Chapter 08 My Nursing Test Banks

 

Kozier & Erbs Fundamentals of Nursing, 9/E
Chapter 08

Question 1

Type: MCSA

Home care nursing is a fast growing sector of the health care system. Which of the following factors have contributed to the growth of home health care?

1. The need for custodial care

2. Third-party payers who support cost control measures

3. The increase in the older adult population

4. The decreasing need for acute care

Correct Answer: 2

Rationale 1: Factors that have contributed to the growth of home care services include the increase in the older population, who are frequent recipients of home care; third-party payers who favor home care to control costs; consumers who prefer to receive care in the home rather than in an institution; and the ability of agencies and institutions to successfully deliver high-technology services in the home. A common misconception about home health nursing is that it is custodial in its scope of practice. Acute care has not decreased, but the length of stay in acute care has.

Rationale 2: Factors that have contributed to the growth of home care services include the increase in the older population, who are frequent recipients of home care; third-party payers who favor home care to control costs; consumers who prefer to receive care in the home rather than in an institution; and the ability of agencies and institutions to successfully deliver high-technology services in the home. A common misconception about home health nursing is that it is custodial in its scope of practice. Acute care has not decreased, but the length of stay in acute care has.

Rationale 3: Factors that have contributed to the growth of home care services include the increase in the older population, who are frequent recipients of home care; third-party payers who favor home care to control costs; consumers who prefer to receive care in the home rather than in an institution; and the ability of agencies and institutions to successfully deliver high-technology services in the home. A common misconception about home health nursing is that it is custodial in its scope of practice. Acute care has not decreased, but the length of stay in acute care has.

Rationale 4: Factors that have contributed to the growth of home care services include the increase in the older population, who are frequent recipients of home care; third-party payers who favor home care to control costs; consumers who prefer to receive care in the home rather than in an institution; and the ability of agencies and institutions to successfully deliver high-technology services in the home. A common misconception about home health nursing is that it is custodial in its scope of practice. Acute care has not decreased, but the length of stay in acute care has.

Global Rationale: Page Reference: 132

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 02 Compare the characteristics of home health nursing to those of institutional nursing care.

Question 2

Type: MCSA

A nursing student wants to understand the difference in care delivery between home health nursing and community nursing. Unlike the community nurse, the focus for the home health nurse is which of the following?

1. Individuals, families, and groups

2. The individual and his or her family

3. The terminally ill client and his or her family

4. The client in a home setting

Correct Answer: 2

Rationale 1: Community health nursing focuses on individuals, families, and aggregate groups; this is not the focus of home health nursing Hospice nursing supports the care of the dying client and the clients family. A home setting identifies the location of home health nursing, but not the focus.

Rationale 2: The focus of home health care nursing is individuals and their families.

Rationale 3: Hospice nursing supports the care of the dying client and the clients family; this is not the focus of home health nursing.

Rationale 4: A home setting identifies the location of home health nursing, but not the focus.

Global Rationale: Page Reference: 132

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 02 Compare the characteristics of home health nursing to those of institutional nursing care.

Question 3

Type: MCSA

A home health client is having difficulty with the medication regimen that is prescribed by the physician. The nurse helps with this situation by consulting the pharmacist for ideas on how to improve the situation. This is an example of which of the following?

1. Hands-on care

2. Direct care

3. Advocacy

4. Indirect care

Correct Answer: 4

Rationale 1: Hands-on care includes physical assessments, dressing changes, managing IV sites for therapies, which is not the scenario described in the stem.

Rationale 2: Direct care is the same as hands-on care which is not the scenario described in the stem..

Rationale 3: Client advocacy is not the scenario described in the stem.

Rationale 4: Indirect care is provided by the home health nurse to the client each time the nurse consults with other health care providers about ways to improve nursing care for the client.

Global Rationale: Page Reference: 135

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 04 Describe the roles of the home health nurse.

Question 4

Type: MCSA

A client is currently seeing a physician who recommends that the client now see a physical therapist. The therapist sees the need to call in a nurse for a wound that is not healing, and the nurse contacts a social worker to help the client with sorting through mounting medical bills. The client will be referred to a home health care provider. Who, in this situation, must write the order to meet the legal reimbursement requirement?

