The nursing instructor is preparing a group of students for their home care rotation. In preparation, the group discusses the patients that they are most likely to care for in the home. Which of the following groups are the most common recipients of home care services?
- A. Mentally ill patients
- B. Patients receiving rehabilitation after surgery
- C. Terminally ill and palliative patients
- D. Elderly patients
Correct Answer: D
Rationale: The elderly are the most frequent users of home care services. The patient must be acutely ill, homebound, and in need of skilled nursing services to be eligible for this service. The other answers are incorrect because it is the elderly who are seen most frequently in the home health setting, though each of the other listed groups may sometimes receive home care.
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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.
You are admitting two new patients to your local home health care service. These patients live within two blocks of each other and both homes are in a high-crime area. What action best protects your personal safety?
- A. Drive a car that is hard to break into.
- B. Keep your satchel close to you at all times.
- C. Do not leave anything in the car that might be stolen.
- D. Do not wear expensive jewelry.
Correct Answer: D
Rationale: Do not drive an expensive car or wear expensive jewelry when making visits. While all of these answers might be wise precautions to take, the other suggestions address property rather than personal safety.
A nurse is collaborating with a team of community nurses to identify the vision and mission for community care. What is the central focus of community-based nursing?
- A. Increased health literacy in the community
- B. Distributing ownership for the health of the community
- C. Promoting and maintaining the health of individuals and families
- D. Identifying links between lifestyle and health
Correct Answer: C
Rationale: Community-based nursing practice focuses centrally on promoting and maintaining the health of individuals and families, preventing and minimizing the progression of disease, and improving quality of life. Health literacy is not a goal in itself, but rather a means to promoting health. Distributing ownership and identifying links between lifestyle and health are not the essence of community-based care.
A home health nurse has been working for several months with a male patient who is receiving rehabilitative services. The nurse is aware that maintaining the patients confidentiality is a priority. How can the nurse best protect the patients right to confidentiality?
- A. Avoid bringing the patients medical record to the home.
- B. Discuss the patients condition and care only when he is alone in the home.
- C. Keep the patients medical record secured at all times.
- D. Ask the patient to avoid discussing his home care with friends and neighbors.
Correct Answer: C
Rationale: If the nurse carries a patients medical record into a house, it must be put in a secure place to prevent it from being picked up by others or from being misplaced. This does not mean, however, that it must never be brought to the home. It is not normally necessary to limit discussions to times when the patient is alone. The patient has the right to decide with whom he will discuss his condition and care.
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.
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