Chapter 02: Transitions in Care Perry et al.: Canadian Clinical Nursing Skills & Techniques, 1st Edition MULTIPLE CHOICE 1. The patient is scheduled to go home after having coronary angioplasty. What would be the most effective way to provide discharge teaching to this patient? a. Provide him with information on health care websites. b. Provide him with written information on what he has to do. c. Sit and carefully explain what is required before his follow-up. d. Use a combination of verbal and written information. ANS: D For discharge teaching, use a combination of verbal and written information. This most effectively provides patients with standardized care information, which has been shown to improve patient knowledge and satisfaction. DIF: Cognitive Level: Application REF: Skill 2.3 (Teaching) OBJ: Identify the ongoing needs of patients in the discharge planning process. TOP: Admission to Discharge Process KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment 2. While preparing for the patient’s discharge, the nurse uses a discharge planning checklist and notes that the patient is concerned about going home because she has to depend on her family for care. The nurse realizes that successful recovery at home is often based on a. the patient’s willingness to go home. b. the family’s perceived abiliNtyUtRoScaIreNfGoTr tBh.e CpaOtiMent. c. the patient’s ability to live alone. d. allowing the patient to make her own arrangements. ANS: B Discharge from a facility is stressful for a patient and family. Before a patient is discharged, the patient and family need to know how to manage care in the home and what to expect with regard to any continuing physical problems. Family caregiving is a highly stressful experience. Family members who are not properly prepared for caregiving are often overwhelmed by patient needs, which can lead to unnecessary hospital readmissions. DIF: Cognitive Level: Analysis REF: Skill 2.3: Discharging Patients OBJ: Identify the ongoing needs of patients in the discharge planning process. TOP: Medication Reconciliation KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity 3. The patient arrives in the emergency department and is complaining of severe abdominal pain and vomiting, and is severely dehydrated. The physician prescribes intravenous (IV) fluids for the dehydration and an IV antiemetic for the patient. However, the patient states that she is fearful of needles and adamantly refuses to have an IV started. The nurse explains the importance of and rationale for the prescribed treatment, but the patient continues to refuse. What should the nurse do? a. Summon the nurse technician to hold the arm down while the IV is inserted. b. Use a numbing medication before inserting the IV.
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