Chapter 12: study questions

Which type of data is most important to a home health nurse who is performing a comprehensive assessment for a new client recently discharged from the hospital?

Subjective data about how the client manages medications at home

Prior to the discharge of a client who is recovering from a stroke from an acute care facility, the nursing case manager has the nursing staff, client, client's family, physical therapist, and home health nurse meet. The most likely purpose of this meeting is to:

prepare the client for home care.

The nurse is admitting a client for outpatient surgery. When the nurse asks what the client has been told about self-care following discharge, the client says, "No one has told me anything." Which nursing intervention is indicated?

provide the teaching

Public health nursing is the branch of nursing that:

provides health care for the community

The focus of community-based care is:

providing care to clients within a defined geographic area.

In preparation for discharge, the nurse is reviewing information related to new dietary guidelines with the client. This is an example of which step in discharge planning?

providing client education

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.

When a multidisciplinary team is involved in meeting the home care needs of a client, who is the person responsible for the coordination of the care provided?

registered nurse

A nurse is caring for a 17-year-old pregnant teenager who needs to obtain assistance with essential baby items such as a crib. The client mentions not having any income from a job. The nurse should encourage the client to go to a:

social welfare office

An 82-year-old client is being discharged from the hospital following a bowel resection. The client lives alone and the client's family is out of town. Which factor will have the greatest effect on the client's home care management?

support system

A hospital has begun to expand home health services to its clients. Which reason is the most likely cause for the expansion of these services?

the change to shorter hospital stays

A nurse is preparing for handoff communication for a client who is being discharged from the hospital to home health care. Which example is not an action performed during this process?

the nurse prepares the new room for the client

A group of nursing students is discussing reasons why they would like to become home health nurses after licensure. The nursing instructor facilitating this discussion would offer additional information when which statement is made? Select all that apply.

"I don't think fast enough to work in a hospital." "I would like to spend more time talking with clients than doing skills."

The home care nurse asks the client and family about their socioeconomic status, culture, and beliefs. Which is the best response by the nurse when the family asks why those questions are being asked?

"I want to understand what your desires are."

A nurse has been asked to chair an action team tasked with prioritizing a list of possible new equipment purchases. Which statements, made by this nurse, will help the team be most effective? Select all that apply.

"Our goal is to prioritize this list of potential equipment purchases, offering rationale for our choices." "Before our next meeting, each of us will ask the nurses on the unit what their priority purchase would be." "Once we have completed the list and rationale, I will compile our recommendations for us all to sign before submission."

The nurse manager of the acute care unit has decided to implement a team nursing approach for client care. One of the staff members asks, "Will we each take care of our own clients?" What is the appropriate response by the manager?

"The care will be divided and the registered nurse (RN) will have a licensed practical/vocational nurse (LPN/LVN) and unlicensed assistive personnel (UAP) to provide care together."

A home health care nurse is explaining to an emergency room nurse how nursing care in the home setting differs from that in the hospital setting. Which statement by the home health care nurse would be most appropriate?

"The client and family are in control of the setting, not the nurse."

The nurse is assigned to care for an older adult client who had a stroke and will be discharged soon from the acute care facility. Which actions by the nurse will help meet the client's outcomes for discharge? Select all that apply.

-Assesses the needs of the client and family throughout the hospitalization -Collaborates with the health care team to obtain referrals the client will need -Teaches the client and family about medications and treatments -Supports the caregivers as they adjust to the discharge

Which interventions would be performed by the occupational therapist as a member of the home health care team? Select all that apply.

-Evaluate the client's functional level. -Teach the client about strengthening exercises. -Educate the client and family about promoting self-care in activities of daily living. -Provide assistance with securing needed equipment.

Which activities should the nurse engage in during the pre-entry phase of the home visit? Select all that apply.

-Gather supplies for the visit. -Review the client's treatment orders. -Evaluate the safety of the neighborhood.

A client says, "You guys are not doing anything for me. I am leaving." Which interventions are indicated by the nurse? Select all that apply.

-Inform the client of the risks of leaving. -Witness the client's signature on the against medical advice form.

Which diseases would warrant a client receiving hospice care? Select all that apply.

-Multiple sclerosis -End-stage renal disease -Congestive heart failure

One significant change in the health care delivery system in recent years is earlier hospital discharges. What is one result of earlier hospital discharges?

Clients with high home care needs are being discharged into the community.

A single parent age 17 years, with one child and pregnant with a second, has the mental age of a 12-year-old. The home care nurse's greatest concern in caring for this client should be the client's ability to do which?

Cognitively understand how to care for the children

A registered nurse is providing community-based health care for a client diagnosed with early onset dementia. Which strategy is best for the nurse to employ to facilitate the family participating in the client's care?

Encourage active participation of the client and family in health care decisions.

Which is the primary goal of continuity of care?

Ensuring a smooth and safe transition between different health care settings

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 nurse is caring for a 17-year-old pregnant client who is unable to afford health care. Which resources will the nurse access to obtain assistance for this client?

Make a referral to the social services department.

Which measure should a home health care nurse integrate into routine practice to minimize the potential for lawsuits?

Perform thorough, accurate, and timely documentation.

A client with severe congestive heart failure (CHF) has been referred to a long-term care facility. The nurse is transferring care from the hospital setting to a long-term care facility. Which action is a priority to ensure continuity of care for this client?

Providing accurate and complete communication to the new facility.

A client diagnosed with terminal leukemia is receiving home health care services to assist in the client's care. After assessing the client, the home health care nurse determines that the client is unable to afford needed medical supplies. Which is the best strategy for the nurse to implement to assist the client?

Refer the client to a social worker to determine eligibility for assistance.

One of the fastest growing venues of practice for the nurse is home health care. What is the basis for the growth in this health care setting?

The discharge home of clients who are more critically ill

A nurse is preparing for handoff communication for a client who is being discharged from the hospital to home health care. Which example is not an action performed during this process?

The nurse prepares the new room for the client.

When would it be appropriate for the nurse to initiate discharge planning with a client who will be discharged the next morning?

When providing preoperative education related to a scheduled cataract extraction

A 16-year-old client has been injured in an accident and is receiving home care due to fractures and multiple trauma-related injuries. The client states, "I don't know why I survived and not my best friend." It is most important for the home care nurse to encourage the client to:

communicate these feelings to family and friends.

A successful discharge includes effective planning. Identifying and meeting client needs beyond the acute care facility reduce readmissions. Which nursing role is of great importance to this success?

coordinator

Which role is the home health nurse exhibiting when demonstrating how to suction the oropharynx of the client?

educator

A home health care nurse develops a client's individualized plan of care during the:

entry phase

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

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.

When educating clients in the community on health promotion and prevention of disease, it is important to stress:

health education can benefit individuals and groups.

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

A client living alone has degenerative joint disease, hypertension, and neuropathy. It is difficult for the client to bathe, and the client's blood pressure is unstable. Which type of care would this client benefit from most?

home care

Home health care nurses are required to complete the Outcome and Assessment Information Set (OASIS) by which entity?

medicare

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

medicare

The client is being discharged to the home setting following a stroke. The client requires assistance in relearning how to cook safely. To which home health care team member should the nurse refer the client?

occupational therapist

Which type of home healthcare agency is a local health department?

official or public agency