A nurse is caring for a client who is requesting to leave the facility against medical advice (AMA). The client states, "I am ready to go immediately." Which of the following actions should the nurse take first?

Teach the client about the potential health risks of leaving early.

Ask the client to sign a document stating they are leaving AMA.

Document the client's statement in direct quotes in the medical record.

Complete an incident report detailing the client scenario.

Answer and Explanation

The Correct Answer is A

A. Teach the client about the potential health risks of leaving early: The first action the nurse should take is to inform the client about the potential health risks associated with leaving the facility against medical advice. Providing this information ensures that the client is fully informed about the consequences of their decision, which is essential for promoting their safety and well-being.

B. Ask the client to sign a document stating they are leaving AMA: While obtaining a signed document is necessary, it should occur after the client has been informed about the risks involved in leaving. The nurse should first ensure the client understands the implications of their decision.

C. Document the client's statement in direct quotes in the medical record: Documentation is important but should not be the first action taken. The nurse must first address the client’s immediate request and provide information regarding potential health risks before focusing on documentation.

D. Complete an incident report detailing the client scenario: Completing an incident report may be necessary later, but the priority should be to address the client’s safety and ensure they are making an informed decision about leaving the facility. The nurse should first engage with the client regarding their choice and the associated risks.

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Correct Answer is D

Explanation

A. The advice of an expert nephrology nurse. While experienced nurses provide valuable clinical insights, their knowledge may be based on personal experience rather than the latest evidence-based research. Best practices should be supported by scientific studies rather than anecdotal expertise.

B. Retrospective chart reviews. Chart reviews can offer useful data on past interventions and outcomes, but they do not always reflect the most current evidence-based practices. Additionally, they may contain inconsistencies or lack standardized guidelines necessary for broad application.

C. Facility critical pathway. Critical pathways are developed based on evidence-based guidelines, but they may not always reflect the most up-to-date research. These protocols are useful for standardizing care within a specific institution but should be supplemented with current peer-reviewed research to ensure best practices.

D. A recent peer-reviewed nursing research article. Peer-reviewed nursing research articles provide the most current and scientifically validated evidence. These sources undergo rigorous evaluation before publication, ensuring that recommendations are based on high-quality research rather than opinion or outdated protocols.

A. Perform a testicular self-examination weekly. B. Do not palpate the epididymis when performing a testicular self-examination. C. Expect testicles to be uniform in consistency when performing a testicular self-examination. D. Perform a testicular self-examination after a cool shower.

Correct Answer is A

Explanation

A. Perform a testicular self-examination weekly: While the recommendation is typically to perform testicular self-examinations monthly, including a focus on the importance of regular examinations reinforces the practice of self-monitoring. Educating clients on self-examinations encourages them to be proactive in detecting any changes in their testicles.

B. Do not palpate the epididymis when performing a testicular self-examination: It is important to palpate the entire testicle, including the epididymis, during a self-examination. Understanding how to properly examine all parts of the testicles helps individuals recognize what is normal and identify any abnormalities.

C. Expect testicles to be uniform in consistency when performing a testicular self-examination: While testicles should feel firm and smooth, variations in texture can be normal. Educating clients about the normal variations in consistency will help them better identify any concerning changes.

D. Perform a testicular self-examination after a cool shower: It is generally recommended to perform a testicular self-examination after a warm shower. The warmth helps relax the scrotum, making it easier to examine the testicles thoroughly and detect any abnormalities.

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A nurse is caring for a client who is requesting to leave the facility against medical advice (AMA). The client states, "I am ready to go immediately." Which of the following actions should the nurse take first?

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