Rehab BN 97 98

A nurse is caring for a 30y female cl with complains lack of lower limb movement & sensation. Which of the following instructions should be given to cl to prevent bladder infection? SATA a. Have frequent examinations by a healthcare provider b. Avoid drinking cranberry juice c. consume an acidophilus free diet # acidophilus-rich diet d. drink an adequate amount of fluid e. clean the perineal area from front to back

Answer: a, d, and e

Which of the following nursing care measures should be included in care plan for client 50y with lung cancer.? SATA a. assist the client in performing activities of daily living b. provide electrical therapy # musculoskeletal disorders c, carry out the client's gait analysis # to evaluate a client's walking ability d. assist the client in doing "lung" physiotherapy e. provide mental & emotional support

Answer: a, d, and e

Which specific nursing care measure should be included in care plan of pt 25y male in braces after paralysis of lower limb? a. provide special tight gloves or body wraps # burns b. assist performing chest physiotherapy. # lung cancer c. assist the client in range-of-motion exercises. d. assistance in medication use. # psychiatric rehabilitation

Answer: c

Which should the nurse tell the caregivers regarding homemaking adaptation for a 30y female cl with an acute spinal cord injury? a. Constructing a ramp instead of stairs # home adaptation category b. providing lever-style faucet handle # home adaptation category c. provide lever -style doorknobs # home adaptation category d. Use of a combination washer and dryer

Answer: d RATIONALE: Homemaking adaptations help a homemaker with a disability to conveniently work at home.

100-A client admitted to a hospice program for metastatic osteosarcoma and complaining of intense bone pain is given corticosteroids. What is a consequence of corticosteroid administration?

Appetite stimulation

98-A nurse works in a home care agency that uses a center of excellence (COE) concept and functions to assist local home care nurses. Which of the following services would be provided by these nurses? Select all that apply.

Wound care Psychiatric management Continence care

The functional activities of daily living include activities of self-care. The following are some examples of functional activities of daily living: 1 ability to self-dress; 3 ability to self-feed;

2 ability to maintain cleanliness, such as bathing, grooming, toileting, and care of teeth, nails, and hair; 4 ability to talk or communicate with others; 5 ability to walk and to transfer from one place to another; 6 ability to rest and sleep.

PAIN 1 evaluate pain base on pain scale 0 to 10 2 nonpharmacologic pain management 21 strengthening and stretching exercises, can be used to relieve back pain in the client

22 Therapeutic heat and cold and equipment providing heat, including diathermy, ultraviolet light, ultrasound, and lasers, can be used for pain management. 23 Electrical therapy in the form of transdermal electrical nerve stimulation (TENS) helps in pain management. 24 Acupuncture, self-hypnosis, and guided imagery are other possibilities for pain management.

basis of MASLOW in rehabilitation 1st Ensure adequate oxygenation 2nd assist the client in independent eating & dressing

3th assist the client to move about independently 4 assist the client in self actualization

CANEs to achieve mobility 1 The most common type of cane is the half-circle cane, which is used by clients who require minimal support. 2 Clients with hand weakness can use a cane with straight handle to walk. 3 A quad cane, which has four feet, provides more support and balance to the client.

4 The Lofstrand crutch, or forearm-support crutch, has a strap that helps to fasten the crutch around the arm, so that the client can free the hand when needed. 5 Canes with spikes are also available, to provide better traction in slippery conditions

adaptive equipment available for people with limited vision: 1 large numbers on telephones, alarm clocks, and television remote control devices; 2 playing cards with large numbers or Braille numbers; 3 appliances with large print or Braille on the knobs;

4 appliance instructions and recipes on tape or on computer; 5 high-wattage light bulbs in lamps, with dimmer switches; 6 talking thermometers; 7 talking/chiming watches; 8 service animals.

caring for a burned client 1 maintaining mobility 2 preventing deformities 3 managing pain and itching 4 regain and maintain intact skin. 5 passive and active range-of-motion to prevent contractures and hypertrophy of muscles

6 use braces and other orthotic appliances 7 special tight gloves or body wraps to provide tissue compression and vascular support 8 performing therapeutic exercises to release contractures. 9 teach the client how to perform activities of daily living.

98-Which of the following clients would be the best candidate for long-term home care?

79 year old man with left-side paralysis following a stroke.

providing skin care 1 Keep the skin dry and clean. 2• Use lotion instead of alcohol to disinfect the skin. 3 • Keep the client's bedding wrinkle-free. 4• Change bedding and clothing promptly. 5• Encourage frequent toileting. 6 • Encourage adequate fluid intake.

7• Reposition the client at least every 2 hours. 8• Encourage the client to be out of bed as much as possible. 9• Keep crumbs out of the bed. 10 • Give the client frequent backrubs and massage. 10• Provide special devices for assistance, such as the hydraulic lift, HoverMatt, transfer board, and turning sheet. 11 • Promptly report and treat any redness, skin irritation, or skin breakdown.

98-A nurse appointed to provide home care to a client feels it is not safe to visit the client on a particular day. What should the nurse do in such a situation?

Inform client and family caregivers about not visiting them

The nurse is performing passive range-of-motion exercises for a client who is immobile. What is the best response by the nurse when the client states, "Why are you doing this?" a. "It will prevent you from developing pneumonia." b. "It will improve appetite and increase metabolism." c. "It will prevent skin breakdown." D "It will prevent joint stiffness and muscle atrophy."

"It will prevent joint stiffness and muscle atrophy."

Which of the following clients would benefit from the use of an exoskeleton? Select one: A. A client who has quadriplegia B. A client who has hemiplegia C. A client who is wheel-chair bound

. A client who has quadriplegia If a client has quadriplegia (all four extremities and possibly the trunk paralyzed), he or she may need a neck or back brace. This client may also use a type of inflatable trousers (exoskeleton) to maintain an upright position and prevent vascular collapse.

A psychiatric clients is living at home with a service dog to help her with certain actives. She had been prescribed clozapine. Which can the nurse do when paying a weekly visit? a. Encourage seeking full guidance # pt is able to live on her own b. Pat & praise the service dog c. Draw the cl blood for laboratory test d. assist the ct in spirometry exercise # respiratory disorders

. Answer: c RATIONALE: When paying a weekly visit to a psychiatric client on clozapine, the nurse should draw blood to help the healthcare provider decide on dose adjustments that may be needed. The service dog should not be touched or patted. The animal is often trained to protect the client and may misunderstand the nurse's intentions.

The nurse is performing a home assessment for a client with paraplegia who is being discharged from a rehabilitation facility in a wheelchair. Which of the following home adaptations would the nurse recommend? Select one: A. Placing scatter rugs on hardwood floors B. Replacing carpets with higher pile C. Replacing lever-style doorknobs with round doorknobs D. Raising the toilet seat and using L-shaped toilet paper holders

. Raising the toilet seat and using L-shaped toilet paper holders A raised toilet seat allows people to sit down and stand up easier and L-shaped toilet paper holders facilitate changing rolls. Round doorknobs should be replaced with lever-style doorknobs for an easier grip and carpets with low pile allow the wheelchair to move easier. Flooring without carpeting is easier for wheelchair use. Scatter rugs should be removed.

The nurse administrating home care services researches quality indicators of home care. What is vital in order for the home care agencies to maintain funding? Select one: A. Avoidance of malpractice lawsuits B. Avoidance of rehospitalization of clients C. Reliance on clients with private insurance D. Emphasis on safety in the home

: Avoidance of rehospitalization of clients During the 8th "Scope of Work (SOW) of the Centers for Medicare and Medicaid Services (CMS)", home care agencies were given the directive and responsibility to reduce unnecessary and avoidable rehospitalizations (Approximately one-fifth of clients return to the hospital within 30 days and many have not seen their primary care provider since discharge). Because Acute Care Hospitalization (ACH) is one of the publicly reported measures (PRM) or quality indicators of home care, the avoidance of unnecessary rehospitalizations is vital for the home care agency to maintain its funding.

