Home Health Nursing Practice (ANA)

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. Visiting nurse associations or services were local agencies and generally led by a board of:

a) Local physicians who specialize in public health
b) Concerned citizens who recognized the need for at-home care
c) Nursing leaders who promoted disease prevention
d) Wealthy women concerned about community health

2. With the introduction of Medicare (Title XV111) which included a home health benefit and reimbursement benefit, physicians and hospitals:

a) Saw an influx of chronic illness
b) Discharged patients earlier
c) Developed more personalized care
d) Identified several complex needs of individuals

3. By 2020 the home health nurse will be caring for more patients who request palliative and hospice nursing services.

a) True
b) False

4. The goal of home health nursing is:
1. Prevent complications in the patient
2. Improve the health, well-being, and quality of life for patients and family
3. Keep costs to a minimum
4. Help people remain in their homes
5. Prevent readmissions to acute-care settings

a) 1, 2, and 3
b) 2 and 4
c) 1, 4, and 5
d) 3 and 5

5. Home health nurses provide nursing services to patients of all ages and cultures, all stages of health and illness

a) Provided they have insurance or Medicare
b) Under the direction of the county health department
c) And those needing end-of-life care

6. Home health nursing also places an emphasis on patient and caregiver teaching by assessing learning needs and styles of health literacy.

a) True
b) False

7. Home health nursing differs from other specialties in the degree of responsibility nurses assume in:

a) Managing the financial cost of care
b) Developing a home-care delivery model
c) Preventing potential problems
d) Assessing available community resources

8. An environmental assessment includes:
1. Support systems
2. Sanitation issues
3. Ability to manage medical equipment and devices
4. Presence of smoke alarms
5. Presence of firearms

a) 1, 3, and 4
b) 2 and 4
c) 1 and 3
d) 2, 4, and 5

9. The SMART goals are based on the patient's:

a) Projected outcome
b) Need for independence
c) Identified problems and diagnosis
d) Ability to pay

10. The plan of care is developed by:

a) Collaborating with the interdisciplinary team
b) Drawing upon evidence-based strategies and best practices
c) The severity of the patient's condition
d) Using community resources and other care givers to achieve goals

11. The ongoing assessment and supervision to ensure positive outcomes is done by the:

a) Registered nurse
b) LPN/LVN

12. Minimum qualifications for a registered nurse practicing in home health are:

a) Associate degree in nursing
b) Diploma
c) Baccalaureate degree in nursing
d) Masters degree in public health

13. The practice of this nurse is targeted toward achieving quality cost-effective outcomes in three spheres of influence: patient care, teaching nurses and colleagues, and acting as change agents:

a) Advanced Practice Registered Nurses
b) Clinical Nurse Specialist
c) Nurse Practitioner

14. When the nurse develops a plan of care for the patient, the patient's progress is continually evaluated and the plan of care is adjusted to:

a) Return the patient to the previous level of functioning
b) Achieve goals in the shortest amount of time possible
c) Enable the patient to achieve the highest possible level of health, well-being, and function

15. Patient advocacy is incorporated into which of the following:

a) Assessment
b) Planning
c) Implementation
d) Evaluation
e) All steps of the nursing process

16. The home health nurse administrator defines values and concentrates on the organization and its first priority which is:

a) The patient and the patient's needs
b) The availability of qualified staff
c) Maintaining accreditation standards
d) Knowing reimbursement requirements

17. This nurse provides education, support, and mentoring for new staff or supervisors:

a) Clinical manager
b) Qualityand performance improvement nurse

18. Teaching staff to document a comprehensive assessment, develop a plan of care, and measure patient success toward outcome achievement is the function of the:

a) Informatics liaison nurse
b) Clinical educator

19.

a) True
b) False

20. Research indicates the "noncompliant" patient may be due to low literacy, low self-esteem, and subtle cognitive impairment. The nurse's role is which of the following:

a) Respect for the individual (Provision 1)
b) Commitment to the patient (Provision 2)
c) Advocacy for the patient (Provision 3)
d) Duties to self and others (Provision 5)

21. In research by Dwyer et al., 2013, it was found that:
1. Common infections in home health patients are urinary tract infections, pneumonia, and cellulitis
2. Patients rather die at home
3. Patients with heart failure and rehospitalizations were the most studied
4. Twelve percent of home health patients had an infection
5. Medication discrepancies between hospital and home were alarmingly high

a) 2 and 3
b) 3 and 4
c) 2 and 5
d) 1 and 4
e) 5 only

22. The goal of these research publications was to evaluate the methodological quality of the studies, identify major trends and suggest further research:

a) The Omaha System
b) Transitional Care
c) Outcome and assessment Information Set
d) The Visiting Nurse Service of New York

23. The goal of telemonitoring is to increase the effectiveness and efficiency of communication to achieve enhanced quality of care, improved patient and clinician safety, and increased productivity.

a) True
b) False

24. This is an electronic collection of health-related information, managed and controlled by the individual.

a) Electronic health record
b) Personal health record
c) Accountable care record
d) Standardized charting record

25. A projected trend of patient engagement places emphasis on:

a) Increasing the use of telemonitoring systems
b) Better understanding of data collection and reporting
c) Greater responsibility for patient self-care in disease management
d) Providing education on coding, data collection, billing practices and regulatory changesChapter 2 Standards of Home Health Nursing Practice

