Ramont2e Rev TIF Ch46

16
8/20/2019 Ramont2e Rev TIF Ch46 http://slidepdf.com/reader/full/ramont2e-rev-tif-ch46 1/16 Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test Bank Chapter 46 Question 1 Type: MCSA The nurse is preparing a client for discharge from the acute care facility. The client's daughter says her mother had two small fires within the past six months because she would heat food on the stove and forget it was there, and sometimes forgot to eat for several days at a time. The client is unsteady on her feet, and needs assistance getting out of the chair. The nurse suggests to the client and family that what type of placement might improve client safety 1 S!illed care facility 2 Custodial care facility ! "#$hour home care 4 %ehabilitation facility Corre"t #ns$er: " Rationa%e 1& The client might benefit from placement in a custodial care facility to assist the client in meeting daily needs. The client has no need for s!illed nursing care, and it is unli!ely the client would benefit from rehabilitation, because it will not improve the client's memory deficit. "#$hour home care is very expensive, and i is unli!ely they will receive third$party reimbursement for this. Rationa%e 2& The client might benefit from placement in a custodial care facility to assist the client in meeting daily needs. The client has no need for s!illed nursing care, and it is unli!ely the client would benefit from rehabilitation, because it will not improve the client's memory deficit. "#$hour home care is very expensive, and i is unli!ely they will receive third$party reimbursement for this. Rationa%e !& The client might benefit from placement in a custodial care facility to assist the client in meeting daily needs. The client has no need for s!illed nursing care, and it is unli!ely the client would benefit from rehabilitation, because it will not improve the client's memory deficit. "#$hour home care is very expensive, and i is unli!ely they will receive third$party reimbursement for this. Rationa%e 4& The client might benefit from placement in a custodial care facility to assist the client in meeting daily needs. The client has no need for s!illed nursing care, and it is unli!ely the client would benefit from rehabilitation, because it will not improve the client's memory deficit. "#$hour home care is very expensive, and i is unli!ely they will receive third$party reimbursement for this. &%o'a% Rationa%e: Cogniti(e )e(e%: Applying %amont, iedringhous, Comprehensive Nursing Care "nd (dition )pdate Test *an! Copyright "+" by -earson (ducation, nc.

Transcript of Ramont2e Rev TIF Ch46

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Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test

Bank 

Chapter 46Question 1

Type: MCSA

The nurse is preparing a client for discharge from the acute care facility. The client's daughter says her mother had

two small fires within the past six months because she would heat food on the stove and forget it was there, and

sometimes forgot to eat for several days at a time. The client is unsteady on her feet, and needs assistance getting

out of the chair. The nurse suggests to the client and family that what type of placement might improve client

safety

1 S!illed care facility

2 Custodial care facility

! "#$hour home care

4 %ehabilitation facility

Corre"t #ns$er: "

Rationa%e 1& The client might benefit from placement in a custodial care facility to assist the client in meetingdaily needs. The client has no need for s!illed nursing care, and it is unli!ely the client would benefit fromrehabilitation, because it will not improve the client's memory deficit. "#$hour home care is very expensive, and iis unli!ely they will receive third$party reimbursement for this.

Rationa%e 2& The client might benefit from placement in a custodial care facility to assist the client in meetingdaily needs. The client has no need for s!illed nursing care, and it is unli!ely the client would benefit fromrehabilitation, because it will not improve the client's memory deficit. "#$hour home care is very expensive, and iis unli!ely they will receive third$party reimbursement for this.

Rationa%e !& The client might benefit from placement in a custodial care facility to assist the client in meetingdaily needs. The client has no need for s!illed nursing care, and it is unli!ely the client would benefit fromrehabilitation, because it will not improve the client's memory deficit. "#$hour home care is very expensive, and iis unli!ely they will receive third$party reimbursement for this.

Rationa%e 4& The client might benefit from placement in a custodial care facility to assist the client in meetingdaily needs. The client has no need for s!illed nursing care, and it is unli!ely the client would benefit fromrehabilitation, because it will not improve the client's memory deficit. "#$hour home care is very expensive, and iis unli!ely they will receive third$party reimbursement for this.

&%o'a% Rationa%e:

Cogniti(e )e(e%: Applying

%amont, iedringhous, Comprehensive Nursing Care "nd (dition )pdate Test *an! 

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C%ient Need: Safe (ffective Care (nvironmentC%ient Need *u':

Nursing+ntegrated Con"epts: ursing -rocess& -lanning

)earning -ut"ome: /ifferentiate between s!illed and custodial care in a long$term care facility and state whythese facilities are important.

