Question 1

In addition to factual data such as name, address, and diagnosis, which of the following information is crucial to the nurse when a referral is received?

Accepted Answer

A)   The amount of reimbursement the agency will receive for a visit
B)   The family's reaction to the suggestion that a nurse visit in their home
C)   The purpose of the referral for a home visit
D)   The patient's agreement with the home visit referral C

Question 2

A nurse is going to visit a client who needs assistance with personal hygiene and feeding. Which of the following suggestions should be made to the family?

Accepted Answer

A)   "I'll teach you how to care for your family member to keep him comfortable or, if you can afford it, you can employ an aide."
B)   "It's important that he try to take care of himself and, if he can't or won't, he'll have to deal with the consequences."
C)   "Reimbursement is available for a nurse to come to the house each day if you would like this assistance."
D)   "You can always have your family member readmitted to the hospital for care." A

Question 3

A client was quite ill and the family was doing their best. After careful assessment and diagnosis, the home health nurse was setting priorities for care. Which of the following should be the basis for deciding which intervention to implement first?

Accepted Answer

A)   Address the problem that is easiest to fix first so the client and family could see some success fairly quickly
B)   Address the most serious problem first for the client's long-term health
C)   Address the problem that is partly causing other problems first
D)   Address the problem that the client and family think should be addressed first D

Question 4

Which of the following best describes why home health care has continued to grow until very recently? (Select all that apply.)

Accepted Answer

A)   Consumers prefer home care, so they will personally pay for it.
B)   Demographics-there are more elderly persons in U.S. society.
C)   Home care does not cost much more than institutional care.
D)   Insurance companies are encouraging home care.
E)   Medicare is encouraging home care rather than institutional care.F)  Physicians prefer to visit clients in their homes rather than institutions.

Question 5

Which of the following is the most important task to be accomplished during the initial home visit?

Accepted Answer

A)   Assess the client and the family
B)   Discuss social topics
C)   Educate the client and the family regarding the health problem
D)   Establish rapport and trust

Question 6

Which of the following is the primary factor in how a hospice nurse makes decisions while giving care in the client's home, surrounded by the client's family?

Accepted Answer

A)   To allow the patient a comfortable, pain-free death
B)   To assure the caregiver and the whole family that they are not hastening the client's death by anything they do to keep the client comfortable
C)   To encourage the family to grieve and confront the reality of the client being terminal
D)   To prevent a decline in the caregiver's health

Question 7

Which of the following 66-year-old clients who needs skilled nursing care would be eligible for home health care reimbursement by Medicare?

Accepted Answer

A)   A client who always worked for the state and enjoys going to the neighborhood coffee shop on a daily basis
B)   A client who needs his wounds cared for every day, including weekends, and needs the nurse to visit at 8 AM every day
C)   A client who is a loner and has no one to assist him except for the home care agency
D)   A client who is homebound and has a very strong support system
E)   A client who is an illegal immigrant who has lived in the United States for 25 years but begged the nurse not to tell

Question 8

A client needed a great deal of care. During a morning visit, the nurse shared information with the client's caregiver and demonstrated technical procedures. Which of the following is most important for the nurse to assess?

Accepted Answer

A)   Client response to the procedures
B)   How the client thought the goals were being achieved
C)   If the client and the caregiver retained all the information the nurse gave
D)   The skill and comfort level of the client's caregiver

Question 9

A nurse shared information with a family concerning a community resource, including a brochure with telephone number. The family agreed to follow up. Which of the following demonstrates to the nurse that the family wants to use those resources?

Accepted Answer

A)   If the agency calls the nurse to share that they will be offering services to the family
B)   If the family always agrees with the nurse's suggestions
C)   If the family asks the nurse to please call and set up the service
D)   If the family calls and sets up the service

Question 10

Which of the following best explains the purpose of the Outcome and Assessment Information Set (OASIS)?

Accepted Answer

A)   To analyze the cost-effectiveness of health agencies
B)   To evaluate and improve clinical performance quality
C)   To measure and publicize hospital data on outcomes such as death rates
D)   To survey patient satisfaction with care received from health agencies

Question 11

Which of the following is the best use of the nurse's time while en route to the client's home?

