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Which of the following describes the goal of alternative care facilities?
- A. An RN and one or more assistive personnel care for a group of clients.
- B. An RN assumes all care for a small group of clients.
- C. There is 24-hour accountability by an RN.
- D. The facility provides the least restrictive living arrangement.
Correct Answer: D
Rationale: The goal of alternative care facilities is to provide the least restrictive living arrangement while maintaining safety and quality. Patient-focused care uses an RN partnered with one or more assistive personnel to care for a group of clients. Total care refers to assignments in which a nurse assumes all the care for a small group of clients. In primary nursing, an RN assumes 24-hour accountability for the client's care and has total responsibility for the nursing care of assigned clients during the shift.
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A client who is receiving respiratory support with a tracheostomy and mechanical ventilation after a stroke is being discharged from the acute care facility. Family members state that they will not be able to care for the client at home to provide the care that is required. What type of care may this client be a candidate for after discharge?
- A. Long-term acute care
- B. Subacute care
- C. Intermediate care facility
- D. Rehabilitation care
Correct Answer: A
Rationale: Clients who require ventilator support or who have other conditions that are potentially unstable but do not have rapid changes may receive care in a long-term acute care facility. Subacute care refers to care that is more intense than traditional long-term care but less intense than acute inpatient care. Intermediate care facilities (ICFs) are nursing homes that provide custodial care for people who cannot care for themselves because of mental or physical disabilities. Rehabilitation centers provide physical and occupational therapy to clients and families to help individuals regain as much independence with ADLs as possible.
A hospital unit has been using a functional nursing model for delivery of care for several years. The manager has been discussing with the staff the idea of a change to total care because functional nursing has some disadvantages to the clients. What disadvantage is the manager referring to?
- A. It is expensive because it only uses RNs.
- B. Some nurses work harder than others to provide care.
- C. It fragments care and is confusing for the clients.
- D. Nurses are accountable for the client's care 24 hours per day.
Correct Answer: C
Rationale: Although efficient, functional nursing fragments care and is confusing for clients. Primary nursing is expensive because it uses RNs only. Nurses are designated certain tasks if functional nursing is employed, so the care is divided. Nurses are accountable for client care in a primary nursing model.
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.
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.
A religious organization is an example of this type of ownership?
- A. Government-owned
- B. Proprietary agency
- C. Nonprofit agency
- D. Public facility
Correct Answer: C
Rationale: Nonprofit institutions include universities and religious organizations. Veterans' hospitals are an example of government-owned or public healthcare institutions, which receive at least some tax support. For-profit agencies (proprietary) are owned and operated by corporate groups with investors and stockholders.