Nokea
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.
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A community health nurse has scheduled a hypertension clinic in a local shopping mall in which shoppers have the opportunity to have their blood pressure measured and learn about hypertension. This nursing activity would be an example of which type of prevention activity?
- A. Tertiary prevention
- B. Secondary prevention
- C. Primary prevention
- D. Disease prevention
Correct Answer: B
Rationale: Secondary prevention centers on health maintenance aimed at early detection and prevention. Disease prevention is not a form of health care but is a focus of primary prevention.
A recent nursing school graduate has chosen to pursue a community nursing position because of increasing opportunities for nurses in community settings. What changes in the health care system have created an increased need for nurses to practice in community-based settings? Select all that apply.
- A. Tighter insurance regulations
- B. Younger population
- C. Increased rural population
- D. Changes in federal legislation
- E. Decreasing hospital revenues
Correct Answer: A,D,E
Rationale: Changes in federal legislation, tighter insurance regulations, decreasing hospital revenues, and alternative health care delivery systems have also affected the ways in which health care is delivered. Our country does not have an increased rural population nor is our population younger.
A home health nurse has completed a scheduled home visit to a patient with a chronic sacral ulcer. The nurse is now evaluating and documenting the need for future visits and the frequency of those visits. What question can the nurse use when attempting to determine this need?
- A. How does the patient describe his coping style?
- B. When was the patient first diagnosed with this wound?
- C. Is the patients family willing to participate in care?
- D. Is the patient willing to create a plan of care?
Correct Answer: C
Rationale: Determining the willingness and ability of friends and family to provide care can help determine appropriate levels of professional home care. The time of initial diagnosis and the patients coping style are secondary. The nurse, not the patient, is responsible for creating the plan of care.
A home health nurse is conducting a home visit to a patient who receives wound care twice weekly for a diabetic foot ulcer. While performing the dressing change, the nurse realizes that she forgot to bring the adhesive gauze specified in the wound care regimen. What is the nurses best action?
- A. Phone a colleague to bring the required supplies as soon as possible.
- B. Improvise, if possible, using sterile gauze and adhesive tape.
- C. Leave the wound open to air and teach the patient about infection control.
- D. Schedule a return visit for the following day.
Correct Answer: B
Rationale: Improvise, if possible, using sterile gauze and adhesive tape. Improvisation is a necessity in many home health situations. It would be logistically difficult to have the supplies delivered and leaving the wound open to air may be contraindicated. A return visit the next day does not resolve the immediate problem.
A community health nurse is aware that restoration of health often depends on appropriate interventions performed early in the course of a disease. Which patient is most likely to seek health care late in the course of his or her disease process and deteriorate more quickly than other patients?
- A. A patient who has been homeless for an extended period of time
- B. A patient who recently immigrated to the United States
- C. A patient who is 88 years old and who has enjoyed relatively good health
- D. A teenage boy
Correct Answer: A
Rationale: Because of numerous barriers, the homeless seek health care late in the course of a disease and deteriorate more quickly than patients who are not homeless. Many of their health problems are related in large part to their living situation. The other answers are incorrect because these populations do not as often seek care late in the course of their disease process and deteriorate quicker than other populations.