Health care is constantly changing and becoming more complex. Select the answers that describe clients as health care consumers today. Show • They prefer to control the decisions made about their own health care. Health care consumers are increasingly more knowledgeable about health, and prefer to control the decisions about their care. They express concern about access to services, and the cost and quality of care. They question duplication of services, and are actively engaged. They have helped to develop client rights and cost-containment measures as protections for clients in health care settings. Today clients are surveyed regarding their experiences with doctors and nurses in hospitals. When admitting the elderly patient to the hospital for surgery, it is the nurse’s responsibility to do a complete assessment and document the patient’s condition. A priority reason for this responsibility is that the nurse knows that the hospital will not be reimbursed for: Decubitus ulcer Medicare will no longer reimburse hospitals for conditions that result from preventable errors, such as pressure ulcers (decubitus ulcers). You must document condition of skin on admission. Preventable errors include air embolism (not fat embolism); the others are not included on the list of preventable errors A nurse is caring for
an elderly client in the home. He concludes that the client needs an x-ray to determine if the client has pneumonia and requires oxygen for shortness of breath. He calls to inform the physician of the client's status and then makes arrangements to carry out the physician's orders. In this scenario, what role does the nurse play? Case manager Case management means the nurse coordinates many resources to maximize the opportunity for people to manage their own healthcare at home. A nursing student is caring for a client who is experiencing pain. In assessing for pain, the nursing student should use what skill in the provision of care? Critical Thinking Developing critical thinking skills enables the nursing student to place multiple factors into complex equations and arrive at appropriate conclusions. You are employed in a large urban hospital. On your unit there is a nurse manager, a charge nurse, a nursing case manager, two team leaders, with nurses (RNs and LPNs) and auxiliary
personnel who are assigned to provide care on each team. It is important for the nurse to understand the role of the case manager. The best description of the nursing case manager’s role is to: develop critical pathways to guide care and to reach patient outcomes in a specific time frame. It is the role of the nursing case manager to enhance continuity of care and effective use of resources by developing specific care protocols/critical pathways to reach patient outcomes in a specific time frame. Case managers do not provide direct patient care, write individual care plans,
or review incident reports. A client has a complex medical history involving the consequences of diabetes. As a result of his diabetic nephropathy, he is now a client of the local hospital's dialysis program and has been referred to an ophthalmologist by his primary care physician following the onset of vision problems. In addition, he receives home care nursing for the treatment of a foot ulcer that
is slow to heal. This client's situation characterizes which of the following phenomena? Fragmentation of care Fragmentation of care occurs when multiple, specialized practitioners are involved in various aspects of a complex client's care. This creates the potential for miscommunication and conflicting advice and treatment with the lack of a unified plan
of care. This situation is not indicative of primary care and it is not necessarily a consequence or manifestation of case management and managed care. Nursing is the largest group of healthcare professionals. They have the potential to have an influence on healthcare reform. Healthy People 2020 suggests that nurses have an important role in: improving access to quality care and cost of care Healthy People 2020 emphasizes the importance of nursing's role in improving access to care, quality of care, and cost of care. Which health care setting provides care with activities of daily living for people of any age who are physically or mentally unable to care for themselves independently? a)Long-term care facilities Long-term care facilities Long-term care facilities provide health care and help with daily living for people of any age who are physically or mentally unable to care for themselves independently. This care may extend for periods ranging from days to years. Rural and ambulatory care centers provide primary care services, while homeless shelters provide housing for people who do not have regular shelter. A nurse is making a visit to a client in the home. As a home health care nurse you may be expected to accomplish which of the
following? • Provide support to the client and family. All of the above. Home health care nurses may provide all of these activities in the home setting. Health care costs are increasing as technology and related services increase. Patients interact with many health care providers, such as RNs, LPNs, physicians, physical therapists, medical technologists, radiation technologists, specialists, and others employed in health care. As a result of the complexity of care and multiple providers, health care is becoming fragmented. What are the major results of fragmented care? a)Less confusion for clients regarding treatment. • Increased
