3: Healthcare in the Community and Home

Question 1

primary healthcare

Answer 1

health promotion, education, protection, and screening

Question 2

secondary healthcare

Answer 2

emergency care, acute and critical care, diagnosis, and treatment

Question 3

tertiary healthcare

Answer 3

rehabilitation, long-term care, support services, and hospice care

Question 4

Community-based healthcare

Answer 4

design, delivery, and evaluation of healthcare services developed in partnership with communities

Question 5

Community-based nursing care

Answer 5

nursing care directed towards individuals of a specific group or population within the context of the community where they live.

Question 6

Community-based nursing

Answer 6

provides acute or chronic care services to the individual within the context of the individual’s community

Question 7

Community health nursing

Answer 7

provides services to individuals, families, and groups identified by the risk factors of the community

Question 8

public health nursing

Answer 8

the community is client with the focus of practice on primary prevention

Question 9

The Pew Commission’s “agenda for action”

Answer 9

identifies 21 competencies that future health professionals must possess

Question 10

Home healthcare

Answer 10

Such services are delivered to persons at home who are recovering from illness, are disabled, or are chronically or terminally ill and need various services to progress, maintain function, or perform their ADLs

Question 11

OASIS

Answer 11

Outcome and Assessment Information Set provides standardized guidelines for admission and care as well as a national database for evaluation, reimbursement, and quality improvement

Question 12

Continuity of care

Answer 12

provision of health services without disruption, regardless of movement between settings

Question 13

Discharge planning

Answer 13

prepares a patient to move from one level of care to another within or outside the current health- care facility

Question 14

Goal Setting

Answer 14

The nurse should develop goal setting in the areas of education, advocacy, and case management in collaboration with the patient and family/caregiver

Question 15

Collaboration

Answer 15

the act of assembling and directing activities to provide services harmoniously

Question 16

Facilitation

Answer 16

making something easier and smoother by eliminating problems and barriers

Question 17

Negotiation

Answer 17

process by which the patient, nurse, and family determine goals

Question 18

Basic Discharge Plan

Answer 18

The least complicated and most common discharge plan is teaching the patient about self-care for the illness

Question 19

Simple referral Discharge Plan

Answer 19

involves referring the patient to community resources

Question 20

Complex Referral Discharge Plan

Answer 20

involves referring the patient to the discharge planner

Question 21

initiation phase

Answer 21

clarifying the source of referral and the purpose of the visit and initial contact with the family

Question 22

previsit phase

Answer 22

establishing an understanding with the family for the purpose of the visit, scheduling the visit, and reviewing pertinent records and information

Question 23

in-home phase

Answer 23

establishing the professional therapeutic relationship and implementing the nursing process

Question 24

termination phase

Answer 24

the nurse and family summarize accomplishments of the visit and make plans for future visits

Question 25

postvisit phase

Answer 25

recording findings and carrying out activities necessary to plan for the next visit

Question 26

Standard of Care I:

Assessment

Answer 26

The home health nurse collects patient health data.

Question 27

Standard of Care II:

Diagnosis

Answer 27

The home health nurse analyzes the assessment data in determining diagnoses

Question 28

Standard of Care III:

Outcome Identification

Answer 28

The home health nurse identifies expected outcomes customized to the patient and the patient’s environment.

Question 29

Standard of Care IV:

Planning

Answer 29

The home health nurse develops a plan of care that prescribes interventions to attain expected outcomes.

Question 30

Standard of Care V:

Implementation

Answer 30

The home health nurse implements the interventions identified in the plan of care.

Question 31

Standard of Care VI:

Evaluation

Answer 31

The home health nurse evaluates the patient’s progress toward attainment of outcomes.

Question 32

Standards of Professional Performance I:

Quality of Care

Answer 32

The home health nurse systematically evaluates the quality and effectiveness of nursing practice.

Question 33

Standards of Professional Performance II:

Performance Appraisal

Answer 33

The home health nurse evaluates his or her own nursing practice in relation to professional practice standards, scientific evidence, and relevant statutes and regulations.

Question 34

Standards of Professional Performance III:

Education

Answer 34

The home health nurse acquires and maintains current knowledge and competency in nursing practice.

Question 35

Standards of Professional Performance IV:

Collegiality

Answer 35

The home health nurse interacts with and contributes to the professional development of peers and other healthcare practitioners as colleagues.

Question 36

Standards of Professional Performance V:

Ethics

Answer 36

The home health nurse’s decisions and actions on behalf of patients are determined in an ethical manner.

Question 37

Standards of Professional Performance VI:

Collaboration

Answer 37

The home health nurse collaborates with the patient, family, and other healthcare practitioners in providing patient care.

Question 38

Standards of Professional Performance VII:

Research

Answer 38

The home health nurse uses research findings in practice.

