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An older-adult patient who lives alone was hospitalized for a fractured hip and has recovered from the surgery but needs to continue to work to improve mobility. Which of the following settings would the nurse anticipate that the patient be transferred to?
- A. Another acute care setting
- B. A transitional care setting
- C. A residential care facility
- D. Their own home with home health nursing
Correct Answer: D
Rationale: Home health nursing is appropriate for patients who need continued rehabilitation and can implement this in their own home. The patient is no longer in need of the more continuous assessment and care given in acute care settings. There is no indication that the patient will need the permanent and ongoing medical and nursing services available in intermediate care. The patient is not yet independent enough to transfer to a residential care facility.
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Which of the following statements represent a current trend in home health nursing?
- A. Increased numbers of registered nurses are being employed as home health nurses.
- B. Decreased numbers of licensed/registered practical nurses are being employed as home health nurses.
- C. There are more employment opportunities for newly graduated nurses.
- D. That a minimum of two years of acute care experience is required before employment as a home health nurse.
Correct Answer: C
Rationale: There are many opportunities for newly graduated nurses to begin practice as a home health nurse. It was widely believed for many years that nurses required a minimum of 2 years of acute care hospital experience before being hired as a home health nurse but is no longer true. Registered nurses generally received hiring preference over licensed practical nurses because it was believed that registered nurse preparation provided the best foundation for home care nursing. However, partly because the growing nursing shortage, enhancements to the scope of practice and educational programs for licensed/registered practical nurses, and the need to provide long-term interventions to a growing population with complex and unpredictable care needs, many home health employers now hire both registered nurses and licensed/registered practical nurses right after graduation.
Which of the following concepts is foundational to home health nursing?
- A. Acute care management
- B. Health promotion
- C. Persistent disease management
- D. Health restoration
Correct Answer: B
Rationale: A foundational concept of home health nursing is health promotion. Acute care and persistent disease management are roles, they are not the foundation upon which home health nursing is based. Health restoration is a core expectation but is not the foundation for home health nursing.
A patient who was in an automobile accident is assigned a nurse as a case manager. Which of the following responsibilities is required of the nurse in this role?
- A. Care for the patient during hospitalization for the injuries.
- B. Assist the patient with home care activities during recovery.
- C. Coordinate the services that the patient receives in the hospital and at home.
- D. Determine the types of medical care the patient needs for optimal rehabilitation.
Correct Answer: C
Rationale: The role of the case manager is to coordinate the patient's care through multiple settings and levels of care to allow the maximal patient benefit at the least cost. The case manager does not provide direct care in either the acute or home setting. The case manager coordinates and advocates for care but does not determine what types of medical care are needed, that is done by the health care provider or other provider.
The nurse is describing home care services to a patient that requires extended care. Which of the following statements is true related to home care services?
- A. Technologically complex therapies must be managed in the hospital.
- B. The patient's family will be included in planning and the patient's care.
- C. Home care services are limited to visits by registered nurses or home health aides.
- D. In order for insurance to cover the home care, the patient must be contained to bed.
Correct Answer: B
Rationale: Family members who are providing care are included in planning the patient's care and treatments. Other disciplines, such as physical and occupational therapy, also provide appropriate home health services. The patient must be homebound, but not bed bound, to receive reimbursement for home care services. High-tech devices are increasingly accomplished in the home setting where the patient is more comfortable and the risks for complications such as infection are less.
A family caregiver tells the home health nurse, 'I feel like I can never get away to do anything for myself.' Which action is the most appropriate for the nurse to take?
- A. Assist the caregiver in finding respite services.
- B. Assure the caregiver that the work is appreciated.
- C. Teach the caregiver that family members provide excellent patient care.
- D. Encourage the caregiver to discuss feelings openly with the nurse as needed.
Correct Answer: A
Rationale: Respite services allow family caregivers to have free time. The other actions also may be helpful, but the caregiver's statement clearly indicates the need for some free time.