Deck 9: Care Coordination and Continuity

Question 1

Which of the following is the major goal of ambulatory care facilities?

A) To save money by not paying hospital rates
B) To provide care to clients capable of self-care at home
C) To perform major surgery in a community setting
D) To perform tests prior to being admitted to the hospital

Answer 1

To provide care to clients capable of self-care at home

Question 2

A home health care agency providing care in a local community is supported by the United Way and local donations. What type of agency is this?

A) Voluntary
B) Public
C) Proprietary
D) Institution-based

Answer 2

Voluntary

Question 3

Which health care provider is responsible for ensuring the room is prepared for admission and that the client is welcomed?

A) Nursing assistant
B) Admitting room clerk
C) Social worker
D) Nurse

Answer 3

Nurse

Question 4

Which of the following phrases best describes continuity of care?

A) Focusing on acute care in the hospital
B) Serving the needs of children
C) Facilitating transition between settings
D) Providing single-episode care services

Question 5

Why would a home health care agency choose to be certified by Medicare?

A) To remain open and offer services
B) To ensure that all available services can be provided
C) To receive reimbursement for Medicare-covered services
D) To be able to admit clients without a physician's order

Question 6

Although all of the following components are important, which two components of nursing care are identified by home health care nurses as most important when caring for clients in the home?

A) Computer knowledge, cultural diversity
B) Physical assessment, infection control
C) Communications, technical skills
D) Documentation, problem solving

Question 7

What role will the nurse play in transferring a client to a long-term care facility?

A) Provide a verbal report to the nurse at the long-term care facility on the client, the hospital care, and the client's current condition.
B) Assure that the client's original chart accompanies the client.
C) Arrange for the client's belongings to remain at the hospital until discharge from the long-term care facility.
D) Inform the client that transferring should be a stress-free situation.

Question 8

The nurse recognizes that the goals established for a client's discharge are more likely to be accomplished when ...

A) the client assists in developing the goals.
B) the physician develops the goals.
C) the nurse develops the goals.
D) the multidisciplinary team develops the goals.

Question 9

A nurse is admitting an older woman (Grace Staples) to a long-term care facility. How should the nurse address the woman?

A) "We will just call you Grace while you live here. Okay?"
B) "I know you have lots of grandchildren, Grandma."
C) "What name do you want us to use for you?"
D) "I think you will enjoy living here, Sweetie."

Question 10

Which of the following health care professionals prescribes home care and certifies the plan of care for the client?

A) Social worker
B) Discharge nurse
C) Home healthcare nurse
D) Physician

Question 11

Which of the following nursing diagnoses would be appropriate for almost all clients entering a health care setting?

A) Impaired Elimination
B) Dysfunctional Grieving
C) Fatigue
D) Anxiety

Question 12

A client is having problems with insurance reimbursement. The home health care nurse discusses the client's need for home health services with the insurance company. What role is the nurse demonstrating?

A) Direct care provider
B) Coordinator of services
C) Educator
D) Advocate

Question 13

What is the goal of nurses who provide home health care?

A) Helping clients achieve maximum independence and health
B) Collaborating with other health care providers and services
C) Minimizing the manifestations of disease processes
D) Encouraging clients' dependence on family members

Question 14

A client has suddenly become very ill, and a nurse is transferring him to the intensive care unit (ICU). How does the nurse provide information to ensure continuity of care?

A) By giving a verbal report to nurses in the ICU
B) By ensuring that the chart and all belongings are moved
C) By delegating a nursing assistant to provide information
D) By asking the family to provide the information

Question 15

In addition to a physician's order, what is one of the eligibility requirements for Medicare-covered home health care?

A) The client must have transportation to the physician's office.
B) The family must be willing to meet health care needs.
C) The client must be essentially homebound.
D) The client must be able to leave the home unassisted.

Question 16

A client asks a nurse, "How does ergotamine (Ergostat) relieve migraine headaches?" The nurse should respond that it:

A) dilates cerebral blood vessels.
B) constricts cerebral blood vessels.
C) decreases peripheral vascular resistance.
D) decreases the stimulation of baroreceptors.

Question 17

A nurse, preparing for a client's discharge after surgery, is teaching the client's wife to change the dressing. How can the nurse be certain the wife knows the procedure?

A) Tell the wife exactly how to do it.
B) Give the wife information about supplies.
C) Have the wife demonstrate the procedure.
D) Ask another nurse to reinforce teaching.

Question 18

At what point during hospital-based care does planning for discharge begin?

