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Foundations And Adult Health Nursing 5th Edition Christensen Kockrow Oden Test Bank

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Foundations And Adult Health Nursing 5th Edition Christensen Kockrow Oden Test Bank

  • ISBN-13: 9780323064866
  • ISBN: 0323064868

 

Description

Foundations And Adult Health Nursing 5th Edition Christensen Kockrow Oden Test Bank

  • ISBN-13: 9780323064866
  • ISBN: 0323064868

 

 

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Chapter 38: Long-Term Care

Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc.

 

MULTIPLE CHOICE

 

  1. In order to assist the resident to preserve a meaningful quality of life in a long-term care setting, the nurse will design a(n)
1. patient care plan.
2. individualized approach.
3. psychologically approved approach.
4. physician-approved approach.

 

 

ANS:   2

Maintain an individualized approach to assist the patient in preserving a meaningful quality of life.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1199

OBJ:    8                      TOP:    Long-term care

KEY:   Nursing Process Step: Planning

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. When a patient of Swedish origin who has lived in a Swedish community all of his life insists on taking a cold shower, the nurse assesses this as
1. a culturally based health behavior.
2. resulting from disorientation.
3. a religious practice.
4. a request that is not in his best interest.

 

 

ANS:   1

Culture greatly influences health behaviors and wellness practices.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    Page 1199

OBJ:    3                      TOP:    Culture            KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Psychosocial Integrity

 

  1. The home health nurse is assisting a family to select a long-term care facility for an 80-year-old widow in good health, who no longer drives, loves to play cards, can ambulate with a walker, and is oriented. The best selection for this patient would be
1. subacute unit setting.
2. long-term care facility (nursing home).
3. assisted living center.
4. continuing care retirement center (CCRC).

 

 

ANS:   3

The assisted living center provides meals, transportation, social interaction, and a home-like quality without the intrusion of the medical model. Her age does not make her a reasonable candidate for a CCRC. She does not require acute skilled nursing care.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    Page 1201 – 1203

OBJ:    3                      TOP:    Long-term care

KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The home health nurse helps an older adult couple plan changes in their home that will facilitate their care in their home as they age. The nurse takes into account that ____ of people over 65 live at home.
1. 40%
2. 45%
3. 55%
4. 67%

 

 

ANS:   4

The majority (67%) of people over the age of 65 live in a family setting.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1201

OBJ:    3                      TOP:    Long-term care

KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse confirms that the cost of caring for a relatively unimpaired older adult in a private home is approximately ____ the cost of placing him or her in a long-term care facility.
1. 1/4
2. 1/3
3. 1/2
4. 2/3

 

 

ANS:   3

It costs approximately half as much to care for an older adult at home as it would cost in a long-term care facility.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    Page 1201

OBJ:    5                      TOP:    Long-term care

KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse differentiates that services provided by home health care agencies are aimed at
1. self-care.
2. assisted living.
3. rehabilitation.
4. improved function.

 

 

ANS:   3

Services provided by home health care agencies are aimed at rehabilitation.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1202

OBJ:    9                      TOP:    Home health   KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse clarifies to the family of a patient that the role of the LPN/LVN in the home care setting is to be a resource person and to evaluate the care provided to the patient by
1. the family.
2. other licensed care providers.
3. nonlicensed staff.
4. the physician.

 

 

ANS:   3

One of the roles of the LPN/LVN in the home care setting may be to evaluate the care provided by CNAs, HHAs, homemakers, and personal care attendants.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1202

OBJ:    4                      TOP:    Home health   KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The LVN/LPN points out to the home health patient that the RN doing home health care provides many services, but is mainly employed by the home health agency in the capacity of
1. daily caregiver.
2. care administrator.
3. liaison between agency and state board.
4. setter of policy and protocols.

 

 

ANS:   2

The RN is also employed by the home health care agency as an administrator.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1202

OBJ:    9                      TOP:    Home health   KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The family caring for an older adult in their home feels like they need assistance from a hospice service. The nurse instructs them that service can be initiated by a
1. family request.
2. patient request.
3. medical certification.
4. referral by a hospice nurse.

 

 

ANS:   3

Hospice agencies provide care at the end of life. Medical certification is required for terminal care.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1202

OBJ:    9                      TOP:    Hospice           KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse suggests to a family who is taking care of an early Alzheimer’s patient in their home that they investigate the services of an adult day care center because such centers
1. will take patient out on recreational outings.
2. can provide daily hygiene.
3. expand social interaction.
4. are free to the public.

