Chapter 41 Flashcards
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.
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.
A nurse who implements a population-focused model of home care delivery would most likely:
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.
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 free-standing, for-profit agencies that are required to pay taxes. Many are part of large chains and now dominate the home care industry.
Which factor is important for the nurse to consider when coordinating care to ensure a comfortable and peaceful death?
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.
What is the primary objective of hospice programs?
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.
The nurse provides direct care services to a stroke victim to avoid complications. This is an example of which level of prevention?
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.
Which nursing intervention is an example of a skilled nursing service?
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
Teaching the client and family to implement a therapeutic plan, such as taking medications, is an example of a skilled nursing service.
A nurse employed in home health nursing practice provides:
a. Intermittent nursing visits
b. Custodial care
c. Family caregiving
d. Palliative care
ANS: A
Provision of intermittent skilled visits is a component of home health care nursing.
Which organization publishes the current scope and standards of home care practice?
a. Centers for Medicare and Medicaid Services
b. American Nurses Association
c. Robert Wood Johnson Foundation
d. Visiting Nurse Association
ANS: B
The American Nurses Association publishes scope and standards for Home Health Nursing and Hospice and Palliative Nursing.
During the performance of which standard of care would the nurse discover the need for Meals on Wheels?
a. Diagnosis
b. Planning
c. Assessment
d. Implementation
ANS: C
The nurse would discover the need for Meals on Wheels during the performance of the assessment.
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.
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 is 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.
In which situation would a nurse use the Omaha System Problem Classification Scheme?
a. When measuring client outcomes
b. When collaborating with other professionals
c. When providing health education
d. When organizing a comprehensive assessment
ANS: D
The Omaha System Problem Classification Scheme is used to organize a comprehensive assessment according to four priority domains.
Why would a nurse use the Omaha 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.
What action should a nurse take to facilitate interprofessional collaboration?
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. Work in isolation 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.
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.
A nurse uses the first stage of the Outcomes and Assessment Information Set (OASIS) outcomes analysis to:
a. Compare an agency’s performance to a national sample.
b. Report data on patient care to a national registry.
c. Stabilize a client’s condition to continue to receive funding.
d. Document 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.
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.
A nurse using telehealth technology in the home setting:
a. Uses WebTV 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.
Which populations may require a high-intensity transitional care program? 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
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.
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
ANS: B, C
The Omaha System Intervention Scheme is comprised of four broad categories of interventions: teaching, guidance, and counseling, treatments and procedures, case management, and surveillance.
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. “Kick-backs” for referrals
ANS: A, B, C, D
All are correct. The home care nurse must abide by established federal regulations when delivering care to clients.
