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At the beginning of a day that will involve several home visits, the nurse has ensured that the health care agency has a copy of her daily schedule. What is the rationale for the nurses action?
- A. It allows the agency to keep track for payment to the nurse.
- B. It supports safety precautions for the nurse when making a home care visit.
- C. It allows for greater flexibility for the nurse and his or her colleagues for changes in assignments.
- D. It allows the patient to cancel appointments with minimal inconvenience.
Correct Answer: B
Rationale: Whenever a nurse makes a home visit, the agency should know the nurses schedule and the locations of the visits. The other answers are incorrect because providing the agency with a copy of the daily schedule is not for the purpose of correctly paying the nurse or for the ease of the nurse in changing assignments. It is also not intended for the patients ease in canceling appointments.
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A nurse is collaborating with a team of community nurses to identify the vision and mission for community care. What is the central focus of community-based nursing?
- A. Increased health literacy in the community
- B. Distributing ownership for the health of the community
- C. Promoting and maintaining the health of individuals and families
- D. Identifying links between lifestyle and health
Correct Answer: C
Rationale: Community-based nursing practice focuses centrally on promoting and maintaining the health of individuals and families, preventing and minimizing the progression of disease, and improving quality of life. Health literacy is not a goal in itself, but rather a means to promoting health. Distributing ownership and identifying links between lifestyle and health are not the essence of community-based care.
Infection control is a high priority in every setting where nursing care is provided. When performing a home visit, how should the nurse best implement the principles of infection control?
- A. Perform hand hygiene before and after giving direct patient care.
- B. Remove the patients wound dressings from the home promptly.
- C. Disinfect the patients syringes prior to disposal.
- D. Establish a sterile field in the patients home before providing care.
Correct Answer: A
Rationale: Infection control is as important in the home as it is in the hospital, but it can be more challenging in the home and requires creative approaches. As in any situation, it is important to clean ones hands before and after giving direct patient care, even in a home that does not have running water. Removing the wound dressings from the home and disinfecting all work areas in the home are not the best implementations of infection control in the home. Used syringes are never disinfected and a sterile field is not always necessary.
A home health nurse is conducting a home visit to a patient who receives wound care twice weekly for a diabetic foot ulcer. While performing the dressing change, the nurse realizes that she forgot to bring the adhesive gauze specified in the wound care regimen. What is the nurses best action?
- A. Phone a colleague to bring the required supplies as soon as possible.
- B. Improvise, if possible, using sterile gauze and adhesive tape.
- C. Leave the wound open to air and teach the patient about infection control.
- D. Schedule a return visit for the following day.
Correct Answer: B
Rationale: Improvise, if possible, using sterile gauze and adhesive tape. Improvisation is a necessity in many home health situations. It would be logistically difficult to have the supplies delivered and leaving the wound open to air may be contraindicated. A return visit the next day does not resolve the immediate problem.
Nursing care is provided in an increasingly diverse variety of settings. Despite the variety in settings, some characteristics of professional nursing practice are required in any and every setting. These characteristics include which of the following?
- A. Advanced education
- B. Certification in a chosen specialty
- C. Cultural competence
- D. Independent practice
Correct Answer: C
Rationale: Cultural competence is necessary in any and every care setting. The other answers are incorrect because an advanced education, specialty certification, and the ability to practice independently are not consistencies between every nursing care delivery setting.
You are the community-based nurse who performs the role of case manager for a small town about 60 miles from a major health care center. When planning care in your community, what is the most important variable in community-based nursing that you should integrate into your planning?
- A. Eligibility requirements for services
- B. Community resources available to patients
- C. Transportation costs to the medical center
- D. Possible charges for any services provided
Correct Answer: B
Rationale: A community-based nurse must be knowledgeable about community resources available to patients as well as services provided by local agencies, eligibility requirements, and any possible charges for the services. The other answers are incorrect because they are not the most important factors about which a community-based nurse must be knowledgeable.