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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.
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The LPN is part of a group of nurses that has an RN team leader as well as another LPN and two nursing assistants who will be providing care to a group of clients. What type of nursing method is this considered?
- A. Functional nursing
- B. Total client care
- C. Case method
- D. Team nursing
Correct Answer: D
Rationale: Team nursing is composed of an RN team leader, other RNs, LPN/LVNs, and nursing assistants who provide care to a group of clients. Functional nursing is a task-oriented method where everyone in the group is assigned to specific tasks. Case method is the same as private duty nursing. Total client care refers to assignments in which a nurse assumes all the care for a small group of clients.
A hospital unit has been using a functional nursing model for delivery of care for several years. The manager has been discussing with the staff the idea of a change to total care because functional nursing has some disadvantages to the clients. What disadvantage is the manager referring to?
- A. It is expensive because it only uses RNs.
- B. Some nurses work harder than others to provide care.
- C. It fragments care and is confusing for the clients.
- D. Nurses are accountable for the client's care 24 hours per day.
Correct Answer: C
Rationale: Although efficient, functional nursing fragments care and is confusing for clients. Primary nursing is expensive because it uses RNs only. Nurses are designated certain tasks if functional nursing is employed, so the care is divided. Nurses are accountable for client care in a primary nursing model.
An older adult client is being transferred to another facility in order to continue physical therapy after having a total right hip replacement. What type of facility will provide skilled nursing and rehabilitative care for this client who will go home after the rehabilitation?
- A. Acute care facility
- B. Long-term acute care
- C. Skilled nursing care
- D. Intermediate care facility
Correct Answer: C
Rationale: Skilled nursing care facilities provide skilled nursing and rehabilitative care to people who have the potential to regain function but need skilled observation and nursing care during an acute illness. Acute care facilities are for clients who have a higher level of acuity. Long-term acute care are for clients who require long-term wound care or ventilator support or who have other conditions that are potentially unstable but do not have rapid changes. Intermediate care facilities provide care for people who cannot care for themselves because of mental or physical disabilities.
The nurse manager of a telemetry unit is considering changing from a team model of nursing to a primary nursing model. When considering this decision, what advantage does the manager understand the primary nursing model brings to nursing care?
- A. The RN will partner with one or more assistive personnel to care for a group of clients.
- B. Caregivers see to all their client's needs, thus providing holistic and comprehensive care.
- C. Tasks are divided, and clients see several people during the shift.
- D. The RN will be the team leader and direct the care that is provided by all of the other personnel.
Correct Answer: B
Rationale: In primary nursing, an RN assumes 24-hour accountability for the client's care and has total responsibility. An advantage is that the client has a caregiver who provides holistic and comprehensive care. An RN partnering with one or more assistive personnel when caring for a group of clients is an example of a client care-focused model. When tasks are divided with clients seeing several people during a shift, this is considered a total care model. An RN serving as a team leader directing the care provided by other personnel constitutes a team approach.
Freestanding apartments are an example of which type of alternative healthcare setting?
- A. Skilled nursing care
- B. Assisted living
- C. Congregate housing
- D. Boarding homes
Correct Answer: C
Rationale: Congregate housing provides independent living or minimal assistance for seniors or disabled adults. Skilled nursing care facilities provide skilled nursing and rehabilitative care to people who have the potential to regain function but need skilled observation and nursing care during an acute illness. Assisted living facilities provide care to residents who need assistance with up to three activities of daily living. Boarding homes are usually small homes with individual rooms where residents pay for room and board and minimal nursing services.