Nokea
A home health nurse is collaborating with a hospice nurse in order to transfer the care of a woman who has a diagnosis of lung cancer. To qualify for hospice care, the patient must meet what criterion?
- A. The patient must be medically inappropriate for hospital care.
- B. The patient must be in the final six months of his or her life.
- C. The patients family must demonstrate that they are unable to provide care.
- D. The patient must have a diagnosis that is associated with high morbidity and mortality.
Correct Answer: B
Rationale: Patients are eligible for hospice care services if they are determined to be within the final 6 months of life. Eligibility is not determined on the basis of the familys inability to provide care and it is not determined by whether the patient can or cannot receive care in a hospital setting.
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A community health nurse is aware that restoration of health often depends on appropriate interventions performed early in the course of a disease. Which patient is most likely to seek health care late in the course of his or her disease process and deteriorate more quickly than other patients?
- A. A patient who has been homeless for an extended period of time
- B. A patient who recently immigrated to the United States
- C. A patient who is 88 years old and who has enjoyed relatively good health
- D. A teenage boy
Correct Answer: A
Rationale: Because of numerous barriers, the homeless seek health care late in the course of a disease and deteriorate more quickly than patients who are not homeless. Many of their health problems are related in large part to their living situation. The other answers are incorrect because these populations do not as often seek care late in the course of their disease process and deteriorate quicker than other populations.
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.
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 recent nursing graduate has been surprised at the sharp contrast between some patients lifestyles in their homes and the nurses own practices and beliefs. To work therapeutically with the patient, what must the nurse do?
- A. Request another assignment if there is dissonance with the patients lifestyle.
- B. Ask the patient to come to the agency to receive treatment, if possible.
- C. Resolve to convey respect for the patients beliefs and choices.
- D. Try to adapt the patients home to the norms of a hospital environment.
Correct Answer: C
Rationale: To work successfully with patients in any setting, the nurse must be nonjudgmental and convey respect for patients beliefs, even if they differ sharply from the nurses. This can be difficult when a patients lifestyle involves activities that a nurse considers harmful or unacceptable, such as smoking, use of alcohol, drug abuse, or overeating. The nurse should not request another assignment because of a difference in beliefs, nor do nurses ask for the patient to come to the agency to receive treatment. It is also inappropriate to convert the patients home to a hospital-like environment.
The community-health nurse has received a referral for a new patient who resides in a high-crime area. What is the most important request that the nurse should make of the agency to best ensure safety?
- A. An early morning or late afternoon appointment
- B. An assigned parking space in the neighborhood
- C. A colleague to accompany the nurse on the visit
- D. Someone to wait in the car while the nurse makes the visit
Correct Answer: C
Rationale: When making visits in high-crime areas, visit with another person rather than alone. A person who is waiting in the car is of little benefit. An early morning or late afternoon appointment would not necessarily guarantee safety. Similarly, assigned parking would not guarantee the nurses safety while performing the visit.