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 A

Explanation

A) Provide a dedicated area for the nurse to prepare medications:
Having a dedicated, quiet area for preparing medications is crucial for reducing the risk of medication errors. A designated space minimizes distractions, ensures proper organization, and allows the nurse to focus on the task at hand, which can help prevent mistakes. It also supports a more organized environment where medications can be checked for accuracy, labels can be read carefully, and correct dosages can be administered. This is the best practice to reduce medication errors.

B) Wait to document medications given to clients until the end of a shift:
Delaying the documentation of medications until the end of a shift increases the risk of forgetting to document or making errors. Medications should be documented immediately after administration to ensure accuracy and prevent omissions. Immediate documentation also provides real-time updates on the client's medication history and avoids any discrepancies between what was actually administered and what is recorded.

C) Remove medications from automatic dispensing systems before they are reviewed by pharmacists:
Removing medications from automatic dispensing systems before they are reviewed by pharmacists increases the risk of errors. Medications should be reviewed by the pharmacist to ensure proper drug selection, dosage, and appropriateness for the patient's condition. Pharmacists play an essential role in medication safety, and bypassing their review increases the likelihood of incorrect medication administration, potentially leading to harmful consequences.

D) Prepare medications for multiple clients at the same time:
Preparing medications for multiple clients simultaneously is risky and can lead to confusion and errors. Nurses should focus on preparing medications for one patient at a time to ensure that the correct medication and dosage are administered to the correct person. This practice reduces the likelihood of mixing up medications or administering the wrong drug or dosage.

A. Potassium level 3 mEq/L. B. BUN 9.5 mg/dl C. Creatinine 0.4 mg/dl D. Sodium 135 mEq/L

Correct Answer is A

Explanation

A) Potassium level 3 mEq/L:
A potassium level of 3 mEq/L is below the normal range (which is typically 3.5-5.0 mEq/L) and represents hypokalemia. Potassium is crucial for normal muscle and nerve function, including cardiac function. Low potassium levels can lead to dangerous arrhythmias, muscle weakness, and cardiac arrest if not addressed promptly. This is the priority value because hypokalemia can be life-threatening and requires immediate attention from the healthcare provider to correct the imbalance.

B) BUN 9.5 mg/dl:
A BUN (blood urea nitrogen) level of 9.5 mg/dL is within the normal reference range for most adults (typically 7-20 mg/dL). While an abnormal BUN level could indicate kidney dysfunction or dehydration, this value is not immediately concerning and does not represent a critical finding that requires urgent attention.

C) Creatinine 0.4 mg/dl:
A creatinine level of 0.4 mg/dL is below the normal range (usually around 0.6-1.2 mg/dL), which might indicate low muscle mass or a transient decrease in kidney function. However, a low creatinine level is generally not as urgent or concerning as an elevated level, and it does not typically require immediate intervention

D) Sodium 135 mEq/L:
A sodium level of 135 mEq/L is slightly below the normal range (135-145 mEq/L), indicating mild hyponatremia. Although this can be concerning if the drop is acute or symptomatic (e.g., causing confusion, seizures, or lethargy), a mild decrease in sodium is not immediately life-threatening unless it worsens rapidly.

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