Question 1

The primary reason a person is provided with home health care is because:

Accepted Answer

Home health care makes it possible for people who are not critically ill to receive health care in the comfort of their own home. The other options are not the primary reason home health care is provided.

Question 2

The nursing assistant providing home health care can expect that all the clients will be:

Accepted Answer

In order to qualify for skilled home care, a client must be homebound (the person is unable to leave the house without a lot of help from another person). The other options are not necessary for a person to qualify for such car

Question 3

When helping a home health client bathe, the nursing assistant notices a reddened area of broken skin on the person's left heel. The nursing assistant will report the situation to the client's:

Accepted Answer

The clinical case manager, usually a registered nurse (RN), is responsible for overseeing all of the client's care, from admission to discharge. The case manager assesses the clients and works with the clients and their family members to create the care plan. The case manager will also coordinate the clients' care and make assignments to the home health care aide and other members of the care team. The case manager will notify the other members of the team if their services are needed. In this situation, the home health nurse will be made aware of the skin problem.

Question 4

It is essential that a home health aide must:

Accepted Answer

By communicating observations to the rest of the health care team, the home health aide becomes the "eyes and ears" of the members of the team who do not see the client as frequently. For this reason, communicating with the case manager and other members of the health care team is an essential part of the home health aide's responsibilities. Although the other options are expected of a home health aide, communication skills are essential.

Question 5

When assigned a client who lives in an area of town known as being unsafe, the home health aide will stay personally safe by: (Select all that apply)

Accepted Answer

Being alert and attending to personal safety are important and can be addressed with the correct options. It may not always be possible or even necessary to have an escort, but it may be a reasonable option in extreme cases.

Question 6

Which action by the home health aide shows a need for more education about how to keep from spreading germs between the homes of various clients?

Accepted Answer

When arriving at the client's home, place the tote bag on a clean surface, such as the kitchen table, but only after laying down a clean barrier. Placing a barrier between the tote bag and the surface helps to prevent contamination of the bag. The other options are correct.

Question 7

When a commercial disinfectant solution isn't available to clean equipment, the home health aide may use a bleach/water solution made of:

Accepted Answer

Bedside commodes and equipment used for bathing and grooming will need to be properly cleaned and disinfected after each use. A commercial disinfectant solution or a solution of bleach and water mixed 1:10 (1 cup of bleach to 10 cups of water) may be used, according to the agency's policy. The other options provide solutions that would be too weak or unnecessarily strong for disinfecting equipment.

Question 8

When a client uses a needle to deliver daily doses of insulin, the home health aide will most likely be responsible for:

Accepted Answer

Many clients will use needles, lancets, or other sharp items on a routine basis due to a medical condition. Clients who routinely use needles and lancets will be taught by the nurse how to properly dispose of these items safely. Clients may be provided with an OSHA-approved sharps disposal container by the home health agency. One duty may be to close and dispose of the sharps containers as they become full. Follow the agency's policy on proper sharps disposal measures. Helping with an injection is not usually a home health aide's responsibility.

Question 9

In order to avoid being bitten by a pet dog when visiting a client, the home health aide initially:

Accepted Answer

The dog may become nervous and protective, resulting in bites or scratches to the home health aide. It is a good idea to call the client before entering the home. Insisting that the dog be confined or leashed may become necessary but only when the aide has a reasonable suspicion the animal is protective of its owner. Treats are not recommended and should always be approved of by the owner.

Question 10

When a home health aide sees a client's child repeatedly strike the client, the aide first:

Accepted Answer

If a family situation turns violent while the home health aide is in the client's home, the aide should first call 911. Never place oneself in danger by attempting to either calm or threaten the abuser. It is appropriate to notify the home health agency, but not as the first action.

Question 11

The primary care provider for a person diagnosed with late-stage Alzheimer disease has asked for some assistance to leave the home to run some errands and go to some physician appointments. What is the term used to describe this kind of care?

Accepted Answer

The person may have a condition, such as dementia, that makes it dangerous for the person to be left alone in the house. Home health care agencies offer respite care services that allow a primary caregiver a chance to "take a break" or leave the house to go to appointments or run errands. Acute care is usually provided in a hospital setting for an acute illness like pneumonia. Palliative care is care providing comfort at the end of life. Long-term care usually refers to nursing home care, round-the-clock, 24 hours a day, and 7 days a week.

Question 12

The home health aide has reported to the case manager that one of their clients appears to have developed some swallowing issues and is beginning to look malnourished. The case manager will likely ask for a consult from which member of the home health care team to assess for a potential swallowing problem?

Accepted Answer

Speech therapy helps clients improve their ability to speak and communicate more clearly, especially after an accident or stroke that causes aphasia. Speech therapists also assist clients who have eating and swallowing difficulties. Physical therapists provide exercises geared toward helping clients gain strength, balance, mobility, movement, and gait. Occupational therapy assists clients to relearn and gain the ability to perform ADLs. The occupational therapist makes recommendations for home safety modifications or adaptive equipment that will improve the client's level of independence. Registered dieticians provide consultation and teaching on diet and nutrition choices and concerns, especially for those with a medically prescribed diet. The dietitian will likely be consulted after the swallowing problem has been diagnosed and resolved.

