BRUNNER AND SUDDARTHS TEXTBOOK OF MEDICAL SURGICAL NURSING 14TH EDITION HINKLE TEST BANK

Chapter 02: Community-Based Nursing Practice 1. A community health nurse has scheduled a hypertension clinic in a local shopping mall in which shoppers have the opportunity to have their blood pressure measured and learn about hypertension. This nursing activity would be an example of which type of prevention activity? A) Tertiary prevention B) Secondary prevention C) Primary prevention D) Disease prevention Ans: B Feedback: Secondary prevention centers on health maintenance aim at early detection and prevention. Disease prevention is not a form of health care but is a focus on primary prevention. 2. The nursing instructor is preparing a group of students for their home care rotation. In preparation, the group discusses the patients that they are most likely to care for in the home. Which of the following groups are the most common recipients of home care services? A) Mentally ill patients B) Patients receiving rehabilitation after surgery C) Terminally ill and palliative patients D) Elderly patients Ans: D Feedback: The elderly are the most frequent users of home care services. The patient must be acutely ill, home bound, and in need of skilled nursing services to be eligible for this service. The other answers are incorrect because it is the elderly who are seen most frequently in the home health setting, though each of the other listed groups may sometimes receive home care. 3. A recent nursing graduate has been surprised at the sharp contrast between some patients lifestyles in their homes and the nurses own practices and beliefs. To work therapeutically with the patient, what must the nurse do? A) Request another assignment if there is dissonance with the patients lifestyle. B) Ask the patient to come to the agency to receive treatment, if possible. C) Resolve to convey respect for the patients beliefs and choices. D) Try to adapt the patients home to the norms of a hospital environment. Ans: C Feedback: To work successfully with patients in any setting, the nurse must be nonjudgmental and convey respect for patients beliefs, even if they differ sharply from the nurses. This can be difficult when a patients lifestyle involves activities that a nurse considers harmful or unacceptable, such as smoking, use of alcohol, drug abuse, or overeating. The nurse should not request another assignment because of a difference in beliefs, nor do nurses ask for the patient to come to you at the agency to receive treatment. It is also inappropriate to convert the patients home to a hospital-like environment. 4. Infection control is a high priority in every setting where nursing care is provided. When performing a home visit, how should the nurse best implement the principles of infection control? A) Perform hand hygiene before and after giving direct patient care. B) Remove the patients wound dressings from the home promptly. C) Disinfect the patients syringes prior to disposal. D) Establish a sterile field in the patients home before providing care. Ans: A Feedback: Infection control is as important in the home as it is in the hospital, but it can be more challenging in the home and requires creative approaches. As in any situation, it is important to clean ones hands before and after giving direct patient care, even in a home that does not have running water. Removing the wound dressings from the home and disinfecting all work areas in the home are not the best implementations of infection control in the home. Used syringes are never disinfected and a sterile field is not always necessary.