Exam 4:NR 442/NR442 (Latest 2026/2027 Update) Community Health Nursing | Comprehensive Questions & Answers | Fully Verified Solutions | Guaranteed A Grade – Chamberlain

…..DLDD Exam 4:NR 442/NR442 (Latest 2026/2027 Update) Community Health Nursing | Comprehensive Questions & Answers | Fully Verified Solutions | Guaranteed A Grade – Chamberlain Q. A nurse defines environmental health and the associated factors. The Nurse recognizes that all factors are related to environmental health with the exception of? a) Chemical b) Biological c) Physical d) Mental ANSWERS Mental Q. A PHN works to prevent bioterrorism in their community, which of the following would be considered to be primary prevention method regarding bioterrorism? a) Creating a bioterrorism response plan b) Educating the community regarding the management of disease c) Implanting decontamination measures d) Administering vaccines as available ANSWERS Creating a bioterrorism response plan Q. A nurse reviews the American nurses association (AMNA) principles of environmental health for guidance in becoming health activist in their community, which of the following principles is not relevant to nursing? a) Advocacy b) Assessing environmental hazards c) Creating environmental policy d) Understanding environmental role in public health ANSWERS Creating environmental policy Q. The ANA principles were designed in order to help support the nurse in their role of health activist for the environment, which of the following are principles related to a healthy and safe environment? SATA. a) understanding legislation related to environmental health b) knowledgeable of the role of individual health, c) Assessment for environmental health hazards d) advocacy e) Utilizing risk communication strategies ANSWERS All the above - understanding legislation related to environmental health - knowledgeable of the role of individual health, - Assessment for environmental health hazards - advocacy - Utilizing risk communication strategies Q. A public health nurse works to advocate for legislation in order to protect the environment the nurse recognizes that the environment regulations are often in conflict with which of the following at the industry level? a) Economic benefits b) Employee health benefits c) Industry safety standards d) OSHA Regulations ANSWERS Economic benefits Q. A nurse assesses a client who has been affected by a hazardous substance for adverse effects which of the following factors should not be included in the nurse's assessment? a) Substance toxicity b) Previous hazardous substance contact c) The amount of substance present d) If the substance reaches susceptible organs ANSWERS Previous hazardous substance contact Q. A nurse uses a process to evaluate the extent to which a community may suffer health effects from an environmental exposure, what is the name of this process? a) Exposure risk assessment b) Point sources c) Community environmental health assessment d) Environmental sustainability ANSWERS Exposure risk assessment Q. A nurse conducts an environmental health history in order to protect the health of their community. Which of the following components should be included in the initial assessment of the environmental health history? ** might be worded differently a) Liability b) Policy c) Time (time & location) d) Route ANSWERS Time (time & location) Q. A PHN prepares for a home visit for the family with a child who has a high blood lead level, which of the following is not an objective of a home visit? a) Environmental assessment of the home b) Education regarding dietary actions to reduce lead poisoning c) Help with the basement in the home d) Reduce lead in drinking water in the home ANSWERS Reduce lead in drinking water in the home Q. A nurse studies environmental hazard for children in urban setting in their community, which of the following is a relevant hazard for a child in an urban setting? a) Broken playground equipment b) Risk of injury from farm equipment c) Environmental tobacco use smoke d) Substances crossing the placenta barrier ANSWERS Broken playground equipment Q. Here are many factors that play role in risk for environmental attributable disease, which of the following should not a factor involved in environmental attributable disease? a) Age b) Gender c) Noncommunicable disease d) Race ANSWERS Race Q. A PHN recognized that climate change can have an, significant impact on human health, for example rising temperatures can contribute to severe weather. Severe weather can contribute to which of the following human health issues? SATA a) Malnutrition b) Injuries c) Mental health impacts d) Cardiovascular disease e) Fatalities ANSWERS - Injuries - Mental health impacts - Fatalities Q. A nurse evaluates the degrees of air pollution in their community, which of the following is measure of air pollution in this specific area? a) ambient air b) Air variability c) Air quality index d) National ambient quality standards ANSWERS Air quality index A nurse looks to contact the organization responsible for helping to protect the public by enforcing federal guidelines in the workplace environment. Which organization should the nurse contact? a) NORA b) OSHA c) NIOSH OSHA An occupational health nurse works to promote health and safety, in a workplace environment the nurse implements appropriate PPE for the