NCLEX/Critical thinking questions - Community based settings for Pt care

1. Which of the following programs illustrates a focus on health in our society?
a. Research on the treatment of AIDS
b. Incarceration of drug addicts
c. Antismoking ads on TV
d. Aggressive therapy for cancer

2. Mrs. Rogers is in acute respiratory distress from pneumonia but refuses to stay for treatment. It is the nurse's responsibility to do which of the following?
a. Restrain the pt until a social worker can talk to her about the possible results of her actions.
b. Call for a psychological consultation to see if she is mentally stable.
c. Notify the physician; discuss the outcomes of the pt's decision and have her sign a release form
d. Call the pt's family and have them discharge her

3. Which of the following actions must be performed by the nurse upon discharging a pt from a healthcare agency?
a. coordinating future care for the pt
b. writing a discharge order for the pt
c. Writing any orders for future home visits that may be necessary for the pt
d. Sending the pt's records to the attending physician.

4. When pts are transferred within or among health care settings, which of the following is most important in ensuring the continuity of care?
a. Notification of all departments of room change
b. Careful moving of all personal items
c. Asking family members to take home the pt's jewelry, money or other valuables
d. Accurate and complete communication

5. Which of the following statements concerning the characteristics of a home care nurse is accurate?
a. Clinical skills are less important in a home care setting than in a hospital setting
b. The nurse should not make independent decisions about pt care
c. The increased autonomy of the nurse reduces the nurse's legal risks.
d. Physical assessment, nursing diagnosis, and infection control are all part of the nurse's role

6. Which of the following statements concerning the unique role of the home care nurse is accurate?
a. Home care is provided to the pt in a setting that is controlled by the nurse
b. The nurse should not feel that she is only a "guest" in the pt's home
c. the nurse must adapt to the pt's environemt instead of the pt adapting to a strange environment.
d. Home care nurses do not need the pt's permission to adjust furniture or pt belongings to provide a safe environment.

7. Which of the following activities would be performed by a home care nurse in the pre-entry phase of the home visit?
a. The nurse gathers supplies that may be needed for the pt
b. The nurse develops rapport c the pt and family
c. The nurse determines desired outcomes, makes assessments and plans and implements care
d. The nurse provides teaching to promote independence in self-care.

Critical thinking:
Identify care priorities for the pts listed below who are being transferred to a home healthcare setting. Include physical, psychological, socioeconomic, environmental, spiritual and cultural assessments for each pt. Think about nursing's role in making necessary resources available to the pt and family.

a. 76yo male, advanced cancer being sent home c a catheter and pca pump. lives alone, son lives 45 min away and has promised to check on him once/day. members of his church have offered to visit him and bring him a meal once/day.

b. 32yo male, advanced AIDS being sent home to spend his remaining days c parents. His life partner died of AIDS the previous year and he is angry about this situation. his parents do not accept his condition and lifestyle but offer to take care of his healthcare needs.

c. young, single mother lives c her boyfreind is released from the hospital c an infant who has Down syndrome. Both the mother and her boyfriend work and two incomes are needed to maintain the household. The mother has expressed concerns about being able to give her infant the proper treatment and attention.