CH11 Foundations of Admissions/Transfers/Discharge study guide questions

When admitting a patient to the hospital, the nurse observes that the patient is distracted and tense. What does this behavior suggest as a common reaction to hospitalization?

1- relief about being care for

2- fear of the unknown

3- feeling of powerlessness

4- concern about cost

A nurse is admitting a patient to an acute care facility. During the admission procedure, what nursing intervention would best help reduce patient anxiety?

1- transport the patient by wheelchair.

2- inform the health care provider that the patient is admitted.

3- greet the patient by name.

4- collect financial information during the interview.

What essential part of the admission procedure is performed by the RN?

1- securing the patient’s valuables.

2- confirming the type of insurance coverage.

3- obtaining a health history.

4- familiarizing the patient with the room.

When should discharge planning begin?

1- day before discharge

2- on the first day postoperatively

3- shortly after admission

4- when the health care provider orders it

Where can a nurse refer the family of a patient to find a source of financial aid to meet medical expenses?

1- local bank

2- clinical nurse specialist

3- hospital administration

4- social services

When a patient demands to be discharged without a health care provider’s order and is leaving the unit with his belongings, what should the nurse ask the patient to sign?

1- form exercising the patient’s rights

2- discharge against medical advice (AMA)

3- informed consent

4- advanced directive

The nurse must be sensitive to an older patient experiencing separation anxiety, they will usually cry. What will an older adult often demonstrate when experiencing separation anxiety?

1- withdrawl

2- anger

3- depression

4- regression

Upon admission, the nurse notes that a patient without family members present has a billfold filled with cash. Where can the nurse suggest the money be placed?

1- in sealed envelope in bedside table.

2- in the care of hospital security.

3- locked in the narcotic cupboard.

4- in the hospital safe.

If a patient has an order for an interagency transfer, where does the nurse explain that the patient will be moved?

1- a double room to a private room

2- one unit of the hospital to another

3- one room of the unit to another

4- one facility to another

Before the actual discharge occurs, what must the nurse ensure?

1- the patient is well enough to go home.

2- the patient has not been overly medicated.

3- the patient understands the discharge instructions.

4- the patient has adequate transportation.

A patient who is alert and oriented is threatening to leave the hospital against medical advice. What action should the nurse take?

1- forcibly detain and restrain the patient.

2- administer a sedative hypnotic medication.

3- prevent patient from leaving until an AMA form is signed.

4- notify the healthcare provider that the patient is threatening to leave AMA.

How can the nurse demonstrate cultural sensitivity to a Haitian American patient?

1- by providing a well-lit room 24hrs a day

2- by writing out all instructions given to the patient

3- by allowing the patient to keep leaves in her room

4- by asking the healthcare provider to provide all directions to the patient

A nurse is caring for a Haitian American patient. How might the nurse demonstrate cultural sensitivity?

1- discarding any leaves the patient may have brought with them.

2- assigning the patient to a room with any Haitian American patient.

3- instructing the patient to ride in a wheelchair when discharged.

4- allowing the patient to walk out of the hospital when discharged.

The nurse is admitting a new patient to the diagnostic and surgical center. What would the nurse do first?

1- assess immediate needs

2- take vital signs

3- check identification band

4- orient patient to the facility routines

An experienced LVN is working on a med-surg unit. The LVN sees that a new RN has not completed the admission assessment on a patient who arrived 20 hours ago. What would the LVN do first?

1- wait to see if the new RN completes the admission assessment.

2- mention the incomplete admission assessment to the nurse manager.

3- remind the RN that the joint commission requires admission assessment within 24 hours.

4- offer to collect data so that the new RN can complete the admission assessment.

An older patient is postoperative for hip surgery. He is transferred by ambulance from the hospital to a rehab unit. One hour after he is assisted into bed at the rehab unit, he dies in his sleep. Which documentation provides the best legal protection for the transferring nursing staff?

1- the provider’s discharge summary and order to transfer the patient to the rehab unit.

2- the discharge assessment that was performed just before the patient left the hospital.

3- the assessment that was performed by the ambulance team in route to the rehab unit.

4- the partially completed admission assessment performed by the rehab unit nurse.

The patient is being transferred from the med-surg unit to a long-term care center. Which tasks can be delegated to the unlicensed assistive personnel (UAP)? select all that apply.

1- change soiled dressings.

2- bathe an incontinent patient.

3- assist to collect personal items.

4- take a final set of vital signs.

5- review transfer details with family.

A rational patient wishes to leave the hospital AMA, despite the nurse’s best attempt at therapeutic communication. What is the nurse’s first responsibility?

1- notify the health care provider (HCP)

2- document the incident

3- detain the patient

4- obtain an AMA form

The patient has an old head injury and demonstrates occasional intermittent episodes of belligerence and confusion interspersed with appropriate behavior. He is currently angry and wants to leave AMA. The nurse is unable to reach the HCP. What would the nurse do first?

