Deck 7: Community-Based Nursing and Home Care

Question 1

A patient who belongs to an HMO is assigned a nurse as a case manager after being in an automobile accident. The actions of the nurse in this role are to

A) care for the patient during hospitalization for the injuries.
B) assist the patient with home care activities during recovery.
C) coordinate the services that the patient receives in the hospital and at home.
D) determine the types of medical care the patient needs for optimal rehabilitation.

Answer 1

coordinate the services that the patient receives in the hospital and at home.

Question 2

Which of these nursing activities is appropriate for the home care RN who is caring for a newly diagnosed diabetic patient to delegate to a home health aide?

A) Assisting the patient to choose an appropriate diet.
B) Checking the patient's feet for signs of breakdown.
C) Taking the patient's vital signs before a daily bath.
D) Teaching the patient how to monitor blood glucose.

Answer 2

Taking the patient's vital signs before a daily bath.

Question 3

The ambulatory care nurse explains to an individual scheduled for an initial clinic appointment after joining an HMO that assigns an RN case manager to every patient in the HMO. The nurse will further explain that

A) the case manager will coordinate the care given to the patient by various members of the health care team.
B) one nurse will be responsible for planning all the interventions needed for the patient in acute and community settings.
C) the ambulatory care nurse is responsible for collaboration with other health care disciplines to plan all future patient care.
D) a health care provider will manage the patient's care with the assistance of nursing and other professional staff members.

Answer 3

the case manager will coordinate the care given to the patient by various members of the health care team.

Question 4

When practicing as a home health care nurse, the RN (Select all that apply.)

A) plans for the health needs of community groups.
B) provides direct care for an individual patient.
C) participates in group screening for common health problems such as hypertension.
D) teaches patients' family members how to provide care such as giving medications.
E) administers chemotherapy and antibiotics through long-term intravenous catheters.
F) instructs groups about special health care needs such as contraception or baby care.

Question 5

In describing home care services to a patient requiring extended care, the nurse tells the patient that

A) home care services are limited to visits by registered nurses or home health aides.
B) in order for Medicare or insurance to cover the expenses of home care, the patient must be confined to bed.
C) the patient's family will be included in planning and teaching about the patient's care.
D) technologically complex therapies, such as mechanical ventilators, are better managed in the hospital.

Question 6

The home health nurse visits a diabetic patient who has an infected heel wound to perform daily dressing changes and wound assessment. The nursing diagnosis of impaired tissue integrity is developed for the patient. To evaluate the patient outcome, the nurse will collect data about

A) the patient's daily capillary blood glucose level.
B) the presence or absence of complications of diabetes.
C) the wound appearance and patient temperature.
D) the patient's appraisal of the nursing services provided.

Question 7

Which of these patients being discharged by the acute care nurse meets the requirements for Medicare reimbursement for home health services?

A) A 65-year-old patient with multiple sclerosis and severe weakness who requires sacral dressing changes
B) A 68-year-old diabetic patient who is unable to drive and needs teaching about a diabetic diet and lifestyle
C) A 70-year-old who receives daily intravenous antibiotics for an infected leg wound
D) A 71-year-old who needs weekly blood sampling for monitoring of prothrombin times

Question 8

A 78-year-old patient hospitalized for surgical repair of a fractured hip has recovered from the surgery but continues to have a nursing diagnosis of impaired physical mobility related to decreased muscle strength. The nurse will anticipate transferring the patient to

A) an acute care setting.
B) a transitional care setting.
C) a residential care facility.
D) an intermediate care facility.

Question 9

When making an initial home visit, the most appropriate approach by the nurse is to

A) tell the patient and family all of the planned interventions.
B) ask the patient and family what their expectations are.
C) discuss the importance of following through with health care provider orders.
D) instruct the family members that they will need to participate in care.

Question 10

A patient tells the nurse, "I have to be insured through a health maintenance organization (HMO) now. I don't understand what a health maintenance organization is." The best response by the nurse includes the information that

A) HMOs provide care in community settings, but hospitals are still used for acute care.
B) HMOs are designed to provide more cost-effective health care.
C) HMOs are better equipped to provide the care for aging patients.
D) HMOs are preferred by most consumers because the services offer more flexibility.

Question 11

Which of these patients should the nurse refer for Medicare-reimbursed home health services?

A) A 67-year-old who requires assistance with shopping, housework, and cooking
B) A 71-year-old with dementia who needs 24-hour care to prevent injury
C) A 79-year-old who needs to have medications placed in a marked pillbox weekly
D) An 82-year-old whose family has asked for respite care for a few days a month