RN Nursing · Home Health Nursing · Practice question
A case manager is performing discharge planning for a client who experienced a traumatic leg amputation and has a new prosthesis. Which of the following assessments should the nurse identify as the priority?
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Ask whether the client's insurance will cover home health services.
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✓
Evaluate the client's home environment.
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Determine whether the client is eligible to go to a skilled nursing facility.
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Collaborate with a prosthetist to teach the client about care of the prosthesis.
Answer & explanation
Correct: Evaluate the client's home environment.
When performing discharge planning for a client with a new prosthesis following a traumatic leg amputation, the priority assessment is to evaluate the client's home environment. This is essential because the nurse must determine whether the home is structurally accessible — for example, whether there are stairs without railings, narrow doorways, or floor hazards that could compromise safety and mobility with the new prosthesis. Identifying environmental barriers guides all subsequent planning and referrals. Asking about insurance coverage is important for facilitating home health services but is a logistical step that follows the assessment of what the client actually needs. Determining eligibility for a skilled nursing facility may be relevant if the home is found to be unsafe or the client is not ready for independent living, but this decision depends on the home assessment findings. Collaborating with a prosthetist to teach prosthesis care is a necessary intervention but is a teaching action rather than a priority safety assessment. Safe discharge planning always begins with understanding the environment the client will return to, which drives all other decisions.
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