Deck 42: Community Home Health Nursing

Question 1

During a home visit the nurse learns that a patient is inconsistent with taking prescribed medications and has a medication organizer partially filled next to a variety of medication containers.What should the nurse do?

A) Show the patient how to put the medications in the organizer for the next 2 days,and 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.

Answer 1

Fill the organizer for each day of the week,explain how to use it,and return in a day or two to evaluate.

Question 2

Which is a common characteristic of the Omaha System and the NANDA-I taxonomy?

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 2

Nursing diagnoses expressed in standardized language

Question 3

The community health nurse meets with residents of government-subsidized senior housing to discuss concerns and evaluate whether they receive healthcare that meets their needs.Which nursing role best describes these actions?

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

Answer 3

Collaborator

Question 4

A community health nurse wants to assess community members prior to planning a program for teen pregnancy prevention.Which area should the nurse include?

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

Question 5

Which response should the nurse make when asked about 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; 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 6

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 7

Which unique aspect 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 8

After gathering data about a community,the nurse identifies weaknesses in the community health system that contribute to poor health outcomes.What should be the next step?

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

Question 9

The community health nurse is assigned census tracts 131 and 132,which cross the border of two towns and include 4,000 people.What components of the community must the nurse assess prior to beginning the 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 10

A patient is discharged home after sustaining injuries from a motor vehicle crash.What would be the primary goal of home care for this patient?

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 11

Which is a function of the public health nurse?

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

Question 12

A patient requiring wound care lives in a hotel that has no running water,bathrooms are shared,and the environment is dirty.What supplies should the nurse bring when making a visit to this patient?

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 13

What do the inhabitants of one zip code form?

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

Question 14

An adult daughter who is the primary caregiver for an older client is fatigued,has stopped socializing with friends,and is saddened by the client's condition.Which nursing diagnosis is the most appropriate for this situation?

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

Question 15

A patient with poorly controlled diabetes,hospitalized for a leg ulcer,is being discharged on insulin,new medications,and the expectation to perform capillary blood glucose measurements,which has never been done.Is a referral to home care appropriate for this patient?

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

Question 16

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 17

A community health nurse is evaluating the current health programs in the community.Which outcome indicates 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 18

A home health nurse has called the 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 19

A community health nurse gathers information about how individuals in a low-income neighborhood perceive the community and its state of health.Which assessment strategy 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 20

What is a chief benefit of using the Clinical Care Classification (CCC)system to document home care?

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 21

The nurse has been assigned to a caseload of home health clients.Before making home visits,which planning activities must be performed first? Select all that apply.

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.
E) Check the bag to ensure all basic supplies are available.

Question 22

Which group 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
E) People with multiple sclerosis needing a walker to ambulate

Question 23

During a home visit the nurse reviews prescribed medications with the client.Which medication should the nurse spend additional time reviewing with the client?

A) Digoxin
B) Warfarin
C) Ibuprofen
D) Furosemide

Question 24

Which intervention 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
E) Teaching people recovering from a stroke how to improve independence

Question 25

Which nurse is functioning in the community health role? 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) A nurse who assesses patients in an outpatient care clinic

Question 26

The spouse of a client with a terminal illness is fatigued and just wants an afternoon off from providing constant care.What should the nurse do to help the spouse?

A) Arrange for a home health aide.
B) Discuss transferring the client to a long-term care facility.
C) Coordinate the client's admission to an acute care facility.
D) Explain it won't be long now because the client is nearing death.

Question 27

The nurse plans to visit a client who has no running water and lives in a building with known drug activity.Which action should the nurse take to ensure for personal safety? 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 arriving at the site.
E) Carry a cell phone.

Question 28

A family caregiver is learning to administer insulin injections to a family member.What should the nurse advise the caregiver 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 29

A community health nurse prepares for a new assignment based on census tracks.What is the purpose of using this approach? 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
E) Determine the school districts and allocation of tax dollars

Question 30

The nurse is visiting a patient who lives alone,has no running water,and needs wound care and medication management.At the first home visit,what 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
E) Living conditions

Question 31

A community health nurse is assigned to work in a different area of the city.Which assessment technique should the nurse 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
E) Read the local newspaper

Question 32

Which client 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
E) 42-year-old client living alone recovering from spinal surgery

Question 33

Which service is 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
E) Direct care of the client requiring ventilatory support

Question 34

Which 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
E) Outpatient rehabilitation sessions

Question 35

What is the difference between home healthcare and home hospice care? 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.
E) Home healthcare is focused on providing care to terminally ill clients; hospice care promotes self-care.