# An older adult is preparing for discharge after an insulin-regimen change. The discharge summary lists glargine 12 units nightly, the pharmacy label lists 20 units nightly, and the client reports using 18 units before admission. Complete the continuity-of-care statement. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=568916&lang=en > language: en > subject: Continuity of Care > category: MOC ## Question An older adult is preparing for discharge after an insulin-regimen change. The discharge summary lists glargine 12 units nightly, the pharmacy label lists 20 units nightly, and the client reports using 18 units before admission. Complete the continuity-of-care statement. The nurse should identify ::선택::an expected difference that can wait until the next clinic visita medication discrepancy that requires reconciliationproof that the pharmacy label is always the correct sourceevidence that the client should resume the preadmission dose, then ::선택::select the lowest dose to reduce riskteach all three doses and let the client choosediscard the discharge summary and follow the pharmacy labelcontact the responsible prescriber and pharmacist to resolve the intended regimen before discharge, and finally ::선택::provide one reconciled list, use teach-back, and confirm follow-up and problem-reporting instructionsask the family to compare the documents after the client returns homedocument the discrepancy without changing the discharge processtell the client to skip glargine until the next routine appointment. ## Explanation Medication reconciliation compares the regimen the client was taking with the current discharge orders so discrepancies can be identified and resolved. The nurse should not choose a dose independently or teach from conflicting records. The intended regimen should be clarified with the responsible prescriber and pharmacist, updated in one accurate medication list, reviewed with the client using teach-back, and connected to a follow-up and problem-reporting plan. ## In-depth explanation Correct Answer Recognize a medication discrepancy, resolve it with the prescriber and pharmacist before discharge, and provide one reconciled list with teach-back and follow-up. Why It Fits Conflicting transition documents can produce duplicate, omitted, or incorrect doses after discharge. Clinical Picture The client is stable, so the priority is preventing a foreseeable transition error rather than selecting one of the three doses from incomplete information. Memory Link Compare, clarify, consolidate: find the mismatch, resolve it, then send one accurate plan forward. NCLEX Rule At a transition, do not teach or hand off an unresolved medication discrepancy. Why the Alternatives Fail Choosing the smallest or most recent dose without clarification exceeds the available evidence. Giving multiple lists transfers the error to the client. Delaying review until the next visit leaves the client exposed at home. Source 1AHRQ MATCH Medication Reconciliation Toolkit 2AHRQ Resources for Discharge and Transitions of Care 32026 NCLEX-RN Test Plan ## Clinical scenario The client is stable and has no current hypoglycemia. The inconsistent doses create a transition risk that must be resolved before the client receives final medication instructions or leaves with conflicting documents. ## Key concepts - **Medication Reconciliation** — A structured comparison of current medications with new orders to identify and resolve discrepancies at transitions. - **Discrepancy** — An unexplained difference between medication histories, orders, labels, or instructions. - **One Source of Truth** — A single current medication list used consistently across the care team and discharge documents. ## Related questions - [A nurse is transferring an older adult from a hospital to a long-term care facility. 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