CGRN Patient Education and Discharge Teaching — Questions and Answers
Question 1: Which discharge instruction is most important for a patient who received moderate sedation for colonoscopy?
- They may drive home if they feel alert
- Do not drive, operate machinery or sign legal documents for 24 hours, and go home with a responsible adult (Correct answer)
- Resume all activities right away
- Take a sleeping pill tonight to rest
Correct answer: Do not drive, operate machinery or sign legal documents for 24 hours, and go home with a responsible adult
Sedatives such as midazolam and fentanyl can impair judgment and reaction time for hours after the patient seems alert. Standard instructions are no driving, machinery, alcohol or important decisions for 24 hours, and discharge to a responsible adult.
Question 2: For a morning colonoscopy using a split-dose prep, when should the second dose usually be taken?
- The night before, together with the first dose
- About 4–6 hours before the procedure, finished at least 2 hours before (Correct answer)
- Immediately after the procedure
- One week before
Correct answer: About 4–6 hours before the procedure, finished at least 2 hours before
Split dosing gives better bowel cleansing. The second half is started about 4–6 hours before the procedure and finished at least 2 hours before, or as anesthesia guidelines require, to lower aspiration risk.
Question 3: What is the best way to confirm that a patient understands their post-procedure instructions?
- Ask, 'Do you have any questions?'
- Have the patient explain the instructions back in their own words (teach-back) (Correct answer)
- Give a printed handout only
- Ask the family to sign the form
Correct answer: Have the patient explain the instructions back in their own words (teach-back)
Teach-back is an evidence-based health literacy technique. The patient restates the key points, so the nurse can spot misunderstandings and correct them. A yes/no question often gets a polite 'no questions' without any real understanding.
Question 4: A patient had a large polyp removed by polypectomy. Which teaching about delayed bleeding is correct?
- Bleeding can only happen in the first hour
- Delayed bleeding can happen up to about 2 weeks later; report large amounts of rectal blood or clots right away (Correct answer)
- Small amounts of black stool are an emergency
- Bleeding is impossible after cautery
Correct answer: Delayed bleeding can happen up to about 2 weeks later; report large amounts of rectal blood or clots right away
Delayed post-polypectomy bleeding happens when the cautery scar (eschar) sloughs off, usually within 1–14 days. Patients should report significant bright red blood, clots, dizziness or fainting right away.
Question 5: After esophageal dilation, which symptom should the patient be taught to report immediately?
- Mild sore throat
- Chest pain, fever, or crackling under the skin of the neck (subcutaneous emphysema) (Correct answer)
- Mild bloating
- Feeling tired that evening
Correct answer: Chest pain, fever, or crackling under the skin of the neck (subcutaneous emphysema)
Chest pain, fever, trouble swallowing, shortness of breath or subcutaneous emphysema after dilation can mean esophageal perforation, a surgical emergency. A mild sore throat is expected.
Question 6: What reading level is generally recommended for written patient-education materials?
- College level
- High school senior level
- About 5th–6th grade level (Correct answer)
- Medical terminology level
Correct answer: About 5th–6th grade level
Many adults have limited health literacy, so agencies such as the AMA and NIH recommend writing patient materials at or below a 6th-grade reading level. Plain language and pictures improve understanding.
