A patient dies after suffering a severe cerebrovascular accident (CVA). The family members are informed of his demise and are at the bedside. What documentation should be noted in the patient's medical record? (Select all that apply.)

Time vital signs ceased

Results of the autopsy

Why the patient died

Official time of death

Who pronounced the patient

Answer and Explanation

Correct Answer : A,D,E

A. Time vital signs ceased. Documenting the time at which vital signs ceased is important for medical and legal documentation. This helps establish the timeline of events leading to death and can be relevant for determining the official time of death.

B. Results of the autopsy. While an autopsy may provide valuable information, it is not typically documented at the time of death unless available. Autopsy results are generally included later after they are completed, not immediately after death.

C. Why the patient died. While the cause of death is often determined, it is generally not the nurse's role to speculate or document the reason for death in the medical record at the time of death. It is more appropriate for the physician or coroner to document the cause.

D. Official time of death. The official time of death should be documented as this is critical for legal, medical, and procedural purposes. It is typically recorded when the attending physician or another authorized individual pronounces the death.

E. Who pronounced the patient. It is necessary to document who pronounced the patient deceased to ensure that the pronouncement of death is legally recognized. This is part of standard medical documentation and ensures proper identification of the responsible party.

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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.

A. assisting the patient to get dressed. B. accompanying the patient to the acute care facility entrance. C. writing the discharge instructions. D. packing the patient's personal belongings.

Correct Answer is C

Explanation

A. Assisting the patient to get dressed: This is a supportive task that can be performed by any nursing staff.

B. Accompanying the patient to the acute care facility entrance: This is not a specific RN responsibility and can be done by other staff.

C. Writing the discharge instructions: Writing discharge instructions requires the professional judgment of an RN, ensuring that the patient receives comprehensive education about their care post-discharge.

D. Packing the patient's personal belongings: This is a clerical or supportive task and not specific to the RN role.

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A patient dies after suffering a severe cerebrovascular accident (CVA). The family members are informed of his demise and are at the bedside. What documentation should be noted in the patient's medical record? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

A patient has an acute care facility discharge order for later that day. The LPN/LVN understands that part of the discharge process to be performed by the registered nurse is:

Correct Answer is C

Explanation

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When instructing the patient about a colonoscopy, you would include that: (Select all that apply.)

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