Deck 43: Community Home Health Nursing

Question 1

Which type of nursing has a focus on the community as a whole and the health status of individuals as an aggregate?
1)School nursing
2)Community health nursing
3)Community-oriented nursing
4)Public health nursing

Answer 1

4

Question 2

At a home visit, the nurse asks the patient, "Have you taken your blood pressure medicine today?" The patient replies, "I don't remember. Maybe." On the table are several bottles of medication, some open, some not. They have all been prescribed for the patient. The patient cannot say how often to take each one, when asked. A compartmentalized medication organizer is on the table, with a few capsules in it, and some compartments left open. Which action would the nurse take?
1)Show the patient how to put the medications in the organizer for the next 2 days; observe while he fills the rest of the organizer.
2)Arrange for a home health aide to come each day to show the patient which pills to take.
3)Administer today's medications and arrange for the pharmacy to put medications in easy-to-open containers in the future.
4)Fill the organizer for each day of the week; explain how to use it; and return in a day or two to evaluate.

Answer 2

4

Question 3

Documentation in home healthcare may take many forms. Some nurses use NANDA-I terminology for diagnoses, whereas others use the Clinical Care Classification (CCC) system. The chief benefit of the CCC system is that it:
1)Contains diagnoses specific to home care, whereas NANDA-I does not.
2)Is simpler to use and more readily understood by other disciplines.
3)Is linked to the OASIS (Online Acquittal Support Information System) reporting forms required by Medicare.
4)Uses standardized terminology, whereas NANDA-I does not.

Answer 3

3

Question 4

A home health nurse is working with a physical therapist and home health aides to work out a schedule for their visits that will best address the patient's needs. Which nursing role does this demonstrate?
1)Direct care provider
2)Client and family educator
3)Client advocate
4)Care coordinator

Question 5

Which activity by the student nurse indicates an understanding regarding secondary prevention?
1)Educating high school students about sexually transmitted infection (STI) prevention
2)Providing a screening for scoliosis for high school athletes
3)Lobbying congress regarding cancer treatment coverage for the uninsured
4)Referring a terminally ill patient for hospice care

Question 6

A community health nurse planning a new program for teen pregnancy prevention designs a community assessment covering the structure of the target. Which of the following areas would be included?
1)Number of residential and commercial buildings
2)Demographic data of residents in the community
3)Morbidity and mortality rates of the population
4)Common strategies for conflict resolution

Question 7

A community health nurse is evaluating the current health programs in the community. Which of these outcomes would indicate a healthy community?
1)Ninety percent of members report adequate access to primary care services.
2)Immunization services are available at hospitals and clinics.
3)Affordable housing in the community is under construction.
4)Mortality rates have been stable over the past 5 years.

Question 8

Today is the last day of work on the medical-surgical unit for a nurse who has decided to work in home care. A patient asks her why the nurse is leaving to work in home care. Select a response that best illustrates the advantages of home care.
1)"Care is much more comprehensive and unhurried in the home; it is more enjoyable for nurses to work in home care."
2)"Home care is much more organized than hospital care; you have access to the whole team, and there is less interference from others."
3)"A home health nurse has more autonomy and skills than a hospital nurse does; I'll get to do more."
4)"In home care, I can see my patients in their personal environment; this will help me understand them more and allow me to give personalized care."

Question 9

The inhabitants of Yulupa, California, form which of the following?
1)Aggregate
2)Community
3)Population
4)Vulnerable population

Question 10

Which of the following unique aspects of home care do Medicare reimbursement regulations require that the nurse include in documentation?
1)Patient assessment data and interventions performed
2)Patient response to care and assessment of environment
3)Evidence of homebound status and continued need for skilled care
4)Skilled care delivered and communication with other providers

Question 11

A 56-year-old patient provides care to their 91-year-old widowed father. The patient frequently reports fatigue and that there is no time to socialize with friends. "I'm so busy taking care of my dad. It's really hard work because he is bedridden. Sometimes it breaks my heart when I have to feed and bathe him. He always seemed so strong when I was a child." The most appropriate nursing diagnosis for this patient is:
1)Caregiver Role Strain
2)Impaired Home Maintenance
3)Interrupted Family Processes
4)Risk for Caregiver Role Strain

Question 12

A home health nurse has called the patient to arrange an initial home visit and has driven to the home. Which is the nurse's objective in the first few minutes of the visit?
1)Develop rapport and trust with the patient and family.
2)Gather demographic data and complete the referral form.
3)Assess the patient's most important health needs.
4)Determine the patient's needs for ongoing care.