 

 

ANS:   3

Adult day care centers are open a large part of the day and offer several modalities to enhance social interaction and also give the family respite.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    Page 1203

OBJ:    9                      TOP:    Adult day care

KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse differentiates the services of a long-term care facility from that of an assisted living facility, which supplies residents with
1. skilled nursing care.
2. personal care services.
3. weekly visits by the staff physician.
4. intensive rehabilitation services.

 

 

ANS:   2

Assisted living is a type of residential care setting where the resident receives personal care services.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1203

OBJ:    9                      TOP:    Long-term care

KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse reminds an older adult couple considering a CCRC that they offer a complete range of heath care services from independent living to 24-hour skilled nursing, and a contract with a CCRC is
1. limited to people who are relatively unimpaired.
2. usually a lifetime commitment.
3. an acceptable tax shelter.
4. on a month-to-month basis.

 

 

ANS:   2

In most cases, signing a contract with a CCRC is a lifetime commitment.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1204

OBJ:    9                      TOP:    Long-term care

KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The LVN/LPN helps an 82-year-old patient recovering from a hip replacement understand that the remainder of her rehabilitation phase will not be spent in the acute hospital setting, but in a(n)
1. subacute care unit.
2. assisted living center.
3. adult day care center.
4. long-term care facility (nursing home).

 

 

ANS:   1

Subacute units have a stronger rehabilitative focus.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1204

OBJ:    2                      TOP:    Subacute         KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse explains that people in a long-term care facility are referred to as
1. patient because they will be receiving acute care.
2. resident because the facility has become their home.
3. patient because they seek professional medical services.
4. customer because they are purchasing care service.

 

 

ANS:   2

The older adult in a long-term care facility is referred to as a resident to reinforce the home-like environment.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1205

OBJ:    3                      TOP:    Long-term care

KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse assures a 50-year-old patient recovering from a stroke that because she is going to a long-term care facility for a short stay,
1. her regular hospitalization insurance will pay for the care.
2. she will still have daily physician visits.
3. she will need to contract outside physical therapy services.
4. she will probably be discharged within 6 months.

 

 

ANS:   4

A short-stay resident in a long-term care facility for rehabilitation will have residential physical therapy services and will usually be discharged within 6 months.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    Page 1205

OBJ:    3                      TOP:    Long-term care

KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. In the long-term care facility, health care professionals work together to meet the needs of older adults and to go over the care plan with the resident and family members. This approach is called a(n)
1. team approach.
2. individualized approach.
3. interdisciplinary approach.
4. outgoing approach.

 

 

ANS:   3

The long-term care facility is an interdisciplinary setting.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1206

OBJ:    8                      TOP:    Long-term care

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

 

  1. The nurse takes into account as he plans his care that there is a time limit for the legal administration of medications, which is
1. ½ hour.
2. 1 hour.
3. 1½ hours.
4. 2 hours.

 

 

ANS:   4

In long-term care, there is a 2-hour window for legal administration of medications, 1 hour before and 1 hour after the official administration time.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1206

OBJ:    4                      TOP:    Long-term care

KEY:   Nursing Process Step: Planning

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse, in planning care in a long-term care facility, is mindful of resident’s rights as Omnibus Budget Reconciliation Act (OBRA) defines the requirements for
1. nursing care.
2. nutritional support.
3. quality of care.
4. staffing requirements.

 

 

ANS:   3

OBRA defines requirements for the quality of care given to residents of long-term care facilities.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    Page 1207

OBJ:    4                      TOP:    Long-term care

KEY:   Nursing Process Step: Planning

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse incorporates a diligent skin assessment on residents in a long-term care facility because the Health Care Financing Administration (HFCA) conducts unannounced institutional surveys annually to assess the quality of life for the patients, which is reported to the
1. various licensing boards.
2. facility administrators.
3. public.
4. Department of Health and Human Services.

 

 

ANS:   3

Surveyors are required by law to visit the long-term care facility unannounced, on an annual basis and as needed, and the report is made public.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    Page 1207

OBJ:    4                      TOP:    Long-term care

KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. When the 48-year-old long-term care facility resident expresses concern over the cost of care that has used up his assets, the nurse suggests that to cover the continued cost of living in a long-term facility that the resident apply for
1. Medicare.
2. hospitalization insurance.
3. Medicaid.
4. public health funds.

