During discharge teaching, a client with a new insulin presc… | MyMerci
Client Rights MOC
Question

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?

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.
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In-depth explanation

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
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