Question 2

Type: MCSA

The nurse is caring for an older client who was admitted for partial$thic!ness burns to the hands and arms

following a !itchen accident. The client says she is afraid to return home for fear something else will happen. The

nurse recommends&

1 A s!illed nursing home.

2 An assisted$living center.

! Moving in with a family member.

4 0ospice care.

Corre"t #ns$er: "

Rationa%e 1& Assisted$living centers range from rooms in a long$term care facility to small independentapartments with a common cafeteria and nursing care to assist with meeting A/1s, and would be mostappropriate for this client. The family's willingness to have this client move in, and proximity, are un!nown.0ospice care is indicated for the client with a life expectancy of six months or less, which does not apply to thisclient. There are no indications that s!illed care is needed.

Rationa%e 2& Assisted$living centers range from rooms in a long$term care facility to small independentapartments with a common cafeteria and nursing care to assist with meeting A/1s, and would be mostappropriate for this client. The family's willingness to have this client move in, and proximity, are un!nown.0ospice care is indicated for the client with a life expectancy of six months or less, which does not apply to thisclient. There are no indications that s!illed care is needed.

Rationa%e !& Assisted$living centers range from rooms in a long$term care facility to small independentapartments with a common cafeteria and nursing care to assist with meeting A/1s, and would be mostappropriate for this client. The family's willingness to have this client move in, and proximity, are un!nown.0ospice care is indicated for the client with a life expectancy of six months or less, which does not apply to this

client. There are no indications that s!illed care is needed.

Rationa%e 4& Assisted$living centers range from rooms in a long$term care facility to small independentapartments with a common cafeteria and nursing care to assist with meeting A/1s, and would be mostappropriate for this client. The family's willingness to have this client move in, and proximity, are un!nown.0ospice care is indicated for the client with a life expectancy of six months or less, which does not apply to thisclient. There are no indications that s!illed care is needed.

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&%o'a% Rationa%e:

Cogniti(e )e(e%: Applying

C%ient Need: Safe (ffective Care (nvironmentC%ient Need *u':

Nursing+ntegrated Con"epts: ursing -rocess& mplementation

)earning -ut"ome: /ifferentiate between s!illed and custodial care in a long$term care facility and state whythese facilities are important.

Question !

Type: MCMA

The 1-213 wor!ing in an acute care facility decides to 4uit and ta!e a position in a long$term care facility.

The nurse correctly anticipates that the change in position will result in& 5Select all that apply.6

*tandard Te.t: Select all that apply.

1 ncreased responsibility.

2 ncreased autonomy.

! ncreased salary.

4 /ecreased hours of wor!.

/ /ecreased wor!load.

Corre"t #ns$er: ,"

Rationa%e 1& 7ften the 1-213 finds she has increased responsibility and autonomy when wor!ing in a long$term care facility as compared with an acute care center. Salary might be the same, less, or more than she was paiwor!ing at the acute care center, and conclusions cannot be drawn about this. 0ours of wor! depend on the hoursshe chooses to wor!8full time is still 9:$#+ hours, depending on whether the facility wor!s ;$ or "$hour shifts.<or!load should be comparable.

Rationa%e 2& 7ften the 1-213 finds she has increased responsibility and autonomy when wor!ing in a long$term care facility as compared with an acute care center. Salary might be the same, less, or more than she was paiwor!ing at the acute care center, and conclusions cannot be drawn about this. 0ours of wor! depend on the hoursshe chooses to wor!8full time is still 9:$#+ hours, depending on whether the facility wor!s ;$ or "$hour shifts.

<or!load should be comparable.

Rationa%e !& 7ften the 1-213 finds she has increased responsibility and autonomy when wor!ing in a long$term care facility as compared with an acute care center. Salary might be the same, less, or more than she was paiwor!ing at the acute care center, and conclusions cannot be drawn about this. 0ours of wor! depend on the hoursshe chooses to wor!8full time is still 9:$#+ hours, depending on whether the facility wor!s ;$ or "$hour shifts.<or!load should be comparable.

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Rationa%e 4& 7ften the 1-213 finds she has increased responsibility and autonomy when wor!ing in a long$term care facility as compared with an acute care center. Salary might be the same, less, or more than she was paiwor!ing at the acute care center, and conclusions cannot be drawn about this. 0ours of wor! depend on the hoursshe chooses to wor!8full time is still 9:$#+ hours, depending on whether the facility wor!s ;$ or "$hour shifts.<or!load should be comparable.

