A nurse is receiving a telephone prescription from a client’s provider. Which of the following actions should the nurse take? (Select all that apply)
Instruct another nurse to record the prescription in the medical record.
Ask the provider to spell out the name of the medication.
Withhold the medication until the provider signs the prescription.
Record the date and time of the telephone prescription.
Request that the provider confirm the read-back of the prescription.
Correct Answer : B,D,E
Choice A reason: Instructing another nurse to record risks errors; the receiving nurse must document directly for accuracy. Scientifically, this violates chain-of-command and transcription protocols, as firsthand recording ensures fidelity to the provider’s intent, reducing miscommunication in medication orders.
Choice B reason: Asking for spelling clarifies the medication, preventing errors like sound-alikes (e.g., Celexa vs. Celebrex). Scientifically, this aligns with safety standards, as precise identification ensures correct drug administration, critical in telephone orders where auditory mistakes are common.
Choice C reason: Withholding until signed delays care; telephone orders allow immediate action with later signature (e.g., 24-48 hours). Scientifically, this contradicts urgent care needs, as timely treatment outweighs procedural lag, provided documentation and verification are complete.
Choice D reason: Recording date and time establishes a legal timeline, ensuring accountability and sequence of care. Scientifically, this is mandatory in telephone orders, supporting traceability and adherence to protocols, critical for auditing and patient safety in medication administration.
Choice E reason: Read-back confirmation verifies accuracy, reducing errors in verbal orders. Scientifically, this is evidence-based, as it ensures the provider’s intent matches the nurse’s record, safeguarding against misheard doses or drugs, a key step in safe prescribing practices.
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Related Questions
Correct Answer is C
Explanation
Choice A reason: A chaplain offers spiritual support, but it’s not the nurse’s primary role. Autonomy in end-stage kidney disease takes precedence over initiating such visits.
Choice B reason: Alternatives don’t apply post-decision in end-stage disease; dialysis cessation reflects prognosis acceptance. Discussing them now dismisses the client’s informed choice.
Choice C reason: Supporting the decision respects autonomy in end-stage kidney disease. It aligns with palliative care, honoring the client’s right to refuse treatment.
Choice D reason: Suggesting family discussion undermines autonomy, adding pressure. In terminal illness, the client’s choice to stop dialysis should be respected directly.
Correct Answer is C
Explanation
Choice A reason: Erythromycin is specified, so the medication is clear. No ambiguity exists here for clarification. Scientifically, drug identity is explicit, and errors arise elsewhere, making this unnecessary to question unless a different antibiotic was intended, which isn’t suggested.
Choice B reason: Dosage (500 mg) is precise, with no range or units needing clarification. Scientifically, this is a standard erythromycin dose, aligning with therapeutic norms for infections, leaving little room for error unless misheard, which isn’t indicated.
Choice C reason: Route (e.g., oral, IV) isn’t stated, critical for erythromycin, as administration affects bioavailability and efficacy. Scientifically, unclear delivery risks under- or overdosing, necessitating provider clarification to ensure safe, effective treatment per pharmacological standards.
Choice D reason: Time (four times daily) is clear, aligning with erythromycin’s pharmacokinetics for steady levels. Scientifically, frequency is unambiguous, requiring no clarification unless intervals were vague, which they aren’t, making this less urgent than route.
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