A) Upon admission to the hospital
B) After the patient is settled in a room
C) Immediately before discharge
D) After leaving the hospital

Question 19

According to established standards, which health care provider should conduct a holistic assessment for all clients admitted to the hospital?

A) Physician
B) Admission clerk
C) Licensed practical nurse
D) Registered nurse

Question 20

What is required of a client who leaves the hospital against medical advice (AMA)?

A) Nothing. The hospital has no legal concerns.
B) Full reimbursement of any medical expenses
C) Providing contact phone numbers if needed
D) Signing a form releasing legal responsibility

Question 21

The wristband is an important safety component during the client's stay because it is one of two identifiers required by which group's national safety standards (2008) to accurately identify a client during such activities as giving medication, fluids, and blood?

A) The Joint Commission
B) NANDA
C) HIPAA
D) The Kardex

Question 22

A client is diagnosed with mild dementia while in the hospital. In preparing for discharge, what should the nurse should discuss with the family?

A) Possible need for home care
B) Legal responsibility for the future
C) Need for transfer to a long-term care facility
D) Lack of free resources of care

Question 23

What technique should the nurse use to implement infection control in the home?

A) Avoid touching any object in the home, including door knobs.
B) Practice hand hygiene when beginning and ending the home visit.
C) Wear gloves at all times when in the home or traveling in the car.
D) Take prescribed antibiotics on a regular basis on working days.

Question 24

The Joint Commission is one agency that accredits health care institutions. The nurse understands that the Joint Commission has mandated the use of which national safety practice to protect clients admitted to a health care facility?

A) Nurses use the Rights checklist prior to administering medications.
B) Upon admission all clients sign advanced directives.
C) The use of a wristband for identification of the patient.
D) The use of standard precautions in the operating room.

Question 25

The models of nursing care delivery have been many and varied throughout the history of nursing. Which of the following best describes the idea of the continuity of care?

A) Money focused
B) Client focused
C) Primary nursing
D) Functional nursing

Question 26

The nurse is identifying needs of the client and family during the initial home visit. Which question would be inappropriate for the nurse to ask?

A) Tell me what responsibilities each member of the family has.
B) "Can we get rid of some of this clutter in your home?
C) What do you believe is causing your illness?
D) What foods are important in your family life?

Question 27

What must a nurse do before altering the arrangement of furniture in the home to facilitate care?

A) Nothing; the nurse may move the furniture if needed.
B) Document the need to move the furniture.
C) Tell the client that the furniture has to be moved.
D) Ask the client's permission to move the furniture.

Question 28

Which of the following is recommended to ensure safety for the home health care nurse?

A) Traveling with another nurse
B) Carrying a cell phone
C) Talking to family members
D) Refusing assignments

Question 29

Which of the following interventions would be performed by the occupational therapist as a member of the home health care team? Select all that apply.

A) Evaluate the client's functional level.
B) Provide muscle-strengthening exercises.
C) Educate client and family about promoting self-care in ADLs.
D) Provide assistance with securing needed equipment.
E) Implement the plan of care designed by the nurse.

Question 30

The nurse is planning the discharge of a client who had surgery for a left hip replacement. The client is being discharged from the hospital to the home and requires a walker and high-rise toilet seat. Which type of home health care service does the client require?

A) Custodial services
B) Home medical services
C) High-technology pharmacology services
D) Hospice services

Question 31

Which of the following roles of the nurse is most important in providing continuity of care to clients? Select all that apply.

A) Educator
B) Collaborator
C) Mentor
D) Advocate
E) Role model

Question 32

The home health nurse receives a referral from the hospital for a client who needs a home visit. After reading the referral, what would be the first action the nurse should take?

A) Identify community services initially for the client
B) Obtain client information from the discharge planner
C) Call the client to obtain permission to visit
D) Schedule a home health aide to visit the client

Question 33

Which of the following are examples of nursing actions performed in the entry phase of the home visit? Select all that apply.

A) Developing rapport
B) Making assessments
C) Evaluating safety issues
D) Gathering supplies
E) Collecting client information

Question 34

Which one of the following roles of the home health care nurse illustrates the role of coordinator of services?

A) Providing certification for home care
B) Providing direct physical care to the client
C) Providing information about community resources
D) Educating the client and caregiver about wound care

Question 35

Nursing continues to recognize and participate in providing appropriate, uninterrupted care and facilitate clients' transitions between different settings and levels of care. What would be an example of this continuity of care?

A) The nurse collaborating with other members of the health care team
B) The nurse accompanying the physician on rounds
C) The nurse taking detailed notes on how each client wants to continue care
D) The nurse attending an appointment with the client in some place other than where the nurse works