Deck 43: Community-Home Health Nursing

Question 1

The similarities between the Omaha System and the NANDA-I taxonomy are that both contain which of the following?

A) Evaluation tools expressed in standardized language
B) Nursing diagnoses expressed in standardized language
C) Diagnoses, outcomes, and interventions
D) Labels that are intended for use in any healthcare setting

Answer 1

Nursing diagnoses expressed in standardized language

Question 2

A 56-year-old man is hospitalized because of poorly controlled diabetes and a leg ulcer that developed as a complication of diabetes.He is awake,alert,and oriented but fatigued and in need of wound care.In the hospital,he was placed on insulin and started on a variety of oral medications.He is learning how to check his blood sugar and administer insulin.He has never given himself insulin and he does not understand how to interpret his blood sugar readings.The physician has prescribed discharge from the hospital with home health follow-up.Is this an appropriate referral?

A) Yes; the patient is in need of skilled services and, therefore, eligible for home care services.
B) Yes; the patient has been unable to control his diabetes, is noncompliant, and needs to be monitored.
C) No; the patient should remain hospitalized; he has too many needs for home care services.
D) No; the patient is relatively young and oriented; he should be able to provide his own care.

Answer 2

Yes; the patient is in need of skilled services and, therefore, eligible for home care services.

Question 3

A nurse serving the community in a public health role would likely perform which of the following functions within a particular community?

A) Tracking the prevalence of gonorrhea between January and June
B) Screening for scoliosis among 12- to 14-year-old girls in middle school
C) Weighing premature infants receiving phototherapy at home
D) Giving the H1N1 vaccine to fire and police personnel

Answer 3

Tracking the prevalence of gonorrhea between January and June

Question 4

A patient was involved in a motor vehicle accident that resulted in multiple traumatic injuries.He was hospitalized for 8 days in the intensive care unit and 3 days on the surgical floor.He has been discharged home with home health support.Identify the primary goal of his home care.

A) Provide comprehensive direct care.
B) Promote sleep and rest for healing.
C) Teach the patient and family how to provide care.
D) Explain how home care differs from hospital care.

Question 5

A home health nurse has called his patient to arrange an initial home visit and has driven to the home.What is the nurse's objective in the first few minutes of the visit?

A) Develop rapport and trust with the patient and family.
B) Gather demographic data and complete the referral form.
C) Assess the patient's most important health needs.
D) Determine the patient's needs for ongoing care.

Question 6

Documentation in home healthcare may take many forms.Some nurses use NANDA-I terminology for diagnoses,whereas others use the Clinical Care Classification (CCC)system.The chief benefit of the CCC system is that it:

A) Contains diagnoses specific to home care, whereas NANDA-I does not
B) Is simpler to use and more readily understood by other disciplines
C) Is linked to the OASIS reporting forms required by Medicare
D) Uses standardized terminology, whereas NANDA-I does not

Question 7

The nurse is visiting a patient who lives in a single-room occupancy hotel.The patient requires wound care and medication management.There is no running water in the room,and the bathroom down the hall is in disrepair and filthy.The patient's room is not clean.What supplies would be essential for the nurse to bring with him when visiting this client?

A) All wound care supplies needed for the duration of the care
B) Reclosable plastic bags for disposal of old dressings
C) Small, biohazard sharps container to be left in the room
D) Waterless, antibacterial hand sanitizer solution

Question 8

A community health nurse gathers information about how individuals in a low-income neighborhood perceive the community and its state of health.Which of the following assessment strategies would be appropriate?

A) Conducting a windshield survey while driving
B) Reviewing a multitude of community databases
C) Interviewing residents living on every fifth block
D) Analyzing demographic data on the community

Question 9

Which of the following unique aspects of home care do Medicare reimbursement regulations require that the nurse include in documentation?

A) Patient assessment data and interventions performed
B) Patient response to care and assessment of environment
C) Evidence of homebound status and continued need for skilled care
D) Skilled care delivered and communication with other providers

Question 10

At a home visit,the nurse asks the patient,"Have you taken your blood pressure medicine today?" The patient replies,"I don't remember.Maybe." On the table are several bottles of medication,some open,some not.They have all been prescribed for the patient.The patient cannot say how often to take each one,when asked.A compartmentalized medication organizer is on the table,with a few capsules in it,and some compartments left open.What should the nurse do?