Rationa%e /& 7ften the 1-213 finds she has increased responsibility and autonomy when wor!ing in a long$

term care facility as compared with an acute care center. Salary might be the same, less, or more than she was paiwor!ing at the acute care center, and conclusions cannot be drawn about this. 0ours of wor! depend on the hoursshe chooses to wor!8full time is still 9:$#+ hours, depending on whether the facility wor!s ;$ or "$hour shifts.<or!load should be comparable.

&%o'a% Rationa%e:

Cogniti(e )e(e%: Applying

C%ient Need: Safe (ffective Care (nvironmentC%ient Need *u':

Nursing+ntegrated Con"epts: ursing -rocess& -lanning

)earning -ut"ome: /iscuss the roles and responsibilities of the 1-213 in long$term care.

Question 4

Type: MCSA

The nurse wor!ing in a long$term care facility safely delegates which of the following to the unlicensed assistive

 personnel 5)A-6

1 *athing a client who is showing signs of imminent death

2 7btaining vital signs on a client who developed shortness of breath

! -roviding fresh ice and water to everyone on the unit

4 Transferring an elderly man from the chair to the bed independently

Corre"t #ns$er: 9

Rationa%e 1& The )A- can safely fill water pitchers for the clients on the unit. The client who is showing signs ofimminent death should be bathed, if absolutely needed, by the nurse. An unstable client should have vital signsassessed by the nurse. Transferring a client from chair to bed is rarely done alone, and usually re4uires others to

ma!e the move safely.

Rationa%e 2& The )A- can safely fill water pitchers for the clients on the unit. The client who is showing signs ofimminent death should be bathed, if absolutely needed, by the nurse. An unstable client should have vital signsassessed by the nurse. Transferring a client from chair to bed is rarely done alone, and usually re4uires others toma!e the move safely.

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Rationa%e !& The )A- can safely fill water pitchers for the clients on the unit. The client who is showing signs ofimminent death should be bathed, if absolutely needed, by the nurse. An unstable client should have vital signsassessed by the nurse. Transferring a client from chair to bed is rarely done alone, and usually re4uires others toma!e the move safely.

Rationa%e 4& The )A- can safely fill water pitchers for the clients on the unit. The client who is showing signs ofimminent death should be bathed, if absolutely needed, by the nurse. An unstable client should have vital signs

assessed by the nurse. Transferring a client from chair to bed is rarely done alone, and usually re4uires others toma!e the move safely.

&%o'a% Rationa%e:

Cogniti(e )e(e%: Applying

C%ient Need: Safe (ffective Care (nvironmentC%ient Need *u':

Nursing+ntegrated Con"epts: ursing -rocess& -lanning

)earning -ut"ome: dentify the 1-213 role in supervising and delegating to nursing assistants and aides.

Question /

Type: MCSA

The nurse delegates bathing, dressing, and vital signs measurement of a client to the unlicensed assistive

 personnel 5)A-6. The nurse supervises the care provided by the )A- and finds the )A- washing the client's arm

from shoulder to wrist. The nurse's best action is to&

1 %eprimand the )A- in front of the client and demonstrate proper techni4ue.

2 Spea! with the )A- privately and explain why the client's extremities are bathed distal to proximal.

! /ismiss the incident as not important enough to be concerned with.

4 nform the nursing supervisor of the )A-'s ineptitude, and recommend a reprimand.

Corre"t #ns$er: "

Rationa%e 1& Correction should always be done privately, and should include rationale for improvement. The )Ashould never be corrected in front of the client, and the error is not serious enough to re4uire a reprimand.0owever, it is important the )A- improve techni4ue to benefit future clients.

Rationa%e 2& Correction should always be done privately, and should include rationale for improvement. The )Ashould never be corrected in front of the client, and the error is not serious enough to re4uire a reprimand.0owever, it is important the )A- improve techni4ue to benefit future clients.

Rationa%e !& Correction should always be done privately, and should include rationale for improvement. The )Ashould never be corrected in front of the client, and the error is not serious enough to re4uire a reprimand.0owever, it is important the )A- improve techni4ue to benefit future clients.

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Rationa%e 4& Correction should always be done privately, and should include rationale for improvement. The )Ashould never be corrected in front of the client, and the error is not serious enough to re4uire a reprimand.0owever, it is important the )A- improve techni4ue to benefit future clients.