1. Physician

2. Nurse

3. Social worker

4. Physical therapist

Correct Answer: 1

Rationale 1: A client may be referred to home health care by providers, nurses, social workers, and therapists, but home care cannot begin without a physicians order and a physician-approved treatment plan. This is a legal reimbursement requirement.

Rationale 2: A client may be referred to home health care by providers, nurses, social workers, and therapists, but home care cannot begin with a nurses order.

Rationale 3: A client may be referred to home health care by providers, nurses, social workers, and therapists, but home care cannot begin with a social workers order.

Rationale 4: A client may be referred to home health care by providers, nurses, social workers, and therapists, but home care cannot begin with a social workers order.

Global Rationale: Page Reference: 134

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 03 Describe the types of home health agencies, including referral and reimbursement sources.

Question 5

Type: MCSA

The client is being seen for the first time by the home health nurse. The nurse determines that the client will need speech therapy, physical therapy, and custodial care several times a week. When can the clients care begin?

1. As soon as the nurse completes the initial assessment

2. As soon as the client agrees to the care.

3. When the physician signs the plan of care the nurse develops

4. Within 48 hours of the nurses visit

Correct Answer: 3

Rationale 1: This intervention identifies but does not initiate client care.

Rationale 2: This intervention shows client involvement in the process but does not initiates client care.

Rationale 3: At the initial visit, the nurse develops a plan of care that identifies the clients needs. This plan must by reviewed, approved, authorized, and signed by the attending physician before the home health agency providers can continue with services.

Rationale 4: This may be true but initiation is dependent on many other factors.

Global Rationale: Page Reference: 138

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 02 Compare the characteristics of home health nursing to those of institutional nursing care.

Question 6

Type: MCSA

A home health client has a complicated case involving occupational therapy, respiratory therapy, a dietitian, the nurse, and a nurses aide who provides assistance with bathing, housekeeping, and grocery shopping. Who is responsible for coordinating the clients care?

1. Physician

2. Nurse

3. Social worker

4. Home health agency

Correct Answer: 2

Rationale 1: Case coordination is essential is not a physician responsibility.

Rationale 2: Because clients often require the services of several professionals, case coordination is essential and generally rests with the registered nurse.

Rationale 3: Case coordination is not the responsibility of a social worker.

Rationale 4: Case coordination is not the responsibility of a social worker.

Global Rationale: Page Reference: 135

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 04 Describe the roles of the home health nurse.

Question 7

Type: MCSA

The home health agency in a community is operated by the state health department and financed by taxes. This is an example of which type of agency?

1. Institution based

2. Private

3. Not-for-profit

4. Official

Correct Answer: 4

Rationale 1: Institution-based agencies operate under a parent organization such as a hospital and are funded by the same sources as the parent. That is not the situation described here.

Rationale 2: Private, proprietary agencies are for-profit organizations and are governed by either individual owners or national corporations. That is not the situation described here.

Rationale 3: Not-for-profit or voluntary agencies are supported by donations, endowments, charities such as the United Way, and third-party reimbursement. That is not the situation described here.

Rationale 4: Official or public agencies are operated by state or local governments and financed primarily by tax funds.

Global Rationale: Page Reference: 134

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 03 Describe the types of home health agencies, including referral and reimbursement sources.

Question 8

Type: MCSA

A clients insurance company has coverage for DME. Which of the following client needs would be covered under this clause?

1. Dressings and bandages

2. Medications

3. A hospital bed

4. Visits by the home health nurse

Correct Answer: 3

Rationale 1: Supplies that the client uses and cannot be reused is not considered DME.

Rationale 2: Supplies that the client uses and cannot be reused is not considered DME.

Rationale 3: Durable medical equipment (DME) ranges from hospital beds to bedside commodes to ventilators and apnea monitors. Equipment that will not be used up is considered DME.

Rationale 4: Visits by the home health nurse are not equipment.

Global Rationale: Page Reference: 134

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 03 Describe the types of home health agencies, including referral and reimbursement sources.

Question 9

Type: MCSA

Clients are entitled to home health care reimbursement if they meet certain criteria. The nurse would like to admit a client to home health care, but is worried about insurance reimbursement because the client:

1. Lives with a spouse.

2. Needs skilled care.

3. Needs intermittent care.

4. Drives a car for trips to the barber.

Correct Answer: 4

Rationale 1: Living with a spouse is allow for reimbursement by insurance companies.

