Prep u chapter 11
A nurse has been asked to obtain a client's blood sample from the client's central venous catheter and send the sample to the laboratory. What must the nurse do to ensure that the blood sample is collected from the right client?
Check the identification band on the wrist
Which statement by the nurse best explains the need of clients who are cared for at a progressive care unit?
"A progressive care unit provides care for clients who were critical and have recovered sufficiently to require less intensive nursing care."
The nurse is planning the discharge of an older adult client who is on postoperative day 3 after having abdominal surgery. The client asks, "What should I expect from home care?" What is the nurse's best response?
"A registered nurse will attend your home to assess and change your dressing."
Which statement could assist the nurse in identifying the role of the admitting department?
"Have you gathered the client's information for billing?"
The health care provider invited a medical intern to assist in the admission process. Which statement by the nurse would indicate that the nurse understands the responsibility of the medical intern?
"Please complete the physical assessment for the client."
Which statement made by an older adult would suggest to the nurse that the client is facing barriers when trying to access community-based services?
"The business hours for the health facility are the same as that of my part-time job."
The nurse is discharging a client who is postoperative day 3 after abdominal surgery. The client will receive follow-up care in the community from a home health nurse. The client asks, "What types of things should I expect the home health nurse will be doing?" How will the nurse respond?
"The nurse will assess any environmental or social factors that are impeding your recovery."
Which statement by the nurse best describes the specific skilled care needs of clients in a nursing home?
"The nursing home provides care for clients whose condition have improved, but the need for gastrostomy feeds remains."
The nurse informed the relatives of an older client as to why the client will be referred to a life care housing option. Which statement by the relative indicates that the teaching was effective?
"This means that my relative will be living in a residential complex that provides services and accommodations as each resident's needs change."
A client tells the nurse, "I am leaving and you can't stop me. This place is terrible, and I can't stay another minute." What is the best response by the nurse?
"What can I do to make your stay more pleasant? Please give me the opportunity to see if I can help you."
Which statement by the client would indicate to the nurse that the client's need for privacy is not being adhered to?
'Visitors can see me while the nurse is attending to me."
The nurse was made aware that the older client's cats are left alone at home. Which statement by the nurse would indicate that the nurse is sensitive to the client's general well-being?
'We have already made arrangement for your friend to care for your cats."
A nurse is caring for a client who will be discharged home but will have a complex medication regimen and follow-up with several providers. Which strategies will the nurse employ to provide discharge teaching? Select all that apply.
Divide the content into several short sessions. Be prepared to review and repeat information. After teaching have the client repeat back the key points. Use visual aids to help explain teaching.
A nurse provides care in a hospital in which there are as many as four beds in each room. The nurse is responsible for the care of all four clients in a particular room, one of whom requires the insertion of a Foley (urinary) catheter. How can the nurse best protect this client's privacy?
Ensure that the curtains around the client's bed are secured so that the client cannot be seen by others.
The nurse is starting the transfer on an adult with a hearing deficit. What is the best nursing action at this time?
Allow additional time to do the discharge
Which nursing action could result in clients losing their identity in health care facilities?
Allow clients to wear gowns that tend to look alike.
A client tells the nurse, "I don't know what is wrong with me. I just feel so uneasy. It is like something bad is going to happen." What feeling is this client describing?
Anxiety
A client has just been admitted to the medical/surgical unit. When is the best time for the nurse to begin discharge teaching?
At the time of admission
After a period of initial recovery, a client who experienced a stroke is being transferred from the acute neurological unit to a rehabilitative unit of the same hospital. What are the neurological nurse's responsibilities during the transfer? Select all that apply.
Ensure the client and the client's family are made aware of the transfer. Complete a written summary of the client's current health status. Liaise with a nurse on the rehabilitative unit to arrange a time for the transfer.
After a period of initial recovery, a client who experienced a stroke is being transferred from the acute neurological unit to a rehabilitative unit of the same hospital. What are the neurological nurse's responsibilities during the transfer? Select all that apply.
Ensure the client and the client's family are made aware of the transfer. Complete a written summary of the client's current health status. Liaise with a nurse on the rehabilitative unit to arrange a time for the transfer.
Which is the primary goal of continuity of care?
Ensuring a smooth and safe transition between different health care settings
One significant change in the health care delivery system in recent years is earlier hospital discharges. What is one result of earlier hospital discharges?
