Chapter 20. Admission, Transfer, and Discharge
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____
1. A nurse appropriately recognizes that a patient will develop his or her initial impression of the nurse during
the
1. Teaching process.
2. Discharge process.
3. Admission process.
4. Implementation process.
____
2. When admitting a patient to a hospital unit, a nurse demonstrates a caring demeanor by
1. Smiling and speaking kindly.
2. Exhibiting tense body language and frowning.
3. Informing the patient he or she is shorthanded.
4. Avoiding eye contact and speaking in a clipped manner.
____
3. A nurse is admitting a patient to a hospital unit. When admitting the patient, the nurse should
1. Maintain prolonged eye contact.
2. Address the patient by his or her last name.
3. Speak rapidly when interacting with the patient.
4. Use terms of endearment when conversing with the patient.
____
4. A nurse is supervising a student nurse on a pediatric nursing unit. The nurse appropriately intervenes when the
student nurse tells a child:
1. “Do you want to hold my stethoscope?”
2. “This shot will not hurt.”
3. “Let’s pretend to give the teddy bear a shot.”
4. “Would you like to take the teddy bear’s temperature?”
____
5. A nurse correctly recognizes that most individuals prefer to recover from illness or injury
1. At home.
2. In the hospital.
3. At a care center.
4. In the emergency department.
____
6. The nurse correctly recognizes that separation anxiety is particularly common in children and
1. Adolescents.
2. Young adults.
3. Middle-aged individuals.
4. Older adults.
____
7. When caring for an elderly patient who is experiencing anxiety related to a new diagnosis of cancer, a nurse
appropriately seeks to alleviate the anxiety by
1. Telling the patient that her cancer is curable.
2. Discouraging the patient from asking questions.
3. Encouraging the patient’s spouse to stay with the patient.
4. Explaining cancer to the patient using medical terminology.
____
8. OA nurse is conducting an admission assessment on a patient with a new diagnosis of AIDS. The nurse
demonstrates a caring demeanor by
1.
2.
3.
4.
____
Closing the door to the patient’s room.
Asking the patient questions at the nurse’s station.
Delivering nursing care as rapidly as possible to allow the patient more time alone.
Refraining from telling the patient why he or she needs to ask personal questions.
9. A nurse is supervising an unlicensed assistive personnel (UAP). The nurse appropriately intervenes when
observing the UAP
1. Allowing a patient to wear underwear.
2. Assisting a patient in putting on pajamas.
3. Using a blanket to cover a patient during a bath.
4. Promoting dependence in activities of daily living.
____ 10. A nurse is supervising a certified nursing assistant (CNA) who is caring for a patient who is alert and oriented
and independent concerning activities of daily living. The nurse appropriately intervenes when hearing the
CNA say to the patient:
1. “You should drink ice water rather than room-temperature water.”
2. “Would you like to leave your socks on?”
3. “Do you prefer your drinks with or without a straw?”
4. “Would you prefer a cup of hot coffee, a glass of iced tea or fruit juice, or maybe a
carbonated drink?”
____ 11. When educating a student nurse about hospital identification bands, a nurse appropriately recognizes that
additional teaching is warranted when the student nurse states:
1. “The hospital identification band displays the patient’s name and birth date and the hospital
identification number.”
2. “I have taken care of this patient before, so I will not need to check the patient’s
identification band before administering medication.”
3. “I should instruct the patient to state his or her name and verify that it matches the name on
the hospital identification band.”
4. “I should ask the patient to state his or her date of birth and verify that it matches the date
of birth listed on the hospital identification band.”
____ 12. When conducting an admission assessment and taking an inventory of items that a patient has brought to the
hospital, a nurse appropriately instructs the patient to send home with a family member her
1. Dentures.
2. Eyeglasses.
3. Credit cards.
4. Hearing aids.
____ 13. When taking an inventory of items that a patient has brought to the hospital, a nurse should document the
patient’s diamond and ruby wedding ring as
1. A ring with rubies and diamonds.
2. A gold-colored ring with red stones and clear stones.
3. A 24-karat gold wedding ring.
4. A 1-karat diamond wedding ring.
____ 14. When conducting an admission assessment, the nurse correctly recognizes that objective data include
1. A patient’s family history.
2. A patient’s complaint of pain.
3. A patient’s description of anxiety.
4. A patient’s fruity-smelling breath.
____ 15. When performing a patient assessment, a nurse correctly recognizes that subjective data include
1.
2.
3.
4.
A patient’s vital signs.
A patient’s unsteady gait.
A patient’s foul-smelling wound.
A patient’s complaint of discomfort.
____ 16. A charge nurse is preparing for a patient’s admission to the hospital unit. When anticipating the patient’s
arrival, the charge nurse appropriately assigns the admission assessment to the
1. Registered nurse (RN).
2. Licensed practical nurse (LPN).
3. Certified nursing assistant (CNA).
4. Unlicensed assistive personnel (UAP).
____ 17. A nurse correctly recognizes that discharge planning should be initiated
1. During the admission process.
2. Before the patient is admitted to the hospital.
3. Immediately before discharging the patient.
4. The day after the patient’s hospital admission.
____ 18. During the admission procedure, a patient informs a nurse that he is a Sikh and must keep his head covered at
all times. He normally wears a turban. The other patient in the double room he has been assigned to is
recovering from detoxification and has had episodes where he’s used racial slurs. In processing the patient’s
admission, which of the following should the nurse do?
