MedSurg - 2 Community Based Nursing

A nurse is evaluating a patient's discharge collaboration between the referring agency and the home care agency. What response by the patient would indicate an understanding of the discharge planning process? a) "The nurse helped me make a list of my needs and goals for recovery and shared them with the home care team." b) "My wife sat down with the discharge planner and established realistic and measurable goals for my recovery." c) "The doctor provided a list of behavioral outcomes for me and his nurse faxed them to the home care agency." d) "My daughter is my health care power of attorney and she decided when I left the hospital and selected my home care provider."

"The nurse helped me make a list of my needs and goals for recovery and shared them with the home care team."

The home nurse is planning visits to the following patients: a newly diagnosed diabetic patient, a patient with congestive heart failure (CHF) with a 3-pound weight gain overnight, a postoperative patient requiring a dressing change, and a patient on warfarin (Coumadin) scheduled for monthly international normalized ratio (INR) testing. Which patient is should be the first visit of the day? a) Postoperative patient requiring a dressing change b) A patient with CHG who has had a 3-pound weight gain overnight experiencing dyspnea c) Patient on warfarin (Coumadin) scheduled for monthly INR testing d) Newly diagnosed diabetic patient requiring teaching

A patient with CHG who has had a 3-pound weight gain overnight experiencing dyspnea

What should the school nurse working in the elementary school setting be aware is one of the most frequent health care problems to affect this population? a) Eating disorders b) Infections c) Drug abuse d) Emotional problems

Infections

Which of the following is the least likely to be a criterion of an expected outcome of a nursing intervention? a) Realistic b) Behavior-centered c) Nurse-centered d) Measurable

Nurse-centered

Which of the following situations describes the accurate order of activities when making a home visit? a) Review agency policies regarding visits, ask permission to enter home, perform hand hygiene, and document care provided. b) Call patient to arrange time for visit, perform hand hygiene, ask permission to enter home, only bring required equipment into the home. c) Confirm need for visit with referring agency, park away from the home, perform hand hygiene, and document teaching and patient response to teaching. d) Investigate the neighborhood prior to visit, leave a message telling the patient the time and nature of the nurse's visit, ask permission to enter the home, and include patient behaviors in charting outcomes.

Review agency policies regarding visits, ask permission to enter home, perform hand hygiene, and document care provided.

Which of the following is a growing population of those who are homeless? a) Employed b) Adolescent males c) Functional families d) Women with children

Women with children

A client is going to be in a subacute care unit for approximately 30 days. The client will require frequent assessments and periodic review of the client's progress. What role will the registered nurse have in the care of this client? a) The RN will coordinate the client's care. b) The RN will order the various treatments for the client. c) The RN will ensure that the client eats 100% of the meals. d) The RN will provide direct care for the client.

a) The RN will coordinate the client's care.

A nurse who is considering the possibility of becoming involved in home care asks a home care nurse about the characteristics needed for this practice area. Which of the following would the home care nurse be least likely to include? a) Need for control over a situation b) Respect for client's differences c) Ability to improvise d) Nonjudgmental attitude

a) Need for control over a situation

A major goal for home care nurses is to a) restore maximum health function. b) promote the health of populations. c) maintain the health of populations. d) minimize the progress of disease.

a) restore maximum health function.

A student nurse asks the nursing instructor, "What will my role as a nurse encompass after I graduate?"What is the best response by the nursing instructor? a) "You will take care of clients who are ill in a hospital or long-term care facility." b) "You will care for individuals and families and play a role in health education, illness prevention, and promotion." c) "It will all depend on where you want to work when you graduate. Nurses do different things in healthcare." d) "You will care for a variety of clients of all ages when they are ill."

b) "You will care for individuals and families and play a role in health education, illness prevention, and promotion."

The charge nurse is making assignments for a group of clients on a medical unit. When reviewing the acuity of the clients, the charge nurse assigns the RN to the clients with higher acuity levels. Why would the charge nurse assign the RN to the patient's with a higher acuity? a) Higher acuity clients request the services of an RN versus other care providers. b) A higher acuity client requires a greater need for highly skilled care. c) Assigning an LPN would allow them to provide care out of their scope of practice. d) LPNs do not understand how to care for clients with complex disorders.

b) A higher acuity client requires a greater need for highly skilled care.

