Exam (elaborations)
Chapter 36 Home Health Nursing
- Course
- Nursing
- Institution
- Western Piedmont Community College
Chapter 36 Home Health Nursing
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Chapter 36: Home Health NursingMULTIPLE CHOICE
1. What became effective in 1966 by an act of legislation that revolutionized home care?
a. Life insurance
b. Medicare
c. Private insurance
d. Social Security
ANS: B
When Medicare became effective in 1966, it revolutionized home care by changing it to a
medical rather than nursing model of practice, defining and limiting services it would
reimburse, and changing the payment source and even changing the reason home care was
provided.
PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1165
OBJ: 2 TOP: Home health KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
2. A major change to Medicare reimbursement was implemented in 1983. The new system paid a
set rate according to diagnosis. What was the new payment system based upon?
a. Interim payment systems
b. Diagnosis-related groups
c. Title XVIII
d. Title XIX
ANS: B
The new payment system introduced in 1983 provided reimbursement based upon set rates
that were determined by diagnosis-related groups (DRGs).
PTS: 1 DIF: Cognitive Level: Application REF: Page 1165
OBJ: 2 TOP: Home health KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
3. How often must the homecare treatment plan be recertified in order for the patient to continue
to receive services?
a. Every 3 days
b. Every 60 days
c. Every 10 days
d. Every 2 weeks
ANS: B
Medicare and Medicaid home care services are based on the medical model of treatment and
depend on the physician for entry into the formalized system. Medicare requires a plan of
treatment signed by the physician, outlining all disciplines, treatment, frequency, and duration.
These orders must be recertified every 60 days.
, MSC: NCLEX: N/A
4. Nurses who work in home settings rather than a hospital setting require a different level of
ability to be technically proficient, self-motivated, and innovative. This requires a higher level
of what quality?
a. Knowledge
b. Performance
c. Independence
d. Cooperation
ANS: C
The independence of home care practice can be difficult for nurses who depend on the
security of the institutional setting.
PTS: 1 DIF: Cognitive Level: Application REF: Pages 1169-1170
OBJ: 7 TOP: Home health KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
5. The LPN/LVN may provide many services to the patient in the home. Several of these are
high-level skills. Under whose supervision should these high-level skills be directed and
performed?
a. Physician
b. Family
c. Facility supervisor
d. RN
ANS: D
The LPN/LVN must always work under the supervision of an RN.
PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1170
OBJ: 7 TOP: Home health KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
6. For physical therapy services to be reimbursed by Medicare, what must be the goal of the
therapy?
a. Preventive
b. Restorative
c. Maintenance
d. Educational
ANS: B
The goals of treatment must be restorative in order for Medicare to provide reimbursement. In
some cases, the goals can be preventive or maintenance for other payer sources.
PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1171
OBJ: 5 TOP: Services KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
7. Speech therapy goals include minimizing speech disorders and maximizing rehabilitation of
speech abilities. To be reimbursed by Medicare, who must provide these services?
a. Bachelor‘s-level clinician
b. Speech therapist
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