A consultant pharmacist is reviewing the medication regimen for a new 85-year-old resident admitted to a skilled nursing facility from a hospital. The hospital discharge summary lists one set of medications, while the separate patient care referral form contains conflicting dosage instructions for the resident's anticoagulant. Which of the following is the MOST critical initial action for the pharmacist to take?
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A
Select the medication regimen that appears most clinically appropriate and document the decision.
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B
Contact the discharging hospital's physician or pharmacist to clarify the correct and current medication orders.
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C
Use the facility's standard protocol for anticoagulation until clarification can be obtained.
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D
Interview the resident and their family to determine which medication list they believe is accurate.