Clients with high home care needs are being discharged into the community.
A nurse has admitted a new client to the hospital unit and completed a comprehensive assessment. After the nurse has collected these data, what should the nurse do next?
Create a plan of nursing care.
In anticipation of discharge, a nurse is teaching the daughter of an older adult client how to change the dressing on the client's venous ulcer. Which teaching strategy is most likely to be effective?
Demonstrate and explain the procedure and then have the daughter perform it.
A client with prolonged vomiting is told to go to the hospital for admission from the health care provider's office. What type of admission is this considered?
Direct
A client with prolonged vomiting is told to go to the hospital for admission from the health care providers office. What type of admission is this considered?
Direct
With the changing population of health care consumers it has become necessary for nurses to work more closely with other nurses (e.g., acute care nurses collaborating with public health and home health nurses). What nursing function has increased in importance because of this?
Discharge planning
The nurse is admitting a client for outpatient surgery. When the nurse asks what the client has been told about self-care following discharge, the client says, "No one has told me anything." Which nursing intervention is indicated?
Provide the teaching.
A client arrives at the emergency department with reports of chest pain. After stabilization, the client is admitted to the intensive care unit with a diagnosis of myocardial infarction. What type of admission is this?
Emergency
Which phrase best describes continuity of care?
Facilitating transition between settings
The licensed practical nurse (LPN) is admitting a client to the medical-surgical unit. What part of the admission process is the responsibility of the registered nurse (RN)?
The admission assessment
The nurse is caring for a client who states, "My health care provider says I am doing well and can. go home today. I do not wish to wait here any longer so I am leaving now." The nurse notes that the health care provider has not yet written an order for the client's discharge. What is the nurse's best response?
Notify the health care provider and document the situation in the client record.
A nurse is caring for a client in the critical care unit. While preparing for the client's transfer to the telemetry unit, which would the nurse implement to facilitate successful handoff?
Phone orders to the receiving nurse in the new unit and submit the chart with notes and reports via online submission.
When doing discharge planning for an older adult client who had a stroke, what is the nursing Priority?
Plan reachable goals with the client and family.
When doing discharge planning for an older adult client who had a stroke, what is the nursing priority?
Plan reachable goals with the client and family.
In preparation for discharge, the nurse is reviewing information related to new dietary guidelines with the client. This is an example of which step in discharge planning?
Providing client education
The nurse is providing care to a homeless client who presents to the emergency department with a foot wound. Which is the priority nursing intervention prior to discharge?
Refer the client to social services for assistance.
The newly admitted client has signs and symptoms of moderate anxiety. The client states, "I have never been in the hospital before. I have always had good health." What action will the nurse take to decrease the client's anxiety?
Remain with the client and tell the client to breathe slowly.
The nurse is administering medication to a client and notices that the client's identification bracelet is missing. What should the nurse do?
Replace the bracelet as soon as possible.
The nurse is preparing to do an admission assessment on an older adult who came from an extended care facility. The nurse notices ecchymosis along both of the client's arms. What is the most appropriate action made by the nurse?
Report the findings to Adult Protective Services.
A nurse is providing a home care visit to a homebound older adult client. During the visit, the client's family primary caregiver states,"I am so exhausted and sleep deprived. Lately, I spend most of the day feeling angry and guilty at the same time." Which recommendation by the nurse will be most effective in relieving caregiver role strain?
Respite care
A hospital has begun to expand home health services to its clients. Which reason is the most likely cause for the expansion of these services?
The change to shorter hospital stays
An older client who has no immediate health care needs, works part-time, and volunteers at a soup kitchen has expressed the need to share living facilities to cut back on costs. Which housing option would best suit this client?
Shared housing
A diabetic client who lives alone is to be discharged from the hospital with a large abdominal wound that requires comprehensive nursing care. Which agency will provide the most appropriate care for this client?
Skilled nursing facility
The nurse is caring for a client newly diagnosed with diabetes mellitus. Which is an appropriate element of discharge planning for the nurse to use?
Teach the client about prescribed medications and how to monitor blood sugars.
One of the fastest growing venues of practice for the nurse is home health care. What is the basis for the growth in this health care setting?
The discharge home of clients who are more critically ill
What is the result of increasing health care costs on hospital admissions?
The length of hospital stay has decreased.
