A nurse is caring for a client who was admitted for an exacerbation of their COPD. The client will be discharged with a new prescription for oxygen therapy and will need assistance with activities of daily living. Which of the following referrals should the nurse obtain for the client?
Case manager
Hospice care facility
Long term care facility
Pharmacist
The Correct Answer is A
A. Case manager A case manager helps coordinate home oxygen therapy, arranges for home health services, and ensures the client has access to needed resources, such as durable medical equipment and personal assistance for ADLs.
B. Hospice care facility Hospice is appropriate for clients with a terminal illness and a life expectancy of 6 months or less. COPD is chronic but not necessarily end-stage.
C. Long-term care facility This client is not indicated for long-term institutional care but rather for home-based support.
D. Pharmacist While a pharmacist is important for medication education, they do not coordinate oxygen therapy or ADL assistance.
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Related Questions
Correct Answer is B
Explanation
A. "Although this is your first incident, we will have to terminate your employment." This response is punitive and does not align with a just culture, which seeks to identify the cause of errors rather than immediately disciplining staff.
B. "We will review the incident report to determine the cause of the missed medication." This aligns with just culture principles by focusing on finding the root cause (e.g., workload issues, system inefficiencies) rather than blaming the nurse.
C. "I will need to report this incident to the state board of nursing." A missed medication dose that caused no harm typically does not require reporting to the state board. Just culture focuses on improving processes rather than unnecessary punishment.
D. "The facility's legal team will be contacting you to discuss the incident." Involving legal action for a minor, non-harmful event is excessive and contradicts just culture, which emphasizes education, accountability, and system improvements over legal consequences.
Correct Answer is B
Explanation
A. "I can discuss client information in the hallway outside a client's room." Discussing client information in a public or semi-public area is a violation of HIPAA (Health Insurance Portability and Accountability Act).
B. "I will need permission from a client to share health information with a relative." Under HIPAA, health information cannot be shared with family members unless the client gives explicit permission.
C. "I can share a client's diagnosis with any member of the health care team." Information should only be shared with team members directly involved in the client's care. Not all healthcare workers need access to all client information.
D. "I will need written permission from the provider to allow a client to access their electronic medical record." Clients have the right to access their medical records without needing provider permission. The facility may have specific procedures, but a provider cannot block access unless there is a legal or safety concern.
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