employees. Which of the following prevention measures is reflected by the nurse actions? a) Primary b) secondary c) Teritary Primary A nurse cares for a client who recently had a hazard exposure in the workplace. The client has been exposed to excessive cold temperatures causing frostbite on their hands. Which of the following categories of exposure is most relevant? a) Physiologic b) Biological c) Physical d) Chemical Physical An occupation Health nurse preforms a workplace assessment in order to observe operations taking place at a workplace facility. Which of the following questions is not important to be addressed during a workplace assessment? a) WHat hazardous exposures are present at the work site b) What PPE is present at the work site c) What mechanisms are present at the work site d) What are Primary business expenses at the work site What are Primary business expenses at the work site An occupational Health nurse recognizes that job stress is a psychological hazard within a workplace setting. Which of the following can help assist employees to discuss work, financial or social issues in a confidential setting to help ease job stress? a) Health risk appraisal b) Employee assistance program c) Case management d) Material safety data sheet Employee assistance program A client recently enrolled in their employers' health promotion program in order to help cope with job stress. which of the following is not an intervention that can help address workplace stress? a) Physical exercise b) Job sharing c) Meditation d) Relaxation Job sharing There are several criteria that need to be met for a client to be considered to meet a disability. which of the following are criteria of a disability? SATA. ** Drag and Drop a) Physical or mental impairment that affects life activities b) Legally bankrupt c) Disease considered incurable d) Record of impairment e) Ability to perform job is not possible without accommodations - Physical or mental impairment that affects life activities - Record of impairment - Ability to perform job is not possible without accommodations A nurse works with minority clients within the workplace in order who are exposed to poor working conditions. which of the following is a most appropriate nursing action to assist these clients? a) Assist in follow up community mental health resources b) Utilizing cultural competence when planning care c) Connect families with respite care and counseling d) Provide safe environment for clients to discuss concerns Utilizing cultural competence when planning care An occupational health nurse utilized the hierarchy of controls in order to help control and prevent workplaces hazards and injury. which level of control in the hierarchy of controls is considered most affective? a) Engineering b) Warning c) Elimination/Substitution d) PPE Elimination/Substitution An occupational health nurse implements a new workplace health promotion strategy, inclusive of discounted health club membership for company employees. Which of the following goals does the implementation of a discounted health club membership meet? a) Reduction in healthcare cost b) Increased productivity c) Absenteeism d) Improves sense of well-being Improves sense of well-being An Occupational health nurse assist a large corporation with an emergency preparedness of planning, which of the following are basic questions relevant to basic assessment of emergency preparedness? SATA a) What is the level of housekeeping needed on site? b) Are fire plans up to date c) What emergency supplies are needed d) What type of PPE is appropriate for the employees e) What type of injuries are anticipated on site? - Are fire plans up to date - What emergency supplies are needed A challenge for nursing regarding primary care, is how to engage primary prevention at individual and family levels, which of the following is most helpful in order to make a plan assist in primary prevention measures? a) Education b) Community assessment c) Case management d) Vaccination schedule Community assessment A nurse works with a school system to develop an anti-smoking campaign, in order to help prevent smoking related health conquests what level of health care is the nurse practicing? a) Primary b) Secondary c) Tertiary Primary A primary health care nurse, which of the following is one of the most effective health promotion and protection efforts that can be conducted in primary health care? a) Smoking cessation programs b) Administration of vaccines c) Free Exercise programs d) Depression screening Administration of vaccines The WHO works to provides quality global access to health care, which of the following levels of care does the WHO primarily promote? a) Primary b) secondary c) Teritary d) Emergency Health Primary A PHN responds to a biological event within their community of a widely distributive E. coli contamination and is planning on the appropriate response action. which of the following PHN roles does this action follow? a) Disease surveillance b) Disaster preparedness c) Case Management d) Quality improvement Disaster preparedness Case management is considered a collaborative process of the assessment, planning and facilitation and advocacy for options and services to meet individual health needs through communication and available resources to promote quality cost-effective