admission, transfer and discharge FON CH 20

The nurse works in a pulmonary intensive care unit (PICU). The nurse is reassessing a patient's breath sounds every hr for changes. Which explanation by the nurse will increase the patient's anxiety?

" I need to auscultate your lungs"

The nurse is aware that a patient is being discharged to home. Which discharge responsibility will the nurse assume? Select all that apply.

-ensure that there is a health care providers order for discharge -review discharge instructions and patient teaching -assist the patient to the car according to facility policy

The nurse is providing care for a patient who reports "crushing chest pain" to the nurse. A health-care provider's order is obtained to move the patient to the cardiac care unit (CCU). Which activities will the nurse perform to complete the transfer? Select all that apply.

-gather the patient's personal belongings, medications, medical supplies, and complete medical record -complete a transfer form that documents patient's condition and reason for transfer -phone the receiving nurse and report the patient's condition and the plan of care -explain the need for the transfer to the patient and family

The nurse is providing care for a patient diagnosed with cancer. Which teaching topics will the nurse include specifically for this patient? Select all that apply.

-how the patient's diagnosis may impact the patient's life -dietary alterations that will meet the patient's nutritional needs

The nurse is reviewing the data collection portion of a patient's admission. Which assessments will the nurse identify as factors for potential health risks? Select all that apply.

-lifestyle choices such as smoking and alcohol use -current prescription and OTC medications -living arrangements

The nurse is caring for a patient who had a stroke resulting in left-sided weakness and speech impairment. The patient will be transferred to a rehabilitation unit. The nurse needs to notify services involved in the patient's care about the transfer. Which services will the nurse contact? Select all that apply.

-occupational therapy -speech therapist -physical therapy

The unlicensed assistive personnel (UAP) reports to the nurse about an assigned patient. Which statement by the UAP will the nurse address?

the enema for the surgery patient is finished

The nurse is caring for a patient diagnosed with a severe respiratory infection who is deteriorating rapidly. The nurse learns from the admitting office that a bed is available in the intensive care unit (ICU). The nurse gives the transfer report to the ICU nurse, gathers the patient's medications and personal belongings, and moves the patient to the ICU. Which reason is likely to result in disciplinary action?

the nurse did not obtain a health care provider's order for the transfer

The nurse is preparing to review discharge instructions with a patient. Which behavior by the nurse verifies the patient's understanding regarding the instructions?

the patient is asked questions about the information presented

The nurse is finishing the transfer process for a patient to another facility. Which final detail should the nurse ensure is completed?

the patient's record are in a sealed manila envelope and sent w/ the patient

The nurse is preparing a patient for transfer to another facility. Which information will the nurse provide on the patient's transfer summary form?

the patients condition and vital signs at discharge

The nurse in a long-term care facility learns that a patient is being transferred to a different facility. The patient's family is waiting to move the patient by car to the new facility and asks about the delay. The nurse learns that the patient's discharge summary is not available. Which member of the staff does the nurse contact for completion of this summary?

the transferring facility's health care provider

The nurse works in a surgery center that has overnight accommodations for patients if needed. Which is the nurse's biggest challenge in this facility?

to present the necessary discharge teaching in a short time period

The nurse is contributing to a plan of care for a newly admitted patient diagnosed with anemia. Which discharge planning should the nurse reinforce immediately?

the causes and symptoms related to the patient's admitting diagnosis

The nurse is preparing to insert an indwelling urinary catheter according to new admission orders for a patient. Which comment by the nurse will alleviate the patient's fear?

"This catheter will drain the urine from your bladder so that you won't have to urinate"

Which of the following patients would be more prone to separation anxiety?

-3 yr old female -75 yr old female -80 yr old male

The nurse is preparing to transfer a patient to a different facility. Which actions are exclusive to the process of transferring a patient to a different facility? Select all that apply.

-a discharge summary by the health care provider may be required -belongings and valuables are transferred personally w/ the patient

The nurse is performing the physical assessment of a patient being admitted to the hospital. Which assessments should the nurse perform? Select all that apply.

-auscultation of heart, breath and bowel sounds -attainment of vital signs including oxygen saturation -examination of pupils, mucous membranes, and skin -actual weight and height

Which of the following are considered final nursing responsibilities during discharge?

-discontinue any equipment and tubes -document patient's vitals -note how patient is being transported -document time patient leaves

The nurse is providing care for an older adult patient disabled by a serious disease. The patient's family is concerned about the patient's care after discharge from the hospital. The patient lives alone and family lives in other states. Which discharge teaching will the nurse determine to present to the patient and family? Select all that apply.

-referrals to home health care (HHC) agencies -process of finding a long term or assisted living facility -available community services that can supply patient meals

The nurse is providing discharge instructions for a patient who had abdominal surgery. Which instructions will the nurse provide for this patient? Select all that apply.

-symptoms to report immediately to health care provider -required modifications or restrictions related to diet -medication directions -restrictions about activities -when to return to health care providers offie

The nurse is performing the data collection process for a patient being admitted. Which information will the nurse collect? Select all that apply.

