Question 1

The nurse is concerned that the spouse of a home care client with multiple sclerosis is experiencing caregiver role strain.What did the nurse observe to come to this conclusion?

Accepted Answer

The spouse expressing feelings of anger and reporting decreased energy are both indications of caregiver role strain. A cluttered home may be an indication of stress, but it is not specific to caregiver role strain. Learning how to manage finances is not necessarily an indication of caregiver role strain. The client asking about the next visit does not provide any information about the spouse's experience as a caregiver.

Question 2

The nurse is attending a seminar that focuses on the changes within the home health care industry.Which statements that the nurse makes indicate an understanding of home care as a primary health service delivery system?
(Select all that apply)

Accepted Answer

B,C,D,E

Question 3

A home health client lives alone in a small apartment and has only one phone,which is a land line.What safety recommendation should the visiting home health nurse make for this particular client?

Accepted Answer

Enrolling the client in an emergency response system would ensure that they have access to help in case of an emergency, even if they are unable to reach the phone or communicate their needs. This would provide an added layer of safety for the client living alone with only one phone line. The other options may not be feasible or applicable to the client's specific situation.

Question 4

While assessing a client's environment for safety concerns,the nurse finds that most of the rooms in the house have only one outlet with various cords entering the outlet.When this concern is shared with the client and spouse,they state that "this is the way we've lived for years." What should the nurse do?

Accepted Answer

The nurse should document the findings and the client and spouse's response to the concern to ensure that it is documented in the client's record. The nurse may also want to provide education on the potential risks of overloaded outlets and offer suggestions for improving the safety of the environment, but ultimately the decision to make changes lies with the client and their family.

Question 5

A client who has been the recipient of home health care has made the decision to discontinue hemodialysis.The client understands all the consequences of this decision and is not supported by his family.The nurse is meeting with the family to help them understand the significance of the client's decision and to help them support the client during this difficult time.In which role is the nurse functioning?

Accepted Answer

The nurse is functioning as an advocate, by helping the family understand the client's decision and supporting the client's wishes. The nurse is not necessarily providing direct care, education, or counseling in this scenario.

Question 6

The nurse would like to admit a client to home health care,but is worried about insurance reimbursement.What client action is causing the nurse to if home care can be prescribed for this client?

Accepted Answer

The fact that the client is able to drive themselves to appointments may suggest that they have a level of independence that does not require constant skilled or intermittent care. This may raise questions about whether home health care is truly necessary for this client, and whether insurance would cover it.

Question 7

To help a home health client with a difficult medication regime,the nurse contacts the pharmacist for ideas to facilitate the process.Which behavior did the nurse demonstrate when caring for this client?

Accepted Answer

The answer of To help a home health client with...

Question 8

A client being discharged needs physical therapy for progressive ambulation,wound care to treat a postoperative wound,and assistance with the payment of hospital bills.Before the nurse contacts a home care agency,who should write the order for the client to receive home care?

Accepted Answer

A physician is authorized to write orders for home care services for a patient being discharged. While the nurse, social worker, and physical therapist can provide input and recommendations regarding the type of care needed, ultimately it is the physician's responsibility to prescribe the necessary services.

Question 9

A client has been receiving home care for several weeks.Which individual should the nurse realize is responsible for ensuring that the client is receiving care at the appropriate times and in the appropriate amounts?

Accepted Answer

The nurse is responsible for ensuring that the client receives care at the appropriate times and in the appropriate amounts. This includes coordinating care, monitoring the client's condition, and adjusting the care plan as necessary to meet the client's needs.

Question 10

The home health nurse has scheduled a visit to a client who lives in a neighborhood that is known to be unsafe because of gang activity.Before going to the client's home,what should the nurse do?

Accepted Answer

The nurse should prioritize personal safety and calling for an escort is the best option to ensure safety in a neighborhood known for gang activity.

Question 11

During orientation with a home care agency,the nurse is learning the difference in care delivery between home health nursing and community nursing.What should the nurse understand as being the focus of home health care nursing?

