CELBAN Giving Patient Instructions 3 — Questions and Answers
Question 1: A patient refuses to listen to discharge instructions, saying 'I'll figure it out at home.' What is the nurse's best response?
- Document refusal and proceed with discharge
- Explore the patient's concerns before attempting to re-engage (Correct answer)
- Call security to delay the discharge
- Force the patient to listen by hospital policy
Correct answer: Explore the patient's concerns before attempting to re-engage
Understanding the reason for refusal allows the nurse to address barriers and motivate the patient to engage.
Question 2: Which environmental factor most interferes with effective patient instruction?
- A quiet private room
- A noisy hallway with interruptions (Correct answer)
- Adequate lighting
- Printed visual aids available
Correct answer: A noisy hallway with interruptions
Noise and interruptions distract both nurse and patient, reducing retention and comprehension of instructions.
Question 3: A nurse must teach a diabetic patient about foot care. Which method best promotes retention?
- Verbal explanation only during a busy shift
- Written pamphlet mailed after discharge
- Return demonstration with immediate feedback (Correct answer)
- Video shown without follow-up discussion
Correct answer: Return demonstration with immediate feedback
Return demonstration with feedback actively engages the patient and confirms skill competency.
Question 4: A patient with heart failure asks why they need to weigh themselves daily. What is the nurse's best teaching response?
- 'Your doctor ordered it, so it must be done.'
- 'Daily weights detect fluid retention early, which signals worsening heart failure.' (Correct answer)
- 'It helps calculate your medication doses.'
- 'You may need to lose weight for your surgery.'
Correct answer: 'Daily weights detect fluid retention early, which signals worsening heart failure.'
Explaining the rationale — detecting fluid retention early — motivates adherence and helps the patient act on significant weight changes.
Question 5: When is the LEAST appropriate time to provide complex discharge instructions?
- The morning before discharge
- One to two days prior to discharge
- When the patient is in severe pain or heavily sedated (Correct answer)
- When a support person is present
Correct answer: When the patient is in severe pain or heavily sedated
Pain and sedation impair cognition and memory, making it impossible for the patient to absorb and retain complex information.
Question 6: A nurse notices a patient nodding throughout instruction but looking confused. What should the nurse do?
- Continue teaching as planned
- Stop and ask the patient to explain what was just covered (Correct answer)
- Speed up to finish before the patient loses interest
- Assume the patient understood and document accordingly
Correct answer: Stop and ask the patient to explain what was just covered
Pausing to check comprehension catches misunderstandings early and prevents nodding from masking confusion.
Question 7: Which instruction format is MOST helpful for a visually impaired patient receiving new medication instructions?
- Standard printed pamphlet in small font
- Large-print materials combined with verbal explanation (Correct answer)
- Website link for self-study
- Instruction sheet taped to the medication bottle
Correct answer: Large-print materials combined with verbal explanation
Large-print materials paired with verbal explanation accommodate visual impairment and reinforce comprehension.
CELBAN Giving Patient Instructions 3
A patient refuses to listen to discharge instructions, saying 'I'll figure it out at home.' What is the nurse's best response?