Deck 23: Admitting, Transferring, and Discharging Patients

Question 1

A young patient has died in the emergency department after suffering severe trauma. The nurse understands that this patient's family may take comfort from the opportunity to:

A) allow donation of the patient's organs.
B) view all of the injuries to the patient's body.
C) plan the funeral before leaving the hospital.
D) donate the patient's belongings to charity.

Answer 1

allow donation of the patient's organs.

Question 2

A nurse who was present at the time of the death of a patient should document:

A) time of death.
B) time at which life signs ceased.
C) notification of the mortuary.
D) which family members were notified.

Answer 2

time at which life signs ceased.

Question 3

A hospitalized patient tells the nurse that he intends to leave the hospital, against medical advice. The nurse's initial action(s) should be to:

A) listen to the patient, answer questions, and offer to have the supervisor or physician speak with the patient.
B) advise the patient that this may mean that insurance would not pay for this hospitalization.
C) obtain a written explanation of the reasons from the patient and have the patient sign at the bottom of the sheet.
D) call both the supervisor and a family member to try to get the patient to reconsider.

Answer 3

listen to the patient, answer questions, and offer to have the supervisor or physician speak with the patient.

Question 4

A patient has a hospital discharge order for later that day. The LPN/LVN understands that part of the discharge process to be performed by the registered nurse is:

A) packing the patient's personal belongings.
B) writing the discharge instructions.
C) assisting the patient to get dressed.
D) accompanying the patient to the hospital entrance.

Question 5

A newly admitted patient has his own walker that he wishes to use during this hospital stay. The responsibility of the nurse to this piece of durable equipment is to:

A) write the patient's name on a wide piece of tape and affix it to the walker.
B) list the walker as part of the patient's personal belongings and place the list in his chart.
C) tell the patient that personal walkers cannot be used in the hospital for safety reasons.
D) write a note in the nursing care plan that the patient has his own walker.

Question 6

For the nurse to provide support to families of patients who have died, it is most important to:

A) have an understanding that all people deal with death in due time.
B) read a number of articles about death and dying.
C) have a personal experience of a similar nature.
D) deal with personal feelings about death and dying.

Question 7

A patient who is scheduled for discharge has items that were stored in the hospital safe. After retrieving them, the nurse should document their return to the patient by:

A) making an entry in the physician progress notes.
B) writing a note to the charge nurse.
C) having the patient sign for them as per policy.
D) asking the unit secretary to place a note in the chart.

Question 8

While admitting a patient from home to the skilled nursing facility, the nurse notes that the patient has brought medications that are not included on the physician's medication order sheet. The nurse's best initial action is to:

A) send the medications home with a family member.
B) seal the medications in an envelope and lock it in the medicine cart.
C) administer the medications with the ordered medications.
D) notify the physician about the medications the patient has been taking.

Question 9

The nurse is aware that patients who are admitted to the hospital as a routine admission under a managed care plan must:

A) have Medicare.
B) be pre-approved.
C) be able to pay the deductible.
D) be admitted several days prior to the procedure.

Question 10

The nurse orienting a new patient to the unit would include:

A) expected cost of the room per day.
B) location of call bell and how to use it.
C) calling the patient by their first name for less formality.
D) times of the shift changes.

Question 11

When the nurse discovers that the patient's consent form for an invasive procedure is incorrect, the nurse should:

A) cross out the incorrect information and write error, and then write in the correct information.
B) destroy the incorrect form and write a new one correctly.
C) cross out the entire form, but leave it in the chart as a permanent record.
D) notify the physician of the error and clarify what the physician prefers to be done.

Question 12

A patient who has questions about the availability of home health services after hospital discharge should be referred to the:

A) physician.
B) registered nurse.
C) occupational therapist.
D) medical social worker (MSW).

Question 13

If there is a prior authorization for hospitalization required for a routine admission, the nurse explains that the notification to the insurance company is the responsibility of the:

A) patient.
B) admissions department of the health facility.
C) patient, physician, and the admissions department.
D) office of the admitting physician.

Question 14

The nurse helping to organize the transfer of an elderly patient from the acute care facility to an extended care facility will be sure to:

A) check drawers and shelves for personal items.
B) give unused medications to the patient.
C) ask the business office to send stored valuables to the receiving facility.
D) send a small snack with the patient.

Question 15

A patient is near death and the family is upset and disorganized. The most helpful intervention for the patient and the family would be for the nurse to:

A) ask the family the name of their mortician.
B) offer to call the spiritual advisor (e.g., priest, minister, or rabbi).
C) encourage the family to perform their rituals.
D) encourage the family to visit the chapel.

