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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.
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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.
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.
When reviewing pediatric medication administration, the nurse recognizes that which type of medication error is most common with children?
- A. Oral medication administration errors
- B. Wrong route errors
- C. Incorrect dosage form errors
- D. Dosing errors
Correct Answer: D
Rationale: Dosing errors are the most common medication errors in pediatrics due to weight-based calculations and variations in pediatric physiology. The other options are possible but less common.
During morning medication administration, the nurse discovered an error on the electronic MAR before the medication was given. Which action by the nurse is appropriate for this 'near-miss'?
- A. Correct the MAR error but say nothing because nothing happened.
- B. Notify the pharmacy about the error they almost caused.
- C. Report the near-miss using the facility's recommended protocol, and correct the error on the MAR.
- D. Report the near-miss to the next shift before the next dose is due.
Correct Answer: C
Rationale: Reporting a near-miss using the facility's protocol and correcting the MAR ensures errors are documented and addressed to prevent future incidents. The other options either ignore the error or delay reporting.
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.