CH8- Safety in Medication Administration

A patient is prescribed a medication with the abbreviation "IN" behind its name. For which other terms is this abbreviation most likely to be mistaken? Select all that apply. a. Injection b. Intramuscular c. International unit d. Intravenous e. Intrajugular

b. intramuscular d. intravenous

The primary care provider has ordered a medication to be given STAT. If all routes are possible for this medication, which is the nurse's best choice? a. Intramuscular (IM) b. Subcutaneous (SQ) c. Intravenous (IV) d. By Mouth (po)

c. intravenous (IV)

Which is an approved medication dosage abbreviation that can safely be used to administer medication to a patient? a. cc b. IN c. U d. mg

d. mg

Why do drug manufacturers not develop single doses for all medications as per the unit-dose dispensing system? a. Packaging for unit-dose medication is not available. b. Formulations for unit-dose medications are difficult to develop. c. Only generic drugs can be dispensed as per the unit-dose dispensing system. d. Not all medications that are prescribed for a patient are dosed in the exact amount manufactured.

d. not all medications that are prescribed for a patient are dosed in the exact amount manufactured

A patient is prescribed a specific oral medication that is not available in the hospital. The nurse gives the patient the same drug but in a different form that needs to be given intravenously. To which patient "right" is the nurse failing to adhere? a. Right patient b. Right drug c. Right time d. Right route

d. right route

The registered nurse is preparing to administer a medication to a pediatric patient. To ensure the proper dosage has been ordered, which should be the nurse's priority in the plan of care? a. Referencing the drug handbook b. Calling the pharmacist c. Reviewing the laboratory tests d. Weighing the patient

d. weighing the patient

Which component of the prescription "Lasix 20 mg po hs" is on the error-prone abbreviations list? a. 20 b. po c. mg d. hs

d. hs

A nurse withdraws a narcotic from the medication dispenser. When double checking the medication record, the order for the narcotic is expired. What is the nurse's priority nursing action? a. Return the medication to the medication dispenser according to protocol. b. Call the nurse manager to document and report the medication error. c. Assess the patient and determine if the medication is needed, and if so, administer as ordered. d. Call the pharmacy and initiate a root cause analysis for the medication error.

a. return the medication to the medication dispenser according to protocol

Which abbreviation is considered error prone and should be avoided with medication orders? a. AD b. IV c. PO d. SL

a. AD

Which is most likely responsible for adverse effects experienced by a patient over 65? a. Age-related changes b. Decreased immune response c. Increased protein levels d. Decreased liver function

a. age-related changes

The nurse works for a health care facility that uses the unit-dose method. Which nursing action is most appropriate when the drugs are delivered in multiple-use bottles? a. Calling the health care provider for clarification and approval b. Calculating the dose and administering the drug accordingly c. Delegating an unlicensed assistive personnel to prepare the dose before administration d. Checking the American Hospital Formulary Service (AHFS) Drug Information for the correct dose

a. calling the health care provider for clarification and approval

Which factors in medication administration records (MARs) can contribute to medication errors? Select all that apply. a. Confusion of dosing units b. Use of inappropriate abbreviations c. Misuse of zeros and decimal points d. Failure to educate patients properly e. Errors in mathematical calculation of dosages

a. confusion of dosing units b. use of inappropriate abbreviations c. misuse of zeros and decimal points

Which statement is correct regarding the distribution of controlled substances by a computerized medication dispensing system? a. Controlled substances are kept in a computerized medication dispensing cart. b. The nurse needs to send requests to the pharmacy to supply controlled substances as per the health care provider's order. c. To access the controlled substances in a computerized medication dispensing system, the nurse only uses a security code and password. d. A biometric fingerprint scan is required to access the controlled substances in a computerized medication dispensing system.

a. controlled substances are kept in a computerized medication dispensing cart

Which statement about unit-dose packaging is correct? a. Dose calculation is sometimes necessary for unit-dose packaging. b. More than one dose of the medications is packed in the containers. c. The pharmacy provides a 48-hour supply of medications for each patient. d. Both generic and trade names of the drug are mandatory on unit-dose packaging.

