A nurse is receiving a telephone prescription from a client’s provider. Which of the following actions should the nurse take? (Select all that apply)

Instruct another nurse to record the prescription in the medical record.

Ask the provider to spell out the name of the medication.

Withhold the medication until the provider signs the prescription.

Record the date and time of the telephone prescription.

Request that the provider confirm the read-back of the prescription.

Answer and Explanation

Correct Answer : B,D,E

Choice A reason: Instructing another nurse to record risks errors; the receiving nurse must document directly for accuracy. Scientifically, this violates chain-of-command and transcription protocols, as firsthand recording ensures fidelity to the provider’s intent, reducing miscommunication in medication orders.

Choice B reason: Asking for spelling clarifies the medication, preventing errors like sound-alikes (e.g., Celexa vs. Celebrex). Scientifically, this aligns with safety standards, as precise identification ensures correct drug administration, critical in telephone orders where auditory mistakes are common.

Choice C reason: Withholding until signed delays care; telephone orders allow immediate action with later signature (e.g., 24-48 hours). Scientifically, this contradicts urgent care needs, as timely treatment outweighs procedural lag, provided documentation and verification are complete.

Choice D reason: Recording date and time establishes a legal timeline, ensuring accountability and sequence of care. Scientifically, this is mandatory in telephone orders, supporting traceability and adherence to protocols, critical for auditing and patient safety in medication administration.

Choice E reason: Read-back confirmation verifies accuracy, reducing errors in verbal orders. Scientifically, this is evidence-based, as it ensures the provider’s intent matches the nurse’s record, safeguarding against misheard doses or drugs, a key step in safe prescribing practices.

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Correct Answer is C

Explanation

Choice A reason: Standing in front risks escalation and injury; de-escalation needs space. Safety protocol prioritizes staff positioning away from a combative client’s reach.

Choice B reason: Standing orders for restraints vary; immediate application skips assessment. Ensuring staff support first allows safer, assessed intervention per guidelines.

Choice C reason: Adequate staff ensures safe de-escalation or restraint if needed. It’s the priority, reducing risk to all in a combative situation effectively.

Choice D reason: PRN restraint orders follow de-escalation attempts; staff availability precedes this. Immediate safety via numbers is critical before seeking prescriptions here.

A. Evaluate the need for the client to remain in mitten restraints. B. Determine the circulation status of the affected extremities every 2 hr. C. Instruct the client's family about the purpose of mitten restraints. D. Assist the client with range-of-motion exercises of the hands.

Correct Answer is D

Explanation

Choice A reason: Evaluating restraint need requires nursing judgment, beyond assistive personnel scope. It involves assessing behavior and alternatives, reserved for licensed staff only.

Choice B reason: Circulation checks demand clinical assessment skills, like pulse and color evaluation. This exceeds assistive personnel training, requiring a nurse’s expertise instead.

Choice C reason: Educating family about restraints involves explaining medical rationale, a nursing role. Assistive personnel lack authority to provide such detailed clinical instruction.

Choice D reason: Assisting with range-of-motion exercises is within assistive personnel scope. It supports mobility under nurse direction, safely maintaining hand function in restraints.

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