Nokea
A community health nurse in a large, urban setting is participating in a pilot project that will involve the establishment of a community hub. On what population should the nurse focus?
- A. Postsurgical patients
- B. Individuals with vulnerable health
- C. Community leaders
- D. Individuals motivated to participate in health education
Correct Answer: B
Rationale: Community hubs are a recent concept that addresses the varied health needs of vulnerable and marginalized populations. Community hubs do not primarily focus on postsurgical patients, community leaders, or individuals who are proactive with health education.
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In two days you are scheduled to discharge a patient home after left hip replacement. You have initiated a home health referral and you have met with a team of people who have been involved with this patients discharge planning. Knowing that the patient lives alone, who would be appropriate people to be on the discharge planning team? Select all that apply.
- A. Home health nurse
- B. Physical therapist
- C. Pharmacy technician
- D. Social worker
- E. Meal-on-Wheels provider
Correct Answer: A,B,D
Rationale: The development of a comprehensive discharge plan requires collaboration with professionals at both the referring agency and the home care agency, as well as other community agencies that provide specific resources upon discharge. The pharmacy technician does not participate in discharge planning and there is no indication that Meals-on-Wheels are necessary.
The home health nurse receives a referral from the hospital for a patient who needs a home visit for wound care. After obtaining the referral, what would be the first action the nurse should take?
- A. Have community services make contact with the patient.
- B. Obtain a physicians order for the visit.
- C. Call the patient to obtain permission to visit.
- D. Arrange for a home health aide to initially visit the patient.
Correct Answer: C
Rationale: After receiving a referral, the first step is to call the patient and obtain permission to make the visit. Then the nurse should schedule the visit and verify the address. A physicians order is not necessary to schedule a visit with the patient. The nurse may identify community services or the need for a home health aide after assessing the patient and the home environment during the first visit with the patient. This would not be delegated to a home health aide.
A nurse who has an advanced degree in primary care for a pediatric population is employed in a health clinic. In what role is this nurse functioning?
- A. Nurse practitioner
- B. Case coordinator
- C. Clinical nurse specialist
- D. Clinic supervisor
Correct Answer: A
Rationale: Nurse practitioners, educated in primary care, often practice in ambulatory care settings that focus on gerontology, pediatrics, family or adult health, or womens health. Case coordinators and clinical supervisors do not necessarily require an advanced degree, and a clinical nurse specialist is not educated in primary care. Primary care is the specific focus of CNPs.
A home health nurse has been working for several months with a male patient who is receiving rehabilitative services. The nurse is aware that maintaining the patients confidentiality is a priority. How can the nurse best protect the patients right to confidentiality?
- A. Avoid bringing the patients medical record to the home.
- B. Discuss the patients condition and care only when he is alone in the home.
- C. Keep the patients medical record secured at all times.
- D. Ask the patient to avoid discussing his home care with friends and neighbors.
Correct Answer: C
Rationale: If the nurse carries a patients medical record into a house, it must be put in a secure place to prevent it from being picked up by others or from being misplaced. This does not mean, however, that it must never be brought to the home. It is not normally necessary to limit discussions to times when the patient is alone. The patient has the right to decide with whom he will discuss his condition and care.
At the beginning of a day that will involve several home visits, the nurse has ensured that the health care agency has a copy of her daily schedule. What is the rationale for the nurses action?
- A. It allows the agency to keep track for payment to the nurse.
- B. It supports safety precautions for the nurse when making a home care visit.
- C. It allows for greater flexibility for the nurse and his or her colleagues for changes in assignments.
- D. It allows the patient to cancel appointments with minimal inconvenience.
Correct Answer: B
Rationale: Whenever a nurse makes a home visit, the agency should know the nurses schedule and the locations of the visits. The other answers are incorrect because providing the agency with a copy of the daily schedule is not for the purpose of correctly paying the nurse or for the ease of the nurse in changing assignments. It is also not intended for the patients ease in canceling appointments.