&%o'a% Rationa%e:

Cogniti(e )e(e%: Applying

C%ient Need: Safe (ffective Care (nvironmentC%ient Need *u':

Nursing+ntegrated Con"epts: ursing -rocess& mplementation

)earning -ut"ome: dentify the 1-213 role in supervising and delegating to nursing assistants and aides.

Question 6

Type: MCSA

The nurse orienting a new graduate nurse who is beginning a new =ob at the facility explains the role of the

respiratory therapist by saying&

1 >f the client has any respiratory needs, you call the respiratory therapist to ta!e care of it.>

2 >The respiratory therapist is the only one who can provide respiratory treatments.>

! >The respiratory therapist helps to care for clients with respiratory problems.>

4 >The respiratory therapist helps to provide respiratory treatments.>

Corre"t #ns$er: 9

Rationa%e 1& <hile the respiratory therapist is not solely, or even ultimately, responsible for care of clients withrespiratory system problems, she is assistive in providing treatments, setting up and caring for mechanicalventilators, overseeing oxygen therapy, and offering advice to improve respiratory care. ?acility policy will dictatwho does what, but the respiratory therapist would not be responsible for only respiratory treatments. n somefacilities, it might be the respiratory therapist who draws arterial blood gases, suctions clients with tracheostomieand possibly even assists with trach care.

Rationa%e 2& <hile the respiratory therapist is not solely, or even ultimately, responsible for care of clients withrespiratory system problems, she is assistive in providing treatments, setting up and caring for mechanicalventilators, overseeing oxygen therapy, and offering advice to improve respiratory care. ?acility policy will dictatwho does what, but the respiratory therapist would not be responsible for only respiratory treatments. n some

facilities, it might be the respiratory therapist who draws arterial blood gases, suctions clients with tracheostomieand possibly even assists with trach care.

Rationa%e !& <hile the respiratory therapist is not solely, or even ultimately, responsible for care of clients withrespiratory system problems, she is assistive in providing treatments, setting up and caring for mechanicalventilators, overseeing oxygen therapy, and offering advice to improve respiratory care. ?acility policy will dictatwho does what, but the respiratory therapist would not be responsible for only respiratory treatments. n some

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facilities, it might be the respiratory therapist who draws arterial blood gases, suctions clients with tracheostomieand possibly even assists with trach care.

Rationa%e 4& <hile the respiratory therapist is not solely, or even ultimately, responsible for care of clients withrespiratory system problems, she is assistive in providing treatments, setting up and caring for mechanicalventilators, overseeing oxygen therapy, and offering advice to improve respiratory care. ?acility policy will dictatwho does what, but the respiratory therapist would not be responsible for only respiratory treatments. n some

facilities, it might be the respiratory therapist who draws arterial blood gases, suctions clients with tracheostomieand possibly even assists with trach care.

&%o'a% Rationa%e:

Cogniti(e )e(e%: Applying

C%ient Need: Safe (ffective Care (nvironmentC%ient Need *u':

Nursing+ntegrated Con"epts: ursing -rocess& mplementation

)earning -ut"ome: /escribe the multidisciplinary approach to long$term client care, including the importanceof family.

Question 0

Type: MCSA

The nurse caring for a client with severe rheumatoid arthritis observes the client eating brea!fast and determines

the client would be more independent if the utensils were easier to hold. The nurse communicates with what team

member to meet this need

1 -hysical therapist

2 -hysician

! %egistered nurse

4 7ccupational therapist

Corre"t #ns$er: #

Rationa%e 1& The occupational therapist provides daily activities to stimulate the mind, and orders adaptivedevices to improve the independence of the client. The physical therapist would be useful if the client re4uiredexercises to strengthen the hand, but not in obtaining assistive devices. The physician might need to approve the

device in some facilities, but the nurse would spea! to the occupational therapist to obtain the device anddetermine the usefulness of a device before tal!ing with the physician. The 1-213 can spea! with theoccupational therapist independently without involving the % in most facilities.

Rationa%e 2& The occupational therapist provides daily activities to stimulate the mind, and orders adaptivedevices to improve the independence of the client. The physical therapist would be useful if the client re4uiredexercises to strengthen the hand, but not in obtaining assistive devices. The physician might need to approve thedevice in some facilities, but the nurse would spea! to the occupational therapist to obtain the device and

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determine the usefulness of a device before tal!ing with the physician. The 1-213 can spea! with theoccupational therapist independently without involving the % in most facilities.