Rationale 2: Needing skilled care is allow for reimbursement by insurance companies.

Rationale 3: Needing intermittent care is allow for reimbursement by insurance companies.

Rationale 4: Clients must meet certain criteria, including homebound status, except for occasional outings. Barber trips are included as occasional outings, but the client is not the driver.

Global Rationale: Page Reference: 132

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 03 Describe the types of home health agencies, including referral and reimbursement sources.

Question 10

Type: MCSA

A client who has been the recipient of home health care has made the decision to discontinue hemodialysis. The client understands all the consequences of this decision and is not supported by his family. The nurse is meeting with the family to help them understand the significance of the clients decision and to help them support the client during this difficult time. In this situation, the nurse is acting in which of the following roles?

1. Caregiver

2. Advocate

3. Educator

4. Counselor

Correct Answer: 2

Rationale 1: The home health nurses major role as caregiver is to assess and diagnose the clients actual and potential health problems. That is not the role described here.

Rationale 2: As a client advocate, the nurse explores and supports the clients choices in health care. Advocacy includes having discussions about the clients rights, advance medical directives, living wills, and durable power of attorney for health care. At times, the clients views may vary from those of other family members. In the event of conflict, the nurse ensures that the clients rights and desires are upheld.

Rationale 3: The educator role focuses on teaching illness care, prevention of problems, and promotion of optimal wellness or well-being. That is not the role described here.

Rationale 4: Counselor is not a role for the home health nurse.

Global Rationale: Page Reference: 134

Cognitive Level: Understanding

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 04 Describe the roles of the home health nurse.

Question 11

Type: MCSA

A home health client has terminal cancer and has signed a DNR (do not resuscitate) order. The client has a respiratory arrest during one of the home health nurses visits. The clients spouse tells the nurse to call 911. The nurse should:

1. Ignore the spouse.

2. Call 911.

3. Start CPR.

4. Remind the spouse of the clients desires.

Correct Answer: 4

Rationale 1: In the event of conflict between the clients desires and the familys wishes, the nurse, being the clients primary advocate, ensures that the clients rights and desires are upheld. This is a difficult situation, but the nurse is bound to the clients desires.

Rationale 2: In the event of conflict between the clients desires and the familys wishes, the nurse, being the clients primary advocate, ensures that the clients rights and desires are upheld. This is a difficult situation, but the nurse is bound to the clients desires.

Rationale 3: In the event of conflict between the clients desires and the familys wishes, the nurse, being the clients primary advocate, ensures that the clients rights and desires are upheld. This is a difficult situation, but the nurse is bound to the clients desires.

Rationale 4: In the event of conflict between the clients desires and the familys wishes, the nurse, being the clients primary advocate, ensures that the clients rights and desires are upheld. This is a difficult situation, but the nurse is bound to the clients desires.

Global Rationale: Page Reference: 134

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 04 Describe the roles of the home health nurse.

Question 12

Type: MCSA

A home health nurse explains the procedures for preventing infection in a clients central venous access device and has the clients spouse watch while the nurse hooks the client to the medication infusion. The nurse is acting in which of the following roles?

1. Caregiver

2. Advocate

3. Educator

4. Coordinator

Correct Answer: 3

Rationale 1: The role of caregiver involves assessing and diagnosing actual or potential health problems, planning care, and evaluating the clients outcomes. That is not the role described here.

Rationale 2: The advocate role ensures that the rights and desires of the client are upheld. That is not the role described here.

Rationale 3: Education can be the most essential aspect of home care practice, the goal of which is to help clients learn to manage as independently as possible. Involving the spouse in care and educating the spouse along with the client promotes wellness and helps prevent problems.

Rationale 4: The home health nurse coordinates the activities of all other home health team members involved in the clients treatment plan. That is not the role described here.

Global Rationale: Page Reference: 135

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 04 Describe the roles of the home health nurse.

