Collaborative Practice and Care Coordination across Settings ch.12 PrepU

client admitted to the hospital is diagnosed with cancer. The client is assigned a nurse who will be the central point of contact for all of the client's care. Which role is the nurse filling? Nurse navigator Client navigator Care coordinator Case manager

Nurse navigator

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 is scheduled for a cardiac catheterization in about an hour and needs monitoring every 15 minutes." B)"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." C)"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." D)"The client had an exploratory laparotomy 2 days ago and was progressing well. The vital signs were stable until this episode."

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

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)Coordinator B)Clinician C)Nurse practitioner D)Caregiver

A)Coordinator

An 18-month-old child is ventilator-dependent due to infantile scoliosis. This is the first time the child has been home since birth and the parents are very concerned about providing care. What is this family's priority need for assistance? A)Emotional bonding B)Health assessment C)Genetic counseling D)Financial needs related to care

A)Emotional bonding

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

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

A nurse is caring for a 17-year-old pregnant client who is unable to afford health care. Which resources will the nurse access to obtain assistance for this client? A)Make a referral to the social services department. B)Call the local welfare agency to see if the client qualifies for services. C)Suggest asking a family member for monetary assistance. D)Tell the client that better management of money is required to care for infants.

A)Make a referral to the social services 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)Occupational therapist B)Physical therapist C)Home health aide D)Social worker

A)Occupational therapist

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)Providing client education B)Assessing the client's needs and identifying problems C)Developing goals with the client D)Making home health care referrals

A)Providing client education

An 82-year-old client is being discharged from the hospital following a bowel resection. The client lives alone and the client's family is out of town. Which factor will have the greatest effect on the client's home care management? A)Support system B)Medication management C)Psychosocial needs D)Transportation

A)Support system

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 client's caregiver is absent whenever the nurse visits and the client is alone. B)The home care nurse has to reschedule an appointment with the client. C)The client refuses to allow the caregiver to help the client sit up in bed. D)The client reports having slipped in the restroom the first night in the hospital.

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

The nurse is preparing to begin the discharge planning process with a client whose pulmonary embolism has recently resolved. Which factor should the nurse prioritize during this process? A)The client's identified needs and goals B)The NANDA diagnoses relevant to the client's condition C)The client's potential for recurrence D)The nurse's knowledge base and experience level

A)The client's identified needs and goals

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 is the primary caregiver. C)The nurse should act as a counselor and advisor. D)Rehabilitation is the major client goal.

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

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 prepares the new room for the client. B)The nurse asks the other health care professionals if they have any questions. C)The nurse uses the SBAR technique during the handoff. D)The nurse determines who should be involved in the handoff communication.

A)The nurse prepares the new room for the client.

When preparing to transfer an older adult client back to the long-term care facility where the client has been for several years, it is the primary responsibility of the nurse to: A)provide for the coordination and continuity of care by the health care providers. B)ensure that the current health state of the client is maintained. C)communicate to the next of kin so they are aware of the transfer. D)discuss the return to familiar surroundings with the client.

A)provide for the coordination and continuity of care by the health care providers.

A client's son says, "Mom can come and live with me, but I will need help. I am going to call a home health agency to see about having someone come out to my house." Which nursing response is indicated? A)"Home health is very expensive. You might wish to check into an individual sitter instead." B)"Your mother's primary health care provider will have to write a prescription for home health." C)"I can get the telephone numbers of several home health agencies for you." D)"Home health can only help you for 60 days."

B)"Your mother's primary health care provider will have to write a prescription for home health."

A single parent age 17 years, with one child and pregnant with a second, has the mental age of a 12-year-old. The home care nurse's greatest concern in caring for this client should be the client's ability to do which? A)Physically perform care needed by the children B)Cognitively understand how to care for the children C)Bond with the children D)Receive financial aid

B)Cognitively understand how to care for the children

Which is the primary goal of continuity of care? A)Increasing clients' knowledge base and improving their health maintenance behaviors B)Ensuring a smooth and safe transition between different health care settings C)Controlling costs and maximizing client outcomes after discharge from the hospital D)Minimizing nurses' legal liability during client transitions between health care institutions

B)Ensuring a smooth and safe transition between different health care settings

Which is the largest single source of reimbursement for home health care services? A)Private insurance B)Medicare C)Client's self-pay D)Medicaid

B)Medicare

Which type of home healthcare agency is a local health department? A)Institution-based agency B)Official or public agency C)Private, proprietary agency D)Private not-for-profit agency

B)Official or public agency

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

B)Plan reachable goals with the client and family.