A new nurse graduate is considering employment in home care. Which of the following type of skills is most important in this area of nursing? Select one: A. Legal/ethical skills B. Cognitive skills C. Clinical skills D. Interpersonal skills

: Clinical skills Although all these skills are valuable in nursing, it is highly recommended that the new graduate, whether LPN or RN, gain added clinical experience before being employed in home care. The level of autonomy requires a very sound clinical background, which often must be enhanced after graduation.

The student nurse is thinking of specializing in home healthcare. Which of the following describes a trend in this field of nursing? Select one: A. Only hospital healthcare employment is expanding faster than home care employment. B. Home care is one of the fastest-growing fields in nursing today. C. In 2008, there were more than 900 Medicare-certified home health agencies in the United States. D. In 2006, more than 1 million clients were served, by nearly 104 million home visits.

: Home care is one of the fastest-growing fields in nursing today.

Which of the following clients would be the best candidate for long-term home care? Select one: A. A newborn diagnosed with Downs syndrome B. A 28-year-old diagnosed with pancreatic cancer C. A 79-year-old with left-side paralysis following a stroke D. A 42-year-old sent home in spinal traction

A 79-year-old with left-side paralysis following a stroke Older clients or people with chronic, disabling conditions may require long-term care in their homes. Long-term services include periodic nursing assessment and case management, with homemaking and personal care services provided. Nurses may assist with "restorative nursing," such as assisting with exercises to maintain muscle integrity. Clients with cardiac disorders comprise a high percentage of the case load in many home care agencies. A client in spinal traction would require short-term home care as would a client with cancer, who may eventually need hospice care. A newborn with Down syndrome would most likely be taken care of by the parents, or cared for on an outpatient basis.

99-Which of the following clients would most likely use telemonitoring in his or her healthcare management

A client who has a pacemaker

Which of the following clients would be most likely to have a neurogenic bladder or bowel? Select one: A. A client who has a prosthetic leg B. A client who uses a walker C. A client who is on bed rest D. A client who is paralyzed

A client who is paralyzed # may have a neurogenic (lacking nerve stimulation) bladder or bowe

99-Specialized healthcare clinics serve target populations. Which of the following is an example of this type of clinic?

A clinic set up to provide immunizations when outbreaks of diseases occur

99-A 50-year-old male diagnosed with hypertension is visiting his primary care provider. Which of the following professionals might provide this care? Select all answers that apply.

A physician A nurse practitioner A physician's assistant

A supportive brace is used temporarily after a knee injury or knee surgery, or permanently to support the knee. The brace can be adjusted to allow limited movement of the knee, which helps to protect the joint while it heals

A supportive brace is used in paraplegic or hemiplegic conditions.

A nurse is preparing a rehabilitation plan for a client with hemiplegia, which includes a record for the activities of daily living (ADLs). Which of the following activities of the client can be classified as an instrumental activity of daily living? Select one: A. Ability to self-feed B. Ability to eliminate waste C. Ability to bathe and dress D. Ability to administer medications

Ability to administer medications The ability of the client to administer medications can be classified as an instrumental activity of daily living. The nurse should assist the client in achieving both instrumental and functional activities of daily living. Activities, such as ability to self-feed, eliminate waste, bathe, and dress, can be classified as functional activities of daily living.

A 50y client with paralysis of lower limb is brought to the rehabilitations center. The nurse should tell him which of the following regarding sexual activity? SATA a The cl may require a penile implant before sex b the cl should avoid participating in sex activity c The client and his partner should be thoroughly interviewed by a sex therapist. d The client should be provided instructions regarding comfortable and safe positions. e client should take medication to increase his sexual activity # need ordered

Answer: a, c, and d

The rehabilitation nurse is reviewing the functional ADLs of a client who has cerebral palsy. Which are examples of this type of ADL? Select all that apply. Select one or more: A. Ability to pay bills B. Ability to shop for groceries C. Ability to dress self D. Ability to communicate E. Ability to use the bathroom safely F. Ability to self-feed

Ability to dress self, Ability to self-feed, Ability to use the bathroom safely, Ability to communicate The basic functional ADLs (FADLs) include aspects of self-care, such as dressing, bathing, toileting and continence, transfer, mobility, and eating. Instrumental ADLs (IADLs) are more complex living skills, such as food preparation, laundry, taking medications, and money management

98-A nursing instructor discusses with students the advantages of working in home care. Which of the following would the instructor include? Select all that apply.

Ability to get to know the client and family members better Being able to assist the client to remain at home Greater flexibility in planning the workday.

A nursing instructor discusses with students the advantages of working in home care. What are advantages that the instructor would include? Select all that apply. Select one or more: A. Less documentation than in other settings B. Greater flexibility in planning the workday C. Caring for a small number of clients D. Ability to get to know the client and family members better E. Being able to assist the client to remain at home

Ability to get to know the client and family members better, Being able to assist the client to remain at home, Caring for a small number of clients, Greater flexibility in planning the workday Advantages of working in home care include the following: the unique opportunity to care for only a small number of clients. In the home, the nurse can get to know the client and the family better, has greater flexibility in planning the workday, and is able to assist the client to remain at home, where he or she is most comfortable. Disadvantages of working in home care nursing include working alone much of the time, being required to be on call, providing personal transportation to the client's home (in some cities, public transportation is available and some agencies provide cars), consideration of safety issues, and the large amount of documentation required for the home care agency and third-party payors.

Which psychiatric rehabilitation care measure should be employed when caring for a 35y female with her husband complains of disorientation, confusion, distractibility, & HPT? a assist in managing physical problems b assist in performing breathing exercise # respiratory disorder c provide compression appliances # breast cancer d assist in doing ROM exercise # musculoskeletal disorder

Answer: a RATIONALE: The nurse should assist the psychiatric client in managing physical problems, such as high blood pressure.

A 30y woman was brought to facility 3months after a double mastectomy & vaginal hysterectomy. The cl was unable to have any children. The nurse notices that the cl is depressed & withdrawn all time. How should the nurse comfort the cl? SATA a. provide mental and physical support b. make arrangements for individual counseling c. encourage the cl to move on with her life d. make arrangements for group therapy e provide emotional support

Answer: a, b, d, and e

98-A new nurse graduate is considering employment in home care. Which of the following type of skills is most important in this area of nursing?

Clinical skills

100-The hospice nurse provides palliative care for clients. Which of the following are clinical practice guidelines for this type of care? Select all that apply.

Assessing pain Treating pain Providing symptom relief Coordinating care

A 40-year-old male client with multiple injuries on his hands and legs is brought to the primary healthcare facility. The nurse should first assist the client in fulfilling which of the following basic needs? Select one: A. Assist him to bathe and dress independently. B. Assist him to take food and water. C. Help him to communicate with family members. D. Assist him to move independently.

Assist him to take food and water.

A nurse is caring for a female client with chronic obstructive pulmonary disease (COPD). Which of the following nursing care measures should be included in the rehabilitation care plan of the client? Select one: A. Encourage the client to perform vigorous physical exercise. B. Assist the client in doing spirometry exercises. C. Provide the client with compression appliances. D. Provide the client with body wraps.

Assist the client in doing spirometry exercises.

98-The nurse administrating home care services researches quality indicators of home care. What is vital in order for the home care agencies to maintain funding?

Avoidance of rehospitalization of clients

100-A nurse places a saline lock to administer IV pain relief medications to a 65-year-old client admitted to home care hospice with a diagnosis of transitional cell carcinoma of the bladder. For what should the nurse use a saline lock?

