Deck 3: Community and Home-Based Care of Adults

Question 1

Upon discharge from the hospital, a patient is going have and will need medication injected weekly, assistance with meal preparation, and minor assistance with activities of daily living. The nurse would identify which of the following community-based care services as being appropriate for this patient?

A)home care
B)hospice care
C)ambulatory surgical care
D)long-term care

Answer 1

home care

Question 2

A patient is being discharged, however, the home care nurse is not going to be able to see the patient for two days. The patient is easily tired and is unable to concentrate on discharge teaching. Which of the following can the nurse defer for the home care nurse to instruct the patient?

A)the activities that will take place during the four-week checkup with the physician
B)the recommended diet after discharge
C)potential adverse reactions of the prescribed medications
D)the actions of the prescribed medications

Answer 2

the activities that will take place during the four-week checkup with the physician

Question 3

A patient who lives alone tells the nurse that he is concerned about being able to perform dressing changes at home after discharge. Which of the following should the nurse do first to assist this patient?

A)Discuss the patient's needs with the physician.
B)Make a referral to the home healthcare agency preferred by the patient.
C)Contact the hospital social worker.
D)Ask the patient if a friend or neighbor can help.

Answer 3

Discuss the patient's needs with the physician.

Question 4

Upon discharge from the hospital, a patient is going to need his blood pressure checked weekly. Which of the following community factors would provide the nurse with information to direct the patient to go for weekly blood pressure checks?

A)community health care structure
B)social support systems
C)environmental factors
D)economic resources

Question 5

The nurse is evaluating a group of patients for referral to a home health agency. Each of the patients is on the Medicare program. Which patient is most likely to qualify for home health services?

A)the patient with a moderate-sized pressure ulcer requiring daily dressing changes
B)the postoperative patient needing to be seen by the physician six weeks after surgery
C)the bedridden patient who is prescribed oral antibiotic therapy for two weeks
D)the patient who needs monthly blood work to adjust Coumadin dosage

Question 6

While completing an assessment of a patient in the home, the nurse learns that the patient has a sufficient social support system. Which of the following did the nurse assess for this patient?

A)church friends who visit several times a week
B)transportation to healthcare providers
C)easy access to bathroom facilities in the home
D)receives Medicare and has an additional healthcare insurance plan

Question 7

A patient is prescribed a new medication and is calling pharmacies to learn what the cost of the prescription is going to be. The nurse realizes this patient is working within which of the following health factors?

A)economic
B)environmental
C)community structure
D)social support

Question 8

A patient asks the nurse what a parish nurse is since one came to see him while he was in the hospital last week. With which of the following should the nurse respond to the patient?

A)"Parish nurses provide health care in non-traditional ways to specific groups of people."
B)"You must practice a certain faith to be involved in parish nursing."
C)"Parish nurses are independent practitioners providing care to members of a selected church."
D)"Parish nursing is reserved for nurse practitioners."

Question 9

The mother of a child who is severely handicapped states she is exhausted and voices the need to "take a break" to the nurse. What type of referral would best benefit the mother?

A)a respite care provider
B)hospice care agency
C)home care
D)ambulatory clinic

Question 10

A patient tells the nurse that whenever he has a minor ailment or illness, he sees the nurse practitioner at the local pharmacy to get "checked out" and receive medication. The nurse realizes the patient is utilizing which of the following community-based care options?

A)urgent care center
B)outpatient center
C)county health department
D)adult day care center

Question 11

A patient who is receiving home care learns that he has to boil his drinking water because of contaminants. The nurse realizes that which of the following health factors has been affected for this patient?

A)environmental
B)social support
C)economic
D)community structure

Question 12

During a home care visit, the nurse does not agree with what the patient wants to do regarding continuing care. Which of the following should the nurse do to support the patient's needs?

A)Support the patient as an advocate.
B)Ask the home care agency to assign another nurse.
C)Contact the patient's physician to assist with conflict resolution.
D)Discharge the patient from home care services.

Question 13

During the first home care visit, the patient says that she cannot remember how to change the dressing on her leg even though the nurse went over the procedure. With which of the following should the home care nurse respond to the patient?