Question 13

Type: MCSA

The home health nurse is assessing the clients environment for safety concerns and finds that most of the rooms in the house have only one outlet with various cords entering the outlet. The nurse notes this concern to the client and the clients spouse. They inform the nurse that this is the way weve lived for years. The nurse should:

1. Provide telephone numbers for local electricians.

2. Continue to persuade the client to have the home rewired.

3. Not bring the subject up again.

4. Document the findings and the client and spouses response to the concern.

Correct Answer: 4

Rationale 1: While not inappropriate, this option is not likely to be acted upon by the client.

Rationale 2: Home health nurses cannot expect to change a familys living space and lifestyle and such an intervention may be resented by the client.

Rationale 3: The nurse has an obligation to bring safety issues to the clients attention.

Rationale 4: Home health nurses cannot expect to change a familys living space and lifestyle. However, they can express concern when a situation suggests the possibility for injury. Nurses must document information they provide and the familys response to instruction as well as make ongoing assessments about the familys use of safety precautions.

Global Rationale: Page Reference: 135-136

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 06 Discuss the safety and infection control dimensions applicable to the home care setting.

Question 14

Type: MCSA

A home health client lives alone in a small apartment and has only one phone, which is a land line. What safety recommendation might the visiting home health nurse make for this particular client?

1. Suggest that the client move to a nursing home or assisted living dwelling.

2. Recommend that the client be enrolled in an emergency response system.

3. Enroll the client in a program that places all the clients vital medical information in one place for emergency personnel.

4. Have the client post a list of emergency numbers (fire, police, ambulance) near the phone.

Correct Answer: 2

Rationale 1: Making suggestions for the client to relocate may be a possibility, but this might be premature to suggest at this point.

Rationale 2: An emergency response system provides a small device with a help button that attaches to the clients wrist or is worn around the neck. The client can send a signal to a home base which would indicate if the client is in trouble (i.e., has fallen or become ill) and cant get to the phone. This system is particularly useful for clients who live alone.

Rationale 3: Having all of the clients medical information in one place is a helpful idea but does not address the concern of effective means of communication.

Rationale 4: An emergency response system provides a small device with a help button that attaches to the clients wrist or is worn around the neck. The client can send a signal to a home base which would indicate if the client is in trouble (i.e., has fallen or become ill) and cant get to the phone. This system is particularly useful for clients who live alone. Making suggestions for the client to relocate may be a possibility, but this might be premature to suggest at this point. Having emergency numbers in a visible spot, is a helpful idea but does address the concern of effective means of communication.

Global Rationale: Page Reference: 135-136

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 06 Discuss the safety and infection control dimensions applicable to the home care setting.

Question 15

Type: MCSA

The home health nurse has scheduled a visit to a client who lives in a neighborhood that is known to be unsafe because of gang activity. Before going to the clients home, the nurse should:

1. Call for an escort.

2. Call the client to let them know the nurse is on the way.

3. Ask if the client could meet the nurse at the agency.

4. Take a second nurse along on the visit.

Correct Answer: 1

Rationale 1: Some less desirable living locations pose safety concerns for the nurse. Many home health agencies have contracts with security firms to escort nurses needing to see clients in potentially unsafe neighborhoods. If there is no such firm for escort, the police can also provide security for the nurse.

Rationale 2: Calling ahead to the clients home is routine practice, regardless of where the client lives.

Rationale 3: Having the client meet the nurse at the agency is inappropriate, especially if the client meets the criteria for home care.

Rationale 4: Taking a second nurse along may not be a realistic intervention.

Global Rationale: Page Reference: 136

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 06 Discuss the safety and infection control dimensions applicable to the home care setting.

Question 16

Type: MCSA

A home health nurse has a weekly visit to a client living in less than desirable cleanliness. The client has a central venous access device and requires weekly infusion therapy. What is the best way for the nurse to protect the client against infection?

1. Have the client wash her hands before the infusion begins.

2. Practice strict aseptic technique during the infusion process.

3. Help the client clean the room before starting the infusion.

4. Suggest that the client have a housekeeper come on the morning of the infusion.

Correct Answer: 2

Rationale 1: This intervention will not directly impact the minimization of the risk for infection since the client is not performing the infusion.

Rationale 2: Infection control can present a challenge to the home health nurse, especially if the home care facilities are not conducive to basic aseptic requirements. The most important ways to prevent infection are making sure the site is clean, accessing the port following sterile procedure, and following Standard Precautions while accessing the line.

