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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.
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An LPN just received a license to practice and applied for a position at a skilled nursing care facility. While being interviewed, the LPN asks what to expect from the role at the facility. What is the best answer by the interviewer?
- A. You will be organizing and coordinating the care of the clients.'
- B. You will be participating in the care of the clients.'
- C. You will be in charge of a unit and have 24-hour accountability.'
- D. You will be responsible for developing and implementing a plan of care for the clients.'
Correct Answer: B
Rationale: An RN must be in charge of client's care, although other healthcare providers, particularly LPN/LVNs, participate in their care. Organizing and coordinating client care, being in charge of a unit with 24-hour accountability, and developing and implementing a plan of care for the clients are under the scope of practice of an RN.
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.
An LPN says to an RN, 'I don't understand why I get paid less, yet we do the same thing here at work.' What role does the RN have in the healthcare setting that the LPN does not?
- A. The RN only cares for clients with well-defined, common problems.
- B. The RN's role is more complex and involves management and coordination of client care.
- C. The RN is responsible for everything that the LPN does in the healthcare setting.
- D. The RN is the only provider that cares for clients that require competency and expertise.
Correct Answer: B
Rationale: The RN's role is more complex, involving the management and coordination of all the care provided to a group of clients. LPN/LVNs care for clients with well-defined, common problems that often require a high level of technical competency and expertise. LPNs are responsible for their own actions and must work within their scope of practice.
A student nurse asks the nursing instructor, 'What will my role as a nurse encompass after I graduate?' What is the best response by the nursing instructor?
- A. You will take care of clients who are ill in a hospital or long-term care facility.'
- B. You will care for individuals and families and play a role in health education, illness prevention, and promotion.'
- C. You will care for a variety of clients of all ages when they are ill.'
- D. It will all depend on where you want to work when you graduate. Nurses do different things in healthcare.'
Correct Answer: B
Rationale: Nursing is concerned with caring for individuals, families, or groups. Nurses not only care for clients when they are ill but also play a significant role in health education, illness prevention, and promotion. Nurses attend to client needs related to: hygiene; activity; diet; the environment; medical treatment; and physical, emotional, and spiritual comfort. Therefore, nurses care for clients in a variety of settings, not just hospitals or long-term care facilities. Though nurses may choose to specialize in a certain area of healthcare, all these areas involve health education and promotion and illness prevention.
A client wishes to be discharged to home and not be admitted to a long-term care facility. The client requires daily wound care for a large sacral pressure ulcer and home health nurses will be consulted. What will be the goal of the home health nurses in the care of this client?
- A. to have the client admitted to a long-term care facility if the ulcer does not heal in a timely manner
- B. to have the client come to the home care agency daily for dressing changes
- C. to continue to see the client daily for dressing changes until the wound heals
- D. to encourage family members to develop self-care skills and perform dressing changes
Correct Answer: D
Rationale: The RN encourages clients and family members to develop self-care skills, with support from community resources. The home health nurse's goal is to allow the client to be cared for in their home and not in a long-term care facility if that is not what the client wishes. The client's condition does not enable self-care. The goal for the family will be to perform dressing changes in the home and the nurse will continue to monitor the condition of the wound.