Question 13

The nurse is visiting a patient who lives in a single-room occupancy hotel. The patient requires wound care and medication management. There is no running water in the room, and the bathroom down the hall is in disrepair and filthy. The patient's room is not clean. Which supplies would be essential for the nurse to bring with him when visiting this client?
1)All wound care supplies needed for the duration of the care
2)Reclosable plastic bags for disposal of old dressings
3)Small, biohazard sharps container to be left in the room
4)Waterless, antibacterial hand sanitizer solution

Question 14

A nurse serving the community in a public health role would likely perform which of the following functions within a particular community?
1)Tracking the prevalence of gonorrhea between January and June
2)Screening for scoliosis among 12- to 14-year-old girls in middle school
3)Weighing premature infants receiving phototherapy at home
4)Giving the H1N1 influenza vaccine to fire fighters and police personnel

Question 15

A 56-year-old patient is hospitalized because of poorly controlled diabetes and a leg ulcer that developed as a complication of diabetes. The patient is awake, alert, and oriented but fatigued and in need of wound care. In the hospital, insulin and a variety of oral medications were prescribed. The patient is learning how to check their blood sugar and administer insulin. The patient has never given himself insulin and does not understand how to interpret blood sugar readings. The physician has prescribed discharge from the hospital with home health follow-up. Is this an appropriate referral?
1)Yes; the patient is in need of skilled services and, therefore, eligible for home care services.
2)Yes; the patient has been unable to control the diabetes, is noncompliant, and needs to be monitored.
3)No; the patient would remain hospitalized; there are too many needs for home care services.
4)No; the patient is relatively young and oriented and would be able to provide their own care.

Question 16

The community health nurse is working with the residents of government-subsidized senior housing. Regular meetings are scheduled to discuss concerns and evaluate whether they receive healthcare that meets their needs. Which of the following nursing roles best describes these actions?
1)Case manager
2)Client advocate
3)Collaborator
4)Counselor

Question 17

A community health nurse has been assigned census tracts 131 and 132 as a new assignment. This large area crosses the border of two towns and includes 4,000 people. Which components of the community must the community health nurse assess prior to beginning the new assignment?
1)Income levels, health status, and relationships among groups
2)Structure of the tracts, effectiveness of the community, and current status
3)Number of clients with health problems compared with the number of healthcare providers
4)Community organizations and beliefs about their role in the community

Question 18

The community health nurse has gathered data about the community, including identifying many weaknesses in the community health systems that contribute to poor health outcomes. Which would be her next step?
1)Analyze the data.
2)Implement interventions.
3)Evaluate the effectiveness of the interventions.
4)Plan the care.

Question 19

Which statement made by the novice nurse requires further teaching regarding the role of a community health nurse?
1)"As a community health nurse, I will assist in providing free prenatal care for low-income women."
2)"I have planned to teach teenagers about preventing sexually transmitted infections (STIs) weekly."
3)"I have scheduled a tuberculosis screening event at the homeless shelter."
4)"I gave an older adult an injection of insulin yesterday."

Question 20

The similarity between the Omaha System and the NANDA-I taxonomy is that both contain which of the following?
1)Evaluation tools expressed in standardized language
2)Nursing diagnoses expressed in standardized language
3)Diagnoses, outcomes, and interventions
4)Labels that are intended for use in any healthcare setting

Question 21

The nurse has been assigned to a caseload of home health clients. Before making home visits, which two planning activities must she perform first?
1)Order supplies for the home care services.
2)Review the cases to determine the reasons for the visits.
3)Contact the clients to arrange for the visits.
4)Develop a schedule for the day so that all visits can be made.
5)Plan for caregiver respite care.

