Question 1

The nurse should initiate discharge planning for a client?

Accepted Answer

Answer reason: Discharge planning begins at admission to ensure a safe, coordinated transition and to integrate teaching and resource needs into the initial plan of care.

Question 2

Which is contrary to the principles of planning a home visit?

Accepted Answer

Answer reason: Planning a home visit should be purposeful, family-centered, and involve the family in ongoing care. Rigidly conducting the visit in the manner prescribed by the agency (RHU) is not client-centered and is contrary to individualized planning principles.

Question 3

Comprehensive, individualized care provided by the same nurse throughout the period of care refers to ?

Accepted Answer

Answer reason: Primary nursing is a care delivery model where one RN assumes responsibility for a patient’s comprehensive, individualized care for the entire period of care, ensuring continuity.

Question 4

Which of the following is NOT a benefit for the midwife of quality documentation in clinical records?

Accepted Answer

Answer reason: Quality documentation provides legal evidence of care, supports reflective practice, and facilitates communication among healthcare providers. It does not directly prevent cross-contamination, which is achieved through infection control practices.

Question 5

Discharge planning for the hospitalized client begins?

Accepted Answer

Answer reason: Effective discharge planning starts at admission to identify needs, set goals, and coordinate continuity of care from the outset.

Question 6

Which statements explain the purpose of documentation?

Accepted Answer

Answer reason: Documentation supports clinical reasoning and team coordination, guides planning of nursing interventions, and reduces miscommunication—therefore all statements are correct.

Question 7

The client with diabetes is preparing for discharge. During discharge teaching, the nurse assesses the client's ability to care for himself. Which statement made by the client would indicate a need for follow-up after discharge?

Accepted Answer

Answer reason: Visual impairment can prevent safe insulin administration, glucose monitoring, and foot inspection, indicating the need for additional support or follow-up after discharge. Living alone, having a pet, or driving do not inherently prevent self-care.

Question 8

Aisha has completed her treatment at an in-patient facility and is ready to be discharged. She has asked her counselor to recommend a therapist to work with her and her husband on an out-patient basis. This process is BEST viewed as an example of?

Accepted Answer

Answer reason: Requesting the counselor to recommend an outpatient therapist involves transferring/connecting care to another provider, which is a referral. Aftercare planning is broader, and consultation or case management do not specifically describe this act.

Question 9

Which nursing action BEST supports continuity of care during discharge planning?

Accepted Answer

Answer reason: Continuity of care is strengthened when follow-up services are arranged prior to discharge, reducing gaps in care and improving adherence. Delaying coordination or limiting education increases the risk of fragmentation.

Question 10

A client with multiple chronic conditions is transferred from the hospital to a skilled nursing facility. Which information is MOST critical to include in the handoff report?

Accepted Answer

Answer reason: Accurate medication lists, recent changes, and pending results are essential to prevent errors during transitions. Preferences and family details are helpful but secondary to safety-critical clinical information.

Question 11

Which practice BEST demonstrates continuity of care for a client receiving home health services after hospitalization?

Accepted Answer

Answer reason: Shared, standardized care plans promote consistent goals, interventions, and communication among providers, reducing duplication and errors. Frequent provider changes or uncoordinated scheduling disrupt continuity.

Question 12

Which of the following statements is true of long-term care?

Accepted Answer

Answer reason: Long-term care (LTC) is designed to support clients who have ongoing functional limitations and persistent health problems, which are most often chronic (e.g., dementia, stroke deficits, COPD). Terminally ill clients can also reside in LTC settings, so option A is false. Some LTC residents may improve and return to the community with supports, so option C is false. While home care can be part of long-term services and supports, LTC is not limited to the home and includes facilities (e.g., nursing homes), making option D too broad to be the single best true statement.

Question 13

Where is long-term care offered?

Accepted Answer

Answer reason: Long-term care refers to ongoing assistance with health needs and activities of daily living over an extended period, often for chronic illness, disability, or functional decline. Skilled nursing facilities are a primary setting for long-term care because they provide 24-hour nursing supervision and supportive services. Hospitals and ambulatory surgical centers are generally for acute or procedural care, and adult day services provide daytime support but not residential long-term care.

