A nurse needs to begin discharge planning for a patient admitted with pneumonia and a congested cough. When is the best time the nurse should start discharge planning for this patient?

Upon admission

Right before discharge

After the congestion is treated

When the primary care provider writes the order

Answer and Explanation

The Correct Answer is A

Choice A reason: Discharge planning upon admission ensures a comprehensive care plan, addressing pneumonia’s impact on oxygenation and energy levels. Early planning identifies home care needs, like oxygen therapy or follow-up, reducing readmission risk. Pneumonia, caused by bacterial or viral infection, impairs gas exchange, and early coordination ensures continuity of care for optimal recovery post-discharge.

Choice B reason: Starting discharge planning right before discharge is too late, as it limits time to arrange resources like home care or education. Pneumonia recovery requires managing infection and oxygenation, which benefits from early planning. Delayed planning risks gaps in care, increasing complications like relapse or inadequate support for respiratory function post-hospitalization.

Choice C reason: Waiting until congestion is treated delays discharge planning, missing opportunities to prepare for post-hospital needs. Pneumonia’s inflammatory response impairs alveolar gas exchange, requiring ongoing management. Early planning ensures patients receive education and resources, like inhalers, to maintain respiratory function, reducing readmission risk compared to waiting for symptom resolution.

Choice D reason: Waiting for the provider’s order delays discharge planning, reducing time for patient education or resource coordination. Pneumonia recovery involves managing infection and supporting oxygenation, which benefits from early planning. Provider orders may guide specifics, but initiating planning upon admission ensures proactive care, addressing respiratory and functional needs for a smooth transition.

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Correct Answer is D

Explanation

Choice A reason: This response dismisses the patient’s anxiety by offering superficial reassurance without addressing their emotional state. Preoperative anxiety activates the sympathetic nervous system, increasing cortisol and adrenaline, which disrupt sleep by elevating heart rate and alertness. This approach fails to validate emotions, potentially worsening stress responses and hindering psychological coping, making it non-therapeutic for addressing the patient’s distress.

Choice B reason: Questioning the patient’s insomnia and implying they should feel reassured invalidates their feelings. Anxiety triggers the hypothalamic-pituitary-adrenal axis, releasing stress hormones that disrupt REM sleep cycles. This response lacks empathy, failing to address the limbic system’s role in emotional distress, which is critical for therapeutic communication to reduce preoperative anxiety and promote emotional stability.

Choice C reason: Minimizing the patient’s concerns and focusing on pharmacological intervention ignores emotional needs. Sedatives may depress the central nervous system to induce sleep, but they don’t address anxiety-driven amygdala activation, which elevates cortisol. A therapeutic response should validate feelings and offer emotional support to mitigate stress responses, making this option inadequate for addressing the patient’s psychological state.

Choice D reason: This empathetic response acknowledges the patient’s uncertainty and invites dialogue, aligning with therapeutic communication principles. Preoperative anxiety, driven by fear of unknown surgical outcomes, activates the limbic system, increasing heart rate and cortisol. By validating emotions and offering support, this response fosters trust, reduces stress hormone release, and supports psychological coping, making it the most appropriate choice.

A. Set mutual goals for knowledge of hypertension. B. Teach what the patient wants to know about hypertension. C. Assess what the patient already knows about hypertension. D. Evaluate the outcomes of patient education for hypertension.

Correct Answer is C

Explanation

Choice A reason: Setting mutual goals is important but premature without assessing the patient’s knowledge. Goals depend on understanding gaps, which are identified through assessment. Without this, goals may be irrelevant, reducing teaching effectiveness, per patient education and learning theory principles.

Choice B reason: Teaching what the patient wants to know assumes prior assessment of their needs and knowledge of their baseline. Without assessing existing knowledge, the nurse risks delivering redundant or irrelevant information, decreasing engagement and retention, per adult learning and education strategies.

Choice C reason: Assessing the patient’s current knowledge of hypertension is the first, as it establishes a baseline understanding, identifying gaps and misconceptions. This guides tailored education, ensuring relevance and effectiveness, enhancing patient engagement, and adherence to management, per patient-centered education and health literacy principles.

Choice D reason: Evaluating outcomes follows education, not precedes it. Assessment of knowledge is needed first to inform teaching. Evaluation without teaching is illogical, as there are no interventions to assess, making this step irrelevant at the start, per educational process and nursing teaching frameworks.

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A nurse needs to begin discharge planning for a patient admitted with pneumonia and a congested cough. When is the best time the nurse should start discharge planning for this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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