Nokea
In two days you are scheduled to discharge a patient home after left hip replacement. You have initiated a home health referral and you have met with a team of people who have been involved with this patients discharge planning. Knowing that the patient lives alone, who would be appropriate people to be on the discharge planning team? Select all that apply.
- A. Home health nurse
- B. Physical therapist
- C. Pharmacy technician
- D. Social worker
- E. Meal-on-Wheels provider
Correct Answer: A,B,D
Rationale: The development of a comprehensive discharge plan requires collaboration with professionals at both the referring agency and the home care agency, as well as other community agencies that provide specific resources upon discharge. The pharmacy technician does not participate in discharge planning and there is no indication that Meals-on-Wheels are necessary.
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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.
A community health nurse in a large, urban setting is participating in a pilot project that will involve the establishment of a community hub. On what population should the nurse focus?
- A. Postsurgical patients
- B. Individuals with vulnerable health
- C. Community leaders
- D. Individuals motivated to participate in health education
Correct Answer: B
Rationale: Community hubs are a recent concept that addresses the varied health needs of vulnerable and marginalized populations. Community hubs do not primarily focus on postsurgical patients, community leaders, or individuals who are proactive with health education.
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.
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.
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.