BIO 102. Medical-Surgical Nursing Critical Thinking in Client Care, 4th Edition Chapter 3

Medical-Surgical Nursing Critical Thinking in Client Care, 4th Edition Priscilla LeMon

Chapter 3

1. A nursing student is reading about the concept of parish nursing. Which of the following statements indicates understanding of the key concepts of parish nursing? 

1. “You must practice a certain faith to be involved in parish nursing.”

2. “Parish nurses are independent practitioners providing care to members of a selected church.”

3. “Parish nursing is reserved for nurse practitioners.”

4. “Parish nurses may be employed by a hospital.”

2. The mother of a severely handicapped child states she is exhausted and voices the need to “take a break” to the nurse. What type of referral would best benefit the client?

1. A respite care provider

2. Hospice care agency

3. Home care

4. Ambulatory clinic

3. The client who lives alone indicates concerns about their ability to perform the necessary dressing changes after discharge. Which action by the nurse is indicated at this time?

1. Explain to the client that she will need to seek the assistance of a friend or neighbor to help as needed.

2. Make a referral to the home healthcare agency preferred by the client.

3. Contact the hospital social worker.

4. Discuss the client’s anticipated needs with the physician.

4. The nurse is evaluating a group of clients for referral to a home health agency. Each of the clients is on the Medicare program. Which client is most likely to qualify for home health services?

1. The postoperative client needing reevaluated by the physician six weeks postoperatively

2. The client having a moderate-sized stage III pressure ulcer requiring daily dressing changes

3. The bedridden client who’s physician has prescribed oral antibiotic therapy for two weeks

4. The client having large stage I pressure ulcer

5. During a home care visit, the nurse notices the client’s dressing supplies are not being kept in a readily assessable environment. The nurse has discussed this with the client and family in previous visits. What action by the nurse is indicated?

1. Document the activities relating to the situation.

2. Continue to discuss the issues each visit.

3. Notify the physician.

4. Take the supplies and arrange to bring them back with each visit.

6. While conducting a home health care visit, the nurse is asked to administer insulin to the client’s ailing husband. What action by the nurse is indicated?

1. The nurse should refuse to administer the medication.

2. The nurse may agree to assist with the administration of the insulin this time only but should caution the client and family that this is not the purpose for their visit.

3. The nurse should contact the physician for the husband for an order for the medication.

4. The nurse should contact his supervisor to obtain permission to administer the medication.

7. The home health nurse observes several small, round bruises on the back side of an elderly client’s arms. What action by the nurse is indicated first?

1. Question the client about the cause of the bruises.

2. Discuss the bruises with the client’s spouse.

3. Document the bruises, with plans to review them for changes on the next visit.

4. Contact the home health supervisor to report the findings.

 8. A home health nurse is preparing to begin a series of visits with a client. Based upon the client’s condition, the client is expected to require home care visits weekly for the next two months. Which of the following tasks should take place first?  

1. Set priorities.

2. Assess the home environment.

3. Establish trust and rapport.

4. Promote learning.

9. A postoperative client is preparing for discharge. A home health nurse has been scheduled to call on the client in two days. The client tires easily and voices an inability to concentrate on all of the information the nurse is attempting to review. Which of the subjects concerning the client’s condition and home care may be deferred for the home health nurse?

1. The recommended diet after discharge

2. The activities that will take place during the four-week checkup with the physician

3. Potential adverse reactions of the prescribed medications

4. The actions of the prescribed medications

10. The home health nurse has identified a series of concerns while providing services to a client. During one of the visits, the nurse becomes concerned about criminal activity in the home. What initial action by the nurse is most appropriate?

1. Dial 911 to obtain assistance in removing the client from the home.

2. Contact the physician to discuss the situation.

3. Leave the home.

4. Advise the client to leave the home as soon as possible.

11. The nurse is teaching the client about ways to increase personal safety in the home. During the interaction, the client advises the nurse that he has no plans to make the recommended changes. What response by the nurse is most appropriate?

1. “You might not get well if you do not follow my recommendations.”

2. “I will need to tell your physician the home is not safe enough.”

3. “If you need more information about what we have discussed, please let me know.”

4. “I might not be able to continue my visits if you do not conform.”

12. During a home health visit, the client indicates he feels he might need physical therapy to facilitate his recovery. What action by the nurse is indicated?

1. The nurse should contact the client’s insurance carrier to determine benefit eligibility.

2. The nurse should provide the client with the contact information for a local agency that offers physical therapy services.

3. The nurse should contact the physician to discuss the client’s concerns.

4. The nurse should advise the client to contact the physician to discuss his concerns.

13. The nurse is assessing the client’s perception of safety issues in the home. Which of the following questions and statements will best assist the nurse in obtaining the needed data? 

1. “Do you feel safe at home?”

2. “Can you see room for improving safety at home?”

3. “Please tell me some safety concerns you have.”

4. “Have you ever fallen at home?”