# Place the medication-reconciliation actions in order for a client transitioning from the hospital to home.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=395471&lang=en  
> language: en  
> subject: Continuity of Care  
> category: MOC

## Question

Place the medication-reconciliation actions in order for a client transitioning from the hospital to home.

Communicate the final list and any unresolved follow-up to the next care team and document completion of reconciliation.

Clarify each unintended discrepancy, duplication, omission, or interaction with the prescriber and pharmacist.

Compare the verified home list with the current inpatient regimen and the proposed discharge prescriptions.

Build the best possible home-medication history using the client or caregiver, medication containers, records, and pharmacy information when available.

Update one accurate discharge list and verify the client or caregiver understands what to start, continue, change, and stop.

## Explanation

First obtain the most accurate medication history possible. Compare it with current and proposed orders, resolve discrepancies with the prescriber and pharmacist, create and teach one final list, and communicate it across the transition with documented follow-up.

## In-depth explanation

Correct sequence
Collect → compare → clarify → update and teach → communicate.

Why this is correct
A medication list cannot be reconciled until the nurse has a credible history from more than one source when possible. Comparison reveals discrepancies; clinical clarification determines which are intentional. The client then receives one actionable list, and the receiving team gets the same information.

NCLEX decision rule
Medication reconciliation is not copying the chart. It is a closed-loop process that identifies, resolves, teaches, and communicates medication changes.Reference
1AHRQ MATCH medication-reconciliation toolkit

## Clinical scenario

Transition-of-care medication safety
The client uses prescriptions from two clinicians, over-the-counter products, and a supplement. The preliminary discharge list differs from the medications the client reports taking at home.

## Key concepts

- **Medication Reconciliation** — A structured comparison of medication histories and orders to identify and resolve discrepancies at care transitions.
- **Transition of Care** — Movement between settings or clinicians when accurate clinical information must follow the client.
- **Sterile Technique** — Practices used to prevent contamination of sterile equipment or tissue.

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