Rationa%e !& The occupational therapist provides daily activities to stimulate the mind, and orders adaptivedevices to improve the independence of the client. The physical therapist would be useful if the client re4uiredexercises to strengthen the hand, but not in obtaining assistive devices. The physician might need to approve thedevice in some facilities, but the nurse would spea! to the occupational therapist to obtain the device and

determine the usefulness of a device before tal!ing with the physician. The 1-213 can spea! with theoccupational therapist independently without involving the % in most facilities.

Rationa%e 4& The occupational therapist provides daily activities to stimulate the mind, and orders adaptivedevices to improve the independence of the client. The physical therapist would be useful if the client re4uiredexercises to strengthen the hand, but not in obtaining assistive devices. The physician might need to approve thedevice in some facilities, but the nurse would spea! to the occupational therapist to obtain the device anddetermine the usefulness of a device before tal!ing with the physician. The 1-213 can spea! with theoccupational therapist independently without involving the % in most facilities.

&%o'a% Rationa%e:

Cogniti(e )e(e%: Applying

C%ient Need: Safe (ffective Care (nvironmentC%ient Need *u':

Nursing+ntegrated Con"epts: ursing -rocess& mplementation

)earning -ut"ome: /escribe the multidisciplinary approach to long$term client care, including the importanceof family.

Question

Type: MCSA

The nurse is wor!ing in a neonatal intensive care unit and is caring for a baby born with myelomeningocele. The

 baby developed multiple infections, one of which resulted in removal of a large part of the bowel and creation of

an ileostomy. The baby was on the mechanical ventilator for several wee!s, and developed bronchopulmonary

dysplasia@ he currently has a tracheostomy. The parents do not feel they are capable of caring for this child's

multiple medical problems, because they both wor! outside the home and have four other children to care for. Th

nurse attends a client care conference and suggests placing the child in a&

1 %ehabilitation facility.

2 1ong$term care facility.

! ?oster home.

4 Acute care facility.

Corre"t #ns$er: "

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Rationa%e 1& This client might benefit from placement in a pediatric long$term care facility that is capable ofcaring for an infant with multiple medical needs until the child's condition is stabilied enough to allow dischargeto the home. The infant is too young to benefit from rehabilitation, although physical therapy will play animportant role in this child's care. The parents' inability to provide s!illed nursing care does not indicate a need toremove the child from their custody. The child is already in an acute care facility.

Rationa%e 2& This client might benefit from placement in a pediatric long$term care facility that is capable of

caring for an infant with multiple medical needs until the child's condition is stabilied enough to allow dischargeto the home. The infant is too young to benefit from rehabilitation, although physical therapy will play animportant role in this child's care. The parents' inability to provide s!illed nursing care does not indicate a need toremove the child from their custody. The child is already in an acute care facility.

Rationa%e !& This client might benefit from placement in a pediatric long$term care facility that is capable ofcaring for an infant with multiple medical needs until the child's condition is stabilied enough to allow dischargeto the home. The infant is too young to benefit from rehabilitation, although physical therapy will play animportant role in this child's care. The parents' inability to provide s!illed nursing care does not indicate a need toremove the child from their custody. The child is already in an acute care facility.

Rationa%e 4& This client might benefit from placement in a pediatric long$term care facility that is capable ofcaring for an infant with multiple medical needs until the child's condition is stabilied enough to allow dischargeto the home. The infant is too young to benefit from rehabilitation, although physical therapy will play animportant role in this child's care. The parents' inability to provide s!illed nursing care does not indicate a need toremove the child from their custody. The child is already in an acute care facility.

&%o'a% Rationa%e:

Cogniti(e )e(e%: Analying

C%ient Need: Safe (ffective Care (nvironmentC%ient Need *u':

Nursing+ntegrated Con"epts: ursing -rocess& mplementation)earning -ut"ome: /iscuss the specialied needs of young adult clients receiving care in a s!illed nursing orrehabilitation facility.

Question

Type: MCSA

The nurse is caring for an adolescent who is 4uadriplegic following an accident and who will re4uire

rehabilitation after discharge from the acute care facility. The nurse encourages placement in a facility that&

1 s as close to the teen's home as possible.

2 Allows the teen to be placed on a unit with peers.

! 0as a lower cost for treatment.

4 Cares for only children.

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Corre"t #ns$er: "

Rationa%e 1& %ehabilitation in a facility accustomed to caring for adolescents that will allow the teen to interactwith peers will be of greatest benefit, and will improve outcome for the client.

