Nclexrn Quiz: Discharge Planning And Continuity Of Care

What this quiz covers

This quiz focuses on Discharge Planning And Continuity Of Care, giving you a quick way to practice the rules, question types, and explanations that matter most for Nclexrn.

How to use this quiz

Try each quiz question before looking at the correct answer. Use the explanations to review missed ideas, then come back to similar questions until the pattern feels familiar.

Question 1

1. Outpatient dermatology for routine skin cancer screening
2. Cardiac rehabilitation to improve endurance and circulation
3. Speech-language pathology to evaluate swallowing and aspiration risk
4. Home health nursing for wound assessment, dressing changes, and teaching (correct answer)

Explanation: This question tests discharge planning and continuity of care in a diabetic client with a foot ulcer requiring ongoing wound management. The primary goal of discharge planning is to ensure continuity of specialized care to prevent complications like infection or amputation. Referring to home health nursing for wound assessment and teaching addresses the highest priority need given the client's physical limitations and need for daily care. Cardiac rehabilitation is not indicated without cardiac issues; speech pathology is irrelevant without swallowing concerns; dermatology screening is routine but lower priority than wound care. Effective discharge planning involves evaluating the client's mobility and support system for task assistance. It also includes coordinating referrals that match the client's specific health needs. A transferable strategy for planning safe discharges is to prioritize referrals that address ongoing skilled needs and involve family in the care plan.

Question 2

1. Use an incentive spirometer every 2 hours while awake for the next 2 weeks
2. Report calf pain, warmth, swelling, or sudden shortness of breath immediately (correct answer)
3. Change the dressing daily and apply antibiotic ointment to the incision
4. Limit fluids after 6 PM to prevent nighttime urination and falls

Explanation: This question tests discharge planning and continuity of care in a postoperative client after total hip arthroplasty. The primary goal of discharge planning is to ensure a safe transition home by addressing potential complications and promoting recovery. Reporting signs of deep vein thrombosis or pulmonary embolism, such as calf pain, warmth, swelling, or sudden shortness of breath, addresses the highest priority need because immobility increases the risk of thromboembolism, which can be life-threatening. Using an incentive spirometer is important for lung expansion but is lower priority than monitoring for clots; changing the dressing daily is unnecessary for a clean, dry incision; limiting fluids after 6 PM may reduce fall risk but does not address the most critical complication. Effective discharge planning involves assessing the client's support system and scheduling follow-up services like physical therapy. It also includes educating on signs of complications and when to seek immediate care. A transferable strategy for planning safe discharges is to prioritize teaching on life-threatening risks and ensure access to emergency resources.

Question 3

1. Provide written instructions on a low-sodium diet and daily exercise goals
2. Encourage the client to purchase a pulse oximeter to monitor oxygen levels
3. Teach the client to take an extra diuretic dose whenever swelling increases
4. Arrange a social work consult to address medication access and follow-up transportation (correct answer)

Explanation: This question tests discharge planning and continuity of care in a client with heart failure facing socioeconomic barriers. The primary goal of discharge planning is to facilitate a smooth transition by identifying and addressing obstacles to self-management and follow-up. Arranging a social work consult for medication access and transportation addresses the highest priority need because limited resources can lead to nonadherence and readmission. Providing diet and exercise instructions is important but lower priority without access to care; teaching extra diuretic doses risks electrolyte imbalance; encouraging a pulse oximeter purchase is unnecessary for stable breathing. Effective discharge planning includes interdisciplinary collaboration to resolve barriers like transportation and finances. It also involves confirming the client's understanding of their condition and management plan. A transferable strategy for planning safe discharges is to assess social determinants of health and connect clients to community resources early.

