CNL Care Transitions & Discharge Planning

Question 1

Which of the following is the PRIMARY goal of a structured discharge planning process in the CNL role?

Accepted Answer

Ensuring continuity of care and preventing avoidable readmissions

Answer

The primary goal of discharge planning is to ensure continuity of care and prevent avoidable readmissions by coordinating resources and follow-up services.

Question 2

The CNL notices a patient has multiple chronic conditions, low health literacy, and limited social support. Which discharge strategy is MOST appropriate?

Accepted Answer

A teach-back session with caregivers plus a follow-up call within 48 hours

Answer

Teach-back with caregivers and a post-discharge follow-up call addresses low health literacy and social isolation, reducing readmission risk.

Question 3

Which model specifically focuses on reducing rehospitalizations through nurse-led home visits and phone follow-up after discharge?

Accepted Answer

Care Transitions Intervention (CTI)

Answer

The Care Transitions Intervention (CTI), developed by Eric Coleman, uses nurse-led home visits and follow-up calls to empower patients and reduce rehospitalizations.

Question 4

A patient being discharged after a hip replacement asks about weight-bearing restrictions. The CNL's BEST response is to:

Accepted Answer

Provide written instructions and use teach-back to confirm understanding

Answer

Using teach-back to confirm understanding of written instructions ensures the patient truly comprehends restrictions, reducing the risk of injury or readmission.

Question 5

Which federal program penalizes hospitals financially for excess readmissions within 30 days for certain conditions?

Accepted Answer

Hospital Readmissions Reduction Program (HRRP)

Answer

The Hospital Readmissions Reduction Program (HRRP) reduces Medicare payments to hospitals with higher-than-expected 30-day readmission rates for qualifying conditions.

Clinical Nurse Leader Certification Practice Test

Clinical Nurse Leader Certification Practice Test

CNL Care Transitions & Discharge Planning