Deck 30: Home Health and Hospice Care

Question 1

The nurse educator knows that the nursing student understands the contributions that Lillian Wald made to home care when the nursing student makes which statement?

A) "Lillian Wald made the earliest known effort to care for the sick poor at home."
B) "Lillian Wald trained nurses so that wealthy women would hire them as visiting nurses."
C) "Lillian Wald began home visiting in New York City and is famed for professionalizing visiting nurses."
D) "Lillian Wald approached congress with the idea of Medicare Home Health Benefit."

Answer 1

"Lillian Wald began home visiting in New York City and is famed for professionalizing visiting nurses."

Question 2

After reviewing the various events associated with the history of home health care, the students demonstrate understanding of the events when they state which event as the most significant influence on the growth of home care agencies?

A) Creation of the visiting nurse associations
B) Era of the Medicare Home Health Benefit
C) Enactment of the Balanced Budget Act
D) Discharge of nonacute clients

Answer 2

Enactment of the Balanced Budget Act

Question 3

Which statement best describes the family caregiver burdens of providing home care?

A) Family members are expected to contribute financially to cover all of the costs of home care.
B) Individuals recovering from severe illness or living with debilitating chronic illness rely on family members for unpaid assistance.
C) Informal caregivers assume a considerable physical, psychological, and economic burden in the care of their loved one at home.
D) Caregivers often describe themselves as emotionally and physically drained.

Answer 3

Caregivers often describe themselves as emotionally and physically drained.

Question 4

When evaluating a client's eligibility for Medicare-reimbursed home care, which is crucial?

A) The client needs visits by a homemaker.
B) The client is homebound.
C) The client is a veteran.
D) The client is terminally ill.

Question 5

An instructor is describing the various types of home health care agencies and uses the visiting nurse association as an example of which type?

A) Voluntary nonprofit
B) Hospital based
C) For-profit proprietary
D) Noncertified

Question 6

Assessment of a client in the home reveals that his or her services will be paid by a government source. Which entity would be a possible source of payment?

A) Insurance company
B) Health maintenance organization
C) Medicare
D) Preferred provider organization

Question 7

A home health care nurse performs an initial visit to a client and determines that the client meets the criteria for services with Medicare reimbursement. The nurse understands that this service will be reimbursed for which period?

A) 30 days
B) 60 days
C) 90 days
D) 120 days

Question 8

Quality measures are being determined for a home health care agency. Which measure would the agency want to achieve higher percentage rates?

A) Hospital admissions
B) Urgent unplanned medical care
C) Deteriorating wound status
D) Decreased pain with movement

Question 9

A home health care nurse is working with informal caregivers. Which action is most important?

A) Include the client's spouse or significant other in the plan.
B) Visit frequently to manage and maintain equipment.
C) Focus on caretaker abilities, not limitations.
D) Use nurse's intuition to determine what to teach first.

Question 10

When providing home health care, which individual is responsible for coordinating the care?

A) Registered nurse
B) Social worker
C) Physician
D) Dietician

Question 11

When visiting a client in the home for the first time, which information is absolutely critical to remember?

A) There may be dangers lurking around every corner.
B) Clients are glad to have the nurse in their home.
C) The nurse is a guest in the client's home.
D) The nurse knows what is best for the client.

Question 12

A home health care nurse reviews the most common conditions managed at home. Which conditions are most commonly managed at home? Select all that apply.

A) Chronic skin ulcer
B) COPD
C) Heart failure
D) Terminal cancer
E) Diabetes

Question 13

When developing the plan of care for a client receiving home health care services, which goal would be the most important?

A) Promotion of client independence
B) Complete resolution of the problem
C) Detecting family conflicts
D) Ensuring access to resources

Question 14

When providing palliative care to a client receiving hospice care, which would be important? Select all that apply.

A) Assume nothing about what is wrong.
B) Use the most complex interventions first.
C) Believe what the client is reporting.
D) Be persistent in trying different strategies.
E) Wait until the symptoms recur to relieve them.

Question 15

The family of a hospice client is holding a vigil at the client's bedside. During a visit, a hospice nurse participates in this vigil and encourages each of the family members to say their good-byes. The nurse is demonstrating:

A) palliative care.
B) guided letting go.
C) connecting.
D) responsive use of self.

Question 16

As part of a group exercise, students are to compare and contrast home care and hospice care. The instructor determines that the activity was successful when the students identify which as reflective of home health care?

A) Emphasis on rehabilitation
B) Focus on health of the whole family
C) Expert use of opioids for suffering
D) Management of symptoms

Question 17

A home health care nurse is assigned to visit a client's home. The nurse identifies the area as a problem neighborhood. Which action would be most appropriate for the nurse to take?

