home care

The home health nurse has scheduled a visit to a client who lives in a neighborhood that is known to be unsafe because of gang activity. Before going to the client's home, what should the nurse do? 1. Call for an escort. 2. Call the client to let the client know the nurse is on the way. 3. Ask if the client could meet the nurse at the agency. 4. Take a second nurse along on the visit.

1

A client being discharged needs physical therapy for progressive ambulation, wound care to treat a postoperative wound, and assistance with the payment of hospital bills. Before the nurse contacts a home care agency, who should write the order for the client to receive home care? 1. Physician 2. Nurse 3. Social worker 4. Physical therapist

1

After completing an initial assessment, the nurse identifies teaching that the client will need. Why did the nurse identify learning needs for this client? 1. Lack of knowledge related to health conditions and self-care 2. The fact that there is little time to complete education in the acute care setting 3. The fact that teaching someone who is willing to learn is easier in the home 4. The need for reimbursement for education by Medicare

1

During a home visit, the nurse is concerned that a client recovering from hip replacement surgery is at risk for falling in the home. What information from the home assessment did the nurse use to come to this conclusion? Standard Text: Select all that apply. 1. Laminated floors highly polished 2. Scatter rugs in the kitchen and bathroom 3. Smoke detector battery low in the bedroom 4. Cleaning solution placed in an unlabeled jar 5. Expired medication in the bathroom cabinet

1, 2

A client has been receiving home care for several weeks. Which individual should the nurse realize is responsible for ensuring that the client is receiving care at the appropriate times and in the appropriate amounts? 1. Client 2. Nurse 3. Physician 4. Client's spouse

2

A client who has been the recipient of home health care has made the decision to discontinue hemodialysis. The client understands all the consequences of this decision and is not supported by his family. The nurse is meeting with the family to help them understand the significance of the client's decision and to help them support the client during this difficult time. In which role is the nurse functioning? 1. Caregiver 2. Advocate 3. Educator 4. Counselor

2

A home health client has a complicated case involving occupational therapy, respiratory therapy, a dietitian, the nurse, and a nurse's aide who provides assistance with bathing, housekeeping, and grocery shopping. Which care provider should be prepared to coordinate this client's care? 1. Physician 2. Nurse 3. Social worker 4. Home health agency

2

A home health client lives alone in a small apartment and has only one phone, which is a land line. What safety recommendation should the visiting home health nurse make for this particular client? 1. Suggest that the client move to a nursing home or assisted living dwelling. 2. Recommend that the client be enrolled in an emergency response system. 3. Enroll the client in a program that places all of the client's vital medical information in one place for emergency personnel. 4. Have the client post a list of emergency numbers (fire, police, ambulance) near the phone.

2

During a home visit, the nurse explains the procedures for preventing infection in a central venous access device to the spouse who watches while the nurse hooks the client to the medication infusion. Which role is the nurse performing at this time? 1. Caregiver 2. Advocate 3. Educator 4. Coordinator

3

During the first home care visit, the nurse determines that the client needs speech therapy, physical therapy, and custodial care several times a week. When should the nurse schedule the client's care to begin? 1. As soon as the nurse completes the initial assessment 2. As soon as the client agrees to the care 3. When the physician signs the plan of care the nurse develops 4. Within 48 hours of the nurse's visit

3

While reviewing a health insurance plan, the nurse learns that a client has coverage for durable medical equipment (DME). What care need should the nurse identify as being covered by the client's health plan? 1. Dressings and bandages 2. Medications 3. A hospital bed 4. Visits by the home health nurse

3

During a home visit, the client with terminal cancer undergoes respiratory arrest. The client has agreed to a DNR (do not resuscitate) order; however, the spouse tells the nurse to call 911. What action should the nurse take? 1. Assess vital signs. 2. Call 911. 3. Start CPR. 4. Remind the spouse of the client's desires.