medication errors. The primary nurse shares with the healthcare team the need for her client, diagnosed with cancer, to go out on pass to attend her daughter's wedding. She is serving in what role as a nurse? a)Caregiver A nurse has been hired to work as an occupational health nurse. In this position as a registered nurse, what will this nurse provide? Education and safety programs in industrial settings. Industrial settings is the best answer to define/describe occupational health nursing, which focuses on employee safety and health-promotion programs. The other options do not address health needs in
an employment setting. Which of the following is an emerging trend in health care delivery? Active involvement of consumers Trends in health care delivery include the active involvement of consumers, continuing nursing shortage, increased complexity of client care, and a technology explosion. Other trends include changing demographics, increasing diversity, globalization of economy and society, increasing costs of health care, and the effects of health policy and regulation Which of the following factors is the primary criterion for admission to a long-term care facility? a)Absence of family members locally Inability to provide self-care Long-term care facilities exist to provide care for individuals who are mentally or physically unable to care for themselves independently. These individuals are frequently older, with multiple health problems. Many many lack family caregivers, but these factors in and of themselves are not criteria for admission to long-term care. After many years of advanced practice nursing, a nurse has recently enrolled in a nurse practitioner program. This nurse has been attracted to the program by the potential to provide primary care for clients after graduation, an opportunity that is most likely to exist in which of the following settings? A rural health center Many rural health centers employ few health care providers, and primary care is often provided by a nurse practitioner (NP). A nurse practitioner may provide care in a long-term care facility or hospital, but in these settings, the NP is less likely to be the provider of primary care to clients. During a home care visit to a home-bound elderly patient, the husband/caregiver verbalizes anger, fatigue, and sleeplessness. Which of the following recommendations by the nurse will be most effective in relieving caregiver role strain? a)Palliative care Respite care Hospice, voluntary services, and palliative care are helpful to the client and her husband, but respite care directly provides the husband with a break from caregiving duties. Nursing practice is based on different models of care, each aiming to enhance the effectiveness of nursing care. In which of the following models of care does the nurse coordinate many resources to maximize the opportunity for people to manage their own
healthcare at home? Case management In case management, the nurses coordinate many resources to maximize the opportunity for people to manage their own healthcare at home. The nurses make decisions specific to each individual client to promote independence for as long as possible. In a functional model of care, each nurse is assigned a specific task to perform and the head nurse is responsible for making decisions. Hospital management is a vast field involving all aspects of care. Nursing administration involves managing the nursing resources according to the policies of the healthcare facility. Which of the following is a characteristic of primary healthcare? Select all that apply. a)It is the same concept as primary healthcare
in that it refers to the delivery of healthcare. • It is made universally accessible to individuals and families in the community. Primary healthcare is defined as essential healthcare based on practical, scientifically sound, and socially acceptable methods and technology, made universally accessible to individuals and families in the community through their full participation and at a cost the community can afford. It brings healthcare as close as possible to where people live and work. Primary healthcare should not be confused with primary care. Primary care is the delivery of healthcare services, including the initial contact and ongoing care. Primary healthcare emphasizes universal access and affordability of healthcare, health of the whole population, and consumer involvement. Primary healthcare was originally conceptualized in 1978 by the World Health Organization (WHO) and the United Nations International Children’s Emergency Fund (UNICEF). The concept was developed based on decreases in illness and death in member countries that were achieved by simple, local, inexpensive solutions to health problems, especially when combined with economic and social development A client considers himself affluent and places a high priority on maintaining his freedom to choose which physicians and health care services he utilizes. Which of the following group plans is most likely to meet this client's needs? a)A preferred provider organization (PPO) Private insurance Private insurance is normally more expensive than alternative group plans such as PPOs, HMOs, and LTC insurance. However, it typically allows the policyholder to have significantly more autonomy around which practitioners and services to utilize A client was admitted to the hospital two weeks ago following an ischemic stroke. Following the early introduction of stroke rehabilitation, he has seen significant improvements in both his medical status and activities of daily living (ADLs). This morning,