Question 14

The nurse is providing care in an organization that supports the maternal and child care continuum. Which type of patient care area is an example of this approach?

Accepted Answer

Answer reason: Emphasizes a coordinated, continuous plan across pregnancy, birth, postpartum, and pediatric phases while incorporating the family as the constant in the client’s life. It supports shared decision-making, consistent education, and involvement of caregivers to ensure smooth transitions between settings and providers. The other options describe settings (primary care) or nursing delivery/coordination methods (team nursing, case management) rather than the core maternal–child continuum philosophy centered on the family unit.

Question 15

A patient is diagnosed with mild dementia while in the hospital. In preparing for discharge, the nurse should discuss with the family the?

Accepted Answer

Answer reason: Discharge planning for mild dementia focuses on ensuring safe functioning at home and arranging supports for activities of daily living, medication management, supervision, and follow-up. Home care services can be scaled to the patient’s current deficits and reduce risks such as medication errors, wandering, or falls. Transfer to long-term care is not automatically required in mild dementia and depends on functional status and caregiver capacity, while “legal responsibility” and “lack of free resources” are not primary, actionable discharge priorities.

Question 16

An 89-year-old man, who was recently discharged from a rehabilitation hospital because of an inability to concentrate and frequent memory lapses, cannot be left alone while his family works. What options should the discharge planning team suggest that will satisfy safety concerns and give the greatest quality of life to the patient?

Accepted Answer

Answer reason: Adult day care provides supervision and structured activities during the hours the family is unavailable, reducing risks related to wandering, medication errors, or unsafe behaviors while maintaining community living. It also supports psychosocial well-being and preserves independence more than institutional placement. A psychiatric facility or high-security nursing home is not indicated based on the information given and would unnecessarily restrict autonomy. A general hospital admission is for acute evaluation and does not address ongoing daytime supervision needs.

Question 17

The nurse is providing care in an organization that supports the maternal and child care continuum. Which type of patient care is an example of this approach?

Accepted Answer

Answer reason: is designed to coordinate and integrate services around the needs of the child within the context of the family, supporting care across settings and over time. In maternal-child health, it emphasizes collaboration with parents/caregivers, shared decision-making, and consistent support from pregnancy through infancy/childhood. The other options describe general care delivery structures or coordination methods but do not specifically define the maternal-child continuum approach centered on the family as the unit of care.

Question 18

A patient is to have a left inguinal hernia repair at the outpatient surgical clinic. Preoperatively, it is most important for the nurse to determine whether the?

Accepted Answer

Answer reason: Outpatient surgery typically involves anesthesia and postoperative sedation, which impair judgment and reflexes, making it unsafe for the patient to drive or be alone immediately after discharge. Ensuring a responsible adult can provide transportation and monitor for complications (e.g., bleeding, uncontrolled pain, nausea/vomiting, dizziness) is a key discharge safety requirement. Without adequate home support, the procedure may need to be postponed or discharge planning modified to prevent avoidable harm.

Question 19

A nurse is reviewing changes in healthcare delivery and funding for pediatric populations. Which current trend in the pediatric setting should the nurse expect to find?

Accepted Answer

Answer reason: Pediatric healthcare delivery has shifted toward outpatient and community-based services to reduce costs, shorten or avoid hospital stays, and manage many conditions safely without admission. Advances in treatment and technology also allow more procedures and follow-up to be done in clinics, same-day surgery centers, and home-care settings. The other choices do not reflect consistent broad trends in pediatric care delivery and funding across systems.

Question 20

In working with the caregivers of a client with an acute or chronic illness, the nurse would?

Accepted Answer

Answer reason: Effective caregiver education is best delivered in small, repeated sessions throughout the hospital stay to support learning, retention, and confidence. Having caregivers perform return demonstrations verifies understanding and identifies gaps that can be corrected before the client goes home. This approach promotes safe transitions and reduces the risk of post-discharge errors or complications. The other options describe clinical manifestations and do not address caregiver teaching strategies.

