A nurse is receiving a telephone prescription from a provider for a client who requires additional medication for pain control. Which of the following entries should the nurse make in the medical record?
"Morphine 3.0 mg sub q every 4 hr PRN for pain."
"Morphine 3 mg subcutaneous every 4 hr PRN for pain."
"Morphine 3 mg SC q 4 hr PRN for pain."
"Morphine 3 mg SQ every 4 hr PRN for pain."
The Correct Answer is B
A. "Morphine 3.0 mg sub q every 4 hr PRN for pain." Including a trailing zero (3.0 mg) is considered unsafe and is discouraged in medication documentation. It increases the risk of a tenfold overdose if the decimal is missed.
B. "Morphine 3 mg subcutaneous every 4 hr PRN for pain." This entry uses the correct dosage format without a trailing zero, the full term "subcutaneous" instead of abbreviations, and proper medical terminology. It adheres to safe documentation practices as per The Joint Commission guidelines.
C. "Morphine 3 mg SC q 4 hr PRN for pain." The abbreviation “SC” is considered unsafe and prone to misinterpretation. Also, "q" for "every" is discouraged in clinical documentation due to potential misreading and error.
D. "Morphine 3 mg SQ every 4 hr PRN for pain." The abbreviation “SQ” can be misinterpreted or mistaken for “5 every” or other terms. Safe practice requires spelling out “subcutaneous” to prevent errors in medication administration.
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Related Questions
Correct Answer is B
Explanation
A. A client who consumes all the food from their meal tray. This is a normal finding and does not require immediate reporting to the nurse. It can be documented by the AP as part of routine care.
B. A client who has a prescription for compression stockings and did not receive them. Compression stockings are a prescribed intervention to prevent complications such as deep vein thrombosis. The nurse must be informed to ensure timely application and follow-up.
C. A client who requests to sit in the bedside chair while watching TV. This is a non-urgent and appropriate activity that does not require nursing intervention unless the client has specific mobility restrictions.
D. A client who requests assistance to use the bedside commode. Assisting with toileting is within the AP’s scope of practice and does not need to be reported unless there is an issue (e.g., change in condition, abnormal findings).
Correct Answer is B
Explanation
A. Social worker. While a social worker can assist with emotional or financial concerns, they are not involved in managing oxygen delivery systems or therapy adherence related to medical devices.
B. Respiratory therapist. The respiratory therapist is the most appropriate team member to consult regarding oxygen delivery methods. They can assess the client’s needs, explain alternatives (e.g., nasal cannula instead of a mask), and help promote comfort and compliance with therapy.
C. Assistive personnel. Assistive personnel can support basic care tasks, but they are not trained to adjust or manage oxygen therapy or address client concerns about medical treatments.
D. Occupational therapist. Occupational therapists assist clients in regaining independence with daily activities, not in managing oxygen therapy. This issue is outside their scope of practice.
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