A nurse is receiving a telephone order from a physician for a new medication for a client.
Which action should the nurse take to ensure accuracy and safety?
Repeat back the order to the physician verbatim.
Ask another nurse to listen to the order on speakerphone.
Write down the order on a piece of paper before entering it into the computer.
Confirm the order with a pharmacist before administering it to the client.
The Correct Answer is A
Repeat back the order to the physician verbatim.
Rationale: The nurse should repeat back the order to the physician verbatim, as this is a standard practice to verify the accuracy and completeness of the order. Repeating back the order allows the nurse and the physician to check for any errors, omissions, or ambiguities, and to clarify any questions or concerns.
Incorrect options:
B) Ask another nurse to listen to the order on speakerphone. - This is not an appropriate action, as it violates the confidentiality and privacy of the client and the physician. Moreover, it does not ensure that the order is correctly understood and recorded by the nurse who will enter it into the computer.
C) Writing down the order on a piece of paper before entering it into the computer is not an appropriate action as it increases the risk of transcription errors, lost or misplaced orders, or delayed entry. The nurse should enter the order directly into the computer as soon as possible and discard any paper notes after verification.
D) Confirming the order with a pharmacist before administering it to the client is not an appropriate action as it adds an unnecessary step and delays the implementation of the order. The nurse should confirm the order with the physician, not the pharmacist, and administer it to the client according to the prescribed schedule. The pharmacist will review the order for any potential interactions, allergies, or contraindications and alert the nurse if any issues arise.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
To prevent lactic acidosis due to contrast dye
Rationale: Metformin is an oral antidiabetic agent that lowers blood glucose levels by decreasing hepatic glucose production and increasing peripheral glucose uptake. However, metformin can cause lactic acidosis, a rare but serious condition that occurs when lactate accumulates in the blood faster than it can be metabolized. Lactic acidosis can be triggered by contrast dye used for radiographic procedures, such as colonoscopy, especially in clients who have renal impairment or dehydration. Therefore, metformin should be discontinued 48 hours before and after any procedure that involves contrast dye.
Incorrect options:
A) To prevent hypoglycemia during fasting - This is not the rationale for discontinuing metformin, as metformin does not cause hypoglycemia by itself. However, the client may need to adjust the dose of other antidiabetic medications or insulin to prevent hypoglycemia during fasting.
C) To prevent hyperglycemia due to stress response - This is not the rationale for discontinuing metformin, as metformin does not cause hyperglycemia by itself. However, the client may need to monitor blood glucose levels more frequently and report any signs of hyperglycemia to the provider.
D) To prevent nephrotoxicity due to dehydration - This is not the rationale for discontinuing metformin, as metformin does not cause nephrotoxicity by itself. However, the client should be advised to maintain adequate hydration before and after the procedure to prevent dehydration and renal impairment.
Correct Answer is C
Explanation
"I will avoid foods that are high in calcium."
Rationale: Hydrochlorothiazide is a thiazide diuretic that lowers blood pressure by increasing urine output and reducing fluid volume. However, it also causes increased excretion of potassium and magnesium, and decreased excretion of calcium and uric acid. Therefore, clients taking hydrochlorothiazide should eat more foods that are rich in potassium and magnesium, such as bananas, oranges, potatoes, spinach, nuts, and seeds; limit their intake of sodium and fluids to prevent fluid retention and edema; avoid foods that are high in uric acid, such as organ meats, shellfish, and alcohol; and monitor their serum calcium levels regularly. There is no need to avoid foods that are high in calcium, as hydrochlorothiazide does not increase calcium excretion.
Incorrect options:
A) "I will eat more foods that are rich in potassium." - This is a correct statement, as hydrochlorothiazide causes increased potassium excretion and can lead to hypokalemia if not supplemented.
B) "I will limit my intake of sodium and fluids." - This is a correct statement, as sodium and fluids can cause fluid retention and edema, which can increase blood pressure and counteract the effects of hydrochlorothiazide.
D) "I will drink alcohol in moderation." - This is a correct statement, as alcohol can increase uric acid levels and cause gout attacks in clients taking hydrochlorothiazide. Alcohol can also lower blood pressure and increase the risk of orthostatic hypotension.
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