Professional Documents
Culture Documents
1. The nurse discusses home care options with an 85-year-old client who recently fractured
her humerus in a fall in her house. She is recovering well now but says the experience
has made her see that it is time for her to change her living arrangements. The client can
still bathe herself and cook meals on occasion but says she would like to live where
nursing care is available onsite and where communal dining and recreation options are
offered. Which of the following living arrangements could the nurse recommend?
A) Assisted living facility
B) Independent living in a senior living facility
C) Nursing home
D) Apartment located near a hospital
Ans: A
Feedback:
Assisted living is a type of community-based care that combines quasi-independent
living with the availability of nursing care onsite and through home care visits. It is
generally a level of care for people who cannot live on their own, but are not yet ready
for a nursing home. This type of living arrangement is different from living
independently in one's own apartment, such as living in a senior living facility, in that
many activities are provided communally (e.g., eating, recreation) and there is an
organized effort to create a “caring community” where residents' needs are supervised
and met.
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B) Supervise cardiac stress tests in the exercise room of the local hospital.
C) Administer emergency insulin when the client arrives at the hospital in a diabetic
coma.
D) Demonstrate use of a glucose meter to the client.
E) Review heart-healthy and diabetic-friendly food options with the client and his
family.
Ans: A, D, E
Feedback:
Disease management often focuses on chronic illness such as heart disease, heart failure,
diabetes, pulmonary disease, urinary incontinence, and asthma. In disease management
programs, in addition to medications, there is strong emphasis on the use of telephone
coaching, Internet resources, and intensive client and family teaching to advance self-
care and adherence to wellness care. Recently, to help clients and families manage their
health problems in an effective and efficient manner, there has been an effort to bundle
disease states together in light of many comorbidity patterns. Supervising a cardiac
stress test and administering emergency glucose are clinical interventions that go
beyond basic disease management.
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articles that present findings on various diets. This aspect of case management is known
as:
A) Care management
B) Advocacy
C) Disease management
D) Interdisciplinary collaboration
Ans: D
Feedback:
Interdisciplinary collaboration is sharing of evidence-based practice and skills by
several disciplines as an integration strategy with clients and families in homes and
other healthcare settings. Advocacy is always moving the needs of clients, families, and
communities to a point of awareness that will advance change and increase quality of a
life and experience. Care management is the coordination of a plan or process to bring
health services together as a common whole in a cost-effective way. Disease
management is a system of coordinated healthcare interventions and communications
for groups of people with conditions in which client self-care efforts are significant.
Disease management emphasizes prevention at the secondary and tertiary level using
evidence-based practice guidelines.
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Ans: A
Feedback:
Voluntary agencies are generally established as not-for-profit entities, although they
operate with the same fiscal objectives as “for-profit agencies.” A hospital-based agency
is a home health agency that is not freestanding in the community but is one of many
specialty services offered at a hospital setting. A proprietary agency is a home health
agency that is motivated by a for-profit philosophy. Official agencies are supported by
public monies that often come from taxes. The public monies can come from local,
state, or federal governments.
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that is motivated by a for-profit philosophy. Official agencies are supported by public
monies that often come from taxes. The public monies can come from local, state, or
federal governments.
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Origin: Chapter 12- Care Management, Case management, 13
13. The nurse provides care covered by Medicare for a client over 2 hours during the day, 3
days during the week, for 60 days. Which type of care is the nurse providing?
A) Interdisciplinary
B) Skilled
C) Intermittent
D) Part-time
Ans: C
Feedback:
Intermittent care refers to a situation in which skilled care is usually provided over
several hours during the day, several days during the week, for a specified time period.
Interdisciplinary care is that provided by several disciplines as an integration strategy
with clients and families in homes and other healthcare settings. Skilled care involves
the professional abilities of a registered nurse or her/his supervised designee. Necessity
means that the service given by a home care agency is reasonable based on the status of
the client.
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assessment by collecting data about home care clients; (2) diagnosis through the
analysis of these data; (3) outcome identification that helps home care nurses identify
nurse-sensitive measures; (4) planning in the form of nurse-sensitive interventions
directed at the identified outcomes; and (5) implementation of nurse-centered actions in
collaboration with clients and families, not with physicians.
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C) 36 hours
D) 48 hours
Ans: B
Feedback:
Generally, home care agencies make sure that an initial visit is made within 24 hours
after receiving a referral.
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C) Rolling with resistance
D) Finding a discrepancy
Ans: A
Feedback:
Empathy is an approach to clients that involves trying to see clients' lives through their
own lens and trying to think about their experiences as they would think about them.
Self-efficacy is the belief on the part of the client that change is possible. In
motivational interviewing, the home care nurse does not fight client resistance but “rolls
with it.” Home care nurses also work to develop opportunities for clients to discover
discrepancies between their current behavior and what they want to accomplish through
changed behaviors.
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