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.

Answer and Explanation

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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Correct Answer is A

Explanation

Choice A reason: Hearing loss is a known gentamicin ototoxicity effect, damaging cochlear hair cells irreversibly. Scientifically, this aminoglycoside targets the inner ear, causing tinnitus or deafness, a critical adverse reaction to monitor in pyelonephritis treatment per pharmacology evidence.

Choice B reason: Slurred speech suggests neurological issues (e.g., stroke), not gentamicin effects. Scientifically, this drug affects kidneys and ears, not speech centers, making this unrelated to its toxicity profile, which focuses on auditory and renal damage.

Choice C reason: Constipation isn’t linked to gentamicin; it’s more typical of opioids or immobility. Scientifically, this antibiotic’s side effects center on nephrotoxicity and ototoxicity, not gastrointestinal motility, rendering this an unlikely adverse reaction in this context.

Choice D reason: Hypotension may occur with rapid IV gentamicin, but it’s less common than ototoxicity. Scientifically, hearing loss is a hallmark toxicity, outweighing transient blood pressure drops, which are manageable and less specific to this drug’s adverse profile.

A. "Swallow the tablet whole to minimize your headaches." B. "You can discontinue the medication until the headache goes away." C. "You should take the medication on an empty stomach to prevent a headache." D. "The headaches should decrease as you get used to the medication."

Correct Answer is D

Explanation

Choice A reason: Swallowing isn’t an option for chewable isosorbide; it’s designed for sublingual absorption. This advice is incorrect and won’t address vasodilatory headache effects.

Choice B reason: Discontinuing isosorbide risks angina exacerbation in cardiac patients. Headaches are tolerable side effects, so stopping isn’t advised without provider input.

Choice C reason: Empty stomach intake doesn’t reduce isosorbide’s vasodilatory headaches. Timing doesn’t alter its nitrate-induced vessel dilation, making this ineffective advice.

Choice D reason: Headaches from isosorbide’s vasodilation typically subside with tolerance over time. This reassures the client, aligning with expected nitrate therapy adaptation.

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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)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who has pyelonephritis and is receiving gentamicin via IV infusion. Which of the following manifestations should the nurse identify as an adverse effect of the treatment?

Correct Answer is A

Explanation

A nurse is caring for a client who reports he has headaches after taking chewable isosorbide dinitrate. Which of the following statements should the nurse make?

Correct Answer is D

Explanation

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