Rationale 3: Even if the clients environment is not clean, that doesnt necessarily mean the client is unclean. There is another option that will impact the risk of infection.

Rationale 4: Teaching about health practices that prevent infection is important, but the nurse cannot expect to change the clients lifestyle.

Global Rationale: Page Reference: 136-137

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 06 Discuss the safety and infection control dimensions applicable to the home care setting.

Question 17

Type: MCSA

A home health client has multiple sclerosis. In the last 6 months, his condition has deteriorated significantly. The home health nurse is concerned about the spouse experiencing caregiver role strain. Which of the following, if present, would the nurse expect to see or hear if this could be the situation?

1. The home appears more unkempt and cluttered.

2. The spouse expresses feelings of anger.

3. The spouse reports decreased energy.

4. The spouse reports that she is learning how to manage finances.

Correct Answer: 3

Rationale 1: Caregiver role strain occurs when caregivers experience physical, emotional, social, and financial burdens that can seriously jeopardize their own health and well-being. Signs of caregiver overload or strain include those identified in the answer as well as difficulty performing routine tasks for the client; concerns that the caregivers responsibilities interfere with other roles as parent, spouse, worker, and friend; anxiety about meeting future needs of the client; and feelings of depression. Learning how to manage finances is a positive statement and would not indicate strain.

Rationale 2: Caregiver role strain occurs when caregivers experience physical, emotional, social, and financial burdens that can seriously jeopardize their own health and well-being. Signs of caregiver overload or strain include those identified in the answer as well as difficulty performing routine tasks for the client; concerns that the caregivers responsibilities interfere with other roles as parent, spouse, worker, and friend; anxiety about meeting future needs of the client; and feelings of depression. Learning how to manage finances is a positive statement and would not indicate strain.

Rationale 3: Caregiver role strain occurs when caregivers experience physical, emotional, social, and financial burdens that can seriously jeopardize their own health and well-being. Signs of caregiver overload or strain include those identified in the answer as well as difficulty performing routine tasks for the client; concerns that the caregivers responsibilities interfere with other roles as parent, spouse, worker, and friend; anxiety about meeting future needs of the client; and feelings of depression. Learning how to manage finances is a positive statement and would not indicate strain.

Rationale 4: Caregiver role strain occurs when caregivers experience physical, emotional, social, and financial burdens that can seriously jeopardize their own health and well-being. Signs of caregiver overload or strain include those identified in the answer as well as difficulty performing routine tasks for the client; concerns that the caregivers responsibilities interfere with other roles as parent, spouse, worker, and friend; anxiety about meeting future needs of the client; and feelings of depression. Learning how to manage finances is a positive statement and would not indicate strain.

Global Rationale: Page Reference: 137

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 07 Identify ways the nurse can recognize and minimize caregiver role strain.

Question 18

Type: MCSA

After completing the initial assessment, the nurse is able to identify the clients teaching needs as well as the support system in the home environment. The main reason that education is a common intervention in the home care setting is related to:

1. Lack of knowledge related to health conditions and self-care.

2. The fact that there is little time to complete education in the acute care setting.

3. The fact that teaching someone who is willing to learn is easier in the home.

4. The need for reimbursement for education by Medicare.

Correct Answer: 1

Rationale 1: One of the most common health issues that nurses address with clients in home care settings is lack of knowledge related to health conditions and self-care. Client education is considered a skill reimbursed by Medicare.

Rationale 2: While this may be true in some situations it is not the reason that education is a focus of home health nursing care. Not all home care clients come from acute care, and education is still implemented in this setting.

Rationale 3: Not all home clients are willing or ready to learn, even though they are in their own home environment.

Rationale 4: Client education is considered a skill reimbursed by Medicare.

Global Rationale: Page Reference: 138

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 05 Identify the essential aspects of the home visit.

Question 19

Type: MCSA

An elderly client is being discharged home after a short illness and stay in acute care. The physician has written an order for home health follow-up. In order to better understand the need for any assistive devices, the home health nurse makes an assessment:

1. At the initial home visit, in order to see the client in the home environment

2. While the client is still a patient in the acute care hospital

3. After the client has been home a few days and can help the nurse decide what is needed

4. When the spouse is available to assist in the assesssment

Correct Answer: 2

Rationale 1: Once the client is at home, the need for the devices will be immediate and the client may have to wait unnecessarily for the required items.