Your client is an 11-year-old boy being treated for injuries that resulted from a skateboarding accident. He is very agitated as you clean several gashes on his head. Which of the nursing responsibilities outlined by the American Nurses Association are you fulfilling? a) Providing health promotion, counseling, and education b) Administering medications, wound care, and numerous other personal interventions c) Interpreting patient information and making critical decisions about needed actions d) Performing physical exams and health histories

b) Administering medications, wound care, and numerous other personal interventions

The advance practice nurse is preparing to write a grant for a local homeless shelter. Based on the nurse's knowledge of a growing population of homeless people, the nurse includes funding for which of the following topics? a) Obesity b) Immunizations c) Skin cancer d) Driver's education

b) Immunizations

Your aunt is in end-stage renal failure. She has been moved to an inpatient hospice facility. What is the rationale for her being placed in hospice? a) She no longer requires skilled care. b) She is terminally ill and needs symptom control. c) She no longer has health insurance. d) She needs help to regain her ability to perform activities of daily living.

b) She is terminally ill and needs symptom control.

Which of the following factors have contributed to the shift in health care delivery from inpatient to outpatient settings? Select all that apply. a) Increasing hospital revenues b) More flexible insurance regulations c) Changes in federal legislation d) New population trends e) Alternative health care delivery systems

c) Changes in federal legislation d) New population trends e) Alternative health care delivery systems

A home care nurse is assessing a client's need for home visits. Which of the following would the nurse use as the primary determinant for future visits? a) Agency's policies b) Available community resources c) Client's current health status d) Client's insurance provider

c) Client's current health status

In what area of nursing practice does the nurse provide palliative care in the patient's home? a) Parish nursing b) Occupational nursing c) Hospice d) Rehabilitation

c) Hospice

Which of the following would be least helpful in ensuring the safety of a home care nurse? a) Having a charged cell phone readily available b) Being familiar with exits from the home c) Making visits in the late evening hours d) Parking near the client's home

c) Making visits in the late evening hours

Which of the following nursing actions is appropriate for the home care nurse to do? a) Volunteering to administer flu vaccinations and the local free clinic b) Organizing a free breast cancer screening for homeless women c) Teaching pursed lip breathing to a client diagnosed with chronic obstructive pulmonary disease (COPD) d) Writing a grant to obtain funding to establish a homeless shelter

c) Teaching pursed lip breathing to a client diagnosed with chronic obstructive pulmonary disease (COPD)

Which of the following is true regarding safety during a nurse's home visit? a) The nurse should schedule visits according to the patient's lifestyle. b) The nurse should park his or her car away from the home. c) The nurse should never walk into a patient's home uninvited. d) The nurse should take reactive measures.

c) The nurse should never walk into a patient's home uninvited.

Which setting has been the traditional site for the nursing work force? a) Same-day surgery units b) Clinics c) Dialysis units d) Inpatient units

d) Inpatient units

A home care nurse is planning to visit a 60-year-old client diagnosed with heart failure for the first time. Which of the following would be most appropriate for the nurse to do? a) Contact the client to say that the nurse is coming out to visit. b) Ask the client if he lives alone or with someone else. c) Obtain information about the client's health insurance. d) Telephone the client to obtain permission to visit.

d) Telephone the client to obtain permission to visit.

Which of the following safety precautions should the nurse implement as a home care nurse? Select all that apply. a) Buy a new car to have reliable transportation. b) Become familiar with all exits from the patient's home. c) Conduct the visit regardless of personal safety concerns. d) Perform all visits alone to allow for patient privacy and confidentiality. e) Post the nurse's schedule of visits at the agency. f) Schedule visits during the day.

• Become familiar with all exits from the patient's home. • Post the nurse's schedule of visits at the agency. • Schedule visits during the day.

The home care nurse is in the process of deciding the need for future home visits. Which of the following factors does the home care nurse need to consider? Select all that apply. a) Current health status of the patient b) Educational needs of the patient c) Mental status of the patient d) Cleanliness of the patient home e) Level of patient self-care f) Existing cultural language barriers

• Level of patient self-care • Educational needs of the patient • Current health status of the patient • Mental status of the patient

Which of the following would be a role of the school nurse? a) Discussing a student's school performance b) Caring for major injuries c) Monitoring immunization status d) Performing comprehensive physical examinations

c) Monitoring immunization status