A nurse is caring for a client who has been admitted and diagnosed with type 1 diabetes mellitus. The client tells the nurse she has decided to go home. Which of the following actions should the nurse take?
Ask the client if she would like a sedative to help her relax.
Inform the client that she cannot leave without a discharge prescription from the provider.
Assign a security officer to the client's room until the provider can speak with the client.
Have the client sign the Against Medical Advice form.
The Correct Answer is B
A. Offering a sedative might not address the situation appropriately; the client's decision to leave needs to be managed through proper channels.
B. Informing the client about the discharge process and the requirement of a discharge prescription from the provider is appropriate and educates the client on the necessary steps.
C. Assigning a security officer might not be necessary unless there are safety concerns or imminent risks.
D. Having the client sign the Against Medical Advice (AMA) form might be necessary if the client insists on leaving against medical advice, but explaining the proper discharge process should be attempted first.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. A client ready for discharge, if stable and prepared for discharge, does not require immediate assessment.
B. Restlessness in a client with Alzheimer's and bacterial pneumonia could indicate a change in condition, potentially signaling an urgent issue that needs immediate assessment.
C. While pain management is important, the sudden onset of restlessness in a client with cognitive impairment and pneumonia takes priority.
D. An elevated fasting blood glucose level in a newly admitted diabetic client requires attention but might not be as immediately critical as the acute change in behavior seen in option B.
Correct Answer is D
Explanation
Rationale for A: An open fracture of the femur is serious and requires prompt treatment, but it does not typically indicate an immediate life threat compared to other conditions.
Rationale for B: Periorbital ecchymosis can indicate facial trauma, but it is not necessarily life-threatening and would not be prioritized as emergent.
Rationale for C: A deep partial thickness burn on the lower extremities is significant and requires treatment, but unless the burn covers a large area or is complicated by other factors, it is not the most critical issue compared to respiratory or cardiovascular threats.
Rationale for D: An asymmetrical thorax may suggest a possible pneumothorax or other significant respiratory issue, which could lead to respiratory distress or failure. This client should be tagged as emergent due to the potential for rapid deterioration.
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