Question 4

1. Use a soft toothbrush and report signs of bleeding such as black stools or unusual bruising (correct answer)
2. Stop apixaban for 2 days before any dental cleaning without notifying the provider
3. Take ibuprofen routinely for leg pain because it is safer than acetaminophen
4. Avoid walking until all swelling is gone to prevent clot migration

Explanation: This question tests discharge planning and continuity of care in a client on apixaban for DVT. The primary goal of discharge planning is to minimize bleeding risks through safety measures. Instructing on soft toothbrush and bleeding signs addresses the highest priority need for anticoagulation safety. Stopping for dental without guidance risks clots; ibuprofen increases bleeding; avoiding walking risks progression. Effective discharge planning includes bleeding precaution education. It also involves family monitoring. A transferable strategy for planning safe discharges is to teach practical safety tips and reporting criteria.

Question 5

1. Avoid sunlight entirely for 6 months while taking doxycycline
2. Complete the full antibiotic course, avoid sexual activity until treatment is finished, and ensure partner evaluation/treatment (correct answer)
3. Stop antibiotics when pelvic pain resolves to reduce yeast infection risk
4. Use douching daily to prevent recurrence of infection

Explanation: This question tests discharge planning and continuity of care in the context of treating pelvic inflammatory disease (PID). The primary goal of discharge planning is to ensure the client understands how to complete treatment effectively, prevent reinfection, and promote long-term health outcomes. The correct answer, completing the full antibiotic course, avoiding sexual activity until treatment is finished, and ensuring partner evaluation/treatment, addresses the highest priority need by reducing the risk of reinfection, complications like infertility, and transmission of sexually transmitted infections that commonly cause PID. Option A is incorrect because while doxycycline causes photosensitivity, avoiding sunlight entirely for 6 months is unnecessary as treatment duration is typically 14 days; option C is wrong as stopping antibiotics prematurely increases resistance and recurrence risk, not reduces yeast infections; and option D is harmful since douching disrupts vaginal flora and heightens infection risk. A key principle of effective discharge planning is assessing the client's social situation, such as inconsistent condom use and lack of a primary care provider, to tailor instructions that promote adherence and follow-up. Another principle is incorporating education on medication side effects, lifestyle modifications, and when to seek medical help to foster self-management. A transferable strategy for planning safe discharges is to prioritize instructions that address immediate risks like reinfection while connecting clients to resources, such as sexual health clinics, for ongoing care.

Question 6

1. Expect mood improvement immediately after the first dose of sertraline
2. Report worsening depression, new agitation, or suicidal thoughts, especially in the first few weeks (correct answer)
3. Stop sertraline when sleep improves to prevent dependence
4. Avoid all carbohydrates to reduce medication side effects

Explanation: This question tests discharge planning and continuity of care in a client with depression on sertraline. The primary goal of discharge planning is to ensure safety through symptom monitoring. Instructing to report worsening or suicidal thoughts addresses the highest priority need due to initial medication risks. Expecting immediate improvement is unrealistic; stopping when better risks relapse; avoiding carbs is unnecessary. Effective discharge planning includes safety plans. It also involves family involvement. A transferable strategy for planning safe discharges is to highlight black box warnings and crisis resources.

Question 7

1. Teach perineal care and the use of sitz baths for comfort
2. Screen for postpartum depression symptoms and provide follow-up resources and crisis contacts (correct answer)
3. Encourage the client to begin jogging within 1 week to improve mood
4. Instruct the client to avoid all visitors for the first month to reduce stress

Explanation: This question tests discharge planning and continuity of care in a postpartum client with a depression history. The primary goal of discharge planning is to promote maternal well-being by addressing mental health risks. Screening for postpartum depression and providing resources addresses the highest priority need given the client's history and feelings of being overwhelmed, which can impact bonding and safety. Teaching perineal care is routine but lower priority; encouraging early jogging risks physical strain; avoiding visitors is isolating. Effective discharge planning includes mental health assessment and crisis contacts. It also involves engaging family support for monitoring. A transferable strategy for planning safe discharges is to integrate mental health screening and connect to support services proactively.