a. dose calculation is sometimes necessary for unit-dose packaging

A nurse in a long-term care facility is reviewing a resident's medication administration record, which is four pages in length. The nurse knows that polypharmacy carries which of the following risks for older adults? Select all that apply. a. Increased risk of complications b. Decreased continuation of care c. Decreased cognition d. Increased medication adherence e. Decreased cost of medical care

a. increased risk of complications c. decreased cognition

When presenting the Omnicell Savvy Mobile Medication System, what feature would the nurse be sure to include? a. Nurses can retrieve scheduled medications from this system. b. Nurses need to go to the Omnicell to retrieve medications. c. No security code or password is necessary to access this system. d. Medications wasted at the patient's bedside require manual reporting.

a. nurses can retrieve scheduled medications from this system

The nurse provides the patient with a new medication. The patient refuses the medication, stating that he or she does not know what the medication is for. What is an important note in the documentation of this incidence? a. Patient's mental status b. Patient's age c. Patient's other medications d. Patient's admission status

a. patient's mental status

The nurse assesses for signs of drug toxicity in older adults because of which physiological change? a. Reduced glomerular filtration rate b. Decreased blood albumin levels c. Decreased gastric peristalsis d. Decrease in cognitive function

a. reduced glomerular filtration rate

A nurse is preparing to administer medications to an older adult patient who is confused. To ensure that the six "rights" of medication are followed, the nurse will identify the patient with which actions? Select all that apply. a. Reviewing the patient's identification (ID) band b. Asking the roommate to identify the patient c. Using the patient's personal belongings d. Asking a family member the patient's name and date of birth e. Asking another nurse to check the patient's identification band

a. reviewing the patient's identification (ID) band d. asking a family member the patient's name and date of birth

Cross-checking a generic medication name with the trade name fulfills which "right" of medication administration? a. Right medication b. Right time c. Right patient d. Right dose

a. right medication

Patient safety is of the utmost importance in the clinical setting. Which are the "rights" of patient safety? Select all that apply. a. Right patient b. Right drug c. Right health care provider d. Right time e. Right documentation

a. right patient b. right drug d. right time e. right documentation

Which medication errors are prevented by inserting a zero in front of a decimal of a medication order? Select all that apply. a. The decimal is mistaken for a zero. b. The position of the decimal is missed. c. The zero indicates the correct strength. d. The dose is mistaken for a whole number. e. The frequency of medication administration becomes unclear.

a. the decimal is mistaken for a zero b. the position of the decimal is missed d. the dose is mistaken for a whole number

What is the difference between the stock-drug method and the unit-dose method of drug distribution? a. The unit-dose method depends more on the pharmacy. b. The stock-drug method is less prone to medication error. c. The unit-dose method requires a nurse to calculate the correct dose. d. The stock-drug method requires storage of drugs in patient-identified drawers in a large cabinet at the nurse's station.

a. the unit-dose method depends more on the pharmacy

Which practices does the nurse recognize that are implemented to reduce medication errors and increase patient safety? Select all that apply. a. Use of safety syringes b. Use of tall man letters c. Delegation to unlicensed assistive personnel d. Patient administration of home medications e. Automated medication dispensing systems

a. use of safety syringes b. use of tall man letters e. automated medication dispensing systems

A nurse is tasked with providing documentation for a patient who has a new prescription of insulin, to be administered in international units (IU) subcutaneously. How is this measurement abbreviation most likely to be mistaken? a. Unit b. 10 c. Morphine d. Magnesium sulfate

b. 10

Which order can be safely interpreted as Lasix 40 milligrams orally daily? a. Lasix 40 μg prn per os q.d. b. Lasix 40 mg PO daily c. Lasix 40 μg PO daily d. Lasix 40 mg PO qd

b. Lasix 40 mg PO daily

When caring for a patient who is transferred between units, which action is most useful in preventing medication errors? a. Informing nurses on previous unit of the transfer b. Completing a medication reconciliation between units c. Bringing the patient's belongings to the new unit d. Notifying the family of the transfer

b. completing a medication reconciliation between units

Oral medications can irritate the gastric lining. Which does the nurse recognize as the formulation that is most effective in decreasing gastric irritation? a. Capsules b. Enteric coating c. Delayed-release d. Scored tablets

b. enteric coating

The nurse administers a medication to the wrong patient. Which is the most appropriate nursing action following this error? a. Do nothing, because the patient appears to be fine and no one witnessed the error. b. Notify the health care provider, and document the error on an incident report. c. Notify the patient, apologize profusely, and then administer the right medication. d. Notify the pharmacy and no one else.

