Discharge

On the NCLEX, discharge items hide a safety gate: the right answer is rarely “give the printed instructions” and instead the step that confirms understanding. Use teach-back—have the client restate or demonstrate, not just nod—and verify a safe environment, transport, and caregiver support before release. Watch the trap that a client may refuse or leave AMA; a competent adult with capacity can do so, so you document the refusal, the risks explained, and the symptoms warranting return—and you still provide written instructions, never withholding them as leverage. Reconcile medications, a leading post-discharge error source.

Distinguish discharge from its siblings. An outcome is the measurable, SMART endpoint you evaluate (Specific, Measurable, Achievable, Relevant—older banks say Realistic—Time-bound); discharge readiness is one criterion, not the outcome itself. Documentation is the legal proof teaching occurred—if it isn’t charted with the client’s response, it legally didn’t happen. Memory hook: teach-back beats hand-back.