A)"I will go over the procedure with you."
B)"Maybe you weren't ready to come home."
C)"Are you having problems with your memory?"
D)"What else have you forgotten that the nurse instructed you?"

Question 14

An elderly patient leaves his home for several hours most days of the week and attends a facility where care is provided specific to the needs of the elderly. The patient is attending which of the following types of community-based nursing care programs?

A)adult day care
B)healthcare clinic
C)urgent care center
D)outpatient center

Question 15

The nurse is determining if a patient is eligible for home care services. Which of the following patient needs would be used to determine the patient's eligibility?

A)biweekly medication injection and physical therapy for home ambulation
B)assistance with meal preparation
C)grocery shopping and laundry
D)scheduling physician appointments and writing monthly utility bills

Question 16

A patient receiving home care tells the nurse that her son has not been getting groceries and she is hungry and unable to take all of her medication. Which of the following should the nurse do to support this patient?

A)Report substandard care being provided by the son.
B)Have the patient admitted to the hospital.
C)Document the patient is not eating.
D)Purchase groceries for the patient.

Question 17

An elderly couple lives alone and receives assistance periodically from adult children, neighbors, and friends. The nurse would document that this couple is receiving which type of care?

A)community
B)support group
C)long-term care
D)home care

Question 18

An elderly patient tells the nurse that it is becoming more difficult for him to prepare meals at home. Which of the following should the nurse suggest to assist this patient?

A)Meals-on-Wheels
B)day care
C)parish nursing
D)home care

Question 19

A patient tells the nurse that he often sleeps at the homeless shelter and has no regular physician for health care. Which of the following community-based services would be applicable for this patient?

A)community clinic
B)day care program
C)Meals-on-Wheels
D)home care

Question 20

The daughter of a patient tells the nurse that she takes her mother to the community center every day while she is at work so that her mother can be with other people, have lunch, and participate in activities. The nurse realizes the patient is participating in which of the following?

A)day care
B)home care
C)community clinic
D)faith community nursing

Question 21

Upon discharge from an acute care facility, the patient is referred to the hospital's home healthcare agency. This patient will be receiving services from which of the following types of agencies?

A)institution-based
B)public
C)voluntary
D)private

Question 22

The nurse is considering working as a community-based nurse. The nurse knows this is a role that may have many contributing factors for providing care. Which of the following factors may affect the health of a community? Select all that apply.

A)social support systems
B)community healthcare structure
C)environmental factors
D)economic resources
E)political affiliations

Question 23

A patient, receiving rehabilitation after a motor vehicle accident, plans to return to home to live alone independently. Which of the following would be a priority for the nurse to assess for this patient?

A)home environment
B)employment status
C)location of shopping facilities
D)accessibility of public transportation

Question 24

The nurse is completing the home health admission for a patient. Which one of the following initial actions should the nurse take with the plan of care created from the admission information?

A)Send it to the physician for review and approval.
B)Keep it in the patient's home.
C)Keep it during every visit.
D)Place it in the patient's medical record.

Question 25

A patient is upset because he is unable to resume his previous activities since sustaining a leg injury that has reduced his ability to bear weight while walking independently. Which of the following can the nurse do to assist this patient?

A)Suggest the patient work with physical therapy to regain a maximum level of independence.
B)Contact Social Services for employment counseling for the patient.
C)Remind the patient that he does have the use of his other limbs.
D)Advise the patient to talk with family regarding his limitations and the need to make changes.

Question 26

The nurse is caring for a patient who has had a reduction in the ability to move his left arm after surgery. At the present time, this patient is experiencing which of the following?

A)impairment
B)disability
C)handicap
D)side effect of surgery

Question 27

During a phone call to coordinate a time for the first home care visit, the nurse learns the patient is on home oxygen therapy, uses a walker for ambulation, and has minimal strength in her lower extremities. This information will be used for which of the following?

A)to plan nursing diagnoses
B)to arrange transportation for the patient
C)to schedule a physical therapy evaluation
D)to evaluate how well the patient is doing since arriving home

Question 28

During the first home care visit, the nurse reviews with the patient all of the information about privacy and informed consent. Which of the following documents should the nurse include in this review?

