PrepU Ch.12; Fundamentals

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. 1. "Before our next meeting, each of us will ask the nurses on the unit what their priority purchase would be." 2. "When I got this assignment, they said something about deciding what equipment to purchase next year." "3. Once we have completed the list and rationale, I will compile our recommendations for us all to sign before submission." 4. "I am willing to prioritize the list if someone else will write the rationale." 5. "Our goal is to prioritize this list of potential equipment purchases, offering rationale for our choices."

1. "Before our next meeting, each of us will ask the nurses on the unit what their priority purchase would be." "3. Once we have completed the list and rationale, I will compile our recommendations for us all to sign before submission." 5. "Our goal is to prioritize this list of potential equipment purchases, offering rationale for our choices."

The home health care nurse is providing information to a client and family on medication changes. What role is the nurse performing? a. Caregiver b. Coordinator of services c. Client advocate d. Client and family educator

d. Client and family educator

In anticipation of discharge, a nurse is teaching the daughter of an older adult client how to change the dressing on the client's venous ulcer. Which teaching strategy is most likely to be effective? a. Demonstrate and explain the procedure and then have the daughter perform it. b. Provide explicit written and verbal instructions and ask the daughter to explain back to the nurse how to perform the procedure. c. Explain the procedure clearly and slowly while providing multiple opportunities for the daughter to ask questions. d. Use a multimedia strategy that combines animation with narration.

a. Demonstrate and explain the procedure and then have the daughter perform it.

The nurse is working with a client's family and social worker to select a home health care agency. Which question does the nurse state should be the family's priority when interviewing potential home health agencies? a. Does the agency meet uniform standards for licensing, certification, and accreditation by state agencies and/or federal programs? b. Does the agency provide care to facilitate transition to a hospital? c. Is the facility listed as a government-approved facility with no infractions? d. How does the agency train employees for accountability and do they require a background check?

a. Does the agency meet uniform standards for licensing, certification, and accreditation by state agencies and/or federal programs?

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." The nurse should prioritize what action? a. Encouraging the client to communicate these feelings to family and friends. b. Making referrals to a religious leader of the client's choosing c. Assessing whether the client is misusing substances to cope d. Confirm that the client's educational needs are being met in the short term

a. Encouraging the client to communicate these feelings to family and friends.

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? a. Home environment b. Previous health status c. Assistance of neighbors d. Costs of the visits

a. Home environment

Which is the largest single source of reimbursement for home health care services? a. Medicare b. Client's self-pay c. Medicaid d. Private insurance

a. Medicare

A nurse working in a primary health care facility would most likely provide which service? a. Screening b. Rehabilitation c. Treatment d. Acute care

a. Screening

It is important for home health care nurses to remember which point? a. The nurse is the guest in the client's home. b. The nurse should act as a counselor and advisor. c. The nurse is the primary caregiver. d. Rehabilitation is the major client goal.

a. The nurse is the guest in the client's home.

On admission to the hospital, each client is asked whether the client has a living will or a durable power of attorney. If not, the admitting staff person provides a sample form to the client if wanted. The purpose of this inquiry is to determine: a. whether the client has a document describing wishes for care when the client is no longer able to make decisions. b. previous decisions made regarding whom to contact should the client die in the hospital. c. how the client feels about being resuscitated and maintained on life support if this is necessary. d. what the client wants to have happen during the hospitalization.

a. whether the client has a document describing wishes for care when the client is no longer able to make decisions.

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? a. "All of these questions are solidly within the nursing scope of practice." b. "I want to ensure your care meets your unique needs." c. "I need to ask because it is required in every referral to home care." d. "I am trying to build a relationship with you."

b. "I want to ensure your care meets your unique needs."

