Deck 2: Patient Care Settings

Question 1

A patient with multiple sclerosis must be fed,bathed,and dressed.The nurse assesses the patient to be:

A) Disabled
B) Disadvantaged
C) Handicapped
D) Impaired

Answer 1

Impaired

Question 2

The nurse explains that the law that provides for a partially paralyzed fork-lift operator to be retrained by vocational rehabilitation services for less demanding office work is the:

A) Vocational Rehabilitation Act of 1920
B) Social Security Act of 1935
C) Rehabilitation Act of 1973
D) Americans with Disabilities Act of 1990

Answer 2

Rehabilitation Act of 1973

Question 3

The nurse explains that in 1990,when the Americans with Disabilities Act (ADA)was passed,it extended many services for the disabled persons such as:

A) Covering the costs for the rehabilitation of disabled World War I servicemen by providing job training
B) Extending protection to the disabled in the military sector, such as wheelchair ramps on military bases
C) Extending protection to the disabled in private areas, such as accessibility to public restaurant bathrooms and telephones
D) Affording the disabled full access to all health care services

Answer 3

Extending protection to the disabled in private areas, such as accessibility to public restaurant bathrooms and telephones

Question 4

Based on guidelines from the ADA,which question is an appropriate choice for the director of nurses to ask a nurse with an artificial leg who is applying for a staff position in an extended care facility?

A) "How long have you had your prosthesis?"
B) "How many flights of stairs are you able to climb without assistance?"
C) "Are you able to lift a load of 45 pounds?'
D) "Has your disability caused you to miss work?"

Question 5

The nurse assesses a patient who needs to be reminded to take premeasured oral medications,wash,go to meals,and undress and come to bed at night,but coming and going as he pleases is considered safe for him.The nurse determines that the appropriate placement would be in a facility that features:

A) Skilled care
B) Intermediate care
C) Sheltered housing
D) Domiciliary care

Question 6

The home health care nurse explains that although she performs all the following actions,the only one that is reimbursable under Medicare payment rules is to:

A) Observe a wife clean and change the dressing.
B) Take a frail couple for a walk to provide exercise.
C) Watch a patient measure out all medications.
D) Teach a patient to give herself insulin.

Question 7

While the home health nurse is making the entry to a service assessment on a home-bound patient,the wife of the patient asks whether Medicare will cover the patient's ventilator therapy and his insulin injections.The nurse responds:

A) "Yes, Medicare will cover both the ventilator therapy and the insulin injections."
B) "No, Medicare will not cover either of these ongoing therapies."
C) "Medicare will cover the ventilator therapy, but it does not cover the insulin injections."
D) "Medicare will cover the ongoing insulin therapy, but it does not cover a highly technical skill such as ventilator therapy."

Question 8

A frail patient in a long-term care facility asks the nurse if a bath is to be given this morning.The best reply by the nurse that would encourage independence and give the patient the most flexibility would be:

A) "Based on your room number, you get bathed on Monday, Wednesday, and Friday. Today is Tuesday."
B) "If you want to eat breakfast in the dining room with the others, you may sponge yourself off in your bathroom."
C) "When your daughter comes this evening, ask her if she can give you a bath."
D) "I will bring a basin of water for a sponge off for right now. After breakfast, we will talk about a bath schedule."

Question 9

The nurse describes community health nursing by using the example of:

A) Visiting patients in their home after hospital discharge to assess their personal health status.
B) Asking a nursing assistant (NA) to identify the health services most needed in the patient's personal life.
C) Meeting with residents of low-income housing to identify their health care needs.
D) Developing a hospital-based home health care service.

Question 10

The wife of a patient asks the nurse whether her husband would be considered for placement in a skilled nursing care facility when he is discharged from the general hospital.The patient is incontinent,has mild dementia but is able to ambulate with a walker,and must have help to eat and dress himself.The nurse's most appropriate reply is:

A) "Yes, your husband would qualify for a skilled care facility because of his inability to feed and dress himself."
B) "No, your husband's disabilities would not qualify him for a skilled facility."
C) "Yes, your husband qualifies for placement in a skilled care facility because of his dementia."
D) "Yes, anyone who is willing to pay can be placed in a skilled nursing facility."

Question 11

The nurse is making a list of the members of the rehabilitation team so that the different types of services available to patients may be taught to a group of families.Which of the following lists should be used?

