Exam 1 NUR 115
A nurse is caring for a patient recently diagnosed with metastatic lung cancer who expresses
concern about managing at home alone. Which action by the case manager is the priority?
A. Arrange a referral to Meals on Wheels for food support.
B. Refer the patient to a social worker for evaluation of available home support.
C. Set up a follow-up appointment with the oncologist.
D. Provide information about local cancer support groups.
Answer: B
Rationale: While referrals to community services, oncology, and support groups are
important, the priority is assessing psychosocial support systems and home resources through
a social worker. This ensures safety and appropriate planning for home care needs.
A hospitalized patient requires a home oxygen setup upon discharge. Which of the following
is the most appropriate case management action?
A. Teach the patient how to use oxygen equipment before discharge.
B. Notify the physician that the patient requires oxygen at home.
C. Contact durable medical equipment (DME) services to coordinate home oxygen delivery.
D. Remind the patient to pick up oxygen equipment at a pharmacy.
Answer: C
Rationale: Case managers coordinate services between hospital and community resources.
Oxygen delivery requires a DME provider referral and arrangement, which is the case
manager's role. Education (A) is the nurse's role, and patients cannot pick up oxygen at a
retail pharmacy.
A patient with a new spinal cord injury requires long-term rehabilitation services. Which
referral is most appropriate?
A. Home health nurse
B. Skilled nursing facility
C. Rehabilitation facility
D. Hospice care
,Answer: C
Rationale: A patient with a new spinal cord injury benefits from intensive rehab services for
mobility and function. Home health (A) may be appropriate later, skilled nursing (B) is for
sub-acute needs, and hospice (D) is only for end-of-life care.
The nurse notes that a patient with limited English proficiency has been missing follow-up
appointments. Which case management action is most important to promote continuity of
care?
A. Arrange for transportation to appointments.
B. Provide written discharge instructions in English.
C. Refer to interpreter services for communication support.
D. Suggest the patient ask family members to interpret.
Answer: C
Rationale: Case managers ensure access to care by addressing health literacy and
communication barriers. Interpreter services are an ethical and legal requirement, ensuring
accurate communication. Family interpretation is not appropriate due to risk of
miscommunication.
A 78-year-old patient hospitalized with pneumonia is being discharged but expresses
concern about preparing meals and getting to appointments. Which referrals should the case
manager prioritize? (Select all that apply.)
A. Meals on Wheels
B. Physical therapy
C. Transportation services
D. Hospice care
E. Home health nursing
Answer: A, C, E
Rationale: This patient requires nutrition support (Meals on Wheels), transportation for
follow-up care, and home health for ongoing monitoring. PT (B) may be considered if
mobility is impaired, but not the priority given the scenario. Hospice (D) is not indicated
because the patient is not terminal.
The nurse is caring for a patient with severe COPD who continues to smoke despite teaching.
The provider prescribes nicotine replacement therapy. Which case management referral
, would be most appropriate?
A. Social services for home assistance
B. Pulmonary rehabilitation program
C. Hospice care
D. Sitter services
Answer: B
Rationale: Pulmonary rehab provides education, smoking cessation support, and exercise
programs tailored to COPD patients. This is the best referral to promote long-term health
outcomes.
A nurse is giving a bedside report to the oncoming shift nurse using SBAR. Which statement
by the nurse demonstrates the "Recommendation" portion of SBAR?
A. "The patient was admitted for pneumonia and has a history of COPD."
B. "The patient's oxygen saturation is currently 88% on 2 L nasal cannula."
C. "I suggest increasing oxygen to 3 L and notifying the provider if the saturation remains
below 90%."
D. "The patient's lungs have coarse crackles in the lower lobes bilaterally."
Answer: C
Rationale: The Recommendation portion of SBAR includes suggestions for action or what
should happen next. A is Situation, B is Assessment data, and D is Background/Assessment.
A nurse is preparing to discharge a patient with newly diagnosed diabetes. Which action by
the nurse is most important to ensure continuity of care?
A. Provide a handout on dietary changes.
B. Inform the patient's primary care provider about the hospitalization.
C. Refer the patient to a diabetes education program and schedule follow-up appointments.
D. Instruct the patient to check blood glucose daily.
Answer: C
Rationale: Continuity of care means ensuring the patient has uninterrupted support after
leaving the hospital. Referral to diabetes education and ensuring follow-up maintains care
beyond hospitalization. Teaching (A, D) is important, but not enough by itself.
