Deck 42: Home Care Teaching

Question 1

What is an expected finding when one is evaluating the patient with a tracheostomy in the home?

A) A stoma site that is hard to the touch
B) An inner cannula that is free of secretions
C) Copious secretions obtained from suctioning
D) Bloody secretions that have been suctioned

Answer 1

An inner cannula that is free of secretions

Question 2

What should the nurse first assess when preparing to teach a patient and/or family member how to read a thermometer?

A) The patient's actual temperature
B) The patient's ability to manipulate the thermometer
C) The family member's temperature
D) The patient's ability to take a pulse and respiratory rate as well

Answer 2

The patient's ability to manipulate the thermometer

Question 3

In teaching the patient how to perform intermittent self-catheterization,the nurse instructs which of the following?

A) Only strict aseptic technique should be used
B) All hospitals use strict aseptic technique
C) Clean intermittent self-catheterization increases the chance for infection
D) Clean intermittent self-catheterization is a safe and effective method

Answer 3

Clean intermittent self-catheterization is a safe and effective method

Question 4

What should the nurse instruct the patient to do when teaching the patient how to take a temperature?

A) Wait at least 30 minutes after smoking or ingesting hot or cold foods
B) Take the temperature immediately upon seeing chills or shivering
C) Wear sterile rubber gloves when taking a rectal temperature
D) Lubricate an oral thermometer with water-soluble lubricant only

Question 5

In teaching the patient how to take his own blood pressure,which of the following statements is true?

A) Blood pressure cuffs that are too small will give a falsely low reading
B) Blood pressure cuffs that are too large will give a falsely high reading
C) Electronic blood pressure cuffs are just as accurate as other methods
D) Mercury manometers create potential environmental risks

Question 6

The patient's caregiver is checking the patient's nasogastric (NG)tube for gastric residual before proceeding with the patient's next feeding.The patient aspirates 250 mL of residual for the second hour in a row.The caregiver held the tube feeding within the last hour.What should the caregiver do now?

A) Hold the feeding again
B) Contact the health care provider
C) Proceed with the feeding
D) Give half of the feeding and see how the patient tolerates it

Question 7

The patient had a heart attack in the past and currently is on digoxin (a cardiac glycoside)and a beta-blocker.What instructions should the nurse give to the patient?

A) Withhold the medication if her blood pressure is above the normal range or her pulse is over 100 beats per minute
B) Withhold the medication if her blood pressure is below the normal range and/or her pulse is less than 60 beats per minute
C) Never withhold her medication. Take it and notify the physician at the next office visit
D) Withhold her medication only if both her blood pressure and pulse rate are too high

Question 8

What should the nurse instruct the parents to do when teaching them about temperature monitoring for a child?

A) Use only a glass mercury thermometer
B) Take the temperature after the shivering subsides
C) Avoid the use of tepid water sponging for fever
D) Take the temperature, but adjust the reading if the child has eaten a Popsicle

Question 9

The patient is taking Synthroid (a thyroid medication)for hypothyroidism.What should the nurse instruct the patient to do when teaching the patient how to assess her own blood pressure and pulse?

A) Withhold the medication if her blood pressure is above the normal range or her pulse is over 100 beats per minute
B) Withhold the medication if her blood pressure is below the normal range and/or her pulse is less than 60 beats per minute
C) Never withhold her medication. Have the patient take it and notify the physician at the next office visit
D) Withhold her medication only if both her blood pressure and pulse rate are too high

Question 10

When teaching the patient about performing trach care,which of the following is an acceptable technique?

A) Remove the old ties before applying the new
B) Keep two trach tubes of the same size at the bedside
C) Place the new trach tie, then remove the old tie
D) Dispose of all old supplies and replace with new

Question 11

When teaching the patient and family about CIC,why is it important for the nurse to teach about the signs and symptoms of complications?

A) Although rare, complications are always severe
B) It is part of the process; complications almost never occur
C) Urinary complications are common with CIC
D) The only major complication is infection

Question 12

Which of the following is essential in teaching the patient how to use a thermometer?

A) How to read a digital thermometer
B) How to shake down the thermometer before use
C) How to use the axillary thermometer
D) How to select the most appropriate thermometer

Question 13

What is an appropriate technique to use when teaching an older patient about self-medication in the home?

A) Speak very loudly
B) Teach the family separately
C) Provide frequent pauses
D) Provide fewer but longer teaching sessions

Question 14

When being taught CIC,at what interval should the patient be taught to replace the catheter?

A) With each use
B) Daily
C) Weekly
D) Monthly

Question 15

The nurse is teaching the patient and family how to perform tracheal suctioning.What does proper technique include?

A) Teaching how to instill normal saline before suctioning
B) Suctioning the nasal and oral pharynx before the trachea
C) Encouraging tooth brushing and oral hygiene daily
D) Having the patient take two to three deep breaths after the procedure

Question 16

Of the following type of thermometers available,which is not recommended for home use?

A) Digital
B) Tympanic
C) Mercury
D) Disposable single-use

Question 17

Information that should be provided to the caregiver of a patient with a nasogastric (NG)tube includes:

A) Keeping the head of the bed lowered for feedings
B) Keeping unused formula at room temperature
C) Aspirating every 4 hours when receiving continuous drip feedings
D) Providing half of the feeding if the residual exceeds 250 mL

Question 18

What is the principal difference in tracheostomy care between care given in the acute-care setting and care given in the home-care environment?

