# A nurse is transferring an older adult from a hospital to a long-term care facility. For each handoff element or action, select the best classification.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=393407&lang=en  
> language: en  
> subject: Continuity of Care  
> category: MOC

## Question

A nurse is transferring an older adult from a hospital to a long-term care facility. For each handoff element or action, select the best classification.

|  | Essential handoff content | Closed-loop transfer action | Unsafe handoff practice |
| --- | --- | --- | --- |
| Report the client's current condition, illness severity, recent changes, and relevant baseline |  |  |  |
| Include medication changes, last clinically relevant doses, allergies, fall precautions, and communication needs |  |  |  |
| Name the pending culture, the expected review time, and the clinician responsible for follow-up |  |  |  |
| Invite questions and ask the receiving nurse to synthesize the critical action list and contingencies |  |  |  |
| Transport the client while both teams assume the other team will follow the pending culture |  |  |  |
| Give only the diagnosis and destination because the electronic record will eventually become available |  |  |  |

## Explanation

A safe handoff transfers current information together with responsibility and accountability. Essential content includes illness severity, a concise patient summary, medication and allergy information, recent changes, action items, pending results with named ownership, safety and communication needs, and contingency plans. Closed-loop transfer gives the receiver an opportunity to ask questions, clarify priorities, and synthesize or repeat critical actions. Sending a client before responsibility and pending-work ownership are clear, or relying on a room number and diagnosis alone, creates an unsafe gap in continuity.

## In-depth explanation

Correct Answer
Include current condition, recent changes, medications and allergies, pending results with ownership, safety needs, and contingency plans. Use questions and receiver synthesis to confirm the transfer. Revise any handoff that leaves responsibility unclear or substitutes a minimal label for the clinical picture.

Why It Fits
A handoff is more than sending information. It transfers accountability and responsibility and requires confirmation that the receiving clinician has the information and can act on it.

Clinical Picture
The pending culture needs a named follow-up owner. The medication change, fall plan, and interpreter preference affect immediate care. These details must arrive with the client and be understood by the receiving team.

Memory Link
Status, actions, ownership, contingency, confirmation.

NCLEX Rule
During transitions, choose the option that closes the communication loop and assigns unfinished work to a specific responsible clinician.

Why the Alternatives Fail
A diagnosis and destination do not communicate severity, changes, or next actions. Leaving pending results unowned invites missed follow-up. One-way transmission without questions or synthesis does not confirm that responsibility was safely received.

Source
1AHRQ TeamSTEPPS Communication Module
2AHRQ TeamSTEPPS Tools
32026 NCLEX-RN Test Plan

## Clinical scenario

The client has a recent medication change, a pending culture, a fall-risk plan, and a family preference for an interpreter during teaching. The sending nurse remains accountable until the receiving clinician accepts the transfer of responsibility.

## Key concepts

- **Continuity of Care** — Coordinated care across clinicians, units, and settings so that current needs, planned actions, and responsibility are not lost during a transition.
- **Handoff Communication** — A structured transfer of information, authority, responsibility, and accountability that includes an opportunity for the receiver to ask questions, clarify, and confirm understanding.
- **Medication Reconciliation** — The systematic comparison and clarification of a client's medication information during transitions to identify discrepancies and communicate the intended regimen to the next care team.

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