Black & Hawks: Medical-Surgical Nursing: Clinical Management for

Positive Outcomes, 7th Edition

Chapter 10: Home Health Care

MULTIPLE CHOICE

1. The area of nursing that is comprehensive and that promotes and preserves the health
of a population defines
a. hospital-based nursing practice.
b. community health nursing practice.
c. psychiatric–mental health practice.
d. private-duty nursing.
ANS: b
Community health nursing is a comprehensive synthesis of many areas of nursing with
the purpose of promoting and preserving the health of populations.

DIF: Cognitive Level: Knowledge REF: Text Reference: 167

TOP: Nursing Process Step: N/A MSC: NCLEX: N/A

2. Consumer need and demand for home health care has increased dramatically in recent
years because of
a. escalating heath care costs.
b. lack of services available in the hospital.
c. decreased number of physicians.
d. increased number of community practitioners.
ANS: a
The increase in home health services has resulted from rising health care costs, consumer
demand, managed care systems, and an aging population.

DIF: Cognitive Level: Comprehension REF: Text Reference: 167

TOP: Nursing Process Step: N/A MSC: NCLEX: N/A

3. The nurse explains to a client that the person who would be most likely to receive
home health care is the client who is
a. 65-years-old with a wrist fracture.
b. 68-years-old with a cataract in one eye.
c. 72-years-old with diabetes mellitus.
d. 74-years-old with a hearing impairment.
ANS: c
Home health clients are quite diverse, but circulatory disease is the primary medical
diagnosis, followed closely by diabetes and cancer.

DIF: Cognitive Level: Analysis REF: Text Reference: 168

Elsevier items and derived items 2005 by Elsevier Inc.

Chapter 10: Home Health Care 2

TOP: Nursing Process Step: Intervention

MSC: NCLEX: Health Promotion and Maintenance

4. The Henry Street Settlement in New York City, which offered public health nursing to
clients with chronic health problems, was established by
a. Frances Root.
b. Clara Barton.
c. Dorothea Dix.
d. Lillian Wald and Mary Brewster.
ANS: d
Lillian Wald and Mary Brewster established the Henry Street Settlement in 1893.

DIF: Cognitive Level: Knowledge REF: Text Reference: 168

TOP: Nursing Process Step: N/A MSC: NCLEX: N/A

5. The program that had the greatest influence on the number of agencies providing
community health care is
a. Medicare.
b. Aid to Families with Dependent Children.
c. Social Security.
d. Medicaid.
ANS: a
The enactment of Medicare legislation in 1965 accelerated the rate of agencies supplying
community health care.

DIF: Cognitive Level: Knowledge REF: Text Reference: 169

TOP: Nursing Process Step: N/A MSC: NCLEX: N/A

6. A home health nurse has a client with permanent left-sided weakness after a stoke
who is cared for by his wife and daughter. The nurse will design the plan of care to
a. help the wife manage the home.
b. reduce the impact of the client’s health care beliefs.
c. stimulate the client to become independent.
d. limit input from the wife and daughter.
ANS: c
The goal for home health care nursing is to help clients and their families become
independent as quickly as possible.

DIF: Cognitive Level: Application REF: Text Reference: 170

TOP: Nursing Process Step: Intervention
MSC: NCLEX: Health Promotion and Maintenance

7. The home health nurse uses the Omaha System for planning care and is able to
evaluate the client’s health status with the portion of that tool known as
a. Problem Classification.

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Chapter 10: Home Health Care 3

b. Intervention Scheme.
c. Problem Rating Scale.
d. Assessment and Analysis.
ANS: c
The Problem Rating Scale is a framework for measuring a client’s problem-specific
knowledge, behavior, and status and the client’s progress.

DIF: Cognitive Level: Application REF: Text Reference: 174, Table 10-1;
TOP: Nursing Process Step: Evaluation
MSC: NCLEX: Health Promotion and Maintenance

8. The client assessed by the nurse as being eligible for home health care covered by
Medicaid is a
a. 22-year-old white single mother receiving Aid to Families with Dependent
Children (AFDC).
b. 68-year-old black woman crippled by arthritis.
c. 65-year-old Hispanic man with end-stage renal failure.
d. 38-year-old Native American man whose arm was amputated in an industrial
accident.
ANS: a
The young mother is entitled because of her receipt of AFDC. Options 2 and 3 are
eligible for Medicare, but not option 4.

DIF: Cognitive Level: Analysis

REF: Text Reference: Evolve website: Bridge to Home Health Care
TOP: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance

9. The service requested and needed by an applicant to home health that would not be
eligible for coverage under Medicare is
a. home health aide.
b. physical therapy.
c. speech therapy.
d. housekeeping services.
ANS: d
Medicare covers many services for home health clients, but not housekeeping.

DIF: Cognitive Level: Knowledge

REF: Text Reference: Evolve website: Bridge to Home Health Care
TOP: Nursing Process Step: N/A MSC: NCLEX: N/A

10. An experienced home health nurse explains to a client that the Omaha System was
designed to facilitate
a. the nurse’s ability to visit more clients during the workday.
b. nursing practice, documentation, and data management.

