Patient Discharge

Every question here, with the answer

1. A patient is scheduled for discharge after a new diagnosis of diabetes. During discharge teaching, the patient says, “I do not understand how I am supposed to check my blood sugar at home.” What is the nurse’s best action?

   1. Notify the interdisciplinary team that the patient needs additional education and resources before discharge.
   2. Ask the family to review the discharge summary after the patient leaves.
   3. Tell the patient that the online patient portal will explain the instructions later.
   4. Provide written discharge papers and continue with discharge because follow-up is scheduled.

   Answer: Notify the interdisciplinary team that the patient needs additional education and resources before discharge.

   The patient has an unmet discharge learning need that affects safe self-management. The nurse should address health literacy and coordinate education/resources rather than relying only on paperwork, portals, or family review after discharge.

2. The nurse is reviewing whether a hospitalized patient is ready for discharge. Which findings should the nurse include as key discharge considerations? Select all that apply.

   1. The patient’s vital signs are stable or within normal limits for them.
   2. The patient has resources to care for themselves or someone available to care for them.
   3. The patient has a place to go after leaving the facility.
   4. The patient has been hospitalized long enough to avoid financial penalties.
   5. The patient has been transitioned to medications that are available and safe outside an acute care setting.

   Answer: The patient’s vital signs are stable or within normal limits for them., The patient has resources to care for themselves or someone available to care for them., The patient has a place to go after leaving the facility., The patient has been transitioned to medications that are available and safe outside an acute care setting.

   Discharge readiness includes medication safety, stable vital signs, a safe destination, and adequate resources or caregiving support. Financial penalties for readmission are discussed as an institutional concern, but length of hospitalization is not listed as a patient benchmark for discharge readiness.

3. During discharge planning rounds, the team is deciding where to discuss the patient’s progress and plan. The patient’s spouse wants to understand the plan and participate. Which approach best supports patient-centered discharge planning?

   1. Ask each discipline to document separately without a team discussion.
   2. Hold rounds in front of the patient and family when appropriate.
   3. Wait until the day of discharge to involve the family.
   4. Discuss the plan only at the nurses’ station to save time.

   Answer: Hold rounds in front of the patient and family when appropriate.

   The section states that rounds conducted in front of the patient and family increase involvement and improve outcomes. Waiting until discharge or relying on separate documentation does not support collaborative, patient-centered planning.

4. A nurse is participating in interdisciplinary discharge planning for a patient whose care plan has changed. Which actions reflect effective interdisciplinary teamwork? Select all that apply.

   1. Inform team members when changes to the patient’s plan of care are made.
   2. Show mutual respect for all members of the team.
   3. Communicate clearly and professionally with team members.
   4. Ensure necessary supplies or specialists are available.
   5. Assume other disciplines will see updates in the chart without direct communication.

   Answer: Inform team members when changes to the patient’s plan of care are made., Show mutual respect for all members of the team., Communicate clearly and professionally with team members., Ensure necessary supplies or specialists are available.

   Effective interdisciplinary teams use clear communication, mutual respect, timely updates, and appropriate resources. The section specifically warns not to assume team members will see changes in the chart.

5. A patient who will need complex care at home is being discharged to live with an adult child who works two jobs and has no other family support. What should the nurse prioritize in the discharge plan?

   1. Delay all education until the caregiver asks for help.
   2. Assess the family’s caregiving capacity and consider resources such as respite or in-home support.
   3. Teach the adult child that caregiving stress is expected and proceed with discharge.
   4. Recommend discharge home because family caregivers are always preferable to facility care.

   Answer: Assess the family’s caregiving capacity and consider resources such as respite or in-home support.

   The nurse should assess caregiver resources before discharge and help plan support when caregiver role strain is possible. Proceeding without assessment or waiting for the caregiver to ask may leave the patient and caregiver unprepared.

6. The nurse is preparing discharge education for a patient who needs wound care at home. Which actions are consistent with the section’s recommendations for discharge teaching and evaluation? Select all that apply.

   1. Use a process in which the learner watches the nurse, performs the skill with supervision, and then performs it independently.
   2. Provide education only through the printed discharge summary because it contains all needed information.
   3. Ensure the plan is clear and seek clarification if the instructions are not clear.
   4. Identify the patient or designated learner who will receive the education.
   5. Ask the patient how they like to learn.

   Answer: Use a process in which the learner watches the nurse, performs the skill with supervision, and then performs it independently., Ensure the plan is clear and seek clarification if the instructions are not clear., Identify the patient or designated learner who will receive the education., Ask the patient how they like to learn.

   Discharge teaching should be adapted to the patient’s learning needs, include the designated learner, and use methods such as “See one, do one, teach one.” Because nurses are often the last face-to-face providers, they must make sure the discharge plan is clear rather than relying only on printed paperwork.