# Stage 5 — Take action. Which discharge-preparation actions should the nurse begin during inpatient stabilization? Select all that apply.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=568694&lang=en  
> language: en  
> subject: Health Promotion and Maintenance  
> category: HPM

## Question

Stage 5 — Take action. Which discharge-preparation actions should the nurse begin during inpatient stabilization? Select all that apply.

1

Develop a collaborative written safety plan with warning signs, coping steps, and crisis contacts

2

Involve a support person chosen by the client in reducing access to medications and other lethal means

3

Arrange timely behavioral-health follow-up and communicate a clear handoff plan

4

Rehearse when and how to use crisis services if suicidal thoughts return

5

Use a signed no-suicide promise as the primary evidence that discharge is safe

6

Require the client to deny every suicidal thought before discussing any follow-up plan

## Explanation

Discharge preparation includes collaborative safety planning, lethal-means risk reduction, timely follow-up, clear handoff, and crisis-resource rehearsal. A promise or forced denial does not replace evidence-based assessment and documented mitigation.

## In-depth explanation

Quick answer
Build and rehearse a real safety and follow-up plan; do not substitute a promise or forced denial for risk assessment.

Why this is correct
Risk can continue after discharge. A usable plan links warning signs to coping actions, chosen supports, restricted lethal means, professional contacts, and crisis services.

Easy analogy or mental picture
A safety plan is an emergency route with named exits and people, not a sentence promising that no emergency will occur.

Memory hook
Plan, people, means, handoff, crisis route.

NCLEX decision rule
Start continuity planning before discharge, but release depends on repeated assessment and effective mitigation rather than a contract or one denial.

Why the other choices are wrong
No-suicide contracts do not control access or create follow-up, and demanding total denial can suppress honest reporting and delay collaborative planning.

References
1Joint Commission National Patient Safety Goal 15.01.01Validated screening, direct risk assessment, observation, environmental safety, reassessment, and discharge follow-up

## Clinical scenario

Case update
The client is still hospitalized. The nurse begins a discharge plan that can be completed only if repeated assessment supports a lower, manageable level of risk.

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