CH 13 Admission, Transfer, Discharge Practice Questions

When a patient demands to be discharged without a physician's order and is leaving the unit with his belongings, what should the nurse ask the patient to sign?

A discharge against medical advice form

To effectively assess and plan for a patient's continuing needs, when should the nurse begin the discharge process?

During hospitalization

What information is not required by the emergency room department of admissions for a patient who was brought in for treatment?

Mother's maiden name

During admission of a patient to a long-term care facility, what is the LVN most likely responsible for?

Obtaining Vital signs

What should a nurse do with a patient's money and jewelry if a family member is not present?

Place them in the hospital safe.

During the admission of a patient to a healthcare facility, the responsibilities of the admission department representative include: (select all that apply)

-obtaining the identifying information - Giving information on HIPPA - Placing the correct ID band on the patient's wrist - obtaining emergency contact information -gathering insurance information

A nurse on a medical-surgical unit is admitting a client. Which of the following information should the nurse document in the client's record first?

Assessment

What essential part of the admission procedure is performed by the RN?

Obtaining a health history

During discharge planning, which discipline of the health care team assists in rehabilitating and restoring a patient's musculoskeletal function to its highest potential?

Physical therapy

The term "empathy" means:

understanding and sharing feelings another is experiencing.

A nurse if performing an admission assessment for an older adult client, After gathering the assessment data and performing ROS, which of the following actions is a priority for the nurse

orient the client to his room

A patient is admitted for observation and various diagnostic tests. What is the initial nursing action in the admission process?

the nurse introduces self and roommates

What does the term AMA mean?

Against medical advice

Some Haitian Americans associate wheelchairs with being sick. How might the nurse demonstrate cultural sensitivity for a Haitian American?

Allowing the patient to walk out of the hospital when discharged

A patient has arrived at the outpatient surgery department before a scheduled surgery. What must the nurse accomplish before the patient goes to surgery?

Ensure the operative consent is signed

When should discharge planning begin?

Shortly after admission

When is the discharge planning process initiated?

Upon admission to the hospital

As part of the admission process, a nurse at a long-term care facility is gathering a nutrition history for a client who has dementia. Which of the following components of the nutrition evaluation is the priority for the nurse to determine from the clients family

any difficulty swallowing

The nurse completes thorough documentation before, during, and after a transfer to ensure

continuity of care

Because of the stress caused by hospitalization, the nurse assesses a newly admitted older adult patient for

disorientation

When the patient is received from the admitting department, what does the nurse expect has been completed? (select all that apply)

-the patient has been informed of the patients bills of rights - the patient has an ID band in place with proper identification information

What is a "telephone admission"?

A phone conversation to obtain information prior to hospitalization and provide the patient with information prior to admission

A male patient has his call light on. As the nurse enters the room, the patient is fully dressed and ready to leave. He begins yelling and asking to remove his IV because he is going home. What term best describes a patient's intent to leave a health care facility without a physician's order?

AMA (against medical advice)

The patients tells the nurse that he would like to be transferred to hospital X, because his cardiologist doesn't come to hospital Y. What should the nurse do?

Advise the patient that a transfer requires an order from the health care provider.

The nurse is admitting a patient to the long-term care facility. What nursing diagnosis is most appropriate at this time?

Anxiety related to new living environment.

What is a discharge planner's role in the hospital environment?

Assist and coordinate the discharge planning needs of patients

The nurse must be sensitive to an older adult patient experiencing separation anxiety when admitted to the hospital. When a child experiences separation anxiety they will usually cry. What will an older adult often demonstrate when experiencing separation anxiety?

Depression

What disciplines might be involved in the discharge planning process?

Dietitian, social worker, and home health care nurse

When admitting a patient to the hospital, the nurse observes that the patient is distracted and tense. What does this behavior suggest as a common reaction to hospitalization?

Fear of the unknown

The services of a transition specialist for patient discharge are most important for which reason?

Improving continuity of care from hospital to home.

