A case manager is preparing a discharge plan for a client following coronary artery bypass grafting surgery. Which of the following client issues should the nurse address first?

Inadequate food supply

Limited social support

Low pain tolerance

Decreased self-esteem

Answer and Explanation

The Correct Answer is A

A. Inadequate food supply is a basic physiological need that directly affects recovery, wound healing, and overall postoperative outcomes after coronary artery bypass grafting. Ensuring access to adequate nutrition is essential for physical recovery and takes priority in discharge planning.

B. Limited social support is important for long-term recovery and adherence to care but does not address an immediate physiological need. It is typically addressed after basic needs are secured.

C. Low pain tolerance affects comfort and recovery experience but is managed through pain control strategies and does not take priority over essential survival needs like nutrition.

D. Decreased self-esteem is a psychosocial concern that, while important for holistic recovery, is addressed after physiological and safety needs have been met.

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Correct Answer is C,B,A,D

Explanation

1. C. Identify what skills to teach the staff members
2. B. Develop learning objectives for the program
3. A. Schedule several sessions of the program
4. D. Conduct program evaluation with staff members

A. Whether the client's refusal is based on religious belief B. Whether the partner is the client's durable power of attorney for health care C. Whether the client understands the risk of refusing the procedure D. Whether the facility ethics committee reaches a consensus on the case

Correct Answer is C

Explanation

A. While religious beliefs may influence a client's decision, they are not the deciding factor. Clients have the right to refuse treatment regardless of the reason, as long as they are competent and informed.

B. The partner’s role as the durable power of attorney for health care is only relevant if the client is unable to make decisions due to incompetence or incapacitation. If the client is competent, their decision takes precedence over the wishes of their partner or any legal proxy.

C. Ensuring the client understands the risks of refusing the procedure is the deciding factor. A competent client has the right to refuse any medical treatment, including surgery, after being informed of the potential consequences. The nurse and provider must ensure the client’s decision is informed and voluntary.

D. The facility ethics committee may provide guidance in complex cases, but they do not override a competent client’s autonomy. The client’s informed decision is the ultimate determinant in whether the surgery is performed.

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A case manager is preparing a discharge plan for a client following coronary artery bypass grafting surgery. Which of the following client issues should the nurse address first?

Nursing Test Bank

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