CAPA Discharge Criteria & Planning 5 — Questions and Answers
Question 1: A patient expresses that they do not understand the discharge instructions due to a language barrier. What is the MOST appropriate action?
- Ask the patient's family member to translate the written instructions
- Use a qualified medical interpreter to review all discharge instructions before the patient leaves (Correct answer)
- Simplify the instructions and use gestures to communicate
- Document that instructions were provided and discharge the patient
Correct answer: Use a qualified medical interpreter to review all discharge instructions before the patient leaves
A qualified medical interpreter ensures accurate communication of discharge instructions, preventing patient safety errors caused by language barriers.
Question 2: Which vital sign parameter is typically required before ambulatory surgery discharge per Modified Aldrete criteria?
- Blood pressure within 20 mmHg of preoperative baseline
- Blood pressure within 20% of preoperative baseline (Correct answer)
- Heart rate below 80 bpm
- Mean arterial pressure above 70 mmHg
Correct answer: Blood pressure within 20% of preoperative baseline
The Modified Aldrete Score requires blood pressure within 20% (not 20 mmHg) of the preoperative baseline value to score maximum points.
Question 3: Which action by the discharging nurse BEST demonstrates adherence to the 'teach-back' method?
- Reading all discharge instructions aloud to the patient and escort
- Asking the patient to repeat back key instructions in their own words (Correct answer)
- Providing written instructions and asking if the patient has questions
- Having the patient sign the instruction sheet confirming understanding
Correct answer: Asking the patient to repeat back key instructions in their own words
Teach-back requires the patient to demonstrate understanding by restating information in their own words, not just acknowledging receipt of instructions.
Question 4: A patient is being discharged home after ambulatory surgery with a prescription for oxycodone. Which instruction is MOST important related to safe opioid use?
- Take opioids around the clock to stay ahead of pain
- Do not drive, operate machinery, or consume alcohol while taking opioids (Correct answer)
- Double the dose if pain is not controlled within 30 minutes
- Store opioids in a visible location for easy access
Correct answer: Do not drive, operate machinery, or consume alcohol while taking opioids
Opioids impair CNS function, making driving and alcohol consumption dangerous; patients must receive explicit counseling on these restrictions.
Question 5: A patient with obstructive sleep apnea (OSA) is discharged after ambulatory surgery. Which discharge instruction is MOST critical?
- Avoid sleeping on your back for 48 hours
- Use your CPAP device as prescribed the first night after surgery (Correct answer)
- Do not use CPAP until you feel fully recovered
- Increase CPAP pressure settings by 2 cm H2O for the first week
Correct answer: Use your CPAP device as prescribed the first night after surgery
OSA patients are at high risk for postoperative respiratory events; CPAP use is mandatory the first night to maintain airway patency during sleep.
Question 6: In which situation would a perianesthesia nurse be JUSTIFIED in contacting the surgeon before discharging a patient?
- Mild incisional discomfort rated 3/10 controlled with ibuprofen
- Unexpected drainage saturating the surgical dressing within 30 minutes (Correct answer)
- Patient requests a follow-up appointment in two weeks
- Nausea that resolved after one dose of ondansetron
Correct answer: Unexpected drainage saturating the surgical dressing within 30 minutes
Rapidly saturating surgical dressings suggest active bleeding requiring immediate surgical evaluation before the patient is discharged.
Question 7: Which statement BEST describes the perianesthesia nurse's legal responsibility at the time of ambulatory discharge?
- Legal responsibility transfers to the surgeon at the time of discharge order
- The nurse must ensure documented, comprehensive discharge teaching and patient/escort understanding before release (Correct answer)
- The nurse is only responsible for verifying the escort's identity
- Legal responsibility ends when the patient exits the building
Correct answer: The nurse must ensure documented, comprehensive discharge teaching and patient/escort understanding before release
Perianesthesia nurses bear legal and professional accountability for documenting complete discharge education and verifying patient and escort comprehension before release.
CAPA Discharge Criteria & Planning 5
A patient expresses that they do not understand the discharge instructions due to a language barrier.
What is the MOST appropriate action?