Avoidance of repeated venipuncture

A client with a hemiplegia prays for God to help him recover and states that he will go to church every day if he just recovers. What state of the grief reaction is this client experiencing? Select one: A. Anger B. Bargaining C. Depression D. Defense, shock, and denia

Bargaining During adjustment to a long-term physical or mental challenge, a person usually experiences grief reactions similar to those experienced when dealing with any loss, including end-of-life issues. In the bargaining stage, many people try to bargain with God or make deals. "I will be a better person if I can just recover."

100-A hospice must meet certain criteria to legitimately be called a hospice. Which of the following is one of these criteria?

Bereavement care must be provided for the family for at least 1 year.

100-A client with end-stage lung cancer who is in hospice care is experiencing severe depression. Which of the following medications might be prescribed to alleviate this symptom? Select all that apply.

Bupropion (Wellbutrin) Citalopram (Celexa) Furosemide (Lasix)

99-Which of the following statistics accurately represents why community health centers are so important in our healthcare system?

CHCs are the only available source of primary healthcare for millions of Americans

98-When a client is to be transitioned from one care site to another, communication between sites is vital, to ensure safe and appropriate care and follow-up. Which of the following agencies was established to promote increased use of technology to improve management of chronic diseases and reduce avoidable rehospitalizations?

CMS

100-The nurse caring for clients in hospice notes that which of the following is the disease state most commonly seen in this program?

Cancer

99-The government publication Healthy People 2020 describes the idea of the community/family health center as a provider of primary care for a large segment of the population, particularly underserved populations. Which of the following are focus area goals for this initiative? Select all that apply.

Cancer, disability & secondary conditions, food safety.

100-Which of the following hospice care team members provides a constant liaison between the client and the hospice team and may suggest approaches to care that meet with everyone's approval?

Caregiver

98-A nurse is providing home care to a client. What safety guideline should the nurse follow during home visits?

Carry a fully charged cell phone

A nurse is providing home care to a client. What safety guideline should the nurse follow during home visits? Select one: A. Wear a badge with the full name. B. Run in the other direction if a family dog seems aggressive. C. Give the family members your residence phone number. D. Carry a fully charged cell phone.

Carry a fully charged cell phone. A nurse providing home care must carry a charged cell phone at all times. This helps the nurse to call the police or family members in case of any danger. A nurse on a home visit should not run in the other direction if a family dog seems aggressive. Sensing danger, this may provoke the dog to attack the nurse. A nurse should wear a badge with only the first name and last initial rather than a badge with the full name. A nurse need not give his or her residence phone number to the family members.

When a client is to be transitioned from one care site to another, communication between sites is vital, to ensure safe and appropriate care and follow-up. Which of the following agencies was established to promote increased use of technology to improve management of chronic diseases and reduce avoidable rehospitalizations? Select one: A. Home Health Resource Group (HHRG) B. Outcome and Assessment Information Set (OASIS) C. Centers for Medicare and Medicaid (CMS) D. Quality Improvement Organizations (QIO

Centers for Medicare and Medicaid (CMS) The CMS is an agency established to promote increased use of technology as a means of improving management of chronic diseases, ultimately to reduce the incidence of avoidable rehospitalizations. The QIOs in each state are also contracted by CMS to work with home care agencies. Payment for home care is based on selected OASIS outcome measures, the new version of which (OASIS-C) became effective January 1, 2010. After OASIS data are collected, the client is assigned to a HHRG for a given episode of care, which is usually a 60-day period.

The nurse is making a first visit with a client receiving home care for COPD. Which of the following safety measures should the nurse take when driving to, and walking into, the client's home? Select one: A. Use isolated stairs instead of the elevator in apartment buildings. B. Check agency guidelines before giving a ride to a client. C. Lock the car doors after putting things away in the car. D. Park the car on a side street, not right in front of the client's residence.

Check agency guidelines before giving a ride to a client. The nurse should check agency guidelines before giving a ride to a client or to a family member to make sure insurance is valid in this situation. The nurse should also look before entering an elevator; in buildings, use common walkways, avoiding isolated stairs, lock the car doors immediately when getting inside before putting things away, park the car in full view of the client's residence, and avoid parking in alleys or on deserted side streets, if at all possible.

discharged from the healthcare facility. Which resource should the nurse tell the client to visit with regard to medical reimbursement? Select one: A. Attending physician B. Hospital administrator C. Laboratory instructor D. Client case manager

Client case manager The client case manager oversees the care and treatment of the client and acts as the client's advocate. Thus, the nurse should instruct the client to approach the client case manager.

The nurse is scheduling a client for a visit with an enterostomal therapist. Which of the following is the specialty of this type of therapist? Select one: A. Assisting with cardiovascular functioning B. Assisting in elimination C. Assisting in skin care D. Assisting in breathing

Clients may visit an enterostomal therapist to assist in skin and wound care, as well as in the care of a colostomy or ileostomy. Clients are often referred to wound care or burn centers for evaluation, treatment, and teaching to maintain skin integrity. Excellent skin care is vital in clients who lack sensation in a portion of the body, who are unable to move independently, or whose skin is particularly friable.

99-The new graduate nurse is researching career opportunities. Which of the following does the nurse find is the fastest-growing segment of the healthcare industry?

Community-based healthcare

98-The home care nurse is speaking to senior citizens about home care in the community. Which of the following accurately describe the advantages and disadvantages of home care? Select all that apply.

Continuous care from hospital to home is provided, Home care agencies can provide hospice care, Many people are more comfortable in their homes surrounded by loved ones., Surroundings and foods are more familiar and comfortable in the home.

The home care nurse is speaking to senior citizens about home care in the community. Which statements accurately describe the advantages and disadvantages of home care? Select all that apply. Select one or more: A. Home care is more expensive than hospital care. B. Clients and families experience more emotional strain with home care. C. Surroundings and foods are more familiar and comfortable in the home. D. Continuous care from hospital to home is provided. E. Many people are more comfortable in their homes surrounded by loved ones. F. Home care agencies can provide hospice care.

Continuous care from hospital to home is provided., Home care agencies can provide hospice care., Many people are more comfortable in their homes surrounded by loved ones., Surroundings and foods are more familiar and comfortable in the home The advantages of home care include the following: Home care is less expensive than hospital or nursing-home care. Nurses, support personnel, and primary caregivers can provide continuous care from hospital to home and until the client's recovery or death. Many people are more comfortable receiving care in their own home, surrounded by loved ones, friends, and pets. The surroundings and foods are familiar and comfortable. Many clients prefer to die at home. Home care agencies often provide hospice care and clients and families experience less emotional strain at home because they avoid separation..

100-The nurse is administering pain medications to clients in a hospice program. Which of the following is a recommended guideline for this procedure?

Correlate the medication to the client's report of pain intensity.

100-A client who is diagnosed with anaplastic thyroid cancer asks a home nurse whether he is eligible to join a hospice program. What is a criterion for the client to be admitted to a hospice?

Curative treatment is not desired by the client's family.

98-The nurse researching the provision of home healthcare finds that national programs are aimed at improvement of quality of home healthcare. What is the goal for improvement instituted by INTERACT II?

Decrease avoidable hospital readmissions.

The nurse researching the provision of home healthcare finds that national programs are aimed at improvement of quality of home healthcare. What is the goal for improvement instituted by INTERACT II? Select one: A. Ensure beneficiaries receive the right care in the right setting. B. Decrease avoidable hospital readmissions. C. Improve client's self-management of oral medications. D. Improve care and transfers from one setting to another.

