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NUR 4150-COMMUNITY EXAM QUESTIONS COMBINED 2.
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NUR 4150-COMMUNITY EXAM QUESTIONS COMBINED 2.
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[Document title]COMMUNITY EXAM QUESTIONS COMBINED 2.
1. A community health nurse has scheduled a HTN clinic. This service would be an example of which type of health care?
A) Tertiary prevention B) Secondary prevention C) Primary prevention D) Disease prevention
~ Secondary prevention centers on health maintenance are aimed at early detection & prevention. Disease prevention is not a form of health
care but is a focus w/primary prevention.
2. The nursing instructor is preparing her students for their home-care rotation. She discusses the Pts that they are likely to care for in
the home. Which of the following are the most frequent users of home care services?
A) Disabled Pts B) Chronically ill Pts C) Terminally ill Pts D) Elderly Pts
~ The elderly are the most frequent users of home care services. The Pt must be acutely ill, home bound, & in need of skilled nursing services
to be eligible for this service. The other answers are incorrect b/c it is the elderly who are seen most frequently in the home health setting.
3. Pts' lifestyles in the home may vary greatly from the nurse's own beliefs. To work successfully w/ the Pt, what must the nurse do?
A) Ask for another assignment if there is a conflict of interest
B) Ask the Pt to come to the agency to receive treatment
C) Convey respect for the Pt's beliefs
D) Adapt the Pt's home to a hospital-like environment
~ To work successfully w/Pts in any setting, nurse must be nonjudgmental & convey respect for Pts' beliefs, even if they differ sharply from
the nurse's. This can be difficult when a Pt's lifestyle involves activities that a nurse considers harmful or unacceptable, such as smoking, use
of alcohol, drug abuse, or overeating. The other answers incorrect b/c you do not request another assignment b/c of a difference in beliefs, nor
do you ask for Pt to come to you if you are a home health nurse. It also inappropriate to convert the Pt's home to a hospital-like environment.
4. Infection control important in every setting where nursing care provided. In home setting, how will nurse best implement infection
control? A) Cleanse the hands before & after giving direct Pt care B) Remove the Pt's wound dressings from the home
C) Dispose of Pt's syringes in the Pt's garbage D) Disinfect all work areas in the Pt's home
~ Infection control is as important in the home as it is in the hospital, but it can be more challenging in the home & requires creative
approaches. As in any situation, it is important to clean one's hands before & after giving direct Pt care, even in a home that does not have
running water. The other ans are incorrect b/c removing the wound dressings from the home & disinfecting all work areas in the home are not
the best implementation of infection control in the home. Disposing of syringes in the Pt's garbage is never done.
5. Your Pt is ready to be discharged from the hospital. When should your Pt's discharge planning begin?
A) The day prior to discharge B) The day of estimated discharge C) The day the Pt is admitted D) Once the nurse determines care needs
~ Discharge planning begins w/ the Pt's admission to the hospital & must consider the possible need for follow-up home care.
6. During the initial visit to a Pt's home, what information is it important to provide to the Pt &
family? A) Available community resources to meet their needs
B) Information on other Pts in the area w/ similar health care needs
C) The nurse's home address & phone number
D) Dates & times of all scheduled home care visits
~ The community-based nurse is responsible for informing Pt & family about community resources available to meet their needs. During
initial & subsequent home visits, nurse helps Pt & family identify these community services & encourages them to contact the appropriate
agencies. When appropriate, nurses may make the initial contact. The other ans incorrect b/c it is inappropriate to ever provide info on other
Pts to a Pt; it is equally inappropriate for a nurse to give her Pts her home address or phone number. Giving the Pt the dates & times of their
scheduled home visits is appropriate, but it is more important to provide them w/ resources available w/in the community to meet their needs.
7. The home health nurse receives a referral from the hospital for a Pt who needs a home visit. After reading the referral, what would be the
first action the nurse should take?
A) Identify community services to initiate for the Pt B) Obtain a physician's order for the visit
C) Call the Pt to obtain permission to visit D) Schedule a home health aide to visit the Pt
~ After receiving a referral, the first step is to call the Pt & obtain permission to make the visit. Then the nurse should schedule the visit &
verify the address. A physician's order is not necessary to schedule a visit w/ the Pt. The nurse may identify community services or the need
for a home health aide after she assesses the Pt & the home environment during the first visit w/ the Pt.
8. Why is it important for the nurse to inform the health care agency of her daily schedule?
A) Allows the agency to keep track for payment of the nurse
B) Supports suggested safety precautions for the nurse when making a home care visit
C) Allows easy accessibility of the nurse for changes in assignments
D) Allows the Pt to cancel appointments w/ minimal inconvenience
~ Whenever a nurse makes a home visit, the agency should know the nurse's schedule & the locations of the visits. The other answers are
incorrect b/c providing the agency w/ a copy of the daily schedule is not for the purpose of correctly paying the nurse or for the ease of the
nurse in changing assignments or for the Pt's ease in canceling appointments.
9. There are specific guidelines & regulations for documentation related to home care that the nurse must consider & follow. For those Pts
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w/ Medicaid, what is most important for the nurse to document to assure reimbursement for services?
