chapter 12

A nurse recommends palliative care for a client who is being discharged following a diagnosis of cancer. What is the chief focus of this type of care?

Relief from physical, mental, and spiritual distress

The nurse understands that planning for discharge actually begins at admission to the facility. The purpose of discharge planning is best described as:

providing continuity of care that is goal directed.

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

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

The nurse is caring for several clients with chronic conditions that need to be evaluated for long-term care. After evaluating each client, the nurse determines which client is most appropriate to receive long-term care?

A client who suffered a stroke who has mobility issues and problems completing activities of daily living (ADLs).

A nurse demonstrates understanding of Healthy People 2020: Understanding and Improving Health by supporting which statement?

A client's health is affected by social, economic, and political factors.

The home health care nurse is providing information to a client and family on medication changes. What role is the nurse performing?

Client and family educator

A new nurse is considering getting a job in either an acute care setting or a home care setting. Which statement about these care settings is most accurate?

Clients play a large role in helping themselves in the home care setting.

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

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

Nurses in various health care settings provide services to prevent the fragmentation of care that is occurring as a health care trend in today's society. What role of the nurse is most important in preventing this effect?

Coordinator of care

A client has been discharged from the hospital following orthopedic surgery and has a referral for home health care. Which actions should the home health nurse perform during the entry phase of the home visit for this client? Select all that apply.

Develop rapport with the client and family Make an initial and thorough assessment Negotiate the time for the next home visi

The growth in home health care is largely attributed to which factor?

Early discharge of clients from the hospital setting

A clinical nurse specialist is preparing a presentation for a group of colleagues about the current state of the health care delivery system. As part of the presentation, the nurse is planning to address trends that may play a role in shaping health care delivery in the near future. Which information would the nurse most likely include? Select all that apply.

Greater numbers of informed persons using health care services Rise in accessible health information due to technology

What is the primary focus of health care today?

Health promotion

The nurse is caring for a client admitted to home care after total knee replacement surgery. Which home health care goal for the client will be the nurse's priority?

Help the client regain mobility and independence

A nurse is providing supportive care to a client diagnosed with a terminal illness who is not expected to live past the next 3 months or so. The nurse is likely working in which setting?

Hospice care

A home health nurse uses different professional skills to achieve a successful care plan for clients in their home setting. Which skill is of most importance to the nurse?

Nurse-client rapport

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

Occupational therapist

Which action by the home health care nurse illustrates the role of coordinator of services?

Providing information about community resources

A home health nurse arrives at the home of a client--an infant who has just been discharged to home--and finds that the infant is on a ventilator and is being cared for by the parents. What should the nurse do next?

Provide teaching to the parents on how to operate the ventilator.

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

Provide the teaching.

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

Providing accurate and complete communication to the new facility.

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

Providing client education

The nurse is providing care for a client who has a tracheostomy and whose pulse oximeter has recently alarmed, showing the client's oxygen saturation to be 77%. The nurse has repositioned the client and applied supplementary oxygen, interventions that have raised the client's oxygen levels to 80% and have somewhat decreased his work of breathing. The client is not in immediate distress, and his level of consciousness remains high. The nurse should page which practitioner?

Respiratory therapist

A client is admitted to the facility after fracturing a hip. The client has undergone surgery to repair the fracture and is receiving services to promote healing of the surgical site and regain mobility. Which discussion should the nurse have with a member of the interdisciplinary team member to promote the goal of regaining mobility?

Speak with the physical therapist about exercises to strengthen muscles.

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

The discharge home of clients who are more critically ill

What is the rationale for conducting discharge planning?

To ensure that client and family needs are met consistently

A nurse is completing a home visit to an older adult client who is receiving regular dressing changes for the treatment of a venous ulcer. What outcome does the nurse hope to achieve in the plan of care for this client?

To maximize the independence and health of the client

Which is the best example of a nurse providing continuity of care?

The nurse collaborating with other members of the health care team in caring for a client

Which statement is true when comparing home care with acute care?

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

The nurse is conducting discharge education on dressing change to a postoperative client and the spouse. The client's spouse appears anxious about changing the dressing correctly. Which is the best indicator that the spouse is competent to perform the dressing change?

The spouse is able to correctly demonstrate performing the procedure.

Which is not a cognitive or sensory deficit?

asthma

Following the death of a hospice client, the nurse continues to care for the family. What is this type of care called?

bereavement care

Regardless of the type of ambulatory care facility, what need is common to all clients who are given care?

education

A nurse has an older adult home care client who lives alone with no family nearby. On a recent visit, the nurse notices that his clothes are very loose, and he has difficulty letting the nurse leave when the visit is ending. After talking with him, the nurse learns that he has not been cooking for himself and he can't get to the grocery store easily. What service could the nurse suggest as an immediate response until a long-term plan can be formed?

enroll on meals on wheels

The Nursing Agenda for Health Care Reform (American Nurses Association [ANA]) identifies the recipients of health care. This reform's main focus is on:

health promotion.

The home health nurse completes the Outcome and Assessment Information Set (OASIS) at the start of home care. This documentation:

includes assessment of core items for improving quality of care.

Public health nursing is the branch of nursing that:

provides health care for the community.

The nurse is caring for a client newly diagnosed with diabetes mellitus. Which is an appropriate element of discharge planning for the nurse to use?

teach patient about prescribed medications and how to take accurate blood glucose levels

A mother of two children has been diagnosed with terminal breast cancer and will be requiring assistance with her own care as well as the care of her children. When planning the client's discharge, the nurse interprets this change in role functioning as:

transition.