Decrease avoidable hospital readmissions. The goal of INTERACT II, developed by the Georgia Quality Improvement Organization (QIO), is to decrease avoidable hospital readmission rates from home care and skilled nursing facilities. The goal of Home Health Quality Improvement National Campaign and Advancing Excellence in America's Nursing Homes is to improve clients' self-management of oral medications and improve care and transfers from one healthcare setting to another. The Centers for Medicare and Medicaid (CMS) is working to ensure that beneficiaries receive the right care at the right time in the right setting, while reducing avoidable or unnecessary rehospitalizations.

100-A client admitted to a hospice facility for breast carcinoma is prescribed morphine for pain relief. What adverse effect should the nurse monitor for in a client receiving morphine?

Decreased respirations

A client who has paralysis following a car accident is experiencing dyspraxia. Which of the following describes this condition? Select one: A. Difficulty performing coordinated movements B. Difficulty swallowing # dysphagia C. Emotional lability # excessive emotional reactions and frequent mood changes. D. Difficulty speaking # aphasia

Difficulty performing coordinated movements # dyspraxia

98-The home care nurse explains to the student nurse the primary reasons for the increase in the provision of home care. Which of the following factors would the nurse cite? Select all that apply.

Discharge of clients with complicated equipment, Greater autonomy of clients, Existence of Telehealth.

The home care nurse explains to the student nurse the primary reasons for the increase in the provision of home care. What factors would the nurse cite? Select all that apply. Select one or more: A. Higher number of hospital admissions B. Discharge of clients with complicated equipment C. Longer hospital stays D. Existence of Telehealth E. Greater autonomy of clients F. Increasing aging population

Discharge of clients with complicated equipment, Greater autonomy of clients, Increasing aging population, Existence of Telehealth Fewer people are being admitted to hospitals, and those who are admitted are going home sooner, with more needs for assistance at home. People are discharged from hospitals with drainage tubes, saline locks, IVs with pumps, patient-controlled analgesia (PCA) pumps, catheters, supplementary oxygen, and other complicated equipment. Also, clients may receive assisted living services, which allow them to live independently. This is important because of the increasing aging population. Through Telehealth—nurses and clients can transmit information about procedures (e.g., ECGs, blood pressure readings) by telephone or computer to hospitals or physician offices for interpretation.

The nurse teaches student nurses to be respectful to any person who is physically or mentally challenged. Which of the following is a recommended nursing intervention when caring for this population? Select one: A. Acknowledge and pet a client's helper animal. # do not touch the helper animal B. Refer to clients as "disabled persons." # a person with a disability, C. Do not offer to assist a client with a disability. # assist D. Do not touch a client's assistive equipment.

Do not touch a client's assistive equipment. The nurse should not touch the person's equipment or helper animal. Many clients consider equipment as an extension of themselves. It is important not to distract the helper animal. In addition, the animal is often trained to protect the client; the animal may misunderstand these intentions.

100-A client with pancreatic carcinoma complains of severe abdominal pain radiating to the back. The healthcare provider prescribes a narcotic analgesic for pain relief. What should the nurse take into account when administering pain relief medications?

Dosage of pain medication should be increased gradually.

98-A nurse is providing intermittent care for clients in their homes. Which of the following are examples of services provided by this and other short-term home care nurses? Select all that apply.

Drawing blood two to three times per week A weekly visit to set up medications Administration of IV medications Administration of a periodic electrocardiogram

A nurse is providing intermittent care for clients in their homes. What are examples of services provided by this and other short-term home care nurses? Select all that apply. Select one or more: A. Administration of IV medications B. Administration of a periodic electrocardiogram C. A weekly visit to set up medications D. Drawing blood two to three times per week E. Daily visits to provide personal hygiene for an elderly client with emphysema F. Dressing changes following surgery for up to one month

Drawing blood two to three times per week, A weekly visit to set up medications, Administration of IV medications, Administration of a periodic electrocardiogram When a client receives short-term services or intermittent care, the nurse provides care in the home for a short period of time or provides care at specific intervals. Examples are drawing blood, setting up medications, administering IV medications, and administering a periodic electrocardiogram. Daily visits to an elderly client with emphysema would be long-term home care, and dressing changes are performed for 1 to 2 weeks following surgery.

100-The hospice nurse provides emotional support to clients in hospice care. Which of the following is the greatest fear of most clients in these programs?

Dying alone

98-A nurse is providing short-term home care to a child being treated for pneumonia. What nursing measure must be adopted when caring for the client?

Educate caregivers on the diet prescribed for the client.

A nurse is providing short-term home care to a child being treated for pneumonia. What nursing measure must be adopted when caring for the client? Select one: A. Visit the client once a week to assess the child's progress. B. Educate caregivers on administering antibiotic injections. C. Educate caregivers on the diet prescribed for the client. D. Teach family caregivers how to maintain the client's personal hygiene.

Educate caregivers on the diet prescribed for the client. A nurse caring for a child with pneumonia should instruct the caregivers on the diet the client should follow. A nurse should not teach the caregivers or the family members to administer antibiotic injections, but a nurse herself must inject the prescribed antibiotic. The nurse must visit the client two to three times a week to assess the medication and treatment provided by the caregivers and also the progress of the client's health. This helps to avoid any complications during treatment. The nurse should educate and assist all the family members of the client to maintain hygienic conditions rather than instructing only the caregiver to maintain personal hygiene. Any family member may visit the client and assist the child in daily activities. Thus, it is important that all the family members practice hygiene to prevent the spread of infection. The correct answer is: Educate ca

100-A 5-year-old child is admitted to a hospice facility with a diagnosis of a metastatic brain tumor. What nursing consideration should be made when dealing with dying children?

Explain death in terms of the child's religious beliefs.

99-The nurse is preparing a client for ambulatory surgery. Which of the following is a recommended nursing function?

Explain the procedure to the client and have him or her sign the consent form.

98-A care-providing agency has appointed a nurse to provide home care to an elderly client. What should the nurse do to ensure that the agency is reimbursed the expenditure for providing care?

Fill out all necessary documents and submit them to the agency.

A care-providing agency has appointed a nurse to provide home care to an elderly client. What should the nurse do to ensure that the agency is reimbursed the expenditure for providing care? Select one: A. Understand the client's rights when receiving care. B. Get along well with the client's family members. C. Fill out all necessary documents and submit them to the agency. D. Document all teachings and procedures for home care

Fill out all necessary documents and submit them to the agency. When providing home care to a client, a nurse should fill out all the necessary documents and submit them to the care-providing agency. Based on the submitted documents, the agency will be reimbursed the amount for providing service to the client. All nurses, in general, should have knowledge of the rights of the client receiving care from the agency. A nurse providing care is expected to understand and respect the client's rights, but the nurse's knowledge will not ensure that the agency will be paid. A home care nurse should get along well with the client's family members, but this is not a criterion necessary to obtain reimbursement. Nurses providing home care should document all the teachings provided to the client and family members and procedures followed when caring for a client. This helps the agency in monitoring the efficiency and duties of the nurses. But these documents will not help in obtaining reimbursement for the services unless they are submitted to the third-party payor.

he nurse is performing a home assessment to determine if a client's home environment is appropriate for long-term rehabilitation from burns. Which of the following are priority considerations when choosing a home environment? Select all answers that apply. Select one or more: A. Community support B. Adequate insurance C. Financial resources D. Safety considerations E. Proximity to a medical center

Financial resources, Safety considerations Clients and their families are vital members of the healthcare team. A home assessment evaluates the home environment and helps determine the appropriateness and possibility of considering home-based rehabilitation. The family will need a safe environment, available caregivers, and financial resources to make adaptations to the home that may be needed. Proximity to a medical center, adequate insurance, and community support are important, but are not the priority considerations when choosing home rehabilitation.