A) The medical diagnosis & supplies needed to care for the Pt
B) Directions to the Pt's home
C) Quality of nursing care needed
D) The Pt's homebound status & the need for skilled professional nursing care
~ Medicare, Medicaid, & 3rd party payers require documentation of Pt's homebound status & the need for skilled professional nursing care.
The medical diagnosis & specific detailed information on the functional limitations of the Pt are usually part of the documentation. The other
answers are incorrect b/c nursing documentation does not include needed supplies, directions to the Pt's home, or the quality of care needed.
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10. Your Pt has had a total knee replacement & will need to walk w/ crutches for 6 weeks. He is being discharged home w/ a referral for
home health care. What will the home care nurse need to assess during her initial assessment?
A) Assistance of neighbors B) Previous health status C) Costs of the visits D) Home environment
~ The initial assessment includes evaluating the Pt, the home environment, the Pt's self-care abilities or the family's ability to provide care, &
the Pt's need for additional resources. There is no assessment made of assistance on part of neighbors, previous health status, or costs of visit.
11. RN w/an advanced degree in primary care for a pediatric population is employed in health clinic. In what role is this RN
functioning? A) Nurse practitioner B) Case cocoordinator C) Clinical nurse specialist D) Clinic supervisor
~ Nurse practitioners, educated in primary care, often practice in ambulatory care settings that focus on gerontology, pediatrics, family or
adult health, or women's health. Case cocoordinators & clinic supervisors do not require an advanced degree, & a clinical nurse specialist is
not educated in primary care.
12. A nurse working in a large meat-packaging plant sees Pts for work-related issues. What is the role of the nurse?
A) Occupational health nurse B) Staff nurse C) Nurse clinician D) Nurse educator
~ Occupational health nurses may provide direct care to Pts who are ill, conduct health education programs for the industry staff, or set up
health programs. The other ans incorrect b/c they are not consistent w/ a nurse's placement in a manufacturing setting.
13. A school nurse is concerned about a 4th grade student w/CF. Nurse is aware that children w/ health problems are at major risk for what?
A) Sports injuries
B) Attention disorders
C) Experiencing school-related stress due to a desire to
overachieve D) Underachieving or failing in school
~ School-aged children & adolescents w/ health problems are at major risk for underachieving or failing in school. The other answers are
incorrect b/c they are not at major risk for sports injuries, attention disorders, or a desire to overachieve.
14. Which Pts seek health care late in the course of their disease process & deteriorate more quickly than other
Pts? A) Homeless B) Immigrants C) Elderly D) Adolescents
~ B/c of numerous barriers, the homeless seek health care late in the course of a disease & deteriorate more quickly than Pts who are not
homeless. Many of their health problems are related in large part to their living situation. The other answers are incorrect b/c these
populations do not seek care late in the course of their disease process & deteriorate quicker than other populations.
15. What changes in the health care system have created an increased need for nurses to practice in community-based settings?
(SATA) A) Tighter insurance regulations
B) Younger population
C) Increased rural population
D) Changes in federal legislation
E) Decreasing hospital revenues
~ Changes in federal legislation, tighter insurance regulations, decreasing hospital revenues, & alternative health care delivery systems have
also affected the ways in which health care is delivered. Our country does not have an increased rural population nor is our population
younger so these answers are incorrect.
16. Nurses are now working in ambulatory health clinics, hospice settings, & homeless shelters & clinics. What has influenced this
increase in practice settings for nurses?
A) Population shift to more rural areas B) Shift of health care delivery into the community
C) Advent of primary care clinics D) Increased use of rehabilitation hospitals
~ As health care delivery shifts into the community, more nurses are working in a variety of community-based settings. These settings include
public health departments, ambulatory health clinics, long-term care facilities, hospice settings, industrial settings (as occupational nurses),
homeless shelters & clinics, nursing centers, home health agencies, urgent care centers, same-day surgical centers, short-stay facilities, & Pts'
homes. The other answers are incorrect b/c our population has not shifted to more rural area, & the use of primary care clinics has not
influenced an increase in practice settings or the use of rehabilitation hospitals.
17. What is the focus of community-based nursing?
A) Community health
B) Maintaining & improving the health of the community
C) Promoting & maintaining the health of individuals & families
D) Family health
~ This nursing practice focuses on promoting & maintaining health of individuals & fams, preventing & minimizing progression of disease,
& improving quality of life. Its focus not really community health, maintaining or improving health of a community, or family health per se.
18. You are the community-based nurse who acts as case-manager for a small town about 60 miles from a major health care center. What
is the most important factor of community-based nursing you should be knowledgeable about?
A) Eligibility requirements for services
B) Community resources available to Pts
C) Transportation costs to the medical center
D) Possible charges for any services provided
~ A community-based nurse must be knowledgeable about community resources available to Pts as well as services provided by local
agencies, eligibility requirements, & any possible charges for the services. The other answers are incorrect b/c they are not the most important
factor for a community-based nurse to be knowledgeable about.
19. A new community-based nurse is looking for community resources for one of her Pts. Where would be the best place to look?
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A) Hospital directories B) Telephone book C) Community directories D) Church directories
~ Most communities have directories of health & social service agencies that the nurse can consult. The other answers are incorrect b/c
hospital directories usually only include people affiliated w/ the hospital, & neither telephone books nor church directories are meant to be
directories of community resources.
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