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You are the community-based nurse who performs the role of case manager for a small town about 60 miles from a major health care center. When planning care in your community, what is the most important variable in community-based nursing that you should integrate into your planning?
- A. Eligibility requirements for services
- B. Community resources available to patients
- C. Transportation costs to the medical center
- D. Possible charges for any services provided
Correct Answer: B
Rationale: A community-based nurse must be knowledgeable about community resources available to patients as well as services provided by local agencies, eligibility requirements, and any possible charges for the services. The other answers are incorrect because they are not the most important factors about which a community-based nurse must be knowledgeable.
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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.
You are a school nurse who will work with an incoming kindergarten student who has a diagnosis of cerebral palsy. Why would you make a home visit before school starts?
- A. To provide anticipatory guidance to the family
- B. To assess the safety of the childs assistive devices
- C. To arrange for a teaching aide to work with the child
- D. To provide follow-up care after the childs clinic visit
Correct Answer: A
Rationale: Public health, parish, and school nurses may make visits to provide anticipatory guidance to high-risk families and follow-up care to patients with communicable diseases. The other answers are incorrect because they are not functions of the school nurse.
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 been working for several months with a male patient who is receiving rehabilitative services. The nurse is aware that maintaining the patients confidentiality is a priority. How can the nurse best protect the patients right to confidentiality?
- A. Avoid bringing the patients medical record to the home.
- B. Discuss the patients condition and care only when he is alone in the home.
- C. Keep the patients medical record secured at all times.
- D. Ask the patient to avoid discussing his home care with friends and neighbors.
Correct Answer: C
Rationale: If the nurse carries a patients medical record into a house, it must be put in a secure place to prevent it from being picked up by others or from being misplaced. This does not mean, however, that it must never be brought to the home. It is not normally necessary to limit discussions to times when the patient is alone. The patient has the right to decide with whom he will discuss his condition and care.
A home health nurse has been assigned to the care of an 82 year-old woman who has been discharged home following hip replacement surgery. At what level of care is this nurse most likely practicing?
- A. Preventative care
- B. Primary prevention
- C. Secondary prevention
- D. Tertiary prevention
Correct Answer: D
Rationale: Nurses in community-based practice provide preventive care at three levels: primary, secondary, and tertiary. Tertiary prevention focuses on minimizing deterioration and improving quality of life, including rehabilitation to assist patients in achieving their maximum potential by working through their physical or psychological challenges. Home care nurses often focus on tertiary preventive nursing care, although primary and secondary prevention are also addressed. Preventive care is an umbrella term for all three levels of care.