outcomes, the nurse is working with a client who had a recent ED visit that does not have health insurance and gets the medication they need for discharge through a compassionate care program. Which objective in the definition of Case management is achieved through this actions? a) Collaboration b) Quality outcomes c) Cost effective outcomes d) Planning Cost effective outcomes A nurse working in case manager role is assisting client with their health care needs. The nurse assists a homeless client with a substance abuse diagnosis get into an addiction clinic program. The nursing action represents role of the case manager? ** might have different answer selection a) Assessment b) Planning c) Efficacy d) Advocacy Advocacy A PHN works with a local developer in order to establish affordable housing options within a community for low-income clients with disabilities, this is an example of which of the following nurse roles? a) Community based participatory research b) Coalition building c) Community Partnership d) Urban Agglomeration Community Partnership A nurse recognizes which of the following are challenges relating to healthcare within in rural communities? SATA a) Language barriers b) Access c) Funding d) Staffing e) PPE - Access - Funding - Staffing Health disparities in rural communities are largely affected by which of the following factors? a) Large percentage of elderly clients b) Difficulty recruiting health care providers c) Lack of up to date tech d) Centralized healthcare systems Difficulty recruiting health care providers A PHN works in rural community would not be expected to assist with the following roles? a) Planning b) Social justice reform c) Diagnosis d) Community assessment Social justice reform Which of the following nursing actions is important to address for the health care needs specific to a rural community? a) Use cultural competency while planning interventions b) Enhance parenting skills that can prevent young people from feeling the need to run away c) Assist clients in finding ways to meet long term shelter needs d) Screen to detect mental health disorders Use cultural competency while planning interventions A PHN obtains a new role working within an urban community, the nurse recognizes that which health factor influences the health of urban community SATA? ** drag and drop a) Crime rates b) Psychosocial distress c) Lack of health care providers d) Funding e) Air quality - Crime rates - Psychosocial distress - Air quality A PHN works within the community in order to identify common goal, and implement strategies for reaching their goals, which action is the nurse achieving? a) Community empowerment b) Community organizing c) Coalition d) Urban agglomeration Community organizing A nurse practices nursing within a faith community, which has their own scope and stand of practice, which types of nursing is this nurse practicing? a) Rural b) Urban c) Nursing within a nursing health center d) Parish nursing Parish nursing A PHN organizes a community-based participatory research program, which individual serve as the best resources for community based participatory research? a) Hospital nurse b) School nurse c) Advanced practice nurse d) Public health nurse (PHN) Public health nurse (PHN) A NP staffs and owns a nurse managed health center, which of the following is considered to be benefit of care provided at a nurse managed health center? SATA a) Affordable care b) High Quality Care c) Care provision for non US residence d) Training for future NP’s e) Provides specialty care - Affordable care - High-Quality Care - Training for future NP's A school Health nurse has a number of roles and responsibilities, which of the following are within the scope a of the school health nurse? SATA a) Provide care coordination b) Advocated for quality student care c) Review student medical changes d) Provide well child services e) Bridge health care and education - Provide care coordination - Advocated for quality student care, - Provide well-child services - Bridge health care and education Which of the following is school nurse role in terms of immunizations? a) Admin all school age vaccinations b) Promote vaccinate administration c) Update Influenza vaccine recommendations nationally Promote vaccinate administration A school nurse addresses the controversial topic of sex education with student, which of the following factors plays into the decision of what content should be taught in the school SATA? ** do not choose "staff opinion" a) Student demographics b) Parental concerns c) Public health prevention concerns d) Role of Education system and public health prevention e) School funding - Parental concerns - Public health prevention concerns - Role of Education system and public health prevention A school nurses knows that violence prevention within dating context is important specifically for HS student, which of the following interventions is a primary prevention method in dating violence? a) Screening with high-risk behaviors for teen dating violence b) Sexual transmitted infection treatment c) Counseling for victims of violents d) Sex education for students Screening with high-risk behaviors for teen dating violence A school nurse provides health screening in order to address potential health problems of students. which of the following is not a health screening