Chapter 02: Community-Based Nursing Practice
Hinkle: Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 13th Edition
MULTIPLE CHOICE
1. A community health nurse has scheduled a hypertension clinic in a local
shopping mall in which shoppers have the opportunity to have their blood
pressure measured and learn about hypertension. This nursing activity would
be an example of which type of prevention activity?
A) Tertiary prevention
B) Secondary prevention
C) Primary prevention
D) Disease prevention
ANS: B
Secondary prevention centers on health maintenance aim at early detection and
prevention. Disease prevention is not a form of health care but is a focus on
primary prevention.
2. The nursing instructor is preparing a group of students for their home care
rotation. In preparation, the group discusses the patients that they are most
likely to care for in the home. Which of the following groups are the most
common recipients of home care services?
A) Mentally ill patients
B) Patients receiving rehabilitation after surgery
C) Terminally ill and palliative patients
, D) Elderly patients
ANS: D
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, though each of the other listed
groups may sometimes receive home care.
3. A recent nursing graduate has been surprised at the sharp contrast between some
patients' lifestyles in their homes and the nurse's own practices and beliefs. To
work therapeutically with the patient, what must the nurse do?
A) Request another assignment if there is dissonance with the patient's lifestyle.
B) Ask the patient to come to the agency to receive treatment, if possible.
C) Resolve to convey respect for the patient's beliefs and choices.
D) Try to adapt the patient's home to the norms of a hospital environment.
ANS: C
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 nurse should not request another
assignment because of a difference in beliefs, nor do nurses ask for the patient to
come to you at the agency to receive treatment. It is also inappropriate to
, convert the patient's home to a hospital-like environment.
4. Infection control is a high priority in every setting where nursing care is
provided. When performing a home visit, how should the nurse best implement
the principles of infection control?
A) Perform hand hygiene before and after giving direct patient care.
B) Remove the patient's wound dressings from the home promptly.
C) Disinfect the patient's syringes prior to disposal.
D) Establish a sterile field in the patient's home before providing care.
ANS: A
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. Removing the
wound dressings from the home and disinfecting all work areas in the home are
not the best implementations of infection control in the home. Used syringes are
never disinfected and a sterile field is not always necessary.
5. An adult patient is ready to be discharged from the hospital after
undergoing a transmetatarsal amputation. When should your patient's
discharge planning begin?
A) The day prior to discharge
B) The day of estimated discharge
, C) The day that the patient is admitted
D) Once the nursing care plan has been finalized
ANS: C
Discharge planning begins with the patient's admission to the hospital and must
consider the possible need for follow-up home care. Discharge planning should
begin prior to the other listed times.
6. A home health nurse is preparing to make the initial visit to a new patient's
home. When planning educational interventions, what information should the
nurse provide to the patient and his or her family?
A) Available community resources to meet their needs
B) Information on other patients in the area with similar health care needs
C) The nurse's contact information and credentials
D) Dates and times of all scheduled home care visits
ANS: A
The community-based nurse is responsible for informing the patient and family
about the community resources available to meet their needs. During initial and
subsequent home visits, the nurse helps the patient and family identify these
community services and encourages them to contact the appropriate agencies.
When appropriate, nurses may make the initial contact. The other answers are
incorrect because it is inappropriate to ever provide information on other
patients to a patient. The nurse's credentials are not normally discussed. Giving
the patient the dates and times of their scheduled home visits is appropriate, but
Hinkle: Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 13th Edition
MULTIPLE CHOICE
1. A community health nurse has scheduled a hypertension clinic in a local
shopping mall in which shoppers have the opportunity to have their blood
pressure measured and learn about hypertension. This nursing activity would
be an example of which type of prevention activity?
A) Tertiary prevention
B) Secondary prevention
C) Primary prevention
D) Disease prevention
ANS: B
Secondary prevention centers on health maintenance aim at early detection and
prevention. Disease prevention is not a form of health care but is a focus on
primary prevention.
2. The nursing instructor is preparing a group of students for their home care
rotation. In preparation, the group discusses the patients that they are most
likely to care for in the home. Which of the following groups are the most
common recipients of home care services?
A) Mentally ill patients
B) Patients receiving rehabilitation after surgery
C) Terminally ill and palliative patients
, D) Elderly patients
ANS: D
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, though each of the other listed
groups may sometimes receive home care.
3. A recent nursing graduate has been surprised at the sharp contrast between some
patients' lifestyles in their homes and the nurse's own practices and beliefs. To
work therapeutically with the patient, what must the nurse do?
A) Request another assignment if there is dissonance with the patient's lifestyle.
B) Ask the patient to come to the agency to receive treatment, if possible.
C) Resolve to convey respect for the patient's beliefs and choices.
D) Try to adapt the patient's home to the norms of a hospital environment.
ANS: C
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 nurse should not request another
assignment because of a difference in beliefs, nor do nurses ask for the patient to
come to you at the agency to receive treatment. It is also inappropriate to
, convert the patient's home to a hospital-like environment.
4. Infection control is a high priority in every setting where nursing care is
provided. When performing a home visit, how should the nurse best implement
the principles of infection control?
A) Perform hand hygiene before and after giving direct patient care.
B) Remove the patient's wound dressings from the home promptly.
C) Disinfect the patient's syringes prior to disposal.
D) Establish a sterile field in the patient's home before providing care.
ANS: A
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. Removing the
wound dressings from the home and disinfecting all work areas in the home are
not the best implementations of infection control in the home. Used syringes are
never disinfected and a sterile field is not always necessary.
5. An adult patient is ready to be discharged from the hospital after
undergoing a transmetatarsal amputation. When should your patient's
discharge planning begin?
A) The day prior to discharge
B) The day of estimated discharge
, C) The day that the patient is admitted
D) Once the nursing care plan has been finalized
ANS: C
Discharge planning begins with the patient's admission to the hospital and must
consider the possible need for follow-up home care. Discharge planning should
begin prior to the other listed times.
6. A home health nurse is preparing to make the initial visit to a new patient's
home. When planning educational interventions, what information should the
nurse provide to the patient and his or her family?
A) Available community resources to meet their needs
B) Information on other patients in the area with similar health care needs
C) The nurse's contact information and credentials
D) Dates and times of all scheduled home care visits
ANS: A
The community-based nurse is responsible for informing the patient and family
about the community resources available to meet their needs. During initial and
subsequent home visits, the nurse helps the patient and family identify these
community services and encourages them to contact the appropriate agencies.
When appropriate, nurses may make the initial contact. The other answers are
incorrect because it is inappropriate to ever provide information on other
patients to a patient. The nurse's credentials are not normally discussed. Giving
the patient the dates and times of their scheduled home visits is appropriate, but
