PVN 144 Exam 1

The nurse is caring for a client who is recovering from a stroke. the primary health care provider has referred the client for rehabilitative care. Which interventions by the nurse help to make a successful referral process? Select all that apply

Explain the need for referral to the client and family Provide the referral with adequate client information Determine what the referral recommends for the care

Which intervention by the nurse would be best represent restorative care for a patient post hip replacement surgery?

Facilitate the performance of physical therapy exercises to strengthen the hip

A nurse is caring for a patient immediately after a complete T6 spinal cord injury and would anticipate the patient's muscle to exhibit which symptom?

Flaccidness

The city health department provides home health services under the governance of a local unit of government. Which sources of funding support this agency? Select all that apply

Grants Country revenues Fees from limited sources

The rehabilitation team is planning services for a child with genetic disorder and hearing impairment. For which reason would the health care provider plan a treatment that focuses on habitlitation?

Habilitation services help in acquiring skills

Which nursing intervention should be performed for an older patient with cardiac disorder under rehabilitation therapy?

Implement the education plan.

After monitoring the vital signs of a patient in hospice, the nurse elevates the head of the bed. Which outcome does the nurse expect from this intervention?

Improved breathing patterns

Which characteristics is associated with patient catastrophic brain injury

In coma for several months

The nurse educator informs the student nurses that the changes in medical insurance policies were a major factor for the increased demand of home health care in the 1980s. which statement further explains the nurse's meaning?

In the 1980s medical insurance was paid based on the patient's diagnosis

The hospice nurse knows that constipation is a problem in terminally ill patients. When opioids are initiated to treat pain, which intervention may be recommended to prevent constipation in the terminally ill patient?

Initiation of a stool softener and stimulant

A patient admitted to hospice experience severe pain. The patient fentanyl (Duragesic) transdermal patch for pain relief. Which intervention is the best to be performed while using this drug?

Instruct the patient to wash the skin only with water once the patch is applied

Which terms are the primary models of rehabilitation team functioning? Select all that apply

Interdisciplinary Multidisciplinary Transdisciplinary

The hospice nurse knows to plan care based on which philosophy?

Maximizing the quality of the patient's remaining life

A patient is experiencing a pounding headache, vertigo, and impaired memory after sustaining a brain injury, but the neurologic findings are normal. Which type of brain injury is this classified as?

Mild

After a car accident, a patient was unconscious for 18 hours. The nurse knows this patient's brain injury will be most accurately classified as which level?

Moderate

A nurse A nurse is providing education in the home to the family of a patient who requires oxygen therapy. Which instruction would be most important for the protection of skin integrity?

Observe the tops and backs of the ears several times a day

A nurse in the long-term care facility is caring for a patient whose religion does not allow him to eat pork, but pork is the only meat option on the menu for dinner. Which action should the nurse to take first.

Offer the patient other sources of protein, including yogurt and cheese.

At a staff meeting, the question of a staff nurse's returning to work after completing a drug rehabilitation program is discussed. What is the most therapeutic way for the staff to handle the nurse's return

Offering the nurse support in a straightforward manner

Which complications can be observed in a patient with a lumbar cord injury? Select all that apply

Paralysis of bladder Loss of sexual function Paralysis of lower extremities

Which home health care p[respective is defined as skilled and compassionate care provided on a one to one basis, based on individual needs and personalized schedules?

Patient

A nurse in the subacute care facility has noticed a huge surge in patient census in the past 30 years, which the nurse knows was caused by which factor?

People are living longer

A nurse is caring for a patient in the beginning stages of the dying process. The patient has anorexia because of stomatitis. Which instruction would be most helpful to facilitate increased oral intake?

Provide high-protein liquid drinks

The nurse is providing hospice care of a terminally ill patient who has stopped oral intake for about 12 hours. The family requests the nurse to administer intravenous (IV) fluids. Which information does the nurse tell the patient's family about the patient's intake?

Providing fluid or food may cause discomfort

A patient has a cervical spine injury with paralysis of all four limbs. Which term describes the medical condition of the patient?

Quadriplegia

Which terms describes a measure of the optimal energy or force that endows a person with the power to cope successfully with the full range of challenges encountered in the real world?

Quality of life

A patient sustained bilateral above-the-knee amputations is a roadside bomb blast. The nurse knows to document this injury with which classifcation?

Quatenary

A patient has been diagnosed with terminal cancer and has been given a prognosis of 3 months to live. How would the nurse introduce the subject of palliative and hospice care?

Redirection of care

The home care nurse is caring for a patient on oxygen therapy. Which nursing action ensures safe administration of oxygen?

Removing the expectorated secretions

The nurse is providing hospice care for a patient nearing death who has loud, wet respirations. Which intervention should the nurse perform for his patient?

Reposition the patient onto one side

the son of a patient on hospice tells the nurse he is concerned about his father's lac of oral intake. How would the nurse respond?

"As life comes to an end, the need for food and drink decreases. Your father will not starve to death."