for school nurse would not be expected to conduct. a) Vision b) Audiometric c) Mental health d) Obesity Mental health Student with disabilities have unique needs within a school environment. which of the following is not a potential need for a student with a disability that can be met by the school nurse? a) Medication administration b) Emergency care planning development c) Health counseling d) Insurance coverage advocacy Insurance coverage advocacy A school nurse works as an advocate for various policies within the school, which of the following is an example of local regulation? a) Federal funding is given for students with disabilities within a school setting b) A nurse must have a minimum bachelor's degree to be a school nurse c) Vision screenings must be completed for each student prior to the school year d) Implement district policy and wellness programs Implement district policy and wellness programs A school nurse prepares for a potential life-threatening event at a school. which of the following actions by the school nurse is not relevant to preparing for emergency in the school? a) Training staff in CPR b) Coordinate a practice of the emergency plan day c) Ensure there are an appropriate amount of AEDs at the school d) Ensure crash carts available on site Ensure crash carts available on site A school in conjunction with educators recognize the issue of cyber bullying between students. What role does a school nurse play in terms of addressing cyberbullying? SATA a) Implement internet filters b) Prevention c) Early identification d) Discipline for violators e) Treatment for victims - Prevention - Early identification - Treatment for victims True or False? The hazard communication standard policies requires both an employee and employer to be knowledgeable about hazards? True The nurse implemented a community wide program to raise awareness about dangers of nicotine use, created a support group aimed at teens to quit smoking, which prevention is this activity? a) Heath Promotion b) Health Protection c) Risk reduction d) Tertiary prevention Health promotion The PH department reached out to all the primary care provider to encourage all of their unvaccinated patients to get vaccinated and to encourages parents of unvaccinated children to get thier vaccines up to date, what type of public health initiatives is this activity? a) Secondary prevention approached related to screening b) Primary prevention approached focused on health protection c) Primary health prevention approached focused on health promotion d) A primary prevention approached focused on screening Primary prevention approach focused on health protection A new primary care nurse is creating a pamphlet of the 5 functions and attributes of a medical home after showing it to charge nurse she is made aware of an errors she made in the literature, which of the following elements does not fit into the medical home model? a) Specialized focus care b) Committed to quality and safety c) Patient centered care d) Population focuses care Specialized focus care What is a primary characteristics of collaboration? a) The primary care physician maintains strict control overall elements of patient care b) The nurse partners with key individuals group coalitions and organizations. c) Social services only called in severe abuse cases d) Case managers are not part of the healthcare team The nurse partners with key individuals group coalitions and organizations. A nurse is moving to rural area and beginning work at a health clinic. The nurse is preforming a basic community assessment to prepare for working with this new community. The nurse knows that which of the following is not characteristic of the needs of a rural population? a) Most likely to smoke tobacco and drink alcohol b) Have less education and higher rates of poverty c) Most likely to have increased dental problems d) More likely to have a higher life expectancy More likely to have a higher life expectancy A nurse has been volunteering at free clinic located at a community center in a rural area twice monthly for several years. Over the last few months, the nurses noticed that the patient load has increased as the population of this community has aged it is not fees able for the nurse to spend more time at this center. What might be the most fess able action she could take to continue to serve needs of the community? a) try to hire a nurse to work at the free clinic b) set up a telehealth arrangement so that the nurse can answer simple questions from home c) set up scheduling and triage system so the nurse only sees the neediest patients d) consider closing the free clinic and opining a fee for service center set up a telehealth arrangement so that the nurse can answer simple questions from home A nurse is working with several community members in inter-city environment to help address broken windows and damaged buildings within the community they had several residents volunteered to form a group that will repair the damages and keep the community well cared for. This is an example of? a) Community organization b) Community empowerment c) Community research d) Community partnerships Community organization A nurse is considering entering the specialty of Parish nursing. Nurses working within this field preform which of the following activities specific to that