A nurse is caring for a patient recently diagnosed with metastatic lung cancer who expresses
concern about managing at home alone. Which action by the case manager is the priority?
A. Arrange a referral to Meals on Wheels for food support.
B. Refer the patient to a social worker for evaluation of available home support.
C. Set up a follow-up appointment with the oncologist.
D. Provide information about local cancer support groups.
Answer: B
Rationale: While referrals to community services, oncology, and support groups are
important, the priority is assessing psychosocial support systems and home resources through
a social worker. This ensures safety and appropriate planning for home care needs.
A hospitalized patient requires a home oxygen setup upon discharge. Which of the following
is the most appropriate case management action?
A. Teach the patient how to use oxygen equipment before discharge.
B. Notify the physician that the patient requires oxygen at home.
C. Contact durable medical equipment (DME) services to coordinate home oxygen delivery.
D. Remind the patient to pick up oxygen equipment at a pharmacy.
Answer: C
Rationale: Case managers coordinate services between hospital and community resources.
Oxygen delivery requires a DME provider referral and arrangement, which is the case
manager's role. Education (A) is the nurse's role, and patients cannot pick up oxygen at a
retail pharmacy.
A patient with a new spinal cord injury requires long-term rehabilitation services. Which
referral is most appropriate?
A. Home health nurse
B. Skilled nursing facility
C. Rehabilitation facility
D. Hospice care
,Answer: C
Rationale: A patient with a new spinal cord injury benefits from intensive rehab services for
mobility and function. Home health (A) may be appropriate later, skilled nursing (B) is for
sub-acute needs, and hospice (D) is only for end-of-life care.
The nurse notes that a patient with limited English proficiency has been missing follow-up
appointments. Which case management action is most important to promote continuity of
care?
A. Arrange for transportation to appointments.
B. Provide written discharge instructions in English.
C. Refer to interpreter services for communication support.
D. Suggest the patient ask family members to interpret.
Answer: C
Rationale: Case managers ensure access to care by addressing health literacy and
communication barriers. Interpreter services are an ethical and legal requirement, ensuring
accurate communication. Family interpretation is not appropriate due to risk of
miscommunication.
A 78-year-old patient hospitalized with pneumonia is being discharged but expresses
concern about preparing meals and getting to appointments. Which referrals should the case
manager prioritize? (Select all that apply.)
A. Meals on Wheels
B. Physical therapy
C. Transportation services
D. Hospice care
E. Home health nursing
Answer: A, C, E
Rationale: This patient requires nutrition support (Meals on Wheels), transportation for
follow-up care, and home health for ongoing monitoring. PT (B) may be considered if
mobility is impaired, but not the priority given the scenario. Hospice (D) is not indicated
because the patient is not terminal.
The nurse is caring for a patient with severe COPD who continues to smoke despite teaching.
The provider prescribes nicotine replacement therapy. Which case management referral
, would be most appropriate?
A. Social services for home assistance
B. Pulmonary rehabilitation program
C. Hospice care
D. Sitter services
Answer: B
Rationale: Pulmonary rehab provides education, smoking cessation support, and exercise
programs tailored to COPD patients. This is the best referral to promote long-term health
outcomes.
A nurse is giving a bedside report to the oncoming shift nurse using SBAR. Which statement
by the nurse demonstrates the "Recommendation" portion of SBAR?
A. "The patient was admitted for pneumonia and has a history of COPD."
B. "The patient's oxygen saturation is currently 88% on 2 L nasal cannula."
C. "I suggest increasing oxygen to 3 L and notifying the provider if the saturation remains
below 90%."
D. "The patient's lungs have coarse crackles in the lower lobes bilaterally."
Answer: C
Rationale: The Recommendation portion of SBAR includes suggestions for action or what
should happen next. A is Situation, B is Assessment data, and D is Background/Assessment.
A nurse is preparing to discharge a patient with newly diagnosed diabetes. Which action by
the nurse is most important to ensure continuity of care?
A. Provide a handout on dietary changes.
B. Inform the patient's primary care provider about the hospitalization.
C. Refer the patient to a diabetes education program and schedule follow-up appointments.
D. Instruct the patient to check blood glucose daily.
Answer: C
Rationale: Continuity of care means ensuring the patient has uninterrupted support after
leaving the hospital. Referral to diabetes education and ensuring follow-up maintains care
beyond hospitalization. Teaching (A, D) is important, but not enough by itself.
