MULTIPLE CHOICE

1. Home care is being considered for a young child who is ventilator-dependent. Which factor is most important in deciding whether home care is appropriate?

a. Level of parents’ education

b. Presence of two parents in the home

c. Preparation and training of family

d. Family’s ability to assume all health care costs

2. The home health nurse asks a child’s mother many questions as part of the assessment. The mother answers many questions, then stops and says, “I don’t know why you ask me all this. Who gets to know this information?” The nurse should take which action?

a. Determine why the mother is so suspicious.

b. Determine what the mother does not want to tell.

c. Explain who will have access to the information.

d. Explain that everything is confidential and that no one else will know what is said.

3. When communicating with other professionals, it is important for home care nurses to:

a. ask others what they want to know.

b. share everything known about the family.

c. restrict communication to clinically relevant information.

d. recognize that confidentiality is not possible.

4. The home health nurse is caring for a child who requires complex care. The family expresses frustration related to obtaining accurate information about their child’s illness and its management. Which is the best action for the nurse?

a. Determine why family is easily frustrated.

b. Refer family to child’s primary care practitioner.

c. Clarify family’s request, and provide information they want.

d. Answer only questions that family needs to know about.

5. A family wants to begin oral feeding of their 4-year-old son, who is ventilator-dependent and currently tube-fed. They ask the home health nurse to feed him the baby food orally. The nurse recognizes a high risk of aspiration and an already compromised respiratory status. The most appropriate nursing action is to:

a. refuse to feed him orally because the risk is too high.

b. explain the risks involved, and then let the family decide what should be done.

c. feed him orally because the family has the right to make this decision for their child.

d. acknowledge their request, explain the risks, and explore with the family the available options.

6. The home health nurse outlines short- and long-term goals for a 10-year-old child with many complex health problems. Who should agree on these goals?

a. Family and nurse

b. Child, family, and nurse

c. All professionals involved

d. Child, family, and all professionals involved

7. One of the supervisors for a home health agency asks the nurse to give the family a survey evaluating the nurses and other service providers. The nurse should recognize this as:

a. inappropriate, unless nurses are able to evaluate family.

b. appropriate to improve quality of care.

c. inappropriate, unless nurses and other providers agree to participate.

d. inappropriate, because family lacks knowledge necessary to evaluate professionals.

8. The home care nurse has been visiting an adolescent with recently acquired quadriplegia. The teen’s mother tells the nurse, “I’m sick of providing all the care while my husband does whatever he wants to, whenever he wants to do it.” Which should be the initial action of the nurse?

a. Refer mother for counseling.

b. Listen and reflect mother’s feelings.

c. Ask father, in private, why he does not help.

d. Suggest ways the mother can get her husband to help.

9. The home health nurse is planning care for a 3-year-old boy who has Down syndrome and is receiving continuous oxygen. He recently began walking around furniture. He is spoon-fed by his parents and eats some finger foods. Which is the most appropriate goal to promote normal development?

a. Encourage mobility.

b. Encourage assistance in self-care.

c. Promote oral-motor development.

d. Provide opportunities for socialization.

10. A mother of a 5-year-old child, with complex health care needs and cared for at home, expresses anxiety about attending a kindergarten graduation exercise of a neighbor’s child. The mother says, “I wish it could be my child graduating from kindergarten.” The nurse recognizes that the mother is experiencing:

a. abnormal anxiety.

b. ineffective coping.

c. chronic sorrow.

d. denial.

11. A ventilator-dependent child is cared for at home by his parents. Nurses come for 4 hours each day giving the parents some relief. Which other strategy should the nurse recommend to give the parents a break from the responsibilities of caring for a ventilator-dependent child?

a. Encourage members from the parent’s church group to provide some relief care.

b. Train a trusted grandparent to provide an occasional break from the responsibilities of care.

c. Encourage the parents to pay out of pocket for additional private duty nurses.

d. Suggest the parents place the child in a care facility.

12. A nurse manager at a home-care agency is planning a continuing education program for the home-care staff nurses. Which type of continuing education program should the nurse manager plan?

a. On-line training modules

b. A structured written teaching module each nurse completes individually

c. A workshop training day, with a professional speaker, where nurses can interact with each other

d. One-on-one continuing education training with each nurse

13. A priority intervention the home-care nurse should teach parents to do to maintain infection control is:

a. sterilize equipment.

b. reuse equipment to decrease costs.

c. use proper hand hygiene.

d. use gloves when repositioning the child.

MULTIPLE RESPONSE

1. Which behaviors by the nurse indicate therapeutic nurse-family boundaries? (Select all that apply.)

a. Nurse visits family on days off.

b. House rules are negotiated.

c. Nurse buys child expensive gifts.

d. Communication is open and two-way.

2. A child dependent on medical technology is preparing to be discharged from the hospital to home. Which predischarge assessments should the nurse ensure? (Select all that apply.)

a. Emergency care and transport plan

b. Reliance on private duty nurses to teach the family infection control practices

c. Financial arrangements

d. Individualized home plan to be completed within the first month of the child’s discharge