Question 39

Standards of Professional Performance VIII:

Resource Utilization

Answer 39

The home health nurse assists the patient/family in becoming informed consumers about the risks, benefits, and costs in planning and delivering patient care.

Question 40

advocacy

Answer 40

the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations

Question 41

The goal of home care

Answer 41

allow people to regain or maintain optimal health and to function within their limitations in the home environment.

Question 42

Among Pima Indians, 50% of adults have diabetes and 95% of those are overweight. Diabetes and obesity are directly correlated with rerouting of waterways, which impacted traditional farming and subsequent dietary supplementation with processed commercial foods. Which health determinants are implicated in this scenario? 
Select all that apply:
a. Educational
b. Economic
c. Political
d. Healthcare services

Answer 42

b. Economic

c. Political

Question 43

A nurse is providing care on an acute care unit to a patient admitted for cellulitis of the right leg, with a history of bipolar disorder and intravenous drug use. She appropriately plans for discharge in order to address mobility issues, safety risk, and continued drug rehabilitation. Such interventions illustrate which type of nursing care?

a. Community-based healthcare
b. Community-based nursing care
c. Primary care
d. Secondary prevention

Answer 43

b. Community-based nursing care

Nursing care directed toward a specific group or population within the community and may be provided for individuals

Question 44

A patient is discharged following a triple coronary artery bypass graft and is seen for follow-up by his cardiologist, his surgeon at the hospital, his primary care physician, and the anticoagulation clinic. He is also seen for diabetes management and renal failure by two other specialists. This patient is at risk for what problem with this health-care coordination?

a. Discontinuity
b. Schism of care
c. Fragmentation
d. Decentralization

Answer 44

c. Fragmentation

Results as patients move from one system of care to the next

Question 45

A patient who has recently begun hemodialysis for kidney failure is discharging home from the hospital. Which of the following elements of discharge planning are integral in order to meet this patient’s healthcare needs?
Select all that apply:
a. A team meeting is planned between the physician, social worker, nurse, and family
b. Discharge planner establishes a dialysis schedule at a facility near the patient’s home
c. The nurse provides discharge paperwork as the patient is leaving
d. A tolerable renal diet is discussed between the dietician and the patient

Answer 45

a. A team meeting is planned between the physician, social worker, nurse, and family (collaboration)
b. Discharge planner establishes a dialysis schedule at a facility near the patient’s home (facilitation)
d. A tolerable renal diet is discussed between the dietician and the patient (negotiation)

Question 46

A nurse is performing a safety assessment at the home of an elderly man who lives independently. He is returning home following hospitalization for a below-the-knee amputation and will have a wheelchair as needed for several weeks. Which of the following issues should be noted by the nurse?
Select all that apply:
a. The surrounding neighborhood has a high crime rate
b. Infrequent home health service availability in the area
c. Wide doorways and handrails on stairs d. A well-kept garden in the backyard

Answer 46

a. The surrounding neighborhood has a high crime rate (barriers to independence)
b. Infrequent home health service availability in the area (barriers to independence)
c. Wide doorways and handrails on stairs (adequate environment)
d. A well-kept garden in the backyard (person’s values)

Question 47

Aesthetics/spirituality

Answer 47

Communion with families that strives to accomplish knowledge of health through the arts, exploration of alternative and complementary therapies, and experience of self-awareness, faith, hope, and love

Question 48

case management

Answer 48

Professional approach to providing care

in which one provider coordinates a client’s services

Question 49

community resources

Answer 49

Economic stability, social and health supports, and cultural norms

Question 50

coordination

Answer 50

Care for a client and family that requires

development of plans of care that maximize the person’s ability to remain in a safe environment

Question 51

facilitators

Answer 51

Examples include audiovisual materials, written handouts, repetition of material, and easily accessible and interested nursing staff.

Question 52

health determinants

Answer 52

Social, economic, political, and educational health factors and trends that can promote positive healthcare in a community

Question 53

healthy communities/healthy cities

Answer 53

Wellness programs, existing in integrated healthcare systems, that nurses often manage

Question 54

hospice

Answer 54

Family-focused health service that provides care for terminally ill clients

Question 55

levels of healthcare

Answer 55

Include primary (health promotion, education, protection, and screening), secondary (emergency care, acute and critical care, diagnosis, and treatment), and tertiary (emergency care, acute and critical care, diagnosis, and treatment)

Question 56

nursing competencies for community-based care

Answer 56

Monitoring, treatment, teaching, prioritizing, intervention, and planning skills that nurses should possess to meet the epidemiologic and demographic needs of a community

Question 57

patient education

Answer 57

Interactive, collaborative process between

nurse and client to progress toward the client’s goal of assuming responsibility for his or her health and self-care