A nurse is receiving a telephone prescription for a client from a provider. Which of the following actions should the nurse take when transcribing the prescription?

Use the provider’s initials after the prescription

Repeat the prescription to the provider

Write the prescription in shorthand

Read back the prescription to the provider

Answer and Explanation

The Correct Answer is D

A) Use the provider’s initials after the prescription:
Using the provider's initials after the prescription is not an appropriate or standard practice. The nurse should transcribe the prescription accurately and include the provider's full name or identification, but not initials. The nurse is responsible for ensuring the correct interpretation and transmission of the order, and abbreviations or initials could lead to errors or confusion.

B) Repeat the prescription to the provider:
Repeating the prescription to the provider may not be sufficient. It is important to read the prescription back to the provider to ensure that both the nurse and the provider are in agreement about the medication order. Repeating the prescription is a good practice, but it does not provide the same level of verification as reading it back to ensure its accuracy.

C) Write the prescription in shorthand:
Writing prescriptions in shorthand is unsafe and should be avoided. Shorthand can lead to misunderstandings or misinterpretations of the order, which could result in medication errors. The nurse should transcribe the prescription clearly and in full, without using any abbreviations or shorthand, to ensure clarity and accuracy.

D) Read back the prescription to the provider:
Reading back the prescription to the provider is the correct action. This practice, often referred to as "read-back," helps to confirm that the nurse has accurately heard and understood the provider’s order. It is a safety measure that reduces the likelihood of medication errors, especially in high-risk situations like verbal or telephone orders. The nurse should repeat the prescription verbatim, including dosage, route, frequency, and any other relevant details, to ensure it has been transcribed correctly.

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Correct Answer is ["A","C","D"]

Explanation

A) Increased blood pressure:
Fluid overload results in an increased volume of fluid in the vascular system, leading to higher blood pressure. The excess volume places additional strain on the heart and blood vessels, causing an elevation in systolic and diastolic pressure. The nurse should expect to find elevated blood pressure in a client experiencing fluid overload due to the increased blood volume.

B) Increased hematocrit:
Hematocrit is the proportion of red blood cells in the blood, and it tends to decrease, not increase, during fluid overload. This is because the excess fluid in the bloodstream dilutes the blood, lowering the hematocrit level. Therefore, an increase in hematocrit would not be expected in fluid overload.

C) Increased respiratory rate:
Fluid overload, particularly when it affects the lungs (as seen in conditions like congestive heart failure), can cause respiratory distress. The accumulation of fluid in the lungs impairs gas exchange, leading to hypoxia and the body compensating by increasing the respiratory rate. This response helps increase oxygenation and expel carbon dioxide, so the nurse should expect to see an increased respiratory rate.

D) Increased heart rate:
An elevated heart rate, or tachycardia, is a compensatory response to fluid overload. The heart tries to pump the excess fluid through the circulatory system, which increases the heart's workload. As a result, the heart rate increases in an attempt to maintain adequate cardiac output despite the increased blood volume.

E) Increased temperature:
An elevated body temperature is not typically associated with fluid overload. In fact, fluid overload is more likely to present with normal or slightly lower body temperature, especially if there is no infection or inflammatory process present. If there is an increase in temperature, the nurse should consider other possible causes, such as infection or inflammatory conditions.

A. Chloride 112 B. Calcium 7.5 C. Potassium 4.0 D. Calcium 12.1

Correct Answer is B

Explanation

A) Chloride 112:
Chloride levels are typically not directly associated with numbness or tingling of the hands and fingers. Elevated chloride levels (greater than 108 mEq/L) may indicate metabolic acidosis, but they would not directly explain the symptoms seen in this client following parathyroidectomy. Therefore, this value is unlikely to be relevant in this scenario.

B) Calcium 7.5:
After the partial removal of the parathyroid glands, the client may experience hypocalcemia, or low calcium levels, due to the reduced production of parathyroid hormone (PTH). PTH helps regulate calcium levels in the blood. When the parathyroid glands are removed or damaged, there may be insufficient PTH to maintain normal calcium levels, leading to hypocalcemia. Symptoms of hypocalcemia include numbness and tingling, especially in the hands and fingers. A calcium level of 7.5 mg/dL is below the normal range (8.5–10.5 mg/dL), indicating hypocalcemia, which is consistent with the patient's symptoms.

C) Potassium 4.0:
A potassium level of 4.0 mEq/L is within the normal range (3.5–5.0 mEq/L) and does not typically cause numbness or tingling. Although potassium imbalances can cause neuromuscular symptoms, they would not be the most likely cause of the symptoms in this case, especially in relation to parathyroidectomy.

D) Calcium 12.1:
A calcium level of 12.1 mg/dL is elevated and would suggest hypercalcemia. Hypercalcemia can cause symptoms like fatigue, confusion, and weakness, but it does not typically cause numbness and tingling in the hands and fingers. Elevated calcium levels are more likely to occur in conditions such as hyperparathyroidism or malignancy, not typically following parathyroid gland removal. Therefore, this is not the expected lab result in this scenario.

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A nurse is receiving a telephone prescription for a client from a provider. Which of the following actions should the nurse take when transcribing the prescription?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has fluid overload. Which of the following findings should the nurse expect? (Select all that apply.)

Correct Answer is ["A","C","D"]

Explanation

The nurse is caring for client who has had partial removal the parathyroid gland. The client reports numbness and tingling of the hands and fingers. Which lab value would the nurse expect to see?

Correct Answer is B

Explanation

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