NCLEX · General

The LPN receives a telephone order from a physician. What is the correct procedure?

Correct answer

Write the order in the chart, read it back in full to the physician, wait for verbal confirmation that the read-back was correct, and sign the order with your name, credentials, date, time, and 'T.O. (telephone order) Dr. [Name]'; the physician must co-sign within the facility's required timeframe

  1. A Write it down, read it back, and execute it
  2. B Write the order in the chart, read it back in full to the physician, wait for verbal confirmation that the read-back was correct, and sign the order with your name, credentials, date, time, and 'T.O. (telephone order) Dr. [Name]'; the physician must co-sign within the facility's required timeframe
  3. C Telephone orders are never permitted for LPNs
  4. D Execute immediately without documentation

Why this is the answer

TELEPHONE/VERBAL ORDER PROCEDURE: SAFETY: High error risk due to misheard words or numbers — standardised read-back prevents most errors; CORRECT PROCESS: Write the order as spoken; read the COMPLETE order back to the prescriber; wait for confirmation ('That is correct' or correction); document as telephone/verbal order with: date, time, complete order, prescriber's name, and your name/credentials; PHYSICIAN CO-SIGNATURE: Required within facility timeframe (typically 24 hours to 72 hours depending on facility policy and state law); NEVER: Modify the order; delay reading back; execute before writing; SPECIFIC CAUTIONS: Numbers (say 'one-five' not '15' for high-risk numbers); medication names (spell it); 'U' for units must be written as 'units' — 'U' can be misread as zero; PN SCOPE: LPNs may receive telephone orders within their scope of practice — check facility policy; some facilities restrict certain order types; JCAHO/CMS: Require read-back of all verbal and telephone orders for medications.
Source: NCLEX-PN Safe Care — Management of Care, Telephone Order Procedure