Nursing Elites

1. The home health nursing director is conducting an educational program for registered nurses and practical nurses about Medicare reimbursement. To obtain payment for Medicare services, what must be included in the client's record?

• A. A prescription from the healthcare provider for each visit made.
• B. Documentation of a skilled care service provided during the visit.
• C. A copy of the client's health history and social security card.
• D. A record of the preventative healthcare services provided during the visit.

Correct answer: B

Rationale: The correct answer is B: Documentation of skilled care services is required for Medicare reimbursement. Medicare reimbursement is based on the provision of skilled care services, not on prescriptions or preventative healthcare services. Including a copy of the client's health history and social security card is not a requirement for Medicare reimbursement.

2. A pre-term baby develops nasal flaring, cyanosis, and diminished breath sounds on one side. The provider's diagnosis is spontaneous pneumothorax. Which procedure should the nurse prepare for first?

• A. Cardiopulmonary resuscitation
• B. Insertion of a chest tube
• C. Oxygen therapy
• D. Assisted ventilation

Correct answer: B

Rationale: The correct answer is B: Insertion of a chest tube. In a case of spontaneous pneumothorax, the primary intervention is to insert a chest tube. This procedure allows the trapped air to escape from the pleural space, relieving pressure and enabling the lung to re-expand. Choices A, C, and D are not the initial interventions for spontaneous pneumothorax. Cardiopulmonary resuscitation is indicated for cardiac arrest, oxygen therapy may provide supportive care but does not address the underlying issue of trapped air in the pleural space, and assisted ventilation may be needed later but is not the first-line treatment for a pneumothorax.

3. An example of the continuum health model of health and wellness would be:

• A. a person is either well or not, and the emphasis is on continuously and aggressively treating people who are ill
• B. predicting that a person will most likely continue good health practices, based on his or her health practices in the past, such as getting flu shots
• C. using acupuncture and therapeutic touch to cure disease instead of traditional medical therapies
• D. none of the above

Correct answer: B

Rationale: The continuum health model emphasizes ongoing health practices based on past behaviors. Choice A is incorrect as it describes a more binary approach to health. Choice C is incorrect as it focuses on alternative therapies rather than the continuity of health practices.

4. What title should be given to this occupational health nurse job description?

• A. manager
• B. case manager
• C. health educator
• D. nurse consultant

Correct answer: D

Rationale: The correct title for this occupational health nurse job description is 'nurse consultant.' A nurse consultant is a registered professional nurse with expertise in occupational and environmental health nursing, effective communication skills, and good administrative and consultative abilities. Choice A, 'manager,' is incorrect as the job description does not primarily focus on managerial duties. Choice B, 'case manager,' is incorrect as it does not fully cover the scope of the described role. Choice C, 'health educator,' is incorrect as it does not encompass the administrative and consultative skills mentioned in the job description.

5. You organize community groups to participate in community activities. You can BEST motivate participation in the community health development program by:

• A. Conducting group work
• B. Instructing the people to agree with your plans
• C. Allowing the people to exercise decision-making
• D. Assigning people participative roles

Correct answer: C

Rationale: Allowing people to exercise decision-making is the best way to motivate participation in community activities. By involving the community in decision-making processes, you empower them and make them feel valued, which can lead to increased engagement and commitment. Choices A, B, and D do not foster a sense of ownership and empowerment among the community members, which are crucial for sustainable participation in community programs.

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