# The nurse reviews medication orders copied from transfer documents. Highlight the entries that require clarification before they are entered into the medication administration record.

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=513810&lang=en  
> language: en  
> subject: Medication Administration  
> category: PPT

## Question

The nurse reviews medication orders copied from transfer documents. Highlight the entries that require clarification before they are entered into the medication administration record.

| Transfer entry | Copied medication order |
| --- | --- |
| Pain | Hydromorphone 1.0 mg IV every 3 hours as needed |
| Cardiac | Digoxin .125 mg by mouth daily |
| Diabetes | Regular insulin 6 U subcutaneously before breakfast |
| Thyroid | Levothyroxine 50 mcg QD |
| Nausea | Ondansetron 4 mg IV every 8 hours as needed |
| Anticoagulation | Heparin 5,000 units subcutaneously every 8 hours |
| Anxiety | Lorazepam 0.5 mg by mouth at bedtime as needed |
| Supplement | Folic acid 1 mg by mouth daily |
| Fever | Acetaminophen 650 mg by mouth every 6 hours as needed |

## Explanation

A trailing zero, a missing leading zero, the abbreviation U, and QD are error-prone. Complete words and unambiguous metric expressions reduce tenfold and route/frequency errors.

## In-depth explanation

Quick answer
Clarify hydromorphone 1.0 mg, digoxin .125 mg, insulin 6 U, and levothyroxine 50 mcg QD.

Why this is correct
ISMP identifies trailing zeros, absent leading zeros, U, and QD as error-prone dose or frequency notation. Each should be rewritten in an unambiguous form before the order is carried into the MAR.

Easy analogy or mental picture
Unsafe notation is like a smudged decimal on a bank transfer: the intended amount may be obvious to one reader but dangerous to the next.

Memory hook
No trailing zero; use a leading zero; spell out units and daily.

NCLEX decision rule
When an order can be misread, clarify and rewrite it before entry or administration. Familiarity with the intended meaning does not make the notation safe.

Why the other choices are wrong
The remaining rows use complete drug names, a leading zero where needed, no trailing zero, and spelled-out frequency or units.References
1ISMP Error-Prone Abbreviations ListUnsafe abbreviations and dose designations

## Clinical scenario

Safe notation check
Review the drug, dose, decimal placement, unit, route, and frequency. Do not normalize an ambiguous order silently.

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