1. Make a note on the patient’s record that a curtain should be kept drawn between the two
patients at all times so the verbally abusive patient cannot see the new patient and make
offensive remarks based on his appearance.
2. Assume that the patient will be fine because Sikh men pride themselves on their strength.
3. Inform the patient of the situation and ask if he is comfortable being in the same room with
the abusive patient.
4. Ask to have the patient assigned to a different room, without an abusive roommate.
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____
1. During the admission process, a nurse should do which of the following? Select all that apply.
1. Speak in a hurried tone.
2. Shake the patient’s hand.
3. Speak to the patient in a kindly manner.
4. Tell the patient his or her credentials.
5. Inform the patient that he or she is shorthanded.
____
2. When working with a pediatric patient, a nurse should do which of the following? Select all that apply.
1. Tell the child that shots hurt a little bit.
2. Inform the child that a shot will not hurt.
3. Distract the child with a story when giving a shot.
4. Tell the child that the pain from a shot is temporary.
5. Encourage the child to take a teddy bear’s tympanic temperature.
____
3. A nurse is caring for a pediatric patient who appears anxious. To help decrease the patient’s anxiety, the nurse
should do which of the following? Select all that apply.
1. Encourage the child to ask questions.
2. Send home toys so they do not get lost.
3. Refrain from using medical terminology.
4. Encourage the parent to stay with the child.
5. Provide a long explanation of the child’s diagnosis.
____
4. When providing care to a hospitalized patient, a nurse appropriately demonstrates a caring demeanor by doing
which of the following? Select all that apply.
1. Pulling the privacy curtain during a bed bath
2. Using a sheet to cover a patient during a bath
3. Encouraging the patient to wear pajamas from home
4. Allowing the patient to wear his own underwear
5. Providing the patient with a second gown to wear backward
____
5. When providing care to a hospitalized patient, a nurse demonstrates a caring demeanor by doing which of the
following? Select all that apply.
1. Learning the patient’s name quickly
2. Calling the patient by her first name
3. Referring to the patient by room number
4. Referring to the patient by her disease process
5. Using a patient’s last name
____
6. A nurse educates a student nurse about hospital identification bands. The nurse correctly teaches that hospital
identification bands contain which of the following pieces of patient information? Select all that apply.
1. Age
2. Birth date
3. Room number
4. Physician’s name
5. Medical diagnosis
____
7. A nurse correctly recognizes that discharge planning can include which of the following? Select all that apply.
1. Arranging for home health care
2. Introducing the health-care team
3. Consulting a social worker
4. Discharge teaching
5. Reviewing all medications the patient is to take at home
____
8. A physician writes an order to teach a patient about nitroglycerin. A nurse correctly educates the patient that
nitroglycerin (Select all that apply.)
1. Should be swallowed.
2. Is administered sublingually.
3. Is used in the treatment of angina.
4. Should be protected from light and moisture.
5. Should be placed under the tongue prior to chest pain.
____
9. When overseeing discharge at the end of a patient’s stay, a nurse appropriately recognizes that the discharge
process includes which of the following? Select all that apply.
1. Obtaining a discharge order from the patient’s physician
2. Informing the patient’s family if the patient is leaving against medical advice (AMA)
3. Documenting the patient’s condition, including vital signs
4. Making sure that the patient has appropriate living conditions and will be properly cared
for after discharge
5. Assisting the patient to the car or other transportation, if needed
____ 10. When working with a certified nursing assistant (CNA), a nurse appropriately intervenes when the CNA says
to the patient or the patient’s family which of the following? Select all that apply.
1. “Could you ask your father to speak English with me? I heard him talk to you in English
when we admitted him, but he’ll only speak to me in Spanish, and I can’t take care of him
if I don’t understand him.”
2. “Yes, ma’am, if you’d like to get out of bed so you can kneel down to pray, I can help you
do that. Can you kneel without difficulty?”
3. “Good morning, Muhammad—I’m just checking up on you. You asked us not to serve
pork with your meals. Has the food service staff been complying with your wishes?”
4. “Yes, Mr. Assad. If you’d rather have a male nurse, I’ll have one assigned to you right
away.”
5. “Hello, Mrs. Chang. I understand that until your surgery, you’d rather take some Chinese
herbal medicine for your pain, instead of ibuprofen. We don’t have any herbal medicine in
stock here, so wouldn’t you rather take some ibuprofen now and then get some herbal
medicine later, after you’re out of the hospital?”
____ 11. A nurse arranging to transfer a patient to a different unit in the same facility would need to do which of the
following? Select all that apply.
1. Notify the business office of the transfer.
2. Obtain the physician’s order for transfer.
3. Explain the reasons for the transfer to the patient and his or her family.
4. Complete a transfer summary form.
5. Reconcile the patient’s list of medications with home medications and any new physician’s
orders.
