Exam

Question 1

1.) A student nurse asks her nurse educator why there is an increased demand for home health care. Which response is the most accurate for the nurse educator?

A.) More family members want to care for their ill members at home.
B.) There is a shortage of nurses who want to work in an acute hospital care setting.
C.) There is an increase in the number of older patients with chronic illnesses.
D.) There is an increased technology in hospitals, which provokes anxiety in many patients.

Answer 1

C.) There is an increase in the number of older patients with chronic illnesses.

Question 2

2.) A 79-year-old patient recently fractured her hip and had a hemiarthroplasty hip repair. Her daughter works during the day but provides care in the evening. Which service agency is most appropriate to provide for this patient’s daily care?

A.) Private duty agency
B.) Home health care agency
C.) Nursing home facility
D.) Outpatient rehabilitation agency

Answer 2

B.) Home health care agency

Question 3

3.) The nurse is assigned to home health care for an 83-year-old patient with a stroke who has right-sided hemiplegia, difficulty swallowing, and speech impairment. He is receiving care in his home from his wife and daughter. Which should the home care nurse provide?

A.) Strict regimen and care plan
B.) Holistic, non-judgmental philosophy
C.) Teaching plan for all family members
D.) Means of transporting the patient to his physician

Answer 3

B.) Holistic, non-judgmental philosophy

Question 4

4.) Which is an example of an evolving future health care trend?

A.) Increased reimbursement fr home health care services
B.) Keeping patients in the hospital longer because of the severity of their illness
C.) Increased use of telehealth
D.) Slowed down growth in the number of agencies involved in home care.

Answer 4

C.) Increased use of telehealth

Question 5

5.) A 68-year-old patient is recovering from an abdominoperineal resection with a permanent colostomy. Her physician has ordered home health care nursing on her discharge. What is the primary patient goal?

A.) The patient will be able to return to their previous lifestyle.
B.) The patient will avoid dependency on medication therapy.
C.) The patient will establish self-care and independence.
D.) The patient will maintain a friendly relationship with family members.

Answer 5

C.) The patient will establish self-care and independence.

Question 6

6.) The home health nurse has been assigned to provide care for a patient with cultural values that differ from the nurses. What is the best action for the nurse to take? Select all that apply.

A.) Ask for an assignment change to allow a colleague who has cultural values more in line with those of the patient to be assigned.
B.) Accept the assignment and provide the patient with information on the values of the nurse to facilitate communication.
C.) Take time to consider the differences between the values held and those of. the assigned patient.
D.) Research the culture of the assigned patient.
E.) Review past experiences with cultural dilemmas.

Answer 6

C.) Take time to consider the differences between the values held and those of. the assigned patient.
D.) Research the culture of the assigned patient.
E.) Review past experiences with cultural dilemmas.

Question 7

7.) When arranging home care for a patient, from whom should the home health care nurse to collect data? Select all that apply.

A.) Home care agency
B.) Patient
C.) primary care provider
D.) community volunteer
E.) family members as per patient wishes.

Answer 7

B.) Patient
C.) primary care provider
E.) family members as per patient wishes.

Question 8

8.) The nurse is reviewing a patient’s eligibility for home services reimbursed by Medicare. What criteria area needed to be eligible?

A.) Age 60 years or older
B.) Under the care of a nurse practitioner
C.) Homebound
D.) In need of an intermittent skilled nursing services
E.) In acute renal failure

Answer 8

C.) Homebound
D.) In need of an intermittent skilled nursing services

Question 9

9.) A group of nursing students is preparing a presentation on the major diagnostic categories and diagnosis- related groups. What is the correct name for this system?

A.) Prospective payment system
B.) Medicaid
C.) Medicare
D.) Older American act

Answer 9

A.) Prospective payment system

Question 10

10.) Which 1997 congressional act imposed new limits on home health payments?

A.) Social security administration
B.) National institutes of health
C.) Balanced budget act
D.) Human and health services

Answer 10

C.) Balanced budget act

Question 11

11.) What was instituted by the health care financing administration (HCFA) in 2000?

A.) A new payment system for home health agencies.
B.) Medicare-certified agencies.
C.) The joint commission
D.) Rules governing certification of home health agencies.

Answer 11

A.) A new payment system for home health agencies.

Question 12

12.) What are the major nursing considerations crucial for patients in their homes and in structured facilities? Select all that apply.

