Question 1

The nurse is describing home care services to a client that requires extended care. Which of the following statements is true related to home care services?&#10;A)Technologically complex therapies must be managed in the hospital.&#10;B)The client's family will be included in planning and the client's care.&#10;C)Home care services are limited to visits by registered nurses or home health aides.&#10;D)In order for insurance to cover the home care, the client must be confined to bed.

Accepted Answer

Family members who are providing care are included in planning the client's care and treatments. Other disciplines, such as physical and occupational therapy, also provide appropriate home health services. The client must be homebound, but not bed bound, to receive reimbursement for home care services. High-tech services are increasingly accomplished in the home setting where the client is more comfortable and the risks for complications such as infection are less.

Question 2

An older-adult client who lives alone was hospitalized for a fractured hip and has recovered from the surgery but needs to continue to work to improve mobility. Which of the following settings would the nurse anticipate that the client be transferred to?

A)Another acute care setting
B)A transitional care setting
C)A residential care facility
D)Their own home with home health nursing

Accepted Answer

Home health nursing is appropriate for clients who need continued rehabilitation and can implement this in their own home. The client is no longer in need of the more continuous assessment and care given in acute care settings. There is no indication that the client will need the permanent and ongoing medical and nursing services available in intermediate care. The client is not yet independent enough to transfer to a residential care facility.

Question 3

Which of these clients should the nurse refer for home health care services?&#10;A)A 71-year-old with dementia who needs 24-hour care to prevent injury&#10;B)An 82-year-old whose family has asked for help to organize pills into a pill box&#10;C)A 67-year-old who requires assistance with shopping, housework, and cooking&#10;D)A 79-year-old with terminal cancer who needs hospice palliative

Accepted Answer

Hospice palliative care is one aspect of home health care services. Services such as shopping, housework, and cooking are not skilled nursing services and do not require home health care. Institutional care is required for clients who need 24-hour care.Medication assistance can be achieved through the client's pharmacy when filling medications, request bubble packs.

Question 4

Afamily caregiver tells the home health nurse, &#34;I feel like I can never get away to do anything for myself.&#34; Which action is the most appropriate for the nurse to take?&#10;A)Assist the caregiver in finding respite services.&#10;B)Assure the caregiver that the work is appreciated.&#10;C)Teach the caregiver that family members provide excellent client care.&#10;D)Encourage the caregiver to discuss feelings openly with the nurse as needed.

Accepted Answer

Respite services allow family caregivers to have free time. The other actions also may be helpful, but the caregiver's statement clearly indicates the need for some free time.

Question 5

Which of the following nursing activities is appropriate for the home care nurse who is caring for a client newly diagnosed with diabetes to delegate to a home support worker?&#10;A)Assist the client to choose an appropriate diet.&#10;B)Check the client's feet for signs of breakdown.&#10;C)Help the client with a daily bath and oral care.&#10;D)Teach the client how to monitor blood glucose.

Accepted Answer

Assisting with client hygiene is included in the home support workers' education and scope of practice. Assessment of the client and instructing the client in new skills, such as diet and blood glucose monitoring, are complex skills that are included in RN education and scope of practice.

Question 6

The nurse is conducting a home visit and notes that the caregiver may be experiencing caregiver burnout. Which of the following assessments would support this finding?&#10;A)Anxiety&#10;B)Sleeplessness&#10;C)Weight gain&#10;D)Increased use of respite care

Accepted Answer

Assessment of the signs of caregiver burnout (e.g., sleeplessness, difficulty concentrating) is a critical role of the home care nurse. Weight gain is an indication that the caregivers' nutritional intake exceeds requirements. An increased use of respite care could indicate an increased involvement of the caregiver in outside support and activity groups. This assessment finding would require further assessment before linking it to caregiver burnout.

Question 7

Aclient who was in an automobile accident is assigned a nurse as a case manager. Which of the following responsibilities is required of the nurse in this role?&#10;A)Care for the client during hospitalization for the injuries.&#10;B)Assist the client with home care activities during recovery.&#10;C)Coordinate the services that the client receives in the hospital and at home.&#10;D)Determine the types of medical care the client needs for optimal rehabilitation.

Accepted Answer

The role of the case manager is to coordinate the client's care through multiple settings and levels of care to allow the maximal client benefit at the least cost. The case manager does not provide direct care in either the acute or home setting. The case manager coordinates and advocates for care but does not determine what types of medical care are needed, that is done by the health care provider or other provider.

Question 8

Which of the following concepts is foundational to home health nursing?&#10;A)Acute care management&#10;B)Health promotion&#10;C)Chronic disease management&#10;D)Health restoration

Accepted Answer

A foundational concept of home health nursing is health promotion. Acute care and chronic disease management are roles; they are not the foundation upon which home health nursing is based. Health restoration is a core expectation but is not the foundation for home health nursing.

Question 9

When the home health nurse is caring for a client who needs to relearn self-care skills such as dressing and self-feeding, which referral will be best?&#10;A)Dietitian&#10;B)Speech therapist&#10;C)Physical therapist&#10;D)Occupational therapist

Accepted Answer

Occupational therapists assist clients with self-care skills. Physical therapists assist clients with strengthening, transferring, and ambulation. Dietitians assist with nutritional choices. Speech therapists assist with speech and swallowing needs.

Question 10

Which of the following statements is true in relation to nursing-sensitive outcomes?&#10;A)Only used to evaluate client care.&#10;B)Are outside of the nurses' scope of practice.&#10;C)Have no influence on health care budgets.&#10;D)Require empirical evidence.

Accepted Answer

Nursing-sensitive outcomes are "those that are relevant, based on nurses' scope and domain of practice, and for which there is empirical evidence linking nursing inputs and interventions to the outcomes." Outcomes data may also be used to evaluate the nurses own practice or that of their team or program, as well as client care. Decision makers and funders require outcomes data to support budget needs, program design and delivery, and the development of accountability mechanisms such as balanced scorecards.

Question 11

Which of the following statements represent a current trend in home health nursing?&#10;A)Increased numbers of registered nurses are being employed as home health nurses.&#10;B)Decreased numbers of licensed practical nurses are being employed as home health nurses.&#10;C)There are more employment opportunities for newly graduated nurses.&#10;D)That a minimum of two years of acute care experience is required before employment as a home health nurse.

Accepted Answer

The answer of Which of the following statements represent a...

Deck 6: Community-Based Nursing and Home Care