A) Perform the visit via telephone.
B) Make joint visits.
C) Reschedule the visit for another time.
D) Leave the cell phone at home.

Question 18

A home health care nurse is invited as a guest speaker to talk to a group of students about challenges of working in the home. As part of the discussion, the nurse describes medication safety. Which would the nurse include as a measure to address this issue?

A) Asking the client what he or she takes the drug for
B) Throwing out any medications over 1 month old
C) Reconciling drugs in the home with those on the discharge sheet
D) Setting up medication boxes to organize the medications

Question 19

When describing the philosophy of hospice care to a group of students, which of the statement made by a student would indicate the need for additional teaching?

A) "The philosophy of hospice includes the client's right to die and euthanasia."
B) "The philosophy of hospice includes working with people in their last year of life."
C) "The philosophy of hospice includes providing holistic and family-centered care to terminally ill clients."
D) "The philosophy of hospice includes weaving hospice concepts around curative treatment."

Question 20

After teaching a group of students about hospice and its view of end-of-life care, which statement by the students indicates a need for additional teaching?

A) Care should attend to the body, mind, and spirit.
B) Death is not considered a taboo topic.
C) Medical technology should be used widely.
D) Clients have a right to truthful discussion.

Question 21

A client will receive hospice care under the Medicare Hospice Benefit. The nurse understands which is true?

A) The client denies terminal prognosis.
B) The client has a prognosis of at least 6 months of life.
C) The client chooses life-extending care.
D) The hospice acts as clinical and financial case manager.

Question 22

When describing the role of hospice nurses to a group of students, a hospice nurse identifies which action as most important?

A) Speaking the truth
B) Sustaining oneself
C) Encouraging choice
D) Strengthening the family

Question 23

Which Medicare policy prevents people who could benefit from hospice services from receiving those services, even when it would be most cost-effective for the client to receive hospice rather than inpatient interventions?

A) Controlled cost at the expense of assuring quality of life and comfort
B) That a person must discontinue treatment in order to receive hospice service
C) Education and support for clients and family caregivers
D) Refusing to pay for homemaking and personal care that might keep a person at home as long as possible

Question 24

The nurse is planning to make a home visit to a client who has Medicare as a primary payer. The client has been receiving home care for 60 days. The nurse would select which assessment to complete during the home visit?

A) OASIS-1
B) Recertification
C) Discharge assessment
D) Transfer assessment

Question 25

The home health nurse is discussing home health nursing practice with a student nurse. Which statement made by the student nurse summarizes the home care nursing?

A) "The home health nurse may only provide care for 60 days per calendar year."
B) "The home health nurse must work closely with the agency social worker who serves as the coordinator of care for clients."
C) "The home health nurse must coordinate a variety of services and other professional caregivers in order to manage clients care."
D) "The home health nurse must be able to transport clients to the hospital if the nurse notes a decline in the client during a scheduled home health visit."

Question 26

The home health nurse is synthesizing evidence and clinical data and theory during an initial home visit. The home health nurse is operating within which standard of practice?

A) Consultation
B) Health promotion
C) Assessment
D) Planning

Question 27

The home health nurse is working with a client and the family during care transition. The home health nurse is operating within which standard of practice?

A) Consultation
B) Coordination of care
C) Collaboration
D) Communication

Question 28

A nurse is asking about care needed for an older home bound client. The client's caregiver states that the client needs help with daily morning care and meal preparation. Which type of care does the nurse seek to coordinate?

A) Custodial care
B) Skill care
C) Durable medical equipment
D) Pharmacy services

Question 29

The nurse has presented on the history of home health to new RNs hired by the organization. Which statement validates that the teaching was effective?

A) "In home health nursing, the nurse is a coordinator of care, managing and providing a plan of care for the client."
B) "Home health nursing has evolved over the years to incorporate referrals and review medication regimens for home bound clients."
C) "Home health nursing is focused more on population health as the population grows."
D) "In home health nursing, the nurse focuses on holistic care and what the client needs."

Question 30

A nurse is caring for a client who has a skin ulcer. The client was a member of the armed services. Which type of health service does the client qualify for?

A) Medicare
B) Medicaid
C) Veterans administration
D) Home care

Question 31

A nurse is caring for a client receiving hospice care and the client's caregiver. Which is the most important factor the nurse should facilitate in this nurse-client relationship?

A) Encourage the client and family to choose next steps.
B) The nurse should not discuss the family's thoughts related to the death of the client.
C) The family should connect with other loved ones.
D) The nurse provides physical and emotional comfort.