A.) Immediate medical direction
B.) Nursing assessment
C.) Frequent peer support
D.) Reinforced patient teaching
E.) Individualized care

Answer 12

B.) Nursing assessment
D.) Reinforced patient teaching
E.) Individualized care

Question 13

13.) A patient is discussing the need for home health care services with the primary care provider.
Which statement by the patient indicates the need for reinforced teaching? Select all that apply.

A.) My Medicaid will pay for a nurse to stay at my house for up to 60 days.
B.) Having home health care will let my doctor make house calls.
C.) My home health nurse can help set up my daily medications.
D.) I will be able to receive my IV medications at home instead of coming in to the hospital.
E.) The federal government pays for all the Medicaid bills.

Answer 13

C.) My home health nurse can help set up my daily medications.
D.) I will be able to receive my IV medications at home instead of coming in to the hospital.
E.) The federal government pays for all the Medicaid bills.

Question 14

14. The nurse is beginning orientation for a positidrit andie o pratice that employs telehealth.
    What statement by the nurse indicates an understanding of telehealth?
    A.) The patient must have a computer in the home to utilize the services.
    B.) Blood glucose monitoring may be performed with telehealth services.*
    C.) Telehealth is more expensive than traditional health care services.
    D.) Insurance rarely covers telehealth- related expenses.

Question 15

15. The student nurse is researching long-term care. What does the student identify as being the overall goal for residents in long-term care?
    A.) The resident will remain free of disease.
    B.) The resident will return home as soon as possible.
    C.) The residents will enjoy their long-term care experience.
    D.) The resident will remain as independent as possible in the long-term care setting.*

Question 16

16.) Which person would benefit from long-term care?
A.) A 98-year-old widow who lives at home independently and can perform
ADL’s but needs a ride to church every Sunday.
B.) A 65-year-old widower who is recovering from a stroke and is unable to move his left side. *
C.) A 75-year-old woman who lives with her husband and has arthritis and osteoporosis with reports of mild to moderate stiffness every morning.
D.) A 70-year-old man who lives alone and has a history of coronary artery disease and hypertension.

Question 17

17.) The nurse identifies which patient as having the highest priority need for hospice care?
A.) A 65-year-old woman who has metastatic lung cancer and receives home health services.
B.) A 77-year-old man who has end- stage prostate cancer and lives in a long-term care facility.*
C.) A 44-year-old- woman who has AIDS and lives in a continuing care retirement community.
D.) A 70-year-old woman who recently was diagnosed with ovarian cancer.

Question 18

18.) A patient is receiving hospice care for his end- stage cardiac disease, Which statement by his wife alerts the nurse for the need for further education regarding hospice care? 86000084t
A.) What are the side effects of my husband’s pain medication?
B.) Are there support groups to help with the grieving process?
C.) My husband finally slept for more than 2 hours last night.
D.) How will I know when it is time to call 9-1-1?*
E.) We will only need hospice care until my husband gets better.

Question 19

19, What institutional setting is a bridge between acute care and long-term care?
A.) Subacute care*
B.) Nursing home care
C.) residential care
D.) adult daycare

Question 20

20.) which scenario best illustrates the effect OBRA has had on the professional practice of LPN in the long-term care setting? Select all that apply.
A.) The LPN may be responsible for administering intravenous therapy.*
B.) The LPN provides direct bedside resident care.
C.) The LPN performs dressing changes.
D.) The LPN functions as medication nurse.
E.) The LPN has the responsibility of being a team leader. *

Question 21

21.) Which is the best example of an interdisciplinary team?
A.) Director of nurses, charge nurse, staff nurse, can, resident.
B.) Residents, nurses, physicians, social workers, pharmacists, dietician, activities director, rehabilitation, specialist, podiatrists, psychiatrist, audiologist, dentist, *
C.) Attending physician, resident physician, inter, medical student, CAN, CMA/CMT, physical therapist.
D.) Gerontologic clinical nurse specialist, physician, pharmacist, social worker, clergy, resident.

Question 22

22. The new nurse has questions about palliative care. Which response by the nurse best describes this type of care?
    A.) Palliative care is usually provided in acute care facilities.
    B.) Palliative care is typically recommended for individuals with less then 6 months’ life expectancy.
    C.) Palliative care is usually affiliated with a church and provided by parish nurses.
    D.) palliative care extends the principles of hospice care to a broader population that has the possibility to benefit from comfort care earlier in the disease process.*

Question 23

23.) Which statement by the student nurse is most accurate in regard to the elderly population?
A.) Most live in a long-term care facility.
B.) Most attend an adult daycare facility.
C.) Most live in a home setting.*
D.) Most live in an assisted living setting.

