A client with new mobility and medication needs is preparing to return home. Complete the collaborative discharge plan.
Drop-down Cloze
Choose your responses, then check the answer.
Explanation
Safe discharge is a coordinated process rather than a collection of separate referrals. The nurse should include the client and chosen support person as partners, convene the appropriate disciplines, reconcile medications, evaluate the home and mobility barriers, and confirm services, equipment, transportation, and follow-up ownership. Teaching should cover home function, medications, warning signs, results, and appointments in plain language with teach-back. The plan is not ready until responsibilities and contingencies are closed loop and the client can explain what to do.
Correct Answer The nurse should coordinate a shared, client-centered discharge plan with explicit ownership and verification.
Why It Fits Mobility, medication, home access, education, and transportation risks cross several disciplines and remain unresolved.
Clinical Picture Care coordination bridges information and responsibility gaps during transitions and includes the patient and family as partners.
Memory Link A referral is not a plan until the service, owner, timing, and patient understanding are confirmed.
NCLEX Rule Align the team around the client's goals, assign responsibilities, reconcile information, and verify both service availability and teach-back before discharge.
Why the Alternatives Fail Handing the client several phone numbers, assuming another discipline completed the work, or delaying education until departure leaves critical gaps.
Sources
1AHRQ IDEAL Discharge Planning
2AHRQ Care Coordination Measures Atlas
3NCSBN 2026 NCLEX-RN Test Plan
Discharge planning conferenceAn older adult recovering from a stroke lives alone in a second-floor apartment without an elevator. The client now uses a walker, has a new anticoagulant prescription, cannot name bleeding warning signs, and has no confirmed transportation for follow-up. Several disciplines entered separate notes, but no shared plan or accountable follow-up owner is documented.
Care coordination — Team-based organization of information, services, and responsibility to meet a client's needs across settings.
Teach-back — Asking a client to explain instructions in their own words to verify that teaching was effective.
Closed-loop ownership — Explicit confirmation of who will complete a task, by when, and how completion or failure will be communicated.