Rationa%e 2& %ehabilitation in a facility accustomed to caring for adolescents that will allow the teen to interactwith peers will be of greatest benefit, and will improve outcome for the client.

Rationa%e !& %ehabilitation in a facility accustomed to caring for adolescents that will allow the teen to interactwith peers will be of greatest benefit, and will improve outcome for the client.

Rationa%e 4& %ehabilitation in a facility accustomed to caring for adolescents that will allow the teen to interactwith peers will be of greatest benefit, and will improve outcome for the client.

&%o'a% Rationa%e:

Cogniti(e )e(e%: Applying

C%ient Need: Safe (ffective Care (nvironmentC%ient Need *u':

Nursing+ntegrated Con"epts: ursing -rocess& mplementation

)earning -ut"ome: /iscuss the specialied needs of young adult clients receiving care in a s!illed nursing orrehabilitation facility.

Question 13

Type: MCSA

The nurse is wor!ing on a rehabilitation unit and caring for a client whose family members come in every day an

as!, ><hat progress was made today> The nurse best responds to these repeated 4uestions by&

1 nforming the family they don't need to as! this 4uestion because they will be told when progress is made.

2 nforming the family that the client's progress can be assessed best by them when they visit.

! -roviding the client's progress and daily activities, with the client's permission.

4 nforming the family that they will need to tal! with the client to get that information.

Corre"t #ns$er: 9

Rationa%e 1& -art of the role of the nurse in rehabilitation is to review signs and symptoms and progress withfamily fre4uently, and this family's concern and involvement should be encouraged, because the client will re4uirthis support in order to maximie recovery. The client's confidentiality must be respected, so permission is neededfrom the client to share information with the family. f the client is unable to provide permission, the medical power of attorney will ma!e the decision.

Rationa%e 2& -art of the role of the nurse in rehabilitation is to review signs and symptoms and progress withfamily fre4uently, and this family's concern and involvement should be encouraged, because the client will re4uir

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this support in order to maximie recovery. The client's confidentiality must be respected, so permission is neededfrom the client to share information with the family. f the client is unable to provide permission, the medical power of attorney will ma!e the decision.

Rationa%e !& -art of the role of the nurse in rehabilitation is to review signs and symptoms and progress withfamily fre4uently, and this family's concern and involvement should be encouraged, because the client will re4uirthis support in order to maximie recovery. The client's confidentiality must be respected, so permission is needed

from the client to share information with the family. f the client is unable to provide permission, the medical power of attorney will ma!e the decision.

Rationa%e 4& -art of the role of the nurse in rehabilitation is to review signs and symptoms and progress withfamily fre4uently, and this family's concern and involvement should be encouraged, because the client will re4uirthis support in order to maximie recovery. The client's confidentiality must be respected, so permission is neededfrom the client to share information with the family. f the client is unable to provide permission, the medical power of attorney will ma!e the decision.

&%o'a% Rationa%e:

Cogniti(e )e(e%: ApplyingC%ient Need: -sychosocial ntegrityC%ient Need *u':

Nursing+ntegrated Con"epts: ursing -rocess& mplementation

)earning -ut"ome: /iscuss the roles of the 1-213 in rehabilitation.

Question 11

Type: MCSA

The nurse is caring for a young adult who came to the rehabilitation facility following severe full$thic!ness burns

over :+B of the body to regain function in order to perform A/1s. After several wee!s of therapy, the clientstates he wishes to leave the facility against medical advice without completing rehabilitation. The nurse&

1 nforms the client that he cannot leave until rehabilitation is completed.

2 Calls the physician to re4uest a sedative for the client.

! Calls the client's family to persuade him to stay in the facility.

4 otifies the % and2or physician that the client would li!e to leave.

Corre"t #ns$er: #

Rationa%e 1& ust as in the acute care facility, the client in the rehabilitation facility has the right to self$determinetreatment, and would not be !ept from leaving. t would be important to notify the % and2or physician dependinon facility policy, and the client will be as!ed to sign an elopement form before leaving.

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Rationa%e 2& ust as in the acute care facility, the client in the rehabilitation facility has the right to self$determinetreatment, and would not be !ept from leaving. t would be important to notify the % and2or physician dependinon facility policy, and the client will be as!ed to sign an elopement form before leaving.