A) Physical therapist, nurse, family members, and personal physician
B) Occupational therapist, dietitian, nurse, and patient
C) Rehabilitation physician, laboratory technician, patient, and family
D) Vocational rehabilitation specialist, patient, and psychiatrist

Question 12

The nurse explains the level of disability to a patient who was injured in a construction accident that resulted in the loss of both his right arm and right leg.Because this loss has affected his quality of life and his ability to return to his previous employment,he would be classified as being disabled at level:

A) I
B) II
C) III
D) IV

Question 13

The nurse has noted that a newly admitted resident to an extended care facility stays in her room,does not take active part in activities,and leaves the meal table after having eaten very little.The nurse analyzes this relocation response as:

A) Regression
B) Social withdrawal
C) Depersonalization
D) Passive aggressive

Question 14

Home health nurses have some different nursing activities than those of community health nurses.Which of the following describes the home health nurse's activities?

A) Conducting health education classes in a senior citizens' common residence building.
B) Conducting blood pressure screening on a regular basis at a local mall.
C) Visiting and assessing the home care and further teaching needs of a patient who has been recently discharged from the hospital.
D) Acting as a nurse consultant to a chronic psychiatric section in a state institution.

Question 15

A computer programmer who lost both legs is being retained by his employer,who has made arrangements for a ramp and a special desk to accommodate the patient's wheelchair.This is an example of disability level:

A) I
B) II
C) III
D) IV

Question 16

Which law initially provided for rehabilitation of disabled Americans?

A) Vocational Rehabilitation Act of 1920
B) Social Security Act of 1935
C) Rehabilitation Act of 1973
D) Americans with Disabilities Act of 1990

Question 17

When their grandmother was admitted to a long-term residential care facility,the family was assured by the admitting nurse that care,in keeping with the concepts of long-term care,would be based on:

A) Amount of activities the resident can do for herself
B) Maintenance care with an emphasis on incontinence
C) Successful adaptation to the regulations of the home
D) Maintenance of as much function as possible

Question 18

As a home health nurse,the licensed practical nurse (LPN)is aware that the care skills that are safe and appropriate to teach family members are:

A) Insulin injection
B) Sterile dressing changes
C) Venipunctures
D) Periodic Foley catheter insertions
E) Instillation of eye drops
F) Changing dressings on small wounds

Question 19

The nurse assures a 58-year-old with diabetes who is recuperating from a broken hip that funds for his rehabilitation are available from the:

A) Vocational Rehabilitation Act of 1920
B) Rehabilitation Act of 1973
C) Disabled American Veterans Act of 1990
D) Title V, Health of Crippled Americans 1935

Question 20

The nurse clarifies to a new patient in a rehabilitation center that rehabilitation means that the patient will:

A) Return to his previous level of functioning.
B) Be counseled into a new career.
C) Develop better coping skills to accept his disability.
D) Attain the greatest degree of independence possible.

Question 21

The nursing care plan in a long-term care facility calls for the documentation of regressive behavior of a newly admitted 82-year-old resident,who has had congestive heart failure and osteoarthritis.Of these behaviors observed by the nurse,the ones documented as regression are:

A) Talks nonstop to staff and other residents.
B) Wets and soils self several times a day.
C) Wakes in the middle of the night and is unable return to sleep.
D) Wears the same clothes day after day.
E) Cries frequently for no apparent reason.

Question 22

The nurse clarifies that an impairment that creates a measurable diminished capacity to work is a ____________________.

Question 23

The nurse explains to the home health patient that most quality-of-care problems are a result of:

A) Patient's noncompliance
B) Family's reluctance to participate in the care
C) Inadequate documentation
D) Limited funding
E) Defective communication among care team members

Question 24

The 80-year-old man newly admitted to a long-term care facility has suddenly become incontinent of urine at night.The nurse plans interventions to help restore self toileting by:

A) Waking the resident every 2 hours and escorting him to the bathroom.
B) Leaving a night light on.
C) Discouraging the use of long-legged pajama bottoms.
D) Placing a urinal at the bedside.
E) Keeping the room uncluttered.

Question 25

The home health nurse,while in the home to change a decubitus dressing,notices that the wound has a musky odor and is weepier than the last visit,2 days earlier.Prioritize these nursing interventions for this situation:

A) Contact the case manager.
B) Assess the patient's entire skin, vital signs, and be prepared to describe the wound findings.
C) Cleanse the decubitus area well, and redress the wound.
D) Chart the appearance of the decubitus completely.
E) Assess the patient's mobility.

Question 26

To teach a family member the skill of injecting insulin effectively,the home health nurse will do which of these? (Prioritize these nursing interventions for this situation.)

A) Offer instruction at an appropriate pace.
B) Write down the steps of the procedure.
C) Assess the level of knowledge of the family member.
D) Inquire about the preferred learning style.
E) Evaluate the family member's performance.