coursepoint ch 2
A nurse educator for a local home care company is teaching staff nurses on the use of the Outcome and Assessment Information Set (OASIS). What statement will the nurse include when teaching about the OASIS?
"Results are used to improve overall quality improvement efforts."
Which element is least likely to be a characteristic of an expected outcome of a nursing intervention?
Nurse-centered
A client receives dialysis four times a week at a dialysis center. Which type of care is provided at a dialysis center?
ambulatory care
A client with multiple sclerosis is unable to independently complete activities of daily living. Which recommendation will the nurse make when the spouse refuses to participate in providing the client's personal care?
"A personal caregiver might be a good idea."
A nurse is evaluating a client's discharge collaboration between the referring agency and the home care agency. What response by the client would indicate an understanding of the discharge planning process?
"The nurse helped me make a list of my needs and goals for recovery and shared them with the home care team"
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?
"You will care for individuals and families and play a role in health education, illness prevention, and promotion."
A novice home health nurse is receiving training on personal safety in home health care. What statements does the nurse recognize as true regarding ensuring personal safety when first visiting a client? Select all that apply.
Avoid visits at night if at all possible. Carry agency identification at all times and ensure it is visible. Park the car near the client's home, and lock the car during the visit. Become familiar with the layout of the client's home.
A community health nurse is aware that restoration of health often depends on appropriate interventions performed early in the course of a disease. Which client is most likely to seek health care late in the course of his or her disease process and deteriorate more quickly than other clients?
A client who has been homeless for an extended period of time
An urban, community-based nurse is looking for community resources for a client who has complex rehabilitation needs and several comorbid, chronic health conditions. Where is the best place for the nurse to search for appropriate resources?
A community directory
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 clients with a higher acuity?
A higher acuity client requires a greater need for highly skilled care.
In which situation is the nurse providing appropriate discharge planning?
Assessing the client's support system at home during the admission assessment
The nurse is completing passive range-of-motion exercises with a client recovering from an acute illness. A muscle spasm occurs in the client's left arm while exercising it. Which action will the nurse take?
Move the joint slowly to the point of resistance and apply gentle pressure.
A nurse is reviewing the medical record of a client to determine his eligibility for home care services. Which of the following would alert the nurse to a potential problem in this area?
Client attends social groups at a senior center three times a week.
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?
Client's current health status
The nurse is starting a new position with a home health agency. Which population most frequently uses home care services?
Clients who are older adults
The home health nurse and the parish nurse have separate roles in health care. What best describes the common factor all community-based nurses share?
Community health nurses focus on community needs as well as the needs of individual patients.
A home care nurse is visiting a new client and notes that the client's home is very messy. There are dirty dishes piled everywhere, the house smells of garbage, and there are very few surfaces that are clean. How should the nurse respond?
Enter the home and continue to treat the client.
A home health nurse is visiting a client's home to perform wound care. The client lives in an impoverished neighborhood and the nurse notes that the client does not have running water. What nursing action will best control infection, despite no running water?
Hand hygiene techniques
A nurse working in the community is involved in secondary prevention. Which activity would most likely apply?
Health screening for diabetes risk
A nurse is working as part of a team developing a community-based care program for the local homeless population. Which of the following would be important to keep in mind when developing the program? Select all that apply.
Homeless people often have no or insufficient health insurance. Health problems are often related to a person's living situation. Ill homeless people often deteriorate more rapidly than those who are not homeless.
Which capability corresponds with home health care?
Improvises when providing care
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?
Infections
Which setting has been the traditional site for the nursing workforce?
Inpatient units
A home care nurse enters the home of a client and finds that the client's son is noticeably intoxicated. The son, who is slurring his words, is becoming increasingly agitated. What action by the home care nurse would be most appropriate?
Leave the home and reschedule the visit.
Which of the following would be least helpful in ensuring the safety of a home care nurse?
Making visits in the late evening hours
According to the 2013 OASIS data study, which client would be at greatest risk for re-hospitalization?
Male client who requires assistance to ambulate
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?
Need for control over a situation
A novice nurse is learning the difference between community-based nursing and community-oriented nursing. Which scenario does the nurse recognize as a role of the community-oriented nurse?
Nurse working a booth at a health fair performing blood pressure and glucose screenings
Which nursing interventions related to a client with breast cancer are appropriate for a nurse working in a community-based setting and a hospital-based nurse? Select all that apply.
Patient education Promotion of a positive body image Intravenous (IV) therapy Incision care
A group of nursing students are preparing for a class presentation that describes community-based nursing. Which of the following would they most likely include?