____ 12. A nurse reconciling a patient’s medications during discharge must make sure of which of the following?
Select all that apply.
1. The dosages are correct.
2. The patient has been prescribed medications for all of his or her conditions.
3. The patient is not allergic to any of the medications prescribed.
4. The patient has not been prescribed brand-name drugs when less expensive generics will
be just as effective.
5. The patient is given a written list of all medications prescribed.
Chapter 20. Admission, Transfer, and Discharge
Answer Section
MULTIPLE CHOICE
1. ANS: 3
Objective: 4. Explain the importance of making the patient feel welcome during the admission process.
Page: 406-410
Heading: Admission > Reactions to Admission
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Communication: Nursing Roles
Difficulty: Easy
Feedback
1
The patient will already have developed an initial impression of the nurse by the time the
nurse starts any teaching.
2
The patient’s impression of the nurse will be fully determined by the time of discharge.
3
The nurse has the opportunity, ability, and responsibility to make admission less stressful
for patients. It is during the admission process that the nurse will make a first impression
on the patient, one that can either improve the patient’s stay or make it a negative
experience. This is the time to begin establishing rapport and a trusting relationship with
the patient.
4
During the implementation of interventions, the patient will continue to form an
impression of the nurse, but the patient’s impression begins to form as soon as he or she
is admitted and begins to interact with the nurse.
PTS: 1
CON: Communication| Nursing Roles
2. ANS: 1
Objective: 4. Explain the importance of making the patient feel welcome during the admission process.
Page: 406-410
Heading: Admission > Reactions to Admission
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication: Nursing Roles
Difficulty: Easy
Feedback
1
The nurse should smile and speak kindly and respectfully to make the patient feel
welcome.
2
The nurse should make a conscious effort to avoid letting negativity—such as being
behind schedule—show in speech, facial expression, or body language.
3
The nurse should make a conscious effort to avoid complaining about being shortstaffed.
4
If the nurse avoids eye contact with the patient, he or she may come off as impersonal
and uncaring. If the nurse uses clipped speech with the patient, he or she can appear to be
in a hurry.
PTS: 1
CON: Communication| Nursing Roles
3. ANS: 2
Objective: 3. Describe therapeutic nursing interventions that will demonstrate respect and compassion for
common reactions to admission.
4. Explain the importance of making the patient feel welcome during the admission process.
Page: 406-410
Heading: Admission > Reactions to Admission
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication: Nursing Roles
Difficulty: Moderate
Feedback
1
2
3
4
The nurse should make brief eye contact and speak at a rate that does not sound hurried.
The nurse should address the patient by his or her last name, such as Mr. or Mrs.
Stephens. The nurse should avoid using the patient’s first name unless specifically asked
to do so by the patient.
The nurse should speak at a rate that does not sound hurried.
The nurse should avoid using terms of endearment such as “honey” and “sweetie.” Use
of these terms may be considered condescending or patronizing.
PTS: 1
CON: Communication| Nursing Roles
4. ANS: 2
Objective: 3. Describe therapeutic nursing interventions that will demonstrate respect and compassion for
common reactions to admission.
8. Outline nursing responsibilities and appropriate interventions during the patient admission and discharge
processes.
Page: 406-410
Heading: Admission > Reactions to Admission
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Immunity: Communication: Nursing Roles
Difficulty: Moderate
1
2
3
4
Feedback
If the patient is a child, it is often helpful to allow the child to hold and become familiar
with supplies or equipment that will be used in his or her care. For example, the nurse
could allow the child to listen to his or her mother’s heart with the stethoscope.
The nurse should never tell the child that a procedure will not hurt unless it is the truth. It
is important to be honest and admit that it will hurt a little bit. The nurse can then follow
up with the child by describing what can be done to decrease the discomfort. If the nurse
tells the child that something will not hurt and it does, distrust rather than trust will
develop, and the nurse’s credibility with the child will be damaged.
It is often helpful to allow the child to hold and become familiar with supplies or
equipment that will be used in his or her care. For example, the nurse could allow the
child to pretend to give the teddy bear a shot using an empty, needleless syringe.
It is often helpful to allow the child to hold and become familiar with supplies or
equipment that will be used in his or her care. For example, the nurse could allow the
child to take a teddy bear’s tympanic temperature.
PTS: 1
CON: Immunity| Communication| Nursing Roles
5. ANS: 1
Objective: 2. Identify four common patient reactions to admission.
Page: 406-410
Heading: Admission > Reactions to Admission
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress: Nursing Roles
Difficulty: Easy
Feedback
1
Patients can develop separation anxiety due to being apart from familiar surroundings
and significant others. Therefore, most individuals prefer to recover from illness or
injury at home, where they are most comfortable and where they can receive care from
family or loved ones rather than from strangers.
2
Patients can develop separation anxiety due to being apart from familiar surroundings
and significant others. Therefore, most individuals prefer to recover from illness or
injury at home, where they are most comfortable and where they can receive care from
family or loved ones rather than from strangers.
