A nurse is transcribing the following provider prescriptions into a client's chart. Which of the following prescriptions should the nurse clarify?

Insulin Glargine 20 units SUBQ qd

Ceftriaxone 250 mg IM stat

Diazepam 5 mg PO Q8h PRN muscle spasms

Digoxin 0.5 mg IV once

Answer and Explanation

The Correct Answer is A

Rationale

A. Insulin Glargine 20 units SUBQ qd: The abbreviation "qd" can be misinterpreted and is considered unsafe in medication orders. Insulin requires precise dosing and timing to prevent hypo- or hyperglycemia. The nurse should clarify the prescription with the provider and document "once daily" to ensure safe administration.

B. Ceftriaxone 250 mg IM stat: This prescription is clear regarding the medication, dose, route, and timing. "Stat" indicates immediate administration, which is understandable and requires no clarification.

C. Diazepam 5 mg PO Q8h PRN muscle spasms: The prescription clearly specifies the dose, route, frequency, and indication. The nurse can safely administer as needed without needing clarification.

D. Digoxin 0.5 mg IV once: The prescription provides complete information about the medication, dose, route, and single administration. No ambiguous abbreviations are present, so clarification is unnecessary.

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Correct Answer is C

Explanation

Rationale

A. Poor skin turgor: Poor skin turgor is typically a sign of fluid volume deficit, not excess. In fluid overload, the skin may appear edematous or stretched rather than dehydrated. Assessing turgor helps differentiate between dehydration and overhydration.

B. Thready pulse: A thready, weak pulse is often associated with hypovolemia due to reduced circulating volume. In fluid volume excess, pulses are usually full and bounding because of increased intravascular pressure. Pulse quality provides insight into circulatory status.

C. Crackles in lung bases: Crackles heard in the lower lung fields indicate pulmonary fluid accumulation, a common finding in fluid volume excess. Excess intravascular fluid can leak into the alveoli, causing impaired gas exchange and respiratory symptoms. Auscultation of crackles helps identify pulmonary edema early.

D. Flat neck veins: Flat neck veins are associated with low central venous pressure, typically seen in dehydration or hypovolemia. In fluid overload, neck veins are often distended due to increased venous pressure. Jugular vein assessment is a key indicator of intravascular volume status.

A. Patient Self-Determination Act B. Patient Protection and Affordable Care Act C. Health Insurance Portability and Accountability Act D. American With Disabilities Act

Correct Answer is C

Explanation

Rationale

A. Patient Self-Determination Act: This act ensures clients are informed about advance directives and their right to make healthcare decisions. It does not address confidentiality or privacy breaches, so discussing client care in an elevator would not violate this statute.

B. Patient Protection and Affordable Care Act: The ACA focuses on healthcare coverage, quality, and access, not the confidentiality of individual client health information. Sharing private client information in a public setting is not directly addressed by this law.

C. Health Insurance Portability and Accountability Act: HIPAA protects the privacy and security of a client’s health information. Discussing a client’s care in a public area where others can overhear constitutes a breach of confidentiality and violates HIPAA regulations, which require safeguarding protected health information.

D. Americans With Disabilities Act: The ADA prohibits discrimination against individuals with disabilities and ensures accessibility. It does not govern the confidentiality of health information, so this scenario does not fall under its provisions.

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A nurse is transcribing the following provider prescriptions into a client's chart. Which of the following prescriptions should the nurse clarify?

Nursing Test Bank

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