Collaborative Practice and Care
Coordination across Settings
(Course point)
In anticipation of discharge, a nurse is teaching the daughter of an older adult client
how to change the dressing on the client's venous ulcer. Which teaching strategy is
most likely to be effective?
A. Use a multimedia strategy that combines animation with narration.
B. Demonstrate and explain the procedure and then have the daughter perform it.
C. Provide explicit written and verbal instructions and ask the daughter to explain
back to the nurse how to perform the procedure.
D. Explain the procedure clearly and slowly while providing multiple opportunities
for the daughter to ask questions.
- Correct answer- B. Demonstrate and explain the procedure and then have the
daughter perform it.
p. 269
All steps of a procedure such as a dressing change should be demonstrated,
practiced, and provided in writing. The client or caregiver should then perform the
procedure or treatment in the presence of the nurse to demonstrate understanding
and ability to carry out the procedure. This is more likely to facilitate success than
providing a passive multimedia resource, explaining, or providing written
instructions alone without reciprocal demonstration.
Which measure should a home health care nurse integrate into routine practice to
minimize the potential for lawsuits?
A. Integrate the client's learning needs and goals into plans of care.
B. Perform thorough, accurate, and timely documentation.
C. Have the client sign a waiver prior to the entry phase of a visit.
, Collaborative Practice and Care
Coordination across Settings
(Course point)
D. Apply more conservative interventions than those used in a hospital setting.
- Correct answer- B. Perform thorough, accurate, and timely documentation.
p. 287
The need for thorough documentation is especially high in home health care
settings, both to ensure continuity of care and to provide a legally acceptable
record of what occurred during nurse-client interactions. The nurse should not
implement more conservative interventions solely to minimize liability. A waiver
of rights is not a component of home health care. The client's learning needs and
goals should indeed be integrated into plans of care, but this action does not protect
against lawsuits.
Continuity of care for a particular client is most important to prevent:
A. rising health care costs.
B. infection.
C. multiple providers.
D. fragmentation of services.
- Correct answer- D. fragmentation of services.
p. 274
Continuity of care is the provision of health care services without disruption,
regardless of movement between settings. It is most important in preventing
fragmentation of health care services. It does not prevent a client from needing the
services of multiple providers, although it can ensure better communication and
coordination among these providers, resulting in improved outcomes for the client.
Continuity of care would not directly prevent infection, but in preventing
fragmentation of care, it could indirectly help prevent infection. Ensuring
, Collaborative Practice and Care
Coordination across Settings
(Course point)
continuity of care for a single client would not help prevent rising health care costs,
in general, although it could help lower some costs for the individual client by
reducing redundancy.
A single parent age 17 years, with one child and pregnant with a second, has the
mental age of a 12-year-old. The home care nurse's greatest concern in caring for
this client should be the client's ability to do which?
A. Bond with the children
B. Cognitively understand how to care for the children
C. Physically perform care needed by the children
D. Receive financial aid
- Correct answer- B. Cognitively understand how to care for the children
p. 288
Regarding all aspects of survival, the cognitive ability of this young client is of
greatest concern. The cognitive ability to understand how to organize work,
manage financial responsibilities, and ensure safety within the home is essential to
a single parent of two young children.
A registered nurse is providing community-based health care for a client diagnosed
with early onset dementia. Which strategy is best for the nurse to employ to
facilitate the family participating in the client's care?
A. Reinforce the care plan to the family if it is determined the client is not properly
cared for. B. Encourage active participation of the client and family in health care
decisions.
, Collaborative Practice and Care
Coordination across Settings
(Course point)
C. Create a care plan based on the client's requests and inform the family of the
client's wishes.
D. Provide referrals for health care professionals to perform the client's activities of
daily living (ADLs).
- Correct answer- B. Encourage active participation of the client and family in
health care decisions.
p. 280
In a community-based health care setting, the nurse should involve the client and
the family in all health care decisions for the client. The nature of the relationship
is that of a partnership based on respect, appreciation, and cooperation.
Reinforcing to the family that the client is not well-cared for should be done, but it
is more important to involve the client and family in the care. The client and family
should be encouraged to provide ADLs as they are able. Client care decisions
should be made in conjunction with the family, and the family should be
encouraged to participate in those decisions. The client's plan of care should
include input from the family.
Which is the largest single source of reimbursement for home health care services?