Question 21

Which of the following documentation used by the head nurse to communicate information about patient has sudden hemorrhage to another head nurse in the next shift?

Accepted Answer

Answer reason: The core principle is continuity of care through effective handoff communication between shifts. A sudden hemorrhage is a significant change in condition that must be conveyed promptly to the oncoming nurse so ongoing monitoring, interventions, and provider notifications continue without delay. The shift report is specifically designed to transfer current, time-sensitive patient status, recent events, and needed follow-up actions. An incident report is used for internal risk management and quality review, not as a handoff tool for clinical communication. Assignment records and Kardex support staffing and summary information, but they are not the primary mechanism for immediate change-of-condition communication at shift change.

Question 22

At what point of the hospitalization of the pediatric patient should discharge planning and teaching begin?

Accepted Answer

Answer reason: Beginning at admission allows ongoing assessment of caregiver readiness, health literacy, and barriers (transportation, home equipment, insurance) that can delay safe discharge. Pediatric teaching often requires repetition, demonstration/return demonstration, and coordination with school/daycare or home health, which cannot be reliably completed at the last minute. Waiting until the day of discharge or post-op concentrates too much information into a short time and increases the risk of errors, missed instructions, and preventable readmissions.

Question 23

One major difference between long term care and respite centers is the fact that long term care facilities?

Accepted Answer

Answer reason: Long-term care is designed for ongoing assistance with activities of daily living and chronic health needs when a client cannot safely live independently for an extended period. Respite care is a short-term service intended to temporarily relieve the primary caregiver while still meeting the client’s care needs, after which the client typically returns home or to their usual setting. This distinction is about duration and continuity of placement, not about limiting respite to outpatient-only services. Therefore, the option describing long-term versus temporary care best matches established care setting definitions.

Question 24

Which of the following is an advantage of a home visit?

Accepted Answer

Answer reason:  Home visits are designed to assess the client within their real living environment to identify safety risks, resources, barriers to care, and caregiver capacity that may not be apparent in a clinic. A direct appraisal supports individualized planning, teaching, and coordination of services that fit the home context, improving follow-through and outcomes. The ability to observe medication storage, hygiene, mobility hazards, and family dynamics is a unique advantage of home care. By contrast, reaching a greater number of people or sharing experiences is more characteristic of group or clinic-based services rather than home visiting.

Question 25

The nurse should initiate discharge planning for a client?

Accepted Answer

Answer reason: Starting early allows the nurse to assess baseline function, home supports, resources, and likely barriers (transportation, equipment, follow-up care) while care is being delivered. Waiting until a discharge date is set or until the client is stable can miss time-sensitive referrals and teaching opportunities and can prolong length of stay. Readiness to learn affects timing of education, but planning and coordination should already be underway.

Question 26

A 72 year-old client with osteomyelitis requires a 6 week course of intravenous antibiotics. In planning for home care, what is the most important action by the nurse?

Accepted Answer

Answer reason: A 6-week IV antibiotic regimen requires consistent aseptic technique, line care, medication administration, and monitoring for complications, so functional ability, cognition, and caregiver dependability determine feasibility and safety. Without this assessment, arranging insurance coverage or choosing a device does not prevent missed doses, contamination, or delayed recognition of adverse events. Home handwashing facilities matter, but they are secondary because the primary determinant is whether competent people are available to perform and adhere to required care.

Question 27

The clinic nurse is counseling a substance-abusing post partum client on the risks of continued cocaine use. In order to provide continuity of care, which nursing diagnosis is a priority?

Accepted Answer

Answer reason: Ongoing cocaine use in the postpartum period places the infant at high risk for neglect, unsafe caregiving, and impaired attachment, making parenting capacity the most urgent focus for discharge planning and community referral. Identifying this diagnosis prompts immediate linkage to child-protective resources, home visiting, substance-use treatment, and family support to maintain continuity of care. While ineffective coping and social isolation may contribute to relapse, they are secondary because they do not directly target the immediate caregiving risks to the infant.

Question 28

An unmarried client delivers a premature neonate. Which intervention would be included in her care plan?