A)NAHC Bill of Rights
B)ANA standards for home health nursing
C)ANA standards for community health nursing
D)HIPAA standards

Question 29

The home care nurse is planning to visit a patient who is on Medicare. The nurse realizes that care can be provided if

A)the patient is considered homebound.
B)the home meets safety standards.
C)the patient can use a wheelchair.
D)the patient lives alone.

Question 30

The nurse is teaching a patient about ways to increase personal safety in the home. During the interaction, the patient advises the nurse that he has no plans to make the recommended changes. Which of the following responses by the nurse is the most appropriate?

A)"If you need more information about what we have discussed, please let me know."
B)"You might not get well if you do not follow my recommendations."
C)"I will need to tell your physician the home is not safe enough."
D)"I might not be able to continue my visits if you do not conform."

Question 31

During a visit with a patient, the home care nurse becomes concerned about criminal activity in the home. Which of the following initial actions by the nurse is the most appropriate?

A)Leave the home.
B)Dial 911 to obtain assistance in removing the patient from the home.
C)Contact the physician to discuss the situation.
D)Advise the patient to leave the home as soon as possible.

Question 32

A patient who is being prepared for discharged from the hospital is identified as needing more care. The family is refusing a transfer to a skilled nursing facility. Which of the following can the nurse do to help this patient?

A)Suggest home care.
B)Nothing.
C)Ignore the family and schedule the patient for transfer.
D)Contact protective services because the patient is at risk.

Question 33

During the admission of a home care patient, the nurse learns the patient is married, has no pets, and has two daughters who live nearby and a mother who is in a nursing home in a suburb across town. Which of the following would the nurse consider as the patient's family?

A)the husband and daughters
B)the husband only
C)the husband and mother
D)no one

Question 34

The home care nurse is preparing to begin a series of visits with a patient who is expected to require home care for the next two months. Which of the following tasks should take place first?

A)Establish trust and rapport.
B)Set priorities.
C)Assess the home environment.
D)Promote learning.

Question 35

The home care nurse observes several small, round bruises on the back side of an elderly patient's arms. What action by the nurse is indicated first?

A)Question the patient about the cause of the bruises.
B)Discuss the bruises with the patient's spouse.
C)Document the bruises, with plans to review them for changes on the next visit.
D)Contact the home health supervisor to report the findings.

Question 36

After mass on Sunday the nurse is measuring blood pressures in the church greeting room. This nurse is most likely practicing which of the following?

A)parish nursing.
B)a Sunday day care program.
C)scheduling parishioners for Meals on Wheels.
D)the first steps to a healthcare clinic.

Question 37

A 79-year-old patient is planning to have a laminectomy. In which of the following healthcare settings is this patient most likely going to have this procedure?

A)An acute care hospital
B)A skilled nursing facility
C)An ambulatory care center
D)An outpatient clinic

Question 38

The patient is in need of home care, is on oxygen therapy, weak from surgery, has a small surgical incision, and needs to increase activity to gain independence. Which of the following home care providers will the nurse most likely suggest for this patient?

A)physical therapy
B)speech therapy
C)social worker
D)occupational therapy

Question 39

The nurse is teaching a group of patients at a senior center about ways to reduce their blood pressure through exercise and recreation. What type of care is this nurse is providing?

A)community-based
B)community health
C)skilled nursing
D)ambulatory

Question 40

A patient receiving home care since discharge from an extended care facility is also to begin home physical therapy. Which of the following should the nurse assess for this patient?

A)patient's needs
B)insurance coverage
C)availability of assistive devices
D)ability to perform activities of daily living

Question 41

The home care nurse sees that a family member is not adhering to the patient's prescribed plan of care and reviews the plan with this family member. The nursing is functioning in which capacity with the family?

A)advocate
B)provider of direct care
C)educator
D)coordinator of services

Question 42

The nurse is exploring parish nursing as a career choice. In what ways will this nurse find that parish nursing is structured? Select all that apply.

