NUR 109 - Week 5 Exam Prep Questions and Answers,100% CORRECT

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NUR 109 - Week 5 Exam Prep Questions and Answers Which are effective ways for the RN to support the caregivers in the home setting? Select all that apply. Arrange for a home health aide. L... isten to the caregivers. Provide critique on errors. Focus on the patient needs Help identify other caregivers. What will the RN assess when conducting an admission home visit for a new patient? Select all that apply. Presence or absence of running water. Level of nursing care needed. Patient’s understanding of treatment plan. Mental status of the patient. Satisfaction of patient with hospital care. The OASIS assessment involves assessing all the factors except satisfaction with hospital care. Reference Treas (2018), p. 1620; Hinkle (2018), p. 20-23. Which nursing intervention will the home care RN perform to reduce infection risk for the patient? Store needed supplies in spare room of the dwelling. Use a 1:2 dilution of chlorine bleach to disinfect items. Teach patient to dispose of syringes in household garbage bags. Provide own infection control supplies to use on visit. Supply storage does not indicate method that will decrease infection. Chlorine solution should be 1:10 dilution. Syringes should be discarded in sharps container or a solid covered container such as plastic laundry container. It is necessary for RN to bring own hand washing and infection control supplies rather than assume patient will have them. Reference Treas (2018), p. 1623-1624, 162. Which action used by the RN helps to maintain infection control in a home visit? Use of bar soap when hands are visibly soiled. Use of a 1:5 dilution of chlorine bleach in water to disinfect surfaces. Place saturated wound dressings in a plastic lined waste can. Schedule home visit last for patients with multidrug-resistant infections Avoid using patients’ bar soap, that may harbor organisms. Patients with more infection prone illness should be seen at end of day to decrease transmission to another ill patient. The chlorine solution of 1:10 dilution, not 1:5 dilution is appropriate to use for disinfection in home setting. Dressings should be double bagged when saturated. Reference: Treas (2018), p. 1628. The medication order for a patient in the home reads: Morphine 0.1mg/kg every three (3) hours as needed for acute pain. The patient weighs 46 kilograms. The pharmacy label reads: Transcript: Morphine Sulfate Injection, USP. 2 mg/mL How many mL per dose will the RN administer? Record your answer using the principles of safe medication documentation. Write only the number; do not include words or abbreviations in your answer. Use a decimal, instead of a fraction, if required. (For example, write 0.5 instead of ½.) mL Answer 1: 2.3 1. Multiply dose times kg (46 X 0.1 = 4.6mg) Ordered (4.6mg) x Volume you have (1mL) On hand (2mg) Reference: Treas (2018), p. 787, 788. The hospital RN is discharging an older adult patient, newly diagnosed with diabetes. The patient has spoken positively about the parish nurse from church. Which role would be most appropriate for the parish nurse to fulfill for the patient? Evaluate the patient’s insulin administration method. Transport the patient to diabetes teaching classes. Plan meals within ordered dietary restrictions. Advise patient of resources and make further referrals. The parish nurse role is not one of providing hands on care to people; they make referrals to other health care providers, educate and support the people. Reference: Treas (2018), p. 1611. The home healthcare RN is finishing patient visits and going home. The RN has the computer and supplies in the car. Which action by the RN is most appropriate? Leave computer and supplies in car Leave computer and supplies in locked car. Remove computer from car and bring in. Remove supplies from car and bring in. HIPAA rights are most protected if the RN always has direct view and control of record or computer with patient information. Reference: Hinkle (2018), p. 21. Which is an appropriate personal safety precaution for the RN to take when caring for a client in the home? Protect client from dangerous family member, then leave the home. Park the car in a lighted area regardless of the distance from the home. Try to schedule visits in the daylight hours whenever this is possible. Alert own family member of your daily schedule and locations for contact. If safety of RN is at risk, leave the home first; park in a well light area close by. Alert the agency of schedule and locations but not the RN’s family. Reference Hinkle (2018), p. 22. What nursing intervention best illustrates the protection of patient confidentiality while providing quality care on the home visit? Only providing information to the patient’s family during the home visit. Leaving the patient’s chart in the trunk of the car before entering the home. Allowing the neighbors into the home during the visit to discuss the situation. Placing the medical record in a secure place within the home for use and reference. The home care patient has a right to confidentiality and information should only be shared with patient permission and with those needing to know, such as caregivers. The RN may need the chart; therefore, leaving it in the trunk may not be the best intervention. Allowing the neighbors into the home does not respect the patient’s privacy. Reference: Hinkle (2018), p. 21. The RN has set up home health