Deck 16: Nursing Care of Patients at Home

Question 1

During a home visit,the patient asks if his spouse could take one of the patient's prescribed pain pills for a severe headache.How should the nurse respond to this request?

A) Explain that only 1 dose is permitted to be taken.
B) Suggest the spouse use an over-the-counter pain medication instead.
C) Discuss how frequently the spouse can safely take the prescribed pain medication.
D) Ask the spouse to contact the health care provider for a prescription for the medication.

Answer 1

Ask the spouse to contact the health care provider for a prescription for the medication.

Question 2

An older patient requires intravenous medication to be infused three times a day.The nurse instructs the spouse to provide these infusions.How frequently should the nurse plan to make home-care visits to this patient?

A) Daily
B) Never
C) Twice a week
D) Every 2 weeks

Answer 2

Never

Question 3

The nurse is making a first home-care visit to a patient recently discharged after hip replacement surgery.Which home observations should the nurse document as safety concerns? (Select all that apply.)

A) The patient's recliner faces the television.
B) A safety bar has been installed in the shower.
C) A bathmat towel is on the floor in front of the tub.
D) Smoke detectors are located in the kitchen and near the bedrooms.
E) The patient has a large birdcage sitting on the floor in the middle of the living room.
F) The hallway between the bedroom and bathroom is partially blocked by a cedar chest.

Answer 3

A bathmat towel is on the floor in front of the tub.
The patient has a large birdcage sitting on the floor in the middle of the living room.
The hallway between the bedroom and bathroom is partially blocked by a cedar chest.

Question 4

The nurse is to see a patient who requires dressing changes.Which staff member obtains the required supplies to be used during the home health care visit?

A) Nurse
B) Physician
C) Social worker
D) Home health aide

Question 5

The nurse is identifying care that a home-care patient requires.For which patient needs should the nurse seek assistance from the social worker? (Select all that apply.)

A) Setting up Meals on Wheels
B) Helping the patient obtain a prescription card
C) Identifying agencies that offer respite care services
D) Assisting the family with long-term placement of the patient
E) Helping the patient use assistive devices such as canes and walkers
F) Assisting the patient with an exercise program to regain strength and mobility

Question 6

The nurse is visiting the home of an 80-year-old patient who has hypertension and diabetes.In addition to obtaining vital signs and blood glucose levels,what other actions would be appropriate for the nurse to do? (Select all that apply.)

A) Inspect bathroom cupboards for contents.
B) Search the kitchen for high-salt or sugar foods.
C) Ask why the bed has not been made or the dishes washed.
D) Check the bathroom for safety bars in the tub/shower area.
E) Note the presence of scatter rugs or other impediments to free movement.
F) Ask the patient about lighting at night when getting up to use the bathroom.

Question 7

After entering a patient's home for a visit,the nurse notes that the living room floor is littered with trash,and pet hair is on furniture and table stands.What should the nurse do to maintain a clean home-care bag? (Select all that apply.)

A) Take the bag back to the car.
B) Wear the bag as a shoulder bag.
C) Place the bag on a disposable pad.
D) Cleanse the bag after leaving the home.
E) Place the bag on the nearest un-upholstered chair.

Question 8

During a home health visit,the nurse learns that the family member who is the primary caregiver of the patient is exhausted and tense.Which nursing diagnosis should the nurse recommend for the patient's plan of care?

A) Social Isolation
B) Caregiver Role Strain
C) Altered Role Performance
D) Ineffective Therapeutic Regimen Management

Question 9

The nurse is making a third home health visit.Which observations indicate that the patient and family have understood safety instructions and recommendations made by the nurse on an earlier visit? (Select all that apply.)

A) The patient is wearing an emergency response call device.
B) The family has removed scatter rugs and installed wall-to-wall carpeting.
C) The bathtub has no nonslip mat, and there is no grab bar near the shower.
D) The patient's telephone, eyeglasses, and TV remote are near the patient's seat.
E) The patient reports getting up frequently at night, but there is no visible night-light.
F) The patient's medications are in labeled bottles with a checklist for medication times.

Question 10

The family of a home-care patient asks the nurse to explain private duty nursing.How should the nurse respond to this question? (Select all that apply.)

A) "It is covered by Medicare."
B) "It is covered by Medicaid."
C) "It is considered an out-of-pocket expense."
D) "Most duties focus on companionship and respite care."
E) "Specific licensure is required to become a private duty nurse."
F) "Either licensed nurses or unlicensed assistive personnel may be used."

Question 11

The nurse is planning to make home-care visits throughout the day.What tasks should the nurse perform before beginning these visits? (Select all that apply.)

A) Place a map in the door sleeve.
B) Plug the cell phone into the charger.
C) Check that the car's gas tank is full.
D) Check the home-care bag for a whistle.
E) Check the wallet for at least $50 in cash.

Question 12

The nurse is completing the home-care flow sheet.When should the nurse plan to return this sheet to the home health agency?

A) In 2 days
B) Within 6 hours
C) Within 24 hours
D) Before the patient is discharged

Question 13

Prior to leaving a patient's home after a visit,the nurse makes a note in the patient's home-care folder.Why did the nurse write a note to be kept in the patient's home?

A) Explains the amount of time each visit takes to complete
B) Provides a reminder to the patient of what care is needed
C) Serves as communication between HCPs who are visiting the patient
D) Provides information to justify the type and level of skilled care the patient requires

Question 14

The nurse is making a home health visit to a patient and needs to contact the case manager of the patient's home-care team.Which person should the nurse contact?

A) Physician
B) Social worker
C) Registered nurse (RN)
D) Home health agency administrator

Question 15

The nurse completes the OASIS form upon a patient's admission to a home health care program.For which reasons does the nurse complete this form? (Select all that apply.)

A) To determine per-visit payments
B) To collect information about patient outcomes
C) To document skills used in a specific home visit
D) To develop a plan of care that meets the patient's needs
E) To generate information about the home health care agency
F) To identify relatives who will be trained as patient caregivers

Question 16

While traveling to a patient's home for a visit,the home-care nurse becomes lost in an unfamiliar part of town and sees a group of teenagers hanging around a boarded-up building.Which action should the nurse take?

A) Proceed to the next appointment.
B) Pull over to the curb to look at a map.
C) Seek assistance from one of the teens.
D) Drive to a familiar area and call the patient for directions.

Question 17

During a home visit,the nurse notes that an older patient is sitting in a poorly lit room listening to the radio.When the nurse turns on a light before starting to evaluate the patient and change a dressing on a wound,the patient says,"Oh,you don't need that light.I try to keep the lights off.Electricity is too expensive." Which response by the nurse is most appropriate?

A) "Oh, I didn't realize you were pinching pennies. I'll use my flashlight."
B) "I will turn off the light as soon as I finish changing the dressing on your wound."
C) "It sounds like it would be helpful for you to talk with the social worker who can identify financial programs that could help you."
D) "If you can't afford electricity, you may need to consider a new residence. I can set up a visit to a nice assisted living complex near here."

Question 18

During a home visit,the nurse documents arrival and departure time,patient vital signs,data collected for the patient,and a narrative note of the patient's response to medications and understanding of care being given.Which action does the nurse need to take prior to submitting this documentation?

A) Obtain signature of case manager.
B) Obtain signature of patient or caregiver.
C) Comment about patient's home surroundings.
D) Record the time of documentation submission.

Question 19

The nurse is preparing to make a telehealth visit to a patient with a foot wound.Which types of technology will the nurse use to complete this visit? (Select all that apply.)

A) E-mail
B) Telephone
C) Fax machine
D) Blood pressure cuff
E) Video conferencing