Discharge Planning And Continuity Of Care - NCLEX Rn
- Which action should the nurse take first to begin discharge planning for a patient?
- Start planning at admission with an initial needs assessment. Early assessment identifies needs and resources, allowing timely coordination for effective discharge.
- Which assessment finding most strongly indicates a need for case management referral?
- Complex needs requiring coordination across multiple services. Case management optimizes resource use and outcomes for patients with multifaceted care requirements.
- Identify the best discharge plan component to reduce falls in an older adult returning home alone.
- Home safety evaluation and assistive device training as needed. Addresses environmental hazards and mobility issues, key factors in preventing falls among vulnerable elders.
- What is the nurse's legal responsibility when providing discharge teaching?
- Provide and document patient-specific discharge instructions. Meets legal standards for patient education, ensuring comprehension and reducing liability risks.
- Which option best describes an appropriate referral for a patient who is homebound and needs skilled care?
- Home health services for intermittent skilled nursing/therapy. Delivers necessary professional care in the home setting for patients unable to travel.
- What is the nurse's priority action when a patient cannot afford prescribed medications at discharge?
- Notify provider/case manager to arrange affordable alternatives. Ensures medication access and adherence, preventing treatment failure and readmissions.
- Which patient statement indicates correct understanding of when to seek urgent care after discharge?
- "I will seek care immediately for worsening symptoms or red flags." Demonstrates awareness of critical indicators, enabling timely intervention to prevent complications.
- What is the priority discharge teaching for a patient with a new central line at home?
- Aseptic technique, site care, flushing protocol, and infection signs. Focuses on infection prevention and management, critical for reducing life-threatening complications at home.
- What is the priority nursing action if a patient refuses the discharge plan and wants to leave?
- Assess decision-making capacity and notify provider; document refusal. Safeguards autonomy while ensuring capacity evaluation and legal documentation for potential risks.
- Which information must be included in a complete discharge medication list for the patient?
- Name, dose, route, frequency, indication, and stop/start changes. Provides comprehensive details to promote safe self-administration and continuity of therapy.
- What is the key distinction between home health and hospice services?
- Hospice is comfort-focused for terminal illness; home health is restorative. Hospice emphasizes palliation for end-of-life, while home health aims at recovery and function improvement.
- Which discharge instruction is highest priority for a patient starting a new high-risk medication?
- Indications, dosing schedule, and specific adverse effects to report. Prioritizes patient safety by addressing key elements that prevent misuse and prompt intervention.
- Which action should the nurse take when an interpreter is needed for discharge teaching?
- Use a qualified medical interpreter, not family members. Ensures accurate communication and cultural sensitivity, avoiding misinterpretations from untrained interpreters.
- Which finding requires the nurse to delay discharge and notify the provider?
- Unstable vital signs or uncontrolled symptoms requiring treatment. Indicates medical instability, necessitating further intervention to ensure safe discharge.
- What is the purpose of medication reconciliation during transitions of care?
- Prevent omissions, duplications, interactions, and dosing errors. Safeguards patient health by identifying and correcting discrepancies during care transitions.
- Identify the most appropriate method to evaluate patient understanding of discharge instructions.
- Teach-back method with patient return demonstration as indicated. Confirms comprehension through active patient participation, enhancing adherence and safety.
- Which discharge destination is most appropriate for a patient needing -hour supervision but not acute care?
- Skilled nursing facility or long-term care facility. Offers supervised care for stable patients needing ongoing assistance without hospital-level interventions.
- Which factor is the strongest predictor of readmission that the nurse should address in discharge planning?
- Inability to manage self-care and medications after discharge. Poor self-management increases complications, making it a critical focus to reduce readmission risks.
- What is the primary goal of discharge planning in nursing care?
- Safe transition to next setting with continuity of care. Ensures seamless care delivery, minimizes risks, and promotes optimal patient outcomes post-hospitalization.
- What is the best definition of continuity of care?
- Coordinated, consistent care across settings and over time. Facilitates seamless transitions, prevents gaps in treatment, and improves long-term health management.
- Identify the best nursing action when a patient with low health literacy nods but cannot restate instructions.
- Use plain language and teach-back; revise teaching until accurate. Adapts teaching to literacy level, ensuring accurate understanding and effective self-care post-discharge.
- Which discharge plan element best supports adherence for a patient with multiple daily medications?
- Simplified schedule and pill organizer with written medication chart. Simplifies complex regimens, reducing errors and improving compliance in polypharmacy scenarios.
- Identify the most appropriate follow-up plan after hospitalization for heart failure.
- Early follow-up visit and daily weights with symptom action plan. Monitors for decompensation early, enabling prompt adjustments to prevent exacerbations and readmissions.
- What is the nurse's priority when a caregiver expresses inability to provide required home care?
- Reassess discharge plan and arrange alternative supports/placement. Protects patient safety by adapting plans to available support, preventing neglect or complications.
- Which document best ensures accurate information transfer to the next level of care at discharge?
- Complete discharge summary including diagnoses, meds, and follow-up. Facilitates informed care by providing essential details to receiving providers, minimizing errors.