3
Patients can develop separation anxiety due to being apart from familiar surroundings
and significant others. Therefore, most individuals prefer to recover from illness or
injury at home, where they are most comfortable and where they can receive care from
family or loved ones rather than from strangers.
4
Patients can develop separation anxiety due to being apart from familiar surroundings
and significant others. Therefore, most individuals prefer to recover from illness or
injury at home, where they are most comfortable and where they can receive care from
family or loved ones rather than from strangers.
PTS: 1
CON: Stress| Nursing Roles
6. ANS: 4
Objective: 2. Identify four common patient reactions to admission.
Page: 406-410
Heading: Admission > Reactions to Admission
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress: Nursing Roles
Difficulty: Easy
Feedback
1
Separation anxiety is less common among adolescents than among young children, who
usually trust and are dependent on and accustomed to having their needs met by their
parents or guardians. The younger the child, the more dependent on the parent or
guardian the child will be.
2
Most younger adults have matured to the point that separation anxiety is not generally an
issue.
3
Middle-aged adults usually do not suffer much from separation anxiety.
4
Separation anxiety is particularly common in older adults. The older adult may have been
married to his or her spouse for 40 or 50 years, sometimes rarely or never having been
separated from the spouse overnight. If the older adult is dependent on a spouse, child, or
other designated caregiver, separation from the caregiver can cause severe anxiety and
loneliness.
PTS: 1
CON: Stress| Nursing Roles
7. ANS: 3
Objective: 3. Describe therapeutic nursing interventions that will demonstrate respect and compassion for
common reactions to admission.
8. Outline nursing responsibilities and appropriate interventions during the patient admission and discharge
processes.
Page: 406-410
Heading: Admission > Reactions to Admission
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress: Communication: Nursing Roles
Difficulty: Moderate
Feedback
1
2
3
4
To decrease anxiety, the nurse should always be truthful and reassure the patient
whenever possible without giving false reassurance.
To decrease anxiety, the nurse should encourage the patient to ask questions and look for
signs of the patient understanding the answers.
To decrease anxiety, the nurse should recognize that allowing a family member to stay
might comfort a patient who is elderly.
To decrease anxiety, the nurse should avoid the use of medical terminology unless it is
clear the patient understands it; otherwise, the nurse should use layperson’s terms.
PTS: 1
CON: Stress| Communication| Nursing Roles
8. ANS: 1
Objective: 3. Describe therapeutic nursing interventions that will demonstrate respect and compassion for
common reactions to admission.
Page: 406-410
Heading: Admission > Reactions to Admission
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Immunity: Assessment: Nursing Roles
Difficulty: Moderate
1
2
3
4
Feedback
The nurse should make certain that the door to the patient’s room is closed when
interviewing the patient.
The nurse should avoid asking questions out in the hall, at the nurse’s station, or at any
other site where other individuals could overhear the conversation.
The nurse should avoid the appearance of hurrying and take the time to allow the patient
to verbalize fears and ask questions, answering such questions as truthfully and tactfully
as possible.
Many of the questions are of a private nature, some being very personal to the point of
discomfort for the patient, and the patient may feel that the answers to some of the
questions are not the business of health-care providers. If the patient feels this way, the
nurse should explain why he or she needs to ask some of the more personal questions
and how they may be applicable to the patient’s care.
PTS: 1
CON: Immunity| Assessment| Nursing Roles
9. ANS: 4
Objective: 3. Describe therapeutic nursing interventions that will demonstrate respect and compassion for
common reactions to admission.
8. Outline nursing responsibilities and appropriate interventions during the patient admission and discharge
processes.
Page: 406-410
Heading: Admission > Reactions to Admission
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Nursing Roles
Difficulty: Moderate
Feedback
1
The nurse should allow the patient to wear underwear unless contraindicated.
2
The nurse should let the patient wear his or her own pajamas if possible.
3
The nurse should avoid exposing more of the patient’s body than is necessary and should
use a sheet or bath blanket for coverage, if needed.
4
The nurse should encourage independence unless there are restrictions on activity.
PTS: 1
CON: Nursing Roles
10. ANS: 1
Objective: 3. Describe therapeutic nursing interventions that will demonstrate respect and compassion for
common reactions to admission.
8. Outline nursing responsibilities and appropriate interventions during the patient admission and discharge
processes.
Page: 406-410
Heading: Admission > Reactions to Admission
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication: Nursing Roles
Difficulty: Moderate
Feedback
1
The patient should be allowed to make decisions when possible—even small ones, such
as whether to have ice water or room-temperature water in his or her pitcher. The nurse
should provide choices and let the patient maintain as much control over the situation as
possible.
2
The patient should be allowed to make decisions when possible—even small ones, such
as whether to wear socks.
3
The nurse should provide choices and let the patient feel like he or she is maintaining as
much control over the situation as possible.
4
The nurse should provide dietary choices (taking into account any dietary restrictions)
and let the patient feel like he or she is maintaining as much control of the situation as
possible.
PTS: 1
CON: Communication| Nursing Roles
11. ANS: 2
Objective: 8. Outline nursing responsibilities and appropriate interventions during the patient admission and
discharge processes.
