A patient who is very angry and is leaving the hospital against medical advice (AMA) demands to have the medical record to take, because it is her personal property. An appropriate response would be:

A. A nursing care plan in the medical record before assessing the patient so that the nurse can identify priorities. The nurse should assess the patient first to determine their needs and priorities rather than create a care plan without assessment.

B. At least three times during the shift: at the beginning, in the middle, at the end, and as needed. Regular documentation is good practice, but the initial assessment must be documented at the beginning of the shift to establish a baseline.

C. An initial assessment of the patient and a plan based on the needs of the patient as assessed at the beginning of the shift. Documenting an initial assessment is crucial for identifying immediate needs and planning care, especially after surgery.

D. At the end of the shift so that the nurse can give full attention to the patient's needs during the shift. Waiting until the end of the shift risks missing critical changes and does not provide a clear baseline assessment.

A. Writing nursing care plans.
Although care plans are essential in nursing, qsen emphasizes broader competencies beyond just planning, such as teamwork and quality improvement.

B. Informatics. Informatics is a core competency highlighted by qsen to ensure nurses can use technology effectively for patient safety and care quality.

C. Familiarity with medical terms. Medical terminology is basic knowledge for nurses, but qsen emphasizes specific competencies beyond terminology.

D. Effective communication.
Effective communication is a fundamental qsen skill that enhances patient safety, teamwork, and patient-centered care.