Accepted Answer

A)   Assess the surrounding neighborhood and the exterior of the client's home
B)   Begin the client record using a computer or oral recording device
C)   Look for appropriate places to obtain food, fuel, or rest stops for the nurse
D)   Consider if another home health agency would be closer to the client's home

Question 12

In which of the following ways is a hospice nurse different from any other nurse who provides care to a client in the context of their family and home environment? (Select all that apply.)

Accepted Answer

A)   Hospice nurses approach care in a holistic fashion.
B)   Hospice nurses continue to support the family after the client has died.
C)   Hospice nurses focus more on care and comfort than cure and control.
D)   Hospice nurses are expert in both physical and psychosocial care.
E)   Hospice nurses are more skilled at pharmaceutical pain management.F)  Some hospice nurses see patients at home and others in institutions.

Question 13

Which of the following should be included when the nurse writes a proposed treatment plan for a home health client?

Accepted Answer

A)   Outline of specific client goals with measurable outcomes
B)   Specific nursing interventions to treat identified client problems
C)   Type of services needed and frequency of visits by each discipline
D)   Typical nursing care plan information from assessment to evaluation

Question 14

Which of the following is required for an agency to receive reimbursement for care given from Medicare?

Accepted Answer

A)   Application for recognition including signing a contract with the federal government
B)   Application for reimbursement from Medicare using the appropriate federal forms
C)   Demonstrating meeting federal quality standards for Medicare-covered services
D)   Providing specialty care such as physical therapy

Question 15

Which of the following is the major assumption of Albrecht's conceptual model?

Accepted Answer

A)   Nurses are the only appropriate case managers for home health patients.
B)   Quality is best measured by using data from assessments, interventions, and outcomes.
C)   Patient outcomes depend primarily on the education and experience of the nurse.
D)   The most important outcome measure is the cost-effectiveness of the care given.

Question 16

A hospice patient is taking rather strong narcotics with good pain control, but today the patient's family tells the nurse that the client does not want to become addicted. Which of the following is the best response by the nurse?

Accepted Answer

A)   "But you're dying, what difference will it make if you become addicted?"
B)   "You can try not to take so much so frequently if you are concerned."
C)   "You may develop tolerance but you can't be addicted when you're using the medication for pain control."
D)   "You need strong narcotics to control your pain; we want to keep you comfortable."
E)   "We'll keep you comfortable using some nonnarcotic drugs if that is what you prefer."

Question 17

Which of the following best explains why home health care agencies that are part of national chains are doing better in the competitive marketplace than individually owned agencies?

Accepted Answer

A)   There is better media coverage and a nationally known "name" recognized by prospective clients.
B)   They are able to offer lower quality care using less well-prepared caregivers to ensure maximum profit.
C)   The chief executive officer usually has extensive experience and makes wise decisions.
D)   There are lower administrative costs and easier negotiating when buying in bulk.

Question 18

Although it was uncomfortable, a home health nurse finally learned to discuss finances with the client and family on the very first visit. Visits had to be reimbursed. Now that she is working for a different agency, funding was no longer such a concern. Which of the following offers the best explanation for this change?

Accepted Answer

A)   Because the nurse was an unpaid volunteer professional, visits made by that nurse had no cost to the agency.
B)   Only clients of high socioeconomic class were admitted for care, so the agency was always immediately reimbursed for care rendered.
C)   Taxpayers fund official (i.e., public)  home health agencies for care not reimbursed by third parties.
D)   The new agency has a large foundation that funds its activities from investment profits.

Question 19

Which of the following created the original expansion of home health care agencies? (Select all that apply.)

Accepted Answer

A)   Changes that decreased reimbursement for hospital-based care
B)   Cost containment in a managed care environment
C)   Meeting clients' preference for care in their homes, not institutions
D)   Offering new career opportunities for nurses who are tired of hospital nursing
E)   The requirement of third-party payers for care to be given in homesF)  So they could serve as a profitable revenue source

Question 20

A new home health nurse realized that what was being observed and now being said by the client were very inconsistent with what had been documented while the client was hospitalized. Which of the following conclusions should be drawn by the nurse?

Accepted Answer

A)   The amount of support available is different from what was stated earlier.
B)   The client had difficulty distinguishing truth from falsehood.
C)   The client had to admit the truth when it was obvious to the nurse.
D)   The family was embarrassed by their living situation.

Exam 33: Home Health and Hospice