Deck 2: Admitting, transfer, and Discharge

Question 1

The phase of the discharge process where medical attention dominates discharge planning efforts is known as:

A) The transitional phase
B) The continuing phase
C) The acute phase
D) The multidisciplinary phase

Answer 1

The acute phase

Question 2

The patient is being admitted to the intensive care department with multiple fractures and internal bleeding.Which of the following are considered roles of the nurse in this situation? (Select all that apply.)

A) Anticipate physical and social deficits to resuming normal activities
B) Involve the family and significant others in the plan of care
C) Assist in making health care resources available to the patient
D) Identify the psychological needs of the patient
E) None of above

Answer 2

Anticipate physical and social deficits to resuming normal activities
Involve the family and significant others in the plan of care
Assist in making health care resources available to the patient
Identify the psychological needs of the patient

Question 3

The nurse is admitting the patient to the medical unit.The patient indicates that he has had several surgeries in the past and has been a diabetic for the last 15 years.He also states that he has allergies to sulfa and eggs.He claims that he had severe back pain earlier that morning,but the pain has finally gone since he received a "pain shot" in the Emergency Department.The nurse realizes that she must:

A) Provide the patient with an allergy arm band and document his allergies
B) Postpone routine admission procedures immediately
C) Ask the patient if he wants a smoking room
D) Have all family or friends leave the room

Answer 3

Provide the patient with an allergy arm band and document his allergies

Question 4

Separation anxiety is most common in:

A) School-age children
B) Preschoolers
C) Middle infancy
D) Newborns

Question 5

An unconscious patient is admitted through the emergency room.Identification of the patient should be:

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

Question 6

The plan for patient discharge from a health care facility begins:

A) At admission
B) After a medical diagnosis is determined
C) When the patient's physical needs are identified
D) After a home environment assessment is completed

Question 7

The nurse is providing discharge instruction to an 80-year-old patient and her daughter.The patient lives in a two-story home.When asked if the patient has difficulty climbing the stairs,the patient says "No," but the nurse notices a look of surprise on the daughter's face.The nurse should:

A) Speak with the daughter separately
B) Cancel the discharge immediately
C) Order a Visiting Nurse consult
D) Notify the physician

Question 8

The patient has been admitted to the Emergency Department after being beaten and raped.She is agitated and frightened that her attacker may find her in the hospital and try to kill her.The nurse informs the patient that:

A) She is safe in the hospital, and that she needs to provide her name
B) She can be admitted to the hospital without anyone knowing it
C) Her records will be used as evidence in the trial
D) Since she has come to the hospital, she has to be examined by the doctor

Question 9

The patient is being transferred from the Emergency Department to another institution for treatment.Which of the following cannot be delegated to nursing assistive personnel (NAP)?

A) Helping the patient get dressed
B) Gathering IV equipment to go with the patient
C) Escorting the patient to the transport area
D) Assessing the patient's respiratory status before transport

Question 10

The patient is admitted to the ICU after having been in a motor vehicle accident.He was intubated in the Emergency Department and needs to receive two units of packed red blood cells.He is conscious but is indicating that he is in pain by guarding his abdomen.To admit this patient,the nurse first will focus on:

A) Examining the patient and treating the pain
B) Orienting the family to the ICU visitation policy
C) Making sure that the consent forms are signed
D) Informing the patient of his HIPAA rights

Question 11

The patient arrives at the emergency department complaining of severe abdominal pain and vomiting.The patient is severely dehydrated.The physician orders the patient to receive IV fluids for the dehydration and an IV antiemetic.However,the patient states that she is fearful of needles and adamantly refuses to have an IV started.The nurse explains the importance and rationale for the ordered treatment,but the patient continues to refuse.The nurse should:

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

Question 12

The patient has decided that he would like to create an advance directive.The nurse is asked if she would be a witness.The nurse should:

A) Agree to be a witness
B) Refuse to be a witness
C) Contact social work
D) Contact the physician

Question 13

During admission of a patient,the nurse notes that the patient speaks another language and may have difficulty understanding English.The nurse should:

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

Question 14

The patient is an older male with the diagnosis of "dementia." He is confused and wanders and is occasionally combative.The physician orders "Posey vest (restraint vest)PRN." The nurse should:

A) Place the Posey vest on the patient as needed
B) Inform the physician that the order is inappropriate
C) Check the condition of the patient every 2 hours after application of the vest
D) Ignore the order

Question 15

The patient is an 83-year-old gentleman who has the beginning stages of dementia.To prevent the patient from falling or "escaping," the nurse should:

A) Have the patient stay in his room
B) Have the family take all of the patient's belongings home
C) Allow the patient to be as independent as possible
D) Give the patient antianxiety medication

Question 16

The patient is in the Emergency Department of a small community hospital complaining of severe chest discomfort.The patient needs to have emergency cardiac catheterization with possible angioplasty,but to receive the procedure,he will have to be transferred to a larger hospital about 10 miles away.To transport this patient,the nurse will need to:

A) Call for basic ambulance service
B) Obtain the patient's consent
C) Make copies of the Emergency Department record
D) Keep the patient calm by not telling him only the benefits of the transfer

Question 17

When a patient's discharge is completed,an activity that may be delegated to assistive personnel is the:

A) Provision of prescriptions to the patient
B) Completion of the discharge summary
C) Gathering of the patient's personal care items
D) Provision of instructions on community health resources

Question 18

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 lives alone.The nurse realizes that successful recovery at home is often based on:

A) The patient's perception of readiness
B) Family involvement
C) The ability to live alone
D) Allowing the patient to make her own arrangements

Question 19

The patient is scheduled to go home after having coronary angioplasty.The most effective way to provide discharge teaching to this patient would be to:

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

Question 20

Under the Health Insurance Portability and Accountability Act (HIPAA),a patient must: (Select all that apply.)

A) Provide his true name in order to be treated
B) Be informed of his privacy rights
C) Have his personal health information used for treatment or payment only
D) Have his personal health information used on a need-to-know basis only

Question 21

Any manual method or physical or mechanical device,material,or equipment attached or adjacent to the patient's body that he or she cannot easily remove that restricts freedom of movement or normal access to one's body is defined as a ___________________.

Question 22

The patient is admitted to the unit for a cardiac catheterization.Which of the following can be delegated to nursing assistive personnel (NAP)? (Select all that apply.)

A) Obtaining admission vital signs
B) Preparing the patient's room
C) Gathering and securing personal care items.
D) Orienting the patient and family to the nursing unit

Question 23

________________________is a federal law intended to protect patients from being transferred against their wishes to another hospital.

Question 24

If a patient is having acute physical problems,postpone routine admission procedures until the patient's immediate needs are met.A ________________ assessment is needed at this point.

Question 25

The greatest challenge in effective discharge planning is _______________.

Question 26

Which of the following are considered "advance directives?" (Select all that apply.)

A) A living will
B) A power of attorney for health care
C) A notarized handwritten document
D) A nursing progress note

Question 27

Completing and documenting an accurate medication history from the patient is the important first step in the _____________ process.

Question 28

The Joint Commission (2007)has stated that matching an individual's ongoing needs with the appropriate level and type of medical,psychological,health,or social care or services within an organization or across multiple organizations is known as ________________.

Question 29

When transferring a patient,the nurse must ensure that the patient will receive ____________________.

Question 30

A document that gives a patient instructions about future medical care or that designates another person(s)to make medical decisions if the individual loses decision-making capacity is known as an ________________.