Nokea
An adult patient is ready to be discharged from the hospital after undergoing a transmetatarsal amputation. When should your patients discharge planning begin?
- A. The day prior to discharge
- B. The day of estimated discharge
- C. The day that the patient is admitted
- D. Once the nursing care plan has been finalized
Correct Answer: C
Rationale: Discharge planning begins with the patients admission to the hospital and must consider the possible need for follow-up home care. Discharge planning should begin prior to the other listed times.
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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.
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.
A recent nursing school graduate has chosen to pursue a community nursing position because of increasing opportunities for nurses in community settings. What changes in the health care system have created an increased need for nurses to practice in community-based settings? Select all that apply.
- A. Tighter insurance regulations
- B. Younger population
- C. Increased rural population
- D. Changes in federal legislation
- E. Decreasing hospital revenues
Correct Answer: A,D,E
Rationale: Changes in federal legislation, tighter insurance regulations, decreasing hospital revenues, and alternative health care delivery systems have also affected the ways in which health care is delivered. Our country does not have an increased rural population nor is our population younger.
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 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.