a 65 year old man has been admitted to the hospital for spinal stenosis surgery when should the discharge training and planning begin for this patient
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Nursing Elites

NCLEX-RN

NCLEX RN Practice Questions Quizlet

1. When should discharge training and planning begin for a 65-year-old man admitted to the hospital for spinal stenosis surgery?

Correct answer: B

Rationale: Discharge training and planning should begin upon admission for a patient undergoing spinal stenosis surgery. It is crucial to initiate this process early to ensure a smooth transition from hospital care to home or a rehabilitation facility. Starting discharge planning upon admission allows for comprehensive involvement of the patient, family, and healthcare team, which can reduce the risk of readmission, optimize recovery, ensure proper medication management, and adequately prepare caregivers. Therefore, option B, 'Upon admission,' is the correct answer. Options A, C, and D are incorrect because waiting until after surgery, within 48 hours of discharge, or during preoperative discussion would not provide sufficient time for effective discharge planning and education.

2. A client is refusing to undergo any more treatments in the hospital and wants to leave against medical advice. When the nurse requests the client to sign an AMA order, the client refuses and leaves. What is the next action of the nurse?

Correct answer: D

Rationale: The nurse cannot force the client to stay in the hospital to receive treatment or to sign an AMA order. It is essential to respect the client's autonomy and decision-making capacity. While involving security or pressuring the client through the physician or spouse may seem like options, they are not appropriate in this situation. The nurse should allow the client to leave if they are competent to make that decision, document the refusal in the client's chart to ensure all actions are appropriately documented, and follow institutional policies for patients leaving against medical advice.

3. A woman presents with bruises on her face and back in various stages of healing. She states, 'sometimes he just gets so angry.' Which of the following statements is most appropriate as a response from the nurse?

Correct answer: D

Rationale: The most appropriate response from the nurse is to gather more information by asking the client to elaborate on what occurs when the individual in question gets angry. It is essential for the nurse to understand the situation better before taking any action or making assumptions. Option A and B are repetitive and do not encourage further exploration of the situation. Option C offers a false promise and reassurance that the nurse cannot guarantee, which may not be helpful in addressing the client's needs.

4. When a blood pressure cuff is too wide for a client's arm, what type of reading might this blood pressure cuff produce?

Correct answer: B

Rationale: When a blood pressure cuff is too wide for a client's arm, it may produce an abnormally low blood pressure reading. This occurs because the oversized cuff can lead to an underestimation of blood pressure. It is essential to ensure that the cuff fits appropriately to obtain an accurate reading. An abnormally high reading (Choice C) is less likely with an oversized cuff, as it generally leads to lower readings. A normal reading (Choice A) is unlikely due to the inaccuracies caused by the oversized cuff. A fluctuating reading (Choice D) is not a typical result of using a cuff that is too wide; instead, it usually leads to consistently low readings.

5. Which of the following is a true statement about assessing blood pressure by palpation?

Correct answer: D

Rationale: When assessing blood pressure by palpation, it is important to note that only the systolic blood pressure can be determined accurately using this method. Diastolic blood pressure cannot be reliably assessed through palpation. The palpation technique is particularly useful in situations where traditional blood pressure measurement methods are challenging, such as in infants, small children, or individuals with low blood pressure that is difficult to hear. Hypertension, a common condition characterized by elevated blood pressure, is typically assessed using auscultation rather than palpation. Therefore, the correct statement is that only the systolic blood pressure can be assessed through palpation.

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