COMMUNITYChapter34 Flashcards
A nurse is going to visit a client who needs assistance with personal hygiene and feeding. Which suggestion should be made to the family?
a. “I’ll teach you how to care for your family member to keep him comfortable or, if you can afford it, you can employ an aide.”
b. “It’s important that he try to take care of himself and, if he can’t or won’t, he’ll have to deal with the consequences.”
c. “Reimbursement is available for a nurse to come to the house each day if you would like this assistance.”
d. “You can always have your family member readmitted to the hospital for care.”
A
A nurse was considering self-employment by starting a home health managed care agency. Which risk is the nurse taking, particularly in the beginning?
a. Because the nurse is a newcomer, most patient referrals may go to other, more long-term agencies.
b. Managed care agencies assume the risk of providing all needed care within the amount budgeted.
c. Most clients would not know the nurse and therefore would be unaware of the nurse’s agency.
d. Other nurses may envy the successful nurse and withdraw their friendship and support.
B
Although it was uncomfortable, a home health nurse finally learned to discuss finances with the client and family on the very first visit. Visits had to be reimbursed. Now that she is working for a different agency, funding was no longer such a concern. Which offers the best explanation for this change?
a. Because the nurse was an unpaid volunteer professional, visits made by that nurse had no cost to the agency.
b. Only clients of high socioeconomic class were admitted for care, so the agency was always immediately reimbursed for care rendered.
c. Taxpayers fund official (i.e., public) home health agencies for care not reimbursed by third parties.
d. The new agency has a large foundation that funds its activities from investment profits.
C
Which best explains why home health care agencies that are part of national chains are doing better in the competitive marketplace than individually owned agencies?
a. There is better media coverage and a nationally known “name” recognized by prospective clients.
b. They are able to offer lower quality care using less well-prepared caregivers to ensure maximum profit.
c. The chief executive officer usually has extensive experience and makes wise decisions.
d. There are lower administrative costs and easier negotiating when buying in bulk.
D
Which is required for an agency to receive reimbursement for care given from Medicare?
a. Application for recognition including signing a contract with the federal government
b. Application for reimbursement from Medicare using the appropriate federal forms
c. Demonstrating meeting federal quality standards for Medicare-covered services
d. Providing specialty care such as physical therapy
C
Which 66-year-old client who needs skilled nursing care would be eligible for home health care reimbursement by Medicare?
a. A client who always worked for the state and enjoys going to the neighborhood coffee shop on a daily basis
b. A client who needs his wounds cared for every day, including weekends, and needs the nurse to visit at 8 AM every day
c. A client who is a loner and has no one to assist him except for the home care agency
d. A client who is homebound and has a very strong support system
e. A client who is an illegal immigrant who has lived in the United States for 25 years but begged the nurse not to tell
D
Which best explains the purpose of the Outcome and Assessment Information Set (OASIS)?
a. To analyze the cost-effectiveness of health agencies
b. To evaluate and improve clinical performance quality
c. To measure and publicize hospital data on outcomes such as death rates
d. To survey patient satisfaction with care received from health agencies
B
Which is the major assumption of Albrecht’s conceptual model?
a. Nurses are the only appropriate case managers for home health patients.
b. Quality is best measured by using data from assessments, interventions, and outcomes.
c. Patient outcomes depend primarily on the education and experience of the nurse.
d. The most important outcome measure is the cost-effectiveness of the care given.
C
In addition to factual data such as name, address, and diagnosis, which information is crucial to the nurse when a referral is received?
a. The amount of reimbursement the agency will receive for a visit
b. The family’s reaction to the suggestion that a nurse visit in their home
c. The purpose of the referral for a home visit
d. The patient’s agreement with the home visit referral
C
Which is the primary task to be accomplished during the initial telephone contact between the home health nurse and the client?
a. Make sure that the name, address, telephone, and other data are accurate
b. Confirm that the nurse will be a guest in their home so socialization can occur
c. Allow the client to give permission and agree to a time for a home visit
d. Warn the family that the nurse will always need to immediately see the proof of insurance before proceeding further
C
Which action should the home health nurse take to get in touch with a client if the client apparently has no telephone?
a. Determine whether the client has family members in the area who might be able to get in touch with the client to ask the client to call the agency
b. Go to the client’s address and discuss making a home visit with the client
c. Send a formal letter asking the client to call the agency for an appointment
d. Tell the referral source you cannot accept referrals without usable telephone numbers, so this client was not visited
B
Which is the best use of the nurse’s time while en route to the client’s home?
a. Assess the surrounding neighborhood and the exterior of the client’s home
b. Begin the client record using a computer or oral recording device
c. Look for appropriate places to obtain food, fuel, or rest stops for the nurse
d. Consider if another home health agency would be closer to the client’s home
A
Which is the most important task to be accomplished during the initial home visit?
a. Assess the client and the family
b. Discuss social topics
c. Educate the client and the family regarding the health problem
d. Establish rapport and trust
D
Which best describes the documentation that the nurse should expect to complete during the home visit?
a. Creation of a carefully laid out nursing care plan for future visits
b. Documentation of assessment data and care given demonstrating the nurse’s effectiveness
c. Necessary documentation will depend on the agency policies and forms
d. Completed Medicare forms per the Health Care Financing Administration (HCFA) regulations for reimbursement
D
A new home health nurse realized that what was being observed and now being said by the client were very inconsistent with what had been documented while the client was hospitalized. Which conclusion should be drawn by the nurse?
a. The amount of support available is different from what was stated earlier.
b. The client had difficulty distinguishing truth from falsehood.
c. The client had to admit the truth when it was obvious to the nurse.
d. The family was embarrassed by their living situation.
A
