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A community-based case manager is sending a community nurse to perform an initial home assessment of a newly referred patient. To ensure safety, the case manager must make the nurse aware of which of the following?
- A. The potential for at-risk working environments
- B. Self-defense strategies
- C. Locations of emergency services in the area
- D. Standard precautions for infection control
Correct Answer: A
Rationale: Based on the principle of due diligence, agencies must inform employees of at-risk working environments. Agencies have policies and procedures concerning the promotion of safety for clinical staff, and training is provided to facilitate personal safety. The physical location of emergency services is not important, though methods for contacting emergency services are a priority. Infection control is part of the nurses own professional responsibility. Self-defense strategies are not always addressed and are not legally mandated.
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A home health nurse is preparing to make the initial visit to a new patients home. When planning educational interventions, what information should the nurse provide to the patient and his or her family?
- A. Available community resources to meet their needs
- B. Information on other patients in the area with similar health care needs
- C. The nurses contact information and credentials
- D. Dates and times of all scheduled home care visits
Correct Answer: A
Rationale: The community-based nurse is responsible for informing the patient and family about the community resources available to meet their needs. During initial and subsequent home visits, the nurse helps the patient and family identify these community services and encourages them to contact the appropriate agencies. When appropriate, nurses may make the initial contact. The other answers are incorrect because it is inappropriate to ever provide information on other patients to a patient. The nurses credentials are not normally discussed. Giving the patient the dates and times of their scheduled home visits is appropriate, but may not always be possible. It is more important to provide them with resources available within the community to meet their needs.
Medicare is a federal program that finances many Americans home health care expenses. The Medicare program facilitates what aspect of home health care?
- A. Providing care without the oversight of a physician
- B. Writing necessary medication orders for the patient
- C. Ordering physical, occupational, and speech therapy if needed
- D. Managing and evaluating patient care for seriously ill patients
Correct Answer: D
Rationale: Many home health care expenditures are financed by Medicare, which allows nurses to manage and evaluate patient care for seriously ill patients who have complex, labile conditions and are at high risk for rehospitalization. Home health nurses, despite who funds their visits, do not provide care without the oversight of a physician; they do not normally write medication orders; nor do they order the services of ancillary specialists such as physical, occupational, or speech therapists.
A home health nurse has completed a scheduled home visit to a patient with a chronic sacral ulcer. The nurse is now evaluating and documenting the need for future visits and the frequency of those visits. What question can the nurse use when attempting to determine this need?
- A. How does the patient describe his coping style?
- B. When was the patient first diagnosed with this wound?
- C. Is the patients family willing to participate in care?
- D. Is the patient willing to create a plan of care?
Correct Answer: C
Rationale: Determining the willingness and ability of friends and family to provide care can help determine appropriate levels of professional home care. The time of initial diagnosis and the patients coping style are secondary. The nurse, not the patient, is responsible for creating the plan of care.
A nurse is collaborating with a team of community nurses to identify the vision and mission for community care. What is the central focus of community-based nursing?
- A. Increased health literacy in the community
- B. Distributing ownership for the health of the community
- C. Promoting and maintaining the health of individuals and families
- D. Identifying links between lifestyle and health
Correct Answer: C
Rationale: Community-based nursing practice focuses centrally on promoting and maintaining the health of individuals and families, preventing and minimizing the progression of disease, and improving quality of life. Health literacy is not a goal in itself, but rather a means to promoting health. Distributing ownership and identifying links between lifestyle and health are not the essence of community-based care.
An urban, community-based nurse is looking for community resources for a patient who has complex rehabilitation needs coupled with several comorbid, chronic health conditions. Where is the best place for the nurse to search for appropriate resources?
- A. A hospital directory
- B. The hospital intranet
- C. A community directory
- D. The nurses own personal network
Correct Answer: C
Rationale: Most communities have directories of health and social service agencies that the nurse can consult. The other answers are incorrect because hospital directories and intranets usually only include people affiliated with the hospital. The nurses personal network of contacts may or may not be of use.