Deck 11: Safe Medication Administration

Question 1

Identify the problem with the order Restoril 7.5 mg 1 capsule po qhs.

A) There is no problem with this order.
B) Dosage strength is not specified.
C) Route is incorrect for dosage form.
D) The error-prone abbreviation qhs is used.

Answer 1

The error-prone abbreviation qhs is used.

Question 2

The patient is ordered Heparin 5,000 units Sub-Q daily. Is this order correct?

A) There is no problem with this order.
B) Sub-Q is an error-prone abbreviation.
C) Route is incorrect for dosage form.
D) Dose is incorrect.

Answer 2

Sub-Q is an error-prone abbreviation.

Question 3

Documentation of medication administration should be done

A) right after you prepare the medication.
B) right before you administer the medication.
C) immediately after you administer the medication.
D) at the end of the shift.

Answer 3

immediately after you administer the medication.

Question 4

Based on the recommendations of The Joint Commission and ISMP, which of the following is the preferred way to abbreviate "morphine sulfate"?

A) MS
B) It should not be abbreviated.
C) MSO4
D) MSulfate

Question 5

Which entity has developed a list of error-prone abbreviations through its Medication Errors Reporting Program?

A) TJC
B) JCAHO
C) ISMP
D) FDA

Question 6

The physician's order does not include why a medication is to be given. The healthcare provider administering the medication will not be able to fulfill which "right" of medication administration without clarifying the order?

A) right drug
B) right reason
C) right to know
D) right documentation

Question 7

Which of these is not one of the three times a medication is checked?

A) when it is documented
B) when it is replaced on the shelf
C) when it is removed from the shelf
D) when it is prepared

Question 8

Checking a medication three times ensures which of the following?

A) The order was transcribed correctly.
B) You know how to administer the medication as ordered.
C) The order is correct.
D) You have the right medication in the correct dosage form.

Question 9

The abbreviation cc (cubic centimeter) is considered to be error prone; what should be used instead?

A) ccm
B) ccL
C) mL
D) ccn

Question 10

In which of the following situations would a verbal order be acceptable?

A) A patient is requesting a laxative and the physician is only available by phone.
B) A patient has an extremely high blood glucose, but the physician is performing a sterile procedure on another patient.
C) A patient is requesting medication for pain; the physician is having coffee in the conference room.
D) While at a patient's bedside, the physician says to take a verbal order for an antihistamine.

Question 11

Once an order has been transcribed to the MAR

A) the registered nurse verifies that the order is transcribed correctly.
B) the medication can be given to the patient with no further actions.
C) the physician will verify the correctness of the order.
D) the medication technician verifies the correctness of the order.

Question 12

Which of these is considered one of the main causes of medication errors?

A) patient noncompliance
B) order filled wrong by the pharmacy
C) incorrect transcription
D) incorrect patient identification

Question 13

Which entry on the MAR was transcribed with all necessary information in the correct format?

A) Probanthine
B) Dilantin
C) Digoxin
D) None

Question 14

Which entry on the MAR was transcribed without a route?

A) Dilantin
B) Cleocin
C) Digoxin
D) Probanthine

Question 15

What is the problem with the transcription for Digoxin?

A) There is no route given for this medication.
B) There is no dosage.
C) The dose has a leading 0.
D) QOD is an error-prone abbreviation.

Question 16

Which transcription is missing the frequency?

A) Dilantin
B) Cleocin
C) Digoxin
D) Probanthine

Question 17

What is the problem with the transcription for Cleocin?

A) It is missing the route.
B) The units for the dose are missing.
C) The dose is missing.
D) The frequency is missing.

Question 18

Who performs the three checks of medication administration?

A) The physician when ordering the medications.
B) The pharmacist when preparing the label.
C) The person administering the medications.
D) The person transcribing the orders.

Question 19

Ms. Anderson was giving medications on the unit. Just as she was taking a medication out of the patient's cassette, she was interrupted by another patient asking about an appointment. While having the discussion, she opened the medication container and poured the dose and gave it to the intended patient. When she returned to the cassette, she realized she gave the wrong medication. What did she neglect to do?

A) She neglected to properly identify the patient.
B) She neglected to perform the three checks of medication administration.
C) She neglected to properly document the medication.
D) She neglected to ensure the dose was correct.

Question 20

Which of the following observations would be made prior to administering an oral medication?