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? a. "Each registered nurse (RN) will be assigned a client and be responsible for planning and evaluating care." b. "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." c. "I will plan the care based on the client's diagnosis or type of case." d. "One person will provide skilled care, one will give medications, and one will help with hygienic needs."

b. "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 nurse is covering all aspects of admission procedures for a client who is receiving home health services. The nurse explains what procedures will be covered during the nurse's visits. Which aspect of the admission process does this represent? a. Assisting in participation of the care-related decisions b. Clearly defining the purpose and expectations of care c. Establishing rapport and showing willingness to listen d. Documenting the procedure

b. Clearly defining the purpose and expectations of care

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? a. Nurse practitioner b. Coordinator c. Clinician d. Caregiver

b. Coordinator

Which role is the home health nurse exhibiting when demonstrating how to suction the oropharynx of the client? a. Care coordinator b. Educator c. Advocate d. Caregiver

b. Educator

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? a. Create a care plan based on the client's requests and inform the family of the client's wishes. b. Encourage active participation of the client and family in health care decisions. c. Provide referrals for health care professionals to perform the client's activities of daily living (ADLs). d. Reinforce the care plan to the family if it is determined the client is not properly cared for.

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

A client is having an increasing amount of difficulty maintaining activities of daily living (ADL's) in the home alone following a below-the-knee amputation. The nurse's assessment reveals that the client may benefit from different assistive devices to facilitate ADL's. Which action would be the most appropriate for the nurse to take? a. Have the physical therapist help the client with rehabilitation b. Have the occupational therapist assess the client's specific needs c. Have the home health aide increase the frequency of visits d. Make a referral to social work so the client may discuss care options

b. Have the occupational therapist assess the client's specific needs

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? a. Pain management b. High-rise toilet seat c. Homemaking d. Intravenous therapy

b. High-rise toilet seat

A client living alone has degenerative joint disease, hypertension, and peripheral neuropathy. The client has challenges with activities of daily living, including hygiene. Which type of care would this client benefit from most? a. Respite care b. Home care c. Acute care d. Ambulatory care

b. Home care

When doing discharge planning for an older adult client who had a stroke, what is the nursing priority? a. Help the client after discharge to establish goals. b. Plan reachable goals with the client and family. c. Involve the family in discussing when the client will go home. d. Realize that goals may not be met after discharge.

b. Plan reachable goals with the client and family.

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? a. The nurse uses the SBAR technique during the handoff. b. The nurse prepares the new room for the client. c. The nurse determines who should be involved in the handoff communication. d. The nurse asks the other health care professionals if they have any questions.

b. The nurse prepares the new room for the client.

Continuity of care is an important concept for quality nursing practice. The responsible nurse understands the best description of the process of continuity of care is to: a. assist the client to focus on health goals and reach outcomes. b. coordinate uninterrupted care and facilitate transfer between units and levels of care. c. teach the client self-care regarding medications and plan of care. d. manage the individual care needs of the client throughout the hospital stay.

b. coordinate uninterrupted care and facilitate transfer between units and levels of care.

Public health nursing is the branch of nursing that: a. administers care for a defined geographic community. b. provides health care for the community. c. provides primary care to individuals. d. assesses individuals for community care.

b. provides health care for the community.

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? a. "It requires that you have high-level critical care skills." b. "You need a graduate degree to specialize in home health care." c. "The client and family are in control of the setting, not the nurse." d. "Each team member works independently of other team members."

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

A nurse is using the SBAR approach for handoff communication when transferring a client to the critical care unit. Which statement would the nurse include as part of the recommendation? a. "The client began complaining of severe chest pain, rating it as a 10 on a scale of 1 to 10, after walking back from the bathroom." b. "This event seemed to come out of the blue. The client denies any history of heart disease but does take a baby aspirin each night." c. "The client is scheduled for a cardiac catheterization in about an hour and needs monitoring every 15 minutes." d. "The client had an exploratory laparotomy 2 days ago and was progressing well. The vital signs were stable until this episode."

c. "The client is scheduled for a cardiac catheterization in about an hour and needs monitoring every 15 minutes."

