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Medicare is a federal program that finances many Americans home health care expenses. The Medicare program facilitates what aspect of home health care?
- A. Providing care without the oversight of a physician
- B. Writing necessary medication orders for the patient
- C. Ordering physical, occupational, and speech therapy if needed
- D. Managing and evaluating patient care for seriously ill patients
Correct Answer: D
Rationale: Many home health care expenditures are financed by Medicare, which allows nurses to manage and evaluate patient care for seriously ill patients who have complex, labile conditions and are at high risk for rehospitalization. Home health nurses, despite who funds their visits, do not provide care without the oversight of a physician; they do not normally write medication orders; nor do they order the services of ancillary specialists such as physical, occupational, or speech therapists.
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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.
A home health nurse is making a visit to a new patient who is receiving home care following a mastectomy. During the visit, the patients husband arrives home in an intoxicated state and speaks to both you and the patient in an abusive manner. What is your best response?
- A. Ignore the husband and focus on the patient.
- B. Return to your agency and notify your supervisor.
- C. Call the police from your cell phone.
- D. Remove the patient from the home immediately.
Correct Answer: B
Rationale: If a dangerous situation is encountered during a visit, the nurse should return to the agency and contact his or her supervisor or law enforcement officials, or both. Ignoring the husband or calling the police while in the home or attempting to remove the patient from the home could further endanger you and the patient.
A home health nurse has completed a scheduled home visit to a patient with a chronic sacral ulcer. The nurse is now evaluating and documenting the need for future visits and the frequency of those visits. What question can the nurse use when attempting to determine this need?
- A. How does the patient describe his coping style?
- B. When was the patient first diagnosed with this wound?
- C. Is the patients family willing to participate in care?
- D. Is the patient willing to create a plan of care?
Correct Answer: C
Rationale: Determining the willingness and ability of friends and family to provide care can help determine appropriate levels of professional home care. The time of initial diagnosis and the patients coping style are secondary. The nurse, not the patient, is responsible for creating the plan of care.
A nurse is comparing some of the similarities and differences between the care that is provided in community- and hospital-based settings. What type of care is provided in both of these settings?
- A. Dieticians
- B. Ambulatory health care
- C. Occupational health care
- D. Hospice care
Correct Answer: B
Rationale: Ambulatory health care is provided for patients in community or hospital-based settings. The types of agencies that provide such care are medical clinics, ambulatory care units, urgent care centers, cardiac rehabilitation programs, mental health centers, student health centers, community outreach programs, and nursing centers. Dieticians are not generally community-based and hospice care is not generally provided in hospital settings. Occupational health care is situated in workplaces.
Discharge planning is an integral part of community-health nursing and home health. Which of the following is prioritized in the discharge-planning process?
- A. Identifying the patients specific needs
- B. Making a social services referral
- C. Getting physical therapy involved in care
- D. Notifying the pharmacy of the discharge date
Correct Answer: A
Rationale: The discharge planning process involves identifying the patients needs and developing a thorough plan to meet them. The other options might be appropriate for some patients, but they are not all appropriate for every patient.