Chapter 41: The Nurse in Home Health and Hospice Nursing School Test Banks
Stanhope: Public Health Nursing, 8th Edition
Chapter 41: The Nurse in Home Health and Hospice
1. Official agencies are financed primarily by:
b. Individual clients
c. Third-party payers
d. Tax funds
Official agencies are financed primarily by tax funds.
DIF: COG: Understanding REF: 894 OBJ: 1
2. Medicare-certified home health agencies place emphasis on _____ care.
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.
DIF: COG: Understanding REF: 895 OBJ: 1
3. 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.
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.
DIF: COG: Applying REF: 892 OBJ: 1
4. 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.
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.
DIF: COG: Applying REF: 895 OBJ: 1
5. 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
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.
DIF: COG: Analyzing REF: 896 OBJ: 1
6. 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
The focus of hospice care is comfort, peace, and a sense of dignity at a very difficult time. Comprehensive services emphasize continuity of care.
DIF: COG: Analyzing REF: 895 OBJ: 1
7. 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
Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability.
DIF: COG: Applying REF: 891 OBJ: 2
8. 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
Teaching the client and family to implement a therapeutic plan, such as taking medications, is an example of a skilled nursing service.
DIF: COG: Applying REF: 895 OBJ: 2
9. A nurse employed in home health nursing practice provides:
a. Intermittent nursing visits
b. Custodial care
c. Family caregiving
d. Palliative care
Provision of intermittent skilled visits is a component of home health care nursing.
DIF: COG: Applying REF: 894 OBJ: 2
10. 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
The American Nurses Association publishes scope and standards for Home Health Nursing and Hospice and Palliative Nursing.
DIF: COG: Understanding REF: 896 OBJ: 3
11. During the performance of which standard of care would the nurse discover the need for Meals on Wheels?
The nurse would discover the need for Meals on Wheels during the performance of the assessment.
DIF: COG: Applying REF: 896 OBJ: 3
12. 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
The Omaha System Problem Rating Scale for Outcomes uses the concepts of Knowledge, Behavior, and Status.
DIF: COG: Understanding REF: 898 OBJ: 4
13. After conducting a comprehensive client assessment, the nurse would organize information about the clients medication regimen into which domain of the Omaha System Problem Classification Scheme?
d. Health-related behaviors
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.
DIF: COG: Analyzing REF: 898 OBJ: 4
14. 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
The Omaha System Problem Classification Scheme is used to organize a comprehensive assessment according to four priority domains.
DIF: COG: Analyzing REF: 897 OBJ: 4
15. Why would a nurse use the Omaha System?
a. To define each health care providers role
b. To use nursing diagnoses in community health nursing practice
c. To foster collaborative practice
d. To provide practitioners a method for communication
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.
DIF: COG: Analyzing REF: 897 OBJ: 4
16. What action should a nurse take to facilitate interprofessional collaboration?
a. Understand who is in charge of the clients 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.
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.
DIF: COG: Analyzing REF: 905 OBJ: 5
17. 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.
After applying for accreditation, a lengthy self-study must be completed that addresses all aspects of the agencys operation. Following completion of the self-study, an accreditation team schedules a site visit.
DIF: COG: Applying REF: 904 OBJ: 5
18. A nurse uses the first stage of the Outcomes and Assessment Information Set (OASIS) outcomes analysis to:
a. Compare an agencys performance to a national sample.
b. Report data on patient care to a national registry.
c. Stabilize a clients condition to continue to receive funding.
d. Document client assessment data and findings.
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 clients condition.
DIF: COG: Analyzing REF: 904 OBJ: 5
19. 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
Medicare introduced regulations for home care practice as well as for reimbursement mechanisms.
DIF: COG: Understanding REF: 892 OBJ: 6
20. 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
Telehealth includes sharing health information between the client and clinicians using electronic communications.
DIF: COG: Applying REF: 908 OBJ: 6
1. 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.
DIF: COG: Applying REF: 893 OBJ: 1
2. 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.
DIF: COG: Remembering REF: 898 OBJ: 4
3. 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.
DIF: COG: Understanding REF: 906 OBJ: 6