# A nurse receives a telephone prescription for regular insulin during treatment of severe hyperkalemia. Which action completes the closed-loop communication process before the prescription is carried out?

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> language: en  
> subject: Client Rights  
> category: MOC

## Question

A nurse receives a telephone prescription for regular insulin during treatment of severe hyperkalemia. Which action completes the closed-loop communication process before the prescription is carried out?

## Option

1. Ask another nurse to restate the order from the written note
2. Enter the order and send a text saying that it was received
3. Repeat the client's room number and diagnosis before ending the call
4. Read back the drug, dose, route, and timing and hear confirmation **✔ Correct answer**

**Correct answer: 4**

## Explanation

A check-back requires the receiver to repeat the message and the sender to verify that it is correct. Reading back the medication details and hearing confirmation closes the communication loop.

## In-depth explanation

Quick answer
Read back the complete medication prescription and obtain confirmation from the prescriber. Both the receiver's repeat-back and the sender's verification are needed to close the loop.

Why this is correct
Telephone prescriptions can be misheard, especially when a dose, route, or timing is urgent. Repeating the exact elements gives the prescriber an opportunity to correct an error before the medication reaches the client.

Easy analogy or mental picture
Closed-loop communication is like repeating a delivery address and hearing the sender say that it is correct before the driver leaves. The analogy shows confirmation, but medication orders also require documentation, authorization, and facility policy compliance.

Memory hook
Sender says it, receiver repeats it, sender confirms it: the loop is closed.

NCLEX decision rule
For a verbal or telephone prescription, choose the action that repeats the complete critical message to the original sender and obtains confirmation. A note, text, or another person's interpretation does not verify the message with its source.

Why the other choices are wrong
Another nurse did not hear the original message. A text only acknowledges receipt, and repeating the room number and diagnosis does not verify the medication, dose, route, or timing.References

- [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing

- [2]AHRQ TeamSTEPPS: Check-Back or Repeat-BackAgency for Healthcare Research and Quality

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