 

 

ANS:   3

When adults have used all of their assets, they may then qualify for Medicaid.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    Page 1207

OBJ:    4                      TOP:    Long-term care

KEY:   Nursing Process Step: Assessment    MSC:   NCLEX: Psychosocial Integrity

 

  1. Although the Occupational Safety and Health Act (OSHA) increases the cost of care, it also specifies the requirements for safe
1. environment.
2. medication administration.
3. food preparation.
4. ambulation and transportation.

 

 

ANS:   1

The OSHA guidelines significantly increase costs, but they also ensure a safe environment, which is mandatory today.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1207

OBJ:    4                      TOP:    Long-term care

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

 

  1. The nurse helps the family to understand that once the hospice service is initiated, the focus of care changes from rehabilitation and restoration to that of
1. maintaining the patient at the optimal level.
2. assisting with funeral planning.
3. relieving the family of care.
4. maintaining comfort as death approaches.

 

 

ANS:   4

Hospice care is focused on the provision of comfort to the person who is approaching death.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1202

OBJ:    9                      TOP:    Hospice care

KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Psychosocial Integrity

 

  1. When the LVN/LPN completes the Resident Assessment Instrument (RAI), it must have the
1. Minimum Data Set (MDS) and the signature of the physician.
2. Resident Assessment Protocols (RAPs) and the drug list.
3. Minimum Data Set, Resident Assessment Protocols, and the RN’s signature.
4. Resident Assessment Protocols and the signature of the administrator.

 

 

ANS:   3

This assessment tool must be signed by the RN and contain the RAPs and MDS.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1207

OBJ:    4                      TOP:    Long-term care

KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse is assessing the patient’s ability to perform self-care activities as well as more complex social and household activities. The result of this assessment provides the patient’s
1. physical status.
2. emotional status.
3. health status.
4. functional status.

 

 

ANS:   4

The functional status is related to activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1208

OBJ:    8                      TOP:    Long-term care

KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse follows guidelines set out by OBRA when documenting a summary including vital signs and weights, which is required every
1. day.
2. week.
3. month.
4. year.

 

 

ANS:   3

A summary, including vital signs and weights, is only required on a monthly basis.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1208

OBJ:    4                      TOP:    Long-term care

KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. In a long-term care facility, the nurse takes an active part in formulating the resident’s plan of care, which is revised every
1. week.
2. 90 days.
3. bimonthly.
4. 30 days.

 

 

ANS:   2

The resident’s plan of care is reviewed by the interdisciplinary team every 90 days.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    Page 1208

OBJ:    4                      TOP:    Nursing process

KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse is aware that her ongoing assessment will help set the priorities in the nursing care plan of a long-term care resident. The timely assessments allow the planning process to be
1. based on the patient’s disease process.
2. patient-centered.
3. preferential.
4. categorized.

 

 

ANS:   2

The planning process must be patient-centered.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1208

OBJ:    7                      TOP:    Nursing process

KEY:   Nursing Process Step: Planning

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The long-term care facility nurse takes into account that seeing the resident, changing position, assessing for incontinence, providing skin care, and offering fluids are part the nurse’s responsibility, and are initiated to provide
1. continuity.
2. safety.
3. prevention.
4. reassurance.

 

 

ANS:   2

Nursing interventions basic to long-term care include monitoring for resident safety.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1209

OBJ:    9                      TOP:    Nursing process

KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The long-term care facility nurse should make rounds and monitor the resident for safety every
1. shift.
2. 4 hours.
3. 2 hours.
4. 6 hours.

 

 

ANS:   3

Nursing interventions basic to long-term care include making rounds and monitoring for resident safety every 2 hours.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1209

OBJ:    8                      TOP:    Nursing process

KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. When the patient asks why he must be transferred to a subacute unit from the hospital, the nurse replies that
1. reimbursement guidelines limit adults’ stays in an acute setting.
2. the physician can oversee care more closely in a subacute setting.
3. financial restrictions of insurance limit time spent in an acute care setting.
4. cost and services at the acute care setting are the same.

 

 

ANS:   1

DRGs limit adult stays in an acute care setting. The services are similar in a subacute unit, but the cost is much lower.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    Page 1204

OBJ:    4                      TOP:    Nursing process

KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance