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Public Health Nursing Population Centered 9th Edition Stanhope Lancaster Test Bank

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Public Health Nursing Population Centered 9th Edition Stanhope Lancaster Test Bank

ISBN-13: 978-0323321532

ISBN-10: 0323321534

 

 

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Public Health Nursing Population Centered 9th Edition Stanhope Lancaster Test Bank

ISBN-13: 978-0323321532

ISBN-10: 0323321534

 

 

 

 

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Free Nursing Test Questions:

 

Chapter 41: The Nurse in Home Health, Palliative Care, and Hospice

Stanhope: Public Health Nursing: Population-Centered Health Care in the Community, 9th Edition

 

MULTIPLE CHOICE

 

  1. Official agencies are financed primarily by:
a. charities.
b. individual clients.
c. third-party payers.
d. tax funds.

 

 

ANS:  D

Official agencies are financed primarily by tax funds. These agencies are typically operated by state, county, city, or other local government units, such as health departments.

 

DIF:    Cognitive level: Understanding        REF:   p. 891             TOP:   Nursing process: Evaluation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. Medicare-certified home health agencies place emphasis on _____ care.
a. chronic
b. distributive
c. intermittent
d. primary

 

 

ANS:  C

As part of the Conditions of Participation, Medicare-certified home health agencies must place an emphasis on intermittent care. Home care services that are provided must be intermittent and provide a skilled service. Primary care refers to the care that is often provided in a physician’s office. Medicare-certified agencies provide care following an acute hospitalization or medical change; they do not provide long-term care for chronic illnesses.

 

DIF:    Cognitive level: Understanding        REF:   p. 888

TOP:   Nursing process: Assessment

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. A nurse is implementing a population-focused model of home care delivery. Which of the following actions would most likely be taken by the nurse?
a. Use an assessment protocol when conducting visits
b. Collaborate with other disciplines
c. Provide care for a specific population
d. Apply high-intensity interventions

 

 

ANS:  A

Population-focused home care models of care usually include structured approaches to regular visits with assessment protocols, focused health education, counseling, and health-related support and coaching.

 

DIF:    Cognitive level: Applying                REF:   p. 889

TOP:   Nursing process: Implementation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. A home care nurse is employed by a proprietary agency. What does this mean?
a. The agency is exempt from federal income taxes.
b. The agency is governed by a board of directors.
c. The agency is a profit-making agency.
d. The agency is reimbursed primarily by tax funds.

 

 

ANS:  C

Proprietary agencies are profit-making agencies. Proprietary agencies are free-standing, for-profit agencies that are required to pay taxes. Many are part of large chains and now dominate the home care industry.

 

DIF:    Cognitive level: Applying                REF:   p. 891             TOP:   Nursing process: Evaluation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. A nurse is coordinating care to ensure a comfortable and peaceful death. Which of the following factors should be an important consideration for the nurse?
a. The unique stress dying patients often experience
b. The cultural values, expectations, and preferences of the family
c. The communication style of each family member
d. The abilities of the nurse and health care team

 

 

ANS:  B

Cultures vary in their beliefs and responses to death. Nurses should know the differences in cultural responses so that they can effectively help people in their time of need. It will be important for the nurse to take cues from the client and the loved ones regarding their needs. The stress experienced by dying patients is different based on the client’s culture.

 

DIF:    Cognitive level: Analyzing              REF:   p. 893 (How To box)

TOP:   Nursing process: Planning

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. A nurse has referred a home care client to hospice care. Which of the following best explains the rationale for this referral?
a. To provide comfort and peace at a difficult time
b. To reduce the cost of care for the terminally ill
c. To keep clients at home until the end of life
d. To provide care for terminally ill clients expected to live longer than 6 months

 

 

ANS:  A

The focus of hospice care is comfort, peace, and a sense of dignity at a very difficult time. Comprehensive services emphasize continuity of care. Hospice care is provided for those with a life expectancy of less than 6 months. Hospice is the only Medicare benefit that includes medications, medical equipment, 24 hours/7 days a week access to care, and support for family members after death. Hospice care does not reduce the cost of care.

 

DIF:    Cognitive level: Analyzing              REF:   p. 892             TOP:   Nursing process: Evaluation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. The nurse provides direct care services to a stroke victim to avoid complications. Which of the following levels of prevention is being implemented?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Assessment

 

 

ANS:  C

Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability. Thus, direct care for a stroke victim is focusing on limiting disability and encouraging rehabilitation. Primary prevention focuses on preventing the disease before it occurs. Secondary prevention focuses on early detection and screening. Assessment is not a level of prevention.

 

DIF:    Cognitive level: Applying                REF:   p. 887 (Levels of Prevention box)

TOP:   Nursing process: Implementation     MSC:  NCLEX: Health Promotion and Maintenance

 

  1. A nurse is providing a skilled nursing service. Which of the following best describes the intervention the nurse is performing?
a. Teaching the client and family about medication administration
b. Consulting with other nurses about the care of a client in the home
c. Coordinating services for maximum benefit at minimal cost
d. Reviewing nursing assistant charting at the end of each day

 

 

ANS:  A

Skilled nursing service is the Medicare term that describes the duties of the registered nurse, and refers to the requirement of nursing judgment. Those services involve assessment, teaching, and selected procedures. Teaching the client and family to implement a therapeutic plan, such as taking medications, is an example of a skilled nursing service. Consultation, coordination, and review of documentation do not fit the definition of a “skilled nursing service.”