Why is it important for the nurse to orient the client to surroundings?
facilitates comfort and adaptation
An 84-year-old man has presented to the primary care provider accompanied by his daughter. The daughter tells the care provider that her father has recently stopped sleeping in his bedroom and bathing in his bathroom. The man denies this, stating that he has simply decided to change his routines around the house. A nurse should consider the possibility that:
The man may be downplaying his lack of mobility out of fear of having to move out of his home
Which is the best example of a nurse providing continuity of care?
The nurse collaborating with other members of the health care team in caring for a client
The nurse is conducting discharge education on dressing change to a postoperative client and the spouse. The client's spouse appears anxious about changing the dressing correctly. Which is the best indicator that the spouse is competent to perform the dressing change?
The spouse is able to correctly demonstrate performing the procedure.
What is the rationale for conducting discharge planning?
To ensure patient and family needs are met consistently
Why is it important for the nurse to maintain a physical arms length distance from the client experiencing anxiety?
When standing too close, anxiety may increase the client's discomfort.
Which client would prompt the nurse to prepare for a direct admission?
a client with prolonged vomiting
The findings of an audit revealed that 40% of medical errors are attributed to inadequate medication reconciliation. Which finding would indicate to the nurse that there is evidence of inadequate medication reconciliation?
failure of the nurse to verify the client's current medication
Continuity of care for a particular client is most important to prevent:
fragmentation of services
Which client at a health care facility requires immediate medical attention from a nurse?
client with bleeding
The initial step in discharge planning is:
collecting and organizing data about the client.
What does the nurse recognize as indications of anxiety? Select all that apply.
restlessness talking excessively irritability
Continuity of care is an important concept for quality nursing practice. The responsible nurse understands the best description of the process of continuity of care is to:
coordinate uninterrupted care and facilitate transfer between units and levels of care.
A new client arrived on the unit while the nurse was obtaining the end-of-shift report from the night nurse. This client is admitted walking and is here for a cardiac workup; the client is assigned to the nurse. The unlicensed assistive personnel has settled the client in the room and oriented the client to the surroundings, call system, bathroom, bedside supplies, and where to place clothes. Which is the nurse's priority action?
gather information and complete the admission database.
A client was newly diagnosed with essential hypertension. Which information should the nurse record in the client's health record under family history?
grandparents dying from high blood pressure
The nurse is caring for a client who would benefit from home health care services. In preparing for discharge, the nurse is aware that home health care can only be initiated if the:
health care provider writes an order for home care.
What is not of importance when preparing a room for client admission?
making the room feel as homey as possible
The nurse cares for multiple clients in the hospital. Which client requires the nurse to complete a medication reconciliation?
newly admitted client who just arrived from the emergency department
A nurse is caring for a client involved in an accident. The client informs the nurse about wanting to leave the facility immediately after first aid, although the health care provider has prescribed tests and not given permission for discharge. Which nursing action is the priority at this time?
obtaining the client's signature on a dated release form
Prior to the discharge of a client who is recovering from a stroke from an acute care facility, the nursing case manager has the nursing staff, client, client's family, physical therapist, and home health nurse meet. The most likely purpose of this meeting is to:
prepare the client for home care.
When preparing to transfer an older adult client back to the long-term care facility where the client has been for several years, it is the primary responsibility of the nurse to:
provide for the coordination and continuity of care by the health care providers.
When preparing to transfer an older adult client back to the long-term care facility where the client has been for several years, it is the primary responsibility of the nurse to:
provide for the coordination and continuity of care by the health care providers.
Public health nursing is the branch of nursing that:
provides health care for the community.
The nurse understands that planning for discharge actually begins at admission to the facility. The purpose of discharge planning is best described as:
providing continuity of care that is goal directed.
Which nursing action should the nurse implement for an adult client who may be anxious during the admission process?
providing explanations and instructions to the client
A client is being discharged from the hospital to a facility that will provide tracheostomy care while the client is under 24-hour supervision by a registered nurse. What type of facility would best fit the needs of this client?
skilled nursing facility
A client who decides to leave the hospital against medical advice (AMA) must sign a form. What is the purpose of this form?
to release the doctors and the institution from any legal responsibility
A mother of two children has been diagnosed with terminal breast cancer and will be requiring assistance with her own care as well as the care of her children. When planning the client's discharge, the nurse interprets this change in role functioning as:
transition