-the patient's diseases along w/ past injuries & surgeries -the patient's employment and type of work performed -the patient's family medical history -the reason the patient is currently seeking health care

The registered nurse (RN) is notified about the admission of a new patient. The RN delegates portions of the admission process to the licensed practical nurse/licensed vocational nurse (LPN/LVN) and unlicensed assistive personnel (UAP). Which delegation by the RN is inappropriate?

The LPN/LVN is instructed to begin the patient's plan of care based on the admitting diagnosis

The nurse is caring for a newly admitted patient. When the nurse asks the patient to change into a hospital gown, the patient states, "I brought my own pajamas and I am more comfortable in them." Which action does the nurse take?

allows the patient to wear the pajamas

During the admission process, the nurse places the patient's identification band on the patient's wrist. Which information is unlikely to be found on the patient's identification band?

social security number

The female nurse is assigned to care for a male patient from a different culture. When the nurse offers to assist the patient, the patient states, "I am not comfortable with you as my nurse." Which action will be taken in regards to the patient's care?

a male nurse is located and assigned to care for the patient

The nurse prepares a patient for a blood transfusion. The health-care provider is obtaining informed consent from the patient for the procedure. Which patient does the nurse recognize as unable to provide treatment consent?

adolescent patient w/ a court appointed guardian

The nurse is working in a new facility and becoming accustomed to the differences from the previous facility. The nurse notes that wristbands of various colors are used in the new facility. For which condition is the nurse most likely to recognize a color consistency between the two places of employment?

allergies

The nurse is caring for a patient who has a roommate. The patient's health-care provider needs to share a diagnosis with the patient. Which arrangement by the nurse will provide the patient with the most privacy with the health-care provider?

arranging for another nurse to take the roommate out of the room

The nurse is admitting a patient from a different culture. Which intervention by the nurse is least beneficial in establishing a culturally trusting relationship?

asking about the patient's practice of making eye contact during verbal exchange

The nurse is admitting an older adult patient who has never been hospitalized before. Which action by the nurse will address the patient's possibility of separation anxiety?

asking if a family member is available to stay w/ the patient

The nurse is providing care for a patient who states, "I am leaving, and the health-care provider does not seem to care about my condition." The nurse suspects that the patient is planning to leave against medical advice (AMA). Which is the nurse's first responsibility?

attempt to reason w/ the patient about why it is in the patient's best interest to stay

The nurse is reinforcing medication orders with a patient scheduled for discharge. The patient states, "I already have a medication for my allergies, but it is different than the one the health-care provider just ordered." Which action will the nurse take?

call the health care provider w/ the information and seek reconciliation of the new order

The nurse is completing the admission process for a patient. When the nurse begins the personal property inventory, the patient states, "I have a large amount of cash in my jacket." Which action will the nurse take?

count the money w/ another nurse and document the amount

The nurse is assisting in the x-ray department. A patient is scheduled for urinary bladder studies that require the placement of an indwelling catheter. The patient appears anxious and embarrassed by the procedures. Which action by the nurse will promote patient comfort?

covering the patient with a sheet, exposing only the perineum

The nurse is admitting a patient to the hospital. Which behavior by the nurse will make a positive impression on the patient?

entering the room w/ a smile and in a warm but professional manner

A patient is being admitted to the hospital through the admission department. Which information gathered during this process can potentially influence nursing care?

existence of an advance directive

The nurse is caring for a patient newly admitted due to respiratory distress. The patient is an adult female with minor children. The patient's spouse is self-employed with a small business. Which source of anxiety is likely to greatest for this patient?

financial concerns

The nurse is attempting to make a newly admitted patient more comfortable. Which action by the nurse will help reach this goal?

introducing the patient to the personnel that will be providing care

When a patient states, "I am not happy with my care and I am not staying," the nurse should suspect that which form may need to be completed?

leaving AMA form

The nurse greets a newly admitted patient. Which patient need is the nurse likely to be meeting?

making the patient feel comfortable and welcome

The nurse manager is concerned about low patient satisfaction ratings. Which specific patient concern is most difficult to address?

patients express distaste about sharing a shower and toilet with another person

The nurse is transferring a patient from the medical unit to the physical rehabilitation unit. Besides the receiving nurse, which other facility department is it most important for the nurse to notify?

physical therapy department

The nurse is admitting a pediatric patient who has a parent present. Which action by the nurse is least effective in alleviating the patient's fear?

placing the patient in bed so that the nurse and the patient are eye level

The nurse has finished admitting a preschool age patient. Which action will the nurse take to prevent the patient from experiencing separation anxiety?

providing a cot and hygiene products for the parent who agrees to stay w/ the patient

The nurse is reviewing the medications for a patient who is being discharged. Which action by the nurse to reconcile the patient's medications is inappropriate?

recognize that a dose change for a medication is intended

The nurse is discharging a patient from the hospital to home. Which discharge action is unnecessary?

reminding the patient to contact the health care provider for prescriptions

The nurse is receiving a patient who is being admitted directly from the emergency department (ED) in serious condition. Which action will the nurse take to complete the admission process?

sending a family member to the admitting office

The nurse is admitting a patient from a different culture who has a good understanding of the English language. Which verbal interaction by the nurse will be a possible source of confusion for the patient?

using some words to acquaint the patient w/ local terminology