A nurse is admitting a patient to hospice care and explaining all the benefits that the hospice covers. The spouse asks about bereavement support. Which response by the nurse is the most appropriate response?

"Bereavement follow-up care lasts for at least 1 year after death."

The family of a patient on hospice calls to tell the nurse that the patient is not breathing for 10 to 30 seconds at a time. Which information would the nurse tell the family first?

"Elevating the head of the patient's bed can provide relief for your loved on."

A patient in hospice who is experiencing anxiety and fear report nausea and vomiting. Which instruction would be appropriate for this patient?

"Feel free to verbalize your fears."

A nurse is caring for a patient after a moderate traumatic brain injury (TBI). Which instruction would be important for the patient and family before the patient returns home?

"It is vital to abstain from alcohol at all time."

A nurse is caring for a patient after a moderate traumatic brain injury (TBI). Which instruction would be important for the patient and family before the patient returns home?

"It is vital to abstain from alcohol at all times."

A nurse is caring for a patient receiving hospice through the Medicare Hospice Benefit. The patient is concerned about who will be there to comfort her family after she has passed. Which response by the nurse would be appropriate?

"The Medicare Hospice Benefit provides for bereavement counseling for 1 year after you have passed."

A nurse is caring for a patient receiving hospice through the Medicare Hospice Benefit. The patient is concerned about who will be there to comfort her family after she has passed. Which response by the nurse would be appropriate?

"The Medicare Hospice Benefit provides for bereavement for 1 year after you have passed."

A home care patient who is financially under privileged is worried because the home care benefits given by Medicare are due to expire. Which suggestion would the nurse give to the patient?

"You can try to get a Medicare recertification after 60 day period"

The wife of a patient who recently sustained a T8 spinal cord injury says to the nurse, "I just don't know what we'll do. Neither of us can quit our jobs, and I won't be able to drive him to his job." Which response by the nurse will be most therapeutic?

"your husband may be able to drive using hand controls."

Which criteria would require a patient to undergo rehabilitation therapy? Select all that apply

-Any loss of physical structure of function in the patient -Any disability that interferes with the patient's normal functioning

Which criteria are necessary for a terminally ill patient to be admitted to hospice? Select all that apply

-Prognosis of 6 months or less to live -Patient desire to have the services -An interdisciplinary team to plan the care -Consent of family and caregiver regarding plan of care

A home health nurse is to see four patients today. Which patient would the nurse see first?

A 40 year old patient with a gastronomy tube and type 1 diabetes requiring administration of levothyroxine (Synthoid)

Four clients are receiving home health services. Which person would qualify for Medicaid services?

A poor client with the last stage of cancer

What phrase describes the underlying philosophy and focus of rehabilitation?

Abilities of the patient

A nurse notes that the patient on hospice has a fecal impaction. Which should the nurse do first?

Administer Xanax

A hospice patient is depressed and avoids talking with family members but has strong spiritual beliefs. Which intervention should the nurse do to make the patient comfortable?

Ask the parish nurse to speak with the patient

A nurse notes that the patient on hospice has not had a bowel movement in 7 days. Which action should the nurse do first?

Assess the patient's abdomen

Which two major skills are needed for a nurse working in the home care setting?

Assessment and teaching

Which information regarding adult daycare services is incorrect

Available 24 hours a day

Which act enacted by the United States Congress imposed new limits on home health care payments?

Balanced Budget Act (BBA)

A nurse receiving report learns that a patient has paraplegia. Which limbs would the nurse anticipate the patient will have control over?

Bilateral arms

When the health care provider instructs the nurse to provide respiratory assistance to a patient with spinal cord injury, which level of spinal cord injury does the nurse expect?

C3

A nurse notes that the patient with terminal lung cancer has extreme muscle weakness and appears emaciated. The nurse knows to use which term to document this patient's condition?

Cachexia

A hospice nurse is visiting a terminally ill patient. During the assessment, the patient complains of pain in the stomach. The patient rates the pain as 7 on a scale of 0 to 10. Which intervention by the nurse is appropriate?

Call the health care provider and see if there is another pain medication that can be given

Which term would the nurse document for a patient with a head injury who has been in a coma for 3 months?

Catastrophic

Which strategy reflects the inrterdisciplinary rehabilitation team approach?

Collaborating with other team members to identify a common goal

Which treatment is most effective for posttraumatic stress disorder (PTSD)

Combination of cognitive and prolonged-exposure therapy

the nurse is caring for a patient who has anoxic encephalopathy and is showing disturbances in attention and coordination. Which patient outcome does the nurse expect after performing the interventions?

Completes the task once it has begun

Which is important for the admission nurse to keep in mind when developing an older patient's plan of care

Consider the physical strength and functional abilities when making modifications to the home environment.

Four days after the client's total hip arthroplasty, the nurse is preparing to transfer the client to a rehabilitation center. Before admission the client tool warfarin sodium (coumadin) daily for a history of pulmonary embolus. While hospitalized, the client received subcutaneous heparin two times a day. The nurse does not see any anticoagulant therapy listed on the client's transfer prescriptions. What should the nurse do?

