sherpath mod 3

A prescriber is in a hurry to leave the unit to get back to the office and states to a nurse, "Please administer the usual dose of paracetamol when my patient comes back from the procedure." Which nurse's response is most appropriate? "Sure, no problem." "Please call me with the order when you get back to your office." "Can you please repeat the order?" "Please write the medication order before you leave."

"Please write the medication order before you leave." A prescriber may not give a verbal order in a nonemergent situation, so the most appropriate action would be to request that the prescriber write the medication order before leaving the unit. Accepting the order can lead to medication errors. A telephone order from the office is a form of a verbal order, which is unacceptable except in cases of emergency. Asking the prescriber to repeat the order is not helpful, because a nurse should not accept the verbal order.

Which step does a nurse use to begin acceptable interpretation of a verbal order for a medication? Review of the active ingredient Verification with a pharmacist Clarification from a charge nurse A formal read back

A formal read back A formal read back with the prescriber is an acceptable interpretation of a verbal order. Reviewing the active ingredient in the medication is not relevant to interpreting a verbal order. A pharmacist or a charge nurse cannot verify or clarify the order, because neither one is the person who prescribed it.

What type of medication order must have a frequency, which designates the minimum time allowed between doses? A single-dose telephone order A prn medication order A single-dose verbal stat order A written one-time dose order

A prn medication order For safety, a prn (or "as needed") order must have a frequency, which designates the minimum time allowed between doses. Single-dose and one-time dose orders of any kind does not require the frequency.

The advantages of computerized physician order entry include which of the following abilities of the computer? Select all that apply. Select all that apply A. Recognizing medication incompatibilities B. Interpreting medication abbreviations C. Identifying safe dosage ranges D. Interpreting symbols E. Preventing incorrect transcription F. Identifying allergies

A, C, E, F The advantages of computerized physician order entry include the computer's ability to recognize medication incompatibilities, to identify a safe dosage range, to prevent incorrect transcription of orders, and to identify a patient's allergies. The computer does not interpret abbreviations or symbols.

The nurse receives a medication order from the primary care provider. Which components must be present for the medication order to be considered valid? Select all that apply. Select all that apply A. Patient's full name B. The generic and trade names of the medication C. Full credentials of the primary care provider D. Frequency of medication administration E. Signature of person writing the order

A, D, E A medication order must contain seven components to be valid. Among these are the patient's full name, the frequency of the medication administration, and the signature of the person writing the order. A valid order only requires one name of the medication; it does not require both the trade and generic names. Full credentials of the provider are also unnecessary.

Which abbreviation is considered error prone and should be avoided with medication orders? Select all that apply. Select all that apply A. AD B. IV C. PO D. SL E. QD

A, E The abbreviation "AD" represents "right ear." It can be mistaken for "right eye," "left eye," or "each eye." Therefore, the Institute for Safe Medication Practices recommends against using "AD" and to instead spell out "right ear." QD has been placed on The Joint Commission (TJC) official "Do Not Use" List, as it is mistaken for similar abbreviations including Q.D., qd, q.d. "IV" represents "intravenous," "PO" represents "by mouth," and "SL" represents "sublingual," none of which is considered an error-prone abbreviation.

Which action or step should a nurse take for a patient who reports a pain score of 7 out of 10 and who has an order for acetaminophen 650 mg orally every 4 hours prn for pain or fever? Contact the pharmacy. Notify the prescriber for clarification. Administer the acetaminophen. Consult with the charge nurse.

Administer the acetaminophen. The order is written in the appropriate sequence with the essential components for a medication order; it is administered "prn," as needed, and a score of 7 on the pain scale indicates that the pain must be better managed. A nurse does not need to contact the pharmacy or obtain clarification. The acetaminophen should be administered after the remaining medication checks are completed. Consulting with the charge nurse is not necessary, because the charge nurse is not the prescriber.

What is the dosage of a medication? Interval between medication administrations Amount and strength of medication Time the medication will be administered Frequency the medication will be administered

Amount and strength of medication The dosage is the amount and strength of medication. The interval between medication administrations is the time in between administering the medication. The time the medication is to be administered is the chronological time. The frequency indicates the number of times per day that the medication is administered.

Which action or step is a nurse's priority on hanging up the phone without a formal "read back" with a telephone order for a medication? Submit the order to the pharmacy Call the prescriber to read back the order Administer the medication to the patient Enter the order in the computer

Call the prescriber to read back the order Calling the prescriber to read back the order is a priority action to ensure safe medication administration. Submitting the order to the pharmacy, administering the medication to the patient, and entering the order in the computer without a formal read back are actions that do not ensure safe communication and clarification of the medication order.