Question 8

1. Encourage the client to take over-the-counter sleep aids to improve rest
2. Arrange a home safety evaluation and confirm a reliable caregiver plan before discharge (correct answer)
3. Teach the client to remove throw rugs after the fracture heals
4. Recommend limiting fluid intake to reduce trips to the bathroom

Explanation: This question tests discharge planning and continuity of care in an elderly client post-fall with cognitive and mobility issues. The primary goal of discharge planning is to ensure a safe home environment and adequate supervision. Arranging a home safety evaluation and caregiver plan addresses the highest priority need to prevent recurrent falls. Encouraging sleep aids risks side effects; removing rugs after healing delays safety; limiting fluids risks dehydration. Effective discharge planning includes assessing living situations for risks. It also involves coordinating community services. A transferable strategy for planning safe discharges is to evaluate home safety and support before release.

Question 9

1. Use ibuprofen daily to prevent inflammation in the artery
2. Avoid all foods containing vitamin K to prevent clot formation
3. Expect mild chest pain daily for several weeks after stent placement
4. Take both antiplatelet medications exactly as prescribed and do not stop without provider guidance (correct answer)

Explanation: This question tests discharge planning and continuity of care in a client post-coronary stent placement. The primary goal of discharge planning is to prevent stent thrombosis through medication adherence. Instructing to take antiplatelets as prescribed addresses the highest priority need to avoid life-threatening clots. Avoiding vitamin K is irrelevant; expecting daily chest pain requires evaluation; using ibuprofen increases bleeding risk. Effective discharge planning includes medication education and side effect monitoring. It also involves family support for compliance. A transferable strategy for planning safe discharges is to emphasize the importance of not discontinuing critical medications without guidance.

Question 10

1. Provide smoking cessation counseling and referral resources to reduce risk of restenosis and complications (correct answer)
2. Teach the client to soak the access site in warm water twice daily
3. Instruct the client to stop antiplatelet therapy if bruising occurs
4. Recommend strict bedrest for 2 weeks to protect the access site

Explanation: This question tests discharge planning and continuity of care in a client post-angioplasty with ongoing smoking. The primary goal of discharge planning is to modify risk factors for long-term vascular health. Providing smoking cessation counseling addresses the highest priority need to prevent restenosis and progression. Soaking the site risks infection; stopping antiplatelets risks clots; bedrest delays recovery. Effective discharge planning includes lifestyle modification education. It also involves family involvement in changes. A transferable strategy for planning safe discharges is to prioritize risk factor reduction and connect to cessation resources.

Question 11

1. Stop the antibiotic when the cough resolves to prevent gastrointestinal upset
2. Seek care for increasing shortness of breath, chest pain, persistent fever, or worsening confusion (correct answer)
3. Avoid all dairy products while taking antibiotics to prevent resistance
4. Use leftover cough suppressant at maximum dose to sleep through the night

Explanation: This question tests discharge planning and continuity of care in a client post-pneumonia. The primary goal of discharge planning is to educate on signs of worsening to prevent complications. Instructing to seek care for increasing symptoms addresses the highest priority need for timely intervention. Stopping antibiotics early risks resistance; avoiding dairy is unnecessary; overusing cough suppressants can suppress expectoration. Effective discharge planning includes antibiotic completion education. It also involves symptom monitoring plans. A transferable strategy for planning safe discharges is to provide clear criteria for when to seek medical help.

Question 12

1. Offer thin liquids to keep the client well hydrated and reduce constipation
2. Have the client sit upright for meals and follow the recommended diet consistency from speech therapy (correct answer)
3. Feed the client quickly to reduce fatigue and shorten mealtimes
4. Stop aspirin if bruising occurs to prevent bleeding complications

Explanation: This question tests discharge planning and continuity of care in a post-stroke client with dysphagia. The primary goal of discharge planning is to minimize risks like aspiration through safe feeding practices. Instructing on upright positioning and diet consistency addresses the highest priority need by preventing pneumonia based on speech therapy recommendations. Offering thin liquids increases aspiration risk; feeding quickly can cause choking; stopping aspirin without guidance risks stroke. Effective discharge planning involves caregiver education on safety measures. It also includes reinforcing therapy recommendations at home. A transferable strategy for planning safe discharges is to tailor teaching to specific risks and involve caregivers in demonstrations.