Contact the health care provider to determine what anticoagulant therapy should be prescribed for this client

The nurse understands that paraplegia has which impact on a patient?

Damage below the cervical area that involves weakness or paralysis in the trunk and lower extremities

An elderly patient with rheumatoid arthritis requires assistance for performing daily activities. The patient's caregivers work during the day. Which type of care would be the best option for this patient?

Daycare

Which service would be beneficial for a patient who is not safe to be alone during the day while family is working and would benefit from activities and companionship?

Daycare

After a thoracic spinal cord injury, the patient has a firm mass, edema, and redness in the right hip. Which complication can occur if aggressive treatment does not begin immediately?

Decreased range of motion

On transfer to a wheelchair, a quadriplegic patient complains of dizziness and lightheadedness. Which action should the nurse take first?

Determine the patient's blood pressure

The nurse at the hospice center is caring for a patient approaching death. The patient is unable to cough up secretions effectively. Which intervention should the nurse perform for this patient?

Elevate the head of the bed with pillows

A patient is having trouble with nausea and vomiting after chemotherapy. Which nursing intervention is most appropriate?

Encourage the patient to eat slowly in a pleasant atmosphere, with relaxation and rest periods after eating.

A nurse caring for a patient with quadriplegia caused by a cervical spinal cord injury knows that this patient is at an increased risk for deep vein thrombosis and anticipates administering which medication?

Enoxaparin (Lovenox)

A nurse is supervising care of a patient receiving hospice care from a hospice aide. The nurse would instruct the aide to report which signs of impending skin impairment?

Erythema

The family caregiver informs the nurse that the patient should be made to perform activities of daily living (ADLs) without any assistance form the staff. Which action should the nurse take?

Explain the goals of the rehabilitation process

After three months of rehabilitation following a craniotomy, a client still is having soem motor speech difficulty. What should the nurse do to promote the client's use of speech?

Respond to the client's efforts of speaking

A nurse in a rehabilitation is caring for a patient with posttraumatic stress disorder (PTSD). The nurse would anticipate administering which medication?

Sertaline (Zoloft)

Of the interdisciplinary team, which member assists with community resources and filing insurance papers, and also supports the patient and caregiver with emotional and grief issues?

Social Worker

A Nurse receives an order to admit a patient to the home health agency. Which action should the nurse take next?

Speak with the referring provider for specific care orders.

While communicating with a patient who is terminally ill, the nurse finds that the patient is experiencing visceral pain.

Squeezing

Which Act increased the need for home health care agencies?

Tax equity and fiscal responsibility act

The nurse is caring for a patient who has a spinal cord injury because of a blast. Which type of blast-related injury would this be classified as?

Tertiary

Respiratory distress is seen often during the end stages of an illness. Which physiologic adaptation does the nurse know the patient may exhibit 24 to 48 hours before death?

The death rattle

A patient with cellulitis of the right arm and a peripherally inserted central catheter (PICC) in the left arm requires a bath today. To which employee would it be appropriate for the staffing coordinator to assign this patient?

The experienced certified nursing assistant (CNA)

A patient suffering from a malignant tumor stops responding the treatment. The health care provider states that curative care is no longer possible. Which information does the nurse give to the patient's family members and the patient about hospice admission?

The hospice team will provide support to control the symptoms

A patient suffering from a malignant tumor stops responding to the treatment. The health care provider states that curative care is no longer possible. Which information does the nurse give to the patient's family members and the patient about hospice admission?

The hospice team will provide support to control the symptoms

What is theunique position within the disciplinary team of the rehabilitation nurse?

The nurse is the only one who provides patient education

A nurse is caring for a patient on hospice with intractable nausea and vomiting in addition to severe cancer pain. Which medication would be most appropriate for this patient on long-term basis?

Transdermal fentanyl

A registered nurse (RN) is sent to as rehabilitation center because of chemical impairment issues. Which member of the healthcare team will be asked to provide feedback about the RN's progress?

Nurse manager

A nurse is coordinating services for an older patient who lives alone but has a niece who visits several times per week to help with bathing, errands, and housework. The niece is also available to transport the patient to health care provider appointments. The patient can dress herself and is safe to live alone but is unable to prepare nutritious meals. which service would be most beneficial to this patient?

Nutrition programs

A patient with terminal lung cancer wishes to return to the home of his son and daughter-in-law, who are capable of meeting the needs of the patient. Which services is most appropriate for this patient?

Palliative care

A patient with a knee replacement needs care from 8 am to 7pm when the patient's son is away for work. Which home health care agency does the nurse suggest?

Private, nonprofit, freestanding agency

A nurse is participating in the quality improvement program for the nurse's agency. Which criteria are included in continuous quality improvement? Select all that apply?

Process Outcome Structural

Which program would be most likely to help a 60 year old patient with end stage renal disease wanting to continue to live at home?

