Nokea
A home care nurse provides care to a client three times a week. The client's family member lives in the home and is employed full time. The family member believes that the client would benefit greatly from care 24 hours a day but wants the client to remain at home. Which is the best action for the nurse to take to meet the family member's goal and to ensure the client receives the care required?
- A. Advocate for the client and the family member to receive additional services as needed.
- B. Encourage the family member to consider placement in a skilled nursing facility.
- C. Teach the family member to provide care to the client during the times the nurse is not in the home.
- D. Recommend enrolling the client in an adult day care center.
Correct Answer: A
Rationale: The best action for the nurse to take to ensure the client receives needed care and to meet the family member's goals for the client is to advocate for the family to receive whatever additional services are required. A skilled nursing facility will provide 24-hour care for the client and will assist in ADLs but will not allow the client to remain at home as the family member wants. An adult day care center allows the client to remain at home but does not provide 24-hour care and can only assist with ADLs during the time frame the client is at the center. Teaching the family member to perform procedures, administer medications, and provide other care would not be the best options because the family member is employed full-time.
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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.
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.
The caregiver of a client with mental disabilities has recently passed away. The client is unable to perform self-care at home. What facility would best meet the needs of this client?
- A. Acute care facility
- B. Rehabilitation care
- C. Intermediate care facility
- D. Ambulatory care
Correct Answer: C
Rationale: Intermediate care facilities (ICFs) are nursing homes that provide custodial care for people who cannot care for themselves because of mental or physical disabilities. Clients must meet specific criteria related to an inability to meet their own activities of daily living (ADL). Rehabilitation centers provide physical and occupational therapy to clients and families to help individuals regain as much independence with ADLs as possible. Acute care facilities care for clients with a higher acuity level. Ambulatory care is also referred to as outpatient care and is a short stay.
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.
A religious organization is an example of this type of ownership?
- A. Government-owned
- B. Proprietary agency
- C. Nonprofit agency
- D. Public facility
Correct Answer: C
Rationale: Nonprofit institutions include universities and religious organizations. Veterans' hospitals are an example of government-owned or public healthcare institutions, which receive at least some tax support. For-profit agencies (proprietary) are owned and operated by corporate groups with investors and stockholders.