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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.
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An urban, community-based nurse is looking for community resources for a patient who has complex rehabilitation needs coupled with several comorbid, chronic health conditions. Where is the best place for the nurse to search for appropriate resources?
- A. A hospital directory
- B. The hospital intranet
- C. A community directory
- D. The nurses own personal network
Correct Answer: C
Rationale: Most communities have directories of health and social service agencies that the nurse can consult. The other answers are incorrect because hospital directories and intranets usually only include people affiliated with the hospital. The nurses personal network of contacts may or may not be of use.
A community health nurse has scheduled a hypertension clinic in a local shopping mall in which shoppers have the opportunity to have their blood pressure measured and learn about hypertension. This nursing activity would be an example of which type of prevention activity?
- A. Tertiary prevention
- B. Secondary prevention
- C. Primary prevention
- D. Disease prevention
Correct Answer: B
Rationale: Secondary prevention centers on health maintenance aimed at early detection and prevention. Disease prevention is not a form of health care but is a focus of primary prevention.
The home health nurse receives a referral from the hospital for a patient who needs a home visit for wound care. After obtaining the referral, what would be the first action the nurse should take?
- A. Have community services make contact with the patient.
- B. Obtain a physicians order for the visit.
- C. Call the patient to obtain permission to visit.
- D. Arrange for a home health aide to initially visit the patient.
Correct Answer: C
Rationale: After receiving a referral, the first step is to call the patient and obtain permission to make the visit. Then the nurse should schedule the visit and verify the address. A physicians order is not necessary to schedule a visit with the patient. The nurse may identify community services or the need for a home health aide after assessing the patient and the home environment during the first visit with the patient. This would not be delegated to a home health aide.
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 recent nursing graduate has been surprised at the sharp contrast between some patients lifestyles in their homes and the nurses own practices and beliefs. To work therapeutically with the patient, what must the nurse do?
- A. Request another assignment if there is dissonance with the patients lifestyle.
- B. Ask the patient to come to the agency to receive treatment, if possible.
- C. Resolve to convey respect for the patients beliefs and choices.
- D. Try to adapt the patients home to the norms of a hospital environment.
Correct Answer: C
Rationale: To work successfully with patients in any setting, the nurse must be nonjudgmental and convey respect for patients beliefs, even if they differ sharply from the nurses. This can be difficult when a patients lifestyle involves activities that a nurse considers harmful or unacceptable, such as smoking, use of alcohol, drug abuse, or overeating. The nurse should not request another assignment because of a difference in beliefs, nor do nurses ask for the patient to come to the agency to receive treatment. It is also inappropriate to convert the patients home to a hospital-like environment.