Community and Home Health
Factors related to the determinants of health identified in Healthy People 2020 include which of the following (select all that apply)?
A) Education and literacy.
B) Family History
C) Gender.
D) Culture.
E) Social status.
A, B, C, D, E
Critical thinking characteristics include
A. Considering what is important in a given situation.
B. Accepting one, established way to provide patient care.
C. Making decisions based on intuition.
D. Being able to read and follow physician's orders
A
Rationale: Critical thinking involves being able to decipher what is relevant and important in a given situation and to make a clinical decision based on that importance. Patient care can be provided in many ways. Clinical decisions should be based on evidence and research. Following physician's orders is not considered a critical thinking skill
A charge nurse is reviewing the steps of the nursing process with a group of nurses. Which of the following data should the charge nurse identify as objective data? ( Select all that apply)
A. Respiratory rate is 22/min with even, unlabored respirations
B. The client's partner states, " They said they hurt after walking about 10 minutes)
C. The client's pain rating is 3 on scale of 0 to 10.
D. The client's skin is pink, warm, and dry.
E. The assistive personnel reports that the client walking with a limp.
A, D, E.
The new nurse has question about palliative care. Which response by the nurse best describes this type of care?
A. "Palliative care is usually provided in acute care facilities."
B. "Palliative care is typically recommended for individuals with less than 6 months' life expectancy"
C. "Palliative care is usually affiliated with a church and provided by parish nurses "
D. "Palliative care extends the principles of hospice care to a boarder population that has the possibility to benefit from comfort care earlier in the disease process"
D. "Palliative care extends the principles of hospice care to a boarder population that has the possibility to benefit from comfort care earlier in the disease process"
The critical thinking skill of evaluation in nursing practice can be best described as
A. Examining the meaning of data.
B. Reviewing the effectiveness of nursing actions.
C. Supporting findings and conclusions.
D. Searching for links between data and the nurse's assumptions
B. Reviewing the effectiveness of nursing actions.
Reviewing the effectiveness of interventions best describes evaluation. Examining the meaning of data is inference. Supporting findings and conclusions provides explanations. Searching for links between the data and the nurse's assumptions describes analysis
Client reports nausea and constipation. Which of the following would be the priority nursing action?
A. Collect a stool sample
B. Complete an abdominal assessment
C. Administer an anti-nausea medication
D. Notify the physician
B. Complete an Abdominal assessment
Rationale: Assessment involves the systematic collection of data about an individual upon which all subsequent phases of the nursing process are built. In response to a client's complaint, a nurse assesses a specific body system to obtain data that will help the nurse make a nursing diagnosis and plan the client's care. The other options reflect interventions, which are not timely unless there is first a complete assessment.
The home health nurse should schedule the first appointment with which of the following clients?
A. Client recently diagnosed with psoriasis.
B. Client recently diagnosed with lung cancer.
C. Client recently diagnosed with tuberculosis.
D. Client discharged after a vaginal hysterectomy.
C
Rationale: Tuberculosis places the community and family members at risk. The nurse needs to assure the client is taking medications appropriately. Psoriasis poses no specific risks. Recent diagnosis of lung cancer can cause significant emotional disturbance, but not necessarily physical risks.
The nurse enters a room to find the patient sitting up in bed crying. How would the nurse display a critical thinking attitude in this situation?
A. Tell the patient she'll be back in 30 minutes.
B. Set a box of tissues at the patient's bedside before leaving the room.
C. Ask the patient what is upsetting her.
D. Limit visitors while the patient is upset
C. Ask the patient what is upsetting her.
Rationale: The nurse should try to find out why the patient is crying to intervene appropriately. Telling the patient that she will return, providing tissues, and limiting visitors may be appropriate actions but do not address the reason why the patient is crying.
A nurse is discussing the nursing process with a newly licensed nurse. Which of the following statements by the newly licensed nurse should the nurse identify as appropriate for the planning step of the nursing process.
A. "I will determine the most important client problems that we should address"
B. "I will review the past medical history on the client's record to get more information."
C. I will carry out the new prescriptions from the provider"
D. "I will ask the client if their nausea has resolved."
A. "I will determine the most important client problems that we should address"
Rationale: Prioritize the client's problems during the planning step of the nursing process.
A nurse teaches an asthmatic client to recognize and avoid exposure to asthma triggers and assists the client's family in implementing specific protection strategies in the home, such as removing carpets and avoiding pets. This nurse's activities can best be described as:
A. Comprehensive assessment.
B. Primary prevention.
C. Secondary prevention.
D. Tertiary intervention.
B. Primary prevention.
The nurse is assigned to care for a client who reports nausea, vomiting, and diarrhea. The client’s vital signs are as follows: T 100.6°F, AP 100, RR 20, BP 92/69, O2 saturation 98%. Which nursing actions represent the nurse using critical-thinking skills to separate important from unimportant data? Select all that apply.
A. The nurse asks what the client has eaten in the past 24 hours.
B. The nurse administers an antiemetic to the client.
C. The nurse asks the client how long the symptoms have been present.
D. The nurse assesses the skin turgor of the client.
E. The nurse asks the client if he or she is employed.
A. The nurse asks what the client has eaten in the past 24 hours.
C. The nurse asks the client how long the symptoms have been present.
D. The nurse assesses the skin turgor of the client.
A charge nurse is observing a newly licensed nurse care for a client who reports pain. The nurse checked the client's who reports pain. The nurse checked the client's MAR and noted the last dose of pain medication was 6 hrs ago. The prescription read every 4 hrs PRN for pain. The nurse administered the medication and checked with the client 40 mins later, when the client reported improvement. The newly licensed nurse left out which of the following steps of the nursing process.
A. Assessment
B. Planning
C. Intervention
D. Evaluation
A. Assessment
Rationale: The newly licensed nurse should have used the assessment step of the nursing process by asking the client to evaluate the severity of pain on a 0 to 10 scale. The nurse also should have asked about the characteristics of the pain and assessed for any changes that might have contributed to the worsening of the pain.
What requirements must be met in order for home health services to be reimbursed by Medicare? Select all that apply.
A. The client needs a skilled service.
B. The agency needs to be approved by Medicare.
C. The client is homebound.
D. The client requires intermittent nursing care.
E. The client requires homemaker services.
F. The care must be authorized by a physician.
The nursing process involves which of the following steps in the clinical decision-making process? (Select all that apply.)
A. Identifying patient needs
B. Diagnosing the disease process
C. Determining priorities of care
D. Setting goals
E. Performing nursing interventions
F. Evaluating effectiveness of medical treatments
A, C, D, E
Rationale: Diagnosing disease is not a nursing action. The nurse does not evaluate the medical treatment only the nursing interventions and patient outcome.
A charge nurse is talking with a newly licensed nurse and is reviewing nursing interventions that do not require a provider's prescription. Which of the following interventions should the charge nurse include? (Select all that apply?)
A. Writing a new prescription for morphine sulfate as needed for pain
B. Inserting a nasogastric tube to relieve gastric distention
C. Showing a client how to use progressive muscle relaxation
D. Preforming a daily bath after the evening meal
E. Repositioning a client every 2 hours to reduce pressure injury risk.
C, D, E.