Chapter 38 Long term care Flashcards
(28 cards)
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. Which facility would be the best selection for this patient?
a. Subacute unit setting
b. Long-term care facility (nursing home)
c. Assisted living center
d. Continuing care retirement center (CCRC)
ANS: C
The assisted living center provides meals, transportation, social interaction, and a homelike
quality without the intrusion of the medical model. The patient’s age does not make her a
reasonable candidate for a CCRC. The patient does not require acute skilled nursing care.
The home health nurse helps an older adult couple plan changes in their home that will
facilitate care in their home as they age. What fraction of the US population live in a home
setting?
a. 1/4
b. 1/2
c. 1/3
d. 3/4
ANS: B
Approximately (11.3 million) of the US population over the age of 65 live in a home or
family setting.
The nurse confirms that the cost of caring for a relatively unimpaired older adult in a private
home is approximately what fraction of the cost of placing the older adult in a long-term
care facility?
a. 1/4
b. 1/3
c. 1/2
d. 2/3
ANS: C
It costs approximately half as much to care for an older adult at home as it would cost in a
long-term care facility.
What is the goal for services provided by home health care agencies?
a. Self-care
b. Assisted living
c. Rehabilitation
d. Improved function
ANS: C
Services provided by home health care agencies are aimed at rehabilitation.
The nurse clarifies to the family of a patient that one of the roles of the LPN/LVN in the
home care setting is to evaluate the care provided to the patient by which provider?
a. The family
b. Other licensed care providers
c. Nonlicensed staff.
d. The health care provider
ANS: C
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.
The family caring for an older adult in their home feels that they need assistance from a
hospice service. What is necessary for hospice service to be initiated?
a. A family request
b. A patient request
c. Medical certification
d. A referral by a hospice nurse
ANS: C
Hospice agencies provide care at the end of life. Medical certification is required for
terminal care.
The nurse suggests to a family caring for a member with early Alzheimer’s disease in their
home that they investigate the services of an adult day care center. What is a major benefit
of adult day care centers?
a. It takes the patient out on recreational outings.
b. It can provide daily hygiene.
c. It expands social interaction.
d. It is free to the public.
ANS: C
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.
What differentiates the services of a long-term care facility from that of an assisted living
facility?
a. Skilled nursing care
b. Personal care services
c. Weekly visits by the staff health care provider
d. Intensive rehabilitation services
ANS: B
Assisted living is a type of residential care setting where the resident receives personal care
services.
What would be the most appropriate guidance the nurse could provide an older adult couple
that is considering a continuing care retirement community (CCRC)?
a. Admittance is limited to people who are relatively unimpaired.
b. A contract is usually a lifetime commitment.
c. A contract is an acceptable tax shelter.
d. Contracts can be signed on a month-to-month basis.
ANS: B
CCRCs offer a complete range of health care services, from independent living to 24-hour
skilled nursing. In most cases, signing a contract with a CCRC is a lifetime commitment.
An 82-year-old patient recovering from a hip replacement could be expected to move from
the acute care hospital to which setting for rehabilitation?
a. A subacute care unit
b. An assisted living center
c. An adult day care center
d. A continuing care retirement community
ANS: A
Subacute units have a strong rehabilitative focus and a shorter length of stay than a
long-term care center.
What is the correct term for people who live in long-term care facilities?
a. Patients, because they will be receiving acute care.
b. Residents, because the facility has become their home.
c. Patients, because they seek professional medical services.
d. Customers, because they are purchasing care service.
ANS: B
The older adult in a long-term care facility is referred to as a resident to reinforce the
homelike environment.
Which statement is true concerning a 50-year-old patient recovering from a stroke who is
going to a long-term care facility for a short stay?
a. Her regular hospitalization insurance will pay for the care.
b. She will still have daily health care provider visits.
c. She will need to contract outside physical therapy services.
d. She will probably be discharged within 6 months.
d. She will probably be discharged within 6 months.
