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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.
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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.
Nursing care is provided in an increasingly diverse variety of settings. Despite the variety in settings, some characteristics of professional nursing practice are required in any and every setting. These characteristics include which of the following?
- A. Advanced education
- B. Certification in a chosen specialty
- C. Cultural competence
- D. Independent practice
Correct Answer: C
Rationale: Cultural competence is necessary in any and every care setting. The other answers are incorrect because an advanced education, specialty certification, and the ability to practice independently are not consistencies between every nursing care delivery setting.
You are a community-based care manager in a medium-sized community that does not have an up-to-date resource directory available. As a result, you have been given the task of beginning to compile such a directory. What would be important to include in this directory? Select all that apply.
- A. Links to online health sciences journals
- B. Lists of social service workers in the community
- C. Eligibility requirements for services
- D. Lists of the most commonly used resources
- E. Costs associated with services
Correct Answer: C,D,E
Rationale: If a community does not have a resource booklet, an agency may develop one for its staff. It should include the commonly used community resources that patients need, as well as the costs of the services and eligibility requirements. The other answers are incorrect because a community resource booklet usually would not include links to online professional journals and it would not identify specific social service workers, only agencies.
A home health nurse is conducting an assessment of a patient who may qualify for Medicare. Consequently, the nurse is utilizing the Outcome and Assessment Instrument Set (OASIS). When performing an assessment using this instrument, the nurse should assess which of the following domains of the patients current status?
- A. Psychiatric status
- B. Spiritual state
- C. Compliance with care
- D. Functional status
Correct Answer: D
Rationale: The Omaha System of care documentation has been required for over a decade to assure that outcome-based care is provided for all care reimbursed by Medicare. This system uses six major domains: sociodemographic, environment, support system, health status, functional status, and behavioral status and addresses selected health service utilization. It does not explicitly assess spirituality, psychiatric status, or compliance with care.
A home health nurse is making a visit to a new patient who is receiving home care following a mastectomy. During the visit, the patients husband arrives home in an intoxicated state and speaks to both you and the patient in an abusive manner. What is your best response?
- A. Ignore the husband and focus on the patient.
- B. Return to your agency and notify your supervisor.
- C. Call the police from your cell phone.
- D. Remove the patient from the home immediately.
Correct Answer: B
Rationale: If a dangerous situation is encountered during a visit, the nurse should return to the agency and contact his or her supervisor or law enforcement officials, or both. Ignoring the husband or calling the police while in the home or attempting to remove the patient from the home could further endanger you and the patient.