Community book ch. 10-12

The community health nurse is reviewing ideal candidates for home health care. Using your knowledge about home health care, which of the following individuals are candidates? 1. People with acute illness 2. People with chronic illness 3. Individuals with a new health-related situation

1, 2, 3

You know that home health agencies are certified through a process where stipulated conditions must be present in order for the agency to give services to the public and receive payment for those services. Using your knowledge about financing, what criteria an individual has to meet in order to receive Medicare for home health services? 1. Home bound 2. Specific plan of care 3. Skilled health care needs 4. Intermittent care needs 5. Continuous 24-hour necessity for care

1,2,3,4

The community health nurse is assessing the dynamics of the family. Using your knowledge of family members' relationships to each other with the degree of kinship identified, what is an example of a nuclear family?

A)First-degree relatives who live together

Your presentation to the student nurses includes information about practice models and disease management programs. Using your knowledge about disease management programs, what is the best practice model?

Collaborative

You are preparing a presentation on care management for a group of student nurses. Based on your knowledge of community health nursing, what will be a key point to include in this presentation about care management?

Coordination of a plan or process to bring health services together as a common whole in a cost-effective way

The community health nurse uses health and illness factors and characteristics from the database to create clinical guidelines specifically related to health promotion at all levelsof prevention. Using your knowledge of health appraisals, what information do health appraisals provide? 1. Information that identifies a common problem2. Specific criteria that confirm that the problem exists3. Tangible examples of the problem4. Treatment recommendations

D)1,2,3,4

The community health nurse is completing a thorough family assessment that involves in-depth examination of a complex system. One approach to gain perspective on family health is to observe and inquire about the family's routines and rituals. Using your knowledge of routines and rituals, what isan exaple of a family health routine?

D)Safety and precautions

There are theoretical approaches to family in community health nursing. Using your knowledge of theories, you know that family members are an integral part of each other's lives. Which theory views the family as the foundation for self-care and a setting for care?

D)Self-Care Agency

You are a community health nurse working in a community recently devastated by a tornado. Many of the survivors are cared for in the home. Care is needed for those who are ill, recovering, or in hospice. In order to provide holistic care to the community, you would

collaborate between experts and the clients.

You are conducting a community assessment. The community is large and the members range from affluent executives to poverty-stricken migrant workers. To accurately assess the community, you

use multiple methods or perspectives.

The community health nurse is reviewing a list of Healthy People 2010 indicators with you. Using your knowledge of Healthy People 2010, what are the key indicators?1. Physical activity2. Anorexiǎ. Responsible sexual behaviòr. Tobacco use. Substance abuse

C)1,2,3,4,5

The community health nurse is assessing the health risk of the family. Using your knowledge that families approach the idea of health risk in many different ways, what are factors to consider?1. What they learn from their present experience in their family of origin2. Economic circumstances, especially health care insurance coveragě. Stress and coping styles4. Internal and external culture

C)2,3,4

There are several approaches to family assessment that use particular concepts that nurses typically encounter in practice. These models provide an organized framework with which to conduct a family assessment. Using your knowledge that the key to select a certain model is to consider the situation, health concerns, and cultural background of the family, what is the aim of the family assessment with a Life Span Development approach?

B)To identify family health practices within a social and historical context

The community health nurse is conducting a 15-minute family interview. Using your knowledge of interviewing techniques, which principle is being used to maximize information when the nurse validates family concerns with their active listening?

B)Use of therapeutic conversation

You are taking care of a dependent family member whose husband is in the military. Using your knowledge of financing and the regulation of home care, what government funding is most likely going to be used for home health care services?

Medicaid

You know that because of the variety of reimbursement mechanisms that have evolved over time in home health care, many different forms of services have evolved based on levels of philanthropy; profit-making needs; and federal, state, and city funding. Using your knowledge about types of agencies, what is a home health agency that is motivated by a not-for-profit philosophy called?

Private/voluntary

You know that because of the variety of reimbursement mechanisms that have evolved over time in home health care, many different forms of services have evolved based on levels of philanthropy; profit-making needs; and federal, state, and city funding. Using your knowledge about types of agencies, what is a home health agency that is motivated by a for-profit philosophy called?

Proprietary

You are completing a community assessment. You note that the computer companies in the community hire a disproportionate amount of their employees from local suburban communities versus the community in which the company is housed. In order to create an accurate assessment you collect data on all of the company's employees, but list those living outside of the community asé

an aggregate

The school nurse notifies you that there have been six confirmed cases of pertussis in the sixth-grade classes. In addition to responding to the cluster of cases you would

research the vaccine compliance in the school.

When the community collaborates in a plan to create services and education to enhance their health and well being, the plan

shifts the focus from dependency to empowerment.

You are a community health nurse assessing the neighborhood in which your clients live. When observing the physical environment, you note that most of the homes in the neighborhood are well kept and the children playing in the yards are wearing clean clothing. The children appear well nourished. You place the neighborhood on the list as a low priority for a neighborhood well-child clinic. Your assessment is based on

subjective data.