Elsevier items and derived items 2005 by Elsevier Inc.

Chapter 10: Home Health Care 4

c. documentation of unusual events and associated malpractice risks.

d. client understanding of the overall health care plan.
ANS: b
The Omaha System is designed to facilitate nursing practice, documentation, and data
management.

DIF: Cognitive Level: Knowledge REF: Text Reference: 171

TOP: Nursing Process Step: Intervention
MSC: NCLEX: Health Promotion and Maintenance

11. The component that is not part of the Omaha System is

a. Problem Classification Scheme.
b. Intervention Scheme.
c. Rating Scale for Client Satisfaction.
d. Problem Rating Scale for Outcomes.
ANS: c
Rating client satisfaction is not part of the Omaha System.

DIF: Cognitive Level: Knowledge REF: Text Reference: 171

TOP: Nursing Process Step: N/A MSC: NCLEX: N/A

12. The domain of the Omaha System that the nurse would reference in making her
assessment relative to caretaking/parenting is
a. Environment.
b. Psychosocial.
c. Physiological.
d. Health-Related Behaviors.
ANS: b
Psychosocial component alludes to patterns of behavior, communication, relationships,
and development.

DIF: Cognitive Level: Comprehension REF: Text Reference: 172, 173, Box 10-1;
TOP: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance

13. All the following are components of the Problem Rating Scale for Outcomes in the
Omaha System except
a. Knowledge.
b. Prognosis.
c. Behavior.
d. Status.
ANS: b
The Omaha System Problem Rating Scale for Outcomes includes Knowledge, Behavior,
and Status, not prognosis.

Elsevier items and derived items 2005 by Elsevier Inc.

Chapter 10: Home Health Care 5

DIF: Cognitive Level: Knowledge REF: Text Reference: 176, Table 10-2;
TOP: Nursing Process Step: N/A MSC: NCLEX: N/A

14. The home health nurse explains to a client that she is using the Nightingale Tracker
as a
a. cumulative mileage log.
b. schedule for the day’s visits.
c. hand-held computer.
d. client satisfaction survey.
ANS: c
The Nightingale Tracker is a computerized communication system small enough to be
held in the hand.

DIF: Cognitive Level: Knowledge REF: Text Reference: 170

TOP: Nursing Process Step: Intervention
MSC: NCLEX: Health Promotion and Maintenance

15. The shift in focus from hospital-based care to home health care in the community has
resulted in
a. increased fragmentation of health care.
b. decreased provider accountability.
c. increased provider cooperation.
d. decreased systematic heath care delivery.
ANS: c
The increasing focus on home health care has increased provider accountability and
cooperation and systematic health care delivery and should decrease fragmentation.

DIF: Cognitive Level: Comprehension REF: Text Reference: 168

TOP: Nursing Process Step: N/A MSC: NCLEX: N/A

16. The primary disorder that accounts for more than 50% of home health services is
a. diabetes.
b. cancer.
c. pulmonary disorders.
d. circulatory disorders.
ANS: d
More than half of clients with home health care service have a circulatory disorder.

DIF: Cognitive Level: Knowledge REF: Text Reference: 168

TOP: Nursing Process Step: N/A MSC: NCLEX: N/A

17. The home health nurse explains that her philosophy is based on the belief that clients
a. should feel no responsibility for their health care.
b. should be knowledgeable about their health care.

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Chapter 10: Home Health Care 6

c. should adhere to the care plan generated by the nurse.

d. should alter cultural practices to meet health needs.
ANS: b
The philosophy of home health nursing is that the client should share in the responsibility
and the care planning and should not be asked to abandon cultural practices.

DIF: Cognitive Level: Comprehension REF: Text Reference: 169

TOP: Nursing Process Step: Intervention
MSC: NCLEX: Health Promotion and Maintenance

18. Besides abbreviating the assessment of a client, the major advantage of the rating
scales of the Omaha System is
a. quantification of the outcomes.
b. assurance of faster reimbursement.
c. elimination of further documentation.
d. improvement in client-nurse rapport.
ANS: a
Because of its taxonomy, the Omaha System can help identify problems more precisely
and can quantify them.

DIF: Cognitive Level: Analysis REF: Text Reference: 172

TOP: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance

19. The Evaluation component of the Omaha System allows the home health nurse to
a. compare ratings points from earlier assessments.
b. add all the points during the entire service period.
c. readjust earlier points based on the present assessment.
d. disregard all previous assessment points.
ANS: a
Evaluation is the concise and quantified product of the Omaha System and allows the
home health nurse to compare points from one assessment period to the next.

DIF: Cognitive Level: Application REF: Text Reference: 174

TOP: Nursing Process Step: Evaluation
MSC: NCLEX: Health Promotion and Maintenance

Elsevier items and derived items 2005 by Elsevier Inc.