Chapter 11: Admission, Transfer, and discharge

1.When admitting a patient to the hospital, the nurse observes that the patient is distracted and tense. This behavior suggests a common reaction to hospitalization, which is:

b.fear of the unknown.

2. During the admission procedure, the nursing intervention would best help reduce patient anxiety?

c.Greet the patient by name.

3. An essential part of the admission procedure performed by the RN is to:

c.obtain a health history.

4. Discharge planning should begin:

c.shortly after admission.

5. To help the family of a patient find a source of financial aid to meet medical expenses, the nurse can make a referral to:

d.social services.

6. When a patient demands to be discharged without a physician's order and is leaving the unit with his belongings, the nurse should ask the patient to sign a(n):

b.discharge against medical advice form.

7. The nurse must be sensitive to an older adult patient experiencing separation anxiety when admitted to the hospital. A child will usually cry, whereas an older adult will often demonstrate:

c.depression.

8. Upon admission, the nurse notes that a patient has a billfold filled with cash. Because there is no family member present, the nurse suggests that the money be:

d.placed in the hospital safe.

9. If a patient has an order for an interagency transfer, the nurse explains that the patient will be moved from:

d.one facility to another.

10. Before the actual discharge, the nurse must ensure that the patient:

c.understands the discharge instructions.

11. A patient who is alert and oriented is threatening to leave the hospital against medical advice (AMA). The nurse should:

d.notify the physician that the patient is threatening to leave AMA

12. The nurse demonstrates cultural sensitivity to a Haitian-American patient by:

c.allowing the patient to keep leaves in her room.

13. A nurse is caring for a Haitian-American patient. The nurse demonstrates cultural sensitivity by:

d.allowing the patient to walk out of the hospital when discharge

14. How can the nurse help reduce the stress of a hospital admission? (Select all that apply.)

a.Show the patient how bedside equipment works.

c.Give simple explanation of policies.

d.Involve the patient in the plan of care.

15. The nurse adheres to the discharge standards set by The Joint Commission (TJC), which include that patients will receive instruction regarding which aspect(s) of care? (Select all that apply.)

a.Medications

b.Rehabilitation techniques

c.Referral to community agencies

d.Medical equipment to be used

16. The nurse completes thorough documentation before, during, and after a transfer to ensure _______ of _______.

continuity, care

17. The nurse reminds the staff that the Haitian-American patient perceives a mystical and healing power in ________.

leaves

18. Because of the stress caused by hospitalization, the nurse assesses a newly admitted older adult patient for ________________.

disorientation

1. A patient's physical mobility is impaired because of paralysis of both lower extremities. Which is the best method for the nurse to use to place the patient in semi-Fowler's position?

d.Pull the patient to the head of the bed (HOB) using a drawsheet and then raise the HOB.

2. The nurse is caring for a patient after a motor vehicle accident and instructs the patient to avoid turning independently because the spine is unstable. Which explanation should the nurse use to explain the purpose of the safeguards in relation to the patient's injury?

b.They keep the neck and spine in straight alignment

3. The nurse and an assistant are moving a dependent patient from the supine to the lateral position. Which should the nurse implement to begin repositioning?

b.Move the patient away from the center toward a side of the bed.

4. After 3 hours in the supine position, an older patient tells the nurse that he or she is stiff and too uncomfortable to move. Which is the best nursing intervention to maintain skin integrity?

c.Assess the patient's need for pain medication before repositioning.

5. The patient with a hemiparesis is very hesitant to transfer from the bed to the chair with a new nurse's help. Which action should this nurse take first to accomplish the transfer?

b.Ask questions about how the patient usually transfers.

6. The nurse is helping a patient set a goal for ambulating after surgery. Which outcome statement for this patient with generalized postoperative weakness is best?

d.The patient transfers self safely from bed to chair 4 times daily within 2 days.

7. The nurse assists the patient with transferring from bed to chair by using a transfer belt. Which is the first instruction that the nurse gives to the patient after properly positioning him or her?

d."Rock to help stand while pushing up with your hands."

8. While the nurse is attempting to transfer a patient to a standing position, the patient cannot get off the bed. Which is the initial intervention for the nurse to implement?

a.Return the patient to a safe position on the bed.