The nurse is evaluating a 23-year-old female client who is confined to a wheelchair, to determine her ability to perform ADLs. Which of the following evaluations is the nurse performing? Select one: A. Vocational assessment # skills, the potential for homemaking or employment, and retraining needs B. Functional evaluation C. Neurologic testing # a motor nerve conduction D. Electromyography (EMG) # to determine electrical activity and potential of muscles

Functional evaluation # ability to perform ADLs. Psychological and neurologic tests determine the person's motivation, attitudes, and neurologic deficits.

A client with muscular dystrophy is prescribed functional electrical stimulation. What is one benefit of this type of therapy? Select one: A. Brain wave stimulation B. Gait improvement C. Prevention of skin breakdown D. Pain management

Gait improvement Functional electrical stimulation (FES) sends a stimulus to the nerves to move muscles. FES assists clients to move or walk, improve gait, reduce spasticity, or better use hands and fingers. Transdermal electrical nerve stimulation (TENS) assists in pain management. This process does not stimulate brain waves or prevent skin breakdown.

98-The visiting nurse is a member of an agency that has been certified by Medicare as a Community Nursing Organization (CNO). For what type of agency does this nurse work?

HHA

A nurse is caring for a 15-year-old client with impaired right hand mobility. Which of the following prostheses provide movement and control similar to normal thumb-finger opposition? Select one: A. Resting splint # hold the body part stationary and to prevent the hand from becoming contracted B. Dynamic hand splint # to achieve mobility of the hand C. Supportive braces # support for the legs D. Handihook

Handihook # provides movement and control similar to normal thumb-finger opposition

100-A woman taking care of her mother who is in a home hospice program is experiencing "compassion fatigue." Which of the following are signs of this caregiver condition? Select all that apply.

Having a sense of hopelessness Having trouble concentrating Considering suicide

99-A mobile outreach clinic housed in a van comes into a local community to provide healthcare to its residents. Which of the following are services provided by a mobile outreach clinic?

Health promotion and teaching

100-A hospice nurse is caring for a 62-year-old female client with metastatic endometrial carcinoma. What is the nursing consideration to be followed when caring for this client in a hospice setting?

Help control the client's symptoms.

The nurse meets with the representative of a company selling specialized clothing for persons with disabilities. Which of the following is the goal of using this type of clothing? Select one: A. Comfort B. Independence C. Safety D. Fashion

Independence The goal of using adaptive clothing is to promote independence in dressing oneself. Companies selling specialized clothing for persons with disabilities will often meet with groups of clients and demonstrate the attractive and easy-to-use clothing available.

A nurse is educating a physically handicapped client about the government policies available to make public places accessible and safe for people with disabilities. Which of the following statements is true regarding the advantages of removing architectural barriers in public places? Select one: A. Provides organizational support during financial crisis B. Provides education to clients about the benefits of rehabilitation C. Helps clients with disabilities to become employed D. Aids in reimbursement for rehabilitation from long-term illness

Helps clients with disabilities to become employed Reduction of architectural barriers helps clients with disabilities to become employed. Reduction of legislative barriers aids in reimbursement for rehabilitation from long-term illness. Reduction of financial barriers provides organizational support during financial crisis. Reduction of educational barriers provides education to clients about the benefits of rehabilitation.

98-The student nurse is thinking of specializing in home healthcare. Which of the following describes a trend in this field of nursing?

Home care is one of the fastest-growing fields in nursing today.

The visiting nurse is a member of an agency that has been certified by Medicare as a Community Nursing Organization (CNO). For what type of agency does this nurse work? Select one: A. Long-term home care agency B. Palliative care agency C. Visiting healthcare professionals D. Home health agency

Home health agency Several types of agencies provide home care services. If an agency is called a "Home Health Agency" or a "Visiting Nurse Service," it has usually been certified by Medicare as a Community Nursing Organization (CNO) Medicare as a Community Nursing Organization (CNO). If Medicare reimbursement is used for funding, the Pay for Performance [P4P] program must be in place. Some agencies maintain certification by The Joint Commission (formerly known as Joint Commission on Accreditation of Healthcare Organizations [JCAHO]. Other agencies are licensed by the health department of the province, state, or territory in which they are located.

he nurse is teaching a 75-year-old female client who is using a walker to ambulate how to facilitate the use of a walker in her home. Besides promoting self-esteem, what physical complications does mobility help to prevent? Select all answers that apply. Select one or more: A. Diabetes B. Constipation C. Diarrhea D. Hypostatic pneumonia E. Thrombophlebitis F. Pressure ulcers

Hypostatic pneumonia, Pressure ulcers, Thrombophlebitis, Constipation

A 58-year-old male client needs long-term rehabilitation following a fall from a ladder that left him with a spinal cord injury. Where will most of his rehabilitation occur? Select one: A. In his community B. In a rehabilitation facility C. In the hospital D. In his doctor's office

In his community Most long-term rehabilitation occurs in the community. Only the initial phase of the process occurs in a rehabilitation facility.

A nurse appointed to provide home care to a client feels it is not safe to visit the client on a particular day. What should the nurse do in such a situation? Select one: A. Take assistance from a colleague when on the home visit. B. Inform client and family caregivers about not visiting them. C. Ignore the instincts, because the client needs assistance. D. Inform a physician and ask for assistance on the home visit.

Inform client and family caregivers about not visiting them. A nurse who has any instincts of danger should avoid going on a visit to the client's home. The nurse should call the client's home and inform the client and the family caregivers about not visiting them that day. A nurse has the right to maintain his or her own safety and should not ignore instincts about any danger. The nurse does not have to inform a physician of any instincts and take assistance from the physician or from any colleagues during home visits. The nurse can visit the client the next day.

A nurse is considering a career in rehabilitation. Which of the following is the rehabilitation nurse's most important skill? Select one: A. Technical B. Decision making C. Interpersonal D. Cognitive

Interpersonal Although all these skills are important, rehabilitation nursing must first provide clients with emotional support. The rehabilitation nurse's most important quality is empathy, which is an element of interpersonal skills. Rehabilitation nurses must also be sensitive and offer encouragement and assistance to clients.

100-The nurse is caring for clients in a hospice setting. Which of the following best describes this type of healthcare?

It is a philosophy of care for dying clients

100-A 42-year-old male client with metastatic renal carcinoma complains of disturbed sleep. What nursing measure would improve his sleep?

Listening to soft music and relaxation tapes

100-A client admitted to home care hospice with terminal stage cervical cancer complains of constipation. What should the nurse provide, with orders, to manage constipation in this client?

MOM

100-The nurse is caring for clients in a hospice program. Which of the following is a recommended nursing care guideline when caring for this population?

Maintain a sense of humor.

100-The nurse is providing comfort measures for a client who is in hospice for terminal cancer of the liver. Which of the following is the most important factor in promoting client comfort?

Maintaining a patent airway

99-The nurse is providing preoperative care for a client undergoing ambulatory surgery for a tumor excision. Which of the following is a nursing responsibility?

Make sure the client is wearing one or two ID bands and an allergy band.

2. The nurse in a rehabilitation facility is caring for a client who sustained a cervical spine injury resulting in quadriplegia. What is the highest priority of care? a. Ensuring adequate bowel/bladder function b. Providing diversional activities c. Maintenance of a patent airway d. Providing skin care

Maslow's hierarchy 1st Maintenance of a patent airway to survival needs 2nd food and water, and eliminating wastes 3th activities of daily living (ADLs) are addressed, such as being able to feed, dress, and bathe oneself; the ability to move independently; and being able to communicate effectively 4th learns to work toward self-actualization and to be independent, and a creative and contributing member of society. or to provide skincare if immobility

100-The hospice nurse is initiating measures to help with nutrition for a client who has anorexia related to a terminal illness. Which of the following is a recommended guideline when providing nutrition to the terminally ill?