of a parish nurse? a) Advocating for individuals who belong to the parish b) Spiritual health counseling and prayer c) Provide health education Spiritual health counseling and prayer A school nurse is assessing a report on the health education components of the whole school, whole community, and whole child WSSC program at one of the elementary school the nurse covers. which of the following element should she point out that is NOT a component on the WSSC? a) A qualified trained person teaches the program b) The program is run for children is run for children 1st thru 5th grade c) It assist children in maintaining and improving health d) The comprehensive health education curriculum The program is run for children is run for children 1st thru 5th grade A role of the school nurse is health protection for the students this element involves which of the following? a) Calling parents about low academic grades b) Conducting classes on healthy eating c) Admin STI vaccines d) Challenges school leaders to add additional carbs in kids diets Conducting classes on healthy eating A new school nurses is reviewing procedure put in place by prior nurse. A woman with more than 30 years of experience the nurse notices that a school wide scoliosis screening occurs every fall. How does the new nurse proceed? a) Continuing to preform scoliosis screening each year b) Only continue scoliosis screening on students who are symptomatic d) Eliminate scoliosis screening all together d) Check state screening guidelines to see what is required for school nurses in the state. Check state screening guidelines to see what is required for school nurses in the state. A school nurse is updating the designated medical emergency response plan. What recommendation should the school nurse make regarding this plan? a) Notify the school board of poor planning actions b) Campaign for more funds c) Email a copy of the plan to each student d) Practice the plan a number of times each year. Practice the plan a number of times each year. John, the nurse manager, in a large urban ED, was alerted to several patients who have come in with possible exposure to toxic substance. What would be used in the epidemiological triangle help him understand? a) How it's not possible for the agent and host to have a connection b) What the interaction is between the host and the environment c) There is no role of water air and waste in the environmental health d) How the environment does not play a role in the health of individuals, health, and families of communities What the interaction is between the host and the environment A nurse working the evening shift in the ED has been assigned the patient who has arrived with a chief complaint of difficulty breathing after mixing house whole cleaning products. The nurse recognizes that this patient is suffering from exposure to which type of environmental hazards? a) Biological b) Mixed exposure c) Physical d) Chemical Mixed exposure A family survived a dangerous weather event but now they are suffering through another part of environmental risk. They are now feeling stress, pain and anxiety what are these elements considered? a) Physical agents b) Mixed exposures c) Psychosocial d) Biological agents Psychosocial While doing physical assessment of an older adults the nurse is concerned about the patient's history of work exposure to toxic chemical over his lifetime. Based on reports level of toxins where within normal limits but the patient had worked in the plant for 50 years. What aspect of exposure is the nurse most worried about? a) Latency period b) Half life c) Bioaccumulation/Accumulation d) Exposure Bioaccumulation/Accumulation A PHN is helping to manage an decrease in air quality from chemical plant, which is a source that shows that there is a decrease in air quality? a) Point source b) Mobile source c) Community source d) Area source Point source An occupation nurse is starting a position with a new company with 35 employees, the nurses ask to see the OSHA 300 form but is told that the company is not required to use that form. How does the nurse replay? a) "Your right, The OSHA 300 logs are voluntary" b) "Your right, The OSHA 300 logs should be kept when the company has 50 employees" c) "That's incorrect, The OSHA 300 logs should be kept when the company has 10 employees" d) "Each employee is required to keep their own logs and report injuries as applicable" "That's incorrect, The OSHA 300 logs should be kept when the company has 10 employees" A nurse is describing the employee health prevention measures available to the members of the hospital staff. What level of prevention is the use of PPE? a) Primary b) Secondary c) Tertiary d) Quintenary Primary A nurse is preparing a lecture about caring for the needs of the American workforce, which of the following statements is true? a) The American workforce se slowly coming less stressful b) Approximately 43% of teenagers are employed and in their first job by the age of 19 years c) Emerging issues are tied to trends of shorter work hours d) The American workplace is becoming more and more active Approximately 43% of teenagers are employed and in their first job by the age of 19 years A PHN is volunteering at clinic that provides care to migrant workers who work in the fields and in their community in addition to routine health