Nokea
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.
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A home health nurse is conducting an assessment of a patient who may qualify for Medicare. Consequently, the nurse is utilizing the Outcome and Assessment Instrument Set (OASIS). When performing an assessment using this instrument, the nurse should assess which of the following domains of the patients current status?
- A. Psychiatric status
- B. Spiritual state
- C. Compliance with care
- D. Functional status
Correct Answer: D
Rationale: The Omaha System of care documentation has been required for over a decade to assure that outcome-based care is provided for all care reimbursed by Medicare. This system uses six major domains: sociodemographic, environment, support system, health status, functional status, and behavioral status and addresses selected health service utilization. It does not explicitly assess spirituality, psychiatric status, or compliance with 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 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.
A nurse is based in an automotive assembly plant and works with the plants employees in the areas of health promotion and basic primary care. What nursing role is this nurse performing?
- A. Occupational health nurse
- B. Community nurse specialist
- C. Nurse clinician
- D. Public health nurse
Correct Answer: A
Rationale: Occupational health nurses may provide direct care to patients who are ill, conduct health education programs for the industry staff, or set up health programs. The other answers are incorrect because they are not consistent with a nurses placement in a manufacturing setting.
You are assessing a new patient and his home environment following the patients referral for community-based care. Which of the following is the most important responsibility that you, as a community-based nurse, have at this initial visit?
- A. Encourage the patient and his family to become more involved in their community.
- B. Encourage the patient and his family to delegate someone to contact community resources.
- C. Encourage the patient and his family to focus primarily on online supports.
- D. Encourage the patient and his family to connect with appropriate community resources.
Correct Answer: D
Rationale: During initial and subsequent home visits, the nurse helps the patient and family identify community services and encourages them to contact the appropriate agencies. This is preferable to delegating another person to make contact. When appropriate, nurses may make the initial contact. A home-health nurse would not normally encourage the patient to become more involved in the community as a means of promoting health. Online forms of support can be useful, but they are not the sole form of support that most patients need.