4

The nurse is hired to provide home care through a community agency that is operated by the state health department and financed by taxes. In which type of agency is this nurse employed? 1. Institution based 2. Private 3. Not-for-profit 4. Official

4

The nurse would like to admit a client to home health care, but is worried about insurance reimbursement. What client action is causing the nurse to question if home care can be prescribed for this client? 1. Lives with a spouse 2. Needs skilled care 3. Needs intermittent care 4. Drives a car for trips to the barber

4

To help a home health client with a difficult medication regime, the nurse contacts the pharmacist for ideas to facilitate the process. Which behavior did the nurse demonstrate when caring for this client? 1. Hands-on care 2. Direct care 3. Advocacy 4. Indirect care

4

The nurse is taking a tour of a home care agency as part of the interview process. Which services should the nurse recognize as being provided through this health agency? 1. A case manager arranging services to meet the client's need for physical therapy after a fall 2. A nurse educating the pregnant teenager on the signs of premature labor 3. A durable supply company delivering a wheelchair to a client with spina bifida 4. A nurse assessing the feet of a home-bound diabetic client 5. A grocery store delivering groceries to a client recovering from cancer surgery

1, 3, 4

A home health nurse has a weekly visit to a client living in less than desirable cleanliness. The client has a central venous access device and requires weekly infusion therapy. What is the best way for the nurse to protect the client against infection? 1. Have the client wash her hands before the infusion begins. 2. Practice strict aseptic technique during the infusion process. 3. Help the client clean the room before starting the infusion. 4. Suggest that the client have a housekeeper come on the morning of the infusion.

2

An older client being discharged from an acute care facility is prescribed home care. When should the home care nurse see the client to understand needs for safety and mobility? 1. At the initial home visit, in order to see the client in the home environment 2. While the client is still a patient in the acute care hospital 3. After the client has been home for a few days and can help the nurse decide what is needed 4. When the spouse is available to assist in the assessment

2

During orientation with a home care agency, the nurse is learning the difference in care delivery between home health nursing and community nursing. What should the nurse understand as being the focus of home health care nursing? 1. Individuals, families, and groups 2. The individual and his or her family 3. The terminally ill client and his or her family 4. The client in a home setting

2

The nurse is concerned that the spouse of a home care client with multiple sclerosis is experiencing caregiver role strain. What did the nurse observe to come to this conclusion? 1. The home appears cluttered. 2. The spouse expresses feelings of anger. 3. The spouse reports decreased energy. 4. The spouse reports that she is learning how to manage finances. 5. The client asks when the nurse will return for the next visit.

2, 3

The nurse learns that two new home care agencies are opening in a community. What should the nurse consider as reasons why home care agencies are increasing in numbers? 1. The need for custodial care 2. Third-party payers who support cost control measures 3. The increase in the older adult population 4. The decreasing need for acute care 5. The focus on the needs of the community

2, 3

The nurse is attending a seminar that focuses on the changes within the home health care industry. Which statements that the nurse makes indicate an understanding of home care as a primary health service delivery system? 1. "It's unfortunate that clients can be screened for illnesses in the privacy of their own home." 2. "With people living well into their 70s and 80s, the healthcare system is being stressed immensely." 3. "The cost of acute hospital-based health care has become an economic burden to most people." 4. "A client's chronic cardiac problems can be monitored well with in-home health services." 5. "It relieves so much stress when care can come to them instead of their going to the health provider."

2, 3, 4, 5

While assessing a client's environment for safety concerns, the nurse finds that most of the rooms in the house have only one outlet with various cords entering the outlet. When this concern is shared with the client and spouse, they state that "this is the way we've lived for years." What should the nurse do? 1. Provide telephone numbers for local electricians. 2. Continue to persuade the client to have the home rewired. 3. Not bring the subject up again. 4. Document the findings and the client and spouse's response to the concern.

4

The nurse has two older parents who were recently hospitalized at the same time and are being discharged home on the same day. What should the nurse do to ensure these family members receive the highest quality of care in the home? (select all that apply) 1. Call off from work to provide care to both parents. 2. Adjust his or her personal schedule to provide care to the parents. 3. Move in with the parents until conditions are stabilized. 4. Determine if custodial support is needed for the parents. 5. Find out when the home care nurse is scheduled to arrive.

4, 5