Accepted Answer

Home health care nursing focuses on the individual and their family in the home setting, providing skilled nursing care, teaching and support services to help individuals manage their health and achieve the best possible outcomes. It differs from community nursing, which focuses on health promotion and disease prevention within the broader community. Home health care nursing is not limited to terminally ill clients, although they may be part of the population served.

Question 12

The nurse learns that two new home care agencies are opening in a community.What should the nurse consider as reasons why home care agencies are increasing in numbers?

Accepted Answer

The increase in home care agencies can be attributed to the third-party payers supporting cost control measures and the increase in the older adult population requiring long-term care. The need for custodial care may also be a contributing factor. However, there is no evidence to suggest that home care agencies are increasing in response to a decreasing need for acute care or a focus on the needs of the community.

Question 13

After completing an initial assessment,the nurse identifies teaching that the client will need.Why did the nurse identify learning needs for this client?

Accepted Answer

The nurse identified learning needs for the client because of their lack of knowledge related to health conditions and self-care.

Question 14

While reviewing a health insurance plan,the nurse learns that a client has coverage for durable medical equipment (DME).What care need should the nurse identify as being covered by the client's health plan?

Accepted Answer

Durable medical equipment (DME) refers to equipment that provides therapeutic benefits to a patient in need. Examples of DME include hospital beds, walkers, and wheelchairs. Therefore, a hospital bed is a care need that would be covered by the client's health plan. Dressings and bandages would typically fall under the coverage of medical supplies, while medications would fall under prescription drug coverage. Visits by the home health nurse would fall under the coverage of skilled nursing services or home healthcare services.

Question 15

During a home visit,the nurse explains the procedures for preventing infection in a central venous access device to the spouse who watches while the nurse hooks the client to the medication infusion.Which role is the nurse performing at this time?

Accepted Answer

The nurse is performing the role of an educator by explaining the procedures for preventing infection in a central venous access device.

Question 16

A home health client has a complicated case involving occupational therapy,respiratory therapy,a dietitian,the nurse,and a nurse's aide who provides assistance with bathing,housekeeping,and grocery shopping.Which care provider should be prepared to coordinate this client's care?

Accepted Answer

Of all the options provided, the nurse is the most appropriate care provider to coordinate the client's care. The nurse is the primary point of contact for the client's healthcare team and has a broad understanding of the client's medical history, treatments, medications, and lifestyle. The nurse can work closely with the other care providers to develop a care plan that addresses the client's unique needs, ensures continuity of care, monitors the client's progress, and makes adjustments as necessary. The nurse can also communicate with the client and their family to ensure that everyone is aware of the care team's plan and understands their roles and responsibilities.

Question 17

A home health nurse has a weekly visit to a client living in less than desirable cleanliness.The client has a central venous access device and requires weekly infusion therapy.What is the best way for the nurse to protect the client against infection?

Accepted Answer

While all of the options may help to some extent in reducing the risk of infection, practicing strict aseptic technique during the infusion process is the most effective way to protect the client against infection. This includes using sterile equipment, disinfecting the area where the central venous access device is located, and wearing gloves and masks to prevent the spread of bacteria. While having the client wash her hands or helping her clean the room may be helpful, these measures cannot fully eliminate the risk of infection. Similarly, suggesting a housekeeper may help improve the overall cleanliness of the environment, but it does not address the specific risks associated with the infusion therapy.

Question 18

During the first home care visit,the nurse determines that the client needs speech therapy,physical therapy,and custodial care several times a week.When should the nurse schedule the client's care to begin?

Accepted Answer

The physician needs to sign the plan of care developed by the nurse before any care can begin. This ensures that the care is appropriate for the client's needs and is covered by insurance or other funding sources.

Question 19

An older client being discharged from an acute care facility is prescribed home care.When should the home care nurse see the client to understand needs for safety and mobility?

Accepted Answer

The home care nurse should see the client while they are still in the acute care hospital to assess their current condition and plan for a safe transition to the home environment.

Question 20

The nurse is hired to provide home care through a community agency that is operated by the state health department and financed by taxes.In which type of agency is this nurse employed?

Accepted Answer

The nurse is employed in an official agency, which is typically operated by the state health department and financed through taxes. These agencies are part of the governmental structure and provide public health services to the community.

Quiz 8: Home Care