The nurse receives a verbal order to administer acetaminophen 650 mg orally as soon as possible. What should the nurse do? Administer the medication. Check the dosage. Clarify the form of medication. Determine what time to administer the medication.

Clarify the form of medication. can be given in a liquid or tablet form; therefore, the form of medication must be clarified with the prescriber since it is missing from the verbal order. The nurse should not administer the medication without first clarifying the form. The dosage does not need to be checked, because it was already given. The nurse has already been given the information about when to administer the medication.

Which action or step should a nurse take if a nurse received an order for metoprolol succinate 50 mg 1 tab every day? Administer the medication Transcribe the order to a medication administration record Request that the pharmacy send the drug to the unit Contact the prescriber for clarification

Contact the prescriber for clarification A prescriber needs to be contacted to clarify the route of administration before any further action, because this information is not included. Administration, transcription, or pharmacy receipt of the medication cannot be carried out before clarification is received.

Which step should a nurse take on receiving the following order: "Give propranolol 40 mg PO STAT"? Administer 140 mg of propanolol orally. Administer 40 mg of propanolol orally. Cross-reference the medication. Contact the prescriber for clarification.

Contact the prescriber for clarification. The prescriber must be notified for clarification because of the potential dosage error. There is inadequate space between the drug name, dose, and unit of measure. Administration of the drug is not safe until the order is clarified, and a nurse can cross-reference the drug once the order has been clarified.

The nurse receives the following order: codeine/acetaminophen 15 mL (36 mg/360 mg) PO q4h prn pain, not to exceed 4 g acetaminophen/day. The patient complains of nausea when taking the liquid form and asks for tablets instead. What is the nurse's next action? Call the pharmacy and request tablets. Contact the prescriber. Encourage the patient to take the liquid. Offer the patient an alternative ordered pain medication.

Contact the prescriber. The nurse should contact the prescriber because the nurse does not have the authority to alter the form or dosage of the medication. The dosage type and amount ordered has a specific strength to it. The pharmacy does not have the authority to change the prescriber's orders. Because the patient states that the liquid causes nausea, encouraging the patient to take the medication may cause further issues. Alternative pain medications ordered have different physiological actions on the patient.

The nurse receives a verbal order for a stat medication from the primary care provider. The provider did not include a route of administration and has left the unit. The nurse is aware that this provider commonly uses only one route for the medication. What should the nurse do before administering the medication? Ask the nursing unit director for permission to administer the medication. Contact the primary care provider or the provider on call for clarification. Add the usual route to the medication order, then administer the medication. Administer the stat medication, then contact the primary care provider to complete the order.

Contact the primary care provider or the provider on call for clarification. The primary care provider or provider on call should be contacted to complete the order before medication administration to prevent potential errors. The nursing unit director does not have the legal authority to complete the order. The nurse does not have the legal authority to add the route to the order. The nurse should not administer a medication using an incomplete medication order.

When is a "repeat back" order acceptable? When giving a telephone order During an emergency situation When giving a verbal order When the nurse does not understand what the prescriber has said

During an emergency situation A "repeat back" order is only acceptable to The Joint Commission (TJC) in situations where a formal "read back" is not feasible, such as during an emergency situation like a code or in the operating room. Such an order is not acceptable when giving a telephone order, or when giving a verbal order. The use of "repeat back" does not refer to the nurse's understanding of what the prescriber has said.

Which description captures the frequency of a medication order? The generic name of the drug The start and stop dates of the medication order How often the drug is to be administered The amount of medication given at a single time

How often the drug is to be administered The frequency indicates how often the drug is administered. The generic name of the drug is the official name of the drug. The start and stop dates of a medication are determined by the date and time the order was written. Dosage refers to the amount of medication given at a single time.

What does the nurse understand about the abbreviation "D/C?" It may be used when discharging a patient. It can be communicated in an electronic order. It may be given in a verbal order. It should not be used.

It should not be used. "D/C" is on the list of error-prone abbreviations and may be interpreted as "discontinue" or "discharge." Because it is considered error-prone, the Institute for Safe Medication Practices states that it should not be used when discharging a patient, in an electronic order, or in a verbal order.

Which order can be safely interpreted as Lasix 40 milligrams orally daily? Lasix 40 μg prn per os q.d Lasix 40 mg PO daily Lasix 40 μg PO daily Lasix 40 mg PO qd

Lasix 40 mg PO daily "Lasix 40 mg PO daily" means Lasix 40 milligrams orally daily. The abbreviation μg is for micrograms and is identified as an error-prone abbreviation; it is the incorrect unit of measurement in the order. "Per os," "q.d.," and "qd" can be misinterpreted and are designated error-prone abbreviations.

