Primary Care Interprofessional
Collaborative Practice and Care
Coordination Chapter 12 with
Complete Solutions
A client diagnosed with terminal leukemia is receiving home health care services to
assist in the client's care. After assessing the client, the home health care nurse
determines that the client is unable to afford needed medical supplies. Which is the best
strategy for the nurse to implement to assist the client?
-Enlist the services of the client's family for some components of care, such as dressing
changes and physical therapy.
-Discuss the client situation with the provider for possible therapies that are more cost-
conscious.
-Refer the client to a local religious organization or non-profit agency for support.
-Refer the client to a social worker to determine eligibility for assistance. - ANSWER-
Refer the client to a social worker to determine eligibility for assistance.
Explanation:
Social workers assist in finding and connecting the client with community resources or
financial resources and provide counseling and support. A social worker is better
equipped to find community resources or financial resources than a health care
provider. Discussing alternative therapies with the provider may be beneficial, but
typically this does not apply to some medical supplies that the client needs. Likewise,
having the client's family participate in dressing changes is helpful, but will not
particularly offset certain medical supplies that may be needed. Local non-profit
organizations and religious organizations may be able to offer some assistance, but a
social worker would be the best person to find resources and make referrals.
A client is receiving home health services after having a stroke and being hospitalized.
After a thorough assessment of the home environment and the client, what would
indicate to the nurse that there is an impairment in the client's home management?
-The client refuses to allow the caregiver to help the client sit up in bed.
-The client reports having slipped in the restroom the first night in the hospital.
-The home care nurse has to reschedule an appointment with the client.
-The client's caregiver is absent whenever the nurse visits and the client is alone. -
ANSWER-The client's caregiver is absent whenever the nurse visits and the client is
alone.
Explanation:
,The nurse determines that there is an impairment in home management when the
caregiver is not present to provide care to the client as well as answer questions
regarding the care of the client. Education should be able to be provided to the client
and caregiver. The nurse having to reschedule an appointment may occur for any
number of reasons, but the client should have support in the home even if the nurse is
unable to be there. Refusal of care does not indicate home management impairment.
Slipping in the hospital environment has no bearing on home management.
A client with severe congestive heart failure (CHF) has been referred to a long-term
care facility. The nurse is transferring care from the hospital setting to a long-term care
facility. Which action is a priority to ensure continuity of care for this client?
-Asking family members to meet with the social worker at the receiving facility prior to
the client's arrival.
-Notifying all departments of the room change.
-Discussing the move with both client and the family.
-Providing accurate and complete communication to the new facility. - ANSWER-
Providing accurate and complete communication to the new facility.
Explanation:
To ensure continuity of care for the client, the nurse should send a detailed assessment
and care plan from the hospital to the extended care facility. Frequently, the nurse at the
hospital provides a verbal report to the nurse at the new facility using the approved
handoff technique. Other departments at the hospital should be notified of the client's
discharge, but this does not affect the client's continuity of care. Discussing the move
with the client and family is important, but this does not ensure continuity of care. The
family members are asked to meet with the social worker but, again, this does not
ensure continuity of care.
A home health care nurse develops a client's individualized plan of care during the:
-referral process.
-pre-entry phase.
-entry phase.
-discharge planning. - ANSWER-entry phase.
Explanation:
Nurses provide home health care interventions during the entry phase, using an
individualized plan of care for each client based initially on identifying individualized
health care needs. In the entry phase, the nurse develops rapport with the client and
family, makes assessments, determines nursing diagnoses, establishes desired
outcomes (along with the client and family), plans and implements prescribed care, and
provides teaching. During the pre-entry phase, which includes the referral process, the
provider or discharge planner of a hospital contacts the home care facility and provides
a brief medical history, along with indications for home health services, and then the
referral nurse at the home care facility collects as much information as possible about
, the client's diagnoses, surgical experience, socioeconomic status, and treatments
ordered. Discharge planning occurs during the pre-entry phase and would be too soon
for creating a client's individualized plan of home health care, as the home health nurse
still needs to meet and assess the client and family first.
A home health care nurse is explaining to an emergency room nurse how nursing care
in the home setting differs from that in the hospital setting. Which statement by the
home health care nurse would be most appropriate?
-"The client and family are in control of the setting, not the nurse."
-"Each team member works independently of other team members."
-"You need a graduate degree to specialize in home health care."
-"It requires that you have high-level critical care skills." - ANSWER-"The client and
family are in control of the setting, not the nurse."
Explanation:
In home health care, the nurse is a "guest" in the client's home. Thus, the client and
family retain the power and control that they normally relinquish to providers in other
settings, such as an acute care facility. A generalist background and focus are useful,
as well as broad assessment skills and a knowledge base to provide clients with
appropriate education that will keep them as independent as possible. A graduate
degree or high-level critical care skills are not necessary. Collaboration among team
members is essential.
A home health client requires intravenous (IV) antibiotics every 4 hours. The client's
spouse asks to be taught how to administer the medication. Which nursing response is
indicated?
-"Since the medication is IV, it must be given by a nurse."
-"Let me teach you how to give this medication."
-"It will be better if a medication aide comes by to give the medication."
-"We will need special permission from the company for you to give the medication." -
ANSWER-"Let me teach you how to give this medication."
Explanation:
Family members or other caregivers may be taught any skill that they are able and
willing to perform. The nurse should teach the spouse, making certain to see a return
demonstration of technique. IV infusions do not require special permission for
medications to be given by family members, as long as family is taught. The medical
supply company does not provide permission for the administration of the medication.
The nurse provides the family and client teaching, not an aide.
A home health nurse uses different professional skills to achieve a successful care plan
for clients in their home setting. Which skill is of most importance to the nurse?
