Deck 16: Nursing Care of the Patient at Home

Question 1

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

Answer 1

The patient's medications are in labeled bottles with a checklist for medication times.
The family has removed scatter rugs and installed wall-to-wall carpeting.
The patient's telephone, eyeglasses, and TV remote are near the patient's seat.
The patient is wearing an emergency response call device.

Question 2

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

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

Answer 2

Nurse

Question 3

A flow sheet documenting a home health care visit should, in most situations, be returned to the home health care facility or agency within ________________hours of the visit.

Answer 3

24

Question 4

The nurse is making a home care visit to see a patient who was recently diagnosed with diabetes. On the way to the patient's home, the nurse becomes lost in an unfamiliar part of town and sees a group of teenagers hanging around a boarded-up building. Which of the following actions is best for the nurse to take?

A)Pull over to the curb to look at a map.
B)Seek assistance from one of the teens.
C)Drive to a familiar area and call the patient for directions.
D)Proceed to the next appointment.Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Question 5

The nurse is part of the home health team. Which of the following would the nurse recognize as being functions performed by the social worker in a home health care team? (Select all that apply.?

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

Question 6

The nurse documents a home health visit. The documentation includes the nurse's arrival and departure time, vital signs of the patient, the nurse's data collection for the patient, and a narrative note of the patient's response to medications and understanding of care being given. Which of the following actions 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 7

The nurse is making a home care visit for the first time to a patient recently discharged after hip replacement surgery. Which of the following, if observed in the home, would the nurse document as safety concerns? (Select all that apply.?

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

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 of the following nursing diagnoses should the nurse recommend for the patient's plan of care?

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

Question 9

The nurse is making a home health visit and the family asks what private duty nursing is. Which of the statements would be correct for the nurse to make about private duty nursing? (Select all that apply.?

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

Question 10

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 of the following responses, by the nurse, is most appropriate?

A)"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."
B)"Oh, I didn't realize you were pinching pennies, I'll use my flashlight."
C)"I will turn off the light as soon as I finish changing the dressing on your wound."
D)"It sounds like it would be helpful for you to talk with the social worker who can identify financial programs that could help you."

Question 11

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 of the following people would the nurse contact?

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

Question 12

The nurse completes the OASIS form upon a patient's admission into a home health care program for which of the following purposes? (Select all that apply.?

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

Question 13

The patient plan of care for home health care is usually certified for ________________days.

Question 14

The nurse is visiting an 80-year-old patient at home 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)Check the bathroom for safety bars in the tub/shower area.
B)Ask why the bed has not been made or the dishes washed.
C)Note the presence of scatter rugs or other impediments to free movement.
D)Ask the patient about lighting at night when getting up to use the bathroom.
E)Inspect bathroom cupboards for contents.
F)Search the kitchen for high-salt or sugar foods.