Accepted Answer

Answer reason: Social services can assess the client’s support system and barriers to care before discharge and rapidly connect her with community programs, insurance/Medicaid resources, and newborn follow-up services. Addressing these needs during hospitalization improves discharge readiness and reduces risk of missed neonatal care. The other options may be helpful but are either less comprehensive (early physician visit), not as immediate/targeted, or assume services after discharge without first ensuring a safe, supported plan.

Question 29

The nurse is preparing a plan of care for a client requiring a dressing change. What is the most important nursing intervention?

Accepted Answer

Answer reason: The core principle is that an individualized plan of care guides and standardizes nursing interventions so they are carried out safely and consistently by all caregivers. Incorporating the dressing-change order into the care plan ensures the intervention is scheduled, communicated, and implemented according to the prescribed technique and frequency. A handoff report supports communication but is time-limited and error-prone if not reinforced by the ongoing plan of care. Narrative documentation is important after the intervention occurs, but it does not ensure the intervention is planned and reliably executed going forward.

Question 30

The client is scheduled for an MRI scan. Which is most important for the nurse to include prior to the client’s MRI scan?

Accepted Answer

Answer reason: An SBAR report ensures the MRI team receives time-critical information (reason for MRI, allergies/contrast risk, implant/metal screening status, IV access, current condition, and safety precautions) to prevent errors and delays. While vital signs and intake/output documentation can be clinically useful, they do not substitute for a structured transfer-of-care report that communicates actionable risks and needs. Discharge planning is not relevant to the immediate safety requirements of an MRI transfer.

Question 31

The older adult client wishes to be discharged home after a kyphoplasty. The client has a history of emphysema requiring oxygen at home. To ensure discharge to home is appropriate, which is most important for the nurse to assess?

Accepted Answer

Answer reason: After kyphoplasty, mobility limits plus chronic emphysema with home oxygen increase the risk for falls, hypoventilation, and inability to manage equipment, making functional capacity the key determinant of a safe discharge plan. Identifying deficits in ambulation, transfers, toileting, and ability to use oxygen appropriately directly informs whether home is feasible versus needing rehab, additional services, or caregiver support. Home resources, pain planning, and medication review are important but are secondary steps that are guided by the client’s demonstrated self-care ability and safety risk.

Question 32

Which outcome should be anticipated of parental care of a child with neonatal chronic lung disease (bronchopulmonary dysplasia)?

Accepted Answer

Answer reason: A key measurable outcome is that parents can explain the disease process, recognize risks (e.g., respiratory distress, infection, oxygen hazards), and describe therapies and home nursing actions such as oxygen use, medications, nutrition, and follow-up. Increased stress may occur, but it is not an intended/desired outcome of care planning and support. Limiting parents to only routine tasks or requiring professional assistance for safe decisions reflects inadequate teaching and poor readiness for discharge and long-term management.

Question 33

A client experienced an acute inferior myocardial infarction at a community hospital. After antithrombolytic therapy fails, the physician wants to transfer the client to another hospital for emergency cardiac catheterization. Which member of the health care team must accompany the client?

Accepted Answer

Answer reason: The accompanying clinician must be able to provide continuous monitoring, administer and titrate IV medications per protocol, and perform advanced clinical judgment with immediate escalation of care. An RN is appropriately prepared and authorized to manage these unstable physiologic changes during transport, whereas an LPN scope is more limited and typically does not include managing unstable, high-acuity transfers. A physician is not required to physically accompany many transfers when an RN can provide appropriate monitoring and interventions with standing orders and receiving-facility coordination.

Question 34

The nurse teaches the postoperative adult client how to perform incision care. Prior to discharge, how should the nurse best evaluate the client’s learning?

Accepted Answer

Answer reason: Return demonstration provides the most objective evidence that the client can independently complete each step of incision cleansing and dressing changes. Verbal discussion can confirm knowledge but may miss technique errors that increase infection risk. A handout and family presence may support reinforcement and adherence, but they do not directly measure the client’s ability to carry out the procedure correctly.

Question 35

A hospital implemented computerized provider order entry (CPOE). Which additional task related to CPOE is required for the nurse to provide safe care?

