Study Guide for Fundamentals of Nursing The Art and Science of Nursing Care

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.

3. 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.


4. 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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