# The nurse reviews the discharge-planning note. Which findings require follow-up before the client leaves the hospital? Highlight the unresolved transition-of-care risks.

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> subject: Assignment/Delegation/Supervision  
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## Question

The nurse reviews the discharge-planning note. Which findings require follow-up before the client leaves the hospital? Highlight the unresolved transition-of-care risks.

Nurses' Notes
1340:
The client is preparing for discharge after treatment of a pulmonary embolism and a tibial fracture. The orthopedic follow-up visit is scheduled for six days after discharge. The client lives in a third-floor walk-up and must remain non-weight-bearing. A neighbor has agreed to drive the client to scheduled appointments. The client will need oxygen during activity. The oxygen supplier has not received a complete equipment order. The client correctly demonstrates cleansing the healing incision with the prescribed supplies. The medication list includes a newly prescribed oral anticoagulant. The client cannot afford the first anticoagulant prescription because of the copayment. The client points to the clinic number to call for new chest pain, shortness of breath, or bleeding. Physical therapy has reviewed transfer technique. During teach-back, the client plans to use a relative's leftover anticoagulant temporarily. The client identifies two friends who can bring groceries during the first week. The client requests written instructions in large print, and the preference is documented. The client accurately explains that both legs should be checked daily for skin injury. The nurse pauses the discharge process and contacts case management, pharmacy, respiratory therapy, and the prescriber.

## Explanation

Mobility access, missing oxygen delivery, inability to obtain a prescribed anticoagulant, and unsafe medication understanding can make discharge hazardous. Resolve these barriers with the client and interdisciplinary team before departure.

## In-depth explanation

Quick answer
Follow up on the inaccessible third-floor apartment, oxygen equipment that has not been arranged, inability to pay for the anticoagulant, and teach-back showing that the client plans to use another person's medication.

Why this is correct
A safe transition requires a workable home plan, needed equipment, access to prescribed medication, and understanding of what to take. AHRQ discharge guidance emphasizes medication review, warning signs, follow-up, and planning for life at home.[2]

Easy analogy or mental picture
Picture discharge as a bridge. Home access, equipment, medication, and understanding keep it stable. Handing over paperwork does not repair a missing support; the team must close the gap with the client.

Memory hook
Can the client get in, get equipment, get medicine, and explain the plan?

NCLEX decision rule
Do not confuse a written discharge order with readiness to leave. Identify barriers early, involve the appropriate discipline, use plain-language teach-back, and confirm that critical services are actually available.

Why the other choices are wrong
A scheduled follow-up, available transportation, correct wound-care demonstration, a reachable clinic number, and a documented preference are supportive findings. They should remain in the plan but do not show an unresolved discharge hazard.References

- [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing

- [2]AHRQ: IDEAL Discharge PlanningAgency for Healthcare Research and Quality

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