A nurse prepares to administer methotrexate based on a handwritten order that is difficult to read. What is the safest action to take?

A. Methotrexate is a high-alert medication, meaning that errors in dosing can result in severe toxicity or death. Administering an order that is illegible without clarification violates safe medication practices. Monitoring after an uncertain dose does not prevent harm from an initial error. B. While collaboration is important, relying on another nurse’s interpretation does not eliminate the risk of misreading. High-alert medications require direct verification from the prescriber, not peer interpretation. C. Clients typically do not have the expertise to evaluate drug doses. Methotrexate dosing is complex, and client input is not a reliable safety check. This does not replace professional verification. D. The safest practice is to contact the prescriber for clarification whenever a medication order is unclear, illegible, or incomplete. This ensures accuracy, prevents dosing errors, and aligns with Joint Commission and medication safety guidelines for high-alert drugs. Clarification protects both the client and the healthcare team.