Most clients benefit from low oral intake in the last stages of illness.

100-The hospice nurse is administering dolasetron mesylate (Anzemet) to a client who is in hospice care. Which of the following is a symptom that this medication is designed to control?

Nausea

A nurse is providing home care to an aging client whose has Medicare insurance. What should the nurse explain to the client regarding the benefits of Medicare insurance? Select one: A. Replacing care provided by the family B. Obtaining skilled nursing or therapy C. Obtaining payment for personal care services D. Moving to senior care centers

Obtaining skilled nursing or therapy The nurse should explain to the client that Medicare coverage helps in obtaining skilled nursing or skilled therapy from care providers. The care providers are reimbursed based on client feedback. A client cannot use Medicare insurance to move to a senior care center. A client is provided home care to supplement the care given by family members rather than replacing family care. Medicare does not cover payments for personal care services, such as bathing, dressing, or feeding, because it is not treating an illness or injury, even if the care may be needed because of an injury or illness.

98-A nurse is providing home care to an aging client whose has Medicare insurance. What should the nurse explain to the client regarding the benefits of Medicare insurance?

Obtaining skilled nursing or therapy.

The nurse is teaching a client who has neurogenic bladder what foods to avoid. Which of the following would be eliminated from this client's diet? Select one: A. Bananas B. Whole grains C. Oranges D. Beef

Oranges Bladder irritants include caffeine, aspartame artificial sweetener, dairy products, tomato products, citrus fruits, spicy foods, alcoholic beverages, and sugar.

98-The visiting nurse is explaining payment systems for home care to an older adult client. Which of the following accurately describes how payment is made in one of these plans?

P4P is based on diagnosis and how well the agency provides care.

The visiting nurse is explaining payment systems for home care to an older adult client. Which of the following accurately describes how payment is made in one of these plans? Select one: A. With OASIS, payment is based on standard diagnoses B. P4P is based on diagnosis and how well the agency provides care. C. Fee for Service (FFS) is now charged by visit as opposed to by episode. D. Payment per day is more expensive for the client.

P4P is based on diagnosis and how well the agency provides care. In P4P (pay for performance), payment is not only based on a diagnosis, but also on how well the agency provides care to Medicare beneficiaries. A prospective payment system (PPS) for home care was instituted by Medicare in October 2000 and represented a major change in home care reimbursement (called FFS—Fee for Service). FFS is now by episode, rather than for each visit, as it was previously. Payment per day is less expensive for the client, but can require much collaboration among disciplines, so they all visit on the same day (to avoid multiple co-pay fees) . With OASIS, payment is based on selected OASIS (Outcome and ASsessment Information Set) outcome measures, the new version of which (OASIS-C) became effective January 1, 2010.

98-A nurse is providing short-term home care for an elderly client with depression. What should the nurse suggest that a caregiver do when taking respite from caring for the client?

Participate in recreational activities every day.

A nurse is providing short-term home care for an elderly client with depression. What should the nurse suggest that a caregiver do when taking respite from caring for the client? Select one: A. Avoid sleeping during the day or taking short naps. B. Eat a large breakfast with a smaller lunch and dinner. C. Participate in recreational activities every day. D. Instruct client's friends to avoid visits during home care.

Participate in recreational activities every day. A nurse assisting a caregiver in taking respite from daily activities should assist the caregiver to plan and participate in recreational activities daily. This helps in managing stress from daily activities. A nurse should teach the caregiver to take small, frequent meals every day to maintain constant energy rather than suggesting that the caregiver eat a large breakfast with a smaller lunch and dinner. The caregiver should be told to relax and take naps at regular intervals to relieve the stress and strain of providing constant care for the client. The caregiver should avoid sleeping only during the night. A caregiver should encourage the client's friends or his or her own friends to visit their home, because it provides a break for the caregiver and also helps the client to overcome depression.

100-A nurse is assessing the pain of a client who is in hospice. Which of the following is the most reliable indicator of pain?

Patient self-report

98-A RN working in home healthcare is assigned to be the case manager (CM) for a 78-year-old male client who has uncontrolled diabetes and pressure ulcers in various stages of healing. Which of the following would be the role of this CM? Select all that apply

Perform an initial home assessment visit. Evaluate the safety of the home. Evaluate the competency of available caregivers. Determine the client's eligibility for services.

A RN working in home healthcare is assigned to be the case manager (CM) for a 78-year-old male client who has uncontrolled diabetes and pressure ulcers in various stages of healing. Which responsibilities would be the role of this CM? Select all that apply. Select one or more: A. Determine the client's eligibility for services. B. Set up and dispense the client's medication. C. Evaluate the safety of the home. D. Evaluate the competency of available caregivers. E. Provide wound care for the pressure ulcers. F. Perform an initial home assessment visit.

Perform an initial home assessment visit., Evaluate the safety of the home., Evaluate the competency of available caregivers., Determine the client's eligibility for services. The CM makes an initial home assessment visit, and evaluates the safety of the home and competency of available caregivers. Often, the CM determines the client's eligibility for services. Sometimes in conjunction with the team the client's nursing or therapy care needs are determined. The CM and the team then determine what services are necessary and available for that client. The team assists the family to obtain needed equipment and makes suggestions about the setup of the home for optimal client care. Other members of the healthcare team would set up and dispense medications and care for pressure ulcers.

99-The nurse knows that community health centers are rapidly becoming the healthcare provider for many special populations. How has the client population for private clinics changed as a result of this trend?

Private clinics tend to see only clients with insurance.

A nurse is preparing a client with a new prosthetic leg for a visit from the physical therapist. What are high priority goals of long-term rehabilitation therapy? Select all that apply. Select one or more: A. Surviving the injury B. Giving pain relief C. Obtaining a complete recovery D. Promoting independence E. Coping with the loss

Promoting independence, Coping with the loss Rehabilitation emphasizes coping with physical or mental challenges and learning to adapt one's environment to facilitate independence and safety. The ultimate goal of rehabilitation is to restore the person to a quality of life that is highly satisfactory. Rehabilitation should offer clients optimal happiness and the ability to use all available assets. It should also offer clients the most independence possible, not just survival or pain relief. A complete recovery is not always possible, especially with long-term rehabilitation.

A 50-year-old client with paraplegia is wheelchair bound. Which instruction should the nurse give to the caregiver regarding adaptations to be made for the convenience of the client at home? Select one: A. Installing overhead showers B. Providing low coffee tables # removed to provide space for moving a wheelchair C. Providing small lights in darker areas D. Installing lowered electrical outlets # raised to provide without having to bend.

Providing small lights in darker areas The client's house should be provided with small lights in darker areas to prevent accidental falls. The nurse should also instruct the client's caregiver to install hand-held showers instead of overhead showers mounted on the wall because they are much easier to use.

99-Following a mass casualty due to a bus accident, 25 admissions are brought to an emergency department at the same time. Which of the following staff is most likely to perform the initial triage?

RN

99-The nurse is assessing a client in an ambulatory surgery center to determine what class of surgery will be performed. Which of the following are class III surgical procedures? Select all that apply.

Radical mastectomy Coronary artery bypass Replacement of heart valves

99-A school nurse is performing a routine health checkup of all the students in an elementary school. Which of the following are the responsibilities of a school nurse?

Recognize symptoms of common illnesses

98-A client who has Medicare insurance is to be discharged from the healthcare facility with a central intravenous catheter inserted. What should the nurse mention as a benefit of home care?

