Chapter 24 Communicating for Continuity of Care

Chapter 24  Communicating for Continuity of Care

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. Which of the following best describes continuity of care?
a.
It involves only clients with acute physical conditions.
b.
It involves client-centered high-quality care across clinical settings.
c.
It should focus on episodic hospital care of seriously ill clients.
d.
Relational, informational, and functional are its key components.

ANS: B
Continuity of care (COC) is the term used to describe a multidimensional longitudinal construct in health care that emphasizes seamless provision, and coordination of client-centered quality care across clinical settings. Health care systems organized around acute, episodic care no longer suffice as a primary service model. The complexity of contemporary health care requires a different care process to match new health realities. There are several reasons: demographics of the population with greater ethnic and racial diversity, longer life spans, serious economic challenges, and health disparities associated with social determinants of health, globalization, and significant skilled provider shortages, most notably physicians and nurses. Technical and scientific advances have revolutionized the prevention, diagnosis, and treatment of acute illness. As people live longer, however, there is a higher incidence of chronic conditions requiring an array of supportive health care services. For these reasons, and more, focus on care provision has shifted from the hospital to the community and a public health emphasis. The three key features of relational, informational, and managerial continuity provide a conceptual framework for study and application of COC strategies.

DIF: Cognitive Level: Application REF: p. 471
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Management of Care

2. A nurse has been employed as a staff nurse for 20 years. When comparing her current clients to those she cared for at the beginning of her career, the nurse finds that clients today are
a.
being discharged later.
b.
coping with being discharged earlier.
c.
dealing with simpler medication and treatment regimens.
d.
significantly healthier at the time of discharge.

ANS: B
Clients are discharged earlier and sicker, often with complex medication and treatment regimens to be followed in the community in primary care settings.

DIF: Cognitive Level: Application REF: p. 469
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Management of Care

3. A nursing instructor is educating a student nurse about bridging the gap between diminishing financial support for chronic care and multifaceted health care demands that can be long lasting. The instructor recognizes that further teaching is warranted when the student nurse lists which of the following as an indispensable means for accomplishing this?
a.
Self-management
b.
Family involvement
c.
Shared decision making
d.
Family nonengagement

ANS: D
Empowering individuals and families to assume primary responsibility for self-management of chronic illness in partnership with ongoing professional support is a critical means of bridging the gap between diminishing financial support for chronic care and multifaceted care demands that can last for years. Relevant primary care strategies focus on client-centered care, collaborative goal setting, problem solving, and coordinated follow up.

DIF: Cognitive Level: Application REF: p. 481
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Management of Care

4. The nurse is caring for a client with a chronic health condition. The nurse recognizes that in order to achieve high-quality health outcomes for this client, which of the following should occur?
a.
Clients and families must have consistency of personnel.
b.
Clients and families must have irresponsible relationships.
c.
Clients and families should be provided with vague information.
d.
Ongoing collaborative support from coordinated health services is discouraged.

ANS: A
Consistency of personnel over time allows clients and the professional team to share a stronger investment in achieving personalized, high-quality health outcomes. Providers and clients learn to know, value, and respect each other.

DIF: Cognitive Level: Application REF: p. 475
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Management of Care

5. The nurse is caring for a client who will be transferred from the hospital unit to an acute rehabilitation facility. In order to ensure continuity of care for the client, the nurse should
a.
manage continuity through a rigid approach.
b.
communicate infrequently with the health care team.
c.
use a shared management plan when providing health services.
d.
prohibit sharing information about the client in order to abide by HIPAA regulations.

ANS: C
Continuity of care contributes to the development of:
• Increased accessibility to coordinated health care services with a smoother flow of care from one service area to another
• Personalization of care to meet a client’s changing needs across delivery systems
• Informational data sharing of various elements of personal and medical data electronically over time and place, which contributes to appropriate care delivery
• Health services provided in an organized, logical, and timely manner, using a shared management plan

DIF: Cognitive Level: Application REF: p. 470
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Management of Care