Editing Management of Care – RN Practice Questions (section)

==Question 8==
A registered nurse receives an order that reads "heparin 25,000 units subcutaneously now" for a client on prophylaxis. Which action should the nurse take '''first'''?
# Administer the dose and monitor the client closely for bleeding.
# Hold the dose and contact the prescribing provider to clarify the order.
# Ask a more experienced nurse to administer the medication.
# Document the order as an error and notify risk management.

'''Answer:''' 2. Hold the dose and contact the prescribing provider to clarify the order.

''Rationale:'' A prophylactic subcutaneous heparin dose is typically 5,000 units, and 25,000 units is a recognizable and potentially lethal deviation. A nurse who carries out an order believed to be incorrect shares liability with the prescriber; the presence of an order is never a defense for administering an unsafe dose. The first step is to clarify directly with the prescriber, and if the concern is not resolved, to escalate through the chain of command. Option 1 administers a dose the nurse already suspects is wrong. Option 3 transfers the act but not the problem. Option 4 skips the clarification that may resolve the issue immediately.