Nokea
Your patient has had a total knee replacement and will need to walk with a two-wheeled walker for 6 weeks. He is being discharged home with a referral for home health care. What will the home care nurse need to assess during the initial nursing assessment in the home?
- A. Assistance of neighbors
- B. Qualification for Medicare and Medicaid
- C. Costs related to the visits
- D. Characteristics of the home environment
Correct Answer: D
Rationale: The initial assessment includes evaluating the patient, the home environment, the patients self-care abilities or the familys ability to provide care, and the patients need for additional resources. Normally an assessment is not made of assistance on the part of neighbors or the costs of the visit. Medicare and Medicaid qualifications would normally be determined beforehand.
You may also like to solve these questions
Medicare is a federal program that finances many Americans home health care expenses. The Medicare program facilitates what aspect of home health care?
- A. Providing care without the oversight of a physician
- B. Writing necessary medication orders for the patient
- C. Ordering physical, occupational, and speech therapy if needed
- D. Managing and evaluating patient care for seriously ill patients
Correct Answer: D
Rationale: Many home health care expenditures are financed by Medicare, which allows nurses to manage and evaluate patient care for seriously ill patients who have complex, labile conditions and are at high risk for rehospitalization. Home health nurses, despite who funds their visits, do not provide care without the oversight of a physician; they do not normally write medication orders; nor do they order the services of ancillary specialists such as physical, occupational, or speech therapists.
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.
A home health nurse is conducting an assessment of a patient who may qualify for Medicare. Consequently, the nurse is utilizing the Outcome and Assessment Instrument Set (OASIS). When performing an assessment using this instrument, the nurse should assess which of the following domains of the patients current status?
- A. Psychiatric status
- B. Spiritual state
- C. Compliance with care
- D. Functional status
Correct Answer: D
Rationale: The Omaha System of care documentation has been required for over a decade to assure that outcome-based care is provided for all care reimbursed by Medicare. This system uses six major domains: sociodemographic, environment, support system, health status, functional status, and behavioral status and addresses selected health service utilization. It does not explicitly assess spirituality, psychiatric status, or compliance with care.
A home health nurse is preparing to make the initial visit to a new patients home. When planning educational interventions, what information should the nurse provide to the patient and his or her family?
- A. Available community resources to meet their needs
- B. Information on other patients in the area with similar health care needs
- C. The nurses contact information and credentials
- D. Dates and times of all scheduled home care visits
Correct Answer: A
Rationale: The community-based nurse is responsible for informing the patient and family about the community resources available to meet their needs. During initial and subsequent home visits, the nurse helps the patient and family identify these community services and encourages them to contact the appropriate agencies. When appropriate, nurses may make the initial contact. The other answers are incorrect because it is inappropriate to ever provide information on other patients to a patient. The nurses credentials are not normally discussed. Giving the patient the dates and times of their scheduled home visits is appropriate, but may not always be possible. It is more important to provide them with resources available within the community to meet their needs.
A school nurse has been working closely with a student who has cystic fibrosis. The nurse is aware that children with health problems are at major risk for what problem?
- A. Mental health disorders
- B. Gradual reduction in intelligence
- C. Psychological stress due to a desire to overachieve
- D. Underachievement in school
Correct Answer: D
Rationale: School-aged children and adolescents with health problems are at major risk for underachieving or failing in school. These students do not necessarily have a high risk of mental health disorders or a desire to overachieve. Health problems do not normally cause a progressive decline in intelligence.