Admission Discharge and Transfer Review

Which nursing action is essential for complying with federal regulations that ensure the client's right to privacy?

• Addressing the clients by first name only

• Obtaining consent for releasing information

• Referring to the client as the person in 201

• Using a code number rather than a name in the medical record

Answer explanation

Although all of the strategies may protect the client's privacy , select the best nursing option among those provided

Which information is essential for the nurse to obtain at the time of a client's admission to a healthcare agency?

• Social Security Number

• Medicare Status

• Advance Directive

• Health Insurance Policy

Answer explanation

Test-Taking strategy- identify options that are unnecessary or may be obtained by personnel in the business office . Select the option that correlates with information that is important to the client's nursing care.

Which nursing observation is most suggestive that a newly admitted client is anxious?

• The client is unusually quiet and withdrawn

• the client is restless and awakens frequently

• the client eats little food at each meal

• the client misses his/her spouse

Answer explanation

Test-taking strategy- select the option that is most representative of manifestations associated with stimulation of the sympathetic nervous system

If the nurse suspects that an older adult in the community is the target of abuse, what agency would be appropriate to contact?

• Commission on Aging

• Visiting Nurse Association

• Older Americans' Ombudsman

• Adult Protective Services

Answer explanation

Test-taking Strategy-

Use the process of elimination to determine which agency is mandated to ensure the safety of vulnerable adults

Which type of extended care facility would be most appropriate for the nurse to recommend for an older adult who needs further rehabilitation for mobility at the time of discharge from an acute care facility?

• Skilled Nursing Facility

  (SNF)

• Assisted Living Facility

  (ALF)

• Basic Care Facility

• Intermediate Care Facility

Answer explanation

Test-Taking Strategy-

Eliminate options that fail to correlate with the client's level of care

The admitting nurse is completing the client's medication reconciliation for the doctor to review. The CNA hands the nurse a CVS bag full of pill bottles that she found in the patient belongings bag sent from the hospital. What should the nurse do with the medications? Select all that apply

• Use the medications from the bottles until the pharmacy delivers the patient's new medications

• Record the medications on the patient inventory list

• Leave the medication at the nurse's station with the chart for the MD to review

• Seal the medications, label with the patient's name and lock in the medication cart

Answer explanation

Patients should not have medications at the bedside. LOCK the medications in the cart ASAP.

A dependent older adult that lives with his son presents to the emergency room with pain on his abdomen and back. The son answers all questions asked to the patient and interrupts if his father tries to answer. The nurse performs a physical assessment and finds multiple bruises in various stages of healing which she knows is suggestive of

• elder abuse

• a fall off the bed

• child Abuse

• diabetes

Answer explanation

multiple old fractures, healing bruises, caregivers answering questions in place of the patient, acting fearful of caregivers and unexplained injuries are all indicative of abuse.

Upon admission the business office is responsible for collecting and communicating the following information to the patient. Select all that apply

• Health Insurance Information

• Demographic Information

• Expected cost of care per day/visit

• Vital Signs and orientation to the unit

Answer explanation

The nurse would be responsible for explaining how the unit runs, meal times, call light use, bed/tv controls, bathroom location

The med-surge nurse is transferring a post-op orthopedic patient to a Skilled Nursing Facility to continue his recovery. The nurse completed the discharge teaching, called the SNF and gave report, packed the patient belongings and is awaiting the Ambulance transfer team when she discovers that there is no physician order for transfer. What action must the nurse take?

• Transfer the patient and then call the physician and ask for an order

• Notify the Skilled Facility that the transfer is cancelled for today

• Call the physician and obtain an order prior to the transfer

• Ask the family to call the physician and ask why he did not write the order

The nurse's patient has packed his belongings and called an Uber to pick him up. The patient is not ready for discharge but is insisting on leaving Against Medical Advice (AMA). What actions should the nurse take? Select all that apply

• Explain the risks of discharging AMA

• Have the patient sign the AMA form stating that he is aware of the risks

• Review all of the medications and treatments with the patient and send the medications home with him

• Tell the patient that he can not leave, call security and physically prevent the patient from leaving.

Answer explanation

Patients leaving AMA must assume all responsibility for their health by signing a form. The nurse is responsible for explaining what could happen as a result of leaving prior to being ready for discharge.

The nurse can not send home any medications or treatments with a patient leaving AMA