Accepted Answer

Answer reason: The nurse must therefore build routine review of the electronic order queue into workflow to prevent missed or delayed treatments, labs, or parameter changes. Hourly checks specifically for medications due is not the core CPOE safety requirement and can still miss non-medication orders or time-critical changes entered between checks. Relying on the provider to telephone new orders defeats the purpose of CPOE and is unreliable except for urgent/critical situations requiring immediate notification.

Question 36

The night shift nurse gives an informative end-of-shift report to the day shift nurse assuming care of the assigned client group. The shift report is an example of which element of a safe client care environment?

Accepted Answer

Answer reason: Effective handoff communication ensures essential patient information is transferred so care remains consistent across shifts and providers. An end-of-shift report supports safe ongoing assessment, prioritization, and intervention planning by the incoming nurse, reducing errors from missing or inaccurate data. This is a standard nursing process element that promotes coordinated care rather than indicating poor communication. Confidentiality is maintained when only necessary patient information is shared with involved staff in an appropriate setting, so the handoff itself is not inherently a breach.

Question 37

A client with bilateral fractured femurs is scheduled for a double-hipspica cast. She says to the nurse, “Only 3 more months and I can go home.” Further investigation reveals that the client and her family believe she'll be hospitalized until the cast comes off. The nurse should explain to the client and her family that the client?

Accepted Answer

Answer reason: The key principle is that discharge planning after spica casting focuses on caregiver teaching and home readiness rather than keeping the patient hospitalized for the entire immobilization period. After the cast is applied, the child is typically observed briefly to ensure neurovascular stability, pain control, and that the family can manage positioning, skin care, toileting, and transfers. Once caregivers demonstrate competence with spica care and appropriate equipment is arranged (e.g., car seat/transport adaptations), discharge is usually possible within a few days. Options implying weeks to months of hospitalization confuse the duration of casting with the length of inpatient stay, and “as soon as she can move” is unsafe/vague because mobility remains limited in a double-hip spica and is not the discharge criterion.

Question 38

The nurse is preparing to discharge the client who had a surgical procedure earlier in the day. The client lives alone. Which information would require the nurse to collaborate with the multidisciplinary team for skilled nursing care at home?

Accepted Answer

Answer reason: Skilled home nursing is indicated when ongoing wound care is needed that the client may not be able to perform safely and consistently, especially when it involves a functional limitation. A dressing on the dominant arm can significantly impair the client’s ability to complete sterile/clean technique, secure the dressing appropriately, and assess the site daily when living alone. This creates risk for infection, delayed healing, and missed complications, so coordination for home health nursing is appropriate. By contrast, transportation issues are typically addressed through social services/community resources rather than skilled nursing, and demonstrated competence with drain care/med prep suggests self-management is feasible.

Question 39

The client who is hard of hearing and primarily speaks German is being discharged home. Which action should be the nurse’s priority when preparing to teach the client about newly prescribed medications?

Accepted Answer

Answer reason: Effective discharge medication teaching must be individualized by first assessing the client’s ability to receive and understand information, including language proficiency, health literacy, and communication barriers such as hearing impairment. Establishing literacy in the relevant languages guides the safest teaching method (e.g., written materials vs. teach-back with interpreter support) and reduces the risk of medication errors after discharge. Written German/English materials may still be unsafe if the client cannot read at the needed level, so assessment comes before selecting teaching tools. Shifting teaching to someone else without assessing the client undermines client rights and informed participation, and having an NA “review” medication instructions is inappropriate because it involves patient education beyond typical NA scope and may bypass qualified interpreter standards.

Question 40

A nurse is performing the admission assessment and documenting the health history information on a newly admitted client. The client reports an allergy to penicillin, but the nurse fails to record this allergy information in the medical record. What is the correct definition of this error of omission by the nurse?