There is a statistically high level of obesity and elevated cholesterol levels in the southern section of the community. There is a central area in the neighborhood that makes fast foods easily accessible. The statistics assist you to

target education and support programs

You are part of a nursing consortium conducting community assessments in New England. At a quarterly meeting you note that the preliminary results of your data collection indicates

the communities have similar goals related to health and safety

You are the community health nurse in a new neighborhood. You introduce yourself to the local minister, and attend various neighborhood meetings. You learn about the ethics, values, and culture of the neighborhood. The community is vocal about the need for public safety and the care of the homeless, especially in the winter. It is important to consider all of the influences in the neighborhood affecting their health and well-being because

the information will help to effectively assess the community.

5. The community health nurse is reviewing guidelines with you for the "15 minute" assessment in order to keep the interview focused and family centered. Using your knowledge of family assessment, what are questions and considerations for the family assessment that can be asked for the question "Who is part of the family?" 1. What is the nature of individuals' connections to one another?2. Does the individual live alone or have no living family members?3. What influences from the family of origin are present in daily life? 4. Do members speak independently or is an interpreter present?

Ā)1, 2, 3

Posthurricane, your disaster team chooses to use a collaborative model to assess the needs of the community. Each of you is given a community analysis and the task to create a tentative plan of action. Why would the use of a collaborative model hamper the progress of the assessment and plan in a disaster? (select all that apply)

-Assessment is time consuming. -Approach to problem solving is linear.

You work as a parish/faith community nurse. Using your knowledge of the parish or faith community nurse, what are key roles of this type of nurse? 1. Health educator 2. Personal health counselor 3. Referral agent 4. Coordinator of volunteers 5. Health advocate

1, 2, 3, 4, 5

You are reviewing the official document called the Scope and Standards of Home Health Nursing Practice. Using your knowledge about the document providing guidelines for nurses involved in home health care practice, what is included in the standards of care? 1. Assessment by collecting data about home care clients 2. Diagnosis through the analysis of data 3. Outcome identification that helps identify nurse-sensitive measures 4. Planning nurse-sensitive interventions directed at the identified outcomes 5. Implementation of nurse-centered actions in collaboration with physicians

1,2,3,4

You are observing the home health nurse using telehealth technology. Using your knowledge that telehealth is a form of electronic communication, what is telehealth used to deliver? 1. Chronic care and specialty consultations 2. Home telenursing 3. Electronic referrals to specialists in expert health facilities 4. Transmit health care information to people in the same geographical area

2,3

You are reviewing the regulations for home health care. Using your knowledge of home health care, who regulates the provisions of home health care? 1. Insurance companies 2. Local government 3. State government 4. Federal government

2,3

You are reviewing the similarities and differences between case management and care management. Using your knowledge that case management involves an intensive process called disease management, at what levels does disease management emphasize prevention using evidence-based practice guidelines? 1. Primary 2. Secondary 3. Tertiary

2,3

The community health nurse can receive a referral to a home health agency at any time. Using your knowledge of home visits, generally home care agencies make sure to do the initial visit within what time frame after receiving a referral?

24 hours

You know that home health agencies are certified through a process where stipulated conditions must be present in order for the agency to give services to the public and receive payment for those services. Your patient wants to know how long Medicare will pay for skilled needs. Using your knowledge about financing, what specific time period is appropriate for renewals if skilled needs continue to exist?

60 days

Home care is part of a continuum of care where clients have the opportunity to live through the experiences of subacute, chronic, and end-of-life care. Using your knowledge about home health care, what is assisted living?

A model of care for the elderly or disabled that includes services such as home care to maintain the independence of clients

The community health nurse can receive a referral to a home health agency at any time. Using your knowledge of home visits, what phases are included in a home visit? 1. Initiating a visit 2. Preparation 3. Actual visit 4. Termination of the visit 5. Plan personal safety of visit

A) 1, 2, 3, 4

The community health nurse is reviewing that culture and diversity are issues that affect all families, whether or not clients openly express it. Using your knowledge that the terms culture and diversity have several meanings, what is cultural diversity?

A)A) Describe people of different racial or ethnic backgrounds in society

The community health nurse reviews that most families tend to express more concern about the possibility that one member might become ill than about overall family wellness. Using your knowledge that a family member who is "at risk" has an increased probability of becoming sick or disabled, or even dying, what do the types of risk relate to? 1. Genetics2. Agě. Psychosocial background4. Personal health habits and lifestyle. Environment

B)1,2,3,4

The community health nurse notices that the family assessment reveals four generations of family members working. Using your knowledge about intergenerational relationships, what is true about generation X?

B)B) Likely to multitask and possibly have more than one career in their lifetime

The community health nurse is establishing goals for the family based on the assessment. Using your knowledge of the grand nursing theory that guides establishment of assessment goals for families, which theory is the nurse using when developing a therapeutic relationship with the family that helps them identify areas for change?

B)Health as Expanding Consciousness

The community health nurse is reviewing with you perspectives on family. Using your knowledge that one way to learn about families is to assess them from a broad perspective, what is the grand nursing theory in nursing practice?

