Question 1

Which organization publishes the current scope and standards of home care practice?

Accepted Answer

The ANA publishes scope and standards for Home Health Nursing and Hospice and Palliative Nursing.The Centers for Medicare and Medicaid Services control the regulations and reimbursement mechanisms for the majority of home care services.The Robert Wood Johnson Foundation provides grant funding for a variety of projects that support nursing.The Visiting Nurse Association is a home care agency.

Question 2

Official agencies are financed primarily by:

Accepted Answer

Official agencies are financed primarily by tax funds.These agencies are typically operated by state,county,city,or other local government units,such as health departments.

Question 3

A nurse is trying to facilitate interprofessional collaboration.Which of the following actions should be taken by the nurse?

Accepted Answer

The factors for successful interprofessional functioning include the categories of knowledge,skill,and attitudes with subheadings including the understanding of the roles of each professional.

Question 4

A community health nurse is using the Omaha System.Which of the following best describes the rationale for using this system?

Accepted Answer

The goals of developing the Omaha System were to develop a structured and comprehensive system that could be both understood and used by members of various disciplines and to foster collaborative practice.Therefore,the Omaha System was designed to guide practice decisions,sort and document pertinent client data uniformly,and provide a framework for an agency-wide,multidisciplinary clinical information management system capable of meeting the daily needs of clinicians,managers,and administrators.

Question 5

A nurse is employed in home health nursing practice.Which of the following terms best describes the care that is being provided?

Accepted Answer

Provision of intermittent skilled visits is a component of home health care nursing.Custodial care refers to the care given in long-term care facilities.Family caregiving may be an important role of keeping the client at home,but it is not a necessary component of home care.Palliative care is an extended continuum of chronic serious illness to acute serious illness during which stabilization and exacerbations may occur.

Question 6

A nurse has referred a home care client to hospice care.Which of the following best explains the rationale for this referral?

Accepted Answer

The focus of hospice care is comfort,peace,and a sense of dignity at a very difficult time.Comprehensive services emphasize continuity of care.Hospice care is provided for those with a life expectancy of less than 6 months.Hospice is the only Medicare benefit that includes medications,medical equipment,24 hours/7 days a week access to care,and support for family members after death.Hospice care does not reduce the cost of care.

Question 7

Which historical event caused dramatic changes in home care nursing?

Accepted Answer

Medicare introduced regulations for home care practice as well as for reimbursement mechanisms.

Question 8

A nurse is implementing a population-focused model of home care delivery.Which of the following actions would most likely be taken by the nurse?

Accepted Answer

Population-focused home care models of care usually include structured approaches to regular visits with assessment protocols,focused health education,counseling,and health-related support and coaching.

Question 9

Which concepts are used to evaluate client outcomes when using the Omaha System Problem Rating Scale for Outcomes?

Accepted Answer

The Omaha System Problem Rating Scale for Outcomes uses the concepts of Knowledge,Behavior,and Status.

Question 10

A nurse is using telehealth technology in the home setting.Which of the following best describes the intervention that is being used by the nurse?

Accepted Answer

Telehealth includes sharing health information between the client and clinicians using electronic communications.Telehealth may or may not include video technology for live interactions.Telehealth allows for monitoring health status and symptom recognition,providing education,increasing communication,and enabling clients to become active partners in their own care.

Question 11

A home care agency has applied for accreditation from the Joint Commission.What is the next step the agency will take?

Accepted Answer

After applying for accreditation,a lengthy self-study must be completed that addresses all aspects of the agency's operation.Following completion of the self-study,an accreditation team schedules a site visit.Attending a conference to learn more about accreditation should be done before applying.A site visit with the Joint Commission occurs after the self-study has been reviewed.Improving methods of documentation of client visits should be addressed before applying for accreditation.

Question 12

A home care nurse is employed by a proprietary agency.What does this mean?

Accepted Answer

Proprietary agencies are profit-making agencies.Proprietary agencies are free-standing,for-profit agencies that are required to pay taxes.Many are part of large chains and now dominate the home care industry.

Question 13

The nurse provides direct care services to a stroke victim to avoid complications.Which of the following levels of prevention is being implemented?

Accepted Answer

Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease,injury,or disability.Thus,direct care for a stroke victim is focusing on limiting disability and encouraging rehabilitation.Primary prevention focuses on preventing the disease before it occurs.Secondary prevention focuses on early detection and screening.Assessment is not a level of prevention.

Question 14

A nurse is coordinating care to ensure a comfortable and peaceful death.Which of the following factors should be an important consideration for the nurse?

Accepted Answer

Cultures vary in their beliefs and responses to death.Nurses should know the differences in cultural responses so that they can effectively help people in their time of need.It will be important for the nurse to take cues from the client and the loved ones regarding their needs.The stress experienced by dying patients is different based on the client's culture.

Question 15

A nurse is providing a skilled nursing service.Which of the following best describes the intervention the nurse is performing?

Accepted Answer

Skilled nursing service is the Medicare term that describes the duties of the registered nurse,and refers to the requirement of nursing judgment.Those services involve assessment,teaching,and selected procedures.Teaching the client and family to implement a therapeutic plan,such as taking medications,is an example of a skilled nursing service.Consultation,coordination,and review of documentation do not fit the definition of a "skilled nursing service."

Question 16

A nurse is using the first stage of the Outcomes and Assessment Information Set (OASIS)outcomes analysis.Which of the following best describes what the nurse is doing?

Accepted Answer

The first stage,outcomes analysis,enables an agency to compare its performance to a national sample,identify factors that may affect outcomes,and identify final outcomes that show improvement in or stabilization of a client's condition.The second stage,outcomes enhancement,enables the agency to select specific client outcomes and determine strategies to improve care.

Question 17

After conducting a comprehensive client assessment,the nurse would organize information about the client's medication regimen into which domain of the Omaha System Problem Classification Scheme?

Accepted Answer

The Omaha System Problem Classification Scheme uses four domains to organize client information.The Health-related behaviors domain includes information related to patterns of activity that maintain or promote wellness,promote recovery,and decrease the risk of disease.The environmental domain includes material resources and physical surroundings both inside and outside the living area.The psychosocial domain includes patterns of behavior,emotion,communication,relationships,and development.The physiological domain includes functions and processes that maintain life.

Question 18

A nurse has discovered that a client should be receiving Meals on Wheels.Which of the following steps of the nursing process is the nurse performing?

Accepted Answer

The Standards of Care and the Standards of Professional Performance both include the six steps of the nursing process: (1)assessment,(2)diagnosis,(3)outcomes identification,(4)planning,(5)implementation,and (6)evaluation.As a nurse performs an assessment,the nurse recognizes the current needs of the client.

Question 19

A nurse is using the Omaha System Problem Classification Scheme.Which of the following situations is the nurse most likely experiencing?

Accepted Answer

The Omaha System Problem Classification Scheme is used to organize a comprehensive assessment according to four priority domains.It's simple and concrete terms are used to organize a comprehensive assessment,an important standard of nursing practice.It does not measure client outcomes,promote collaboration with other professionals,or provide health education.

Question 20

Medicare-certified home health agencies place emphasis on _____ care.

Accepted Answer

As part of the Conditions of Participation,Medicare-certified home health agencies must place an emphasis on intermittent care.Home care services that are provided must be intermittent and provide a skilled service.Primary care refers to the care that is often provided in a physician's office.Medicare-certified agencies provide care following an acute hospitalization or medical change; they do not provide long-term care for chronic illnesses.

Quiz 41: The Nurse in Home Health, Palliative Care, and Hospice