A hospitalized patient tells the nurse that he intends to leave the acute care facility, against medical advice. The nurse's initial action(s) should be to:

Listen to the patient, answer questions, and offer to have the supervisor or physician speak with the patient.

Call both the supervisor and a family member to try to get the patient to reconsider.

Obtain a written explanation of the reasons from the patient and have the patient sign at the bottom of the sheet.

Advise the patient that this may mean that insurance would not pay for this hospitalization.

Answer and Explanation

The Correct Answer is A

A. Listen to the patient, answer questions, and offer to have the supervisor or physician speak with the patient. Understanding the patient’s concerns and providing information may help address their reasons for leaving and promote informed decision-making. Involving the supervisor or physician allows for further discussion.

B. Call both the supervisor and a family member to try to get the patient to reconsider: Family involvement should only occur with the patient’s consent.

C. Obtain a written explanation of the reasons from the patient: This can be done after addressing the patient’s concerns.

D. Advise the patient that insurance may not pay for this hospitalization: This may seem coercive and is not an immediate priority.

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Correct Answer is B

Explanation

A. Arrive 2 hours before the scheduled procedure: Usually unnecessary for outpatient procedures unless sedation is planned.

B. Wear comfortable clothing. Comfortable, non-restrictive clothing allows the patient to be more at ease during the procedure and may reduce the need to change into a gown.

C. Read printed materials about the procedure: This is important but not specific advice for the day of the procedure.

D. Be prepared to pay at least 10% of the predicted cost: Billing specifics are handled separately and vary by facility.

A. "This small amount of bleeding is expected after the removal of polyps." B. "I will watch your husband very carefully to assess any further haemorrhage." C. "I will notify the primary care provider about this haemorrhage.” D. "Don't worry. This small amount of blood happens with these procedures."

Correct Answer is A

Explanation

A. "This small amount of bleeding is expected after the removal of polyps." Minor rectal bleeding is a common occurrence after polyp removal during a colonoscopy and generally does not indicate a complication. This reassurance helps alleviate the family’s concern.

B. "I will watch your husband very carefully to assess any further haemorrhage.": This could unnecessarily alarm the family.

C. "I will notify the primary care provider about this haemorrhage.": This overstates the concern, as slight bleeding is expected.

D. "Don't worry. This small amount of blood happens with these procedures.": This is dismissive and does not provide a professional explanation.

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A hospitalized patient tells the nurse that he intends to leave the acute care facility, against medical advice. The nurse's initial action(s) should be to:

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Naxlex Comprehensive Predictor Exams

A patient is scheduled to have a diagnostic procedure performed on an outpatient basis at 9:00 AM. The nurse will advise the patient to:

Correct Answer is B

Explanation

Following a colonoscopy with polyp removal, the wife of the patient is distressed that there is slight bleeding from her husband's rectum. The nurse's most helpful response would be:

Correct Answer is A

Explanation

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