14. Identify specific safety features.
Page: 410-411
Heading: Admitting Procedure > Identification Bands
Integrated Processes: Teaching and Learning
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Nursing Roles: Safety
Difficulty: Easy
1
2
3
4
Feedback
Either the nurse or the admission office personnel apply an identification wristband
displaying the patient’s name, age, birth date, and room number; hospital identification
number; and physician’s name.
The nurse should check the identification band before administering medications, even if
the nurse has previously provided care for that patient. It is easy to become distracted, to
begin to think about another patient who may need something, or to engage in
conversation with staff or other patients in the hall. Checking the patient’s identification
band once at the bedside helps the nurse focus and verify the patient’s identity.
The nurse should check the identification band for the correct name.
The nurse should check a second form of identification, such as the patient’s birth date.
PTS: 1
CON: Nursing Roles| Safety
12. ANS: 3
Objective: 8. Outline nursing responsibilities and appropriate interventions during the patient admission and
discharge processes.
Page: 410-411
Heading: Admitting Procedure > Identification Bands
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive Level: Application [Applying]
Concept: Assessment: Communication
Difficulty: Easy
1
2
3
4
Feedback
The nurse should complete an inventory of clothing and personal items—such as
eyeglasses, dentures, and hearing aids—brought to the hospital. These items may be kept
at the bedside. The patient will need to have the dentures to eat properly.
The nurse should complete an inventory of clothing and personal items—such as
eyeglasses, dentures, and hearing aids—brought to the hospital. These items may be kept
at the bedside. The patient will need the glasses to be able to see and read.
The nurse should instruct the patient to send home with family members all valuables,
such as money, credit cards, or jewelry.
The nurse should complete an inventory of clothing and personal items—such as
eyeglasses, dentures, and hearing aids—brought to the hospital. These items may be kept
at the bedside. The patient will need the hearing aid to hear and communicate.
PTS: 1
CON: Assessment| Communication
13. ANS: 2
Objective: 7. Discuss the importance of completing an admission orientation checklist and personal
belongings inventory.
Page: 410-411
Heading: Admitting Procedure > Identification Bands
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive Level: Application [Applying]
Concept: Communication
Difficulty: Moderate
1
2
3
4
Feedback
The nurse cannot be 100% certain that the stones are rubies and diamonds.
A patient’s valuables should be inventoried and listed using only general descriptions.
The nurse should write “gold-colored ring with red stones and clear stones.”
The nurse cannot be certain the ring is 24-karat gold and should describe it as goldcolored only.
There is no way for the nurse to be certain that the stone is a 1-karat diamond.
PTS: 1
CON: Communication
14. ANS: 4
Objective: 1. Define various terms associated with admission, transfer, and discharge.
6. Discuss components of the admitting procedure.
Page: 410-411
Heading: Admitting Procedure > Identification Bands
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive Level: Application [Applying]
Concept: Assessment: Communication
Difficulty: Moderate
1
2
3
4
Feedback
Subjective data are those that only the patient can perceive and tell the nurse about, such
as pain, family history, or feelings.
The patient’s description of pain is subjective. Only observable behaviors that may
accompany the pain would be objective.
A patient’s description of his or her anxiety is subjective. Only observable behaviors that
may indicate anxiety are objective.
Objective data are limited to those the nurse can perceive or measure with one of his or
her senses: hear, see, touch, taste, or smell.
PTS: 1
CON: Assessment| Communication
15. ANS: 4
Objective: 1. Define various terms associated with admission, transfer, and discharge.
6. Discuss components of the admitting procedure.
Page: 410-411
Heading: Admitting Procedure > Identification Bands
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive Level: Application [Applying]
Concept: Assessment: Communication
Difficulty: Moderate
1
2
3
4
Feedback
Vital signs can be observed, felt, and heard, making them objective.
An unsteady gait can be observed, making it objective.
The foul-smelling wound can be detected with the nurse’s sense of olfaction, making it
objective.
Subjective data are those that only the patient can perceive and tell the nurse about, such
as pain, family history, or feelings.
PTS: 1
CON: Assessment| Communication
16. ANS: 1
Objective: 8. Outline nursing responsibilities and appropriate interventions during the patient admission and
discharge processes.
Page: 410-411
Heading: Admitting Procedure > Identification Bands
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive Level: Application [Applying]
Concept: Assessment: Regulations: Communication: Management
Difficulty: Moderate
1
2
3
4
Feedback
The Joint Commission, an accrediting agency for health-care facilities, requires each
patient to be assessed by an RN upon admission, although portions of the assessment
may be delegated to an LPN/LVN.
The Joint Commission, an accrediting agency for health-care facilities, requires each
patient to be assessed by an RN upon admission, although portions of the assessment
may be delegated to an LPN/LVN.
The Joint Commission, an accrediting agency for health-care facilities, requires each
patient to be assessed by an RN upon admission, although portions of the assessment
may be delegated to an LPN/LVN. A few assessments—such as assessment of vital
signs, weight, and height—may be delegated to a CNA.