A)The nurse is employed by a church.
B)The nurse is employed by a hospital.
C)The nurse volunteers services at a church.
D)The nurse is employed by a state agency.
E)The nurse is employed by a federal agency.

Question 43

Arrange the steps of how home health is initiated in the order in which they must occur. Click and drag the options below to move them up or down.

A)The physician orders home health care.
B)The physician treatment plan is documented.
C)The nurse visits to make an assessment.
D)The nursing plan of care is reviewed and approved by the physician.
E)The plan of care is instituted.

Question 44

The nurse has been employed to oversee the professional caregivers in a home health agency. Which groups will this nurse oversee? Select all that apply.

A)the physical therapist that provides ambulation exercises to patients
B)the social workers that help to coordinate patient services
C)the home health aide that provides hygiene for patients
D)the service that provides oxygen equipment in patient homes
E)the medical supply company that provides dressings and other supplies

Question 45

Which situations reflect the roles of a professional nurse in the home care setting? Select all that apply.

A)The nurse is present to support the patient during a family discussion of advanced directives.
B)The nurse assesses the patient's home environment for safety and security.
C)The nurse teaches the patient's spouse how to change the patient's dressings.
D)The nurse talks to the patient's physician about the possibility of starting a new medication.
E)The nurse visits three times a week to bathe the patient and change the bed linens.

Question 46

The nurse is assessing the health of a community. Which factors should this nurse assess? Select all that apply.

A)the community's environment
B)what economic resources are available to the community
C)health care services available locally
D)social support systems in place in the community
E)the dominant political party of the community

Question 47

The home care nurse sees that the patient uses a walker and oxygen. During the home assessment, the nurse finds several safety issues. Which of the following should the nurse be most concerned about in the patient's home?

A)throw rugs everywhere in the home
B)large spaces between the furniture in the living room
C)grab bars in the bathroom
D)light switches at arms' length

Question 48

The home health nurse has been asked to assume the care of a patient that lives in an isolated country house. What actions by the nurse are appropriate? Select all that apply.

A)Keep car doors locked when traveling to the home.
B)Be certain to have a fully charged cell phone.
C)Keep supplies out of sight.
D)Refuse the assignment.
E)Make visits sporadically on an unannounced basis.

Question 49

The home health patient has a reputation of being demanding and stern. The home health aide tells the patient, "If you don't be nice to me, I'm going to stop coming out here to help you take a bath." Which of the patient's rights as seen above does this situation violate? Select all that apply.

A)Right 1
B)Right 3
C)Right 6
D)Right 2
E)Right 8

Question 50

After the initial assessment of a home care patient, the nurse identifies areas in which the patient can improve their health status. What should the nurse do with this information? Select all that apply.

A)Work with the patient to set goals.
B)Write this information in the plan of care.
C)Contract with the patient to meet the goals.
D)Discuss with the family what to do with the information.

Question 51

A difference exists between community nursing and community-based nursing. Which of these nursing positions are community-based? Select all that apply.

A)The nurse is the primary care provider in a jail.
B)The nurse is the director of an adult day care center.
C)The nurse administers immunizations at a county health department.
D)The nurse works on a commission whose focus is eradication of tuberculosis.
E)The nurse is a lobbyist at the state capitol.

Question 52

During the home care visit, the nurse learns the patient cannot remember what they were taught about bathing and wound care. The nurse realizes this patient

A)forgot what was taught.
B)is cognitively challenged.
C)is hard of hearing.
D)cannot read.

Question 53

The nurse learns that the family has been throwing dirty dressings in with the family's regular trash. Which of the following would be appropriate for the nurse to instruct the family about this practice?

A)Bag the dressing so as not to cause infection of other family members with the soiled dressing.
B)No instruction is necessary, because this is what the family was taught.
C)Make sure they are wearing sterile gloves when throwing the dressing away.
D)Store the used dressings in a bag in the patient's room.

Question 54

The home health nurse fulfills the role of health educator in the home. Place these categories of knowledge into priority order. Click and drag the options below to move them up or down.

A)needs-to-know
B)wants-to-know
C)ought-to-know
D)nice-to-know