Chapter 2: Medical-Surgical Nursing
1. The nurse navigator is coordinating the transition from the hospital to a rehabilitation
facility of a client who had a total hip replacement. Which activity would be an example of
the nurse navigator role for this client?
A. Ensuring cost-effective care
B. Communicating with the medical insurance company
C. Educating the client on the goals of rehabilitation
D. Providing direct care to the client
ANS: C
Rationale: The role of the nurse navigator is to assist clients with transitions in different
levels of care, such as from the hospital to a rehabilitation facility. It is the role of a case
manager to ensure cost-effective care and to communicate with the medical insurance
company. The nurse navigator does not provide direct care to clients.
PTS: 1 REF: p. 35
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 2: Medical-Surgical Nursing
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice
2. The nursing instructor is preparing a group of students for their home care rotation.
Which of the following types of care are the students most likely to provide?
A. Primary care
B. Assistance with food shopping
C. Performing household chores
D. Skilled nursing care
ANS: D
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,Rationale: The role of the home health nurse is to provide skilled nursing care to clients.
The home health nurse does not provide primary care to the client as this is not within the
scope of practice of a nurse without an advanced practice certification. The home health
aide or other assistive person may help with household chores and shopping.
PTS: 1 REF: p. 49
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 2: Medical-Surgical Nursing
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice
3. The community health nurse is preparing to conduct a home visit on a client without an
active infection. When performing the home visit, how should the nurse best implement
the principles of infection control?
A. Perform hand hygiene before and after giving direct client care.
B. Remove the client's soiled wound dressings from the home promptly.
C. Use transmission-based precautions with the client.
D. Establish a sterile field in the client's home before providing care.
ANS: A
Rationale: Infection control is as important in the home as it is in the hospital. As in any
situation, nurses should clean the hands before and after giving direct client care.
Removing the wound dressings from the home is not necessary as long as they are
disposed of properly. Transmission-based precautions are only necessary when the client
is infected with an infectious organism. A sterile field is not necessary to provide routine
care.
PTS: 1 REF: p. 50
NAT: Client Needs: Safe, Effective Care Environment: Safety and Infection Control
TOP: Chapter 2: Medical-Surgical Nursing
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
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,4. An adult client with a history of diabetes is scheduled for a transmetatarsal
amputation. When should the client's discharge planning begin?
A. The day prior to discharge
B. The day of estimated discharge
C. The day that the client is admitted
D. Once the nursing care plan has been finalized
ANS: C
Rationale: Discharge planning begins with the client's admission to the hospital and must
consider the possible need for follow-up home care. Discharge planning should begin
prior to the other listed times.
PTS: 1 REF: p. 53
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 2: Medical-Surgical Nursing
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
5. A home health nurse is preparing to make the initial visit to a new client's home. When
planning educational interventions, what information should the nurse provide to the
client and family? Select all that apply.
A. Available community resources to meet their needs
B. Information on other clients in the area with similar health care needs
C. The nurse's contact information
D. Dates and times of scheduled home care visits
E. The goals of care established by the nurse
ANS: A, C, D
Rationale: The community-based nurse is responsible for informing the client and family
about the community resources available to meet their needs. During initial and
subsequent home visits, the nurse helps the client and family identify these community
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Join our community and turn your knowledge into income!
, services and encourages them to contact the appropriate agencies. The nurse also
provides the client with contact information so that the client and family know how to
reach the nurse with questions or a problem. The nurse also provides the client with a
schedule of futures visits so the client knows when to expect visits. Following HIPAA
guidelines the nurse is not able to share information on other clients. The goals for care
should be developed with the client and not by the nurse alone.
PTS: 1 REF: p. 51
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 2: Medical-Surgical Nursing
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Response
6. At the beginning of a day that will involve several home visits, the nurse has ensured
that the health care agency has a copy of the nurse's daily schedule. What is the rationale
for this action?
A. It allows the agency to keep track for billing purposes.
B. It supports safety precautions for the nurse when making a home care visit.
C. It allows for greater flexibility for the nurse and colleagues for changes in
assignments.
D. It allows the client to cancel or change appointments with minimal
inconvenience.
ANS: B
Rationale: Whenever a nurse makes a home visit, the agency should know the nurse's
schedule and the locations of the visits. The other answers are incorrect because
providing the agency with a copy of the daily schedule is not for the purpose of correctly
handling payment or for the ease of the nurse in changing assignments. It is also not
intended for the client's ease in cancelling appointments.
PTS: 1 REF: p. 51
NAT: Client Needs: Safe, Effective Care Environment: Safety and Infection Control
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1. The nurse navigator is coordinating the transition from the hospital to a rehabilitation
facility of a client who had a total hip replacement. Which activity would be an example of
the nurse navigator role for this client?
