Nursing Chapter 8 Competencies Context And Environment Practice Conduct

Kozier & Erb’s Fundamentals of Nursing, 10/E

Chapter 08

Question 1

Type: MCMA

The nurse learns that two new home care agencies are opening in a community. What should the nurse consider as

reasons why home care agencies are increasing in numbers?

1. The need for custodial care

2. Third-party payers who support cost control measures

3. The increase in the older adult population

4. The decreasing need for acute care

5. The focus on the needs of the community

Page Number: 118

Question 2

Type: MCSA

During orientation with a home care agency, the nurse is learning the difference in care delivery between home

health nursing and community nursing. What should the nurse understand as being the focus of home health care

nursing?

1. Individuals, families, and groups

2. The individual and his or her family

3. The terminally ill client and his or her family

4. The client in a home setting

Question 3

Type: MCSA

To help a home health client with a difficult medication regime, the nurse contacts the pharmacist for ideas to

facilitate the process. Which behavior did the nurse demonstrate when caring for this client?

1. Hands-on care

2. Direct care

3. Advocacy

4. Indirect care

Question 4

Type: MCSA

A client being discharged needs physical therapy for progressive ambulation, wound care to treat a postoperative

wound, and assistance with the payment of hospital bills. Before the nurse contacts a home care agency, who

should write the order for the client to receive home care?

1. Physician

2. Nurse

3. Social worker

4. Physical therapist

Question 5

Type: MCSA

During the first home care visit, the nurse determines that the client needs speech therapy, physical therapy, and

custodial care several times a week. When should the nurse schedule the client’s care to begin?

1. As soon as the nurse completes the initial assessment

2. As soon as the client agrees to the care

3. When the physician signs the plan of care the nurse develops

4. Within 48 hours of the nurse’s visit

Question 6

Type: MCSA

A home health client has a complicated case involving occupational therapy, respiratory therapy, a dietitian, the

nurse, and a nurse’s aide who provides assistance with bathing, housekeeping, and grocery shopping. Which care

provider should be prepared to coordinate this client’s care?

1. Physician

2. Nurse

3. Social worker

4. Home health agency

Question 7

Type: MCSA

The nurse is hired to provide home care through a community agency that is operated by the state health

department and financed by taxes. In which type of agency is this nurse employed?

1. Institution based

2. Private

3. Not-for-profit

4. Official

Question 8

Type: MCSA

While reviewing a health insurance plan, the nurse learns that a client has coverage for durable medical equipment

(DME). What care need should the nurse identify as being covered by the client’s health plan?

1. Dressings and bandages

2. Medications

3. A hospital bed

4. Visits by the home health nurse

Question 9

Type: MCSA

The nurse would like to admit a client to home health care, but is worried about insurance reimbursement. What

client action is causing the nurse to question if home care can be prescribed for this client?

1. Lives with a spouse

2. Needs skilled care

3. Needs intermittent care

4. Drives a car for trips to the barber

Question 10

Type: MCSA

A client who has been the recipient of home health care has made the decision to discontinue hemodialysis. The

client understands all the consequences of this decision and is not supported by his family. The nurse is meeting

with the family to help them understand the significance of the client’s decision and to help them support the

client during this difficult time. In which role is the nurse functioning?

1. Caregiver

2. Advocate

3. Educator

4. Counselor

Question 11

Type: MCSA

During a home visit, the client with terminal cancer undergoes respiratory arrest. The client has agreed to a DNR

(do not resuscitate) order; however, the spouse tells the nurse to call 911. What action should the nurse take?

1. Assess vital signs.

2. Call 911.

3. Start CPR.

4. Remind the spouse of the client’s desires.

Page Number: 121

Question 12

Type: MCSA

During a home visit, the nurse explains the procedures for preventing infection in a central venous access device

to the spouse who watches while the nurse hooks the client to the medication infusion. Which role is the nurse

performing at this time?

1. Caregiver

2. Advocate

3. Educator

4. Coordinator

Question 13

Type: MCSA

While assessing a client’s environment for safety concerns, the nurse finds that most of the rooms in the house

have only one outlet with various cords entering the outlet. When this concern is shared with the client and spouse,

they state that “this is the way we’ve lived for years.” What should the nurse do?

1. Provide telephone numbers for local electricians.

2. Continue to persuade the client to have the home rewired.

3. Not bring the subject up again.

4. Document the findings and the client and spouse’s response to the concern.

Question 14

Type: MCSA

A home health client lives alone in a small apartment and has only one phone, which is a land line. What safety

recommendation should the visiting home health nurse make for this particular client?