Upon admission, the nurse notes that a patient without family members present has a billfold filled with cash. Where can the nurse suggest the money be placed?

In the hospital safe

The patient has an old head injury and demonstrates intermittent periods of belligerence and confusion interspersed with appropriate behavior. He is currently angry and wants to leave AMA. The nurse is unable to reach the health care provider. What should the nurse do first?

Notify the RN, because the patient now has acute needs

A rational patient wishes to leave the hospital against medical advice (AMA) despite the nurse's best attempt at therapeutic communication. What is the nurse's first responsibility?

Notify the health care provider

A patient who is alert and oriented is threatening to leave the hospital against medical advice (AMA). What action should the nurse take?

Notify the physician that the patient is threatening to leave AMA.

The nurse is trying to explain the bed controls and the call button and other items related to hospitalization, but the elderly patient keeps telling the nurse to "wait for my son to get here." What should the nurse do first?

Offer comfort measures and ensure patient safety.

If a patient has an order for an interagency transfer where does the nurse explain that the patient will be moved?

One facility to another

A young child is being admitted to an acute care setting. He has never been hospitalized before. As the nurse enters the room, the child begins to cry and cling to his mother. According to Maslow's hierarchy of needs, what need is the child is exhibiting?

Safety and security

Where can a nurse refer the family of a patient to find a source of financial aid to meet medical expenses?

Social services

A 52 year old patient is being transferred to the surgical unit from the recovery room after extensive surgery as the result of trauma from an automobile accident. What concept should the nurse remember when transferring this patient?

The patient Is a human who deserves dignity, courtesy, and respect

Before the actual discharge occurs, what must the nurse ensure ?

The patient understands the discharge instructions.

A patient has been diagnosed and hospitalized for type 1 diabetes. The multi disciplinary health care team has been preparing her for discharge. What is the primary purpose of discharge planning?

ensuring continuity of care

The nurse is discharging a patient for the first time. What documentation demonstrates that the nurse understands the discharge process?

The method of discharge.

The nurse is placing an ID band on a patient who was admitted through the emergency department. What is the best thing to say as the band is applied?

"The primary purpose of the band is to maintain safety."

A patient with Alzheimer's disease is being transferred from a long-term care facility to an acute care hospital for possible sepsis and change in mental status. Which question is most important to ask the nurse who is giving the report?

"What is the patient's baseline mental status and behavior?"

How can the nurse help reduce the stress of a hospital admission? (Select all that apply.)

- Show the patient how bedside equipment works. -Give simple explanation of policies. -Involve the patient in the plan of care.

The patient is newly admitted and seems anxious, but also appears very tentative about asking questions. Which statement by the nurse best demonstrates empathy?

"You seem a little uncertain; do you have some questions?"

A nurse is preparing the discharge summary for a client who has had knee arthroplasty and is going home. Which of the following info about the client should the nurse include in the discharge summary (Select all that apply)

- Follow-up care - instructions for diet and meds - contact info for home health care agency

An 84 year old patient has been hospitalized for 6 days with a diagnosis of a stroke. When should the nurse begin the patient's discharge planning?

on his admission to the hospital

A patient is being admitted to the hospital for stabilization of her heart condition. Before arriving on the nursing unit, what tasks will the admissions department complete?

- The patient will have signed consent for treatment - The admission staff will place the hospital ID band on the patient's wrist.

A nurse is caring for a client who had a stroke and is scheduled for a transfer to a rehab center. which of the following tasks are the responsibility of the nurse at the transferring facility (Select all that apply)

- ensure the client has possession of valuables - confirm that the rehab center has a room available at the time of transfer -give a verbal transfer report via telephone - complete a transfer form for the receiving facility

Nurses today care for patients from many different cultures and backgrounds. Which ideas/beliefs from the Japanese culture are accurate in what causes illness? (select all that apply)

-Contact with blood -Contact with skin disease -Improper care of the body -Lack of sleep

The nurse adheres to the discharge standards set by The Joint Commission (TJC), which include that patients will receive instruction regarding which aspect(s) of care? (Select all that apply.)