Question 24

24.) The nurse working in an outpatient clinic refers which patient to PACE based on the nurse’s assessment.
A.) A 52-year-old who is being treated for hypertension and lives alone.
B.) A 70-year-old who has no support and has chronic venous ulcers requiring treatment at the local wound center.
C.)
A 90-year-old has 2 type 2 diabetes controlled by oral diabetic agents and lives with family.
D.) A 49-year-old- who is disabled because of a chronic debilitating neuromuscular disease and requires physical therapy services three times a week.

Question 25

25.) In accordance with national patient safety goal for nursing care centers, which action by the nurse demonstrates an understanding of the goals? Select all that apply.
A.) The nurse asks the patient to state his or her name and hospital ID number before administering their medication.*
B.)
The nurse provides indwelling catheter care to a patient by following facility policy and procedures.*
C.) The nurse performs a thorough skin assessment of a new resident upon admission to the health care facility.*
D.) The nurse performs a sterile dressing change to the central line of a resident as directed by facility policy.*
E.)
The nurse asks the resident’s family to bring in all home medications to ensure the list given by the patient upon admission to the facility is accurate.*

Question 26

26. When setting goals for an elderly patient, the nurse should consider what primary goal of rehabilitation?
    A.) Enabling patient’s return to work
    B.) Teaching safe mobility*
    C.) Improving quality of life
    D.) Reducing cellular destruction

Question 27

27.) An 11-year-old boy had a head injury from being struck in the skull by a baseball bat. When he awakens in the hospital 3 weeks later, how would his head injury be classified?
A.) Mild brain injury
B.) Moderate brain injury
C.) Severe brain injury*
D.) Catastrophic brain injury

Question 28

28.) A patient has been in the intensive care unit for several days after a head injury. His condition is stable, but today he has shown no signs of improvement. Over the past shift, the patient’s father has seemed increasingly upset over small concerns. Toward the end of the shift, he yells at the nurse when the intravenous alarm goes off. What would be the most appropriate response by the nurse?
A.) You sound upset.*
B.) I am going to get my supervisor for you.
C.) You need a break.
D.) Maybe you had better speak to the physician.

Question 29

29.) What term is the student nurse referring to that describes a disadvantage for a person that results from an impairment or a disability and limits that person’s fulfillment of his or her normal roles?
A.) Disability *
B.) Impairment
C.) Handicap
D. Inconvenience

Question 30

30.) The nurse is considering a position on a rehabilitation care unit that uses the concept of a transdisciplinary rehabilitation team. The nurse must be aware that this type of care will require what characteristics? Select all that apply.

A.) The ability to work with all members of the rehabilitation team.*
B.) Organized approaches to care *
C.)
Skills in all therapies that are provided.
D.)
willingness to cross-train with other disciplines.
E.) Developing expertise in a limited number of skills

Question 31

31.) Which are barriers to cultural competence? Select all that apply.
A.) Respect for the beliefs of others.
B.) Knowing all members of a cultural group are not necessarily alike.
C.) Believing that one’s own culture is better than others.*
D.) Treating one group better than another on the basis of culture or race.*

Question 32

32.) As part of the rehabilitation treatment team, why is the nurse often the first professional to detect symptoms of posttraumatic stress disorder (PTSD)
A.) Nurses are more intuitive than other members of the team.
B.) The rehabilitation team has no need to address this issue.
C.) Nurses are the only members of the team knowledgeable about PTSD.
D.) Nurses are in the unique position of having extended time to talk with patients and hear their concerns, feelings, and needs.*

Question 33

33.) The nurse is caring for a veteran who has shrapnel embedded in his eye as a result of a polytrauma/ blast-related injury (PT/BRI). How should the nurse classify this injury?
A.) Primary
B.) Secondary
C. Tertiary
D.) Quanternary

Question 34

34.) When caring for a patient with PTSD, what should the nurse’s initial action with the patient be?
A.) The nurse should first communicate the planned routine for the rehabilitation unit.
B.) The nurse should first work with the patient to establish goals for the plan of care.
C.) The nurse should first determine the family’s level involvement with care.
D.) The nurse should establish a therapeutic nurse- patient relationship.*

Question 35

35.) Which nurse is demonstrating a desired quality of a rehabilitation nurse? Select all that apply.
A.) The nurse is focusing on helping the patient work toward a cure for his condition.
B.) The nurse includes the patient’s family in the plan of care.*
C.) The nurse helps the patient achieve the goal of reentry into the home or community.*
D.) The nurse uses therapeutic communication skills with the patient and family.*
E.) The nurse encourages the patient to delay rehabilitation until his strength increases.

