A nurse is receiving a telephone prescription for a client from a provider. Which of the following actions should the nurse take when transcribing the prescription?

Use the provider’s initials after the prescription

Repeat the prescription to the provider

Write the prescription in shorthand

Read back the prescription to the provider

Answer and Explanation

The Correct Answer is D

A) Use the provider’s initials after the prescription:
Using the provider's initials after the prescription is not an appropriate or standard practice. The nurse should transcribe the prescription accurately and include the provider's full name or identification, but not initials. The nurse is responsible for ensuring the correct interpretation and transmission of the order, and abbreviations or initials could lead to errors or confusion.

B) Repeat the prescription to the provider:
Repeating the prescription to the provider may not be sufficient. It is important to read the prescription back to the provider to ensure that both the nurse and the provider are in agreement about the medication order. Repeating the prescription is a good practice, but it does not provide the same level of verification as reading it back to ensure its accuracy.

C) Write the prescription in shorthand:
Writing prescriptions in shorthand is unsafe and should be avoided. Shorthand can lead to misunderstandings or misinterpretations of the order, which could result in medication errors. The nurse should transcribe the prescription clearly and in full, without using any abbreviations or shorthand, to ensure clarity and accuracy.

D) Read back the prescription to the provider:
Reading back the prescription to the provider is the correct action. This practice, often referred to as "read-back," helps to confirm that the nurse has accurately heard and understood the provider’s order. It is a safety measure that reduces the likelihood of medication errors, especially in high-risk situations like verbal or telephone orders. The nurse should repeat the prescription verbatim, including dosage, route, frequency, and any other relevant details, to ensure it has been transcribed correctly.

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Correct Answer is C

Explanation

A) A client who has early dementia and awoke confused to their location this morning:
Confusion in a client with early dementia could indicate a range of possible causes, such as infections, medication side effects, or changes in routine. However, while this warrants investigation, confusion alone does not represent an immediate life-threatening situation according to the ABCDE priority framework. The focus is on managing airway, breathing, circulation, and disability issues first.

B) A client who is scheduled for discharge and has a 38.4°C (101.1°F) temperature this morning:
A fever may indicate infection, which would require further assessment and potentially treatment. While this is a concern, it does not immediately threaten the client's airway, breathing, or circulation. Since the client is not in an acute crisis and is scheduled for discharge, this would be a lower priority compared to clients with more urgent issues like breathing problems or insufficient urine output.

C) A client who has pneumonia and has developed wheezing:
Wheezing indicates potential airway constriction, which could impair the client's breathing. Given that breathing difficulties are a primary concern in the ABCDE priority framework (Airway, Breathing, Circulation, Disability, and Exposure), this client requires immediate attention. Pneumonia combined with wheezing can signify a worsening respiratory condition, which poses an acute risk to the client's oxygenation and overall stability.

D) A client who is postoperative and has a urine output of 50 mL for the past 3 hours:
Oliguria (low urine output) postoperatively is concerning, as it may indicate kidney dysfunction, hypovolemia, or other complications. While it is an important issue that requires attention, it is not immediately life-threatening unless the client shows signs of worsening shock or kidney failure. However, given that this issue does not immediately affect the client’s airway or breathing, it is a lower priority than the client with pneumonia and wheezing.

A. Decreased peripheral pulses B. Heart rate 108/min C. Respiratory rate 10 breathes/min D. Dilated pupils

Correct Answer is B

Explanation

A) Decreased peripheral pulses:
Increased body temperature typically causes vasodilation rather than vasoconstriction, leading to improved blood flow rather than decreased. As a result, peripheral pulses are more likely to be normal or even increased in response to fever. Decreased peripheral pulses would be more indicative of conditions like shock or hypoperfusion, not fever.

B) Heart rate 108/min:
Fever causes an increase in metabolic demand, which often results in a compensatory increase in heart rate (tachycardia). This phenomenon, known as "fever tachycardia," occurs as the body attempts to circulate blood more rapidly to meet the increased oxygen and nutrient demands caused by elevated body temperature. A heart rate of 108 beats per minute is a normal response to fever, particularly when the temperature reaches 39°C (102.27°F).
C) Respiratory rate 10 breaths/min:
A respiratory rate of 10 breaths per minute is considered bradypnea (abnormally slow breathing), which is typically not associated with fever. Fever usually leads to an increase in respiratory rate (tachypnea) as the body attempts to cool itself through increased evaporation of sweat and breathing. A respiratory rate of 10 breaths/min is more likely to be seen in conditions like drug overdose, head injury, or respiratory depression, rather than fever.
D) Dilated pupils:
Dilated pupils (mydriasis) are typically associated with sympathetic nervous system activation, which can be caused by certain drugs, trauma, or neurological conditions. Fever, however, generally causes only mild changes in pupil size and is more likely to lead to constricted pupils (miosis) in response to certain stress hormones. Dilated pupils are not a typical finding with fever.

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A nurse is receiving a telephone prescription for a client from a provider. Which of the following actions should the nurse take when transcribing the prescription?

Nursing Test Bank

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