CNL Care Transitions & Discharge Planning 2

Question 1

During medication reconciliation at discharge, the CNL discovers a patient was prescribed two anticoagulants — one new and one pre-admission. The FIRST action should be:

Accepted Answer

Clarify the discrepancy with the prescribing physician before discharge

Answer

Fill both prescriptions and let the patient decide which to take

Answer

Document the discrepancy and discharge the patient

Answer

Instruct the patient to take the lower dose of the two

Question 2

The BOOST (Better Outcomes by Optimizing Safe Transitions) tool is primarily used to:

Accepted Answer

Identify patients at high risk for readmission so targeted interventions can be applied

Answer

Calculate hospital billing for discharge services

Answer

Train nursing staff on documentation requirements

Answer

Audit compliance with Joint Commission standards

Question 3

Which element is considered a CORE component of an effective transition of care record (transition of care summary)?

Accepted Answer

Reconciled medication list, active problem list, and pending test results

Answer

Patient's dietary preferences and hobbies

Answer

Insurance billing codes for the hospitalization

Answer

Nursing staff assignments during the hospital stay

Question 4

A CNL is implementing a bundle to reduce heart failure readmissions. Which intervention has the HIGHEST evidence for reducing 30-day readmissions in this population?

Accepted Answer

Patient self-monitoring of daily weight with a clear action plan for weight gain

Answer

Restricting patient visitors during the last 24 hours before discharge

Answer

Providing printed pamphlets about heart failure at admission

Answer

Scheduling a follow-up appointment within 90 days of discharge

Question 5

When using the 'teach-back' method during discharge education, the nurse's CORRECT approach is to ask:

Accepted Answer

'Can you explain to me in your own words how to take this medication?'

Answer

'Do you understand everything we went over today?'

Answer

'Is there anything you didn't understand?'

Answer

'Are you comfortable going home today?'

Question 6

Which team member is MOST important to include in discharge planning for a patient with complex social needs such as homelessness or food insecurity?

Accepted Answer

The social worker or case manager

Answer

The hospital chaplain

Answer

The pharmacy technician

Answer

The radiology technologist

Question 7

A CNL is evaluating a newly implemented discharge planning protocol. Which metric BEST measures the protocol's effectiveness at improving care transitions?

Accepted Answer

30-day all-cause readmission rate

Answer

Average number of discharge teaching sessions per patient

Answer

Number of discharge summaries completed on time

Answer

Patient satisfaction scores for hospital food