Family and Caregiver Involvement

1. Mr. Lavoie, 82, is being discharged after treatment for heart failure. His daughter insists on receiving all discharge instructions because she “handles everything.” The patient is alert, oriented, and states he wants to manage his own care but accepts that his daughter helps with medications. Which action must the nurse take before sharing health details with the daughter? *

Ask the daughter to sign a release form verifying she is the primary caregiver

Share only medication instructions because it involves safety

Decline to speak with the daughter to avoid privacy violations

Obtain Mr. Lavoie’s verbal or written consent specifying what information can be shared

2. A patient recovering from abdominal surgery lives with her husband, who wants to attend all teaching sessions. The patient says she prefers to learn privately but agrees he can participate in “some parts.” How should the nurse proceed? *

Exclude the husband because the patient requested privacy

Allow the husband to participate in all sessions since he is the spouse

Ask the patient which specific topics she consents to sharing with the husband

Teach them separately to avoid any confidentiality issues

3. Ms. Tremblay, diagnosed with early-stage dementia, relies heavily on her son for transportation and meal preparation. She becomes anxious during appointments. The son asks for detailed updates to “reduce her stress.” What is the nurse’s priority to ensure ethical involvement of the caregiver? *

Provide full updates to the son to prevent the patient’s stress

Assess Ms. Tremblay’s capacity and obtain her consent about what can be shared

Decline to speak with the son because dementia affects consent

Only discuss non-medical concerns to avoid violations

4. A patient’s spouse wants to demonstrate wound care at discharge. The patient agrees but becomes visibly uncomfortable when the nurse begins teaching. What should the nurse do to encourage family involvement without violating confidentiality? *

Continue teaching because the patient previously agreed

Pause teaching and reassess the patient’s comfort and willingness

Ask the spouse to leave immediately

Document the discomfort and proceed with teaching anyway

5. A single mother caring for her child with uncontrolled asthma says she is “exhausted and overwhelmed.” She does not have extended family nearby. Which nursing strategy best supports family coping? *

Advise her to rest more

Refer her to respite services and offer problem-solving education

Suggest she seek help from neighbors

Ask the physician to prescribe medication that reduces caregiver stress

6. During teaching about PEG-tube feeding, the patient refuses to allow his nephew to be present, even though the nephew will be the primary caregiver at home. What is the nurse’s best action? *

Teach the patient only and hope he will relay information later

Encourage the patient to reconsider because the nephew needs the training

Respect the refusal and arrange separate teaching for the nephew with the patient’s consent

Teach both simultaneously because home safety depends on it

7. A patient authorizes her sister to receive information. Later that day, the sister asks about the patient’s mental health diagnosis, which the patient never mentioned in the consent conversation. What should the nurse do? *

Share the information because family involvement is helpful

Decline and clarify the limits of the consent with the patient

Ask the physician to share the information instead

Give general mental health advice without revealing diagnosis

8. A hospitalized child requires complex dressing changes. The parents are anxious and unsure whether they can manage the care at home. How can the nurse best encourage effective family participation? *

Provide written steps and assume they will learn at home

Delay discharge until the parents feel fully confident

Record a video tutorial for the parents to watch independently

Demonstrate the procedure, then have the parents perform a return-demonstration

9. A patient with advanced COPD is transitioning to palliative home care. His partner feels guilty and fears making the “wrong decisions.” Which intervention best supports caregiver emotional burden? *

Encourage the partner to “stay positive”

Limit the partner’s responsibilities to reduce stress

Ask the physician to speak with the partner instead

Refer the partner to caregiver support groups and provide anticipatory guidance

10. During discharge planning, the patient states he does not want his adult children involved. Later, one child calls requesting details, saying, “I make his decisions when he’s stubborn.” What is the nurse’s legal and ethical duty? *

Share the information because the child claims to be involved

Confirm whether there is a legal mandate or POA; if not, decline to share

Give only part of the information to maintain family harmony

Ask another nurse to handle the situation