Reduced emotional strain

A client who has Medicare insurance is to be discharged from the healthcare facility with a central intravenous catheter inserted. What should the nurse mention as a benefit of home care? Select one: A. Prevention of infection B. Availability of ready-to-eat food C. Reduced medical expenses D. Reduced emotional strain

Reduced emotional strain A nurse should explain to the client that the family members and the client will experience reduced emotional strain as a benefit of home care. Providing home care does not prevent infection unless the family caregivers, the client, and the nurse follow strict aseptic techniques during care. A client can be provided with ready-to-eat foods even when he or she is in a healthcare facility and has difficulty swallowing solid foods or requires a balanced diet. A client who has Medicare insurance does not have to pay for medical expenses; instead, the care provider is reimbursed by the government.

100-An end-stage human immunodeficiency virus (HIV)-positive client admitted to a hospice with metastatic Kaposi sarcoma is found to be unresponsive when the nurse approaches the client for assessing the vitals. The client is declared dead after examination. What is the nurse's responsibility after the death of the client?

Refer the family to a bereavement support group.

A nurse is preparing a rehabilitation care plan for a client who was admitted to the healthcare facility with lower back pain. Which of the following is the goal of rehabilitation? Select one: A. Correction of the client's disability B. Prevention of such pain in the future C. Evaluation of the cause of the condition D. Restoring the client's physical abilities as much as possible

Restoring the client's physical abilities as much as possible Rehabilitation is defined as "restoring a person who becomes physically or mentally challenged to his or her former abilities, as much as possible." If complete restoration is impossible, rehabilitation assists the client to adjust and to live as independently as possible. Evaluation, correction, and prevention of the disability are not the goals of the rehabilitation process.

A nurse is preparing a list of members of the rehabilitation team required to care for a 20-year-old client with spinal cord injuries. Which of the following should be included as a member of the rehabilitation team? Select one: A. Sex therapist B. Laboratory instructor C. Orthodontist D. Pharmacist

Sex therapist A sex therapist should be included as a member of the rehabilitation team to address specific sexual problems. The other members of the rehabilitation team include the physician, physiatrist, nurse, advanced practice nurse, therapists (physical, occupational, speech, music, recreation), as well as a psychologist, vocational counselor, and social worker. Pharmacists, orthodontists, and laboratory instructors are not a part of the rehabilitation team.

The nurse is caring for clients with mobility alterations. Which of the following nursing considerations would be appropriate when caring for these clients? Select one: A. Sit or kneel when talking to clients in wheelchairs or scooters. B. Encourage the client to use assistance from family to ambulate whenever possible. C. Allow the client to determine the type of wheelchair or walker that is safest to use. D. Discourage clients from using their wheelchairs for sports-related activities.

Sit or kneel when talking to clients in wheelchairs or scooters. When talking to clients confined to wheelchairs or scooters, the nurse should sit or kneel, to be at the client's eye level. Many persons in wheelchairs take part in marathons, sports, and other activities along with able-bodied people. Each client is evaluated to determine which type of walker will be the most comfortable and safe to use.It is important to encourage the client to move independently as much as possible.

The nurse is preparing a rehabilitation plan for a client who has had a major stroke. Which of the following members of the team would help to improve the client's aphasia? Select one: A. Physical therapist B. Nutritionist C. Occupational therapist D. Speech therapist

Speech therapist The person who has had a major stroke (cerebrovascular accident [CVA]) often must overcome aphasia (difficulty in speaking). A speech therapist would be included to help with speaking, an occupational therapist helps with ADLs, a physical therapist helps with paralysis that may occur with stroke, and a nutritionist helps with meal plans and eating.

A nurse is to provide home care for an ill and frail client. What measure should the nurse implement to ensure the client's safety? Select one: A. Suggest the use of an alarm system to summon help. B. Do a fall risk assessment of the client's bedroom. C. Provide the client with socks as the main means of footwear. D. Instruct family members to use rugs to cover the floors.

Suggest the use of an alarm system to summon help. When a nurse is providing home care for an ill and frail client, the nurse must suggest that the family members use an alarm system for the client to summon help. This ensures that the client gets immediate assistance if needed. A nurse should provide the client with footwear with nonskid soles made of leather or rubber rather than providing socks; socks can cause sliding. The nurse should instruct the family members not to use any rugs or cloth to cover the floor. This prevents the client from slipping or tripping over such floor covers. The nurse should do a fall risk assessment for the client's entire home rather than only the client's bedroom.

According to Maslow, which of the following needs should be the priority for the client in the acute stage of illness? Select one: A. Activities of daily living B. Survival needs C. Self-esteem needs D. Self-actualization needs

Survival needs When Maslow's hierarchy of needs is applied to rehabilitation, the person in the acute stage of illness or injury first requires assistance with basic survival needs, such as maintaining an open airway and an adequate oxygenation level, obtaining food and water, and eliminating wastes. Next, activities of daily living (ADLs) are addressed, such as being able to feed, dress, and bathe oneself; the ability to move independently; and being able to communicate effectively. Later, the person learns to work toward self-actualization and to be a creative and contributing member of society.

98-The nurse is counseling the caregiver of a home care client with a feeding tube who requires constant attention. Which of the following measures would the nurse suggest? Select all that apply.

Take a vitamin or mineral supplement, as prescribed. Get plenty of rest and take naps. Encourage the client's friends and family to visit. Attend a support group.

The nurse is counseling the caregiver of a home care client with a feeding tube who requires constant attention. Which measures would the nurse suggest?Select all that apply. Select one or more: A. Manage stress to avoid seeking outside counseling. B. Take a vitamin or mineral supplement, as prescribed. C. Get plenty of rest and take naps. D. Encourage the client's friends and family to visit. E. Listen to loud music while at the bedside. F. Attend a support group.

Take a vitamin or mineral supplement, as prescribed., Get plenty of rest and take naps., Encourage the client's friends and family to visit., Attend a support group. The nurse should take vitamins or mineral supplements, as prescribed, get plenty of rest and naps, encourage visits from friends and family (to get a break and stimulate the client), and attend support groups to share feelings with others. The nurse should manage stress and seek outside counseling, if necessary, and listen to soothing music at the client's bedside (this is also helpful for the client).

99-Although all roles of the nurse are important during ambulatory surgery, which of the following is the most important?

Teacher

100-A caregiver of a client in hospice tells the nurse that if she "doesn't get a break from the situation, she will no longer be able to care for her family member." The nurse recommends respite care. What generally occurs when respite care is initiated?

The caregiver "takes a break," usually for a period of less than 30 days.

100-A client diagnosed with end-stage leukemia is placed in hospice care. In a hospice setting, who is in control of client care?

The client

100-A client with end-stage renal failure is being admitted to a hospice program. Which of the following is a requirement for admission to this type of program?

The client must have a diagnosis of a progressive, terminal illness.

A client with quadriplegia complains of fecal impaction. Which of the following should the nurse recommend to the client as part of the continence program? Select one: A. The client should eat a low-protein, low-calorie diet. # well-balanced diet B. The client should maintain a regular time for elimination. C. The client should manually disimpact daily. D. The client should restrict fluid intake to relieve the problem. # take adequate fluid

The client should maintain a regular time for elimination.

99-A client presents at a community healthcare center for management of hypertension. Which of the following is one characteristic of the CHC that distinguishes these clinics from primary care clinics?

The services are tailored to fit the needs of the community.

99-A nurse is providing care for clients in an ambulatory care setting. Which of the following is an initial priority function for which this nurse is responsible?

Triaging the client to determine clinical acuity

99-The nurse is caring for clients in an ambulatory care center. Which of the following might be the responsibility of the nurse?

Ultrasound

99-Which of the following innovations has greatly improved continuity of care in the healthcare system?

Use of the electronic health record

100-The nurse is providing bereavement care for a family who lost a loved one. Which of the following is a role of the nurse in this process?

Visit the family after the client's death to evaluate how they are coping.

