A nurse receives a new prescription over the telephone from a client's provider. Which of the following actions should the nurse take first?
Write down the complete prescription.
Read back the prescription to the provider.
Document the prescription as a telephone prescription in the medical record.
Ensure that the provider signs the prescription.
The Correct Answer is A
When receiving a new prescription over the telephone from a client’s provider, the nurse should first write down the complete prescription to ensure that all the details are accurately recorded.
Choice B is wrong because reading back the prescription to the provider should be done after writing down the complete prescription.
Choice C is wrong because documenting the prescription as a telephone prescription in the medical record should be done after writing down the complete prescription and reading it back to the provider.
Choice D is wrong because ensuring that the provider signs the prescription should be done after writing down the complete prescription, reading it back to the provider, and documenting it in the medical record.
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Correct Answer is D
Explanation
The nurse should place the extremity in a dependent position before inserting an IV catheter.
This helps to dilate the veins and make them more visible and easier to access.
Choice A is wrong because the nurse should choose a site that is distal to the most proximal site on the extremity selected.
This helps to preserve more proximal sites for future use if needed.
Choice B is wrong because applying a cool compress before insertion of an IV catheter can cause vasoconstriction and make it more difficult to access the vein.
Instead, a warm compress can be applied to help dilate the veins.
Choice C is wrong because the tourniquet should be placed above, not below, the proposed insertion site to help dilate the vein and make it easier to access.
Correct Answer is C
Explanation
When caring for a client who has wrist restraints after an episode of violent behavior, the nurse should remove one restraint at a time.
This allows the nurse to assess the client’s behavior and response to having one arm free while still maintaining some level of control and safety.
Choice A is wrong because tying the restraints to the side rail can be dangerous as it can cause injury to the client if they move suddenly.
Choice B is wrong because removing the restraints every 3 hours is not a specific guideline and may vary depending on the facility’s policy and the client’s condition.
Choice D is wrong because securing restraints with a square knot can make it difficult to quickly release the restraints in an emergency.
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