A. Client's self-pay
B. Medicaid
C. Medicare
D. Private insurance
- Correct answer- B. Medicare
Coordination across Settings
(Course point)
In anticipation of discharge, a nurse is teaching the daughter of an older adult client
how to change the dressing on the client's venous ulcer. Which teaching strategy is
most likely to be effective?
A. Use a multimedia strategy that combines animation with narration.
B. Demonstrate and explain the procedure and then have the daughter perform it.
C. Provide explicit written and verbal instructions and ask the daughter to explain
back to the nurse how to perform the procedure.
D. Explain the procedure clearly and slowly while providing multiple opportunities
for the daughter to ask questions.
- Correct answer- B. Demonstrate and explain the procedure and then have the
daughter perform it.
p. 269
All steps of a procedure such as a dressing change should be demonstrated,
practiced, and provided in writing. The client or caregiver should then perform the
procedure or treatment in the presence of the nurse to demonstrate understanding
and ability to carry out the procedure. This is more likely to facilitate success than
providing a passive multimedia resource, explaining, or providing written
instructions alone without reciprocal demonstration.
Which measure should a home health care nurse integrate into routine practice to
minimize the potential for lawsuits?
A. Integrate the client's learning needs and goals into plans of care.
B. Perform thorough, accurate, and timely documentation.
C. Have the client sign a waiver prior to the entry phase of a visit.
, Collaborative Practice and Care
Coordination across Settings
(Course point)
D. Apply more conservative interventions than those used in a hospital setting.
- Correct answer- B. Perform thorough, accurate, and timely documentation.
p. 287
The need for thorough documentation is especially high in home health care
settings, both to ensure continuity of care and to provide a legally acceptable
record of what occurred during nurse-client interactions. The nurse should not
implement more conservative interventions solely to minimize liability. A waiver
of rights is not a component of home health care. The client's learning needs and
goals should indeed be integrated into plans of care, but this action does not protect
against lawsuits.
Continuity of care for a particular client is most important to prevent:
A. rising health care costs.
B. infection.
C. multiple providers.
D. fragmentation of services.
- Correct answer- D. fragmentation of services.
p. 274
Continuity of care is the provision of health care services without disruption,
regardless of movement between settings. It is most important in preventing
fragmentation of health care services. It does not prevent a client from needing the
services of multiple providers, although it can ensure better communication and
coordination among these providers, resulting in improved outcomes for the client.
Continuity of care would not directly prevent infection, but in preventing
fragmentation of care, it could indirectly help prevent infection. Ensuring
, Collaborative Practice and Care
Coordination across Settings
(Course point)
continuity of care for a single client would not help prevent rising health care costs,
in general, although it could help lower some costs for the individual client by
reducing redundancy.
A single parent age 17 years, with one child and pregnant with a second, has the
mental age of a 12-year-old. The home care nurse's greatest concern in caring for
this client should be the client's ability to do which?
A. Bond with the children
B. Cognitively understand how to care for the children
C. Physically perform care needed by the children
D. Receive financial aid
- Correct answer- B. Cognitively understand how to care for the children
p. 288
Regarding all aspects of survival, the cognitive ability of this young client is of
greatest concern. The cognitive ability to understand how to organize work,
manage financial responsibilities, and ensure safety within the home is essential to
a single parent of two young children.
A registered nurse is providing community-based health care for a client diagnosed
with early onset dementia. Which strategy is best for the nurse to employ to
facilitate the family participating in the client's care?
A. Reinforce the care plan to the family if it is determined the client is not properly
cared for. B. Encourage active participation of the client and family in health care
decisions.
, Collaborative Practice and Care
Coordination across Settings
(Course point)
C. Create a care plan based on the client's requests and inform the family of the
client's wishes.
D. Provide referrals for health care professionals to perform the client's activities of
daily living (ADLs).
- Correct answer- B. Encourage active participation of the client and family in
health care decisions.
p. 280
In a community-based health care setting, the nurse should involve the client and
the family in all health care decisions for the client. The nature of the relationship
is that of a partnership based on respect, appreciation, and cooperation.
Reinforcing to the family that the client is not well-cared for should be done, but it
is more important to involve the client and family in the care. The client and family
should be encouraged to provide ADLs as they are able. Client care decisions
should be made in conjunction with the family, and the family should be
encouraged to participate in those decisions. The client's plan of care should
include input from the family.
Which is the largest single source of reimbursement for home health care services?
A. Client's self-pay
B. Medicaid
C. Medicare
D. Private insurance
- Correct answer- B. Medicare