Accepted Answer

Answer reason: Accurate, complete documentation is essential to ensure all members of the healthcare team have the information needed to provide safe, coordinated care. Omitting a known penicillin allergy from the record creates a communication gap that can lead to administration of a contraindicated medication and patient harm. This is best defined as a breakdown in continuity of care because the next clinician cannot reliably follow the plan based on incomplete data. It is not a confidentiality breach because the error is failure to document critical information, not unauthorized disclosure. It is also not the nurse’s role to diagnose the client; the primary risk is unsafe ongoing care due to missing allergy documentation.

Question 41

The nurse is about to receive a change-of-shift report. Which type report is acceptable?

Accepted Answer

Answer reason: Change-of-shift handoff must support continuity of care by allowing clarification of ambiguous or high-risk details to prevent omissions and errors. Having the reporting nurse available enables immediate two-way communication, confirmation of critical information (e.g., changes in condition, pending tests, safety risks), and timely follow-up questions. A recording alone can miss nuance and does not allow real-time verification, increasing risk of miscommunication. Calling a nurse at home is inappropriate for confidentiality and boundary reasons and is not a reliable safety process. Relying on another nurse who did not give the report increases the chance of secondhand inaccuracies and incomplete transfer of responsibility.

Question 42

The client is being transferred to a subacute unit at another facility. The nurse calls the facility to give a verbal report to the nurse assuming the client's care. Which statement best ensures that the continuity of care is maintained?

Accepted Answer

Answer reason:  Continuity of care during interfacility transfer depends on a complete handoff that communicates current status, ongoing therapies, and anticipated needs so the receiving nurse can safely assume care. A concise overview of condition, treatment plan, and needs aligns with structured handoff principles (e.g., SBAR) and reduces omissions that lead to delays or errors. Relying on transfer forms alone risks missing time-sensitive changes or nuances that are not captured or are misfiled. Documenting the receiver’s name supports accountability but does not itself ensure clinical continuity, and informing the client addresses education rather than handoff completeness.

Question 43

A night shift nurse receives shift report from the day shift nurse when the day nurse states, “I have an appointment and I need to leave. Can you get the rest of the clients’ information from the medical records?” Which client right is violated by the day nurse?

Accepted Answer

Answer reason: Continuity of care requires a complete, timely handoff so the oncoming nurse has the information needed to provide safe, coordinated care. Leaving before giving a full report shifts the burden to the next nurse to reconstruct essential details from the chart, which can delay interventions and increase risk for omissions. Appropriate handoff communication is part of the departing nurse’s responsibility and is central to safe transitions between caregivers. Confidentiality is not the primary issue here because accessing records for legitimate care purposes by the receiving nurse is permitted within the care team.

Question 44

A client is being discharged to a rehabilitation facility. The primary nurse caring for the client on the day of discharge carefully inventories the client’s belongings and checks the list against the admission list of belongings for accuracy. The nurse then makes a client report for the nurse assuming client care at the receiving rehabilitation facility and answers the receiving nurse’s questions before concluding the report. The nurse has demonstrated which element of a safe client care environment?

Accepted Answer

Answer reason: Safe transitions require accurate handoff communication and coordination so the next setting can safely assume care without gaps. Reconciling belongings prevents loss and supports a safe discharge process, while a structured report with opportunity for questions ensures essential information is transferred. These actions directly reflect maintaining seamless care across settings. Case management is broader discharge planning/resource coordination, and quality improvement focuses on system-level monitoring rather than the immediate handoff.

Question 45

A pediatric client with moderate cognitive impairment is admitted for knee surgery. During the preoperative period, what is the priority nursing action?

Accepted Answer

Answer reason: Preoperative nursing priority is to complete an individualized assessment that will guide the plan of care and reduce perioperative anxiety and behavioral escalation in a child with cognitive impairment. Establishing the child’s baseline communication, coping strategies, triggers, mobility level, and self-care abilities helps tailor teaching, pain assessment methods, and postoperative routines to what the child can understand and tolerate. This information also supports safe discharge planning by identifying what assistance and resources will actually be needed after surgery. Teaching and equipment planning are important but should be based on the assessment data; social visits are not the priority for perioperative safety and care planning.

Question 46

The nurse cares for a patient on an acute cardiac unit. The nurse writes her note for the next shift. It is vital to communicate which of the following information to the next shift?

