# A client with limited English proficiency needs teaching before a high-risk medication change. Complete the nurse's communication plan.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=547007&lang=en  
> language: en  
> subject: Client Rights  
> category: MOC

## Question

A client with limited English proficiency needs teaching before a high-risk medication change. Complete the nurse's communication plan.

The nurse should first ::선택::arrange a qualified interpreter at no cost to the clientask the adult child to interpret all teachingprovide an English handout and obtain a signaturedelay teaching until the client finds an interpreter, then ::선택::speak only to the interpreterask the family to make all decisionsspeak directly to the client in short segments and pause for interpretationavoid questions that could prolong discharge. Understanding is best checked by ::선택::asking whether the client understandsasking the client to explain the plan in the client's own words through the interpreterasking the child whether the client noddedreviewing only the signed form, and the nurse should ::선택::document only that a handout was givenavoid recording interpreter userecord that the family accepted responsibilitydocument interpreter mode or identifier, key questions, and demonstrated understanding.

## Explanation

Meaningful access and client autonomy require understandable communication. For high-risk medication teaching, the nurse should offer a qualified interpreter at no cost rather than relying on an accompanying family member. The nurse continues to speak directly to the client in short segments, pauses for interpretation, and asks the client to explain the plan in the client's own words through the interpreter. Documentation should identify the interpreter mode or identifier, key questions, and the client's demonstrated understanding. A signature or family assurance alone does not verify comprehension.

## In-depth explanation

Correct Answer
Use a qualified interpreter, communicate directly with the client, verify understanding through teach-back, and document the process.

Why It Fits
The content is complex and high risk, and the client's hesitation makes family interpretation especially unsuitable as the default plan.

Clinical Picture
The interpreter facilitates communication; the therapeutic relationship and clinical responsibility remain between nurse and client.

Memory Link
Interpreter for access, direct speech for respect, teach-back for understanding.

NCLEX Rule
People with limited English proficiency must receive meaningful access to health information through competent language assistance without shifting the burden to family.

Why the Alternatives Fail
Speaking only to the family, accepting a nod, or collecting a signature does not establish an informed understanding of the medication plan.

Sources
1HHS Limited English Proficiency and Effective Communication
2AHRQ Teach-Back Method
3NCSBN 2026 NCLEX-RN Test Plan

## Clinical scenario

Discharge teaching
The alert client speaks little English. An adult child offers to interpret, but the client appears hesitant and the teaching includes dose changes, bleeding precautions, and when to seek emergency care. A qualified video interpreter is available through the hospital.

## Key concepts

- **Qualified interpreter** — An interpreter who can accurately and impartially communicate specialized health information with appropriate language proficiency.
- **Teach-back** — A method that asks the client to explain information in the client's own words so the clinician can assess and clarify communication.
- **Meaningful access** — Effective opportunity for a person with limited English proficiency to understand and participate in services.

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