Nokea
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.
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You are assessing a new patient and his home environment following the patients referral for community-based care. Which of the following is the most important responsibility that you, as a community-based nurse, have at this initial visit?
- A. Encourage the patient and his family to become more involved in their community.
- B. Encourage the patient and his family to delegate someone to contact community resources.
- C. Encourage the patient and his family to focus primarily on online supports.
- D. Encourage the patient and his family to connect with appropriate community resources.
Correct Answer: D
Rationale: During initial and subsequent home visits, the nurse helps the patient and family identify community services and encourages them to contact the appropriate agencies. This is preferable to delegating another person to make contact. When appropriate, nurses may make the initial contact. A home-health nurse would not normally encourage the patient to become more involved in the community as a means of promoting health. Online forms of support can be useful, but they are not the sole form of support that most patients need.
A nurse is comparing some of the similarities and differences between the care that is provided in community- and hospital-based settings. What type of care is provided in both of these settings?
- A. Dieticians
- B. Ambulatory health care
- C. Occupational health care
- D. Hospice care
Correct Answer: B
Rationale: Ambulatory health care is provided for patients in community or hospital-based settings. The types of agencies that provide such care are medical clinics, ambulatory care units, urgent care centers, cardiac rehabilitation programs, mental health centers, student health centers, community outreach programs, and nursing centers. Dieticians are not generally community-based and hospice care is not generally provided in hospital settings. Occupational health care is situated in workplaces.
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.
You are a school nurse who will work with an incoming kindergarten student who has a diagnosis of cerebral palsy. Why would you make a home visit before school starts?
- A. To provide anticipatory guidance to the family
- B. To assess the safety of the childs assistive devices
- C. To arrange for a teaching aide to work with the child
- D. To provide follow-up care after the childs clinic visit
Correct Answer: A
Rationale: Public health, parish, and school nurses may make visits to provide anticipatory guidance to high-risk families and follow-up care to patients with communicable diseases. The other answers are incorrect because they are not functions of the school nurse.
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.