Chapter 2 Admitting, Transfer, and Discharge

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Chapter 2  Admitting, Transfer, and Discharge

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. The patient is scheduled to go home after having coronary angioplasty. What would be the most effective way to provide discharge teaching to this patient?
a.
Provide him with information on health care websites.
b.
Provide him with written information on what he has to do.
c.
Sit and carefully explain what is required before his follow-up.
d.
Use a combination of verbal and written information.

ANS: D
For discharge teaching, use a combination of verbal and written information. This most effectively provides patients with standardized care information, which has been shown to improve patient knowledge and satisfaction.

DIF: Cognitive Level: Application REF: Text reference: p. 12
OBJ: Identify the ongoing needs of patients in the process of discharge planning.
TOP: Admission to Discharge Process KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe and Effective Care Environment

2. While preparing for the patient’s discharge, the nurse uses a discharge planning checklist and notes that the patient is concerned about going home because she has to depend on her family for care. The nurse realizes that successful recovery at home is often based on:
a.
the patient’s willingness to go home.
b.
the family’s perceived ability to care for the patient.
c.
the patient’s ability to live alone.
d.
allowing the patient to make her own arrangements.

ANS: B
Discharge from an agency is stressful for a patient and family. Before a patient is discharged, the patient and family need to know how to manage care in the home and what to expect with regard to any continuing physical problems. Family caregiving is a highly stressful experience. Family members who are not properly prepared for caregiving are frequently overwhelmed by patient needs, which can lead to unnecessary hospital readmissions.

DIF: Cognitive Level: Analysis REF: Text reference: p. 22
OBJ: Identify the ongoing needs of patients in the process of discharge planning.
TOP: Medication Reconciliation KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity

3. The patient arrives in the emergency department complaining of severe abdominal pain and vomiting, and is severely dehydrated. The physician orders IV fluids for the dehydration and an IV antiemetic for the patient. However, the patient states that she is fearful of needles and adamantly refuses to have an IV started. The nurse explains the importance of and rationale for the ordered treatment, but the patient continues to refuse. What should the nurse do?
a.
Summon the nurse technician to hold the arm down while the IV is inserted.
b.
Use a numbing medication before inserting the IV.
c.
Document the patient’s refusal and notify the physician.
d.
Tell the patient that she will be discharged without care unless she complies.

ANS: C
The Patient Self-Determination Act, effective December 1, 1991, requires all Medicare- and Medicaid-recipient hospitals to provide patients with information about their right to accept or reject medical treatment. The patient has the right to refuse treatment. Refusal should be documented and the health care provider consulted about alternate treatment.

DIF: Cognitive Level: Application REF: Text reference: p. 13
OBJ: Describe the nurse’s role in maintaining continuity of care through a patient’s admission, transfer, and discharge from an acute care facility.
TOP: Patient Self-Determination Act KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe and Effective Care Environment

4. An unconscious patient is admitted through the emergency department. How and when is identification of the patient made?
a.
Determined only when the patient is able
b.
Postponed until family members arrive
c.
Given an anonymous name under the “blackout” procedure
d.
Determined before treatment is started

ANS: B
If a patient is unconscious, identification often is not made until family members arrive. Delaying treatment can cause deterioration of the patient’s condition. Blackout procedures are intended mainly to protect crime victims.

DIF: Cognitive Level: Application REF: Text reference: p. 12
OBJ: Describe the nurse’s role in maintaining continuity of care through a patient’s admission, transfer, and discharge from an acute care facility. TOP: The Unconscious Patient
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

5. During admission of a patient, the nurse notes that the patient speaks another language and may have difficulty understanding English. What should the nurse do to facilitate communication?
a.
Use hand gestures to explain.
b.
Request and wait for an interpreter.
c.
Work with the family to gather information.
d.
Complete as much of the admission assessment as possible using simple phrases.

ANS: B
If the patient does not speak English or has a severe hearing impairment, the clerk must have access to an interpreter to assist during the admission procedure. Translation services are preferable to using family members to ensure correct translation of medical terminology.
Hand gestures and simple phrases may not be adequate for everything that will be discussed at the time of admission.

DIF: Cognitive Level: Application REF: Text reference: p. 15
OBJ: Describe the nurse’s role in maintaining continuity of care through a patient’s admission, transfer, and discharge from an acute care facility.
TOP: The Patient Who Does Not Speak English
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe and Effective Care Environment

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