Nokea
Which nursing theorist stated that clients are open systems in constant interaction with their environment?
- A. Florence Nightingale
- B. Virginia Henderson
- C. Imogene King
- D. Dorothea Orem
Correct Answer: C
Rationale: Imogene King stated that clients are open systems in constant interaction with their environment. Florence Nightingale described the role of the nurse as putting 'the patient in the best condition for nature to act upon him.' Virginia Henderson envisioned the nurse's role as helping people (sick or well) to carry out activities contributing to health, recovery, or a peaceful death that they would do for themselves if they had the necessary strength, will, or knowledge. Dorothea Orem was a proponent of the self-care deficit theory.
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A client is admitted to an acute care facility after having a stroke. The client will require a variety of healthcare services throughout the hospital stay as well as coordination of care prior to discharge. What referral would be a priority for overseeing the client's care?
- A. Case management
- B. Physical therapy
- C. Occupational therapy
- D. Dietary services
Correct Answer: A
Rationale: The person responsible for overseeing the client's care, usually an RN with a bachelor's or master's degree or another highly experienced health professional, is called the case manager. Physical therapy, occupational therapy, and dietary services are all important care disciplines but do not encompass all of the client's needs.
An RN has been assigned to care for three clients on the medical unit and will assume 24-hour accountability for those clients' care. When the nurse goes off duty, the plan of care will be continued by a secondary nurse. What type of nursing model is this considered?
- A. Team nursing
- B. Case method
- C. Functional nursing
- D. Primary care nursing
Correct Answer: D
Rationale: In primary care nursing, the RN assumes 24-hour accountability for the client's care and has total responsibility for the nursing care of assigned clients during a shift. Team nursing is made up of an RN team leader, other RNs, LPN/LVNs, and nursing assistants who provide care to a group of clients. The case method is the same as a private duty nurse. In functional nursing, distinct duties are assigned to specific personnel.
An LPN just received a license to practice and applied for a position at a skilled nursing care facility. While being interviewed, the LPN asks what to expect from the role at the facility. What is the best answer by the interviewer?
- A. You will be organizing and coordinating the care of the clients.'
- B. You will be participating in the care of the clients.'
- C. You will be in charge of a unit and have 24-hour accountability.'
- D. You will be responsible for developing and implementing a plan of care for the clients.'
Correct Answer: B
Rationale: An RN must be in charge of client's care, although other healthcare providers, particularly LPN/LVNs, participate in their care. Organizing and coordinating client care, being in charge of a unit with 24-hour accountability, and developing and implementing a plan of care for the clients are under the scope of practice of an RN.
A home care nurse provides care to a client three times a week. The client's family member lives in the home and is employed full time. The family member believes that the client would benefit greatly from care 24 hours a day but wants the client to remain at home. Which is the best action for the nurse to take to meet the family member's goal and to ensure the client receives the care required?
- A. Advocate for the client and the family member to receive additional services as needed.
- B. Encourage the family member to consider placement in a skilled nursing facility.
- C. Teach the family member to provide care to the client during the times the nurse is not in the home.
- D. Recommend enrolling the client in an adult day care center.
Correct Answer: A
Rationale: The best action for the nurse to take to ensure the client receives needed care and to meet the family member's goals for the client is to advocate for the family to receive whatever additional services are required. A skilled nursing facility will provide 24-hour care for the client and will assist in ADLs but will not allow the client to remain at home as the family member wants. An adult day care center allows the client to remain at home but does not provide 24-hour care and can only assist with ADLs during the time frame the client is at the center. Teaching the family member to perform procedures, administer medications, and provide other care would not be the best options because the family member is employed full-time.
Freestanding apartments are an example of which type of alternative healthcare setting?
- A. Skilled nursing care
- B. Assisted living
- C. Congregate housing
- D. Boarding homes
Correct Answer: C
Rationale: Congregate housing provides independent living or minimal assistance for seniors or disabled adults. Skilled nursing care facilities provide skilled nursing and rehabilitative care to people who have the potential to regain function but need skilled observation and nursing care during an acute illness. Assisted living facilities provide care to residents who need assistance with up to three activities of daily living. Boarding homes are usually small homes with individual rooms where residents pay for room and board and minimal nursing services.