assessments what work related potential health issues would be important for the nurse to include as part of their routine screening? a) Hearing loss b) Skin cancer c) Diabetes d) Heart failure Skin cancer A nurse is among the first responders to a mass causality incidence and does not know what type of PPE is needed. Which of the following actions should the nurse take? a) Wait until the type of equipment needed is known b) Decontaminate victims before intervening c) Choose the highest level of protection equipment available d) Uses a dosimeter to measure the level of radiation in the area before intervening. Choose the highest level of protection equipment available The Purpose of this to prevent or reduce risk and adverse consequences posed by natural or man-made disasters? a) Mitigation b) Response c) Disaster planning d) Recovery Disaster planning This can result in elevated body temp in relation to hyperthermia? a) Heat b) Extreme cold c) Hurricane d) Extreme heat Extreme heat Any human-made or natural event that causes destruction and devastation that cannot be relieved without assistance is called? Disaster EX: tornadoes, earthquakes, floods, bombs, fires, pollution, structural collapse What are 3 at-risk populations of disasters? Elderly Homeless Veterans What are the 3 stages of disaster involvement? Stage1 - Preparedness Stage 2 - Response Stage 3 - Recovery What are 4 types of preparedness? Personal - personal checklist and emergency supplies kit Professional - nurse understands disaster plans & participates in drills Community - nurse reviews disaster hx of the community & OEM - OEM = Office of Emergency Management Mass Casualty Drills or Mock Disasters What are 6 roles the nurse plays in disaster preparedness? Help initiate disaster plan Provide educational programs regarding disasters specific to area Organize disaster drills Provide updated record of vulnerable populations Advocate for safe environment - check for hazards Report environmental hazards What are the 3 ways to classify a disaster during stage 2? Disaster type - Manmade or natural Disaster level - Designated by Red Cross by amount of money Disaster scope - How many people are affected An outbreak of an infectious disease that occurs over a wide geographic area and affects an exceptional high proportion of the population is called? Pandemic What is the strategy to minimize the spread of infectious agents? Immunized health care staff An incident or outbreak that affects an anticipated amount of people within a community or region at the same time is called? Endemic An incident or outbreak that affects over the anticipated amount of people within a community or region at the same time is called? Epidemic What are 5 nursing roles within Stage 2 of disaster involvement? Assessment, early identification, intervention Clinical skills Disaster planning, response, and support Develop educational materials and teaching Training in behavioral techniques to cope with grief, exhaustion, fear What are 5 nursing roles when dealing with terrorism? Help people cope with aftermath of terrorism Allay public concerns and fears Identify feelings others may be experiencing Assist victims to think positively and move to future Prepare nursing personnel to be effective in a crisis People react to disaster based on what 4 criteria? Age - children are scared and regress Culture Health status - emotionally sad or angered Social support structure - cant let go of personal loss What do each of the colors mean when triaging patients? Black Red Yellow Green Black - Death Red - Immediate/life-threatening Yellow - Delayed/Non life-threatening Green - Minor Injury Stage 2 of disaster involvement involves what 4 things? Triaging of patients Shelter Management International Relief Efforts Psychological stress of disaster workers - make them take breaks What are 3 complications of being a disaster worker? Post-traumatic Stress Syndrome Flashbacks Nightmares What are 4 nursing roles when dealing with disaster recovery? Teach proper hygiene and make sure immunizations are current Make referrals to mental health professionals Be alert for environmental hazards Assess dangers of live or dead animals What are 5 components of a comprehensive response to outbreaks of illness caused by bioterroism? Detecting the outbreak Determining the cause Identify risk factors Implement measures to control outbreak Inform medical and public communities What are 2 agents of bioterrorism? Anthrax (airisalized) 100% fatal if untreated - military receives anthrax vaccine Smallpox (no cure) -vaccination only lasts 10 years What is the most important role of the nurse associated with bioterrorism? Disease Suveilance 2 or more individuals that rely on each other for emotional, physical, and/or financial support and is very important is called? Family - members are self-defined What is an important role of family function? Passing on culture and conferring status What 3 words define family? Integrated Interacting Interdependent What are 6 nursing interventions to help a family deal with illness? Educate that what a family does affects all members Ask about coping mechanisms - family strengths Assess capacity of family to fill other roles Listen to family concerns Help family prepare for death in the family Educate about advanced directives What are 3 models of