A) Show the patient how to put the medications in the organizer for the next 2 days; observe while he fills the rest of the organizer.
B) Arrange for a home health aide to come each day to show the patient which pills to take.
C) Administer today's medications and arrange for the pharmacy to put medications in easy-to-open containers in the future.
D) Fill the organizer for each day of the week; explain how to use it; and return in a day or two to evaluate.

Question 11

A community health nurse is evaluating the current health programs in the community.Which of these outcomes would indicate a healthy community?

A) Ninety percent of members report adequate access to primary care services.
B) Immunization services are available at hospitals and clinics.
C) Affordable housing in the community is under construction.
D) Mortality rates have been stable over the past 5 years.

Question 12

The inhabitants of Yulupa,California,form which of the following?

A) Aggregate
B) Community
C) Population
D) Vulnerable population

Question 13

A community health nurse planning a new program for teen pregnancy prevention designs a community assessment covering the structure of her target.Which of the following areas would she include?

A) Number of residential and commercial buildings
B) Demographic data of residents in the community
C) Morbidity and mortality rates of the population
D) Common strategies for conflict resolution

Question 14

A 56-year-old woman provides care to her 91-year-old widowed father.She says she is frequently fatigued and that she no longer socializes with her friends."I'm so busy taking care of my dad.It's really hard work because he is bedridden.Sometimes it breaks my heart when I have to feed and bathe him.He always seemed so strong when I was a child." The most appropriate nursing diagnosis for this woman is

A) Caregiver Role Strain
B) Impaired Home Maintenance
C) Interrupted Family Processes
D) Risk for Caregiver Role Strain

Question 15

What is the type of nursing with a focus on the community as a whole and the health status of individuals as an aggregate?

A) School nursing
B) Community health nursing
C) Community-oriented nursing
D) Public health nursing

Question 16

The community health nurse has gathered data about the community.She identifies many weaknesses in the community health systems that contribute to poor health outcomes.What should be her next step?

A) Prioritize the list of problems.
B) Validate the data.
C) Evaluate the effectiveness of the interventions.
D) Plan the care.

Question 17

Today is the last day of work on the medical-surgical unit for a nurse who has decided to work in home care.A patient asks her why she is leaving to work in home care.Select a response that best illustrates the advantages of home care.

A) "Care is much more comprehensive and unhurried in the home; it is more enjoyable for nurses to work in home care."
B) "Home care is much more organized than hospital care; you have access to the whole team, and there is less interference from others."
C) "A home health nurse has more autonomy and skills than a hospital nurse does; I'll get to do more."
D) "In home care, I can see my patients in their personal environment; this will help me understand them more and allow me to give personalized care."

Question 18

A community health nurse prepares for a new assignment.She has been assigned census tracts 131 and 132.This large area crosses the border of two towns and includes 4,000 people.What components of the community must the community health nurse assess prior to beginning her new assignment?

A) Income levels, health status, and relationships among groups
B) Structure of the tracts, effectiveness of the community, and current status
C) Number of clients with health problems compared with the number of healthcare providers
D) Community organizations and beliefs about their role in the community

Question 19

The community health nurse is working with the residents of government-subsidized senior housing.She meets with them regularly to discuss concerns and evaluate whether they receive healthcare that meets their needs.Which of the following nursing roles best describes these actions?

A) Case manager
B) Client advocate
C) Collaborator
D) Counselor
E) Educator

Question 20

A home health nurse is working with a physical therapist and home health aides to work out a schedule for their visits that will best address the patient's needs.Which nursing role does this demonstrate?

A) Direct care provider
B) Client and family educator
C) Client advocate
D) Care coordinator

Question 21

Which of the following interventions has a public health focus? Select all that apply.

A) Controlling the blood sugar of a diabetic client with cardiovascular disease
B) Assisting with the launch of an after-school program in a high-crime neighborhood
C) Providing an influenza vaccination program for seniors and persons with chronic illness
D) Offering counseling to the family of a child with severe cognitive deficits

Question 22

The nurse is visiting a patient who lives alone in a two-room house.The patient requires wound care and medication management,but his health is not expected to improve much,even with care.There is no running water in the house,and the bathroom is in disrepair and filthy.At the first home visit,which of the following should the nurse assess? Select all that apply.