The Joint Commission, an accrediting agency for health-care facilities, requires each
patient to be assessed by an RN upon admission, although portions of the assessment
may be delegated to an LPN/LVN. A few assessments—such as assessment of vital
signs, weight, and height—may be delegated to the CNA.
PTS: 1
CON: Assessment| Regulations| Communication| Management
17. ANS: 1
Objective: 8. Outline nursing responsibilities and appropriate interventions during the patient admission and
discharge processes.
Page: 413
Heading: Discharge > Discharge Planning
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive Level: Application [Applying]
Concept: Critical Thinking: Communication: Management
Difficulty: Difficult
Feedback
Discharge planning should be initiated during the admission process.
Discharge planning should be initiated during the admission process.
Discharge planning should be initiated well before this—during the admission process.
Discharge planning should be initiated before this—during the admission process.
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2
3
4
PTS: 1
CON: Critical Thinking| Communication| Management
18. ANS: 4
Objective: 4. Explain the importance of making the patient feel welcome during the admission process.
8. Outline nursing responsibilities and appropriate interventions during the patient admission and discharge
processes.
Page: 410
Heading: Admission > Cultural Considerations
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Diversity: Critical Thinking: Nursing Roles
Difficulty: Difficult
Feedback
The nurse must make the patient feel welcome and respected, so the patient should be
reassigned to another room where he is not likely to suffer verbal abuse.
The nurse should never assume anything about a patient based on his ethnic group,
religion, or culture.
The nurse must make the patient feel welcome and respected, so the patient should be
reassigned to another room where he is not likely to suffer verbal abuse.
The nurse must make the patient feel welcome and respected, so the patient should be
reassigned to another room where he is not likely to suffer verbal abuse.
1
2
3
4
PTS: 1
CON: Diversity| Critical Thinking| Nursing Roles
MULTIPLE RESPONSE
1. ANS: 2, 3, 4
Objective: 3. Describe therapeutic interventions that will demonstrate respect and compassion for common
reactions to admission.
4. Explain the importance of making the patient feel welcome during the admission process.
Page: 406-410
Heading: Admission > Reactions to Admission
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication: Nursing Roles
Difficulty: Easy
1.
Feedback
This is incorrect. The nurse should make a conscious effort to avoid letting negativity—
2.
3.
4.
5.
such as being shorthanded or behind schedule—show in his or her speech, facial
expression, or body language.
This is correct. The nurse should walk into the room with a smile, shake the patient’s
hand, introduce himself or herself and include his or her credentials, and speak in a kind
and respectful manner.
This is correct. The nurse should walk into the room with a smile, shake the patient’s
hand, introduce himself or herself and include his or her credentials, and speak in a kind
and respectful manner.
This is correct. The nurse should walk into the room with a smile, shake the patient’s
hand, introduce himself or herself and include his or her credentials, and speak in a kind
and respectful manner.
This is incorrect. The nurse should make a conscious effort to avoid letting negativity—
such as being shorthanded or behind schedule—show in his or her speech, facial
expression, or body language.
PTS: 1
CON: Communication| Nursing Roles
2. ANS: 1, 3, 4, 5
Objective: 3. Describe therapeutic nursing interventions that will demonstrate respect and compassion for
common reactions to admission.
8. Outline nursing responsibilities and appropriate interventions during the patient admission and discharge
processes.
Page: 406-410
Heading: Admission > Reactions to Admission
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Immunity: Communication: Nursing Roles
Difficulty: Moderate
1.
2.
3.
4.
5.
Feedback
This is correct. The nurse should be truthful and tell the child that the shot will hurt. The
nurse can then describe what he or she can do to decrease the child’s discomfort, such as
distract the child by telling a story. The nurse can also emphasize that it will only hurt
for the blink of an eye.
This is incorrect. The nurse should never tell the child that a procedure will not hurt,
unless it is the truth. It is important to be honest and admit that it will hurt a little bit. If
the nurse tells the child that something will not hurt and it does, distrust rather than trust
will develop, and the nurse’s credibility with the child will be damaged.
This is correct. The nurse should be truthful and tell the child that the shot will hurt. The
nurse can then describe what he or she can do to decrease the child’s discomfort, such as
distract the child by telling a story.
This is correct. The nurse should be truthful and tell the child that the shot will hurt.
However, the nurse can emphasize that it will only hurt for the blink of an eye.
This is correct. It is often helpful to allow the child to hold and become familiar with
supplies or equipment that will be used in his or her care. For example, the nurse can
allow the child to take a teddy bear’s tympanic temperature or listen to his or her
mother’s heart with the stethoscope.
PTS: 1
3. ANS: 1, 3, 4
CON: Immunity| Communication| Nursing Roles
Objective: 3. Describe therapeutic nursing interventions that will demonstrate respect and compassion for
common reactions to admission.
8. Outline nursing responsibilities and appropriate interventions during the patient admission and discharge
processes.
Page: 406-410
Heading: Admission > Reactions to Admission
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress: Communication: Nursing Roles
Difficulty: Moderate
1.
2.
3.
4.
5.
Feedback
This is correct. To decrease anxiety, the nurse should provide a brief but factual
explanation of the patient’s diagnosis and encourage the patient to ask questions,
looking for signs of understanding as the questions are answered.