A) The temperature dropped in a patient receiving acetaminophen for fever.
B) The patient is alert and able to swallow solid foods.
C) The patient vomited immediately upon taking her medications.
D) The patient reports relief of pain and is resting comfortably.

Question 21

You observe that Mrs. Eagle is becoming more lethargic. Which of these would not occur as a result of this observation?

A) The route of administration may have to be altered if she is not alert enough to take oral medications.
B) The medications may have to be held until she is more alert.
C) You would go ahead and give the medications.
D) You should check to see if Mrs. Eagle can swallow solids before giving oral medications.

Question 22

Which of these is an observation that might be made following the administration of a medication?

A) The NG tube is in the correct position.
B) The IV is patent and there are no signs of inflammation at the site.
C) The patient is allergic to penicillin.
D) The patient's blood pressure decreased as expected.

Question 23

Which of the following promotes patient compliance with medication regimen?

A) Ordering medications to be taken at multiple times a day.
B) Educating the patient about his medications.
C) Telling the patient to take the medications because the doctor ordered them.
D) Explaining that the doctor knows best.

Question 24

Which of the following is not part of the basic information a patient should be taught about her medications?

A) purpose of the medication
B) interactions with other drugs
C) how to pay for the drugs
D) side effects

Question 25

Prior to providing patient education, the medicating practitioner must

A) ensure that the patient will take the medications.
B) assess the patient's prior knowledge and literacy level.
C) assess the patient's financial status.
D) ensure that the patient understands the information.

Question 26

You need to _____ in order to teach patients as well as observe the effects of unfamiliar medications.

A) ask co-workers for information
B) call the manufacturer to obtain information
C) be familiar with available medication reference materials
D) read the medication's label

Question 27

A registered nurse is transcribing a verbal order dictated over the telephone by a physician. The physician has a thick accent and is difficult to understand. The nurse writes, "750 mg Clozaril three times daily for 30 days for ulcerative colitis." When the nurse reads this back to the physician, the physician says the medication is not correct and repeats the name of the medication; again, it sounds to the nurse like Clozaril. At this point, what should the nurse do?

A) Assume that the physician means Clozaril, since she repeated it twice.
B) Ask the physician to spell the name of the medication.
C) Write the order for Colazal because it is used to treat ulcerative colitis.
D) Tell the physician that she must fax the medication order.

Question 28

Mr. Anderson is to receive a medication that was prepared, prepackaged, and labeled with his name by the hospital pharmacy. The medication technician greets Mr. Anderson and verifies his identity, then removes the medication from its storage container and checks it against the MAR. She then administers the medication to Mr. Anderson. What did the medication technician do wrong?

A) She did not prepare the medication.
B) She failed to verify the medication against the medication order.
C) She did not perform all of the three medication checks.
D) She did not call the pharmacy to confirm the medication amount.

Question 29

How many times should the drug label be checked before a medication is administered to a patient?

A) 1
B) 2
C) 3
D) 4

Question 30

The medication order for Mrs. Valentino is to administer a medication via the patient's nasogastric tube. When the medication technician enters Mrs. Valentino's room, he observes that Mrs. Valentino no longer has a nasogastric tube; it was discontinued earlier in the day. What should the medication technician do?

A) Administer the medication by mouth.
B) Ask the patient if she is able to swallow.
C) Document that the medication could not be administered.
D) Consult the RN or the authorized practitioner.

Question 31

A hospital patient is experiencing severe nausea and asks for medication to help relieve it. The RN checks the patient's chart and notes that the physician has authorized Compazine 25 mg pr q12h as needed for nausea. The patient has not had any Compazine for the last 24 hours, so the RN administers a rectal suppository. For which of the following should the nurse observe after administering the Compazine?

A) that the suppository is retained by the patient
B) that the patient does not vomit
C) that the patient's IV line is functional
D) that the suppository dissolves as expected

Question 32

Which of the following observations should be made following medication administration regardless of the route of administration?

A) Observe whether the IV infiltrated.
B) Observe for untoward reactions to the medication.
C) Observe whether the patient is able to swallow.
D) Observe whether the patient vomits within 5 minutes.

Question 33

Patient teaching about a medication should include all of the following except

A) purpose of the medication.
B) medication schedule related to food intake.
C) name of the drug manufacturer.
D) name of the medication.