Programs of all-inclusive care for the elderly (PACE)

Which type of home health care agency is most likely to be owned by corporate chains and profit oriented

Proprietary agency

Which system has majority influenced home health care cost?

Prospective payment system

Which actions could be performed by a rehabilitation registered nurse (RN)?

Promotes independence

Which aspect of patient care is the highest priority in both the acute and long-term care setting?

Ensuring patient safety

Which services in home health nursing are directly reimbursable by Medicare? Select all that apply

Skilled nursing Physical therapy Speech language therapy

Why would the home health nurse not include the family's herbal medicine in the treatment plan of a patient?

The health care provider has not approved the herbal medicine for use

What is the goal of a rehabilitation organization

To restore the clients level of functioning

What is the role of a chaplain on a rehabilitation team?

Spiritual consultant

What is an example of a voluntary home health agency?

Visiting Nurse association

Which instruction to the unlicensed assistive personnel (UAP), who will be providing a patient's bath, aids the nurse in preventing skin breakdown?

"Please inform me of reddened areas that you see during the bath."

Two months after hip replacement surgery, a patient performs the prescribed daily strengthening exercises, reports increased and flexibility, and demonstrates the ability to walk 20 yards farther than the home health nurses last visit. How would the nurse document this evaluation?

"The patient reports compliance with the treatment plan and demonstrates an ability to walk 20 yards farther than the previous visit. Continued therapy is indicated."

A husband of a patient in the hospital asks the nurse if his spouse will be eligible for Medicare coverage of home health care. Which question would the nurse ask first?

"Will your spouse be homebound?"

The nurse is explaining to an elderly couple about the benefits of living in a continuing care retirement community (CCRC). which statements will the nurse include in the discussion? Select all that apply

"You would get 24-hour nursing assistance if you fall ill." "You will be allotted a separate house from other residents." "You can enjoy various recreational facilities in the community."

Which of the following are features of a transdiciplinary rehabilitation team? Select all that apply

-Allows for the burning of boundaries between different disciplines -Uses cross-training and flexibility to minimize the duplication of effort toward individual goal attainment -Relies solely on communication for success -Collaborates to identify individual goals of different disciplines

Which statements are true regarding the multidisciplinary model of rehabilitation team functioning? Select all that apply

-The team works toward discipline specific goals -Outcomes are the sum of each disciplines efforts -This type of team is commonly used today in rehabilitation hospitals

After reviewing the reports of a patient, a nurse finds that the patient is eligible to receive Medicare insurance. Which findings led the nurse to identify the Medicare insurance? Select all that apply

70 years of age Physical disability End-stage renal disease

A staffing coordinator is making assignments for registered nurse (RN), licensed practical/ Vocational nurse (LPN/LVN), and home health aide. Which patient would be most appropriate to assign to the LPN/LVN.

A 54-year-old patient with cellulitis requiring a dressing change.

A nurse is coordinating home health care for four patients. The nurse knows which patient will qualify for insurance coverage of home health care?

A 77-year old patient recovering from hip replacement surgery who requires physical therapy daily

Who governs a proprietary home health agency?

A board appointed by owner

On the third postoperative day following a below-the-knee amputation, a client is refusing to eat, talk, or perform any rehabilitative activities. What is the best initial approach that the nurse should take when interacting with the client?

Acknowledge that the client's withdrawal is an expected and necessary part of initial grieving

A large family that is financially struggling is being instructed by the home health nurse about ways to increase the dietary intake of calcium. Which suggestion should the nurse make?

Collards or kale in one meal a day

A client with along history of alcohol dependence spends 28 days in an alcohol-rehabilitation unit. What type of referral does the nurse anticipate will be included in the discharge plan?

Community-based self-help group

Which medical diagnosis is seen most commonly in home care patients?

Diabetes Mellitus

Which components would the home car nurse include in a care plan for a patient? Select all that apply

Duration of the services Outcomes of the treatment Medications given tot he patient

The nurse is reviewing the demographic report of a patient. Which criteria would the nurse check for referring the patient to Medicaid services?

Economic status

The nursing is caring for an Asian patient with pulmonary disorders in a long-term health care facility. the health care provider instructs the nurse to administer vitamin supplements to the patient after meals to prevent irritation, but the nurse finds out that the patient abstains from solid food on Fridays. Which action should the nurse take in this situation?

Gives supplements to the patient with fruit juice.

What is the role of a vocational rehabilitation counselor who is caring for a client in a rehabilitation center?

Helps the client obtain training for new employment

Which forms of home intravenous (IV) therapy are the most common? Select all that apply

Hydration Long-term antibiotic therapy Total parental nutrition (TPN)

The family members of a patient with diabetes inform the nurse that they would like to provide home health care for the patient. Which role would be the nurse's responsibility as an intake coordinator in this situation?

Inform the staffing coordinator for the patient's family members' request.