aide services to assist the patient with personal hygiene and housekeeping needs. The patient is a private person and lives alone in a new city. The RN anticipates these personal care needs will persist beyond home care discharge. What resources will the RN utilize to assist patient to find long term support with this? Consult community resources directory for providers. Discuss the patient’s needs with a senior citizen center. Encourage family members to provide care. Suggest current aide might do it long term. The only practical plan to assist patient to arrange on going home aide services is by using a community resource directory. The other options may violate HIPAA and put the current aide in an awkward position. Reference: Hinkle (2018), p. 19, 20. Which example is a tertiary intervention the community-based RN would do? Educating the patient on long term low sodium diet. Immunizing patients for measles, mumps, and rubella. Developmental screening for school-aged children. Teaching of dental care: brushing and flossing twice daily Tertiary interventions involve stopping disease progression and rehabilitation. Primary interventions involve prevention; secondary intervention involves screening and early treatment. Reference: Treas (2018), p. 1609. Which patient is likely to have Medicare cover home health services? School aged child needing glasses and hearing aids Ill adult with low income with new medical diagnosis. Older retired adult with chronic disease management Elderly person needing homemaker services. Medicare coverage is for those who are retired or disabled or have end stage renal disease and have skilled need (not homemaker services). Medicaid provides coverage for those with low incomes. Reference: Treas (2108), p. 1618. Which assessment will the home health care RN perform during an initial home visit to assess the patient’s mental status? Degree of fatigue and report of pain. Forgetfulness or limited attention span. Prognosis of disease and rehabilitative potential. Presence of willing and able care providers. Assessments other than forgetfulness and attention span do not relate to mental status, although they would be assessed. Reference: Hinkle (2018), p. 23. Which nursing care would be appropriate when planning home care for the more common needs of an older adult? Select all that apply. Refer to a mental health program. Provide nutrition information Develop an exercise plan. Arrange for alcohol support group. Conduct vision screening exam. The medication for the patent in the home reads: lorazepam (Ativan) oral concentrate 3 mg by mouth every 4 hours for terminal restlessness. The pharmacy label reads: Transcript: LORAZEPAM ORAL CONCENTRATE, USP. 2mg/mL. Each mL contains: Lorazepam 2 mg How many mL per dose will the RN administer? Record your answer using the principles of safe medication documentation. Write only the number; do not include words or abbreviations in your answer. Use a decimal, instead of a fraction, if required. (For example, write 0.5 instead of ½.) mL Answer 1: 1.5 Ordered (3mg) On hand(2mg) x Volume you have (1mL) Answer: 1.5mL Reference: Treas (2018), p. 787, 788. Which patient group does the RN recognize has increased vulnerability? Patients with chronic illness. Those with some social support. Those 30 to 55 years of age. Those with a moderate income. Vulnerable groups are: Chronically ill, low income, limited social resources, young & old, and abuse or trauma victims. Reference: Treas (2018), p. 1607. Why is family involvement with patient care so important with home health nursing? Because the RN will not always be present, when the patient needs care in the home. Family members may want to be involved with patient and caregiving allows this. The RN must decide if the family members are able to provide the needed care. The community-based RN has limited visits per admission after hospital discharge. The RN role is intermittent and coordinating, but not to be the provider of all care. Visit # is based upon needs, not set per admission. Main priority is ensuring caregiver available to provide care. Reference: Hinkle (2018), p. 21-23. Where do community-based RNs practice? Select all that apply. Private homes. Houses of religious worship. Community physician offices. Private and public schools. Local emergency department. Which characteristics describe the successful qualities of an RN who provides home healthcare? Works as a team member, likes continual direction and instruction. Skilled in a specific area of nursing, recent graduate from nursing school. Independent, knowledgeable, accountable, and caring. Introverted, prefers swift completion of skills such as dressing changes. The home care RN needs to be able to work independently and have experience to support the independent nature of the role. Reference: Treas (2018), p. 1617; Hinkle (2018), p. 19. The home health nurse is visiting a prenatal adolescent patient on bed rest. The parents are at work all day and her siblings are in school. Which nursing diagnosis label or patient problem might the home health nurse anticipate? Social isolation. Ineffective coping. Impaired physical mobility. Altered nutrition: less than body requirements. Social Isolation can be a major problem for the adolescent. Feelings of fear, boredom and separation anxiety may be expressed by isolated teens. Reference: Silbert-Flagg (2018) p. 61-62. Quiz Score: 96.25 out of 100 [Show More]

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