A patient who is very angry and is leaving the hospital against medical advice (AMA) demands to have the medical record to take, because it is her personal property. An appropriate response would be:
“The information in your medical record is confidential, and you cannot leave this facility with it."
"Because you are leaving against the medical advice of your primary care provider, you may not have the medical record."
"You are entitled to the information in your medical record, but the medical record is the property of the hospital. I will see about having a copy made for you."
"Certainly. This hospital doesn't need to keep it if you are leaving and will not be returning here."
The Correct Answer is C
A. “The information in your medical record is confidential, and you cannot leave this facility with it." While confidentiality is true, this response may seem dismissive and doesn’t address the patient’s right to access their health information.
B. "Because you are leaving against the medical advice of your primary care provider, you may not have the medical record." Leaving AMA does not negate the patient’s rights to access their medical information.
C. "You are entitled to the information in your medical record, but the medical record is the property of the hospital. I will see about having a copy made for you." This response respects the patient’s rights and explains that while the original record is hospital property, a copy can be made.
D. "Certainly. This hospital doesn't need to keep it if you are leaving and will not be returning here." This response is inaccurate as the original medical record must remain with the hospital per legal guidelines.
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Correct Answer is C
Explanation
A. Have the patient explain the procedure to the nurse to assess understanding.
This could be a helpful way to assess knowledge, but it doesn’t provide practical, hands-on experience immediately after the demonstration.
B. Give the patient a day to allow him to process and absorb the information.
Delaying practice may reduce the effectiveness of learning by increasing the chance of forgetting details.
C. Have the patient practice the procedure with the nurse helping.
Practicing the skill right away reinforces learning and allows the nurse to provide guidance and feedback.
D. Give the patient written materials to study and learn the procedure.
Written materials can be helpful but should complement, not replace, hands-on practice.
Correct Answer is B
Explanation
A. Speaking in simple sentences, as if to a child. This is inappropriate and could be perceived as patronizing, which may hinder communication. Older adults should be treated with respect, not as children.
B. Speaking slowly in order to allow the patient to process the message. Older adults may need more time to process information, so speaking slowly can aid understanding without appearing patronizing.
C. Addressing him by his first name to encourage a therapeutic relationship. Addressing older adults by their first names may be seen as disrespectful or overly familiar, unless the patient specifically requests it.
D. Standing in the doorway rather than entering the room to give the older adult patient more privacy. Standing in the doorway may create a physical barrier and distance, which can hinder effective communication and rapport.