Continuity of care NCLEX-RN Practice Questions

Continuity of care NCLEX-RN Practice Questions help you master safe transitions, coordinated interventions, and effective handoffs across settings—core competencies within the Management of Care domain. This topic-wise question blog focuses on practical, exam-level scenarios that highlight discharge planning, care coordination, interprofessional collaboration, case management, medication reconciliation, home health referrals, and use of standardized communication tools like SBAR. You’ll encounter decisions around patient education, follow-up appointments, resource linkage, community services, and protection of patient privacy during transitions. Designed to be simple yet rigorous, these questions sharpen clinical judgment and prioritization for real-world nursing practice and NCLEX success. Use them to assess readiness and reinforce the processes that keep patients safe beyond the bedside.

Q1. A nurse prepares to give an SBAR handoff to a receiving unit. Which information is most critical to include to support continuity of care?

• Patient’s full lunch order and food preferences
• Pending lab tests and critical results requiring follow-up
• Names of all visiting family members
• Exact number of visitors allowed per policy

Correct Answer: Pending lab tests and critical results requiring follow-up

Q2. During discharge, which action best supports safe medication continuity for a patient with multiple chronic conditions?

• Providing the pharmacy’s brochure about generic medications
• Conducting medication reconciliation with the patient’s home medication list
• Scheduling a dietitian consult in two months
• Recommending over-the-counter supplements for energy

Correct Answer: Conducting medication reconciliation with the patient’s home medication list

Q3. When should discharge planning begin to optimize continuity of care?

• At the time of initial admission assessment
• On the day before anticipated discharge
• After the primary provider writes discharge orders
• Only when family requests resources

Correct Answer: At the time of initial admission assessment

Q4. A patient with new-onset heart failure is being discharged. Which referral most directly supports continuity and reduces readmission risk?

• Referral to a cosmetic specialist for skin concerns
• Referral to home health nursing for daily weight monitoring and medication education
• Referral to a vocational counselor
• Referral to a podiatrist for routine nail care

Correct Answer: Referral to home health nursing for daily weight monitoring and medication education

Q5. The nurse prepares discharge teaching for a patient with limited English proficiency. Which approach best ensures continuity of care?

• Using a trained medical interpreter for teaching with teach-back
• Relying on the patient’s bilingual neighbor for translation
• Speaking slowly and louder in English
• Providing written instructions in English only

Correct Answer: Using a trained medical interpreter for teaching with teach-back

Q6. Which documentation should be prioritized for transfer from the hospital to a skilled nursing facility to maintain continuity?

• The patient’s social media account information
• A complete medication administration record and current treatment plan
• Only the last set of vital signs
• Visitor logs from hospitalization

Correct Answer: A complete medication administration record and current treatment plan

Q7. A nurse identifies that a patient cannot afford prescribed medications after discharge. What is the most appropriate action?

• Suggest the patient skip doses on weekends
• Notify the provider and consult a social worker for financial assistance resources
• Advise the patient to borrow medications
• Tell the patient to wait until the next paycheck

Correct Answer: Notify the provider and consult a social worker for financial assistance resources

Q8. A patient with COPD is discharged after an exacerbation. Which action best supports continuity and reduces readmission risk?

• Encouraging the patient to return if symptoms worsen
• Scheduling a follow-up with the primary care provider within 48–72 hours
• Providing a brochure on COPD without discussion
• Referring to a gym membership without clinical follow-up

Correct Answer: Scheduling a follow-up with the primary care provider within 48–72 hours

Q9. Which action by the nurse most effectively verifies patient understanding of complex discharge instructions?

• Asking, “Do you understand?” before leaving the room
• Using the teach-back method for key steps the patient must perform at home
• Having the family sign the discharge paperwork
• Providing extra handouts for the patient

Correct Answer: Using the teach-back method for key steps the patient must perform at home

Q10. A patient with a new wound VAC requires home therapy. Which nursing action best ensures continuity?

• Instructing the patient to buy supplies from any local store
• Coordinating with case management and DME vendor for equipment delivery and home health setup
• Asking the patient to watch an online video after discharge
• Deferring all setup until the first outpatient visit

Correct Answer: Coordinating with case management and DME vendor for equipment delivery and home health setup

Q11. During bedside shift handoff, which practice best improves continuity and patient safety?

• Discussing patient care only at the nurses’ station
• Conducting handoff at the bedside with the patient, using the medication list and plan for the next shift
• Recording a voice note and emailing it
• Sharing minimal information to protect privacy

Correct Answer: Conducting handoff at the bedside with the patient, using the medication list and plan for the next shift

Q12. A patient requires insulin instruction before discharge. Which delegation is appropriate to support continuity?

• Delegate insulin injection teaching to an unlicensed assistive personnel (UAP)
• RN performs insulin education and evaluates technique using teach-back
• Ask a family member to teach the patient
• Leave pamphlets at bedside for self-teaching

Correct Answer: RN performs insulin education and evaluates technique using teach-back

Q13. Which best describes the case manager’s role in continuity of care?

• Providing direct wound care during hospitalization
• Coordinating services, insurance coverage, and transitions across settings
• Prescribing medications for discharge
• Performing physical therapy evaluations

Correct Answer: Coordinating services, insurance coverage, and transitions across settings

Q14. A patient with metastatic cancer seeks symptom relief and wants to continue disease-directed therapy. Which referral supports continuity?

• Hospice services only
• Palliative care consult for symptom management alongside ongoing treatment
• Immediate discontinuation of all current treatments
• Referral to dermatology

Correct Answer: Palliative care consult for symptom management alongside ongoing treatment

Q15. A patient’s DNR status needs verification during transfer to a rehab facility. What should the nurse do?