Question 36

36. When dealing with the patient, what must the rehab nurse remember?
    A.) The nurse frequently interacting with people experiencing change.*
    B.) The nurse must ensure change is occurring with each patient.
    C.) The nurse is always changing.
    D.) The nurse is the center of change.

Question 37

37.) Family-centered care recognizes that, when caring for a child with disabilities, which of the following is true?
A.) The family need assistance.
B.) The family and professional are equal in a partnership.*
C.) The family is in charge.
D.) The family must understand they must change.

Question 38

38.) reasons a patient may be admitted for rehabilitation include which of the following? select all that apply
A.) past coronary bypass*
B.) cardiopulmonary disease
C.) diabetic ketoacidosis
D.) urinary tract infection
E.) cardiovascular accident*

Question 39

39.) A 10 year old patient keeps crying and saying, no no, moving as if uncomfortable, then returns to sleep every few hours throughout the night. Her mother is not sure why this is happening. What should the nurse suspect?
A.) the patient is not comfortable in her bed and should be awakened to assess
comfort level.
B.) the patient may have experienced a traumatic event, which may need further
investigation.*
C.) the mother is upsetting the patient by standing in the room.
D.) the patient is acting out because of staying in a strange place.

Question 40

40.) The health care provider is explaining to a 74-year-old patient that his prostate cancer is progressing and that curative treatment is no longer feasible. The health care provider recommended hospice to the patient and his wife. What information may be included with recommendation to hospice?
A.) we can provide support and control your symptoms and discomfort so that
you have good quality days. *
B.) with hospice we would continue with aggressive curative care.
C.) there is no hope left for you, and you should just go home and wait to die.
D.) we can no longer guarantee controlled symptoms or a dignified life, but we
can still provide sympathy.

Question 41

41.) the patient’s wife calls the hospice nurse and reports that her husband is complaining of pain in his leg and is not able to get comfortable. What action by the hospice may be implemented.

A.) explain to the wife that pain will increase because of the progression of the
disease and there is nothing to be done.
B.) ask the wife how the patient rates his pain and whether he has taken any
medication for breakthrough pain. *
C.) advise the wife that her husband must be a complainer.
D.) advise the wife to wait until morning and call the health care provider.

Question 42

42. The patient is experiencing a decreased appetite and voices concerns about his weight loss.
    What action by the hospice nurse is most appropriate?
    A.) encourage the patient’s wife to cook all of his favorite foods, and maybe he
    will eat.
    B.) tell the patient to force himself to eat.
    C.) explain to the patient that decreased appetite is normal. *
    D.) contact the primary care provider for an order for an appetite stimulator.

Question 43

43.) The patient’s wife is exhausted and expresses the need to get away for a short period of time.
How can the volunteer coordinator help in this situation?
A.) advise the wife that a volunteer will not help in this situation
B.) instruct the wife that it is best for her to just stay with her husband because
he might die while she is away.
C.) assign a volunteer to sit with the patient for a couple of hours two or three
times a week so that the wife is able to either take a nap or to leave for a short time to do errands.*
D.) assign a volunteer to do errands so that the patient’s wife does not have to
leave.

Question 44

44.) as part of the hospice program, the patient has a core interdisciplinary team that manages his care. what members make up the core interdisciplinary team?
A.) spiritual coordinator*
B.) physical therapist
C.) nurse coordinator *
D.) social worker*
E.) medical director*

Question 45

45.) the patient’s wife tells the hospice aid that she is having problems meeting their financial obligations, what action by the hospice aide is most important?
A.) tell no one because this is confidential information

B.) ask for her permission to report this to the interdisciplinary team, and have
the social worker make a visit to see whether it is possible to provide assistance.*
C.) report this to the patients church to see whether there is some financial
assistance
D.) encourage the patient’s wife to consider government assistance during this
difficult time.

Question 46

44.) the patient is complaining of constipation. He has had very little food intake the past 4 days. What action by the nurse is most appropriate?
A.) advise the wife to stop all food and water.
B.) asses for bowel sounds, abdominal distention, possible impaction.*
C.) explain that reduced intake will result in reduced stool output.
D.) instruct him to bear down to assist in elimination of his stool.