 

DIF:    Cognitive level: Applying                REF:   p. 891

TOP:   Nursing process: Implementation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. A nurse is employed in home health nursing practice. Which of the following terms best describes the care that is being provided?
a. Intermittent nursing care
b. Custodial care
c. Family caregiving
d. Palliative care

 

 

ANS:  A

Provision of intermittent skilled visits is a component of home health care nursing. Custodial care refers to the care given in long-term care facilities. Family caregiving may be an important role of keeping the client at home, but it is not a necessary component of home care. Palliative care is an extended continuum of chronic serious illness to acute serious illness during which stabilization and exacerbations may occur.

 

DIF:    Cognitive level: Applying                REF:   p. 891

TOP:   Nursing process: Implementation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. Which organization publishes the current scope and standards of home care practice?
a. Centers for Medicare and Medicaid Services
b. American Nurses Association (ANA)
c. Robert Wood Johnson Foundation
d. Visiting Nurse Association

 

 

ANS:  B

The ANA publishes scope and standards for Home Health Nursing and Hospice and Palliative Nursing. The Centers for Medicare and Medicaid Services control the regulations and reimbursement mechanisms for the majority of home care services. The Robert Wood Johnson Foundation provides grant funding for a variety of projects that support nursing. The Visiting Nurse Association is a home care agency.

 

DIF:    Cognitive level: Understanding        REF:   pp. 893-894    TOP:   Nursing process: Evaluation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. A nurse has discovered that a client should be receiving Meals on Wheels. Which of the following steps of the nursing process is the nurse performing?
a. Diagnosis
b. Planning
c. Assessment
d. Implementation

 

 

ANS:  C

The Standards of Care and the Standards of Professional Performance both include the six steps of the nursing process: (1) assessment, (2) diagnosis, (3) outcomes identification, (4) planning, (5) implementation, and (6) evaluation. As a nurse performs an assessment, the nurse recognizes the current needs of the client.

 

DIF:    Cognitive level: Applying                REF:   pp. 893-894

TOP:   Nursing process: Implementation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. Which concepts are used to evaluate client outcomes when using the Omaha System Problem Rating Scale for Outcomes?
a. Problem, Intervention, and Outcome
b. Knowledge, Behavior, and Status
c. Knowledge, Skill, and Attitude
d. Problem, Category, and Modifiers

 

 

ANS:  B

The Omaha System Problem Rating Scale for Outcomes uses the concepts of Knowledge, Behavior, and Status.

 

DIF:    Cognitive level: Understanding        REF:   p. 897 (Table 41-1)

TOP:   Nursing process: Evaluation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. After conducting a comprehensive client assessment, the nurse would organize information about the client’s medication regimen into which domain of the Omaha System Problem Classification Scheme?
a. Environmental
b. Psychosocial
c. Physiological
d. Health-related behaviors

 

 

ANS:  D

The Omaha System Problem Classification Scheme uses four domains to organize client information. The Health-related behaviors domain includes information related to patterns of activity that maintain or promote wellness, promote recovery, and decrease the risk of disease. The environmental domain includes material resources and physical surroundings both inside and outside the living area. The psychosocial domain includes patterns of behavior, emotion, communication, relationships, and development. The physiological domain includes functions and processes that maintain life.

 

DIF:    Cognitive level: Analyzing              REF:   p. 896 (Box 41-2)

TOP:   Nursing process: Implementation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. A nurse is using the Omaha System Problem Classification Scheme. Which of the following situations is the nurse most likely experiencing?
a. Measuring client outcomes
b. Collaborating with other professionals
c. Providing health education
d. Organizing a comprehensive assessment

 

 

ANS:  D

The Omaha System Problem Classification Scheme is used to organize a comprehensive assessment according to four priority domains. It’s simple and concrete terms are used to organize a comprehensive assessment, an important standard of nursing practice. It does not measure client outcomes, promote collaboration with other professionals, or provide health education.

 

DIF:    Cognitive level: Analyzing              REF:   p. 895

TOP:   Nursing process: Implementation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. A community health nurse is using the Omaha System. Which of the following best describes the rationale for using this system?
a. To define each health care provider’s role
b. To use nursing diagnoses in community health nursing practice
c. To foster collaborative practice
d. To provide practitioners a method for communication

 

 

ANS:  C

The goals of developing the Omaha System were to develop a structured and comprehensive system that could be both understood and used by members of various disciplines and to foster collaborative practice. Therefore, the Omaha System was designed to guide practice decisionsRemember,rt and document pertinent client data uniformly, and provide a framework for an agency-wide, multidisciplinary clinical information management system capable of meeting the daily needs of clinicians, managers, and administrators.