• Rely on verbal report from previous nurse
• Include a copy of the signed DNR order in the transfer packet and document status in handoff
• Wait for the receiving facility to determine status
• Ask the family to verbally confirm

Correct Answer: Include a copy of the signed DNR order in the transfer packet and document status in handoff

Q16. A patient on warfarin is transitioning from heparin. Which nursing action ensures safe continuity of anticoagulation?

• Stop both heparin and warfarin at discharge
• Verify therapeutic INR and clarify bridging plan with provider; communicate in discharge summary
• Advise the patient to adjust doses based on how they feel
• Discontinue INR monitoring after discharge

Correct Answer: Verify therapeutic INR and clarify bridging plan with provider; communicate in discharge summary

Q17. The nurse is transferring a patient with MRSA to a long-term care facility. What information is essential to include?

• Preferred television channels
• Contact precautions status and current antibiotic regimen
• Names of friends who will visit
• Parking details for the family

Correct Answer: Contact precautions status and current antibiotic regimen

Q18. Which action upholds HIPAA while promoting continuity during interfacility transfer?

• Sending records through unsecured personal email
• Using a secure, encrypted transmission channel for the medical summary
• Handing records to a friend to deliver
• Posting discharge details in a public charting area

Correct Answer: Using a secure, encrypted transmission channel for the medical summary

Q19. A patient with diabetes and low health literacy is being discharged. Which instruction supports continuity?

• Provide detailed pathophysiology without visuals
• Use plain language, visuals, and demonstrate glucometer use with teach-back
• Encourage internet research independently
• Use only medical terminology to maintain precision

Correct Answer: Use plain language, visuals, and demonstrate glucometer use with teach-back

Q20. During an ED-to-inpatient transfer, which SBAR element is most critical to prevent missed care?

• Number of pillows used in ED
• Pending diagnostics and time-sensitive therapies initiated
• Visitor names and times
• Parking validation details

Correct Answer: Pending diagnostics and time-sensitive therapies initiated

Q21. A patient with stroke requires PT/OT after discharge. What should the nurse do to best support continuity?

• Tell the patient to call clinics after going home
• Place referrals, schedule initial appointments, and provide written therapy plan
• Suggest watching exercise videos online
• Delay referrals until the first PCP visit in 6 weeks

Correct Answer: Place referrals, schedule initial appointments, and provide written therapy plan

Q22. A patient’s discharge prescription list omits their long-standing beta-blocker. Which action supports safe continuity?

• Discharge as planned and let outpatient provider correct later
• Clarify with the prescribing provider immediately and update the reconciled list
• Tell the patient to restart at home if desired
• Discard the home medication

Correct Answer: Clarify with the prescribing provider immediately and update the reconciled list

Q23. Which patient is the best candidate for telehealth follow-up to support continuity of care?

• Patient with stable hypertension and reliable internet access
• Patient requiring daily complex wound dressing changes
• Patient needing in-person infusion therapy
• Patient with no phone or internet access

Correct Answer: Patient with stable hypertension and reliable internet access

Q24. A nurse notes a patient uses St. John’s wort and is discharged on sertraline. What should the nurse do to ensure continuity?

• Ignore, as herbs are harmless
• Notify the provider about potential interaction and include herbals in the reconciled medication list
• Tell the patient to take both to enhance effect
• Advise the patient to keep herb use private

Correct Answer: Notify the provider about potential interaction and include herbals in the reconciled medication list

Q25. For a patient with frequent falls at home, which discharge plan component best supports continuity and safety?

• General advice to be careful
• Home health and OT referral for home safety assessment and equipment recommendations
• Scheduling only a diet consult
• Asking a neighbor to check periodically without formal plan

Correct Answer: Home health and OT referral for home safety assessment and equipment recommendations

Q26. A patient nearing discharge needs transportation to follow-up appointments but lacks resources. What is the nurse’s best action?

• Instruct the patient to walk to the clinic
• Consult social services to arrange community transportation resources
• Tell the patient to reschedule until they have funds
• Advise calling a taxi and paying later

Correct Answer: Consult social services to arrange community transportation resources

Q27. Which statement best ensures continuity when educating a heart failure patient on daily weights?

• “Weigh yourself randomly each day.”
• “Weigh every morning after urinating, before eating, in the same clothes, and call if you gain 2–3 lb in a day or 5 lb in a week.”
• “Only weigh weekly.”
• “Weigh only if you feel swollen.”

Correct Answer: “Weigh every morning after urinating, before eating, in the same clothes, and call if you gain 2–3 lb in a day or 5 lb in a week.”

Q28. During interprofessional rounds, which contribution by the nurse most strongly promotes continuity?

• Remaining silent to avoid disagreement
• Sharing barriers to discharge identified from patient interview and proposing resources
• Deferring all decisions to the physician
• Focusing only on shift-specific tasks

Correct Answer: Sharing barriers to discharge identified from patient interview and proposing resources

Q29. A patient with advanced COPD wishes to avoid intubation but wants noninvasive support. Which action ensures continuity with preferences?

• Document preferences verbally only
• Ensure advance directives and code status are documented, communicated, and included in transfer paperwork
• Tell night shift verbally without documentation
• Delay discussions until the next admission

Correct Answer: Ensure advance directives and code status are documented, communicated, and included in transfer paperwork

Q30. A nurse notes that crucial culture results will return after the patient’s discharge today. What is the best action to maintain continuity?

• Do nothing; outpatient team will see results
• Establish a follow-up plan: verify contact information, notify provider, and communicate result-following responsibility in discharge summary
• Tell the patient to call the lab daily
• Cancel discharge until results are available

Correct Answer: Establish a follow-up plan: verify contact information, notify provider, and communicate result-following responsibility in discharge summary

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