Nokea
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.
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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.
An older-adult patient who lives alone was hospitalized for a fractured hip and has recovered from the surgery but needs to continue to work to improve mobility. Which of the following settings would the nurse anticipate that the patient be transferred to?
- A. Another acute care setting
- B. A transitional care setting
- C. A residential care facility
- D. Their own home with home health nursing
Correct Answer: D
Rationale: Home health nursing is appropriate for patients who need continued rehabilitation and can implement this in their own home. The patient is no longer in need of the more continuous assessment and care given in acute care settings. There is no indication that the patient will need the permanent and ongoing medical and nursing services available in intermediate care. The patient is not yet independent enough to transfer to a residential care facility.
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.
The nurse is conducting a home visit and notes that the caregiver may be experiencing caregiver burnout. Which of the following assessments would support this finding?
- A. Anxiety
- B. Sleeplessness
- C. Weight gain
- D. Increased use of respite care
Correct Answer: B
Rationale: Assessment of the signs of caregiver burnout (e.g. sleeplessness, difficulty concentrating) is a critical role of the home care nurse. Weight gain is an indication that the caregivers' nutritional intake exceeds requirements. An increased use of respite care could indicate an increased involvement of the caregiver in outside support and activity groups. This assessment finding would require further assessment before linking it to caregiver burnout.
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.