The nurse is preparing a plan to assess the quality of life of a patient with chronic obstructive pulmonary disease. Which questions should the nurse remember during the assessment? select all that apply

Is the patient willing to undergo treatment? How does the patient cope with the stress of illness? What daily activities does the patient perform independently?

Which statement is true regarding rehabilitation services?

It focuses on restoring maximal possible function after illness or injury

Which definition of home health care is appropriate from a clients perspective?

It is skilled and compassionate care provided on a one-to-one basis in the comforting and familiar surroundings of the home

A home care agency discontinued providing services when the patient relocated to a different state. The nurse can infer that the home care agency has which credential?

Licensure by the state government

The nurse finds that an elderly patient has confusion, disorientation, short-term memory loss, and hallucination. The patient is completely dependent on others for performing daily activities. Which type of care facility should be provided to the patient?

Long-term care

A 55-Year-old patient who has metal and cognitive disorders is completely dependent on others for care. The patient does not have economic support and is unable to afford the cost of health care. Which option would be best for the patient?

Medicaid

The nurse is caring for an elderly patient who has acute respiratory failure. Which document is initially required to obtain hospice service?

Medical certification for terminal care

A 45- year-old patient returned home after a debilitating spinal cord injury that left her paraplegic. Which entity will most likely pay for the home health care?

Medicare

A client who is in the first trimester is being discharged after a week of hospitalization for hyperemesis gravidarum. She is to be maintained at home with rehydration infusion therapy. What is the priority nursing activity for the home health nurse?

Monitoring the client for signs of electrolyte imbalances

Which statement explains the main reason why an increased number of debilitating chronic illness are now seen in home health care settings?

More illnesses are being managed than cured

What should a nurse identify as the most important factor in rehabilitation of a client addicted to alcohol?

Motivational readiness

A group of individuals is working as a team in a rehabilitation program. Which nursing team member has the responsibility of acting as the team leader?

Registered Nurse

In a rehabilitation care center, a team member assists the coordinator in teh development and implementation of care plan. Which team members is involved in this situation?

Rehabilitation licensed practical nurse

The rehabilitation is caring for an older adult client, who is completely immobile, with a history of knee replacement. Which member of the team reinforces education about the processes of rehabilitation provided to the client and family members?

Rehabilitation licensed practical nurse/licensed registered nurse

Which components does the nurse working in the home care setting understand are integral parts of providing effective nursing services? Select all that apply

Respecting the patient's dignity Respecting the patient's privacy Understanding the need for autonomy

A man has completed an alcohol detoxification program and setting goals for rehabilitation. When setting goals it is important for this client to understand the need to do what?

Restructure his life without alcohol

A nurse is caring for a patient in the hospital whose insurance will stop paying for a hospital stay the next day. The patient, who lives alone and will require assistance with all activities of daily living, medication organization and administration, administration of intravenous antibiotics, and dressing changes, will not be able to safely return home until his wound has healed. Which facility would be the best option for this patient?

Skilled nursing facility

Which rehabilitation team member plays a role in designing a rehabilitation communication program?

Speech-language pathologist

Which action can save thousands of dollars in the process of rehabilitation

Starting the process of rehabilitation early

A client who was involved in a car accident was admitted tot he hospital. After the client received immediate care, the primary health care provider suggested the client receive intensive dietary and rehabilitative care. Which facility is most appropriate for the client?

Subacute care

A nurse in the hospital is caring for a patient with extreme weakness and fatigue requiring cardiac rehabilitation after a massive myocardial infraction. The husband of the patient is concerned about his ability to meet the patient's needs at home. To which location should the patient be discharged?

Subacute care facility with a rehabilitation program

Where does a patient who has just had a hip replacement begin rehabilitation before being transferred to long-term facility?

Subacute unit

A license practical nurse finds that he or she is not properly educated to provide home health care according to the rules of Medicare. What should the nurse refer to in order to understand the new standards of education and competency evaluation?

The Omnibus Budget Reconciliation Act

Which statements are true regarding home health-care organizations? Select all that apply

The Visiting Nurses Association is an example of a home health agency Individual payments may help fund home health services

A 70- year-old client with minor burns on his hands and legs receives care from a voluntary home health agency. Which of these statements about this agency are true? Select all that apply

The agency receives fees from the client This agency offers public health services A community-based board of directors governs this agency

The home health nurse has advised a patient's caregiver to set up a telemonitoring system in the patient's home. How would this system help the nurse?

The nurse can plan the visits according to the patient's findings.

The nurse is caring for a patient who is homebound and recovering from a stroke. The nurse finds that the patient has achieved the restorative goal. Which evidence supports this findings?

The patient feeds well without chocking

Why would the nurse advise a patient to exercise the right of durable power of attorney for pet care?

The patient is terminally ill and is worried about the pet's care after death

A nurse is caring for a client with paraplegia as a result of a spinal cord injury. which rehabilitation plan will be most effective for this client?

The plan is formulated and implemented early int he clients care

The registered nurse (RN) informs the licensed practical/vocational (LPN/LVN) about a subacute unite. Which statement by the LPN/LVN about a subacute unit is applicable?

