Discharge Planning for Certified Emergency Nursing (CEN)

Adaptive Brain SIMCLEX Study Plan – 26 Jan 2026

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6 Discharge Planning NCLEX Questions

Question 1 of 6

One of the nurse’s responsibilities is to determine whether the patient understands his discharge instructions. The best way to accomplish this is to:

All of the above

Have the patient explain the instructions to the nurse

Have the patient repeat the instructions verbatim

Have the patient sign the ED record, indicating that he received the instructions

Question 2 of 6

The goals of discharge planning are to:

Prevent the patient or family from using the ED as a primary care facility

Prevent readmission and foster good public relations

Conform to JCAHO requirements, provide patient or family education, and enhance facility revenues

Conform to JCAHO requirements, prevent readmission for the same problem, and provide patient or family education

Question 3 of 6

Which of the following is the most appropriate way to legally document patient teaching?

Providing the patient with written instructions

Referring to it in the nurses' notes

Giving the patient a written examination

Conducting the patient-teaching session in the presence of a witness

Question 4 of 6

When should the nurse begin discharge planning for a patient admitted to the ED?

When discharge is imminent

When the patient shows signs of improvement and can participate in the planning

As soon as the patient arrives at the ED

As soon as a definitive diagnosis is made

Question 5 of 6

The policy of an ED where most of the patient population is non-English speaking is to provide all discharge and patient instructions in English. For a patient who does not speak English but is accompanied by a friend who does, the nurse should:

Determine the friend's ability to understand the instructions, and then have the friend interpret them for the patient, and document this in the patient report

Delay the patient's discharge until a hospital interpreter or translation service can be found

Advise the patient to take the instructions to his private physician, who will interpret them for him

Have the friend interpret the instructions for the patient

Question 6 of 6

The nurse is aware that patient education is necessary for:

Professional responsibility

Medical and legal reasons

JCAHO requirements

All of the above

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Outline

Discharge Planning

Discharge instructions:

Provide written discharge instructions; avoid use of medical abbreviations
Review discharge instructions with patient and caregivers
Answer questions, clarify unclear items, explain medical terms and directions
Request that physician return to clarify patient education or information needs
Involve family and significant others in interaction
Explain rationale for prescribed medication (e.g., drug actions, side effects) – offer specific instruction with medication (e.g., “Do not drive while taking this medication”)
Refer to specific community resources

Teaching Effectiveness:

Results in positive behavior/attitude changes
Ask patient to restate in own words (or mime/demonstrate)
Test understanding of learning
Better learning if related to something familiar
Return demonstration
Follow-up phone call
Specific language – signs of infection
Focus on behavior, avoid absolute words
Positive feedback

Barriers:

Lack of privacy, time, rapport, nurse knowledge
Distractions, cognitive impairment
Unable to secure community follow-up
Physiological barriers – pain, age, critical illness, medication, cognition, sight/hearing deficits
Psychological barriers – trust, anxiety, denial, depression, psychosis
Sociocultural – language, ethnic background, education, literacy
Motivation

Compliance:

Patient has right to choose whether to follow nurse’s advice
Compliance with teaching depends – Recall ability, Comprehension, Desire to comply, Ability to perform, Health care literacy

Follow-up Arrangements:

Follow-up appointment with primary care provider or specialist (e.g., orthopaedic surgeon, obstetrician, diabetic nurse educator)
Clinic appointment
Return visit to the emergency department or hospital
Home health care/visiting nurse/community paramedicine program
Social service or case management referral
Psychiatric facility or outpatient psychiatric program
Substance abuse/alcohol detoxification centers
Condition-specific patient and caregiver support groups