A nurse is caring for a client who states, "I am leaving this hospital because I'm frustrated with my therapy." Which of the following actions should the nurse take?
Arrange for the client to speak with other clients who are undergoing the same therapy.
Ask the provider to speak with the client in person regarding their plan of care.
Explain to the client that no additional treatment will be provided if they choose to come back.
Tell the client that they cannot leave without a discharge prescription from their provider.
The Correct Answer is B
A. While connecting the client with others may provide support, it does not directly address the client’s frustrations or concerns about their therapy.
B. Asking the provider to speak with the client directly can facilitate communication about their concerns and may help address their frustrations regarding the plan of care.
C. Threatening the client with consequences for leaving is not appropriate and may increase their frustration and disengagement from care.
D. It is important to respect the client’s autonomy and right to leave, so informing them they cannot leave is not appropriate or legal without proper discharge procedures being followed.
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Correct Answer is D
Explanation
A. Establishing the priorities of client care is part of the planning phase, not the implementation phase.
B. Comparing laboratory values is an assessment activity that occurs before planning and implementing care.
C. Asking the client about pain is an assessment activity used to gather information rather than an implementation task.
D. Reinforcing teaching about the client's diagnosis is an action that occurs during the implementation phase, as it involves executing the care plan and providing direct client education.
Correct Answer is A
Explanation
A. Ecchymoses (bruising) over the buttocks and lower back in an older adult could be a sign of physical abuse or an underlying bleeding disorder, and it should be reported immediately.
B. Hirsutism, or increased facial and chest hair, is a common age-related change and does not usually require reporting unless it indicates an endocrine disorder.
C. Reduced skin elasticity is a normal age-related finding due to decreased collagen and elastin in aging skin.
D. Increased macules, or age spots, are benign and typical with aging, especially with prolonged sun exposure, and do not require reporting.