Chapter 02 Community-Based Nursing Practice

Chapter 02  Community-Based Nursing Practice

Multiple Choice

1. A community health nurse has scheduled a hypertension clinic. This service would be an example of which type of health care?
A) Tertiary prevention
B) Secondary prevention

C) Primary prevention D) Disease prevention

Ans: B
Chapter: 2
Client Needs: B
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process Objective: 2
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Feedback: Secondary prevention centers on health maintenance are aimed at early detection and prevention. Disease prevention is not a form of health care but is a focus with primary prevention.

2. The nursing instructor is preparing her students for their home-care rotation. She discusses the patients that they are likely to care for in the home. Which of the following are the most frequent users of home care services?
A) Disabled patients

B) Chronically ill patients C) Terminally ill patients D) Elderly patients

Ans: D
Chapter: 2
Client Needs: A-1
Cognitive Level: Comprehension Difficulty: Moderate
Integrated Process: Caring
Objective: 5
Page and Header: 16, Home Health Care

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.

3. Patients’ lifestyles in the home may vary greatly from the nurse’s own beliefs. To work successfully with the patient, what must the nurse do?
A) Ask for another assignment if there is a conflict of interest
B) Ask the patient to come to the agency to receive treatment

C) Convey respect for the patient’s beliefs
D) Adapt the patient’s home to a hospital-like environment

Ans: C
Chapter: 2
Client Needs: C
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Caring
Objective: 5
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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 nurse’s. This can be

difficult when a patient’s lifestyle involves activities that a nurse considers harmful or unacceptable, such as smoking, use of alcohol, drug abuse, or overeating. The other answers are incorrect because you do not request another assignment because of a difference in beliefs, nor do you ask for the patient to come to you if you are a home health nurse. It is also inappropriate to convert the patient’s home to a hospital-like environment.

4. Infection control is important in every setting where nursing care is provided. In the home setting, how will the nurse best implement infection control?
A) Cleanse the hands before and after giving direct patient care
B) Remove the patient’s wound dressings from the home

C) Dispose of patient’s syringes in the patient’s garbage D) Disinfect all work areas in the patient’s home

Ans: A
Chapter: 2
Client Needs: A-2
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process Objective: 2
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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 one’s hands before and after giving direct patient care, even in a home that does not have running water. The other answers are incorrect because removing the wound dressings from the home and disinfecting all work areas in the home are not the best implementation of infection control in the home. Disposing of syringes in the patient’s garbage is never done.

5. Your patient is ready to be discharged from the hospital. When should your patient’s discharge planning begin?
A) The day prior to discharge
B) The day of estimated discharge

C) The day the patient is admitted
D) Once the nurse determines care needs

Ans: C
Chapter: 2
Client Needs: A-1

Cognitive Level: Application Difficulty: Moderate
Integrated Process: Nursing Process Objective: 3

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Feedback: Discharge planning begins with the patient’s admission to the hospital and must consider the possible need for follow-up home care. The other answers are incorrect because they are not when discharge planning begins.