CNL Care Transitions & Discharge Planning 3

Question 1

Which legislation mandates that hospitals share discharge planning information with patients in a timely manner and offer them a choice of post-acute care providers?

Accepted Answer

Improving Medicare Post-Acute Care Transformation (IMPACT) Act

Answer

HIPAA Privacy Rule

Answer

Emergency Medical Treatment and Labor Act (EMTALA)

Answer

The Affordable Care Act individual mandate

Question 2

A patient with limited English proficiency is being discharged. The CNL's PRIORITY action regarding discharge education is to:

Accepted Answer

Use a qualified medical interpreter to provide and verify discharge instructions

Answer

Ask the patient's adult child to translate all instructions

Answer

Provide written instructions only in English and assume the patient can read them

Answer

Defer detailed education to the outpatient provider

Question 3

A CNL is designing a care transition program for high-risk elderly patients. Which post-discharge contact timeline is supported by EVIDENCE as optimal for preventing early readmission?

Accepted Answer

Phone or in-person contact within 24-72 hours of discharge

Answer

Contact within 7-14 days only if the patient calls first

Answer

A single follow-up appointment at 30 days

Answer

Monthly phone check-ins for one year

Question 4

In the CNL competency framework, 'lateral integration of care' during transitions refers to:

Accepted Answer

Coordinating care across multiple providers and settings simultaneously for a specific patient

Answer

Transferring patients between hospitals in the same health system

Answer

Implementing vertical management structures in nursing units

Answer

Aggregating billing data across departments

Question 5

When performing a comprehensive discharge needs assessment, which domain is MOST commonly overlooked but critical for safe transitions?

Accepted Answer

Social support and home environment safety (e.g., caregiver availability, fall hazards)

Answer

The patient's insurance type

Answer

The patient's employment status

Answer

The hospital's current occupancy rate

Question 6

A CNL is reviewing data showing that 40% of post-discharge patients do not fill their prescriptions within 72 hours. The BEST system-level intervention is:

Accepted Answer

Implementing a bedside medication delivery program before discharge (meds to beds)

Answer

Providing an extra copy of the prescription at discharge

Answer

Informing patients that unfilled prescriptions void their insurance coverage

Answer

Reducing the number of medications prescribed at discharge

Question 7

Which statement BEST reflects the CNL's role in supporting patients during care transitions as defined by the American Association of Colleges of Nursing (AACN)?

Accepted Answer

The CNL serves as the coordinator of care at the point of care, overseeing the microsystem and facilitating safe transitions

Answer

The CNL delegates all discharge planning to case managers and social workers

Answer

The CNL is responsible for clinical education of staff only, not patient transitions

Answer

The CNL approves all discharge orders written by physicians