B)Relates human experience to nursing practice and nursing care

The community health nurse documents in the chart that the family is blended. Using your knowledge of blended families, what are reasons for this type of family becoming more widespread?1. Increased divorced married peoplé. Increased widowed single peoplě. Increased gay and lesbian relationships

C)1,3

The community health nurse is assessing stressful life events in the family. Using your knowledge of life events that most people and their families find stressful, what is an example of a family inventory of life events related to illness and family care strains?

C)Filial responsibility for oldest girl sibling to care for chronically ill parents

The community health nurse has limited time for family assessments because of demanding caseloads or staffing shortages. Using your knowledge that focused family interviews of 15 minutes or less can yield a wealth of information, what is an example of an activity that will acknowledge the family's strengths?

C)Share any genograms and ecomaps that illustrate relationships with family members.

Your research reveals that care management is related to case management. Using your knowledge about case management, care management, and disease management, what is correct about the building blocks of these key concepts?

Case management can be considered a building block of care management.

The community health nurse is using a genogram to aid in the family assessment. Using your knowledge of tools that help identify families and their relationships, what aspect of family connections and relationships is included in the genogram?

D) Show relationships across two or more generations

As in other areas of clinical practice, community health nurses frequently have limited time for family assessments because of demanding caseloads or staffing shortages. Using your knowledge about assessment, what are principles that maximize informationgleaned in a "15-minute" family interview?1. Manners2. Use of therapeutic conversation3. Ecomaps and genograms4. Acknowledgement of family strengths5. Use of therapeutic questions

D)1,2,3,4,5

Family risk reduction is the process by which either individual family members or family as a group work together toward a goal of reducing the probability of sickness, disability, or death. The community health nurse is reviewing with you formal settings for sources of family risk reduction information. Using your knowledge of family risk reduction, what is an example of a formal setting for receiving this information?

D)D) Health care providers provide clients with information in clinics, physicians' offices, emergency departments, and urgent care centers.

There is a tornado alert in the community. What resource would be valuable to the disaster team to ascertain the areas in the community at greatest risk for damage due to the structure of land mass and infrastructure?

Geographic information systems

You know that because of the variety of reimbursement mechanisms that have evolved over time in home health care, many different forms of services have evolved based on levels of philanthropy; profit-making needs; and federal, state, and city funding. Using your knowledge about types of agencies, what type of agency can be profit or nonprofit?

Hospital based

You know that home health agencies are certified through a process where stipulated conditions must be present in order for the agency to give services to the public and receive payment for those services. Using your knowledge about financing, what are the criteria of providing care over several hours during the day, several days during the week, for a specified time period called?

Intermittent care needs

You are approach by the health department to investigate and assess the rise in developmental disabilities in an isolated section in the community. In order to begin your assessment you gather objective data from

Internet—aggregate data.

You know that falls are a major health problem in the home. One third of older adults fall every year with serious consequences that include death, fractures, and head injuries. The home health nurse has to ensure that a safety plan is in place to address falls. Using your knowledge that 55% of fall-related injuries occur with falls inside the home, a total of over 60% of these falls occur in which two rooms?

Living room and bedroom

You are conducting a community assessment in a town once supported by multiple paper factories. The factories closed 2 years ago and the majority of the population is now out of work. The school nurse notes that 68% of the students are behind in their physicals and immunizations. On the basis of your community assessment, you will recommend

a)the initiation of neighborhood clinics at low or no cost to the community

The community that you are assessing is changing. Five years ago, a series of setbacks caused the local foundry to close. Through interview, you discover that generations of families worked at the foundry. Research indicates that no other businesses have grown in the community to provide work for those who worked at the foundry. The research into the communities' history will assist you to

determine what variables may have detracted from community development.

A significant number of the members of your community have developed cancer. The EPA has discovered a leak of biohazardous waste from a local factory that has leached into the water table. The area is decontaminated and cleaned. The community identifies the need for a local hospice for those with cancer who are dying. Area communities participate in the fund drive. This type of community effort may be considered (a)

community of solutions

As a community health nurse, you are responsible for the general health of the community on multiple levels. The local school nurse identifies that there are an increased number of sick days for children ages 7 to 12 at the local school. On the basis of your research, you note that there is a disparity in the education of the families of the asthmatic children as well as other factors that influence noncompliance with current treatment plans. The next step in your plan of care is to

develop school-based education programs for both the children and their caregivers.

There are 12 students in grades 5 to 7 at the local school with confirmed cases of H1N1 flu. The caregivers of the ill children are advised to keep the children home for a minimum of 5 to 7 days. The next step is

education in the school setting regarding respiratory and hand hygiene.

As a public health nurse, you may participate in individual, family, or community assessments. An organized approach to assessment in the form of an evaluation that is commonly used is

functional health pattern

Community assessment is a critical process for the future because the process may

identify a method to improve the health of at-risk clients.

The community you are involved in is concerned regarding public safety and the care of their elders living at home. When you assess the community you find that there is potential to solve their problems within the community setting without outside resources. The plans to meet the community needs are accepted by the members of the community. One method to create a successful environment for assessment is to

make the assessment process empowering to the community.