An order written by which of the following people will need to be cosigned? Medical intern Student nurse Anesthesiologist Charge nurse

Medical intern A person licensed to write orders might need to have the order cosigned. Interns, residents, and persons other than the physician writing an order must secure the signature of the attending physician. Student nurses do not have prescriptive authority. Anesthesiologists are licensed physicians who have the authority to write orders without a co-signature. Charge nurses do not have prescriptive authority.

The nurse receives an order for "docusate 100 mg PO b.i.d." What is the correct dosage, route, and frequency of the medication? Micrograms, per rectum, three times a day Milligrams, orally, four times a day Micrograms, orally, two times a day Milligrams, orally, twice a day

Milligrams, orally, twice a day The , "PO" is the abbreviation for orally, and "b.i.d." is the abbreviation for twice a day. Micrograms is abbreviated with "mcg," per rectum is abbreviated "rect;" three times a day and four times a day should not be abbreviated. The potential for misinterpretation could create a medication error.

Which is the appropriate sequence for a medication order? Name of the medication, route, frequency, dosage Name of the medication, dosage, route, frequency Dosage, frequency, route, name of the medication Name of the medication, route, dosage, frequency

Name of the medication, dosage, route, frequency Medication orders are written in the following sequence: name of the medication, dosage, route, and frequency. Dosage comes before route and frequency. The name of the medication always comes first. Frequency comes before dosage.

Which abbreviation would a nurse record on taking a medication order via the telephone when the provider indicates the medication should be taken "by mouth"? PO NPO SL IV

PO "PO" or "per os" is the correct abbreviation for "by mouth." "NPO," or "nil per os," means "nothing by mouth." "SL" stands for "sublingual," and "IV" means "intravenous."

Which component is necessary to add to an as-needed medication order to ensure it is valid and appropriately administered? Both the generic and trade names of the medication All possible routes of administration for the medication Purpose of administration and minimum time allowed between doses Signatures from all primary care providers caring for the patient

Purpose of administration and minimum time allowed between doses Because as-needed medication orders do not have regular schedules, they require the reason for administration, such as for pain or fever, and the minimum time frame allowed between doses. Both the trade and generic names are not necessary for these orders. As-needed medications do not require a listing of all possible routes of administration; only those routes that are ordered for the specific patient are required. As-needed orders require only the signature of the ordering primary health care provider.

Which action or step would occur after a nurse has read back a telephone order and received verification? Sign the order. Implement the medication order. Transcribe the order. Send the order to the pharmacy.

Sign the order. After a nurse receives the verification following read back of a telephone order, a nurse must sign the order. Additionally, a nurse should also document the prescriber's name and make a notation that this was a verbal order. Implementation of the order occurs after it is sent to the pharmacy, which cannot take place until after it is signed. The order cannot be transcribed until it has been written.

Which must be included among the components of a medication order in order for it to be legal? Special instructions Purpose of administration Signature of the prescriber Side effects of the medication

Signature of the prescriber For a medication order to be legal, it must be signed by the prescriber. Special instructions, the purpose of administration, and the medication's side effects are not legally required components of a medication order.

SSI is on a list of error-prone abbreviations. How should the abbreviation be spelled out? 551 Sliding scale of insulin Skin and skin structure infection Selective serotonin reuptake inhibitor

Sliding scale of insulin "Sliding scale" specifically refers to insulin dosing and should be spelled out. "SSI" can be mistaken for the number 551. "SSSI" is an abbreviation that can be used to mean skin and skin structure infection. "SSRI" is a selective serotonin reuptake inhibitor.

What does the nurse know the abbreviation "SR" means? Slow release Sustained release Spontaneous rupture Stereotactic radiotherapy

Sustained release The abbreviation "SR" stands for "sustained release." It may be used for "slow release," but sustained release is a more accurate term. "SROM" stands for "spontaneous rupture of membranes." "SRS" stands for "stereotactic radiotherapy."

Which organization established a National Patient Safety Goals to prevent medication errors and created the official Do Not Use list? The Institute for Safe Medication Practices (ISMP) The Joint Commission (TJC) Quality and Safety Education for Nurses (QSEN) United States Pharmacopeia (USP

The Joint Commission (TJC) TJC established National Patient Safety Goals to address areas of concern regarding patient safety and created the official Do Not Use list of abbreviations to prevent medication errors. ISMP also came up with an extensive list of abbreviations, symbols, and dose designations that have led to medication errors but not the National Patient Safety Goals. QSEN addresses quality and safety competency of prelicensed nurses. USP develops and publishes standards for drug substances, drug products, excipients, and dietary supplements in the United States.