 

DIF:    Cognitive level: Analyzing              REF:   p. 895             TOP:   Nursing process: Evaluation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. A nurse is trying to facilitate interprofessional collaboration. Which of the following actions should be taken by the nurse?
a. Understand who is in charge of the client’s care
b. Make appropriate referrals
c. Recognize what other professionals do and how they view their roles
d. Request assistance when performing complex skills

 

 

ANS:  C

The factors for successful interprofessional functioning include the categories of knowledge, skill, and attitudes with subheadings including the understanding of the roles of each professional.

 

DIF:    Cognitive level: Analyzing              REF:   p. 902 (Box 41-6)

TOP:   Nursing process: Planning

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. A home care agency has applied for accreditation from the Joint Commission. What is the next step the agency will take?
a. Attend a conference to learn more about the accreditation process
b. Schedule a site visit with the Joint Commission
c. Complete a self-study of the agency
d. Improve methods of documentation of client visits

 

 

ANS:  C

After applying for accreditation, a lengthy self-study must be completed that addresses all aspects of the agency’s operation. Following completion of the self-study, an accreditation team schedules a site visit. Attending a conference to learn more about accreditation should be done before applying. A site visit with the Joint Commission occurs after the self-study has been reviewed. Improving methods of documentation of client visits should be addressed before applying for accreditation.

 

DIF:    Cognitive level: Applying                REF:   p. 901             TOP:   Nursing process: Planning

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. A nurse is using the first stage of the Outcomes and Assessment Information Set (OASIS) outcomes analysis. Which of the following best describes what the nurse is doing?
a. Comparing an agency’s performance to a national sample
b. Reporting data on patient care to a national registry
c. Stabilizing a client’s condition to continue to receive funding
d. Documenting client assessment data and findings

 

 

ANS:  A

The first stage, outcomes analysis, enables an agency to compare its performance to a national sample, identify factors that may affect outcomes, and identify final outcomes that show improvement in or stabilization of a client’s condition. The second stage, outcomes enhancement, enables the agency to select specific client outcomes and determine strategies to improve care.

 

DIF:    Cognitive level: Analyzing              REF:   p. 901

TOP:   Nursing process: Implementation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. Which historical event caused dramatic changes in home care nursing?
a. Passage of Medicare legislation
b. Establishment of Visiting Nurse Associations
c. Creation of the Montefiore Hospital Home Care Program
d. Provision of funds by the Civil Works Administration

 

 

ANS:  A

Medicare introduced regulations for home care practice as well as for reimbursement mechanisms.

 

DIF:    Cognitive level: Understanding        REF:   p. 888             TOP:   Nursing process: Evaluation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. A nurse is using telehealth technology in the home setting. Which of the following best describes the intervention that is being used by the nurse?
a. Uses Web TV to teach clients about their health
b. Shares health information using electronic communications
c. Makes regular visits to clients to check the technology
d. Risks violation of the Health Insurance Portability and Accountability Act

 

 

ANS:  B

Telehealth includes sharing health information between the client and clinicians using electronic communications. Telehealth may or may not include video technology for live interactions. Telehealth allows for monitoring health status and symptom recognition, providing education, increasing communication, and enabling clients to become active partners in their own care.

 

DIF:    Cognitive level: Applying                REF:   p. 906

TOP:   Nursing process: Implementation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

MULTIPLE RESPONSE

 

  1. A nurse is coordinating care through a high-intensity transitional care program. Which of the following best describes the populations that the nurse is working with? (Select all that apply.)
a. Adults with cognitive impairments
b. Women with high-risk pregnancies
c. Older adults with heart failure
d. People who are moving from one state to another
e. Men who have just experienced divorce

 

 

ANS:  A, B, C

Transitional care ensures the coordination and continuity of health care as clients transfer between different locations and different levels of care in the same location. High-intensity transitional care programs are designed for populations who have complex or high-risk health problems.

 

DIF:    Cognitive level: Applying                REF:   pp. 889-890    TOP:   Nursing process: Planning

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. Which are categories of classifying interventions according to the Omaha System Intervention Scheme? (Select all that apply.)
a. Health education
b. Case management
c. Treatments and procedures
d. Direct care services
e. Skilled nursing care

 

 

ANS:  B, C

The Omaha System Intervention Scheme is comprised of four broad categories of interventions: (1) teaching, guidance, and counseling; (2) treatments and procedures; (3) case management; and (4) surveillance.

 

DIF:    Cognitive level: Remembering         REF:   p. 891             TOP:   Nursing process: Evaluation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

  1. Which illegal and unethical activities have occurred in health care systems in the past? (Select all that apply.)
a. Inappropriate use of home health services
b. Inaccurate billing for services
c. Excessive administrative staff
d. “Kickbacks” for referrals
e. Primary care services provided in the home

 

 

ANS:  A, B, C, D

Examples of Medicare fraud and abuse in home health and hospice include inappropriate use of services, excessive payments to administrative staff or owners, “kickbacks” for referrals, and billing for visits and/or medical supplies that are not authorized or provided. The home care nurse must abide by established federal regulations when delivering care to clients.

 

DIF:    Cognitive level: Understanding        REF:   p. 903             TOP:   Nursing process: Evaluation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

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