2.Sample answers:
a.Knowledge and skills: Home care nurses must
have knowledge of legal regulations, physical
assessment, body mechanics, nursing diagnoses,
and infection control.
b.Independence: Home care nurses enjoy practic-
ing in an autonomous setting where they can
use their expertise in an expanded role.
c. Accountability: Home care nurses are
accountable to the patient, the family, and the
primary healthcare provider.
- a.Patient advocate: Protecting and supporting the
patient’s rights—the home care nurse helps a
patient prepare a living will.
b.Coordinator of services: The home care nurse is
the coordinator of all other healthcare providers
visiting the patient—the home care nurse helps
arrange for rehabilitation services for a stroke
patient.
c. Educator: Home care nurses spend time teaching
patients and families about the disease process,
nutrition, medications, or treatment and care of
wounds—the home care nurse teaches a patient
with diabetes about diet. - a.Wash hands before removing supplies from the
bag.
b.Anything the nurse takes out of the bag must be
cleaned before returning it to the bag.
c. Anytime the nurse needs to access the bag,
handwashing must take place first.
d.The bag should be placed on a liner before
setting it down in the patient’s home.
5.Teaching is geared to the patient’s readiness to learn
and adapted to the patient’s physical and emotional
status. Information that is essential to keep patients
safe until the next visit is the major focus. Teaching
is adapted to what works best in the home.
Incentives to learn include knowledge of serious
consequences as well as positive benefits of carrying
through with certain behaviors.
6.As healthcare continues to shift from the hospital
setting to community-based care, families will bear
the burden associated with this change. Patients are
discharged sooner with a higher acuity level; chron-
ically ill patients will need continued long-term
personal care at home not covered by Medicare.
7.Sample answer:
The nurse would work with an interdisciplinary
team of other healthcare professionals such as
social workers, pastoral counselors, home health
aides, and volunteers to provide comprehensive
palliative care. Emotional support would be
provided for the husband and children as well as
the patient, and pain and symptom management
would be conducted. The focus is on improving the
quality of life for the patient and preserving dignity
for the patient in death. Bereavement care would
continue for the family for 6 months after the
patient’s death.
REFLECTIVE PRACTICE USING CRITICAL
THINKING SKILLS
Sample Answers
1.What is the role of the home healthcare nurse in
providing continuity of care for Mr. Califano?
The home healthcare nurse must identify the needs
of the family and caregiver and assesses whether
the patient and family understand and agree with
the plan of care. The nurse can also help the patient
and family identify and use community resources
to meet various needs. If a caregiver is becoming
overwhelmed, the nurse can provide resources to
relieve the stress. In Mr. Califano’s case, the nurse
would need to coordinate care related to his
diabetes, hypertension, and renal disease.
2.What would be a successful outcome for this
patient?
Mr. Califano and his caretakers verbalize the home
treatment plan designed to care for his foot ulcers
and other related diabetic conditions.
Mr. Califano lists resources that may be contacted
to assist with care in the home setting as necessary.
3.What intellectual, technical, interpersonal, and/or
ethical/legal competencies are most likely to bring
about the desired outcome?
Intellectual: ability to incorporate knowledge of
the healthcare delivery system to meet the needs
of patients receiving care in the home
Technical: ability to adapt technical nursing
assistance as necessary for an older adult with
numerous health concerns
Interpersonal: ability to work with different
resources to ensure safe quality home care
Ethical/Legal: ability to practice in an ethically and
legally defensible manner in home settings
4.What resources might be helpful for Mr. Califano?
Community services, housekeeping services, home
healthcare services
CHAPTER 11
PRACTICING FOR NCLEX
MULTIPLE CHOICE QUESTIONS
1.c 2.a 3.b 4.c 5.d
6.c 7.d
ALTERNATE-FORMAT QUESTIONS
Multiple Response Questions
1.a, b, c
2.c, e, f
3.a, c, d, e
4.b, e, f
5.b, d, e
Prioritization Questions
1.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing:
ANSWER KEY 339
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