-Medications -Rehabilitation techniques -Referral to community agencies -Medical equipment to be used

Which task(s) related to admitting a new patient can be delegated to the UAP? (Select all that apply)

-Obtain personal care-items, such as water pitcher or packaged cleansing cloths -Position the bed for transfer from stretcher or wheelchair -Assist patient to arrange desired items, such as eyeglasses within reach.

A nurse is admitting a client who has acute cholecystitis to a med-surg unit. which of the following actions are essential steps of the admission procedure (Select all that apply)

-explain roles of other care delivery staff - begin discharge planning - document the clients wishes about organ donation - introduce client to roommate

What is the correct order of the steps for discharging a patient from a long-term care facility?

1. Initial planning for the discharge of the resident. 2. Asking the patient what the home situation is in regards to people who can assist in care, levels of floors, and the number of steps. 3. Meet the members of the healthcare team, such as the physical therapist or dietician, to discuss the patient's discharge. 4. Obtaining the order for the resident to be discharged.

Which newly admitted patient is mostly likely to need and benefit from an individualized explanation of the bathroom facilities?

A 65-year-old man who is from a rural farming region of China

Which patient is likely to have the most complex discharge plan?

A 73-year-old man with chronic disease who has no family in the area

What is the role of the LPN when a patient is admitted to a health care facility?

Assist with the plan of care and recommend revisions as necessary

A 90 year old patient has been hospitalized with pneumonia and needs reorientation to his surroundings periodically. The nurse assisting him with his morning care hears the unlicensed assistive personnel refer to the patient as "Gramps" What action should the nurse take?

Educate the UAP that it is not acceptable to call the patient "Gramps" unless the patient has requested to be called this.

A patient is determined to leave the hospital. His healthcare provider is not aware of his intent, nor is it his best interest to be discharged at this time. When a patient chooses to leave a healthcare facility without a healthcare provider's order, what should the nurse do?

Explain the risks of leaving and request that the patient sign a paper accepting responsibility for problems that may occur.

What is transitional care?

A discharge planning approach in which the specialists assist with the discharge process and are available to the patient after discharge

The LPN is assisting the RN with a newly admitted female patient. What is the most appropriate way to address the patient?

"Hello, Ms. Green, my name is ..."

The patient is being discharged from the hospital to home and will be assisted with abdominal bandage changes by his wife. Which nursing action is most important?

Ask the patient and his wife to perform the bandage change and observe their technique.

The nurse is giving instructions to a family caregiver of an older patient who will need help after discharge from the hospital. The nurse senses tension, resentment, and unwillingness from the caregiver. What should the nurse do first?

Assess the caregiver's attitude toward the patient and the circumstances

How can the nurse demonstrate cultural sensitivity to a Haitian American patient?

By allowing the patient to keep leaves in her room

A patient is being transferred to a long-term care facility for rehabilitation. What is the nurse's responsibility in providing continuity of care for this patient?

Call the admitting nurse at the facility and give a brief summary of the patient's medical diagnosis, treatment care plan, and medications

A nurse is admitting a patient to an acute care facility. During the admission procedure, what nursing intervention would best help reduce patient anxiety?

Greet the patient by name.

Which type of patients consider sundown Friday to sundown Saturday to be the Sabbath, which is a time of rest.

Orthodox Jewish

The nurse realizes that an older adult who resides in a long-term care facility can become confused and upset during hospitalization. Which intervention would be most appropriate when caring for this patient?

Sit face to face with the patient, conversing slowly and clearly.

What actions by the nurse might ease a patient's anxiety?

The nurse is kind, empathetic, warm, and patient and treats the patient with respect.

A patient has been transferred out of ICU to a medical unit. A nurse has been assigned to complete the transfer what type of transfer is this?

intra-agency transfer