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. What is this
approach called?
a. Team approach
b. Individualized approach
c. Interdisciplinary approach
d. Outgoing approach
ANS: C
The long-term care facility is an interdisciplinary setting.
What is the time limit for the legal administration of medications?
a. 30 minutes
b. 1 hour
c. 90 minutes
d. 2 hours
ANS: D
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.
The Omnibus Budget Reconciliation Act (OBRA) defines the requirements for which aspect
of care as it relates to long-term care?
a. Nursing care
b. Nutritional support
c. Quality of care
d. Staffing requirements
ANS: C
OBRA defines requirements for the quality of care given to residents of long-term care
facilities.
The Health Care Financing Administration (HCFA) conducts unannounced institutional
surveys annually to assess the quality of life for the patients. The findings of the surveys are
reported to:
a. various licensing boards.
b. facility administrators.
c. the public.
d. the US Department of Health and Human Services.
ANS: C
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.
A 48-year-old long-term care facility resident expresses concern that the cost of his care has
used up his assets. For what program should the nurse suggest that the resident apply to
cover the continued cost of living in a long-term facility?
a. Medicare
b. Hospitalization insurance
c. Medicaid
d. Public health funds
ANS: C
When adults have used all of their assets, they may then qualify for Medicaid. Medicaid is a
federally funded, state-operated program of medical assistance for people with low incomes.
Although the Occupational Safety and Health Act (OSHA) increases the cost of care, what
is a benefit that it provides for long-term care?
a. It ensures a safe environment for personnel.
b. It ensures that medications are administered safely.
c. It ensures that food is prepared safely.
d. It ensures safe ambulation and transportation of patients.
ANS: A
The OSHA guidelines significantly increase costs, but they also ensure a safe environment
for personnel, which is mandatory today.
A nurse helps a family understand that once hospice service is initiated, the focus of care
changes from rehabilitation and restoration to what type of care?
a. Maintaining the patient at the optimal level
b. Assisting with funeral planning
c. Relieving the family of care
d. Maintaining comfort as death approaches
ANS: D
Hospice care is focused on the provision of comfort to the person who is approaching death.
While hospice will assist with funeral planning as needed, it is not the focus of care.
Hospice provides respite for the family, but hospice does not relieve the family of care
duties.
What is included when the LVN/LPN completes the Resident Assessment Instrument
(RAI)?
a. Minimum Data Set (MDS) and the signature of the health care provider
b. Resident Assessment Protocols (RAPs) and the drug list
c. Minimum Data Set, Resident Assessment Protocols, and the RN’s signature
d. Resident Assessment Protocols and the signature of the administrator
ANS: C
The RAI must be signed by the RN and contain the RAPs and MDS.
The nurse assesses a patient’s ability to perform self-care activities, as well as more
complex social and household activities. What is provided from this assessment?
a. Physical status
b. Emotional status
c. Health status
d. Functional status
ANS: D
The functional status is related to activities of daily living (ADLs) and instrumental
activities of daily living (IADLs).
How often does the Omnibus Budget Reconciliation Act (OBRA) require that a summary
(including vital signs and weight) be obtained in the long-term care setting?
a. Daily
b. Weekly
c. Monthly
d. Yearly
ANS: C
A summary, including vital signs and weight, is only required on a monthly basis.
In a long-term care facility, the nurse takes an active part in formulating the resident’s plan
of care. How often is the plan of care revised?
a. Weekly
b. Every 90 days
c. Monthly
d. Every 6 months
ANS: B
In long-term care, the resident’s plan of care is reviewed by the interdisciplinary team every
90 days for resolution of problems or revision of goals and interventions.
The nurse recognizes that an ongoing assessment will help set priorities in the nursing care
plan of a long-term care resident. What does this allow the planning process to become?
a. Timely
b. Patient-centered
c. Preferential
d. Categorized
ANS:B