This is incorrect. To decrease anxiety, the nurse should ask the parent to bring a couple
of toys or a favorite blanket from home to make the room seem more familiar to the
child
This is correct. The nurse should avoid the use of medical terminology unless it is clear
that the patient understands it; otherwise, the nurse should use layperson’s terms.
This is correct. The nurse should encourage the child’s parent or guardian to stay with
the child if at all possible to reduce separation anxiety.
This is incorrect. The nurse should avoid giving very lengthy explanations of the
diagnosis unless it is clear that the child or parent is very interested in those details.
PTS: 1
CON: Stress| Communication| Nursing Roles
4. ANS: 1, 2, 3, 4, 5
Objective: 3. Describe therapeutic nursing interventions that will demonstrate respect and compassion for
common reactions to admission.
8. Outline nursing responsibilities and appropriate interventions during the patient admission and discharge
processes.
Page: 406-410
Heading: Admission > Reactions to Admission
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Nursing Roles
Difficulty: Moderate
1.
2.
3.
4.
5.
Feedback
This is correct. The nurse should protect the patient’s modesty while providing personal
care by closing the door and pulling the privacy curtain around the bed.
This is correct. The nurse should avoid exposing more of the patient’s body than is
necessary and use a sheet or bath blanket for coverage, if needed.
This is correct. The nurse should let the patient wear his or her own underwear unless
contraindicated, as well as his or her own pajamas if possible.
This is correct. The nurse should let the patient wear his or her own underwear unless
contraindicated, as well as his or her own pajamas if possible.
This is correct. If the patient must wear a hospital gown, a second gown can be applied
backward to serve as a robe for added modesty.
PTS: 1
CON: Nursing Roles
5. ANS: 1, 5
Objective: 3. Describe therapeutic nursing interventions that will demonstrate respect and compassion for
common reactions to admission.
8. Outline nursing responsibilities and appropriate interventions during the patient admission and discharge
processes.
Page: 406-410
Heading: Admission > Reactions to Admission
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication: Nursing Roles
Difficulty: Difficult
1.
2.
3.
4.
5.
Feedback
This is correct. The nurse should make it a priority to learn the new patient’s name
quickly and use his or her last name.
This is incorrect. The nurse should make it a priority to learn the new patient’s name
quickly and use his or her last name.
This is incorrect. The nurse should never refer to a patient by a room number or a
disease or condition.
This is incorrect. The nurse should never refer to a patient by a room number or a
disease or condition.
This is correct. The nurse should avoid calling a patient by his or her first name unless
requested to do so.
PTS: 1
CON: Communication| Nursing Roles
6. ANS: 1, 2, 3, 4
Objective: 8. Outline nursing responsibilities and appropriate interventions during the patient admission and
discharge processes.
14. Identify specific safety features.
Page: 410-411
Heading: Admitting Procedure > Identification Bands
Integrated Processes: Teaching and Learning
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Nursing Roles: Safety
Difficulty: Moderate
1.
2.
3.
4.
Feedback
This is correct. Identification wristbands contain the patient’s name, room number,
hospital identification number, age, birth date, and physician’s name.
This is correct. Identification wristbands contain the patient’s name, room number,
hospital identification number, age, birth date, and physician’s name.
This is correct. Identification wristbands contain the patient’s name, room number,
hospital identification number, age, birth date, and physician’s name.
This is correct. Identification wristbands contain the patient’s name, room number,
5.
hospital identification number, age, birth date, and physician’s name.
This is incorrect. Identification wristbands contain the patient’s name, room number,
hospital identification number, age, birth date, and physician’s name.
PTS: 1
CON: Nursing Roles| Safety
7. ANS: 1, 3, 4, 5
Objective: 8. Outline nursing responsibilities and appropriate interventions during the patient admission and
discharge processes.
Page: 413
Heading: Discharge > Discharge Planning
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive Level: Application [Applying]
Concept: Critical Thinking: Communication
Difficulty: Moderate
1.
2.
3.
4.
5.
Feedback
This is correct. Arranging for home health care can be part of discharge planning, if the
patient needs it.
This is incorrect. The patient should be oriented to the health-care team on admission,
not discharge.
This is correct. It may be necessary to consult with a social worker to arrange some
aspects of care after discharge.
This is correct. Discharge planning (including discharge teaching) should begin during
the admission process and should continue until the patient is discharged from the
hospital.
This is correct. Discharge planning should always include verbal review and a written
list of all the medications the patient should take after discharge.
PTS: 1
CON: Critical Thinking| Communication
8. ANS: 2, 3, 4
Objective: 8. Outline nursing responsibilities and appropriate interventions during the patient admission and
discharge processes.
Page: 414
Heading: Discharge > Discharge Instructions
Integrated Processes: Teaching and Learning
Client Need: Physiological Integrity: Pharmacological Therapies
Cognitive Level: Application [Applying]
Concept: Medication: Nursing Roles
Difficulty: Difficult
1.
2.
3.
4.
Feedback
This is incorrect. Nitroglycerin is taken sublingually, meaning it is placed underneath the
tongue to dissolve and should never be swallowed.
