# A client is preparing for discharge after several medication changes. The verified preadmission list, inpatient MAR, and draft discharge prescriptions contain an unexplained omission and a possible duplicate therapy. Which medication-reconciliation actions are appropriate? Select all that apply.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=513812&lang=en  
> language: en  
> subject: Medication Administration  
> category: PPT

## Question

A client is preparing for discharge after several medication changes. The verified preadmission list, inpatient MAR, and draft discharge prescriptions contain an unexplained omission and a possible duplicate therapy. Which medication-reconciliation actions are appropriate? Select all that apply.

1Compare the verified preadmission list with the final discharge medication list.
2Discuss unexplained omissions, additions, and duplicates with the prescriber for resolution.
3Delete uncertain medications so the discharge list is shorter.
4Document resolved discrepancies and give the client an updated medication list.
5Ask the client to choose which medication to take when duplicate therapies remain listed.
6Use teach-back to verify that the client understands the final regimen.
7Carry every admission medication entry forward unchanged and defer all discrepancy resolution to the first outpatient visit.
8Resolve a dose discrepancy by selecting the entry with the newest timestamp without confirming what the client actually used.

## Explanation

Safe reconciliation compares sources, resolves unexplained differences through the authorized team, documents the outcome, communicates the final list, and verifies understanding.

## In-depth explanation

Quick answer
Select comparison, authorized discrepancy resolution, documentation with an updated list, and teach-back.

Why this is correct
AHRQ describes medication reconciliation as obtaining and verifying an accurate history, comparing it with transition orders, resolving unintended discrepancies, and communicating the updated list. Teach-back checks whether the final plan was understood.

Easy analogy or mental picture
Reconciliation is a chain of custody: identify the list, compare it, resolve differences, document the final version, and hand it over with confirmation.

Memory hook
Compare, resolve, document, communicate, confirm.

NCLEX decision rule
Do not close a transition with unexplained differences. The nurse coordinates resolution but does not independently delete prescriptions or ask the client to choose between unresolved therapies.

Why the other choices are wrong
Deleting uncertain medications can omit necessary therapy. Asking the client to select between duplicate entries transfers a clinical decision to the client and preserves the hazard.References
1AHRQ MATCH ToolkitMedication reconciliation at transitions of care

## Clinical scenario

Discharge medication reconciliation
Use one verified source, resolve every unexplained difference through the authorized team, document the final regimen, and confirm client understanding.

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