A nurse is caring for a client who has a prescription for a referral for case management services. Which of the following actions should the nurse identify is the responsibility of case management services?

Arrange for the client to receive home health care services

Write a prescription for the client's medications

Perform nursing skills for the client such as dressing changes

Provide education to the client about adverse effects of their medications

Answer and Explanation

The Correct Answer is A

A.   This is a primary responsibility of case management services. Case managers coordinate various aspects of a client’s care, including arranging for home health care services. They work with healthcare providers and agencies to ensure the client receives the necessary services and resources, such as nursing care, physical therapy, or other supportive services at home.
B.   Writing prescriptions is the responsibility of licensed healthcare providers such as physicians or nurse practitioners, not case managers. Case managers do not have the authority to prescribe medications; instead, they focus on coordinating care and ensuring that clients have access to the necessary resources and services.
C.   Performing specific nursing skills, such as dressing changes, is within the scope of practice for registered nurses or other licensed nursing professionals. Case managers typically do not provide direct clinical care or perform nursing procedures. Their role is more focused on coordinating care and ensuring that clinical needs are met through appropriate services and providers.
D.   Providing education about medication adverse effects falls within the role of healthcare providers who prescribe and manage medications, such as physicians, nurse practitioners, or pharmacists. While case managers may assist in coordinating educational resources and facilitating communication between the client and healthcare providers, they generally do not provide direct medication education.

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Correct Answer is C

Explanation

A. Waiting for the patient to leave before filing an incident report is not the most appropriate response. The immediate priority should be addressing the situation to ensure the patient's safety and attempting to resolve any issues before the patient leaves.
B. Contacting the patient’s next-of-kin can be appropriate if the nurse is concerned about the patient’s safety and if it’s necessary to inform the family about the patient’s condition or situation. However, this should be done only after attempting to address the situation directly with the patient, if feasible. It’s important to first try to resolve the issue directly with the patient before involving family members.
C. Walking with the patient and explaining the risks of leaving against medical advice (AMA) shows a proactive approach to addressing the patient's concerns and ensuring they understand the potential consequences of their actions. This approach aims to de-escalate the situation, provide important information, and potentially encourage the patient to stay for necessary care.
D. Calling security personnel should be a last resort and is generally used in situations where there is a safety threat or risk of harm. In this case, the patient is leaving in a disgruntled state but not exhibiting violent or threatening behavior.

A. “I will begin upon the client's admission to the facility." B. “I will begin 48 hr before the client's discharge." C. ‘I will begin once the client's insurance company approves discharge coverage." D. “I will begin once the client's discharge order is written."

Correct Answer is A

Explanation

A. Discharge planning should start as soon as the client is admitted to the facility. Early planning helps anticipate and address the patient’s needs and ensures that all necessary arrangements for post- discharge care are made well in advance.
B. Starting discharge planning 48 hours before discharge is generally too late. Effective discharge planning requires more time to coordinate care, education, and resources. Beginning the process 48 hours before discharge may not allow enough time to address all aspects of the plan adequately, potentially leading to issues in the transition.
C. Waiting for insurance approval before starting discharge planning can lead to delays and may not be in the best interest of the patient. Discharge planning should be initiated based on the patient’s needs rather than insurance coverage. Waiting for approval can also disrupt the timeline for arranging follow- up care and services.
D. Waiting until the discharge order is written is too late for effective discharge planning. By the time the discharge order is written, many elements of the discharge plan should already be in place. Waiting until this point can lead to rushed arrangements and potentially inadequate preparation for the patient’s needs after leaving the facility.

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A nurse is caring for a client who has a prescription for a referral for case management services. Which of the following actions should the nurse identify is the responsibility of case management services?

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