Question 34

A patient comes into the drugstore and gives the pharmacy technician a handwritten prescription from his physician. The writing is barely legible, but it looks like the ordered medication is spelled Z-O-C-C-O-R-E. The pharmacy technician looks up the name in the Physicians' Desk Reference but cannot find it. The pharmacist is on the phone with a physician and is not currently available. What should the pharmacy technician do?

A) call the AP to verify the name of the medication.
B) assume that this is a misspelling of the medication Zocor.
C) ask the patient the name of the medication.
D) search online for a medication named Zoccore.

Question 35

Which personnel may accept verbal orders in the United States is governed by

A) local ordinance.
B) state law.
C) the Institute for Safe Medication Practice.
D) The Joint Commission.

Question 36

Which of the following is not included in the TJC guidelines for verbal orders?

A) Read the order.
B) Write the order.
C) Revise the order.
D) Confirm the order.

Question 37

To verify that you have the _______________ patient in the outpatient setting, you can request the patient's driver's license to compare it to the medication order.

Question 38

Mr. Gibbs questioned one of his medications. The healthcare provider should recheck the order to make sure the patient receives the right _______________.

Question 39

Care must be taken when performing drug calculations to be sure the patient is given the right _______________.

Question 40

Mrs. Walsh requested more pain medication. According to the MAR, she can have the medication every 4 hours. She last received a dose at 1400 and it is now 1630. The healthcare provider gives the medication. This violates the basic right of the right _______________ for medication administration.

Question 41

A healthcare provider giving medications must know the _______________ for giving the drug.

Question 42

Medication administration must be followed by the right _______________ on the patient's MAR.

Question 43

The use of an eMAR requires a(n) _______ password when logging on to the computer.

Question 44

If an order is not _______________ or you do not understand an abbreviation, you must contact the prescribing physician to clarify the order.

Question 45

The patient has the right to _______________ a medication; however, the healthcare provider must document this and notify the physician.

Question 46

Before administering a medication, it is important to _______________ the patient and make sure the patient name on the medication record is exactly the same as the patient's name.

Question 47

T.I.W. for three times a week is a(n) _______________ abbreviation and should not be used.

Question 48

The patient is ordered Tobramycin 1% ophthalmic gtt i OD qid. This medication should be transcribed as Tobramycin 1% ophthalmic 1 drop to _______________ four times a day.

Question 49

The Zantac order is missing the _______________.

Question 50

The dose specified for digoxin is missing the _______________, which could lead to a medication error by misreading the dose as 125 mg.

Question 51

The instructions for Norvasc should be written "hold if BP is _______________

Question 52

The _______________ is missing from the Nitrobid transcription.

Question 53

The instructions for _______________ should be written "hold if the heart rate is less than 60 or greater than 100."

Question 54

When taking a(n) _______________ order, the practitioner should write the order as she receives it, read the order back to the AP, and have the AP confirm the order.

Question 55

The _______________ identified guidelines for verbal orders.

Question 56

The first TJC guideline for verbal orders is to _________ the order.

Question 57

It is important to _______________ a verbal order with the prescriber to ensure that it is correct.

Question 58

The process of transferring information from a physician's order to the MAR is called_____________.

Question 59

The Joint Commission and the Institute for _______________ Medication Practice have identified abbreviations that should not be used.

Question 60

The purpose of ____________ a patient during medication administration is to be sure the medication is safely received.

Question 61

Patients should be told to keep a current list of _______________ to give to the AP.

Question 62

Patient ______________ promotes accuracy and patient compliance with medications.

Question 63

In order to provide patient teaching, it is important to be familiar with medication _______________ materials to be able to look up unfamiliar medications.

Question 64

After an authorized practitioner writes a verbal order, according to TJC guidelines, the next step is to _______________ the order.

Question 65

To promote accuracy and safety, the medication label should be checked _______________ before the medication is administered to the patient.

Question 66

Patient _______________ refers to explaining to the patient or caregiver how to procure the prescribed medication, how to administer it, and what to look for when administering it.

Question 67

Usually, medication orders must be written and/or personally _______________ either by hand or electronically by a licensed prescribing practitioner.

Question 68

After a verbal order has been taken, the authorized prescriber must go back into the patient's medical record and sign the order, usually within _______________.

Question 69

In most cases, delivering a medication "on time" means administering it within _______________ of the scheduled time.

Question 70

The _______________ is an authoritative, current drug reference that contains comprehensive information from the manufacturers of prescription medications.