Ch 38 Long-Term Care exam study guide 2024 with questions and answers already graded a+.

1. To help the resident preserve a meaningful quality of life in a long-term care setting, the nurse will implement a(n): a. patient care plan. b. individualized approach. c. psychologically approved approach. d. physician-approved approach. ANS: B Long-term care services are provided in a variety of settings and offer a broad spectrum of services. The specific setting used and services offered are based on the individual and unique needs of each patient. A patient-centered approach is needed to achieve and maintain an individualized approach and to assist the patient in preserving a meaningful quality of life. REF: Page 1193 TOP: Long-term care Step: Planning 2. The home health nurse is assisting a family to select a long-term care facility for an 80-year-old widow in good health who no longer drives, loves to play cards, can ambulate with a walker, and is oriented. The best selection for this patient would be: a. subacute unit setting. b. long-term care facility (nursing home). c. assisted living center. d. continuing care retirement center (CCRC). ANS: C The assisted living center provides meals, transportation, social interaction, and a home-like quality without the intrusion of the medical model. The patient's age does not make her a reasonable candidate for a CCRC. The patient does not require acute skilled nursing care. REF: Page 1197 TOP: Long-term care 3. The home health nurse helps an older adult couple plan changes in their home that will facilitate care in their home as they age. The nurse recognizes that what percentage of people over 65 live at home? a. 42% b. 48% c. 55% d. 67% ANS: D The majority (67%) of people over the age of 65 live in a home or family setting. REF: Page 1194 TOP: Long-term care 4. The nurse confirms that the cost of caring for a relatively unimpaired older adult in a private home is approximately what fraction of the cost of placing him or her in a long-term care facility? a. 1/4 b. 1/3 c. 1/2 d. 2/3 ANS: C It costs approximately half as much to care for an older adult at home as it would cost in a long-term care facility. REF: Page 1195 TOP: Long-term care 5. The nurse recognizes that services provided by home health care agencies are aimed at: a. self-care. b. assisted living. c. rehabilitation. d. improved function. ANS: C Services provided by home health care agencies are aimed at rehabilitation. REF: Page 1195 TOP: Home health 6. The nurse clarifies to the family of a patient that the role of the LPN/LVN in the home care setting is to be a resource person and to evaluate the care provided to the patient by: a. the family. b. other licensed care providers. c. nonlicensed staff. d. the physician. ANS: C One of the roles of the LPN/LVN in the home care setting may be to evaluate the care provided by CNAs, HHAs, homemakers, and personal care attendants. REF: Page 1196 TOP: Home health 7. The LVN/LPN informs the home health patient that the home health care RN provides many services, but is mainly employed by the home health agency in the capacity of: a. daily caregiver. b. care administrator. c. creator of policy and protocols. d. liaison between the agency and the state board. ANS: B The RN is also employed by the home health care agency as an administrator. REF: Page 1196 TOP: Home health 8. The family caring for an older adult in their home feels that they need assistance from a hospice service. The nurse instructs them that service can be initiated by: a. family request. b. patient request. c. medical certification. d. referral by a hospice nurse. ANS: C Hospice agencies provide care at the end of life. Medical certification is required for terminal care. REF: Page 1196 TOP: Hospice 9. The nurse suggests to a family caring for a member with early Alzheimer's disease in their home that they investigate the services of an adult day care center because such centers: a. will take patient out on recreational outings. b. can provide daily hygiene. c. expand social interaction. d. are free to the public. ANS: C Adult day care centers are open a large part of the day and offer several modalities to enhance social interaction and also give the family respite. REF: Pages TOP: Adult day care 10. The nurse differentiates the services of a long-term care facility from that of an assisted living facility, which supplies residents with: a. skilled nursing care. b. personal care services. c. weekly visits by the staff physician. d. intensive rehabilitation services. ANS: B Assisted living is a type of residential care setting where the resident receives personal care services. REF: Pages TOP: Long-term care 11. The nurse informs an older adult couple considering a continuing care retirement community (CCRC) that these facilities offer a complete range of health care services from independent living to 24-hour skilled nursing and that a contract with a CCRC is: a. limited to people who are relatively unimpaired. b. usually a lifetime