A nurse is caring for an adolescent hospitalized for cellulitis. The nurse notes that the adolescent experiences many “mood swings” throughout the day. How should the nurse interpret this behavior?

Correct Answer: C

Rationale: The correct answer is C: It is normal behavior. Adolescents often experience mood swings due to hormonal changes and stress. The nurse should interpret this behavior as a normal part of adolescence. Referring to a mental health counselor (choice A) is not necessary unless there are other concerning symptoms. Further lab testing (choice B) is not indicated for mood swings. While feelings of depression (choice D) can cause mood swings, it is important to first consider the normal developmental changes in adolescents.

Correct Answer: B

Rationale: Managed care agencies contract with payers, such as insurance companies, to provide specified services to the enrolled clients at a predetermined price. Managed care agencies receive payment before offering services and are responsible for taking the financial risk of providing care to patients within the budgeted allotment. The nurse will not need to worry about patient referrals or personally knowing the clients before referral as this home care agency is part of a managed care group that has enrolled clients that need services. Envy from other nurses is not a risk faced by the nurse starting this business endeavor.

Correct Answer: C

Rationale: Certified home health agencies meet federal standards; therefore they are able to receive Medicare payments for services provided to eligible individuals. Not all home health agencies are certified.

Correct Answer: C

Rationale: An underlying premise of Albrecht's conceptual model is that professional satisfaction and effective patient outcomes depend on the education and experience of the home health nurse. Within the Albrecht nursing model, the three major elements for measuring the quality of home health care patient outcomes include structural, process, and outcome elements. Although nurses are usually the case managers, Medicare pays for skilled services, including occupational therapy and physical therapy. If nursing is not involved, the skilled professional would be the case manager.

Correct Answer: B

Rationale: Not all clients have a telephone. If that is the case, the nurse should check the referral for a telephone number where messages can be left. It is also worthwhile to contact the health care provider who made the referral to see whether the telephone number was omitted unintentionally. If the client does not have a telephone, the nurse may choose to make a drop-in visit. This type of visit consists of an unannounced visit to the client's home, during which the nurse explains the purpose of the referral, receives the client's permission for the visit, and appoints a time for a future visit with the client. The client may agree to the first visit while the nurse is there. It may be very difficult to determine if the client has family members in the area to relay information to the client. Sending a formal letter would not get to the client who needs services in a timely manner.