9. The nurse successfully transfers a patient from the bed to the chair and back. What information is most vital for the nurse to include in the progress notes?

d.A description of the patient's response to each transfer

10. The nurse wants to transfer a patient from the bed to the chair by using a mechanical lift. The patient has difficulty following directions, and the nurse cannot find help. Which is the most important action for the nurse to implement?

c.Delay the transfer until help is found.

11. The nurse is teaching other caregivers about using a mechanical lift. What should the nurse include in the instructions focusing on patient safety?

a.Place the base of the lift under the side of the bed.

12. The nurse transfers the patient from the bed to the chair using a mechanical lift. Which should the nurse do before leaving the patient's room to ensure patient safety?

c.Secure the call bell within the patient's reach.

13. A 225-pound patient is unconscious and needs to be transferred from the bed to the stretcher. Which action is most critical for the nurse to initiate before moving the patient?

a.Obtain a friction-reducing device and at least two other staff members.

14. The nurse is preparing to place a patient in the prone position. What action should the nurse take during the positioning?

c.Insert a pillow under the abdomen.

15. While transferring a patient who has been bedridden for several weeks, the nurse notes that the patient becomes fatigued rapidly. What assessment data does the nurse expect to find to validate the patient's changing status?

a.Increased pulse and increased respirations

16. A weak but motivated patient is ambulating for the first time. Which nursing intervention is most likely to facilitate patient participation in ambulation and ensure patient safety?

d.Perform a quick assessment, including patient fatigue while talking.

17. The patient will be transferred to the chair an hour after receiving pain medication. Which activity should the nurse delegate to nursing assistive personnel (NAP)?

c.Position the gait belt around the patient.

18. The nurse is teaching a patient's family how to maintain personal safety and prevent injury when lifting or moving the patient. Which concept should the nurse include in the instructions?

b.Keep the patient close to the mover.

19. The nurse teaches the caregiver to maintain the patient's safety when transferring to a chair. Which teaching should the nurse include to address the weakness of the patient's right side?

b.Place the chair to the patient's left side after sitting the patient on the edge of the bed.

20. You are moving a patient onto a stretcher using a slide board. Two nurses are positioned on the side of the stretcher. Where is the third nurse positioned?

d.On the side of the bed without the stretcher

1. You are orienting a new NAP about the steps of proper body mechanics. Which of the follow statements are correct steps? (Select all that apply.)

a.Avoid twisting.

b.Bend at the knees.

c.Tighten stomach muscles as you lift.

d.Straighten the legs.

e.Keep the weight close to the body.

a.Avoid twisting.

b.Bend at the knees

e.Keep the weight close to the body.

2. Which of the following patients are at higher risk of complications from improper positioning? (Select all that apply.)

a.The patient who is post hip fracture who has osteoarthritis

b.The patient who has COPD

c.The patient who is a paraplegic

d.The patient who suffered a stroke

e.The patient with Alzheimer's

a.The patient who is post hip fracture who has osteoarthritis

c.The patient who is a paraplegic

d.The patient who suffered a stroke

e.The patient with Alzheimer's

3. You are getting ready to transfer your patient from the bed to a chair for the first time after surgery. Which of the following are important to assess? (Select all that apply.)

a.Sensory status

c.Upper arm strength

d.Postural hypotension

e.Cognitive status

f.Pain level

4. You are transferring a patient and he or she sustains an injury during the transfer. What steps must you take? (Select all that apply.)

a.Stay with the patient.

b.Notify the healthcare provider.

c.Complete an occurrence report per agency policy.

d.Evaluate the incident.

e.Provide supportive care to the patient

a.Stay with the patient.

b.Notify the healthcare provider.

c.Complete an occurrence report per agency policy.

d.Evaluate the incident.

e.Provide supportive care to the patient

1. Workers in ________ and ________ occupations suffer the most lost-time cases of general musculoskeletal pain and back pain.

nursing, support staff

support staff, nursing

2. The most effective way to prevent musculoskeletal injuries when positioning patients is to teach _______________and ____________.

proper body mechanics, use of patient-handling equipment

use of patient-handling equipment, proper body mechanics