A. Ensuring cost-effective care
B. Communicating with the medical insurance company
C. Educating the client on the goals of rehabilitation
D. Providing direct care to the client
ANS: C
Rationale: The role of the nurse navigator is to assist clients with transitions in different
levels of care, such as from the hospital to a rehabilitation facility. It is the role of a case
manager to ensure cost-effective care and to communicate with the medical insurance
company. The nurse navigator does not provide direct care to clients.
PTS: 1 REF: p. 35
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 2: Medical-Surgical Nursing
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice
2. The nursing instructor is preparing a group of students for their home care rotation.
Which of the following types of care are the students most likely to provide?
A. Primary care
B. Assistance with food shopping
C. Performing household chores
D. Skilled nursing care
ANS: D
Discover more educational resources and start earning by selling your own documents at Schootex.com
Join our community and turn your knowledge into income!
,Rationale: The role of the home health nurse is to provide skilled nursing care to clients.
The home health nurse does not provide primary care to the client as this is not within the
scope of practice of a nurse without an advanced practice certification. The home health
aide or other assistive person may help with household chores and shopping.
PTS: 1 REF: p. 49
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 2: Medical-Surgical Nursing
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice
3. The community health nurse is preparing to conduct a home visit on a client without an
active infection. When performing the home visit, how should the nurse best implement
the principles of infection control?
A. Perform hand hygiene before and after giving direct client care.
B. Remove the client's soiled wound dressings from the home promptly.
C. Use transmission-based precautions with the client.
D. Establish a sterile field in the client's home before providing care.
ANS: A
Rationale: Infection control is as important in the home as it is in the hospital. As in any
situation, nurses should clean the hands before and after giving direct client care.
Removing the wound dressings from the home is not necessary as long as they are
disposed of properly. Transmission-based precautions are only necessary when the client
is infected with an infectious organism. A sterile field is not necessary to provide routine
care.
PTS: 1 REF: p. 50
NAT: Client Needs: Safe, Effective Care Environment: Safety and Infection Control
TOP: Chapter 2: Medical-Surgical Nursing
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
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Join our community and turn your knowledge into income!
,4. An adult client with a history of diabetes is scheduled for a transmetatarsal
amputation. When should the client's discharge planning begin?
A. The day prior to discharge
B. The day of estimated discharge
C. The day that the client is admitted
D. Once the nursing care plan has been finalized
ANS: C
Rationale: Discharge planning begins with the client's admission to the hospital and must
consider the possible need for follow-up home care. Discharge planning should begin
prior to the other listed times.
PTS: 1 REF: p. 53
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 2: Medical-Surgical Nursing
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
5. A home health nurse is preparing to make the initial visit to a new client's home. When
planning educational interventions, what information should the nurse provide to the
client and family? Select all that apply.
A. Available community resources to meet their needs
B. Information on other clients in the area with similar health care needs
C. The nurse's contact information
D. Dates and times of scheduled home care visits
E. The goals of care established by the nurse
ANS: A, C, D
Rationale: The community-based nurse is responsible for informing the client and family
about the community resources available to meet their needs. During initial and
subsequent home visits, the nurse helps the client and family identify these community
Discover more educational resources and start earning by selling your own documents at Schootex.com
Join our community and turn your knowledge into income!
, services and encourages them to contact the appropriate agencies. The nurse also
provides the client with contact information so that the client and family know how to
reach the nurse with questions or a problem. The nurse also provides the client with a
schedule of futures visits so the client knows when to expect visits. Following HIPAA
guidelines the nurse is not able to share information on other clients. The goals for care
should be developed with the client and not by the nurse alone.
PTS: 1 REF: p. 51
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 2: Medical-Surgical Nursing
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Response
6. At the beginning of a day that will involve several home visits, the nurse has ensured
that the health care agency has a copy of the nurse's daily schedule. What is the rationale
for this action?
A. It allows the agency to keep track for billing purposes.
B. It supports safety precautions for the nurse when making a home care visit.
C. It allows for greater flexibility for the nurse and colleagues for changes in
assignments.
D. It allows the client to cancel or change appointments with minimal
inconvenience.
ANS: B
Rationale: Whenever a nurse makes a home visit, the agency should know the nurse's
schedule and the locations of the visits. The other answers are incorrect because
providing the agency with a copy of the daily schedule is not for the purpose of correctly
handling payment or for the ease of the nurse in changing assignments. It is also not
intended for the client's ease in cancelling appointments.
PTS: 1 REF: p. 51
NAT: Client Needs: Safe, Effective Care Environment: Safety and Infection Control
Discover more educational resources and start earning by selling your own documents at Schootex.com
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