For which of the following clients will the nurse provide a "simple referral" level of discharge planning? a. An older client who will return home after being treated for community-acquired pneumonia b. A mother an infant being discharged home one day after an uncomplicated vaginal birth c. A client who will continue cardiac rehabilitation following discharge after a coronary artery bypass graft d. A client who is being discharged home following a heart-lung transplant

c. A client who will continue cardiac rehabilitation following discharge after a coronary artery bypass graft

Which of the community health nurse's clients should the nurse monitor most closely for fragmentation of care? a. A client who lives in a rural area and who must travel to a nearby city for much of their medical care b. A client with a demonstrated history of not adhering to prescribed treatment c. A client with complex psychosocial and medical needs, requiring several specialists d. A client who has no health insurance and who does not qualify for Medicare or Medicaid

c. A client with complex psychosocial and medical needs, requiring several specialists

One significant change in the health care delivery system in recent years is earlier hospital discharges. What is one result of earlier hospital discharges? a. Clients are locked into prenegotiated payment rates that have remained unchanged. b. Client use of ambulatory care has decreased. c. Clients with high home care needs are being discharged into the community. d. Clients are in the hospital for a longer period of time.

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

The nurse is providing education and interventions on health promotion and prevention of disease in the community. When planning this care, the nurse will integrate what guiding principle? a. Health promotion should be primarily focused on individuals who do not currently have significant health problems b. Education is generally most effective in a health care institution but can also be performed in the community c. Health education can benefit both individuals and groups d. Health promotion is most effective when focused on the very young and older adults

c. Health education can benefit both individuals and groups

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? a. Asking family members to meet with the social worker at the receiving facility prior to the client's arrival. b. Notifying all departments of the room change. c. Providing accurate and complete communication to the new facility. d. Discussing the move with both client and the family.

c. Providing accurate and complete communication to the new facility.

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? a. Developing goals with the client b. Assessing the client's needs and identifying problems c. Providing client education d. Making home health care referrals

c. Providing client education

A health care organization has begun to expand home health services to its clients. Which reason is the most likely cause for the expansion of these services? a. The increase in the incidence and prevalence of infectious diseases b. Changes to the structure of Medicare and Medicaid c. The change to shorter hospital stays d. The need for decreased financial expenditures

c. The change to shorter hospital stays

A client is receiving home health services after having a stroke and being hospitalized. After a thorough assessment of the home environment and the client, what would indicate to the nurse that there is an impairment in the client's home management? a. The home care nurse has to reschedule an appointment with the client. b. The client reports having slipped in the restroom the first night in the hospital. c. The client's caregiver is absent whenever the nurse visits and the client is alone. d. The client refuses to allow the caregiver to help the client sit up in bed.

c. The client's caregiver is absent whenever the nurse visits and the client is alone.

The focus of community-based care is: a. promoting the health of the nation. b. providing appropriate care for mental health. c. providing care to clients within a defined geographic area. d. providing population-based care of the entire community.

c. providing care to clients within a defined geographic area.

A nurse is caring for a 17-year-old pregnant client who is unable to afford health care. Which action will the nurse perform to obtain assistance for this client? a. Assess the reasons why the client is experiencing financial challenges b. Offer to work with the client to explore money management strategies c. Offer to mediate between the client and her family to obtain financial assistance d. Create a referral to the social work department

d. Create a referral to the social work department

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? a. Social worker b. Home health aide c. Physical therapist d. Occupational therapist

d. Occupational therapist

Which type of home healthcare agency is a local health department? a. Private, proprietary agency b. Private not-for-profit agency c. Institution-based agency d. Official or public agency

d. Official or public agency

When initiating home health care services, during which phase is it appropriate for the home health nurse to implement the initial client assessment? a. Referral phase b. Initiation phase c. Termination phase d. Pre-entry phase

d. Pre-entry phase

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 nurse will identify what priority purpose for this meeting? a. Evaluate the effectiveness of the hospitalization b. Determine hospital-based services needed by the client c. Provide client education d. Prepare the client to receive home care

d. Prepare the client to receive home care

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? a. The social worker b. The chaplain or minister c. The home health care aide d. The registered nurse

d. The registered nurse

The nurse understands that planning for discharge actually begins at admission to the facility. The purpose of discharge planning is best described as: a. promoting less dependence on others. b. decreasing stress for client and family members. c. ensuring client safety and health maintenance. d. providing continuity of care that is goal directed.

d. providing continuity of care that is goal directed.