Rationa%e !& ust as in the acute care facility, the client in the rehabilitation facility has the right to self$determinetreatment, and would not be !ept from leaving. t would be important to notify the % and2or physician dependinon facility policy, and the client will be as!ed to sign an elopement form before leaving.

Rationa%e 4& ust as in the acute care facility, the client in the rehabilitation facility has the right to self$determinetreatment, and would not be !ept from leaving. t would be important to notify the % and2or physician dependinon facility policy, and the client will be as!ed to sign an elopement form before leaving.

&%o'a% Rationa%e:

Cogniti(e )e(e%: Applying

C%ient Need: Safe (ffective Care (nvironmentC%ient Need *u':

Nursing+ntegrated Con"epts: ursing -rocess& mplementation

)earning -ut"ome: dentify legal and ethical concerns for long$term care and rehabilitation.

Question 12

Type: MCSA

The nurse observes the unlicensed assistive personnel caring for a pediatric client in the long$term care facility.

The client is in an obtunded state, and cries fre4uently with a high$pitched, cat$li!e cry. The )A- turns the child

abruptly when changing linen, tells the child to >shut up> when he cries, and grabs one foot to lift the child's

 buttoc!s to change the diaper. The nurse's priority action is to&

1 otify Child -rotective Services.

2 otify the % of the )A-'s behavior.

! Ta!e over care of the child and tell the )A- to wait in the staff lounge.

4 %eprimand the )A- and tell them to be gentler.

Corre"t #ns$er: 9

Rationa%e 1& The greatest priority is to remove the )A- from the responsibility of caring for the child. The )A-

should be as!ed to wait in the staff lounge, because the nurse would not want the )A- to move to another client.After the child is cared for, the nurse would notify the % supervisor of what was witnessed, and the incidentwould be properly documented.

Rationa%e 2& The greatest priority is to remove the )A- from the responsibility of caring for the child. The )A-should be as!ed to wait in the staff lounge, because the nurse would not want the )A- to move to another client.After the child is cared for, the nurse would notify the % supervisor of what was witnessed, and the incidentwould be properly documented.

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Rationa%e !& The greatest priority is to remove the )A- from the responsibility of caring for the child. The )A-should be as!ed to wait in the staff lounge, because the nurse would not want the )A- to move to another client.After the child is cared for, the nurse would notify the % supervisor of what was witnessed, and the incidentwould be properly documented.

Rationa%e 4& The greatest priority is to remove the )A- from the responsibility of caring for the child. The )A-should be as!ed to wait in the staff lounge, because the nurse would not want the )A- to move to another client.

After the child is cared for, the nurse would notify the % supervisor of what was witnessed, and the incidentwould be properly documented.

&%o'a% Rationa%e:

Cogniti(e )e(e%: Analying

C%ient Need: Safe (ffective Care (nvironmentC%ient Need *u':

Nursing+ntegrated Con"epts: ursing -rocess& mplementation

)earning -ut"ome: dentify legal and ethical concerns for long$term care and rehabilitation.

Question 1!

Type: MCSA

The nurse wor!ing in a custodial care facility wal!s into a room to administer medication and finds the client

having a sexually intimate encounter with another client. The nurse's best action at this time is to&

1 Ma!e a noise to indicate that the nurse is in the room, and wait for the clients to regain composure.

2 Call Security to investigate the matter.

! Duietly leave the room and !noc! on the door.

4 otify the % supervisor and physician.

Corre"t #ns$er: 9

Rationa%e 1& The nurse should leave the room and, depending on the urgency of what the nurse planned to do,either come bac! in a little while or !noc! on the door. This respects the client's privacy and preventsembarrassment. There is no need to notify anyone, and the client's need for privacy should be respected.

Rationa%e 2& The nurse should leave the room and, depending on the urgency of what the nurse planned to do,

either come bac! in a little while or !noc! on the door. This respects the client's privacy and preventsembarrassment. There is no need to notify anyone, and the client's need for privacy should be respected.

Rationa%e !& The nurse should leave the room and, depending on the urgency of what the nurse planned to do,either come bac! in a little while or !noc! on the door. This respects the client's privacy and preventsembarrassment. There is no need to notify anyone, and the client's need for privacy should be respected.

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Rationa%e 4& The nurse should leave the room and, depending on the urgency of what the nurse planned to do,either come bac! in a little while or !noc! on the door. This respects the client's privacy and preventsembarrassment. There is no need to notify anyone, and the client's need for privacy should be respected.

