Nokea
A client has end-stage chronic obstructive pulmonary disease (COPD) and is terminally ill. The family wants the client to spend their last days in a facility that will be able to keep the client comfortable and control their severe dyspnea. What facility will meet the needs of the client and family?
- A. Rehabilitation care
- B. Hospice care
- C. Intermediate care facilities
- D. Ambulatory care
Correct Answer: B
Rationale: Hospice provides care for clients diagnosed with a terminal illness whose life expectancy is fewer than 6 months. Hospices allow terminally ill clients to live as fully as possible while managing pain, discomfort, and other symptoms. Rehabilitation centers provide physical and occupational therapy to clients and families to help individuals regain as much independence with ADLs as possible. Intermediate care facilities (ICFs) are nursing homes that provide custodial care for people who cannot care for themselves because of mental or physical disabilities. Ambulatory care is also outpatient care.
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A client in an acute care facility is assigned a case manager to oversee and coordinate care. What important function does a case manager have?
- A. Provide early, thorough discharge planning.
- B. Make sure the client is administered medications.
- C. Provide care to the client who is terminally ill and has less than 6 months to live.
- D. Make home visits to see that the client is taken care of after discharge.
Correct Answer: A
Rationale: An important function of case managers is to provide early, thorough discharge planning. The case manager is not responsible for the administration of medications. Hospice care provides care to the client who is terminally ill. The case manager oversees the care of the clients while they are hospitalized. Referrals to community agencies and home healthcare will be made for home visits.
A client is going to be in subacute care for approximately 30 days. The client will require frequent assessments and periodic review of the client's progress. What role will the registered nurse have in the care of this client?
- A. The RN will provide direct care for the client.
- B. The RN will ensure that the client eats 100% of the meals.
- C. The RN will order the various treatments for the client.
- D. The RN will coordinate the client's care.
Correct Answer: D
Rationale: RNs coordinate clients' care, and LPN/LVNs provide and oversee care provided by unlicensed connective personnel (UAPs). The RN does not generally provide the direct care, and this would include overseeing meals. It is beyond the scope of practice for RNs to order treatments and medications.
Which nursing theorist stated that clients are open systems in constant interaction with their environment?
- A. Florence Nightingale
- B. Virginia Henderson
- C. Imogene King
- D. Dorothea Orem
Correct Answer: C
Rationale: Imogene King stated that clients are open systems in constant interaction with their environment. Florence Nightingale described the role of the nurse as putting 'the patient in the best condition for nature to act upon him.' Virginia Henderson envisioned the nurse's role as helping people (sick or well) to carry out activities contributing to health, recovery, or a peaceful death that they would do for themselves if they had the necessary strength, will, or knowledge. Dorothea Orem was a proponent of the self-care deficit theory.
The LPN has been assigned to a medical floor and to do all of the dressing changes and other treatments. The RN will make the rounds with the physicians, transcribe orders, and administer all of the IV medications. Another LPN will administer medications. What type of nursing is this group providing?
- A. Team nursing
- B. Total client care
- C. Functional nursing
- D. Primary care nursing
Correct Answer: C
Rationale: Functional nursing is a task-oriented method, and distinct duties are assigned to specific personnel. Total client care refers to assignments in which a nurse assumes all the care for a small group of clients. In team nursing, teams made up of an RN team leader, other RNs, LPN/LVNs, and nursing assistants provide care to a group of clients. Primary care nursing is when the RN assumes 24-hour accountability for the client's care and has total responsibility for the nursing care of assigned clients during a shift.
Which of the following describes the goal of alternative care facilities?
- A. An RN and one or more assistive personnel care for a group of clients.
- B. An RN assumes all care for a small group of clients.
- C. There is 24-hour accountability by an RN.
- D. The facility provides the least restrictive living arrangement.
Correct Answer: D
Rationale: The goal of alternative care facilities is to provide the least restrictive living arrangement while maintaining safety and quality. Patient-focused care uses an RN partnered with one or more assistive personnel to care for a group of clients. Total care refers to assignments in which a nurse assumes all the care for a small group of clients. In primary nursing, an RN assumes 24-hour accountability for the client's care and has total responsibility for the nursing care of assigned clients during the shift.