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 A
Explanation
A. The nurse-patient relationship ends when the patient is discharged.
The nurse-patient relationship is time-limited and often ends when the patient is discharged, which aligns with its structured, goal-oriented nature.
B. A social relationship does not have goals or needs to be met. While social relationships may not have structured goals, they can still have mutual needs or goals. In contrast, the nurse-patient relationship has specific health-related goals and objectives focused on patient care.
C. The focus is mainly on the nurse in the nurse-patient relationship. This is incorrect, as the primary focus of the therapeutic relationship is on the patient's needs and well-being, not the nurse’s.
D. A social relationship does not require trust or sharing of life experiences. Social relationships do require trust and sharing of experiences; however, they are typically not bound by the professional boundaries, goals, and time limitations that define the nurse-patient relationship.
Correct Answer is D
Explanation
A. Actions of the nurse are appropriate since his neighbor is his confidante, and the neighbor has assured him the information provided will not be shared. Confidentiality must be maintained regardless of assurances from others; sharing patient information outside a professional context is a violation of privacy.
B. Nurse has not violated the confidentiality of the patient because the patient is terminal; sharing this information will not harm the patient. Confidentiality must be maintained regardless of the patient's condition. Privacy and confidentiality are ethical requirements for all patients, terminal or otherwise.
C. Nurse is actively promoting nursing as a profession, and it is important to share information that might encourage others to pursue a nursing career. While promoting the profession is valuable, using a patient’s personal information is inappropriate and unprofessional. There are ethical ways to promote nursing without breaching confidentiality.
D. Nurse has violated the confidentiality of the patient by discussing personal information about the patient with his neighbor. Sharing patient information with someone who is not involved in the patient’s care violates HIPAA and confidentiality standards. This action is unprofessional and unethical.