however, his nurse notes that the client has been coughing since he ate his minced and pureed breakfast. Auscultation of his chest reveals the presence of coarse crackles. Which of the following practitioners should the nurse consult with in order to obtain a swallowing assessment? Speech therapist The diagnosis and treatment of dysphagia (swallowing problems) is within the purview of speech therapists. The physician should be made aware, and respiratory therapy may be involved with assessing and promoting the client's oxygenation, but swallowing assessment is a task most often performed by a speech therapist. Which of the following is the acute care setting for people who are too ill to care for themselves at home or who are severely injured or who require surgery? a) Primary care centers Hospitals Hospitals are the most appropriate care provider for people who are too ill to care for themselves at home, who are severely injured, or who require surgery or complicated treatments or who are having babies. The growth in home healthcare is largely attributed to which of the following? a) The inability of hospitals to care for increasing numbers of patients Early discharge of patients from the hospital setting Home healthcare is one of the most rapidly growing areas of the healthcare system. The prospective payment system of reimbursement encourages early discharge from the hospital and has created a new, acutely ill population that needs skilled nursing care at home. Which healthcare setting provides care with activities of daily living for people of any age who are physically or mentally unable to care for themselves independently? a) Homeless shelters Long-term care facilities Long-term care facilities provide healthcare and help with the activities of daily living for people of any age who are physically or mentally unable to care for themselves independently. This care may extend for periods ranging from days to years. Rural and ambulatory care centers provide primary care services while homeless shelters provide housing for people who do not have regular shelter. Which of the following patients is the most appropriate candidate for hospice services? A patient with lung cancer and a 3-4 month life expectancy The patient with lung cancer and a 3-4 month life expectancy is a candidate for hospice care. Hospice care provides support and services to dying patients and their families. The patient with breast cancer is undergoing treatment for the cancer and is not a candidate for hospice. An active hemodialysis patient and a patient seeking treatment for Guillain-Barre are also not candidates for hospice care. n the 1980s, the nursing care delivery model shifted from a team nursing model to a a)Managed care model Primary nursing model In primary nursing, registered nurses provide most of the client care. The wife of an elderly man with Alzheimer's disease contacts a community health nurse because she is planning to visit her sister in a neighboring state and needs assistance in arranging care for her husband while she is away. Which type of care is the wife seeking? Respite care The wife of the patient is seeking respite care. Respite care is a type of care provided for caregivers of homebound ill, disabled or elderly patients. The main purpose is to give the primary caregiver some time away from the responsibilities of day-to-day care. Hospice services provide care to dying persons and their family members. Rehabilitation care specializes in services for patients requiring physical or emotional rehabilitation and for treatment of chemical dependency. Parish nursing is often volunteer-based and situated within the church. Which agency focuses on the epidemiology, prevention, control and treatment of communicable diseases? a) Indian Health Services Centers for Disease Control and Prevention Which therapist is most likely to focus on teaching a patient to hold a toothbrush with an adaptive device and brush his teeth? a) An occupational therapist An occupational therapist The implementation of diagnosis-related groups (DRGs) by Medicare in 1983 affected hospitals in which of the following ways? a) Benefits and reimbursement cannot be changed annually. Medicare pays only the amount of money preassigned to a treatment for a diagnosis. A middle-aged couple is considering enrolling in a long-term care insurance plan. What will this insurance cover? a) Inpatient hospital services Nursing home and home care services Which of the following patients is the most appropriate candidate
for receiving outpatient care? A patient whose complaints of irregular bowel movements have necessitated a colonoscopy Outpatient services are appropriate for patients who are medically stable but who require diagnostic testing, such as a colonoscopy. Patients in active labor and patients who are actively septic of suicidal require close monitoring and frequent interventions that can only be safely provided on an inpatient basis. A student nurse is
anticipating graduation and is aware of the changing nature of healthcare and nursing practice. Which of the following statements most accurately describes an aspect of contemporary nursing practice in the United States? Most nurses are still employed in hospitals. While the percentage of nurses who are employed in hospitals decline, 59% of nurses are still employed in a hospital setting. Which of the following factors is the primary criterion for eligibility in the federally funded Medicare program? a) Diagnosis with more than one chronic health condition Age greater than 65 The National Academy of Sciences (2003) has proposed five core competencies necessary for healthcare professionals to meet the needs of the 21st-century healthcare system. Which of the following are among these competencies? Select all that apply. a)Using evidence-based practice Using informatics The nurse is providing care for a patient who has a tracheotomy and whose pulse oximeter has recently alarmed, showing the patient's oxygen saturation to be 77%. The nurse has repositioned the patient and applied supplementary oxygen, interventions that have raised the patient's oxygen levels to 80% and somewhat decreased his work of breathing. The patient is not in immediate distress, and his level of consciousness remains high. The nurse should page which of the following