The subacute unit is a bridge between acute care and long-term care

A teenager who attempted suicide was admitted to a psychiatric center for care. On assessment, the teenager tells the nurse the reason was the end of a romantic relationship. Which member of the rehabilitation care team may play a major role in providing care to this teenager?

Therapeutic recreation therapist

The spouse of a client who had a brain attack (cerebrovascular accident) tells the home health nurse that the client cries easily and without provocation. The spouse asks why the client is so emotionally fragile. What is the nurse's best response?

This behavior is a common response over which the client has very little control

Why does a proprietary home health agency apply for a certificate of need to start up the business?

To state considerations of the costs of starting and running the agency

The nurse manager of a home health care agency is teaching a group of nursing assistants about pica. Which age group is most likely to engage in this practice

Toddlers

Which supportive service would be most beneficial for an elderly patient who lives with her daughter, which is within walking distance from a senior center, and has no way in getting to medical appointments

Transportation services

A nurse in a long-term care facility knows that the quality of care provided is monitored by the Health Care Financing Administration (HFCA) through which mechanism?

Unannounced visits

A secretary in a home health agency gossips about coworkers and then writes them notes to tell them how they are to the organization and how much she likes working with them. What defense mechanism is being used by the secretary?

Undoing

A home health agency receives support form tax-deductible contributions under the governance of a community-based board of directors. What type of home health agency is this?

Voluntary

A nurse is considering a career change to a long-term care and plans to base the decision solely on whether or not there will be job security in the long-term care arena. On the basis of an understanding of the U.S. population makeup by 2050, would a change to a long term care facility be a good decision?

Yes, because 42% of the population will be older adults

The daughter of a patient in the rehabilitation facility does not feel her mother is progressing appropriately and demands to speak with the medical team regarding the patient's care plan. Which response by the nurse is best?

"I will gather the interdisciplinary team as soon as possible to bring you up to speed with your mother's care plan."

A nurse is preparing a patient with severe heart failure for discharge home for hospice care but then learns the patient has been prescribed a dobutamine infusion. Which action should the nurse take first?

Continue discharge teaching

A nurse is a rehabilitation center teaches clients with quadriplegia to use an adaptive wheelchair. Why is it important that the nurse provide this intruction?

It is unlikely that the client will regain the ability to walk

A nurse is preparing to care for a patient who sustained a C# spinal cord injury. Which intervention will be most important for this patient?

Maintaining a patient airway

The nurse is preparing to transfer a patient with traumatic brain injury to the rehabilitation center. Which focus of care in the rehabilitation center is the primary focus?

Manage chronic and disabling conditions

The nurse is preparing to transfer a patient with traumatic brain injury to the rehabilitation center. Which focus of care in the rehabilitation center is the primary focus?

Mange chronic and disabling condition

The family members of a patient report to the nurse about their inability to meet the financial needs of hospice care. Which member of the interdisciplinary team is responsible for resolving this issue?

Social worke

A nurse is instructing the family of a patient on hospice who is receiving opioid pain medication on ways to prevent constipation. Which statement, if made by a family member, indicates a need for further teaching?

"If she develops constipation, we should withhold the pain medication until she stools."

The family of an elderly patient who has been diagnosed with terminal cancer tells the nurse, "We can't afford hospice care. How are we going to provide for our mother." Which response by the nurse is best?

"If two physicians provide documentation that your mother has less than 6 months to live, Medicare will pay for hospice."

The family of the patient who has been on hospice for over 5 months is concerned that reimbursement will end for their mother's care after 6 months. Which response by the nurse is best?

"The original process of two physicians attesting to a prognosis of less than 6 months to live will repeat until your mother passes away."

A patient in the terminal stage of breast cancer is admitted to hospice. The family caregiver tells the nurse to reduce the dosage of pain medication because it is making the patient sleepy. Which response is the most appropriate asner by the nurse to the caregiver?

"The patient had not slept well because of pain; the patient is resting better with reduced pain."

A registered nurse is making an admission visit to a patient who was referred to home health care. What nursing actions should the nurse perform during the admission visit? Select all that apply

-Inform the patient about billing practices -Notify the patient of patient rights at admission. -Determine if the patient has good family support

Which nursing interventions should be performed for a patient who has anoxic encephalopathy and risk for injury? Select all that aplply

-Initiate appropriate safety precautions during care -Use verbal cueing in all care activities of the patient -Anticipate the patient's needs, such as eating and drinking

The nurse finds that a patient with a thoracic cord injury is depressed because of paralysis of the lower extremities. Which patient outcomes indicate thea the nursing interventions are effective? Select all that apply

-Acknowledges the disability -Verbalizes the sense of loss -Reorganizes life with the current abilities

Which characteristics describe a culturally competent health care provider? Select all that apply

-Can disseminate cultural knowledge -Has the capacity for cultural self-assessment -Has the awareness of the dynamics of difference

To provide effective hospice care, the nurse needs to have an understanding of the goals of hospice care. Which statement appropriately addresses the goals of hospice care? Select all that apply

-Control and alleviate the patient's symptoms -Encourage the patient caregiver to live to the fullest -Allow the patient and caregiver to be involved in the decisions regarding the plan of care.

