CPNRE Community Health and Home Care Nursing — Questions and Answers
Question 1: During a home visit, a PN notices that an elderly client's refrigerator contains expired food and the client appears confused about when they last ate. Which of the following is the PN's priority action?
- Report the client to Adult Protective Services immediately
- Conduct a comprehensive nutritional and cognitive assessment and discuss findings with the care team (Correct answer)
- Provide the client with a grocery list and schedule another visit in 2 weeks
- Arrange for Meals on Wheels without further assessment
Correct answer: Conduct a comprehensive nutritional and cognitive assessment and discuss findings with the care team
The priority is to conduct a thorough assessment — nutritional status and cognitive function — before taking action. The findings should be shared with the interprofessional team to determine the most appropriate intervention. Reporting or arranging services without assessment is premature.
Question 2: A PN working in a community health centre is conducting a community needs assessment. Which data source would be most useful for identifying the leading causes of preventable death in the catchment area?
- Individual client intake forms from the past month
- Provincial vital statistics and epidemiological data (Correct answer)
- A survey of PN opinions about common presenting problems
- The centre's appointment scheduling records
Correct answer: Provincial vital statistics and epidemiological data
Provincial vital statistics and epidemiological data provide population-level information on morbidity, mortality, and risk factors — the foundation of a community needs assessment. Individual or anecdotal sources do not represent the broader population.
Question 3: Which of the following is a social determinant of health that a PN should consider when planning care for a client in the community?
- The client's current serum albumin level
- The client's housing stability and income level (Correct answer)
- The client's most recent blood pressure reading
- The client's prescribed medication list
Correct answer: The client's housing stability and income level
Social determinants of health include non-medical factors such as income, housing, education, and social support. These factors significantly influence health outcomes and must be incorporated into community care planning. Clinical parameters like albumin or blood pressure are health indicators, not social determinants.
Question 4: A PN in a home care setting observes that a client is not taking their medications as prescribed. Before concluding the client is non-compliant, which factor should the PN explore first?
- Whether the client understands the consequences of not taking their medications
- Whether the client can afford the medications and read the labels (Correct answer)
- Whether the client's family agrees with the medication regimen
- Whether the prescribing physician is aware of the client's history
Correct answer: Whether the client can afford the medications and read the labels
Health literacy and financial barriers are among the most common reasons for medication non-adherence in community settings. Before assuming intentional non-compliance, the PN must assess practical barriers such as cost, ability to read labels, and health literacy.
Question 5: A public health PN is planning a vaccination clinic for an underserved community. Which approach best reflects culturally safe nursing practice?
- Scheduling the clinic during standard business hours for staff convenience
- Translating pamphlets into the dominant local language and partnering with community leaders (Correct answer)
- Offering only English-language education materials as a standardization measure
- Focusing education efforts solely on the health risks of not vaccinating
Correct answer: Translating pamphlets into the dominant local language and partnering with community leaders
Culturally safe practice requires acknowledging and responding to the cultural, linguistic, and community context. Partnering with community leaders and providing materials in the local language increases access, trust, and uptake in underserved populations.
Question 6: A PN providing home care for a client with COPD notes that the client is smoking inside the home. The client states, 'I know it's bad, but I've smoked for 40 years and it's my choice.' What is the most appropriate response?
- Refuse to continue the home visit until the client agrees to stop smoking
- Document the refusal and take no further action to respect autonomy
- Acknowledge the client's autonomy, provide brief cessation information, and document the discussion (Correct answer)
- Contact the family to intervene on the client's behalf without the client's knowledge
Correct answer: Acknowledge the client's autonomy, provide brief cessation information, and document the discussion
The PN must balance respect for client autonomy with a professional obligation to provide health information. Acknowledging the client's right to choose while offering brief cessation counselling and documenting the interaction is the appropriate standard. Refusing care or bypassing the client to contact family violates autonomy.
CPNRE Community Health and Home Care Nursing
During a home visit, a PN notices that an elderly client's refrigerator contains expired food and the client appears confused about when they last ate.
Which of the following is the PN's priority action?