commitment. c. an acceptable tax shelter. d. on a month-to-month basis. ANS: B In most cases, signing a contract with a CCRC is a lifetime commitment. REF: Page 1198 TOP: Long-term care 12. The LVN/LPN helps an 82-year-old patient recovering from a hip replacement understand that the remainder of her rehabilitation phase will not be spent in the acute hospital setting, but in a(n): a. subacute care unit. b. assisted living center. c. adult day care center. d. long-term care facility (nursing home). ANS: A Subacute units have a stronger rehabilitative focus. REF: Pages TOP: Subacute 13. The nurse explains that people in a long-term care facility are referred to as: a. patients because they will be receiving acute care. b. residents because the facility has become their home. c. patients because they seek professional medical services. d. customers because they are purchasing care service. ANS: B The older adult in a long-term care facility is referred to as a resident to reinforce the home-like environment. REF: Page 1199 TOP: Long-term care 14. The nurse assures a 50-year-old patient recovering from a stroke that because she is going to a long-term care facility for a short stay: a. her regular hospitalization insurance will pay for the care. b. she will still have daily physician visits. c. she will need to contract outside physical therapy services. d. she will probably be discharged within 6 months. ANS: D A short-stay resident in a long-term care facility for rehabilitation will have residential physical therapy services and will usually be discharged within 6 months. REF: Page 1199 TOP: Long-term care 15. In the long-term care facility, health care professionals work together to meet the needs of older adults and to go over the care plan with the resident and family members. This approach is called a(n): a. team approach. b. individualized approach. c. interdisciplinary approach. d. outgoing approach. ANS: C The long-term care facility is an interdisciplinary setting. REF: Page 1199 TOP: Long-term care 16. The nurse recognizes that there is a time limit for the legal administration of medications, which is: a. 30 minutes. b. 1 hour. c. 90 minutes. d. 2 hours. ANS: D In long-term care, there is a 2-hour window for legal administration of medications, 1 hour before and 1 hour after the official administration time. REF: Page 1200 TOP: Long-term care Step: Planning 17. When planning care in a long-term care facility, the nurse is aware of resident's rights as Omnibus Budget Reconciliation Act (OBRA) defines the requirements for: a. nursing care. b. nutritional support. c. quality of care. d. staffing requirements. ANS: C OBRA defines requirements for the quality of care given to residents of long-term care facilities. REF: Page 1201 TOP: Long-term care Step: Planning 18. The Health Care Financing Administration (HCFA) conducts unannounced institutional surveys annually to assess the quality of life for the patients, which is reported to: a. various licensing boards. b. facility administrators. c. the public. d. the U.S. Department of Health and Human Services. ANS: C Surveyors are required by law to visit the long-term care facility unannounced, on an annual basis and as needed, and the report is made public. REF: Page 1201 TOP: Long-term care 19. When a 48-year-old long-term care facility resident expresses concern over the cost of care that has used up his assets, the nurse suggests that to cover the continued cost of living in a long-term facility, the resident should apply for: a. Medicare. b. hospitalization insurance. c. Medicaid. d. public health funds. ANS: C When adults have used all of their assets, they may then qualify for Medicaid. REF: Page 1201 TOP: Long-term care 20. Although the Occupational Safety and Health Act (OSHA) increases the cost of care, it also specifies the requirements for safe: a. environment. b. medication administration. c. food preparation. d. ambulation and transportation. ANS: A The OSHA guidelines significantly increase costs, but they also ensure a safe environment, which is mandatory today. REF: Page 1201 TOP: Long-term care 21. The nurse helps the family understand that once hospice service is initiated, the focus of care changes from rehabilitation and restoration to that of: a. maintaining the patient at the optimal level. b. assisting with funeral planning. c. relieving the family of care. d. maintaining comfort as death approaches. ANS: D Hospice care is focused on the provision of comfort to the person who is approaching death. REF: Page 1196 TOP: Hospice 22. When the LVN/LPN completes the Resident Assessment Instrument (RAI), it must have the: a. Minimum Data Set (MDS) and the signature of the physician. b. Resident Assessment Protocols (RAPs) and the drug list. c. Minimum Data Set, Resident Assessment Protocols, and the RN's signature. d. Resident Assessment Protocols and the signature of the administrator. ANS: C The RAI must be signed by the RN and contain the RAPs and MDS. REF: Page 1202 TOP: Long-term care