98-A woman who lives several miles away from her aging father seeks the help of a home care agency to look after him. What expenses should the nurse say are covered by Medicare?

Visits by a PT

A woman who lives several miles away from her aging father seeks the help of a home care agency to look after him. What expenses should the nurse say are covered by Medicare? Select one: A. Visits by a physical therapist B. Spiritual support provided by chaplains C. Personal care services by a housekeeper D. Home delivery of meals

Visits by a physical therapist The nurse should explain that Medicare covers the visits by a physical therapist. Skilled nursing services such as this are covered under Medicare. However, spiritual support by chaplains and home delivery of meals are not skilled nursing services and, therefore, are not covered by Medicare. Similarly, personal care services by a housekeeper are not covered under Medicare.

100-A 56-year-old male client with metastatic lung cancer rates his pain as a 5 on a pain assessment scale. What type of pain medication would be appropriate for this client?

Weak opioid

A nurse works in a home care agency that uses a center of excellence (COE) concept and functions to assist local home care nurses. What services would be provided by these nurses? Select all that apply. Select one or more: A. Wound care B. Continence care C. Bowel/bladder retraining D. Psychiatric management E. Light housekeeping F. Cooking meals for clients

Wound care, Psychiatric management, Continence care, Bowel/bladder retraining With a COE, a team of nurses with specific expertise is in place to assist local home care nurses. The expertise of a COE team may include wound care, continence care and bowel/bladder retraining, IV and other high-technology care, psychiatric management and crisis intervention, maternal-child healthcare or maternity consultation, and pediatric high-technology, including care of ventilator-dependent children. The COE nurses may make the actual home visits or may serve as consultants to a staff nurse from the local home care agency. Housekeeping and cooking may be provided by home care aides, and daily medications would be provided by visiting home care nurses.

5. The home health nurse requires the assistance of Center of Excellence (COE) nurses for a client. Which client would benefit the most from this specialized nurse? a. A pediatric client that is ventilator dependent b. A client with a small sacral pressure wound c. A client requiring teaching of insulin administration d. A client who requires indwelling catheter changes monthly

a. A pediatric client that is ventilator dependent

The home health agency is preparing to dispatch the nurse to perform a new admission for home care. What should the nurse be sure is done before making this home visit? a. A risk assessment for the home has been performed. b. Make sure the client is able to pay for the visit. c. Have a police officer arranged to meet the nurse at the house. d. Have social service visit the client before the nurse is dispatched.

a. A risk assessment for the home has been performed.

4. According to Maslow's hierarchy of needs, what would be a priority need in the acute phase of rehabilitation? a. Maintenance of a patent airway b. Bathing the client c. Dressing in appropriate clothing. d. Adequate communication

a. Maintenance of a patent airway

3. A family member caring for a client at home informs the nurse that caring for the client is exhausting because the client is unable to be left alone. What suggestion can the nurse offer to alleviate the risk of caregiver burnout? a. Make a referral for respite care. b. Inform the caregiver that the client will not be around much longer. c. Tell the family member to leave the client home alone for brief periods. d. Tell the family member to find someone else to care for the client.

a. Make a referral for respite care.

1. The nurse is caring for a client who is admitted to the rehabilitation facility after a stroke. What outcome does the nurse anticipate will be achieved for this client? Select all that apply. a. The client will not require assistance with activities of daily living (ADLs). b. The client will not have another stroke. c. The client will regain former abilities. d. The client will regain a level of independence. e. The client will adjust to the disability.

a. The client will not require assistance with activities of daily living (ADLs). c. The client will regain former abilities. d. The client will regain a level of independence. e. The client will adjust to the disability.

4. The LV/LPN would like to work for a home health agency. What is the best opportunity for this nurse? a. Working with a child with special needs b. Working as a home health supervisor c. Working as a contract nurse to perform admissions d. Working to administer IV medications via vascular access

a. Working with a child with special needs

99-Which of the following healthcare workers provides most of the primary care to clients of all ages in the CHC/FHC?

advanced practice nurses

99-A nurse is assessing a client admitted to the emergency department with a laceration wound in the abdomen. Which of the following can the nurse perform independently in an emergency care setting?

applying cold packs

3. A client with hemiplegia is being taught how to dress more easily and independently. How should the nurse demonstrate this to the client? a. Use a tool, such as tongs, to place the clothing on the body. b. Place the clothing on the unaffected arm or leg first. c. Have someone else dress the client. d. Place clothing on the affected arm or leg first.

b. Place the clothing on the unaffected arm or leg first.

99-A nurse is assessing a client who is a potential candidate for carpal-tunnel release. Which of the following factors are used to determine a client's suitability for ambulatory surgery?

underlying disorder

Which prosthesis helps to provide tissue compression & vascular support to a 50y female cl with 50% burn? a. Supportive braces # support the legs when walking b. Compression appliances # breast cancer clients to prevent swelling of lymph nodes c. special tight gloves d. Dynamic splints # skeletal disorders to function and move more easily

c

Which prosthesis helps a client with quadriplegia maintain an upright position & prevents vascular collapse? a. A hook with adaptive splint prosthesis # provides movement and control similar to normal thumb-finger opposition b. A Lofstrand crutch # has a strap that can be fastened around the client's arm, helping the client to free the hand when needed.

c. A resting splint # hold the body part stationary and prevent hand or limb contractures. d. Inflatable trousers Answer: d

1. The nurse is preparing to transition a client from the acute care facility to home with assistance from home health services. What is important for the nurse to do to ensure safe and appropriate follow-up care? a. Have a representative from the hospital go home with the client. b. Call the client the day after discharge to be sure the client is well. c. Communicate with the home health nurse prior to discharge. d. Call social service to make a home visit the next day.

c. Communicate with the home health nurse prior to discharge.

98-The nurse is making a first visit with a client receiving home care for COPD. Which of the following safety measures should the nurse take when driving to, and walking into, the client's home?

check guidelines before giving a ride.

99-A 25-year-old client who sustained a knee injury when playing football is advised to undergo arthroscopy and joint repair. The client has no relevant past medical or surgical history. Into which of the following groups will the nurse classify the client?

class I

99-The nurse working in a free-standing clinic treats only "vertical clients." Which of the following is an example of this type of client?

client who has bronchitis

99-Which of the following clients would be considered a class II for outpatient surgery?

client who has mild diabetes and is undergoing tubal ligation.

99-A nurse is educating a potential client for polyp removal that same-day surgery can be safer and have faster recovery than inpatient surgery. Which of the following is a benefit of outpatient surgery?

clients ambulate sooner after surgery

98-A nurse is to provide home care for an ill and frail client. What measure should the nurse implement to ensure the client's safety?

suggest the use of an alarm

99-A nurse is teaching a client who is to undergo ptosis correction at an ambulatory surgery center about the procedure. Which of the following is information the nurse should provide to the client?

discontinue use of any herbal supplement.

99-The nurse assists with many procedures in same-day surgery centers. Which of the following procedures allows accurate visualization and manipulation of internal structures and removal of organs and biopsy samples through a small "stab wound" or "port"?

endoscopy

100-The nurse is administering pain medications to clients with severe pain related to end-stage diseases. Which of the following is the first route of choice for these clients?

oral

99-A nurse is assessing a 48-year-old client presenting with fever at the community health center. Which of the following is usually a nonnursing procedure performed by the nurse in this setting?

perform lab procedures

99-A nurse assigned to the operating room of a same-day surgery clinic is arranging the equipment and supplies required for laproscopic appendectomy of a client. Which of the following equipment is used in laproscopy?

pickup forceps

99-The nurse is explaining the benefits of ambulatory surgery to a client. Which of the following risks is reduced using this method of surgery?

resp complications, infection, and hemorrhage.