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

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?

A)"Home visits allow you to focus on the entire family and see threats to health and safety."
B)"Making home visits will increase your marketability after you graduate."
C)"Our State Board of Nursing requires home visits as part of community/public health education."
D)"The national accreditation policies require that students make home visits before they graduate."

Answer 1

"Home visits allow you to focus on the entire family and see threats to health and safety."

Question 2

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

A)To assess the health of all family members and the immediate environment
B)To discuss the time and financial limits to the care the nurse can give
C)To establish rapport with the clients and work with them to define mutually agreeable goals
D)To implement the nursing care plan established before hospital discharge

Answer 2

To establish rapport with the clients and work with them to define mutually agreeable goals

Question 3

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

A)Confirming that all needed assessment data are obtained
B)Creating an accurate and appropriate list of nursing diagnoses
C)Establishing a systematic evaluation plan
D)Establishing trust for a productive relationship

Answer 3

Establishing trust for a productive relationship

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?

A)"All nurses try to help people stay well,but I can also help you assess your home for any dangers to the baby."
B)"Hospital nurses and I all try to be helpful,but I can also tell you how to obtain excellent child care."
C)"In the hospital,you had a nurse focus on your baby and another nurse focus on your care.I'll be focusing on both you and your baby."
D)"The other nurses in the hospital focus on helping you and the baby get off to a great start.I'm going to repeat everything to be sure you really know it."

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?

A)It documents the cost of each nursing service.
B)It protects the nurse if the nurse is ever sued for malpractice.
C)It is legally binding for both parties.
D)It clarifies who will do what,when,where,and why.

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?

A)Ambivalence because the nurse could be helpful but also judgmental of their situation
B)Glad because the nurse can be of immediate help
C)Fearful because the nurse is someone who has the authority to intervene in their lives
D)Angry because the nurse is essentially an intruder into their lives

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?

A)Chart that the mother was noncompliant and would not let the nurse return.
B)Plan on returning in 1 week to answer any new questions the mother might have about her baby,how to care for him,or how infants grow and develop.
C)Stress how to get in touch with the public health agency if the mother ever has questions or needs assistance and then wish her the very best.
D)Try to find free formula,baby cereal,infant clothes,and other goodies to give the new mother so she will let the nurse back into the apartment.

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?

A)"I am going to ask you to come back tomorrow to help the new mother further."
B)"Why would the new mother experience any problems?"
C)"We have to assume that the new mother will be able to manage without us."
D)"We'll have another nurse stop by tomorrow to help the new mother."

Question 9

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

A)Home visits are a new skill to be mastered,and learning is uncomfortable.
B)Home visits reflect a situation under the client's control and in the client's environment.
C)Home visits require lots of supervision,backup,and extra resources.
D)Home visits take much more time and effort than does giving care in the hospital.

Question 10

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

A)Before leaving his or her car,he or she should check the immediate surroundings for anyone or any situation that makes the nurse uncomfortable.
B)The nurse should intervene immediately with a family whose fighting is starting to become physical,before it escalates further.
C)The nurse should visit a family over the weekend,when no one is expecting an outsider to drop by.
D)When approached on the street by an unknown person,the nurse should stop and tell them how to reach the agency to be formally accepted as a client.

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?

A)"Research has shown home visits save far more than their cost in decreasing child abuse,drug-resistant infections,and even emergency department visits."
B)"The public health department staff members are the most knowledgeable concerning funding needed and how best to spend the funds."
C)"The voters agreed on the tax levy funding the department.It would not be politically wise to act against voters' obvious desires."
D)"With all the fear about bioterrorism,it is an inappropriate time to cut funds to the public health department."

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?

A)It demonstrated that the home-bound man was trying to be compliant with the nurse's suggestion.
B)It made the apartment so much nicer for both the client and the nurse.
C)It was a successful short-term achievement toward the long-term goal of environmental safety.
D)The elderly gentleman obviously expected considerable praise for doing such a female task.

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?

A)To geriatric clients and the local senior citizen centers
B)To the neighborhood at highest risk in the city
C)To the neighborhood where the nurse lives
D)To wherever the nurse selects

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?

A)"Are these cats hungry? Or do they want something else?"
B)"Cats can really cause health problems.Would you like me to call the animal shelter for you?"
C)"Would you like to introduce me to your cats?"
D)"Would you please lock up your cats until we're done?"