A) Wound status
B) Patient concerns
C) Ability to perform care independently
D) End-of-life planning

Question 23

Which of the following clients would most likely require home health services? Select all that apply.

A) 45-year-old man with an injured rotator cuff that requires surgery
B) 32-year-old terminally ill woman with a supportive family
C) 92-year-old man living independently with multiple medical problems
D) 6-year-old with a fractured hip requiring a leg and pelvic cast

Question 24

Which of the following is a primary intervention? Select all that apply.

A) Immunization for meningitis of college-bound students
B) Safer sex education for high school students
C) Lobbying for health education in the schools
D) Tuberculosis screening via PPD testing

Question 25

Which of the following groups represents a vulnerable population? Select all that apply.

A) Homeless persons with no known illnesses
B) Women who have experienced domestic violence
C) Fifth grade students at the local elementary school
D) Persons with type 1 diabetes mellitus

Question 26

A community health nurse prepares for a new assignment.She has been assigned census tracts 131 and 132.This large area crosses the border of two towns and includes 4,000 people.She recognizes that assignments are based on census tracts because census tracts do which of the following? Select all that apply.

A) Define the geopolitical boundaries of a community
B) Are made up of persons who share a common heritage and customs
C) Divide populations into smaller groups that can be assessed more readily
D) Are natural divisions in communities that are based on voting patterns

Question 27

The nurse has been assigned to a caseload of home health clients.Before making home visits,which two planning activities must she perform first?

A) Order supplies for the home care services.
B) Review the cases to determine the reasons for the visits.
C) Contact the clients to arrange for the visits.
D) Develop a schedule for the day so that all visits can be made.

Question 28

A community health nurse is assigned to work in a different area of the city.Which of the following assessment techniques would she likely use to develop an overview of the community? Select all that apply.

A) Windshield survey
B) Review of demographic data
C) Physical assessment of a sample of the inhabitants
D) Review of the records of area providers

Question 29

The nurse is visiting a client who resides in a single-room occupancy hotel.Groups of people are leaning against the building and smoking on the steps.There is obvious substance abuse occurring in the lobby and halls of the building.There is no running water in the room,and the bathroom down the hall is in disrepair and filthy.A primary concern that the nurse must consider when making this visit is safety.Which of the following actions are appropriate safety measures? Select all that apply.

A) Notify the police that the nurse plans to visit this site.
B) Carry something that can be used as a weapon if necessary.
C) Inform the home health agency of the nurse's route and time of visit.
D) Do not visit if the nurse senses danger when he arrives at the site.

Question 30

Home healthcare and home hospice care are two different types of home health services.What are the differences between these services? Select all that apply.

A) Home healthcare promotes independence in clients; home hospice care promotes comfort and quality of life.
B) Home healthcare promotes comfort and symptom management; hospice care promotes self-care.
C) Home healthcare is focused on teaching self-care; home hospice care is focused on teaching skilled care to caregivers.
D) Home hospice care is focused on managing symptoms; home healthcare is focused on fostering independence.

Question 31

Which of the following services are provided by home health agencies? Select all that apply.

A) Direct care of clients in the home, performing treatments
B) Indirect care such as provision of medication and supplies
C) Acute care services for clients with complex diseases
D) Respite care of clients to relieve family caregivers

Question 32

A family caregiver is learning to administer insulin injections to her homebound sister.What should the nurse advise her to do with the used needles?

A) Discard the needle and syringe in a thick plastic milk jug with a lid.
B) Securely recap them and place them in a paper bag in the household trash.
C) Remove the needle and put it in a coffee can with a lid; put the syringe in the trash.
D) Do not recap the needle; break it by bending it on the tabletop.

Question 33

Identify the nurse who is acting as a community health nurse.Select all that apply.

A) School nurse who provides screening and direct care in the elementary school
B) Parish nurse who offers health education after services each Sunday
C) Nurse who works for the Red Cross by providing disaster relief
D) A nurse administering vaccines to inmates in a correctional facility
E) None of the above