practitioners? a) Physical therapist Respiratory therapist A respiratory therapist is an expert in lung function and oxygenation whose expertise is needed in the care of this patient. Because the patient is not experiencing severe distress or respiratory arrest, the nurse is justified in foregoing contact with the physician in the short term. A physical therapist or occupational therapist is not likely able to provide needed interventions at this time. A group of students are reviewing information about hospitals in preparation for a quiz the next day. Which of the following, if identified by the students as associated with a hospital, demonstrates the need for additional study? a) Provision of acute care Parish nursing activities Hospitals are acute care providers, providing services to both inpatients and outpatients. Which type of healthcare facility employs the largest percentage of RNs? a) Ambulatory care Despite a downward trend, the largest percent of RNs are employed by hospitals. When reviewing information about the growth of healthcare services, which are would the nurse expect to find as the most rapidly growing area? a)
hospitals Home care services are the most rapidly growing area of healthcare. Which healthcare provider is a major source of health assessment and health education for children? a) hospital emergency department d)
school nurse School nurses do provide much of the health assessment and health information for the nation's children. A caregiver asks a nurse to explain respite care. How would the nurse respond? a) "A service that allows time away for caregivers" a) "A service that allows time away for caregivers" Respite care is provided to enable a primary caregiver time away from the day-to-day responsibilities of homebound patients. After teaching a class about the various healthcare agencies and services, the instructor determines that the teaching was successful when the class identifies which of the following as a government agency? a) alcoholics anonymous b) public health service The Public Health Service is a government agency. Which purpose best describes managed care as a framework for healthcare? a) A design to control the cost of care while maintaining the quality of care. A design to control the cost of care while maintaining the quality of care. Managed care is a way of providing care, designed to control costs while maintaining the quality of care. Your newly employed friend is a part of the company's HMO. You interpret that to mean the friend a) can have healthcare services from a provider of his choice. receives all healthcare from providers within the organization. In most HMOs, the patient does not have a choice of healthcare providers and receives all services from providers within the HMO. Private insurance most often is called a third-party payer, indicating which of the following? a) You
pay no monthly premium, paying for all healthcare costs yourself. You pay a monthly premium, and the insurance company pays the bills. You (and your employer, if appropriate) pay monthly premiums, and the insurance company pays all or most of the cost of care. A nurse is developing a presentation for a local community group about the knowledgeable healthcare consumer. Which technology would the nurse include as having the greatest effect on this area? a) television computers Consumers are increasingly using their home computers to access healthcare information through the internet. A nurse is caring for clients at an ambulatory care facility. Which of the following is a hallmark of good ambulatory care? a)Focus on rehabilitation Focus on client education The hallmark of good ambulatory care is focus on thorough family and client education. Clients who come to an ambulatory care facility are discharged the same day; therefore, client education is very important for continuing care at home. Community-based healthcare settings focus on disease prevention, rehabilitation, and diagnosis. One of the newest concepts in providing long-term care is called “aging in place.” What is the best description of this type of care? a)Clients are maintained in their own homes with home health care. Clients move to an independent living apartment or home, then have access to increasing health care services as needed, provided within the health care community where they live. The best description of "aging in place" is the type of care where the client moves into an independent living space, and then has access to more services, such as assisted living and/or skilled care, that are part of the health care community in which they live. Home healthcare is a rapidly growing area of the healthcare system. Factors that have influenced the growth of home healthcare include which of the following? Select all that apply. a)Home health nursing requires that its nurses are prepared at the advanced practice
level. • Patients have an increased acuity
level following earlier hospital discharge. A nurse is employed with an emergency medical service. Consulting nurses triage specific calls and prioritize them in order of importance. Which of the following calls should the nurse place on priority? a)Head