During rehabilitation, a patient with a spinal cord injury has periods of despondency. Which nursing interventions help reduce the periods of despondency in the patient? Select all that apply.

-Guide the patient in planning and setting realistic goals. -Provide guidance to the patient during the early stages of grieving. Assist the patient in using his or her current abilities to perfomr self-care skills

The nurse is caring for a patient with spinal injury at the T2 and T3 positions. Which interventions should the nurse perform? Select all that apply

-Help the patient during elimination -Recommend that the patient walk with braces -Instruct the patient to drive with hand controls

Which are the purposes of hospice care? Select all that Apply

-Implements an interdisciplinary approach to patient care -Directs care to provide the relief of symptoms -Promotes patient comfort during the dying process

Which outcomes are expected by the rehabilitation staff while planning a rehabilitation plan of care? Select all that apply

-Improvement in the patient's quality of life -Adjustment of the patient to an altered lifestyle -Patient's reentry into the family and community -Reduction in the complications of the patient's health

Which nursing interventions in rehabilitation therapy would be beneficial for a patient with impaired bed mobility? Select all that apply.

-Instruct the patient to maintain optimal body alignment -Instruct the patient to maximize the ability to move around -Provide instructions on different ways to maximize energy in the patient -Provide instructions to the patient on different methods of increasing mobility in the bed.

Pain control for a hospice patient is best attained through use of long-acting medications. Which medications are long-acting medications? Select all that apply

-MS Contin -Oxycontin -Duragesic Patch

Which functions would the nurse coordinator perform for a patient in hospice? Select all that apply

-Manage the patient care -Assign the primary team for the patient

A patient with bone metastasis reports shortness of breath. Which outcomes would indicate the nursing interventions were effective? Select all that apply

-Performing relaxation techniques -Performing diaphragmatic breathing -Improved respiratory status -Breathing easily while doing exercises

A patient is undergoing cardiac rehabilitation therapy. Which patient outcomes indicate that the nursing interventions were effective? Select all that apply

-Performs exercises -Follows stress reduction methods -Shows increased ability to perform daily activities

Which nursing interventions should be performed to reduce the risk of postural hypotension in a patient with quadriplegia? Select all that apply

-Place the patient in a horizontal position -Encourage the patient to use elastic stockings -Encourage the patient to use abdominal binders -Raise the head of the patient's bed prior to mobility

Which factors may lead to skin impairment in a terminally ill patient? Select all that apply

-Poor nutrition -Dehydration -Impaired circulation -Increased weakness

A patient with colon cancer being admitted to hospice care does not have an advance directive. Which elements does the nurse include in the discussion with the patient and family about advance directives? Select all that apply

-Portable do-not resuscitate (DNR) -Instruction about life-sustaining treatment -Instructional directive for health care professionals -Durable power of attorney for health care (DPOAHC)

Which factors would a rehabilitation nurse consider while planning interventions for a patient who has sustained brain injury? Select all that apply.

-Protecting the patient form injuries -Behavior modification in the patient -Side effects of medication prescribed -Cognitive and physical deficits in the patient

The home health team plans strategies to improve the quality of services offered by the agency. Which factors should the team assess before implementing the strategies? Select all that apply

-Quality of care delivery by the home health team -Proper documentation by the home health team

Which statements define rehabilitation? Select all that apply

-Relearning of former skills and learning new skills necessary to adapt and live fully in an altered lifestyle -The process of restoring the individual to the fullest physical, mental, social, vocational, and economic capacity that he or she is capable -The involvement and application of previous knowledge and skills in combination with a variety of new ideas, knowledge, and skills to adjust to a new set of needs

Which nursing interventions should be performed for a patient undergoing pulmonary rehabilitation? select all that apply

-Teach the patient about proper diet and nutrition -Teach effective breathing strategies to the patient -Teach energy conservation techniques to the patient

A group of licensed practical nurses plan to open a home health agency. Which information would the nurses gather to apply for a certificate of need? Select all that apply

-Total cost required to start the agency -Number of personnel required to start the agency -Need for home health services in the particular area

A patient in the terminal stage of acute myeloid leukemia has become unconscious. On examination, the nurse finds that the patient's mouth is very dry. How should the nurse help the patient to restore the moisture?

-Use moist cloths for the oral mucosa -Provide complete and regular oral care. -Apply lubricant to the lips and oral mucous membrane as needed.

The nurse is caring for a patient in a home agency that is a public, nonprofit organization. Which source of support cant he nurse suggest to the patient regarding hospital bills? Select all that apply

-grants -charity -State revenue

A nurse is educating the patient and family on the structure of hospice care. The nurse would include which individuals as the core interdisciplinary team members? Select all that apply

-social worker -Medical director -Nurse coordinator _spiritual coordinator

A client with arterial insufficiency of both lower extremities is visited by the home health care nurse. An essential nursing intervention is to teach the client to do what?