A) In the acute-care setting, the inner cannula is cleaned
B) In the home-care setting, dressings are not necessary
C) In the acute-care setting, hydrogen peroxide is used for cleaning
D) In the home-care setting, the procedure may be done with clean technique

Question 19

What does the nurse teach the patient and caregiver to do when setting up and changing administration sets for continuous tube feedings to preserve medical asepsis?

A) Add formula to formula already hung to prevent waste
B) Store unused formula at room temperature to prevent spasm
C) Hang only enough formula that will be infused in a 4- to 6-hour period
D) Change the administration set every 48 hours

Question 20

Which of the following is an appropriate step when teaching temperature monitoring in the home?

A) Suggest aspirin to decrease fevers
B) Recommend using only tympanic membrane sensors
C) Encourage the use of alcohol rubs to reduce fevers
D) Demonstrate the technique on yourself or a family member rather than on the patient

Question 21

While teaching how to check for gastric residual,the nurse instructs the caregiver to delay the tube feeding if he/she obtains more than _________ mL of gastric aspirate.

Question 22

OCDs reduce the amount of oxygen the patient uses,resulting in an overall cost reduction to the patient.The type of OCD that delivers oxygen only during inspiration is called a _______________.

Question 23

A patient is discharged and is sent home with enteral feedings.What instructions should the nurse give to the caregiver?

A) Flush the tube out after administering medications
B) Keep the tube loose to allow for patient movement
C) Use sterile technique when preparing and administering feedings
D) Hang enough formula each time to cover 8 to 12 hours of feeding

Question 24

Expected outcomes for patients who are being taught how to use a thermometer include which of the following? (Select all that apply.)

A) Ability to correctly measure temperature
B) Ability to properly clean and store the thermometer
C) Knowledge of normal temperature ranges
D) Signs and symptoms of fever
E) None of above

Question 25

In teaching older adult patients how to exercise safely,the nurse realizes that cardiac output is lower in older adults,and that the heart of the older adult cannot adapt as well to sudden demands for increased oxygen.Therefore,the nurse uses the following calculation to determine a safe maximum heart rate during exercise in the older adult population: _______________.

Question 26

In teaching the patient the best sites for assessing bp,which of the following should the patient be taught to avoid? (Select all that apply.)

A) Sites with intravenous catheters
B) Arms with arteriovenous shunts
C) Arms on the side of mastectomy
D) The left arm following a heart attack

Question 27

Which of the following are signs of hyperthermia? (Select all that apply.)

A) Dry, warm, flushed skin
B) Chills and piloerection
C) Uncontrolled shivering
D) Loss of memory

Question 28

Reusable supplies need to be disinfected at least weekly.To disinfect supplies,use which of the methods described below? (Select all that apply.)

A) Boil reusable (boilable) supplies for 5 minutes. Allow to cool and dry.
B) Boil reusable (boilable) supplies for 15 minutes. Allow to cool and dry.
C) Soak reusable supplies in equal parts of vinegar and water for 30 minutes. Remove, rinse thoroughly, and dry.
D) Soak reusable supplies in prepared solutions of quaternary ammonium chloride compounds according to manufacturer's instructions. Rinse and dry.

Question 29

The nurse is teaching the patient about the signs of hypothermia.She teaches that the signs of hypothermia include which of the following? (Select all that apply.)

A) Piloerection
B) Restlessness
C) Cool skin
D) Uncontrolled shivering

Question 30

Oxygen-conserving devices (OCD)reduce the amount of oxygen the patient uses,resulting in an overall cost reduction to the patient.The type of OCD that stores oxygen in a chamber during the expiratory phase of respirations is known as the _______________.

Question 31

Temperatures in the older adult are different from those in the younger adult.The mean oral temperature for older adults often ranges from ____________.

Question 32

The patient needs to be taught the signs of hypoxia.Which of the following are causes of hypoxia? (Select all that apply.)

A) Incorrect flow rate
B) Poor tubing connection
C) Use of long oxygen tubing
D) Airway plugging
E) None of above

Question 33

A ___________________ delivers oxygen through a catheter permanently inserted into the trachea,thus allowing the patient to speak and bypassing anatomical dead space.

Question 34

While assessing the need to teach a patient about home oxygen therapy,the nurse must assess for which of the following? (Select all that apply.)

A) Working smoke detectors
B) The presence of fire extinguishers
C) The presence of a home safety plan
D) The presence of a certificate of medical necessity (CMN)

Question 35

What instructions should the nurse provide when teaching the patient and the patient's caregiver how to administer parenteral nutrition (PN)?

A) PN solution should be kept refrigerated until time of administration
B) Remixing separated mixture components by shaking the bag is common
C) PN is compatible with most intravenous (IV) medications
D) Blood glucose monitoring will be necessary

Question 36

In preparing to teach a patient how to self-administer mediation,the nurse realizes that 80% of patients who self-medicate for preventative care fail to do so.Reasons for this include which of the following? (Select all that apply.)

A) Symptoms subside
B) Medication regimens are confusing
C) Prescriptions are costly
D) Many patients fear addiction
E) None of above

Question 37

In teaching the patient how to take his own blood pressure,the nurse instructs the patient to avoid which of the following 30 minutes before taking the blood pressure (BP)? (Select all that apply.)

A) Exercise
B) Caffeine
C) Smoking
D) Resting