search for appropriate resources?

A community directory

A nurse is working as part of a team developing a community-based care program for the local homeless population. Which of the following would be important to keep in mind when developing the program? Select all that apply.

-Homeless people often have no or insufficient health insurance. -Health problems are often related to a person's living situation. -Ill homeless people often deteriorate more rapidly than those who are not homeless.

A novice home health nurse is receiving training on personal safety in home health care. What statements does the nurse recognize as true regarding ensuring personal safety when first visiting a client? Select all that apply.

-Park the car near the client's home, and lock the car during the visit. -Avoid visits at night if at all possible. -Become familiar with the layout of the client's home. -Carry agency identification at all times and ensure it is visible.

Which of the following are considered the primary concepts of community-based nursing? Select all that apply.

-Self-care -Preventive care within the context of culture and community

A nurse is comparing some of the similarities and differences between the care that is provided in community- and hospital-based settings. What type of care is provided in both of these settings?

Ambulatory health care

A home care nurse has just completed the initial visit and is documenting the findings. Which of the following would best support reimbursement by the client's third-party payer?

Ankle wound with quarter-sized amount of yellow drainage; irrigated with normal saline and redressed

In which situation is the nurse providing appropriate discharge planning?

Assessing the client's support system at home during the admission assessment

A client is admitted to an acute care facility after having a stroke. The client will require a variety of healthcare services throughout the hospital stay as well as coordination of care prior to discharge. What referral would be a priority for overseeing the client's care?

Case management

A home care nurse is looking at ways that home care nurses can promote holistic care of the client. What action will the nurse implement in order to accomplish this task?

Collaboration with an interdisciplinary team

A home health nurse is visiting a client's home to perform wound care. The client lives in an impoverished neighborhood and the nurse notes that the client does not have running water. What nursing action will best control infection, despite no running water?

Hand hygiene techniques

Which setting has been the traditional site for the nursing workforce?

Inpatient units

A home care nurse enters the home of a client and finds that the client's son is noticeably intoxicated. The son, who is slurring his words, is becoming increasingly agitated. What action by the home care nurse would be most appropriate?

Leave the home and reschedule the visit

Which of the following would be least helpful in ensuring the safety of a home care nurse?

Making visits in the late evening hours

According to the 2013 OASIS data study, which client would be at greatest risk for re-hospitalization?

Male client who requires assistance to ambulate

A novice nurse is learning the difference between community-based nursing and community-oriented nursing. Which scenario does the nurse recognize as a role of the community-oriented nurse?

Nurse working a booth at a health fair performing blood pressure and glucose screenings

Which element is least likely to be a characteristic of an expected outcome of a nursing intervention?

Nurse-centered

A client is being discharged home after a hemorrhagic stroke. To which discipline should the nurse case manager make a referral to improve the client's ability to perform activities of daily living?

Occupational Therapy

A client is being discharged home after a hemorrhagic stroke. To which discipline should the nurse case manager make a referral to improve the client's ability to perform activities of daily living?

Occupational therapy

Which order of activities is accurate when making a home visit?

Review agency policies regarding visits, ask permission to enter home, perform hand hygiene, and document care provided.

A nurse is caring for an older adult with emphysema. Which nursing action demonstrates primary prevention?

Teaching the client various methods to help prevent pneumonia

The nurse is caring for a patient who is to be discharged from the acute care facility to a rehabilitation unit after having a stroke. What type of prevention is this considered to be?

Tertiary

The nurse is making an initial home visit to assess a patient for home health services. Which patients most frequently require home health services?

The frail and elderly who need skilled care

A nurse works in a community setting that deals with a large number of homeless individuals. Which of the following would be most important for the nurse to understand?

The health problems faced by homeless people are often related to their living situation

The nurse is making an initial home visit for a client requiring wound care. What statement is true regarding safety during a home visit by a nurse?

The nurse should never walk into a patient's home uninvited.

A community health nurse understands the importance and impact of cultural competence when caring for clients in the community. In what situation will the nurse find that cultural competence is particularly important?

When members of the community share a heritage that is unfamiliar to the nurse

A client receives dialysis four times a week at a dialysis center. Which type of care is provided at a dialysis center?

ambulatory care

Which tools do case managers commonly rely on to plan and coordinate client care?

clinical pathways, practice guidelines, and standards of care

A male client recovering from a stroke is receiving anticoagulant therapy. Which item will the nurse instruct the client to use for self-care?

electric razor

The nurse is transitioning to a home health setting. What factor has resulted in a shift in the health care delivery setting?

growing number of elderly clients

In a team meeting for a nursing home client, the client's development of a lower leg wound, including its potential cause and treatment, is being discussed. The nurse proposed a strategy for treating the wound and preventing its recurrence. This action reflects which of the nursing responsibilities outlined by the American Nurses Association?

interpreting client information and making critical decisions about needed actions

The home health nurse and the parish nurse have separate roles in health care. What best describes the common factor all community-based nurses share?

Community health nurses focus on community needs as well as the needs of individual patients

The nurse is discharging an unemployed homeless client who was hospitalized with a wound infection. What is the best point of contact for the client to use for continued services for the wound care?

Community hubs

A public health nurse describes the role of the nurse in public health to a group of community stakeholders during a budget meeting. Which category of care will the nurse place public health nursing?

Community-oriented nursing

A home care nurse is visiting a new client and notes that the client's home is very messy. There are dirty dishes piled everywhere, the house smells of garbage, and there are very few surfaces that are clean. How should the nurse respond?

Enter the home and continue to treat the client.

A home care nurse is scheduled to visit a client who lives in an area that is considered a high-crime area. Which of the following would be most appropriate?

Have another home care nurse come along on the visit.

A nurse working in the community is involved in secondary prevention. Which activity would most likely apply?

Health screening for diabetes risk

A community health nurse is helping develop teaching on the role of the community health nurse and how this discipline can help the community. What does the nurse describe as a key component of community-based care?

Improving quality of life

Which capability corresponds with home health care?

Improvising when providing care

The nurse is completing passive range-of-motion exercises with a client recovering from an acute illness. A muscle spasm occurs in the client's left arm while exercising it. Which action will the nurse take?

Move the joint slowly to the point of resistance and apply gentle pressure.

A nurse who is considering the possibility of becoming involved in home care asks a home care nurse about the characteristics needed for this practice area. Which of the following would the home care nurse be least likely to include?

Need for control over a situation

The nurse is providing a community education program about sexually transmitted infections for a group of 13- to 16-year-olds. What type of prevention is the nurse targeting?

Primary prevention

The nurse is working in an ambulatory health clinic. What is the focus of community-based nursing practice?

Promoting and maintaining population health and preventing and minimizing disease progress

A client in an acute care facility is assigned a case manager to oversee and coordinate care. What important function does a case manager have?

Provide early, thorough discharge planning

A nurse is working as an occupational health nurse at a local factory. With which activity would the nurse least likely be involved?

Providing case management services for the employees