NSG 440 Topic 11

Home health care can be defined as a broad spectrum of health and social services offered in the home environment to recovering, disabled, or chronically ill persons. Participation in providing the needed maintenance care for the home care client is essential for which of the following?

• Chaplain

• Family caregivers

• Home health aides

• Physician

Answer explanation

Family caregivers play a crucial role in providing maintenance care at home, as they are often the primary support for recovering, disabled, or chronically ill individuals, ensuring their needs are met in a familiar environment.

Hospice care would be an appropriate option to discuss with which of the following patients?

• Patient with stage II lung cancer who is undergoing chemotherapy.

• Patient with early Alzheimer’s disease whose caregiver needs respite care.

• Patient with metastatic breast cancer who has discontinued chemotherapy.

• Patient with severe debilitating osteoporosis.

Answer explanation

Hospice care is suitable for patients with a terminal prognosis. The patient with metastatic breast cancer who has discontinued chemotherapy is likely nearing end-of-life, making hospice care an appropriate option.

Home health agency types, whether official, private and voluntary, combination, hospital based, or proprietary, are similar in terms of which of the following?

• Conditions of participation (COP) for Medicare and Medicaid

• Federal income tax exemption status or accreditation status

• Governance models and administrative structures

• Homemaker services or service contracting practices

Answer explanation

Home health agency types must comply with the Conditions of Participation (COP) for Medicare and Medicaid, ensuring they meet federal standards for care, regardless of their specific type or structure.

The home health nurse completes an initial assessment on a recently admitted home health client. The nurse should now analyze the assessment data and complete what step in the nursing process that is consistent with the standards of home health practice?

• Diagnosis

• Implementation

• Outcome identification

• Planning

Answer explanation

After completing the initial assessment, the nurse should analyze the data to identify client health issues, which aligns with the diagnosis step in the nursing process, essential for home health practice.

A home health nurse is working with a client who requires a catheter insertion and wound care. The nurse is also helping the client and family to develop positive coping skills and identify resources that will help the client to attain a state of optimal functioning. It is important for the nurse to specifically document nursing services provided because of which of the following?

• The agency is required to practice within the guidelines set up by regulatory agencies.

• Each criterion has minimum standards to which the program must adhere.

• Nurses are required to provide supervision of services.

• Reimbursement is dependent on the provision of skilled care.

Answer explanation

The correct choice is that reimbursement is dependent on the provision of skilled care. Proper documentation ensures that the services provided meet the criteria for reimbursement from insurance or other payers.

The model of care delivered in the home setting which focuses on symptom management at the end of life is known as:

• hospice care.

• palliative care.

• personal care.

• transitional care.

Answer explanation

Palliative care is a model of care focused on symptom management for patients with serious illnesses, especially at the end of life, making it the correct choice over hospice care, which is more specific to end-of-life care.

A current challenge for home health care is the issue of family responsibility for the role of caregiver. Which of the following statements reflect underlying factors that contribute to this home health care challenge? (Select all that apply.)

• Able family members with multiple obligations

• Debilitation of family members

• Number of women working outside the home

• Reimbursement to family

• Social support systems for caregivers

Answer explanation

The increasing number of women working outside the home limits available family members to take on caregiving roles, contributing to the challenge in home health care.

Which of the following is a primary goal of home health nursing care?

• To provide acute hospital-level interventions in the home

• To promote client independence and self-care abilities

• To replace the role of family caregivers

• To focus solely on medication administration

Answer explanation

The primary goal of home health nursing is to promote client independence and self-care abilities, enabling patients to manage their health effectively at home rather than relying solely on acute interventions or family caregivers.

When planning care for a home health client, which factor is most important for the nurse to consider?

• The client's home environment and available support systems

• The nurse's personal preferences for care delivery

• The agency's administrative structure

• The client's insurance provider

Answer explanation

The client's home environment and available support systems are crucial for effective care planning, as they directly impact the client's ability to receive and adhere to care. Other factors are secondary.

Which member of the interdisciplinary team is primarily responsible for coordinating all aspects of a home health client's care plan?

• Social worker

• Home health nurse

• Physical therapist

• Pharmacist

Answer explanation

The home health nurse is primarily responsible for coordinating all aspects of a home health client's care plan, ensuring that all team members work together effectively to meet the client's needs.