A client diagnosed with terminal leukemia is receiving home health care services to assist in the client's care. After assessing the client, the home health care nurse determines that the client is unable to afford needed medical supplies. Which is the best strategy for the nurse to implement to assist the client? A)Enlist the services of the client's family for some components of care, such as dressing changes and physical therapy. B)Refer the client to a social worker to determine eligibility for assistance. C)Refer the client to a local religious organization or non-profit agency for support. D)Discuss the client situation with the provider for possible therapies that are more cost-conscious.

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

One of the fastest growing venues of practice for the nurse is home health care. What is the basis for the growth in this health care setting? A)The focus on treatment of disease B)The discharge home of clients who are more critically ill C)The preference of nurses to work during the day instead of evening or night shifts D)The chronic nursing shortage

B)The discharge home of clients who are more critically ill

When educating clients in the community on health promotion and prevention of disease, it is important to stress: A)health promotion may not be possible for many of the older members of a community. B)health education can benefit individuals and groups. C)strenuous exercise is necessary for health. D)the ideal location for education is in a health care institution.

B)health education can benefit individuals and groups.

Public health nursing is the branch of nursing that: A)assesses individuals for community care. B)provides health care for the community. C)administers care for a defined geographic community. D)provides primary care to individuals.

B)provides health care for the community.

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)providing continuity of care that is goal directed. C)decreasing stress for client and family members. D)ensuring client safety and health maintenance.

B)providing continuity of care that is goal directed.

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

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

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)Provide explicit written and verbal instructions and ask the daughter to explain back to the nurse how to perform the procedure. B)Use a multimedia strategy that combines animation with narration. C)Demonstrate and explain the procedure and then have the daughter perform it. D)Explain the procedure clearly and slowly while providing multiple opportunities for the daughter to ask questions.

C)Demonstrate and explain the procedure and then have the daughter perform it.

The home care nurse is providing care and education to a client who is pregnant for the first time. The client states, "I have no money or food. I don't know what I should do. I want to provide for my unborn child." The nurse refers the woman to the WIC program and a local food bank. This is an example of what aspect of community-based nursing? A)Evaluation B)Restoration C)Planning D)Assessment

C)Planning

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)Making home health care referrals C)Providing client education D)Assessing the client's needs and identifying problems

C)Providing client education

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

C)The change to shorter hospital stays

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? A)The preference of nurses to work during the day instead of evening or night shifts B)The focus on treatment of disease C)The discharge home of clients who are more critically ill D)The chronic nursing shortage

C)The discharge home of clients who are more critically ill

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 home health care aide B)The social worker C)The registered nurse D)The chaplain or minister

C)The registered nurse

Continuity of care for a particular client is most important to prevent: A)multiple providers. B)rising health care costs. C)fragmentation of services. D)infection.

C)fragmentation of services.

Prior to the discharge of a client who is recovering from a stroke from an acute care facility, the nursing case manager has the nursing staff, client, client's family, physical therapist, and home health nurse meet. The most likely purpose of this meeting is to: A)determine hospital-based services needed by the client. B)provide client education. C)prepare the client for home care. D)evaluate the effectiveness of the hospitalization.

C)prepare the client for home care.

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)Documenting the procedure B)Assisting in participation of the care-related decisions C)Establishing rapport and showing willingness to listen D)Clearly defining the purpose and expectations of the admission

D)Clearly defining the purpose and expectations of the admission

The nurse is assessing the birth rates and death rates of the local municipality and comparing these rates to those of the nation and the world. Which type of nursing is this nurse practicing? A)Research nursing B)Home health nursing C)Parish nursing D)Community health nursing

D)Community health nursing

A client is having an increasing amount of difficulty caring for oneself in the home alone. The client states to the nurse, "I need more help. What am I going to do?" Which action would be the most appropriate for the nurse to take? A)Have the home health aide increase visits for bathing the client. B)Have the occupational therapist assess for the client's need for adaptive devices. C)Have the physical therapist help the client with rehabilitation. D)Have the social worker visit the client to discuss care options.

D)Have the social worker visit the client to discuss care options.

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)Intravenous therapy B)Pain management C)Homemaking D)High-rise toilet seat

D)High-rise toilet seat

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

D)Home care

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)what the client wants to have happen during the hospitalization. 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)whether the client has a document describing wishes for care when the client is no longer able to make decisions.

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