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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.
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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.
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.
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 nursing student has taught a colleague that nursing practice is not limited to hospital settings, explaining that nurses are now working in ambulatory health clinics, hospice settings, and homeless shelters and clinics. What factor has most influenced this increased diversity in practice settings for nurses?
- A. Population shift to more rural areas
- B. Shift of health care delivery into the community
- C. Advent of primary care clinics
- D. Increased use of rehabilitation hospitals
Correct Answer: B
Rationale: As health care delivery shifts into the community, more nurses are working in a variety of community-based settings. These settings include public health departments, ambulatory health clinics, long-term care facilities, hospice settings, industrial settings (as occupational nurses), homeless shelters and clinics, nursing centers, home health agencies, urgent care centers, same-day surgical centers, short-stay facilities, and patients homes. The other answers are incorrect because our population has not shifted to a more rural base, and the use of primary care clinics has not influenced an increase in practice settings or the use of rehabilitation hospitals.
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.