Nokea
The nurse is describing home care services to a patient that requires extended care. Which of the following statements is true related to home care services?
- A. Technologically complex therapies must be managed in the hospital.
- B. The patient's family will be included in planning and the patient's care.
- C. Home care services are limited to visits by registered nurses or home health aides.
- D. In order for insurance to cover the home care, the patient must be contained to bed.
Correct Answer: B
Rationale: Family members who are providing care are included in planning the patient's care and treatments. Other disciplines, such as physical and occupational therapy, also provide appropriate home health services. The patient must be homebound, but not bed bound, to receive reimbursement for home care services. High-tech devices are increasingly accomplished in the home setting where the patient is more comfortable and the risks for complications such as infection are less.
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Which of the following nursing activities is appropriate for the home care nurse who is caring for a patient newly diagnosed with diabetes to delegate to a home support worker?
- A. Assist the patient to choose an appropriate diet.
- B. Check the patient's feet for signs of breakdown.
- C. Help the patient with a daily bath and oral care.
- D. Teach the patient how to monitor blood glucose.
Correct Answer: C
Rationale: Assisting with patient hygiene is included in the home support workers' education and scope of practice. Assessment of the patient and instructing the patient in new skills, such as diet and blood glucose monitoring, are complex skills that are included in RN and LPN/RPN education and scope of practice.
When the home health nurse is caring for a patient who needs to relearn self-care skills such as dressing and self-feeding, which referral will be best?
- A. Dietitian
- B. Speech therapist
- C. Physical therapist
- D. Occupational therapist
Correct Answer: D
Rationale: Occupational therapists assist patients with self-care skills. Physical therapists assist patients with strengthening, transferring, and ambulation. Dietitians assist with nutritional choices. Speech therapists assist with speech and swallowing needs.
Which of these patients should the nurse refer for home health care services?
- A. A 71-year-old with dementia who needs 24-hour care to prevent injury
- B. An 82-year-old whose family has asked for help to organize pills into a pill box
- C. A 63-year-old who requires assistance with shopping, housework, and cooking
- D. A 79-year-old with terminal cancer who needs hospice palliative
Correct Answer: D
Rationale: Hospice palliative care is one aspect of home health care services. Services such as shopping, housework, and cooking are not skilled nursing services and do not require home health care. Institutional care is required for patients who need 24-hour care. Medication assistance can be achieved through the patient's pharmacy when filling medications, request bubble packs.
Which of the following concepts is foundational to home health nursing?
- A. Acute care management
- B. Health promotion
- C. Persistent disease management
- D. Health restoration
Correct Answer: B
Rationale: A foundational concept of home health nursing is health promotion. Acute care and persistent disease management are roles, they are not the foundation upon which home health nursing is based. Health restoration is a core expectation but is not the foundation for home health nursing.
A patient who was in an automobile accident is assigned a nurse as a case manager. Which of the following responsibilities is required of the nurse in this role?
- A. Care for the patient during hospitalization for the injuries.
- B. Assist the patient with home care activities during recovery.
- C. Coordinate the services that the patient receives in the hospital and at home.
- D. Determine the types of medical care the patient needs for optimal rehabilitation.
Correct Answer: C
Rationale: The role of the case manager is to coordinate the patient's care through multiple settings and levels of care to allow the maximal patient benefit at the least cost. The case manager does not provide direct care in either the acute or home setting. The case manager coordinates and advocates for care but does not determine what types of medical care are needed, that is done by the health care provider or other provider.