Rationale 2: Assessment for the elderly client being discharged to home health should be initiated while the client is in the hospital to determine the need for assistive devices or environmental changes before the client returns home.

Rationale 3: Waiting a few days is a delay that is not beneficial for the client who requires these items upon arriving home.

Rationale 4: Waiting until the spouse is able to help is a delay that is not beneficial for the client who requires these items upon arriving home.

Global Rationale: Page Reference: 137-138

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 04 Describe the roles of the home health nurse.

Question 20

Type: MCSA

Once the client has been receiving home care for a period of time, the nurse is able to evaluate the effectiveness of the education and interventions provided. The responsibility for assurance that the client is receiving prescribed therapy at the appropriate times belongs to which of the following?

1. Client

2. Nurse

3. Physician

4. Clients spouse

Correct Answer: 2

Rationale 1: Even though the client may become independent in self-care skills assurance is not his/her responsibility.

Rationale 2: Even though the client and family may become independent in self-care skills, the home health nurse still has the ultimate responsibility to ensure that the client is receiving the prescribed therapy at the appropriate timed intervals. On subsequent home visits, the nurse observes the same parameters assessed on the initial visit.

Rationale 3: Even though the physician has responsibilities to the client, assurance in this area is not one of them.

Rationale 4: Even though family members may assume responsibility for a clients care, it is not their responsibility to assure appropriate care.

Global Rationale: Page Reference: 138

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 04 Describe the roles of the home health nurse.

Question 21

Type: MCMA

The nurse shows an understanding of the factors that have contributed to the redefining of home health care as a primary health servicedelivery system when stating:

Standard Text: Select all that apply.

1. Its unfortunate that the client can be screened for illnesses in the privacy of their own home.

2. With people living well into their 70s and 80s, the healthcare system is being stressed immensely.

3. The cost of acute hospital-based health care has become an economic burden to most people.

4. A clients chronic cardiac problems can be monitored well with in-home health services.

5. It relieves so much stress when care can come to them instead of their going to the health provider.

Correct Answer: 2,3,4,5

Rationale 1: Health preventative screening can be accomplished as a part of home care when needed.

Rationale 2: A number of factors have contributed to trend toward home health care; among them the increasing number of aging adult clients.

Rationale 3: A number of factors have contributed to the trend toward home health care; among them rising healthcare costs.

Rationale 4: A number of factors have contributed to the trend toward home health care; among them the growing emphasis on managing chronic illness.

Rationale 5: A number of factors have contributed to the trends toward home health care; among them the growing emphasis on managing stress for the chronically ill.

Global Rationale: Page Reference: 132

Cognitive Level: Analyzing

Client Need:

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: 02 Compare the characteristics of home health nursing to those of institutional nursing care.

Question 22

Type: MCMA

Services that are representative of todays concept of home care include:

Standard Text: Select all that apply.

1. A case manager arranging services to meet the clients need for physical therapy after a fall.

2. A nurse educating the pregnant teenager on the signs of premature labor.

3. A durable supply company delivering a wheelchair to a client with spina bifida.

4. A nurse assessing the feet of a home bound diabetic client.

5. A grocery store delivering groceries to a client recovering from cancer surgery.

Correct Answer: 1,3,4

Rationale 1: Home care today involves a wide range of healthcare professionals providing services, such as physical therapy, in the home setting to people who are recovering from an acute illness or injury, are disabled, or have a chronic condition.

Rationale 2: Pregnancy education would not be addressed in the home setting unless the pregnancy required bed rest.

Rationale 3: Home care today involves a wide range of healthcare professionals providing services, such as assistive devices, in the home setting to people who are recovering from an acute illness or injury, are disabled, or have a chronic condition.

Rationale 4: Home care today involves a wide range of healthcare professionals providing services, such as nursing care, in the home setting to people who are recovering from an acute illness or injury, are disabled, or have a chronic condition.

Rationale 5: Home care does not include non-professional services such as grocery delivery.

Global Rationale: Page Reference: 132

Cognitive Level: Understanding

Client Need:

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: 01 Define home health care.

Kozier & Erbs Fundamentals of Nursing, 9/E Test Bank

Copyright 2012 by Pearson Education, Inc.

Leave a Reply