Accepted Answer

Answer reason: In an acute cardiac unit, respiratory symptoms, decreased activity tolerance, abnormal rhythm findings/interpretations, and unstable vital signs can signal decompensation (e.g., ischemia, dysrhythmia, heart failure) and require rapid assessment or escalation. This option captures both current status and critical trend information that directly guides the next nurse’s surveillance and interventions. Other options include useful but lower-acuity details (education needs, demographics, nutrition) that should not displace urgent physiologic warnings during shift-to-shift report.

Question 47

A client is hospitalized with a hypertensive emergency after missing medication doses at home. The nurse consults with the provider, client, and family to prepare for discharge. Which action is best?

Accepted Answer

Answer reason: Medication nonadherence is most effectively addressed by first identifying the underlying cause (eg, cost, side effects, health literacy, cognitive/visual limitations, complex regimen, access to pharmacy, or beliefs). This assessment guides individualized discharge planning and allows the team to select targeted interventions that are feasible and sustainable, reducing the risk of recurrent hypertensive crisis. Jumping straight to tools (pill organizer) or delegating management to a partner may miss the true driver of missed doses and can undermine the client’s autonomy. Counting remaining pills provides limited information and does not resolve the root problem that led to the emergency.

Question 48

A 65-year-old man, who is a retired professional dancer, has been admitted to the orthopedic unit for spinal stenosis surgery. He lives alone in a two-story house and is concerned about his mobility and self-care post-surgery. Given his unique living situation and profession, which has contributed to his current condition, when should the nurse initiate discharge training and planning to ensure a smooth transition and recovery for this patient?

Accepted Answer

Answer reason: Starting on admission allows assessment of home environment risks (stairs, living alone), baseline function, anticipated postoperative limitations, and the need for PT/OT, assistive devices, and possible home health services. Waiting until after surgery or within 48 hours of discharge compresses teaching and coordination, increasing the risk of unsafe discharge and readmission. Preoperative teaching is important, but discharge planning should be initiated at admission and then reinforced throughout the stay as needs become clearer.

Question 49

The nurse is discharging a client with emphysema who is on continuous oxygen. The case manager alerts the nurse that the home oxygen will not be delivered until 2 hours later. What action should the nurse take?

Accepted Answer

Answer reason: Providing a portable cylinder for the trip home and until the home concentrator is delivered ensures continuity of therapy while still allowing safe discharge. Delaying discharge may be unnecessary if a safe bridging plan is available and can disrupt care flow without improving safety. Asking the client to go without oxygen is unsafe, and calling the provider is not needed when nursing can implement an immediate, safe equipment solution.

Question 50

Pt 21 years came to ER with pneumonia pt said she has two sisters and one brother not educated. They live in home is two rooms and one bathroom only father earned bread for them, which type of information?

Accepted Answer

Answer reason: Family composition, education level, and living conditions are standard demographic/social history elements used to understand baseline context and plan care and discharge needs. Demographic information captures who the patient is and their social environment rather than details of the acute illness itself. Economic status is mentioned (single earner), but the overall set of details is broader than finances, making the demographic category the best fit.

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The nurse should initiate discharge planning for a client?

Which is contrary to the principles of planning a home visit?

Comprehensive, individualized care provided by the same nurse throughout the period of care refers to ?

Which of the following is NOT a benefit for the midwife of quality documentation in clinical records?

Discharge planning for the hospitalized client begins?

Which statements explain the purpose of documentation?

The client with diabetes is preparing for discharge. During discharge teaching, the nurse assesses the client's ability to care for himself. Which statement made by the client would indicate a need for follow-up after discharge?

Aisha has completed her treatment at an in-patient facility and is ready to be discharged. She has asked her counselor to recommend a therapist to work with her and her husband on an out-patient basis. This process is BEST viewed as an example of?

Which nursing action BEST supports continuity of care during discharge planning?

A client with multiple chronic conditions is transferred from the hospital to a skilled nursing facility. Which information is MOST critical to include in the handoff report?

Which practice BEST demonstrates continuity of care for a client receiving home health services after hospitalization?