family assessment? Developmental - staging family by life cycle Structural - family composition (genograms) Functional - family's perceptions What are 4 things that are included in a genogram? Initials Age Educational level Health History A map of a family that includes their relationships and social networks is called? Ecomap What are 3 types of nursing interventions related to helping families? Cognitive - Perceive, understand Affective - Know their feelings, attitudes, values Behavioral - Teach them to do something What are 3 levels of prevention when helping families? Primary - Birth control Secondary - Screenings (BP) Tertiary - Treatments Intentional acts that result in physical or psychological injury to one or more people involved is called? Violence What are 6 common factors that influence the level of violence? Jobless Overcrowding Media Poverty Feeling of powerlessness Diversity - hate crimes What are 6 types of violence within communities? Homocide Assault Rape Suicide Emotional/Sexual/Physical Abuse Child Abuse (can also be neglect) What are 4 nursing roles when dealing with a violence situation? Be nonjudgmental Listen Discuss Plan for future What is the best question for a nurse to ask a victim who has a black eye and bruises around the mouth? "Who hit you?" - alone in room What are methods of intervention at each level for violence? Primary - Self defense, parenting class Secondary - Screenings, shelter information, respit care for family Tertiary - Care for the abused (counseling) What are 4 factors that may lead to a development of abuse patterns? Family up-bringing Living Conditions Increased Stress Poverty Which field of nursing is rapidly growing due to cost, more chronic illnesses, and shorter hospital stays? Home Health Care Nursing Who began the concept of Home Health Care with creating the Visiting Nursing Association? Lillian Wald and Mary Brewster What 3 types of people usually receive home health care? Older than 65 Recently discharged from acute care Diagnosis related to circulatory system issues How is the goal of home health care achieved? Short-term, intermittent, direct nursing care in the home What 3 factors contributed to the growth of home care? 1965 Medicare & Medicaid Diagnosis Related Groups (DRGs) Technology Why does home health usually only hire experienced nurses? New graduates may not have every supply they need and would not have the knowledgeor experience to improvise How is the relationship with a home health client different than a hospital setting? More trusting relationship with client and involvement with the family What are 7 advantages of home health care? Lower cost Familiar environment Easier access to family and support Self-care emphasized Decreases burden on family Personalization of health education Higher job satisfaction What are 7 challenges that nurses must overcome working in home health care? Elderly don't approve of younger workers Intrusion on family privacy Racism Personality conflicts Out of pocket expenses Paperwork and documentation of everything Job stress, weather, unsafe neighborhood, less money paid What is the role of the hospital discharge planner? Determine how close to discharge the patient is and what they will need at home Do clients need to be hospitalized prior to receiving home care? No, just meet with doctor 90 days prior to home care or 30 days after Who is the single largest payer of home care services? Medicare -Medicaid is 2nd What are 4 conditions that must be met for Medicare to pay for home care? Ordered by a MD Change in client's condition or must be unstable Require skilled care Homebound - must be taxing to leave How often is the OASIS (Outcome and assessment information set) gathered to see if improvements are occurring? Admission Every 60 days Discharge Change in the clients condition What is one of the worlds fastest growing unpaid professions? Lay-care giving = family What are 6 ways to avoid ethical and legal issues working in home health care? Provide home care bill of rights Educate about HIPPA Explain the agency expectations Listen to family's expectations Discuss advanced directives Address consequences of noncompliance What are 5 examples of specialized nursing care in a patient's home... Infusion therapy (chemo) Wound Care Maternal-Child Home Care (hi-risk infants) Pain Management Hospice Care A facility or nurse providing palliative care to a patient with 6 months or less to live is called? Hospice Is teaching in the home covered by Medicare during a home health visit? Depends, only if found to be reasonable and necessary What are 5 advantages to telehomecare? Lower costs No transportation needed Medicare does cover cost Not many readmissions because of non-adherence Fewer nurse visits to the home unless needed What is the most common diagnosis of people using telehomecare? Heart Failure How should the nurse begin the home visit? Introductions and a short period of casual, social conversation to put the client and family at ease The nurse is caring for an elderly male client who has Alzheimer disease and needs constant care and supervision. When providing a home visit the nurse notes that the client's daughter, who is caring for him, is disheveled and looks tired. What would be the best intervention by the nurse in this situation? Provide respite care for the daughter