&%o'a% Rationa%e:

Cogniti(e )e(e%: Analying

C%ient Need: -sychosocial ntegrityC%ient Need *u':

Nursing+ntegrated Con"epts: ursing -rocess& mplementation

)earning -ut"ome: dentify legal and ethical concerns for long$term care and rehabilitation.

Question 14

Type: MCSA

The nurse is caring for a :E$year$old client who was admitted for care of partial$thic!ness burns caused by the

client's wea!ened condition secondary to chemotherapy side effects. The family wants the client admitted to a

long$term care facility for custodial care until the chemotherapy treatments are completed. The nurse informs thefamily&

1 >Medicare will not cover the cost of custodial care.>

2 >Medicare will cover ++B of the cost of the first ++ days.>

! >Medicare will cover ++B of the cost for the first "+ days and all but FGH for the next ;+ days.>

4 >Medicare will cover the cost of admission to the long$term care facility.>

Corre"t #ns$er:

Rationa%e 1& Medicare will cover only s!illed care, not custodial care, and only if the client is admitted for threedays and is transferred for care related to the reason for admission, which in this case is burns, which do notre4uire s!illed care. As a result, this client's cost of custodial care will not be covered by Medicare.

Rationa%e 2& Medicare will cover only s!illed care, not custodial care, and only if the client is admitted for threedays and is transferred for care related to the reason for admission, which in this case is burns, which do notre4uire s!illed care. As a result, this client's cost of custodial care will not be covered by Medicare.

Rationa%e !& Medicare will cover only s!illed care, not custodial care, and only if the client is admitted for three

days and is transferred for care related to the reason for admission, which in this case is burns, which do notre4uire s!illed care. As a result, this client's cost of custodial care will not be covered by Medicare.

Rationa%e 4& Medicare will cover only s!illed care, not custodial care, and only if the client is admitted for threedays and is transferred for care related to the reason for admission, which in this case is burns, which do notre4uire s!illed care. As a result, this client's cost of custodial care will not be covered by Medicare.

&%o'a% Rationa%e:

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Cogniti(e )e(e%: Applying

C%ient Need: Safe (ffective Care (nvironmentC%ient Need *u':

Nursing+ntegrated Con"epts: ursing -rocess& mplementation

)earning -ut"ome: /iscuss Medicare, Medicaid, and insurance reimbursement for long$term care andrehabilitation.

Question 1/

Type: MCSA

The nurse is caring for a H;$year$old client who was recently diagnosed with a chronic disease. The client as!s

what he can do to offset the cost of long$term care if it becomes necessary as he ages. The nurse advises the clien

to tal! with their insurance agent about the possibility of&

1 1ong$term care insurance.

2 (xtended Medicare coverage.

! nvesting a portion of his income for future needs.

4 1ocal nursing home prepayment.

Corre"t #ns$er:

Rationa%e 1& 1ong$term care insurance is available, and helps to cover the cost of long$term care at any age.-olicies differ based on daily amount, length of time coverage will continue, and cost, so the client would be bestserved by discussing this with an insurance agent. ursing homes do not have prepayment plans at this time.

Rationa%e 2& 1ong$term care insurance is available, and helps to cover the cost of long$term care at any age.-olicies differ based on daily amount, length of time coverage will continue, and cost, so the client would be bestserved by discussing this with an insurance agent. ursing homes do not have prepayment plans at this time.

Rationa%e !& 1ong$term care insurance is available, and helps to cover the cost of long$term care at any age.-olicies differ based on daily amount, length of time coverage will continue, and cost, so the client would be bestserved by discussing this with an insurance agent. ursing homes do not have prepayment plans at this time.

Rationa%e 4& 1ong$term care insurance is available, and helps to cover the cost of long$term care at any age.-olicies differ based on daily amount, length of time coverage will continue, and cost, so the client would be best

served by discussing this with an insurance agent. ursing homes do not have prepayment plans at this time.

&%o'a% Rationa%e:

Cogniti(e )e(e%: Applying

C%ient Need: Safe (ffective Care (nvironmentC%ient Need *u':

Nursing+ntegrated Con"epts: ursing -rocess& mplementation

%amont, iedringhous, Comprehensive Nursing Care "nd (dition )pdate Test *an! 

Copyright "+" by -earson (ducation, nc.

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)earning -ut"ome: /iscuss Medicare, Medicaid, and insurance reimbursement for long$term care andrehabilitation.

%amont, iedringhous, Comprehensive Nursing Care "nd (dition )pdate Test *an! 

Copyright "+" by -earson (ducation, nc.