Question 13

During the morning assessment of the home health care client, the nursing assistant has collected the following data. Which data, collected by the nursing assistant, should be reported to the case manager immediately? Select all that apply.

Accepted Answer

The nursing assistant should make sure to report any of the following observations to the case manager immediately: one or more of the client's vital signs is above or below the standards set by the agency; the client has a fever or other signs of infection; there is a change in the client's mental alertness or orientation. A urine output of 400 mL for the nighttime is a normal amount. When clients refuse care like a bath that could sometimes be a normal occurrence and does not need to be reported immediately. Requesting ice cream for breakfast is not an item that needs reported to the case manager. The priority assessments are the change in vital signs and change in level of conscious.

Question 14

A family member calls the agency to report that the home health aide did not come to the client's home as scheduled and did not call to inform them. In legal terms, this situation is referred to as what?

Accepted Answer

A home health aide who fails to show up at a client's home to provide scheduled care is guilty of abandonment. A home health aide who leaves a client's home without completing scheduled tasks may also be guilty of abandonment. If the home health aide is unable to arrive at a client's home on time or unable to report to work at all, the aide should make sure to notify the agency according to policy. The home health aide should also contact the client about the delay and when the aide expects to arrive. Nonmaleficence means do no harm. Beneficence means doing good. Autonomy means respect for one another.

Question 15

The home health aide preparing to cook lunch for the client finds that the refrigerator appears to not be working since everything inside the refrigerator is warm and moist. When there appears to be no food in the house that is safe for the client to eat what should the nursing assistant do first?

Accepted Answer

The nursing assistant should report to the case manager immediately if the household has poor sanitation practices such as spoiled food. Food in the refrigerator should be inspected and disposed of before it is outdated or spoiled. Raw or cooked food that is not stored properly can easily spoil and cause foodborne illnesses. The other options will not assist with getting safe food in the house in a timely manner. It is the family's responsibility to have food available for the aide to prepare.

Question 16

The home health aide examines the cupboard and observes that there are outdated cans and boxes of food present. The leftovers and raw chicken are in the refrigerator without dates. The milk is outdated. The client stated that the food is still good. What action is appropriate for the nursing assistant to take?

Accepted Answer

In this scenario, the nursing assistant should remove all spoiled or outdated foods or leftovers that are not dated and dispose of them. Only food that has not expired should be kept or used to prepare as meals. The family has the responsibility to supply food, so the home health aide would not shop after work. Raw chicken without a date should not be used, and cooking may not kill all harmful bacteria the chicken is spoiled. The home health aide would not use that are expired or spoiled, even if the client insists they are safe. The home health aide should report the issues to the case manager.

Question 17

The nursing assistant provides a morning assessment of the older adult home health client. The client recently had pacemaker surgery, and the pacemaker is set at 60 beats per minute. Which data, collected by the nursing assistant, should be reported to the case manager immediately? Select all that apply.

Accepted Answer

The nursing assistant should immediately report the abnormal data that the home health client is exhibiting to the case manager. The vital signs are normal, but it is not unusual for an older adult to not have a fever with an infection. The pulse was not elevated because the client has a pacemaker pacing the heart. The hallucinations and urinary symptoms must be reported as they strongly suggest that the client has a urinary tract infection. It is normal to have a surgical dressing that is dry and intact.

Question 18

The home health aide assists the client with a bath and light housekeeping. What method should the nursing assistant employ to decrease the spread of pathogens?

Accepted Answer

The nursing assistant should use standard precautions when caring for a client and don clean gloves before changing any bed linens, especially wet ones. The wet linens should go into a bag, and if one is not available, the linens should be placed onto a dry pad and taken to the washing machine right away. Linens should never be shaken because doing so can spread dust and microbes. When washing linens or items, follow the manufacturer's directions and use warm water and detergent and not bleach because it may remove any fabric dye.

Question 19

The home health client trips over a small rug in the living room and is unharmed. What action should the nursing assistant take first?

Accepted Answer

The nursing assistant should remove the rug from the floor since it is a tripping hazard. The nursing assistant should then chart the occurrence and report it to the case manager. Charting should never happen before providing an intervention that helps the client. Two-way tape may come loose or damage the floor. Placing a furniture leg on the rug will not prevent it from rolling or moving on the nonanchored sides. The nursing assistant should inspect the environment for any safety issues and address and report them to keep the client safe.

Question 20

The home health aide prepares to assist the client to take a shower. What action should the nursing assistant take first?

Accepted Answer

Before helping a client take a shower, the nursing assistant should inspect the shower, grab bar, and shower chair to make sure they are all in proper condition. Then the nursing assistant may gather the supplies that the client wants and place a nonslip mat on the shower floor. The nursing assistant should then adjust the water temperature using a bath thermometer before helping the client into the shower.

Quiz 33: Caring for People in the Home Environment