26. An additional competency for the graduate level prepared home health nurse or the advanced practice registered nurse would be:

a) Obtain an acute medical history and identify discrepancies
b) Identify barriers to effective communication
c) Assess family dynamics, coping and caregiving skills, and knowledge of health and wellness
d) Using available information to identify patterns and variances
e) Initiate and interpret diagnostic tests and procedures

27. The home health registered nurse derives the diagnosis, needs or issues from:

a) Assessment data
b) Recommendations of the physician
c) Previous health records
d) Expected outcomes

28. A time estimate is included for the attainment of expected outcomes.

a) True
b) False

29. Strategies in the plan address the patients:

a) Support groups and community resources
b) Expected outcomes within a specific time frame
c) Identified diagnosis, deficits, or issues
d) SMART goals

30. It is acceptable to integrate traditional and complementary health care practices as appropriate in the implementation phase of the care plan.

a) True
b) False

31. The patient's care is managed so as to maximize patient engagement, independence, quality of life and optimal health. This is the role of the:

a) Home health registered nurse
b) Advanced practice registered nurse

32. Which of the following is utilized by the advanced practice registered nurse when promoting health and teaching:

a) Encourages patient engagement, especially self-care management decisions
b) Seeks opportunities for feedback and evaluation of the effectiveness of strategies
c) Engages patient alliances and advocacy groups in health teaching and health promotion activities
d) Provide patients with information about intended effects and adverse effects of therapies

33. When facilitating effectiveness of a consultation, the advanced practice registered nurse involves the patient, family, and caregivers in decision-making and negotiation of role responsibilities.

a) True
b) False

34. The home health registered nurse does which of the following in the evaluation phase:

a) Evaluates the accuracy of the diagnosis and the effectiveness of interventions
b) Evaluates the patient's achievement of short-term goals that empower self-efficacy
c) Provides information about costs and alternative treatment
d) Evaluate therapeutic and potential adverse effects of pharmacologic and non-pharmacologic treatment

35. One of the home health competencies when practicing ethically is:

a) Supports accuracy and truthfulness in coding, financing, and reporting at all levels
b) Uses expertise to influence health policy
c) Recognizes the centrality of the patient and family as core members of any health care team

36. The home health registered nurse provides education and consultation to other home health clinicians regarding strategies to enhance patient care and improve the disease self-management skills of patients, families and caregivers.

a) True
b) False

37. Research findings can be disseminated through presentations, publications, and consultation by the?

a) Home health registered nurse
b) Advanced practice registered nurse

38. In order to maintain a quality nursing practice, the home health registered nurse:

a) Develops a therapeutic and professional patient and nurse relationship
b) Conducts personalized health teaching and counseling
c) Serves as a role model to staff using evidence-based interventions
d) Applies and documents the nursing process in a responsible, accountable and ethical manner

39. The advanced practice registered nurse maintains quality of practice by:
1. Performing advanced assessments on patients with complex needs
2. Identifies expected outcomes that include effectiveness and patient satisfaction
3. Obtains and maintains relevant professional certification
4. Designs innovations to effect change in practice and improve health outcomes

a) I and 2
b) 3 only
c) 3 and 4

40. Which of the following communication skills promote behavior change in patients:
1. Motivational interviewing
2. A literature review
3. Videos and photographs
4. Counseling
5. Health coaching

a) 2 and 3
b) 1 and 3
c) 2 and 4
d) 5 only
e) 1, 4, and 5

41. A home health registered nurse participates in the education of nursing students and also:

a) Demonstrates how to resolve conflict among staff
b) Serves as a role model
c) Involves the student in patient and family-care issues
d) Gives hands-on advice and real-life situations to evaluate

42. The advanced practice registered nurse exhibits leadership by:

a) Using expertise to change health policies
b) Designing health information and patient education appropriate to patient and family
c) Documenting coordination of care
d) Mentoring colleagues in the acquisition of clinical knowledge, skills, abilities, and judgment

43. In order to achieve a positive outcome, the home health registered nurse applies negotiation techniques and group process with patients, families, caregivers, and the healthcare team.

a) True
b) False

44.

a) Adjusting the plan of care to facilitate the patient, family and caregiver
b) Conducting expert assessments and using evidence-based practice
c) Embracing change and becoming more effective
d) Inviting the contributions of the patient, family and team members to achieve optimal outcomes

45. The home health registered nurse can evaluate their own nursing practice in relation to professional practice standards and guidelines by:

a) Participating in a chart review
b) Documenting coordination of care
c) Promoting sharing of assessment data
d) Providing palliative and hospice care

46.

a) Prevent further illness, injury and disease
b) Recognize values, beliefs, and the need to remove bias
c) Assist the patient and family in factoring costs, risks, and benefits in decisions about treatment and care at home
d) Provide holistic care that addresses needs of diverse populations across the lifespan

47. The home health registered nurse can practice environmentally safe methods by:

a) Identifying the evidence when evaluating resources
b) Using judicious and appropriate use and disposal of products used in patient care
c) Improving the professional practice environment
d) Formulating recommendations to monitor safety

48. The advanced practice registered nurse can create an environmentally safe practice by:

a) Assessing a home for unsafe and unsanitary conditions
b) Advocating for technology to enhance safe practices
c) Taking action to achieve goals when evaluating a community
d) Critically evaluating the manner in which environmental health issues are presented by the popular media