b. notify the health care provider, and document the error on an incident report

A nurse checks a bottle of bulk generic medication received from the pharmacy before administration. The drug's name is correct as per the health care provider's order, but the nurse refuses to administer it and sends it back to avoid a medication error. What is the most likely rationale behind the nurse's action? a. The drug differed in shape and color. b. The institution uses the unit-dose method for drug distribution. c. The institution uses the stock-drug method for drug distribution. d. The nurse could not calculate the correct dose of administration.

b. the institution uses the unit-dose method for drug distribution

Which statement regarding a medication error is correct? a. Medication errors can occur only during the administration of the medication. b. The nurse who administers a medication is legally liable for the medication error. c. Medication administration bar code scanners are thought to increase medication errors. d. Handwritten orders by health care providers enhance clear communication and minimize the risk of medication errors.

b. the nurse who administers a medication is legally liable for the medication error

When admitting an older adult patient to an acute care setting, which nursing strategy is most appropriate in preventing medication errors? a. Make sure the patient has applesauce to take with his or her medications. b. Ask the patient what medications he or she takes. c. Ask the patient and/or family to bring in all medications the patient was taking at home. d. Ask the patient's family what medications he or she takes.

c. Ask the patient and/or family to bring in all medications the patient was taking at home

Which example of the use of the tall man letters that can reduce errors for look-alike and sound-alike medications is correct? a. dopAMINE and dobutAMINE b. DOpamine and DObutamine c. DOPamine and DOBUTamine d. DOpAMINE and DObutAMINE

c. DOPamine and DOBUTamine

What does the Food and Drug Administration (FDA) require for labeling generic name pairs that are associated with medication errors? a. Lowercase letters b. Capital letters c. Tall man letters d. Mixed letters and numbers

c. Tall man letters

Which is an example of a medication error? a. Administering intravenous medication too slowly b. Administering an intramuscular injection in the left gluteus c. Administering subcutaneous insulin using a tuberculin syringe d. Administering ear drops in both ears when the prescriber used the abbreviation "AU"

c. administering subcutaneous insulin using a tuberculin syringe

The nurse accidentally spills liquid medication minutes before administration. Which nursing action is most appropriate if the facility follows the unit-dose method of drug dispensing? a. Prepare an incident report. b. Call the health care provider and request a reorder. c. Ask the pharmacy to replace the drug on a priority basis. d. Prepare the dose again from the large container stored on the floor.

c. ask the pharmacy to replace the drug on a priority basis

A nurse gives a patient two tablets of acetaminophen instead of the prescribed one tablet of acetaminophen-codeine. Which is the priority nursing action after the medication error is identified? a. Informing the health care provider b. Notifying the nursing supervisor c. Assessing the patient for side effects d. Documenting the problem on an incident report

c. assessing the patient for side effects

Which statement is correct regarding controlled substances in a computer-controlled medication dispensing system? a. It does not distribute Schedule I and II controlled substances. b. It distributes controlled substances only when the pharmacy gives the system access. c. It provides a detailed record regarding the usage and the user of the controlled substances. d. It cannot monitor the distribution of controlled substances after 48 hours of a health care provider's order.

c. it provides a detailed record regarding the usage and the user of the controlled substances

What is an advantage of the unit-dose method of drug dispensing? a. More drugs are available for selection. b. Drugs are always available for administration. c. Nurses save time preparing drugs for administration. d. The availability of large quantities of a drug enhances the cost efficiency.

c. nurses save time preparing drugs for administration

The nurse recognizes many factors contributing to medication errors in older adults. Which of the following is a priority for home care nurses in minimizing the risk for error? a. Explaining the purposes of each medication b. Providing the patient with a list to keep in the wallet c. Providing detailed directions, including the time of administration d. Ensuring that childproof containers are provided by the pharmacy

c. providing detailed directions, including the time of administration

A nurse reads an order for 25 mg of a medication. After administering 25 mg of the medication to the patient, the nurse discovers that the order actually reads 2.5 mg. What is the nurse's priority action? a. Call the health care provider. b. Initiate a rapid response. c. Contact poison control. d. Assess the patient.

d. assess the patient

Which step should a nurse take on receiving the following order: "Give propranolol 40 mg PO STAT"? a. Administer 140 mg of propranolol orally. b. Administer 40 mg of propranolol orally. c. Cross-reference the medication. d. Contact the prescriber for clarification.

d. contact the prescriber for clarification