Question 22

Which interventions would the nurse implement in the home of an elderly patient to promote safety? Select all that apply.
1)Encourage dim lighting throughout the home.
2)Change batteries in all smoke detectors.
3)Fix loose railings up the stairs.
4)Ensure rugs in the home are loose.
5)Check that all medications are tightly sealed and out of the patient's reach.

Question 23

Which of the following is a primary intervention? Select all that apply.
1)Immunization of college-bound students against meningitis
2)Safer sex education for high school students
3)Lobbying for health education in the schools
4)Tuberculosis (TB) screening via purified protein derivative (PPD) testing
5)Cardiac rehabilitation for post-operative patients

Question 24

A family caregiver is learning to administer insulin injections to a homebound family member. Which would the nurse advise the caregiver to do with the used needles?
1)"Discard the needle and syringe in a thick plastic milk jug with a lid."
2)"Securely recap them and place them in a paper bag in the household trash."
3)"Remove the needle and put it in a coffee can with a lid; put the syringe in the trash."
4)"Do not recap the needle; break it by bending it on the tabletop."

Question 25

Identify the nurse who is acting as a community health nurse. Select all that apply.
1)A nurse who provides screening and direct care in the elementary school
2)A nurse who offers health education after services each Sunday
3)Nurse who works for the Red Cross by providing disaster relief
4)A nurse administering vaccines to inmates in a correctional facility
5)A nurse who starts an intravenous (IV) line on a patient admitted to the hospital with dehydration

Question 26

Home healthcare and home hospice care are two different types of home health services. Which statements describe the differences between these services? Select all that apply.
1)Home healthcare promotes independence in clients; home hospice care promotes comfort and quality of life.
2)Home healthcare promotes comfort and symptom management; hospice care promotes self-care.
3)Home healthcare is focused on teaching self-care; home hospice care is focused on teaching skilled care to caregivers.
4)Home healthcare is focused on fostering independence; home hospice care is focused on managing symptoms.
5)Home healthcare is provided in the home; hospice care is only provided in a hospital setting.

Question 27

Which of the following clients would most likely require home health services? Select all that apply.
1)A 45-year-old with an injured rotator cuff that requires surgery
2)A 32-year-old terminally ill individual with a supportive family
3)A 92-year-old living independently with multiple medical problems
4)A 6-year-old with a fractured hip requiring a leg and pelvic cast
5)An 18-year-old who lives with their parents with newly diagnosed type I diabetes

Question 28

Which of the following interventions has a public health focus? Select all that apply.
1)Controlling the blood sugar of a diabetic client with cardiovascular disease
2)Assisting with the launch of an after-school program in a high-crime neighborhood
3)Providing an influenza vaccination program for seniors and persons with chronic illness
4)Offering counseling to the family of a child with severe cognitive deficits
5)Providing food nutrition classes to obese adults in a rural area

Question 29

Which of the following services are provided by home health agencies? Select all that apply.
1)Direct care of clients in the home, performing treatments
2)Indirect care, such as provision of medication and supplies
3)Acute care services for clients with complex diseases
4)Respite care of clients to relieve family caregivers
5)Teaching patients or caregivers to perform services

Question 30

The nurse is visiting a client who resides in a single-room-occupancy hotel. Groups of people are leaning against the building and smoking on the steps. There is obvious substance abuse occurring in the lobby and halls of the building. There is no running water in the room, and the bathroom down the hall is in disrepair and filthy. A primary concern that the nurse must consider when making this visit is safety. Which of the following actions are appropriate safety measures? Select all that apply.
1)Notify the police that the nurse plans to visit this site.
2)Carry something that can be used as a weapon, if necessary.
3)Inform the home health agency of the nurse's route and time of visit.
4)Do not visit if the nurse senses danger when arriving at the site.
5)Assess the surroundings for stores, community resources, or police department.

Question 31

Which of the following groups represents a vulnerable population? Select all that apply.
1)Homeless persons with no known illnesses
2)Women who have experienced domestic violence
3)Ninth grade students at the local high school
4)Persons with type 1 diabetes mellitus
5)An elderly individual with heart failure