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A nurse is based in an automotive assembly plant and works with the plants employees in the areas of health promotion and basic primary care. What nursing role is this nurse performing?
- A. Occupational health nurse
- B. Community nurse specialist
- C. Nurse clinician
- D. Public health nurse
Correct Answer: A
Rationale: Occupational health nurses may provide direct care to patients who are ill, conduct health education programs for the industry staff, or set up health programs. The other answers are incorrect because they are not consistent with a nurses placement in a manufacturing setting.
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A home health nurse has been assigned to the care of an 82 year-old woman who has been discharged home following hip replacement surgery. At what level of care is this nurse most likely practicing?
- A. Preventative care
- B. Primary prevention
- C. Secondary prevention
- D. Tertiary prevention
Correct Answer: D
Rationale: Nurses in community-based practice provide preventive care at three levels: primary, secondary, and tertiary. Tertiary prevention focuses on minimizing deterioration and improving quality of life, including rehabilitation to assist patients in achieving their maximum potential by working through their physical or psychological challenges. Home care nurses often focus on tertiary preventive nursing care, although primary and secondary prevention are also addressed. Preventive care is an umbrella term for all three levels of care.
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.
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.
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.
Discharge planning is an integral part of community-health nursing and home health. Which of the following is prioritized in the discharge-planning process?
- A. Identifying the patients specific needs
- B. Making a social services referral
- C. Getting physical therapy involved in care
- D. Notifying the pharmacy of the discharge date
Correct Answer: A
Rationale: The discharge planning process involves identifying the patients needs and developing a thorough plan to meet them. The other options might be appropriate for some patients, but they are not all appropriate for every patient.