This is correct. Nitroglycerin is taken sublingually, meaning it is placed underneath the
tongue to dissolve and should never be swallowed.
This is correct. Nitroglycerin is used for heart-related chest pain known as angina.
This is correct. Nitroglycerin should be protected from light and moisture to maintain its
efficacy, meaning its ability to achieve its desired effect.
5.
This is incorrect. Nitroglycerin should be placed under the tongue as soon as the patient
begins to have chest pain, not prior to chest pain.
PTS: 1
CON: Medication| Nursing Roles
9. ANS: 1, 3, 5
Objective: 8. Outline nursing responsibilities and appropriate interventions during the patient admission and
discharge processes.
12. Provide appropriate documentation for admission, transfer, and discharge scenarios.
Page: 413
Heading: Discharge
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive Level: Application [Applying]
Concept: Communication
Difficulty: Difficult
1.
2.
3.
4.
5.
Feedback
This is correct. The nurse is responsible for obtaining a discharge order from the
patient’s physician.
This is incorrect. If the patient decides to leave AMA, the nurse is responsible for trying
to talk the patient out of it, for getting the patient to sign a “leaving AMA” form if
persuasion fails, and for documenting the leaving AMA circumstances if the patient
refuses to sign the form. The nurse’s responsibilities end there, so the nurse is not
responsible for notifying the patient’s family that the patient has left AMA.
This is correct. The nurse is responsible for documenting the patient’s condition,
including vital signs, before discharge.
This is incorrect. It is the social worker, not the nurse, who is responsible for making
sure that the patient has appropriate living conditions and will be properly cared for after
discharge.
This is correct. The nurse is responsible for assisting the patient to the car or other
transportation, if needed.
PTS: 1
CON: Communication
10. ANS: 1, 3, 5
Objective: 5. Relate specific ways you can enhance communication in a culturally diverse patient population.
8. Outline nursing responsibilities and appropriate interventions during the patient admission and discharge
processes.
Page: 410
Heading: Admission > Cultural Considerations
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Diversity: Spirituality: Communication: Nursing Roles
Difficulty: Difficult
1.
2.
Feedback
It is important to respect the patient’s language and culture, so if the patient would rather
speak in his or her native language (for whatever reason), the CNA should get an
interpreter.
It is important to respect the patient’s religion, so if the patient wishes to kneel down to
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4.
5.
pray and is physically able to do so, the CNA should allow it and assist if necessary.
It is important to always address the patient by his or her last name unless he or she says
otherwise, so the CNA should not use the patient’s first name.
Although it may seem sexist to many Westerners, if the patient comes from a culture
where it is deemed inappropriate for a nurse to take care of patients of another sex,
another nurse should assigned to the patient if feasible.
If patients would rather take traditional medicine from their own culture, the patient’s
wishes should be respected, although the nurse should inform the patient’s physician of
the patient’s choice.
PTS: 1
CON: Diversity| Spirituality| Communication| Nursing Roles
11. ANS: 2, 3, 4, 5
Objective: 11. Compare the transfer of a patient to another facility to a transfer within the same facility.
12. Provide appropriate documentation for admission, transfer, and discharge scenarios.
Page: 416
Heading: Patient Transfer > Transfer Within the Facility
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive Level: Application [Applying]
Concept: Medication: Communication: Nursing Roles: Management
Difficulty: Difficult
1.
2.
3.
4.
5.
Feedback
This is incorrect. If the patient is being transferred to a new unit in the same facility, it is
not necessary for the nurse to inform the business office—that occurs when the patient is
discharged or transferred to another facility.
This is correct. It is necessary to obtain a physician’s order for the transfer.
This is correct. The nurse should educate the patient and/or his or her family about the
reasons for the transfer
This is correct. It is necessary to document the transfer and the reasons for the transfer
and to inform the receiving unit of the patient’s condition.
This is correct. The nurse must make sure the patient’s medications are up to date and
reconciled.
PTS: 1
CON: Medication| Communication| Nursing Roles| Management
12. ANS: 1, 5
Objective: 12. Provide appropriate documentation for admission, transfer, and discharge scenarios.
Page: 416
Heading: Patient Transfer > Transfer Within the Facility
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive Level: Application [Applying]
Concept: Medication: Communication
Difficulty: Difficult
1.
2.
Feedback
This is correct. It is the nurse’s responsibility to make sure that dosages are correct and
that the patient leaves with a list of all medications prescribed.
This is incorrect. It is the physician’s responsibility to make sure the patient is properly
3.
4.
5.
prescribed medications for all conditions that require medication.
This is incorrect. The physician is responsible for making sure that the patient is not
allergic to prescribed medications and deciding whether a generic drug will do in place of
a brand-name drug.
This is incorrect. The physician is responsible for making sure that the patient is not
allergic to prescribed medications and deciding whether a generic drug will do in place of
a brand-name drug.
This is correct. It is the nurse’s responsibility to make sure that dosages are correct and
that the patient leaves with a list of all medications prescribed.
PTS: 1
CON: Medication| Communication