During discharge teaching, a client with a new insulin prescription says, "I cannot afford this medicine, so I will use it only when my glucose feels high." Which action should the nurse take?
1Tell the client to reduce each insulin dose so the supply lasts longer
2Complete discharge and advise the client to call the clinic if symptoms develop
3Pause discharge and coordinate affordable medication options with the care team✓ Correct answer
4Ask a relative to purchase the insulin before reviewing any other alternatives
Explanation
The client has identified a medication-access barrier that makes the discharge plan unsafe. The nurse should coordinate with the prescriber, pharmacist, case manager, or social worker to establish an affordable regimen before the client leaves.
Quick answer Pause discharge and solve the insulin-access barrier with the interprofessional care team before the client leaves.
Why this is correct Insulin is a high-risk medication, and rationing it according to symptoms can cause serious glucose instability. Discharge planning should confirm that the client can obtain and use the prescribed regimen, including cost-sensitive alternatives or assistance resources.
Easy analogy or mental picture A discharge prescription is like a bridge plan; it is unsafe if the client cannot obtain the materials needed to cross. The analogy highlights access, but the prescriber and pharmacist must determine clinically appropriate substitutions.
Memory hook Cannot afford a required medicine means fix access before discharge, not after failure.
NCLEX decision rule When a client reports that cost will prevent adherence, treat the barrier as a current safety problem. Coordinate medication, financial, and follow-up resources before discharge instead of recommending self-adjustment.
Why the other choices are wrong Reducing doses without an order is unsafe. Discharging without a workable plan delays action, and relying on a relative assumes resources while bypassing available clinical and financial options.
References
[1]
NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing
[2]
AHRQ: Help Patients Pay Less for MedicineAgency for Healthcare Research and Quality
[3]
AHRQ PSNet: Discharge Planning and Transitions of CareAgency for Healthcare Research and Quality