Which of the following statements is true of long-term care?

Where is long-term care offered?

The nurse is providing care in an organization that supports the maternal and child care continuum. Which type of patient care area is an example of this approach?

A patient is diagnosed with mild dementia while in the hospital. In preparing for discharge, the nurse should discuss with the family the?

The nurse is providing care in an organization that supports the maternal and child care continuum. Which type of patient care is an example of this approach?

A patient is to have a left inguinal hernia repair at the outpatient surgical clinic. Preoperatively, it is most important for the nurse to determine whether the?

A nurse is reviewing changes in healthcare delivery and funding for pediatric populations. Which current trend in the pediatric setting should the nurse expect to find?

In working with the caregivers of a client with an acute or chronic illness, the nurse would?

Which of the following documentation used by the head nurse to communicate information about patient has sudden hemorrhage to another head nurse in the next shift?

At what point of the hospitalization of the pediatric patient should discharge planning and teaching begin?

One major difference between long term care and respite centers is the fact that long term care facilities?

Which of the following is an advantage of a home visit?

The nurse should initiate discharge planning for a client?

A 72 year-old client with osteomyelitis requires a 6 week course of intravenous antibiotics. In planning for home care, what is the most important action by the nurse?

The clinic nurse is counseling a substance-abusing post partum client on the risks of continued cocaine use. In order to provide continuity of care, which nursing diagnosis is a priority?

An unmarried client delivers a premature neonate. Which intervention would be included in her care plan?

The nurse is preparing a plan of care for a client requiring a dressing change. What is the most important nursing intervention?

The client is scheduled for an MRI scan. Which is most important for the nurse to include prior to the client’s MRI scan?

The older adult client wishes to be discharged home after a kyphoplasty. The client has a history of emphysema requiring oxygen at home. To ensure discharge to home is appropriate, which is most important for the nurse to assess?

Which outcome should be anticipated of parental care of a child with neonatal chronic lung disease (bronchopulmonary dysplasia)?

A client experienced an acute inferior myocardial infarction at a community hospital. After antithrombolytic therapy fails, the physician wants to transfer the client to another hospital for emergency cardiac catheterization. Which member of the health care team must accompany the client?

The nurse teaches the postoperative adult client how to perform incision care. Prior to discharge, how should the nurse best evaluate the client’s learning?

A hospital implemented computerized provider order entry (CPOE). Which additional task related to CPOE is required for the nurse to provide safe care?

The night shift nurse gives an informative end-of-shift report to the day shift nurse assuming care of the assigned client group. The shift report is an example of which element of a safe client care environment?

The nurse is preparing to discharge the client who had a surgical procedure earlier in the day. The client lives alone. Which information would require the nurse to collaborate with the multidisciplinary team for skilled nursing care at home?

The client who is hard of hearing and primarily speaks German is being discharged home. Which action should be the nurse’s priority when preparing to teach the client about newly prescribed medications?

The nurse is about to receive a change-of-shift report. Which type report is acceptable?

The client is being transferred to a subacute unit at another facility. The nurse calls the facility to give a verbal report to the nurse assuming the client's care. Which statement best ensures that the continuity of care is maintained?

A night shift nurse receives shift report from the day shift nurse when the day nurse states, “I have an appointment and I need to leave. Can you get the rest of the clients’ information from the medical records?” Which client right is violated by the day nurse?

A pediatric client with moderate cognitive impairment is admitted for knee surgery. During the preoperative period, what is the priority nursing action?

The nurse cares for a patient on an acute cardiac unit. The nurse writes her note for the next shift. It is vital to communicate which of the following information to the next shift?

A client is hospitalized with a hypertensive emergency after missing medication doses at home. The nurse consults with the provider, client, and family to prepare for discharge. Which action is best?

The nurse is discharging a client with emphysema who is on continuous oxygen. The case manager alerts the nurse that the home oxygen will not be delivered until 2 hours later. What action should the nurse take?

Pt 21 years came to ER with pneumonia pt said she has two sisters and one brother not educated. They live in home is two rooms and one bathroom only father earned bread for them, which type of information?

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