Nokea
During a period of time when the computerized medication order system was down, the prescriber wrote admission orders, and the nurse is transcribing them. The nurse is having difficulty transcribing one order because of the prescriber's handwriting. Which is the best action for the nurse to take at this time?
- A. Ask a colleague what the order says.
- B. Contact the prescriber to clarify the order.
- C. Wait until the prescriber makes rounds again to clarify the order.
- D. Ask the patient what medications he takes at home.
Correct Answer: B
Rationale: If a prescriber's order is illegible, the nurse should contact the prescriber for clarification to ensure accuracy. Asking a colleague or the patient does not verify the order, and waiting for rounds delays implementation.
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Digoxin is available in 0.25-mg tablet form. Convert this dose to microgram strength, (do not round)
Correct Answer: 250 mcg
Rationale: One mg equals 1000 mcg. To convert 0.25 mg to mcg, multiply by 1000: 0.25 * 1000 = 250 mcg, or move the decimal point three spaces to the right.
When given a scheduled morning medication, the patient states, 'I haven't seen that pill before. Are you sure it's correct?' The nurse checks the medication administration record and verifies that it is listed. Which is the nurse's best response?
- A. It's listed here on the medication sheet, so you should take it.'
- B. Go ahead and take it, and then I'll check with your doctor about it.'
- C. It wouldn't be listed here if it were not ordered for you.'
- D. Let me check on the order first before you take it.'
Correct Answer: D
Rationale: When a patient expresses doubts about a medication, the nurse should verify the order to ensure safety. Checking the written order or with the prescriber addresses the patient's concerns, unlike the other options which dismiss or delay addressing the concern.
The nurse is reviewing medication errors. Which situation is an example of a medication error?
- A. A patient refuses her morning medications.
- B. A patient receives a double dose of a medication because the nurse did not cut the pill in half.
- C. A patient develops hives after having started an IV antibiotic 24 hours earlier.
- D. A patient complains of severe pain still present 60 minutes after a pain medication was given.
Correct Answer: B
Rationale: A medication error is defined as a preventable adverse drug event that involves inappropriate medication use by a patient or health care provider. A double dose due to not cutting a pill is a preventable error. Patient refusal, hives (a possible allergic reaction), and persistent pain are not preventable errors.
When taking a telephone order for a medication, which action by the nurse is most appropriate?
- A. Verify the order with the charge nurse.
- B. Call back the prescriber to review the order.
- C. Repeat the order to the prescriber before hanging up the telephone.
- D. Ask the pharmacist to double-check the order.
Correct Answer: C
Rationale: Repeating the order back to the prescriber before hanging up ensures accuracy of verbal or telephone orders. The other options do not directly confirm the order with the pres125criber.
The nurse is reviewing a list of verbal medication orders. Which is the proper notation of the dose of the drug ordered?
- A. Levothyroxine .75 mg
- B. Levothyroxine .750 mg
- C. Levothyroxine 0.75 mg
- D. Levothyroxine 0.750 mg
Correct Answer: C
Rationale: Levothyroxine 0.75 mg illustrates the correct notation with a leading zero before the decimal point. Omitting the leading zero (as in A and B) may cause the order to be misread, resulting in a large drug overdose. Trailing zeros (as in D) are also incorrect.