Practice on all the three levels of preventive care
The nurse is working in an ambulatory health clinic. What is the focus of community-based nursing practice?
Promoting and maintaining population health and preventing and minimizing disease progress
A client in an acute care facility is assigned a case manager to oversee and coordinate care. What important function does a case manager have?
Provide early, thorough discharge planning.
A nurse is working as an occupational health nurse at a local factory. With which activity would the nurse least likely be involved?
Providing case management services for the employees
Which safety precautions should the home care nurse implement? Select all that apply.
Schedule visits during the day. Post the nurse's visit schedule at the agency. Become familiar with all exits from the client's home.
The home care nurse is finishing a visit with a client. What teaching points should the nurse cover with the client and client's family member prior to leaving? Select all that apply.
Teach back instruction on new procedures or medication administration Positive findings during the visit in order to provide encouragement A review of the teaching plan with written instructions
A nurse is caring for an older adult with emphysema. Which nursing action demonstrates primary prevention?
Teaching the client various methods to help prevent pneumonia
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?
Telephone the client to obtain permission to visit.
A client is going to be in subacute care 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?
The RN will coordinate the client's care
After making the initial home visit, a nurse develops a plan of care for a client with diabetes. As part of the plan of care, the nurse identifies the nursing diagnosis "deficient knowledge related to daily insulin administration for diabetic self-care." Which outcome would be most appropriate?
The client will demonstrate independence in daily insulin self-administration.
The nurse is making an initial home visit to assess a patient for home health services. Which patients most frequently require home health services?
The frail and elderly who need skilled care
A nurse works in a community setting that deals with a large number of homeless individuals. Which of the following would be most important for the nurse to understand?
The health problems faced by homeless people are often related to their living situation.
A home care nurse is planning to visit a client newly diagnosed with diabetes. Further review of the chart reveals the client is of Japanese heritage. Upon arriving at the home, the home care nurse observes several pairs of shoes on a mat next to the door. Which of the following actions by the nurse demonstrates cultural competence?
The nurse removes her shoes and announces her arrival.
The nurse is making an initial home visit for a client requiring wound care. What statement is true regarding safety during a home visit by a nurse?
The nurse should never walk into a patient's home uninvited.
A client receiving home care observes the visiting nurse place a bag on a paper barrier at the beginning of the visit. To avoid misunderstanding, what does the nurse teach the client about the practice of placing the supplies on the barrier?
The placement of the barrier is to follow universal precautions.
Results from the 2013 OASIS data study revealed that data from the study can be used to identify individuals at greatest risk for readmission to the hospital. Using this data, what can the nurse determine will decrease the readmission rate of hospitalizations?
The shift of resources to the community
A public health nurse administers influenza vaccines to a group of individuals during a community vaccination clinic. The nurse understands that this action is considered primary prevention due to which statement?
The vaccination focuses on health promotion and prevention of illness.
A community health nurse understands the importance and impact of cultural competence when caring for clients in the community. In what situation will the nurse find that cultural competence is particularly important?
When members of the community share a heritage that is unfamiliar to the nurse
A client is being treated for injuries resulting from a skateboarding accident and is very agitated as the nurse cleans several gashes on the client's head. Which of the nursing responsibilities outlined by the American Nurses Association is the nurse fulfilling?
administering medications, wound care, and numerous other personal interventions
A client is admitted to an acute care facility after having a stroke. The client will require a variety of healthcare services throughout the hospital stay as well as coordination of care prior to discharge. What referral would be a priority for overseeing the client's care?
case management
Which tools do case managers commonly rely on to plan and coordinate client care?
clinical pathways, practice guidelines, and standards of care
The nurse is transitioning to a home health setting. What factor has resulted in a shift in the health care delivery setting?
growing number of elderly clients
A client has end-stage chronic obstructive pulmonary disease (COPD) and is terminally ill. The family wants the client to spend their last days in a facility that will be able to keep the client comfortable and control their severe dyspnea. What facility will meet the needs of the client and family?
hospice care
A client is being discharged home after a hemorrhagic stroke. To which discipline should the nurse case manager make a referral to improve the client's ability to perform activities of daily living?
occupational therapy
What are the responsibilities of a case manager?
plan and coordinate the client's progress through the various phases of care and maximize fiscal outcomes
The nurse is providing a community education program about sexually transmitted infections for a group of 13- to 16-year-olds. What type of prevention is the nurse targeting?
primary prevention
