A nurse is orienting a newly hired nurse about obtaining telephone prescriptions. Which of the following statements by the new nurse indicates a need for further teaching?
I will ask the provider for clarification when I do not understand.
Telephone prescriptions should be signed by the provider as soon as possible.
All telephone prescriptions must be directly transcribed into the nurse's notes.
I will always repeat the prescription back to the provider after receiving it.
The Correct Answer is C
Choice A reason: Seeking clarification when a prescription is unclear is a safe and appropriate practice. It ensures accuracy and prevents medication errors.
Choice B reason: Providers are required to sign telephone orders promptly to validate them. This is a correct and necessary step in the process.
Choice C reason: Telephone prescriptions must be transcribed into the appropriate order section of the medical record, not into the nurse’s notes. This ensures they are properly categorized and accessible for pharmacy and provider review.
Choice D reason: Repeating the prescription back to the provider is a critical safety step to confirm accuracy and prevent errors.
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Correct Answer is D
Explanation
Choice A reason: Admission assessments require comprehensive evaluation and clinical judgment, which are within the RN’s scope of practice. LPNs do not perform initial assessments or admissions for complex conditions such as renal failure.
Choice B reason: Chest tube insertion is an invasive procedure requiring advanced clinical skills and sterile technique. Assisting with this procedure is typically reserved for RNs or specially trained personnel.
Choice C reason: Monitoring a client with chest pain and pending cardiac enzyme results involves critical thinking and interpretation of lab data, which is outside the LPN’s scope. This task should be handled by an RN.
Choice D reason: LPNs are trained to perform routine wound care and dressing changes for stable postoperative clients. A client who is 2 days post-op from a total hip arthroplasty is typically stable, making this task appropriate for an LPN.
Correct Answer is B
Explanation
Choice A reason: Administering a prescribed sedative for insomnia is a routine clinical action and does not meet the criteria for a sentinel event. Sentinel events are unexpected occurrences involving death or serious physical or psychological injury.
Choice B reason: Administering incompatible blood products is a classic example of a sentinel event. It can result in hemolytic reactions, organ failure, or death, and requires immediate investigation and reporting. This reflects a serious breakdown in safety protocols.
Choice C reason: Administering medications 30 minutes late may be a documentation or workflow issue but does not typically result in serious harm. It is not classified as a sentinel event unless it leads to significant adverse outcomes.
Choice D reason: Documenting vital signs at the wrong time is a charting error that may affect continuity of care but does not constitute a sentinel event unless it contributes to a serious incident. It is considered a documentation discrepancy.
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