Question 13

1. Instruct the client to weigh weekly instead of daily to reduce joint strain
2. Arrange for a home health visit to reinforce daily weight monitoring and assess for fluid overload (correct answer)
3. Tell the client to increase salt intake on days when dizziness occurs
4. Advise the client to take furosemide only when shortness of breath becomes severe

Explanation: This question tests discharge planning and continuity of care in a client with heart failure on new diuretic. The primary goal of discharge planning is to facilitate home monitoring despite physical limitations. Arranging home health for weight checks addresses the highest priority need to detect fluid overload early. Weekly weighing misses changes; increasing salt risks worsening; taking diuretic only when severe delays intervention. Effective discharge planning includes adaptive strategies for monitoring. It also involves spouse training. A transferable strategy for planning safe discharges is to use home services for clients with barriers to self-care.

Question 14

1. Encourage cranberry juice daily as the primary prevention strategy
2. Confirm the client can obtain and correctly take antibiotics and has a plan for monitoring for recurrent confusion or fever (correct answer)
3. Teach the client to restrict fluids to reduce urinary frequency
4. Recommend postponing follow-up until the next routine annual visit

Explanation: This question tests discharge planning and continuity of care in an elderly client post-UTI with delirium. The primary goal of discharge planning is to ensure medication adherence and symptom surveillance. Confirming antibiotic access and monitoring plan addresses the highest priority need given limited supervision. Cranberry is adjunctive; restricting fluids risks recurrence; postponing follow-up delays care. Effective discharge planning includes caregiver coordination. It also involves recurrence education. A transferable strategy for planning safe discharges is to verify self-management capability and arrange oversight.

Question 15

1. Expect yellowing of the skin and eyes for 1–2 weeks after surgery
2. Call the provider for fever, worsening abdominal pain, or redness/drainage at incision sites (correct answer)
3. Avoid all dietary fat permanently to prevent recurrence of gallstones
4. Stop walking for 2 weeks to prevent bleeding at the incision sites

Explanation: This question tests discharge planning and continuity of care in a client post-laparoscopic cholecystectomy. The primary goal of discharge planning is to educate on self-monitoring and promote recovery while preventing complications. Instructing to call for fever, worsening pain, or incision redness/drainage addresses the highest priority need by focusing on signs of infection, a common postoperative risk. Expecting jaundice is incorrect as it suggests complications like bile duct injury; avoiding all dietary fat permanently is unnecessary; stopping walking increases risks like clots. Effective discharge planning includes pain management education and dietary guidance tailored to the procedure. It also involves confirming reliable support and transportation for follow-up. A transferable strategy for planning safe discharges is to emphasize recognition of infection signs and provide written instructions for reference.

Question 16

1. Use the inhaled corticosteroid daily even when asymptomatic and reserve the rescue inhaler for acute symptoms (correct answer)
2. Stop the inhaled corticosteroid once breathing is normal to reduce oral thrush risk
3. Use the rescue inhaler on a fixed schedule every 2 hours to prevent attacks
4. Avoid receiving influenza vaccination because it can trigger asthma symptoms

Explanation: This question tests discharge planning and continuity of care in a client with asthma post-exacerbation. The primary goal of discharge planning is to promote long-term control through proper inhaler use. Teaching daily controller use and rescue for symptoms addresses the highest priority need to prevent future attacks. Stopping the corticosteroid risks exacerbations; fixed rescue use is incorrect; avoiding flu vaccine increases infection risk. Effective discharge planning involves creating an asthma action plan. It also includes technique demonstration. A transferable strategy for planning safe discharges is to provide personalized management plans and verify understanding.