Check pulses in the legs regularly

Which term describes a condition or state that lasts for 3 months or longer?

Chronic illness

A nurse is caring for clients who are undergoing therapy of dependence of alcohol. Which member of the health team has the primary responsibility for their rehabilitation?

Client

A nurse reviews the bills of Medicare-eligible clients who received home health care services. Which client's bill would be reimbursed through Medicare?

Client A: Leg fracture Ambulation

A nurse is preparing a patient with severe heart failure for discharge home for hospice but then learns that the patient has been prescribed a dobutamine infusion. Which action should the nurse take first?

Continue discharge teaching

A nurse is caring for a patient in the hospice setting assesses the development of a stage !! pressure ulcer on the patient's sacral area. Which nursing intervention is appropriate?

Apply a skin protector

A nurse is planning care fora patient in a cardiac rehabilitation facility. Which intervention would be most appropriate for this patient?

Counseling the patient on stress reduction techniques

A nurse is assisting whit interdisciplinary care planning for a patient in a cardiac rehabilitation program. Which factor should the team focus on first?

Determine the patient's current level of functioning and independence.

Which intervention during rehabilitation should be performed first to help a patient suffering form posttraumatic stress disorder (PTSD)?

Develop a trusting relationship with the patient

What is the primary difference between children and adults going through rehabilitation?

Developmental potential

The nurse at the hospice center is caring for a terminally ill patient. Which psychosocial intervention by the nurse provides support to the patient and family?

Encouraging reminiscence

The nurse working at the rehabilitation center is caring for a patient who had undergone knee replacement surgery. What is the primary duty of the nurse toward the patient as part of the rehabilitation team?

Ensure implementation of the plan of care.

A nurse is caring for a patient immediately after an L4 spinal cord injury. The nurse anticipates the patient will be able to obtain which level of ambulation?

Full

Which term is defined as any loss of ability to perform tasks and obligations of usual roles and normal daily life?

Functional limitation

The rehabilitation team is planing services for a child with a genetic disorder and hearing impairment. For which reason would the health care provider plan a treatment that focuses on habilitation?

Habilitation services help in acquiring skills.

A family member of a patient at the hospice center tells the nurse that the patient has been seeing and talking to people not visible to others. Which explanation does the nurse give the family member about what the patient is doiing?

Having vision-like experiences

A 55 year old patient who has mental and cognitive disorders is completely dependent on others for care. The patient does not have economic support and is unable to afford the cost of health care. Which option would best for the patient?

Medicaid

A 68 year old home health patient enquires about reimbursement support. Which reimbursement source can the nurse suggest to the patient?

Medicare

A patient with a spinal cord injury at the T4 level begins to experience a severe, pounding headache and becomes flushed and diaphoretic. which action should the nurse take first?

Move the patient tot he sitting position.

A nurse is working in a rehabilitation facility in which each of the rehabilitation disciplines has specific goals, plans and outcomes that are separate from those of the other disciplines. Which term describes this team model of rehabilitation?

Multidisciplinary

A patient complains of tingling and burning pain in the extremities. the nurse knows to document this as whichtype of pain?

Neuropathic

A nurse is assisting with care planning for four patients receiving home health care. A patient with which condition would benefit most from telehealth services?

Newly diagnosed type 2 diabetes mellitus

A nurse is planning care for a patient with an L3 spinal cord injury he sustained 5 years ago. Which level of assistance with activities of daily living should the nurse plan to provide?

None; the patient will be independent

A patient who recently had a stroke must learn to feed himself again. Which service would be most important for teaching the patient to feed himself?

Occupational therapy

A patient in rehabilitation with a spinal cord injury at the level of T6 and T7 is experiencing an extreme elevation in blood pressure, diaphoresis, and shivering. Which immediate intervention would the nurse perform?

Raise the head end of the patient's bed to an angle of 60 degrees

Which type of brain injury does the nurse suspect in a patient who has been unconscious for 8 days?

Severe

A patient requires daily dressing changes for a pressure injury on the right calcaneus. Which service will the patient require?

Skilled nursing

A nurse in a hospital is caring for a patient who has sustained a C3 spinal cord injury; the nurse knows the patient will most likely be discharged to which location?

Skilled nursing facility

After three months of rehabilitation after a craniotomy, a client continues to have motor speech difficulties. To promote the client's use of speech the nurse should do what?

Support the client's efforts to communicate

A health-care agency plans to provide incentives to a primary healthcare provider who is providing home health care. Which act is being followed by the health-care agency in this situation?

Tax Equity and Fiscal Responsibility Act

A rehabilitation nurse would like to develop a community outreach project to reduce the number of spinal cord injury victims. Which population would it be most important to reach with this project?

Young men

Which symptoms would the nurse expect an injured soldier that has sustained primary blast-related injuries to exhibit?

spinal cord compression