injury Head injury Head injury is a priority over diarrhea, a stuffy nose, and a fractured leg. Head injury is life-threatening and requires immediate attention. Cases of diarrhea, stuffy nose, and leg fractured would be of secondary concern. When the patient’s primary care physician does not have hospital privileges, there is a service to provide the patient’s care and communicate to the patient’s physician. This service is provided by physicians called: a)on-call physicians. hospitalists. The hospitalist is a physician who provides care to the patient in the emergency room and after admission to the hospital. The hospitalist communicates with the patient's primary doctor but manages the hospital care. The nurse understands that a diagnostic-related group is one of the reimbursement strategies in a prospective payment system. The diagnostic-related group is a part of which health care system? a)Medicaid Medicare The federal government implemented a system of prospective payment in 1983 for people enrolled in Medicare. A prospective payment system uses financial incentives to decrease total health care charges by reimbursing hospitals on a fixed rate basis. Reimbursement is based on the diagnostic-related group, which is a classification system used to group clients with similar diagnoses. Medicaid provides health care through funds obtained from federal, state, and local sources. In capitation strategy, a preset fee per member is paid to a health care provider, regardless of whether the member requires services. AmeriCare provides health care services through employers. The nurse working in the hospital understands the changes that have resulted in shorter hospital stays, with a focus on acute care needs of the client. Which of the following factors influence shorter hospital stays? Select all that apply. a)Increased
emphasis on preventive care. • Increased emphasis on preventive care. In providing nursing care, it is most important to perform which of the following actions? a)Administration of prescribed
medications Coordination of care with the health care team Nurses have moved from simply observing and giving prescribed medications to coordinating clinical information for the entire health care team A client with
a terminal illness has been placed in hospice care. Under which of the following circumstances can hospice care be discontinued? When the client no longer meets the Medicare criteria Hospice care for a client can be discontinued when the client no longer meets the Medicare criteria. While receiving hospice care, the client can “transfer to another hospice program, but may not be discharged because of inability to pay, high cost of treatment, 'high-tech' palliative care ordered by the physician, or 'difficult' behavior.” If a client survives beyond 6 months, he or she continues to receive care as long as the physician certifies that the client continues to meet hospice criteria. Nurses who assist clients to deal holistically with their health care needs at the end of their lives work primarily in which health care delivery system? a)Rehabilitation Hospice The opportunity to help people maintain their ability to remain at home and deal holistically with their health and family needs at the end of their lives is home health hospice care. The growth in home health care is largely attributed to which of the following? a)The nursing shortage in hospitals
Early discharge of clients from the hospital setting Home health care is one of the most rapidly growing areas of the health care system. The prospective payment system of reimbursement encourages early discharge from the hospital and has created a new, acutely ill population that needs skilled nursing care at home It is important for members of the nursing profession to understand and be able to interpret managed care to patients and families. The nurse describes managed care as: a)a system that employs a gatekeeper to ease the patients’ access to any healthcare provider. a healthcare system that is aimed at controlling healthcare costs while maintaining quality of care. Managed care systems are designed to control costs while maintaining quality of care. They limit the providers and may have gatekeepers to monitor care. A. is incorrect as managed care limits providers, B. is not the best definition and limiting abuse and access is not the primary purpose of managed care. D. When insurance providers group together, "umbrella organizations" provide all aspects of care and compete for the consumer's business. Nursing students are reviewing information about the changes in the healthcare industry and the effects on the scope of nursing practice. The students demonstrate understanding of this information when they identify which of the following as having significantly affected the delivery of home healthcare? a)Reduced emphasis for self-care Advances in technology Advances in medical technologies have allowed patients previously required to remain in institutional settings to receive the necessary healthcare services at home. The increased enrollment in managed care plans is driving healthcare services out of institutional settings and into the home. The burden of care is shifting to lay caregivers, and individuals are taking greater responsibility for making healthcare choices. Which of the following services can be provided through home health care?Patients can receive a wide range of services from home health agencies, including wound care, IV therapy, and pain management. In some cases, home health agencies may also offer social services and psychological support. Not all home health services are covered by insurance.
Which are home health services provided by the nurse select all that apply?Which are home health services provided by the nurse? Select all that apply. The nurse's role in home health services includes education, IV therapy, and nutritional therapy.
What is the purpose of home health care give an example?Examples of skilled home health services include:
Patient and caregiver education. Intravenous or nutrition therapy. Injections. Monitoring serious illness and unstable health status.
What is the most common diagnosis for home health care?The 5 Most Common Conditions that Lead to Home Health Care. Arthritis.. Heart Disease.. Cancer.. Respiratory Diseases.. Parkinson's.. |
Which client would be appropriate for home health care services select all that apply
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