An older adult client is being transferred to another facility in order to continue physical therapy after having a total right hip replacement. What type of facility will provide skilled nursing and rehabilitative care for this client who will go home after the rehabilitation?
- A. Acute care facility
- B. Long-term acute care
- C. Skilled nursing care
- D. Intermediate care facility
Correct Answer: C
Rationale: Skilled nursing care facilities provide skilled nursing and rehabilitative care to people who have the potential to regain function but need skilled observation and nursing care during an acute illness. Acute care facilities are for clients who have a higher level of acuity. Long-term acute care are for clients who require long-term wound care or ventilator support or who have other conditions that are potentially unstable but do not have rapid changes. Intermediate care facilities provide care for people who cannot care for themselves because of mental or physical disabilities.
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Which nursing theorist stated that clients are open systems in constant interaction with their environment?
- A. Florence Nightingale
- B. Virginia Henderson
- C. Imogene King
- D. Dorothea Orem
Correct Answer: C
Rationale: Imogene King stated that clients are open systems in constant interaction with their environment. Florence Nightingale described the role of the nurse as putting 'the patient in the best condition for nature to act upon him.' Virginia Henderson envisioned the nurse's role as helping people (sick or well) to carry out activities contributing to health, recovery, or a peaceful death that they would do for themselves if they had the necessary strength, will, or knowledge. Dorothea Orem was a proponent of the self-care deficit theory.
A client has end-stage chronic obstructive pulmonary disease (COPD) and is terminally ill. The family wants the client to spend their last days in a facility that will be able to keep the client comfortable and control their severe dyspnea. What facility will meet the needs of the client and family?
- A. Rehabilitation care
- B. Hospice care
- C. Intermediate care facilities
- D. Ambulatory care
Correct Answer: B
Rationale: Hospice provides care for clients diagnosed with a terminal illness whose life expectancy is fewer than 6 months. Hospices allow terminally ill clients to live as fully as possible while managing pain, discomfort, and other symptoms. Rehabilitation centers provide physical and occupational therapy to clients and families to help individuals regain as much independence with ADLs as possible. Intermediate care facilities (ICFs) are nursing homes that provide custodial care for people who cannot care for themselves because of mental or physical disabilities. Ambulatory care is also outpatient care.
The LPN is part of a group of nurses that has an RN team leader as well as another LPN and two nursing assistants who will be providing care to a group of clients. What type of nursing method is this considered?
- A. Functional nursing
- B. Total client care
- C. Case method
- D. Team nursing
Correct Answer: D
Rationale: Team nursing is composed of an RN team leader, other RNs, LPN/LVNs, and nursing assistants who provide care to a group of clients. Functional nursing is a task-oriented method where everyone in the group is assigned to specific tasks. Case method is the same as private duty nursing. Total client care refers to assignments in which a nurse assumes all the care for a small group of clients.
A student nurse asks the nursing instructor, 'What will my role as a nurse encompass after I graduate?' What is the best response by the nursing instructor?
- A. You will take care of clients who are ill in a hospital or long-term care facility.'
- B. You will care for individuals and families and play a role in health education, illness prevention, and promotion.'
- C. You will care for a variety of clients of all ages when they are ill.'
- D. It will all depend on where you want to work when you graduate. Nurses do different things in healthcare.'
Correct Answer: B
Rationale: Nursing is concerned with caring for individuals, families, or groups. Nurses not only care for clients when they are ill but also play a significant role in health education, illness prevention, and promotion. Nurses attend to client needs related to: hygiene; activity; diet; the environment; medical treatment; and physical, emotional, and spiritual comfort. Therefore, nurses care for clients in a variety of settings, not just hospitals or long-term care facilities. Though nurses may choose to specialize in a certain area of healthcare, all these areas involve health education and promotion and illness prevention.
A client is going to be in subacute care for approximately 30 days. The client will require frequent assessments and periodic review of the client's progress. What role will the registered nurse have in the care of this client?
- A. The RN will provide direct care for the client.
- B. The RN will ensure that the client eats 100% of the meals.
- C. The RN will order the various treatments for the client.
- D. The RN will coordinate the client's care.
Correct Answer: D
Rationale: RNs coordinate clients' care, and LPN/LVNs provide and oversee care provided by unlicensed connective personnel (UAPs). The RN does not generally provide the direct care, and this would include overseeing meals. It is beyond the scope of practice for RNs to order treatments and medications.
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