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Which of the following statements is true in relation to nursing-sensitive outcomes?
- A. Only used to evaluate patient care.
- B. Are outside of the nurses' scope of practice.
- C. Have no influence on health care budgets.
- D. Require empirical evidence.
Correct Answer: D
Rationale: Nursing-sensitive outcomes are 'those that are relevant, based on nurses' scope and domain of practice, and for which there is empirical evidence linking nursing inputs and interventions to the outcomes.' Outcomes data may also be used to evaluate the nurses' own practice or that of their team or program, as well as patient care. Decision makers and funders require outcomes data to support budget needs, program design and delivery, and the development of accountability mechanisms such as balanced scorecards.
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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.
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.
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 the following statements represent a current trend in home health nursing?
- A. Increased numbers of registered nurses are being employed as home health nurses.
- B. Decreased numbers of licensed/registered practical nurses are being employed as home health nurses.
- C. There are more employment opportunities for newly graduated nurses.
- D. That a minimum of two years of acute care experience is required before employment as a home health nurse.
Correct Answer: C
Rationale: There are many opportunities for newly graduated nurses to begin practice as a home health nurse. It was widely believed for many years that nurses required a minimum of 2 years of acute care hospital experience before being hired as a home health nurse but is no longer true. Registered nurses generally received hiring preference over licensed practical nurses because it was believed that registered nurse preparation provided the best foundation for home care nursing. However, partly because the growing nursing shortage, enhancements to the scope of practice and educational programs for licensed/registered practical nurses, and the need to provide long-term interventions to a growing population with complex and unpredictable care needs, many home health employers now hire both registered nurses and licensed/registered practical nurses right after graduation.
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.