Collaborative Practice and Care Coordination Across Settings

A client asks a nurse, “How does ergotamine (Ergostat) relieve migraine headaches?” The nurse should respond that it

• A) dilates cerebral blood vessels.

• B) constricts cerebral blood vessels.

• C) decreases peripheral vascular resistance.

• D) decreases the stimulation of baroreceptors.

Answer explanation

Ergotamine relieves migraine headaches by constricting, not dilating, cerebral arterial vessels. The drug’s ability to prevent norepinephrine reuptake may add to this effect. The net result is decreased pulsatile blood flow through the cerebral vessels and symptom relief. Ergotamine doesn’t decrease peripheral vascular resistance or stimulation of baroreceptors.

2. What role will the nurse play in transferring a client to a long-term care facility?

• Provide a verbal report to the nurse at the long-term care facility on the client, the hospital care, and the client’s current condition.

• B) Assure that the client’s original chart accompanies the client.

• C) Arrange for the client’s belongings to remain at the hospital until discharge from the long-term care facility.

• D) Inform the client that transferring should be a stress-free situation.

Answer explanation

The nurse at the hospital will provide a verbal report to the nurse at the long-term facility. The client’s belongings will accompany the client to the long-term facility, and the nurse should assure that this occurs. The original chart will not accompany the client, but copies of the chart or sections of the chart may be sent based upon agency protocols. The nurse should also recognize and inform the client that while a transfer may be a welcome event, it also can be stressful.

3. The nurse recognizes that the goals established for a client’s discharge are more likely to be accomplished when …

• A) the client assists in developing the goals.

• B) the physician develops the goals.

• C) the nurse develops the goals.

• D) the multidisciplinary team develops the goals.

Answer explanation

If the client is involved in establishing the goals, it is more likely that the expected outcomes of the discharge plan will be met. The client may fail to follow the plan if the goals are not mutually agreed on, or are not based on a complete assessment of the client’s needs.

4. Which of the following phrases best describes continuity of care?

• A) Focusing on acute care in the hospital

• B) Serving the needs of children

• C) Facilitating transition between settings

• D) Providing single-episode care services

Answer explanation

Continuity of care is a process by which health care providers give appropriate uninterrupted care and facilitate the client’s transition between different settings and levels of care. The other choices do not describe continuity of care.

Which of the following nursing diagnoses would be appropriate for almost all clients entering a health care setting?

• A) Impaired Elimination

• B) Dysfunctional Grieving

• C) Fatigue

• D) Anxiety

Answer explanation

Entering and leaving a health care setting, as well as receiving care at home, are experiences that produce anxiety for both clients and family members. Most clients entering a health care setting do not have impaired elimination, dysfunctional grieving, or fatigue.

A nurse is admitting an older woman (Grace Staples) to a long-term care facility. How should the nurse address the woman?

• A) “We will just call you Grace while you live here. Okay?”

• B) “I know you have lots of grandchildren, Grandma.”

• C) “What name do you want us to use for you?”

• D) “I think you will enjoy living here, Sweetie.”

Answer explanation

The nurse should communicate with the client as an individual so he or she can maintain his or her own identity. Ask clients how you should address them. Do not call older adults Grandma or Grandpa.

7. Which of the following is the major goal of ambulatory care facilities?

• A) To save money by not paying hospital rates

• B) To provide care to clients capable of self-care at home

• C) To perform major surgery in a community setting

• D) To perform tests prior to being admitted to the hospital

Answer explanation

An individual may receive care in many different kinds of ambulatory facilities, including physician offices, clinics, hospital outpatient services, emergency rooms, and same-day surgery centers. The goal of these facilities is to provide health care services to patients who are able to provide self-care at home. Although this saves money on hospital bills, that is not the major goal of ambulatory facilities. Major surgery and pretesting for surgery are not usually done at these centers.

According to established standards, which health care provider should conduct a holistic assessment for all clients admitted to the hospital?

• A) Physician

• B) Admission clerk

• C) Licensed practical nurse

• D) Registered nurse

Answer explanation

The Joint Commission has established standards for hospital admission. These standards include assessment of each client’s need for nursing care by a registered nurse and biophysical, psychosocial, environmental, self-care, educational, and discharge planning factors. The admission health assessment is not the responsibility of the physician, licensed practical nurse, or admission clerk.

Which health care provider is responsible for ensuring the room is prepared for admission and that the client is welcomed?

• A) Nursing assistant

• B) Admitting room clerk

• C) Social worker

• D) Nurse

Answer explanation

Although the nurse may delegate most of the activities necessary to prepare a room for an admission, it is the nurse’s responsibility to ensure other personnel complete the activities and to welcome the client to the unit.

A client has suddenly become very ill, and a nurse is transferring him to the intensive care unit (ICU). How does the nurse provide information to ensure continuity of care?

• A) By giving a verbal report to nurses in the ICU

• B) By ensuring that the chart and all belongings are moved

• C) By delegating a nursing assistant to provide information

• D) By asking the family to provide the information

Answer explanation

When a client is transferred to another unit, the nurse in the original unit gives a verbal report about the client to the nurse in the new area. Continuity of care is not ensured by moving the chart and belongings, delegating responsibility to a nursing assistant, or asking the family to provide information