With whom might a nurse clarify the route of delivery of a medication that was received over the telephone? The pharmacy The initial prescriber The charge nurse A prescriber on the unit

The initial prescriber If clarification is needed, the route given in the initial order should be checked with the initial prescriber. It would not be appropriate to check it with the pharmacy, the charge nurse, or a prescriber on the unit, because the order did not originate with any of them and they therefore would not have the required information.

What should the nurse understand when accepting a verbal order? The nurse can be responsible for a medication error. The nurse is the originator of the order. The nurse has 24 hours to sign the order. The nurse needs a prescriber's signature before processing the order.

The nurse can be responsible for a medication error. Acceptance of a verbal order is a major responsibility and can lead to medication errors if the order is not verified correctly; therefore, such orders are only acceptable in an emergency situation. The prescriber is the originator of the order. The nurse must sign the order after receiving and verifying it. The prescriber is also responsible for signing the order, but usually within 24 hours. The order may be processed without the prescriber's signature immediately after the order is clarified.

Which is accurate regarding the nurse's responsibility in a non-emergent medication administration order? The nurse is the originator of the order. The nurse is not liable if the medication dosage ordered is incorrect. The nurse may take a telephone order if the prescriber is not available. The nurse is the point person before the patient receives the medication.

The nurse is the point person administering the medication. The practitioner is the originator of the order. The nurse who incorrectly administers a medication incorrectly will share in the liability for the injury to the patient. Telephone orders should be accepted in emergencies only.

Which component of a verbal order is always included to ensure it is complete? The patient's meal schedule The stop date of the medication The same elements as in a written order The side effects of the medication

The same elements as in a written order A verbal order contains the same elements as in a written order. It contains the date, name and dosage of medication, route, frequency, special instructions, purpose for administration if it is an as-needed medication, and length of time the patient is to receive the medication. The physician should verify the verbal order as soon as possible. The patient's meal schedule is not included in a verbal order. The stop date on the medication may not be on the order, and the side effects of the medication are not listed on an order.

Which statement is true of routine medication orders given verbally? They should be written by the nurse. They must be signed by the prescriber within 72 hours. They will not be accepted. They must be written on a medication administration record.

They will not be accepted. Routine medication orders may not be given verbally. Verbal orders should only be accepted in an emergency or in certain situations. A prescriber must write the order. Many institutions require that orders be signed within 24 hours. A medication administration record is used only after the medication order has been written.

Which sequence appropriately describes how a nurse should receive a verbal order? Write it down, read it back, and receive confirmation. Read it back, write it down, and receive confirmation. Write it down, receive confirmation, and read it back. Receive confirmation, read it back, and write it down.

Write it down, read it back, and receive confirmation. The authorized individual receiving a verbal or telephone order should write it down, read it back, and then receive verification. A nurse should not read it back before writing it down. A nurse should read it back before receiving verification. A nurse should write it down before reading it back and receiving verification. Additionally, the prescriber's name, a notation that this is a verbal order, and a nurse's signature are required on the medication order.

Which interpretation of "QD" is correct? q.d. q.i.d. daily every other day

daily "Daily" is the correct written communication. "QD" is considered an error-prone abbreviation according to the Institute for Safe Medication Practices. "QD," "q.d.," or "q.i.d." may be misinterpreted. "Q.I.D." represents "four times daily." "Every other day" is incorrect.

Which component of the prescription "Lasix 20 mg po hs" is on the error-prone abbreviations list? 20 po mg hs

hs The can be mistaken for "half-strength" and is on the error-prone abbreviations list from the Institute for Safe Medication Practices; therefore, it should not be used. Writing the dosage as "20" is acceptable. The abbreviation "po" is acceptable for "per os," or "by mouth." The abbreviation "mg" is acceptable for "milligrams."

Which is an approved medication dosage abbreviation that can safely be used to administer medication to a patient? cc IN U mg

mg The abbreviation "cc" can be mistaken for units when poorly written; "mL" or milliliters is safely used in place of "cc." "IN" was formerly used to indicate intranasal but can be misread as "IM" or "IV;" "IN" can also be misheard in a verbal or telephone order as "IM." The intended meaning of "U" is unit but could be mistaken as the number 0 or 4, causing a significant overdose; "unit" must be spelled out.