Which of the following statements is correct about abbreviations?
Every facility should have an approved abbreviations list.
Creating abbreviations saves time for the person reading the chart.
Writing out questionable abbreviations could make a jury think you're hiding something
Abbreviating drug name and dosages helps reduce medication errors.
The Correct Answer is A
A. Every facility should have an approved abbreviations list. Hospitals and healthcare settings maintain a list of approved abbreviations to ensure consistency and prevent misinterpretation.
B. Creating abbreviations saves time for the person reading the chart: Unapproved abbreviations can lead to confusion and errors, potentially harming the patient.
C. Writing out questionable abbreviations could make a jury think you're hiding something: Avoiding abbreviations improves clarity, and using full words is preferred in legal documentation.
D. Abbreviating drug names and dosages helps reduce medication errors: Abbreviating drug names can cause dangerous medication errors (e.g., MS can mean morphine sulfate or magnesium sulfate). The Joint Commission prohibits certain abbreviations.
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Related Questions
Correct Answer is A
Explanation
A. Confidentiality: The biggest concern is maintaining patient confidentiality due to risks of unauthorized access, hacking, and breaches of protected health information (PHI).
B. Adequate forms for documentation: Computerized charting typically has structured templates, ensuring that all necessary fields are included.
C. Incorrect information: While errors can occur, computerized charting often includes safeguards like drop-down menus, alerts, and validation checks to reduce mistakes.
D. None of the answers are correct: Confidentiality is a significant concern, making option A the best answer.
Correct Answer is D
Explanation
A. Physician's Order Sheet: While the physician orders narcotics, administration is not documented here.
B. Narcotic Administration Sheet: The Narcotic Administration Sheet is specifically for controlled substances, ensuring proper tracking and preventing misuse.
C. Care Plan: The care plan outlines patient goals and interventions, not medication administration.
D. MAR (Medication Administration Record) and Narcotic Administration Sheet: The MAR (Medication Administration Record) documents all medications given to the patient. The Narcotic Administration Sheet is required for controlled substances to comply with regulations.
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