Question 1

A senior student nurse asked the instructor,"Why do we have to make home visits? The client learned self-care in the hospital." Which of the following statements would be the best response from the instructor?

Accepted Answer

Home visits allow the nurse to see threats to the family health and safety in the home or immediate environment.Home visits also encourage a family focus,although they do not guarantee it.It is common for new nurses who have little experience in home visiting to feel uncertain and ambivalent about the experience.

Question 2

Which of the following would be the nurse's primary goal during the first visit to home-bound clients?

Accepted Answer

Although all the steps are important,establishing rapport,defining problems,and agreeing on goals must be done before it is possible to begin the other steps.These events occur during the initiation phase,which starts during the first visit and may take several visits.

Question 3

What is the most crucial aspect of the first visit to a new client?

Accepted Answer

Although all the options listed are important,the relationship is the most important because without it,the other tasks cannot be completed.Without at least earning trust,the nurse will not be able to visit the family again.Also,building and preserving relationships is a central focus of home visiting.

Question 4

A new mother asked the community/public health nurse what a nurse visiting her at home would do differently from what the nurses in the hospital had already done.Which of the following would be the best response from the nurse?

Accepted Answer

Although all nurses try to keep clients safe and healthy,the community/public health nurse is most qualified to assess the home environment and wider community for dangers as well as resources.

Question 5

The supervisor suggested that a nurse use a contract to confirm goals and plans with an elderly man who had recently moved into a self-care halfway house.Which of the following is an advantage of such a contract?

Accepted Answer

A contract clarifies and documents mutual understandings.The agreement usually entails one or more family members continuing to meet with the nurse for a specific number of visits or weeks.Initially,specific goals and the nurse's role regarding health promotion and illness prevention may be unclear.

Question 6

The nurse is to visit newly referred clients for the first time after their discharge from the nursing home back to their apartment.Which of the following is the most likely feeling the clients will have regarding the nurse's visit to them?

Accepted Answer

Although all the options are possibly True,if the clients are home for the nursing visit they are at worst feeling ambivalent about the meeting.They are willing to consider what the nurse may have to offer.

Question 7

A new mother seemed hesitant to let the community/public health nurse into her apartment.However,the visit seemed to go well,with the nurse sharing information,resources,and positive support to the new mother.At the end of the visit,the mother thanked the nurse profusely but said she thought she was all right now so there was no need for the nurse to return.Which of the following actions would be most appropriate for the nurse to take?

Accepted Answer

After discussing the options and choices that the family has if it declines further visits,the nurse has provided information so the family can engage in informed decision making.The nurse has no further obligation.

Question 8

After leaving the home of a new mother and her newborn,the student nurse asked the instructor,"What will the new mother do when we aren't there to help?" Which of the following statements would be the best reply from the nursing instructor?

Accepted Answer

The purpose of care in the community is to enable the family to remain at home and manage without the constant presence of health care providers.

Question 9

Which of the following reasons explains why new community/public health nurses are very uncomfortable with home visiting,even in nice neighborhoods?

Accepted Answer

All of these factors can lead a nurse,especially an inexperienced one,to feel uncomfortable.However,the major difference is that the setting and the control are clearly the client's,not the nurse's.

Question 10

Which of the following would be appropriate to help ensure a nurse's safety?

Accepted Answer

Any of these behaviors could cause the nurse to be physically injured except checking one's surroundings before exiting the car,which is an effective precaution the nurse should always take.

Question 11

It was suggested a public health department's funding for home visits be cut because so much time and money were spent in travel and such expenses seemed inappropriate in a time of fiscal restraint.Which of the following would be the nurse's best response to this suggestion?

Accepted Answer

Research has demonstrated that home visits result in fewer instances of child abuse and neglect and fewer emergency department visits,accidents,and poisonings during the child's first 2 years of life.These effects were still apparent 15 years later.

Question 12

During the second visit,a nurse noticed that although an elderly gentleman had not been able to clean up the apartment,he had been able to clean up the kitchen.Why would the nurse praise him for his cleaning efforts when only one room had changed?

Accepted Answer

Short-term objectives are often helpful toward slowly achievable long-term goals.It is also wise to be aware of and verbalize small,subtle changes or achievements.

Question 13

A clinical specialist in gerontology accepted a position with the local health department as a community/public health nurse.For whom can the nurse expect to provide care?

Accepted Answer

A nurse can be assigned a specific neighborhood or a specific aggregate.As a clinical specialist in gerontology,the nurse would probably be assigned to work where there is a need for such expertise.The nurse could also be assigned a specific neighborhood,but not on the basis of risk,the nurse's own residence,or the nurse's choice.

Question 14

As the nurse entered the house of an elderly couple and was invited to sit,three cats rubbed against the nurse's legs.Which of the following would be the most appropriate comment for the nurse to make?

Accepted Answer

The appropriate response to animals in the house is to first assess for safety.If safety is not an issue,then ask for an introduction.Pets are often considered members of the family.

Question 15

A home health nurse was making an initial visit to an elderly man.As the nurse began the assessment,the wife gave all the information requested.Which of the following actions would the nurse take next?

Accepted Answer

Having heard from only the wife,the nurse must attempt to validate the information with the husband or recognize that all information was from only one perspective.

Question 16

Which of the following would be the first priority when a nurse is completing a home visit?

Accepted Answer

Because the client is the ultimate decision maker,the client's priorities must be addressed first.

Question 17

On the first home visit,a nurse explained to an elderly couple how the nurse could help them.Who would be the most knowledgeable concerning the couple's health needs?

Accepted Answer

The clients are the experts in their own health,their health history,their experience in various stages of health and illness,and their health and illness concerns.

Question 18

Which of the following would be essential characteristics of a professional helping relationship?

Accepted Answer

Carl Rogers wrote that the three characteristics of a helping relationship are positive regard,empathy,and genuineness,which are relevant in all nurse-client relationships.

Question 19

A nurse visited a new family to help them adapt to the needs of their newborn.The family asked the nurse to help them obtain diapers,formula,and transportation to the clinic.How should the nurse respond?

Accepted Answer

Families may test what the nurse is willing to do,or they may be so overwhelmed that they make inappropriate or unrealistic demands.The nurse must state limits immediately to maintain trust.However,referrals are appropriate for emergency food,clothing,and shelter,including formula for newborns.

Question 20

A nurse is often frustrated when clients do not comply with the nurse's suggestions that would improve their health.What might be helpful to remember in such situations?

Accepted Answer

The only person the nurse can change is the nurse.Trying to change another person may make that person feel dominated and thus feel more strongly that change must be resisted.

Quiz 11: Home Visit: Opening the Doors for Family Health