-Comprehensive health assessment
Collaborative Practice and Care
Coordination Chapter 12 with
Complete Solutions
A client diagnosed with terminal leukemia is receiving home health care services to
assist in the client's care. After assessing the client, the home health care nurse
determines that the client is unable to afford needed medical supplies. Which is the best
strategy for the nurse to implement to assist the client?
-Enlist the services of the client's family for some components of care, such as dressing
changes and physical therapy.
-Discuss the client situation with the provider for possible therapies that are more cost-
conscious.
-Refer the client to a local religious organization or non-profit agency for support.
-Refer the client to a social worker to determine eligibility for assistance. - ANSWER-
Refer the client to a social worker to determine eligibility for assistance.
Explanation:
Social workers assist in finding and connecting the client with community resources or
financial resources and provide counseling and support. A social worker is better
equipped to find community resources or financial resources than a health care
provider. Discussing alternative therapies with the provider may be beneficial, but
typically this does not apply to some medical supplies that the client needs. Likewise,
having the client's family participate in dressing changes is helpful, but will not
particularly offset certain medical supplies that may be needed. Local non-profit
organizations and religious organizations may be able to offer some assistance, but a
social worker would be the best person to find resources and make referrals.
A client is receiving home health services after having a stroke and being hospitalized.
After a thorough assessment of the home environment and the client, what would
indicate to the nurse that there is an impairment in the client's home management?
-The client refuses to allow the caregiver to help the client sit up in bed.
-The client reports having slipped in the restroom the first night in the hospital.
-The home care nurse has to reschedule an appointment with the client.
-The client's caregiver is absent whenever the nurse visits and the client is alone. -
ANSWER-The client's caregiver is absent whenever the nurse visits and the client is
alone.
Explanation:
,The nurse determines that there is an impairment in home management when the
caregiver is not present to provide care to the client as well as answer questions
regarding the care of the client. Education should be able to be provided to the client
and caregiver. The nurse having to reschedule an appointment may occur for any
number of reasons, but the client should have support in the home even if the nurse is
unable to be there. Refusal of care does not indicate home management impairment.
Slipping in the hospital environment has no bearing on home management.
A client with severe congestive heart failure (CHF) has been referred to a long-term
care facility. The nurse is transferring care from the hospital setting to a long-term care
facility. Which action is a priority to ensure continuity of care for this client?
-Asking family members to meet with the social worker at the receiving facility prior to
the client's arrival.
-Notifying all departments of the room change.
-Discussing the move with both client and the family.
-Providing accurate and complete communication to the new facility. - ANSWER-
Providing accurate and complete communication to the new facility.
Explanation:
To ensure continuity of care for the client, the nurse should send a detailed assessment
and care plan from the hospital to the extended care facility. Frequently, the nurse at the
hospital provides a verbal report to the nurse at the new facility using the approved
handoff technique. Other departments at the hospital should be notified of the client's
discharge, but this does not affect the client's continuity of care. Discussing the move
with the client and family is important, but this does not ensure continuity of care. The
family members are asked to meet with the social worker but, again, this does not
ensure continuity of care.
A home health care nurse develops a client's individualized plan of care during the:
-referral process.
-pre-entry phase.
-entry phase.
-discharge planning. - ANSWER-entry phase.
Explanation:
Nurses provide home health care interventions during the entry phase, using an
individualized plan of care for each client based initially on identifying individualized
health care needs. In the entry phase, the nurse develops rapport with the client and
family, makes assessments, determines nursing diagnoses, establishes desired
outcomes (along with the client and family), plans and implements prescribed care, and
provides teaching. During the pre-entry phase, which includes the referral process, the
provider or discharge planner of a hospital contacts the home care facility and provides
a brief medical history, along with indications for home health services, and then the
referral nurse at the home care facility collects as much information as possible about
, the client's diagnoses, surgical experience, socioeconomic status, and treatments
ordered. Discharge planning occurs during the pre-entry phase and would be too soon
for creating a client's individualized plan of home health care, as the home health nurse
still needs to meet and assess the client and family first.
A home health care nurse is explaining to an emergency room nurse how nursing care
in the home setting differs from that in the hospital setting. Which statement by the
home health care nurse would be most appropriate?
-"The client and family are in control of the setting, not the nurse."
-"Each team member works independently of other team members."
-"You need a graduate degree to specialize in home health care."
-"It requires that you have high-level critical care skills." - ANSWER-"The client and
family are in control of the setting, not the nurse."
Explanation:
In home health care, the nurse is a "guest" in the client's home. Thus, the client and
family retain the power and control that they normally relinquish to providers in other
settings, such as an acute care facility. A generalist background and focus are useful,
as well as broad assessment skills and a knowledge base to provide clients with
appropriate education that will keep them as independent as possible. A graduate
degree or high-level critical care skills are not necessary. Collaboration among team
members is essential.
A home health client requires intravenous (IV) antibiotics every 4 hours. The client's
spouse asks to be taught how to administer the medication. Which nursing response is
indicated?
-"Since the medication is IV, it must be given by a nurse."
-"Let me teach you how to give this medication."
-"It will be better if a medication aide comes by to give the medication."
-"We will need special permission from the company for you to give the medication." -
ANSWER-"Let me teach you how to give this medication."
Explanation:
Family members or other caregivers may be taught any skill that they are able and
willing to perform. The nurse should teach the spouse, making certain to see a return
demonstration of technique. IV infusions do not require special permission for
medications to be given by family members, as long as family is taught. The medical
supply company does not provide permission for the administration of the medication.
The nurse provides the family and client teaching, not an aide.
A home health nurse uses different professional skills to achieve a successful care plan
for clients in their home setting. Which skill is of most importance to the nurse?
-Comprehensive health assessment
