The nurse appropriately begins discharge planning when:
the patient feels ready to be discharged home.
the primary care provider writes orders to discharge the patient.
the patient is admitted to the health care facility.
it is anticipated the patient will be discharged in 8 hours.
The Correct Answer is C
A. Asking the patient, "Did you graduate from high school?" This question is not a direct way to assess reading or comprehension ability. A person’s educational level does not necessarily reflect literacy skills.
B. Giving the patient a printed instruction sheet and saying, "Some people have difficulty with written instructions. Others find them helpful. Would these be helpful to you?" This approach is indirect and does not confirm whether the patient can actually read or understand the instructions.
C. Giving the patient some printed materials and saying, "After you have read this, I'll ask you some questions about what's in them, to see if you've learned it." This option allows the nurse to assess both the patient's reading ability and understanding by following up with questions, ensuring comprehension.
D. Asking the patient, "Are you able to read?" While this question is direct, it may embarrass the patient, and it does not assess comprehension.
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Correct Answer is C
Explanation
A. Defensive response
A defensive response would involve protecting oneself or one's position rather than addressing the patient’s concerns. The nurse’s statement here is more dismissive than defensive.
B. Asking probing questions
Probing questions would involve persistent questioning, which does not apply here, as the nurse is not asking questions but making a dismissive comment.
C. Using clichés
"Every cloud has a silver lining" is a cliché, which may come across as dismissive and minimize the patient’s concerns. Using clichés can make the patient feel unheard and invalidated.
D. Changing the subject
Changing the subject would involve diverting attention to an unrelated topic. The nurse here is not introducing a new topic but is using a cliché instead.
Correct Answer is B
Explanation
A. is packing belongings in preparation for discharge. Although discharge is an appropriate time for patient education, it may be too late to introduce complex information that requires practice or understanding. Teaching moments often occur earlier in the care process.
B. says, "How will I remember all the things about my new diet?" This is an ideal teaching moment as the patient is expressing concern and showing readiness to learn about the diet. The nurse can use this moment to provide guidance on strategies to remember dietary instructions.
C. has just returned from surgery for a deviated septum. Immediately post-surgery, the patient may be under the influence of anesthesia or pain medication, limiting their ability to absorb information. Teaching at this time may not be effective.
D. has just been told of the malignancy of his tumor. Right after receiving bad news, patients may experience shock, grief, or distress, making it difficult for them to process additional information. This may not be the right time for education.