Question 16

A patient admitted to the hospital through the emergency department has jewelry and a large amount of money. The most efficient intervention about these valuables would be:

A) send them home with a family member.
B) put them away quickly in the patient's closet.
C) lock them in the narcotics cabinet on the nursing unit.
D) place them in a valuables envelope and have them locked in the agency safe.

Question 17

As a member of the health care team, the LPN/LVN understands that discharge planning for the hospitalized patient begins:

A) the day before discharge.
B) at the time of admission.
C) immediately following diagnostic procedures or surgery.
D) as soon as a family meeting is scheduled.

Question 18

A patient is scheduled to have a diagnostic procedure performed on an outpatient basis at 9:00 AM. The nurse will advise the patient to:

A) arrive 2 hours before the scheduled procedure.
B) wear comfortable clothing.
C) read printed materials about the procedure.
D) be prepared to pay at least 10% of the predicted cost of the hospitalization.

Question 19

A patient's condition warrants a transfer from Intensive Care to a regular nursing unit in the same hospital. Before assisting with the patient's move, the nurse notes that the transfer has been authorized by the:

A) patient.
B) charge nurse.
C) physician.
D) family.

Question 20

New orders have been written by the attending physician for a patient admitted to a skilled nursing facility. After transcription, the orders will be verified by the:

A) unit secretary.
B) administrative RN.
C) LPN/LVN in charge.
D) director of nurses.

Question 21

It is determined that a patient is brain dead after suffering a massive cerebral bleed. The physician has just talked to the family about removing the patient from life support. The nurse would anticipate:

A) calling the coroner's office.
B) calling the insurance company.
C) contacting the organ donation team.
D) asking about an autopsy.

Question 22

The nurse explains that the Admitting Department of the acute care facility has a number of significant duties, which include: (Select all that apply.)

A) arranging for pre-admission lab work and radiographs.
B) notifying the patient's spiritual counselor of the admission.
C) confirming that all admission criteria are met.
D) arranging for special diets.
E) making arrangements for co-pays and deductibles.

Question 23

An examination of the remains of a body by a pathologist to determine the cause of death is a(n) ______________.

Question 24

The nurse appreciates that a routine hospital admission differs from an emergency admission in that a routine admission: (Select all that apply.)

A) is scheduled in advance.
B) is not stressful.
C) is completely covered by insurance.
D) has a predictable outcome.
E) allows time to arrange for disruptions in routine.

Question 25

The nurse is orienting an elderly patient newly admitted to the nursing unit. Which are appropriate interventions to apply to alleviate the patient's anxiety? (Select all that apply.)

A) Call the patient by his first name.
B) Instruct the patient on the use of the call light.
C) Encourage the patient to ask questions regarding admission.
D) Allow extra time for the patient to process any new information.
E) Lock all patient valuables in the facility's safe storage.

Question 26

The nurse recognizes that an autopsy must be performed when the patient:

A) is over 52.
B) died of unknown causes.
C) has requested it on admission.
D) has died in an industrial accident.

Question 27

The nurse reminds a patient that if enrolled in a managed care program, some procedures will not be approved for payment, such as:

A) cosmetic surgery to repair a scar from an accident.
B) breast augmentation.
C) emergency admission for shortness of breath.
D) post-mastectomy breast implants.

Question 28

When the orders have been verified, the nurse:

A) draws a line below the orders and signs his or her name and the date.
B) signs his or her name in red immediately below the physician's signature.
C) writes: transcribed by A Nurse at 0900.
D) draws a line down the left margin; then signs, dates, and times the transcription.

Question 29

A blind, elderly patient is admitted to the hospital for dehydration and weakness. The nurse can make the admission process less stressful by:

A) sending all personal belongings home with family members.
B) performing the initial assessment in a non-hurried manner.
C) providing a printed orientation handout regarding hospital policy.
D) performing a quick assessment before orienting the patient to the unit.

Question 30

A patient dies after suffering a severe cerebrovascular accident (CVA). The family members are informed of his demise and are at the bedside. What documentation should be noted in the patient's chart? (Select all that apply.)

A) Results of the autopsy
B) Who pronounced the patient
C) Official time of death
D) Time vital signs ceased
E) Why the patient died

Question 31

The nurse is assisting with an admission assessment of a patient with hypertension. While the nurse is preparing to weigh the patient, the patient states, "It is not necessary to weigh me, because I weighed 130 pounds last week." What would be the nurse's best response?

A) "Are you sure that your weight has not changed?"
B) "I will write down your stated weight."
C) "It is important to get a more recent weight."
D) "Don't worry; your weight is confidential."

Question 32

The nurse is performing an initial assessment on a patient with respiratory difficulty. The nurse would anticipate documenting signs and symptoms such as:

A) alteration in sensation.
B) use of accessory muscles.
C) regular respiratory pattern.
D) excessive dryness.