1- explain the AMA form and consequences to the patient

2- call the supervising RN, because the patient now has acute needs

3- notify the family and ask them to take responsibility

4- contact the risk manager and ask for permission to detain

During the admission of a patient to a health care facility, what are the responsibilities of the admission department representative? Select all that apply.

1- obtaining identifying information

2- giving information on the HIPAA act

3- placing the correct ID band on patient’s wrist

4- obtaining a list of medications

5- obtaining emergency contact info

6- gathering insurance info

Which newly admitted patient is most likely to need and benefit from an individualized explanation of the bathroom facilities?

1- a 75 y.o. woman with advanced Alzheimer’s

2- a 20 mo. old child who has just started toilet training

3- a 65 y.o. man who recently emigrated

4- a 50 y.o woman who has stress incontinence

The nurse is placing an ID band on a patient who was admitted through the emergency department. What is best to say as the band is applied?

1- “this is your assigned hospital ID number. “

2- “the primary purpose of the band is to maintain safety.”

3- “all patients have to wear these; it’s standard procedure.”

4- “we don’t want to lose you while you are in the hospital.”

The patient is newly admitted and seems anxious, but also appears very hesitant to ask questions. Which statement by the nurse best demonstrates empathy?

1- “call me if you need anything; i’ll be happy to help you.”

2- “there’s nothing to worry about; we’ll take care of you.”

3- “I know you must have a lot of questions; I know I would.”

4- “you seem a little uncertain; do you have some questions?”

The nurse is trying to explain the bed controls and the call button and other items related to hospitalization, but the older adult patient keeps telling the nurse to “wait for my son to get here.” What would the nurse do first?

1- go find the son or other available family members.

2- leave written information at the bedside.

3- give brief language using very simple language.

4- offer comfort measures and ensure patient safety.

Which tasks related to admitting a new patient can be delegated to the UAP? Select all that apply.

1- obtain personal care items, such as water or packaged cleansing cloths.

2- position the bed for transfer from stretcher or wheelchair.

3- hang signs above the bed related to care, such as “nothing by mouth.”

4- ask the patient if they need special equipment, such as walker.

5- assist the patient to arrange desired items, such as eyeglasses, within reach.

The patient tells the nurse that he would like to be transferred to hospital X, because his cardiologist doesn’t come to hospital Y. What would the nurse do?

1- obtain an AMA form and have the patient sign it.

2- call hospital X and advise that the patient desires transfer.

3- advise the patient that the cardiologists in hospital Y are good.

4- advise the patient that a transfer requires an order from the HCP.

A patient with Alzheimer’s disease is being transferred from a long-term care facility to an acute care hospital for possible sepsis and change in mental status. Which question is the most important to ask the nurse who is giving the report?

1- “Has the family been advised about the reason for the transfer?”

2- “what is the patient’s baseline mental status and behavior?”

3- “when is the patient scheduled to be transferred?”

4- “will the patient be accompanied by a nurse or family member?”

Which patient is likely to have the most complex discharge plan?

1- a 73 y.o man with chronic disease who has no family in the area

2- a 23 y.o mother who just delivered her first baby

3- a 17 y.o adolescent who broke his leg during a ski trip

4- a 35 y.o woman who had an emergency appendectomy

The nurse is giving instructions to a family caregiver of an older patient who will need help after discharge from the hospital. The nurse senses tension, resentment, and unwillingness from the caregiver. What would the nurse do first?

1- continue to give the instructions and ask for feedback from the caregiver.

2- notify the HCP for an order from home health nursing.

3- get a social service consult to resolve family tensions and problems.

4- assess the caregiver’s attitude toward the patient and the circumstances.

The nurse is admitting a patient with limited English language ability who smiles and nods in response to the nurse’s questions. What would be the best action by the nurse?

1- ask the patient’s teen daughter who is present to translate.

2- call the patient’s english-speaking husband and ask him to check that his wife has understood everything.

3- ask the UAP on the floor who speaks the patient’s language to translate.

4- utilize the video translation service provided by the hospital.

A frail older woman has been admitted to the hospital during a time of pandemic with no visitor policy in place. The patient’s daughter asks to accompany her mother just to “help her get settled and decrease her fear.” How would the nurse respond to this request?

1- “you can come in just for a few moments, to help her; but then, I’m sorry, you must leave.”

2- “I’m sorry, but due to the pandemic, ,you cannot come in, but I will set up a video visit with your mother in just a few minutes so you can help her with the admission process.”

3- “there is a pandemic going on, and I am sorry, but you cannot enter the hospital. I will call you later with information about how your mother is doing.”

4- “I will ask your mother if she feels the need to have you during her admission. “