Question 17

1. Occupational health to evaluate workplace chemical exposure
2. Genetic counseling to assess inherited risk of appendicitis
3. Palliative care to manage end-of-life planning and symptom control
4. Case management to coordinate interpreter-supported teaching, follow-up, and transportation resources (correct answer)

Explanation: This question tests discharge planning and continuity of care in a client post-appendectomy with language and access barriers. The primary goal of discharge planning is to overcome obstacles for effective self-care and follow-up. Referring to case management for interpreter and transportation support addresses the highest priority need for equitable care. Genetic counseling is irrelevant; palliative care is not indicated; occupational health doesn't apply. Effective discharge planning involves cultural and linguistic assessments. It also includes resource coordination. A transferable strategy for planning safe discharges is to address health literacy and access barriers through interdisciplinary referrals.

Question 18

1. Stop prednisone as soon as breathing feels normal to avoid side effects
2. Avoid all physical activity for 1 month to prevent another exacerbation
3. Increase oxygen flow to 6 L/min whenever shortness of breath occurs
4. Use the rescue inhaler first, then the maintenance inhaler as prescribed, and demonstrate correct technique (correct answer)

Explanation: This question tests discharge planning and continuity of care in a client with COPD post-exacerbation. The primary goal of discharge planning is to optimize respiratory management and prevent readmissions through proper medication use. Teaching correct inhaler technique and sequence addresses the highest priority need by ensuring effective symptom control and adherence. Avoiding all activity risks deconditioning; increasing oxygen flow can cause retention; stopping prednisone abruptly risks rebound. Effective discharge planning involves hands-on demonstration of skills like inhaler use. It also includes assessing home support for monitoring symptoms. A transferable strategy for planning safe discharges is to verify client competency in self-care tasks and provide action plans for exacerbations.

Question 19

1. Skip the bedtime insulin dose on days when you eat less to avoid weight gain
2. Demonstrate insulin pen use and teach signs and treatment of hypoglycemia before discharge (correct answer)
3. Stop metformin now that insulin has been started
4. Check urine ketones every morning and call 911 if ketones are present

Explanation: This question tests discharge planning and continuity of care for a diabetic patient starting new insulin therapy. The primary goal of discharge planning is to ensure patients have the knowledge and skills needed to safely manage new treatments at home. The correct answer (B) addresses the highest priority need by teaching proper insulin administration technique and hypoglycemia management, which are essential safety skills before discharge. Option A (skipping insulin) is dangerous and incorrect; Option C (stopping metformin) is incorrect as both medications are often used together; Option D (checking urine ketones daily) is unnecessary for type 2 diabetes patients on basal insulin. Effective discharge planning includes hands-on demonstration and return demonstration of critical skills, especially for vision-impaired patients who may benefit from insulin pens over syringes. When planning safe discharges with new medications, always verify the patient or caregiver can demonstrate proper technique and verbalize safety precautions before leaving the hospital.

Question 20

1. Durable medical equipment provider to deliver oxygen and teach safe home use before discharge (correct answer)
2. Inpatient psychiatric consultation to address anxiety related to dyspnea
3. Orthopedic clinic referral for evaluation of activity intolerance
4. Dermatology referral to prevent nasal cannula skin breakdown

Explanation: This question tests discharge planning and continuity of care for a COPD patient requiring new home oxygen therapy. The primary goal of discharge planning is to ensure patients have necessary equipment and education for safe home management. The correct answer (A) addresses the highest priority need by arranging oxygen delivery and safety education before discharge, essential for this hypoxic patient who needs continuous oxygen support. Option B (psychiatric consultation) may be helpful but doesn't address the immediate oxygen needs; Option C (orthopedic referral) is inappropriate as dyspnea is due to COPD, not orthopedic issues; Option D (dermatology referral) addresses a potential minor issue rather than the critical oxygen requirement. Effective discharge planning ensures all necessary durable medical equipment is arranged and patients receive proper training before leaving the hospital. When planning safe discharges for patients with new oxygen requirements, coordinate equipment delivery and safety education as the top priority, especially in homes with smoking hazards.