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?

A)Agreeing upon appropriate interventions with the family
B)Creating appropriate nursing diagnoses
C)Assessing the environment of the wider community
D)Confirming the information obtained with the client

Question 16

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

A)Consistency with agency rules and procedures
B)Legally,whatever the medical referral requires
C)Unless a medical emergency,whatever the client believes is most important
D)What the nurse's professional judgment determines to be the major threat to health

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?

A)The nurse who had analyzed all of the background data
B)The hospital case manager who had coordinated the couple's care
C)The elderly couple themselves
D)The nurse who had been the primary care provider in the hospital before discharge

Question 18

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

A)Acceptance and sympathy
B)Enthusiasm and energy
C)Positive intent,supportiveness,and trust
D)Positive regard,empathy,and genuineness

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?

A)"I can't believe you even asked me that.I don't have any money!"
B)"I can't help with those items,but I can share with you some other resources that may help you adapt to having this new little person in your lives."
C)"I'll ask at the home office and see if someone knows a resource for you."
D)"My sister has some cloth diapers she isn't using anymore;I can bring those over,but I don't have any formula.Have you tried asking the hospital for free samples?"

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?

A)It takes a long time and much effort to change people's behavior.
B)The clients may not change today,but they may change tomorrow.
C)The nurse may have to change the client's values in order for the client to want to change behaviors.
D)The only person the nurse can change is the nurse.

Question 21

A nurse briefly summarized a home visit with the agency supervisor.How can discussing clients with a colleague help the nurse?

A)By ensuring that the agency's policies and procedures are correct
B)By confirming the nursing inferences that have been developed
C)By ensuring that appropriate referrals are made for the client
D)By confirming that the client understands the obligations of the agency

Question 22

Which of the following would most likely be a problem for the nurse making home visits? (Select all that apply.)

A)Assessing the client may be more complex when family and environmental factors are considered in the assessment.
B)The nurse may be unable to care for as many clients because of the time lost in transportation.
C)Clients will be unable to receive individualized care.
D)Teaching may be more time-consuming when both the client and the family are involved.
E)The nurse may sometimes be concerned for personal safety.
F)It may be difficult to control distractions,such as noisy children.

Question 23

What should a nurse bring to the home visit when first going to the apartment of a newly admitted patient whose referral sheet was essentially blank?

A)Everything that might possibly be needed
B)Liquid soap,paper towels,educational materials,and assessment equipment
C)Nothing;the nurse should assess the situation and then get supplies
D)Agency forms and a pen

Question 24

After a completing a home visit,which of the following would be the priority action for the nurse?

A)Submit the insurance and other third-party payer forms correctly.
B)Call the family and determine their satisfaction with the visit.
C)Complete the documentation and discuss questions beyond the nurse's expertise with a consultant.
D)Order the necessary supplies and equipment for the return visit.

Question 25

After being invited into the apartment of some elderly clients,the nurse was shocked to realize the elderly husband was smoking marijuana.Which of the following actions should the nurse take?

A)Indicating that he or she will return at another time and then leaving the home
B)Asking the man to stop and stress that the nurse cannot return if they are going to engage in illegal behavior while the nurse is there
C)Calling the police,reporting the illegal behavior,and agreeing to serve as a witness if the case goes to trial
D)Leaving and refusing to come back until all illegal drugs are out of the apartment

Question 26

Of the five clients listed below,whom should a nurse visit first?

A)A married couple who have been having problems with independent living since the husband developed a staphylococcal infection
B)A client with acquired immune deficiency syndrome (AIDS)who is waiting for a hospice opening
C)A new admission who was discharged from the hospital with a diagnosis of pneumonia
D)A man with a draining chest abscess who is receiving intravenous antibiotics

Question 27

A nurse visited a middle-aged client at home after his hospital discharge.The client was cleaning a gun.When the nurse asked the client to put the gun away,the client became agitated.What is the nurse's best action at this time?

A)Apologizing and saying that the visit will be rescheduled when the client is feeling better
B)Focusing on client assessment and staying calm because filling out the necessary forms will not take long
C)Hurrying through the visit and finishing the documentation inside the safety of the nurse's car
D)Using a low voice and slow,calm movements,and asking whether there is a problem