Medication Study Guide for Unlicensed Person in Adult Care Homes

The physician's order is for Lactulose 2 tsp. by mouth at bedtime. How much would you give using the metric system? A. 10 ml. B. 15 ml. C. 20 ml. D. 30 ml.

A

When new orders are received, the MAR is changed to reflect the new orders. A. True B. False

A

You are legally responsible for any medication or treatment you administer. A. True B. False

A

A medication cannot cause a resident to be confused. A. True B. False

B

Never administer medications that: A. are discolored. B. are outdated or expired. C. both A and B.

C

The following are abbreviations for dosages or strengths of medications EXCEPT: A. mg B. ml C. gm D. PD

D.

An order is received for Mellaril 10mg every morning. The physician orders Mellaril Liquid, since the resident is not able to swallow tablets or capsules. Which of the measuring devices above would you use to measure 10mg of Mellaril? A. Medication Cup. B. Tablespoon. C. Oral Syringe. D. Oral Dropper. E. None of the devices should be used.

E

Information or documentation on the MAR for PRN (as needed) medications that are administered includes: A. the amount or quantity of medication administered. B. the specific time of administration. C. the initials of the person administering the medication. D. the effectiveness of the medication. E. all of the above.

E

Hour of sleep or bedtime

HS or qhs

MAR

Medication Administration Record

Tbsp

Tablespoonful

q

every

gram

gm

milligram

mg

oz

ounce

tsp

teaspoonful

bid or BID

twice a day

If a resident is using the bathroom at the time you are to administer the resident's medications, it is acceptable to: A. Flag the MAR to remind you to return to that resident later in the medication pass to administer the medications. B. Omit the medications and record the medications were not administered on the MAR. C. Administer the medications while the resident is using the bathroom. D. A and C.

A

It is important to know the policy on approved abbreviations for your facility. A. True B. False

A

Labels Group Care Pharmacy 701 Barbour Drive Raleigh, NC 27603 919-855-3765 Rx 200000 01/03/03 Jim Barefoot Take one tablet by mouth three times daily before meals and at bedtime. Metoclopramide 10mg #30 tablets Dsp. By J. Brickley, RPh. Dr. Doug Fitzgerald Refills: 0 Exp. 01/30/04 The name of the pharmacist is: A. Dr. Doug Fitzgerald. B. Jim Barefoot. C. J. Brickley. D. Not given.

A

Medications should be given within one hour before or one hour after the prescribed or scheduled time of administration. A. True B. False

A

Mr. Cook who is an alert and oriented resident refuses all of his morning medications. He says the medications do not help him and he doesn't need them. Your best response is to: A. Encourage the resident to take the medications by explaining the importance and purposes of the medications. B. Tell the resident " Your physician said that you must take this medication." And force him to take the medications. C. Hide the medication in the resident's food or drink. D. Leave the medications with the resident, in case he decides to take them later

A

You receive an order for Nitroglycerin to be given sublingually. It would be given: A. Under the tongue B. By mouth C. Instilled in the ear D. Applied to the skin

A. under the toungue

If you are unable to read the physician's handwriting on a prescription or health services record or the directions for a medication are incomplete, you should: A. Leave the orders for the staff on the next shift. B. Contact your supervisor, the pharmacist or the physician. C. Ask the resident or a family member. D. Use your best "guess."

B

On 02/06/00, the physician ordered Coumadin 5mg by mouth every other day. The facility did not receive the Coumadin until 02/13/00. According to the MAR, was the Coumadin administered as ordered? A. Yes B. No

B

You are assigned to administer 8:00AM medications today. It is 8:00AM and the residents need to be at the workshop by 8:00AM, the van is waiting. You should: A. Pour medications from memory. B. Get the untrained staff (no medication training) to assist you. C. Administer medications as you were trained, even if this means the residents will be late for the workshop. D. Tell the residents you will bring their medications to the workshop and administer them later.

C

The physician orders Haldol Solution 2mg by mouth at bedtime. Which of the measuring devices above would you use to measure 2mg of Haldol? A. Medication Cup. B. Tablespoon. C. Oral Syringe. D. Oral Dropper. E. None of the above devices should be used.

E

When administering two or more different eye drops at the same time, which of the following apply: A. Wash your hands prior to and after administration of the eyedrops. B. Wear gloves when there is redness, drainage or possibility of infection. C. Allow a 3-minute to 5-minute period between the administration of each eye medication. D. Sign/initial the medication administration record (MAR) after the administration of each type of eye drop. E. All of the above.

E

ac

before meals

Twice a day

bid or BID

The following are abbreviation for drug routes, EXCEPT: a. PO b. IM c. PD d. SL

c

ml

milliliter

OTC

over the counter

qid or QID

4 times a day

A delay in administering a medication may cause a life-threatening incident. A. True B. False

A

A drug reference book is a helpful tool to identify or find information on medications and dosages and side effects. A. True B. False

A

A resident's allergies should be documented on the MAR and the resident's record. A. True B. False

A

A telephone or verbal order for medications and treatments must be signed by the person who prescribed the medications within: A. 15 days from the date the order is given. B. 30 days from the date the order is given. C. 20 days from the date the order is given. D. None of the above

A

An inhaler must be shaken: A. Before each and every time you use it. B. After each and every time you use it. C. If the physician orders more than one puff to be administered to the resident. D. Only if it becomes clogged.

A

Checking the medication label against the MAR three times should always: A. Be done with each medication administered to each resident. B. Be done by the new staff members. C. Be done if you do not know the resident. D. Be done if it is a new medication order.

A

Oral medications must be stored separately from topical or external medications. A. True B. False

A

Over-the-counter drugs may be kept as floor stock or house stock in an adult care home. A. True B. False

A

Regulations for the accountability or recordkeeping of controlled substances differ from the regulations for non-controlled medications. A. True B. False

A

Residents have a right to refuse medications. A. True B. False

A

Staff giving medications in adult care homes have to demonstrate certain skills with administering medications and be checked off or validated by a registered nurse or registered pharmacist. A. True B. False

A

The facility is required to maintain or keep all medication orders for a resident: A. in the resident's record in the facility. B. at the pharmacy. C. in any type of notebook or record, as long as the order is in the facility. D. in the resident's room.

A

The physician ordered Darvocet N-100 1 tablet every 4 hours by mouth as needed for pain. The medication order for Darvocet is not transcribed correctly on the MAR because: A. Specific administration times are not scheduled for prn medications. B. Administration times on the medication administration record (MAR) should include 12PM and 4PM.

A

The physician orders Potassium Chloride Solution 1 tablespoonful mixed with water or juice every morning. Which of the measuring devices would you use to measure 1 tablespoon of Potassium Chloride? A. Medication Cup. B. Tablespoon. C. Both A (Medication Cup) and B (Tablespoon) may be used.

A

The physician's order is for Milk of Magnesia 2 Tbsp. by mouth at bedtime. How much would you give using the metric system? A. 30 ml. B. 45 ml. C. 10 ml. D. 60 ml.

A

When a medication cannot be administered on time: A. document the reason for the delay on the MAR. B. call the resident's family. C. don't worry about it and continue with your work. D. tell the kitchen staff.

A

When administering medications, the main concern with leaving medications at the bedside is that: A. the resident may never take the medications and someone else may. B. the medications may accumulate dust. C. it may increase confusion. D. a staff member might report you.

A

When measuring liquids, which of the following statements is FALSE: A. A teaspoon or tablespoon from the kitchen may be used. B. A calibrated syringe or dropper is often necessary for measuring amounts less than 5ml and unequal or odd amounts. C. When using a medication cup, it should be placed on a flat surface and measured at eye level. D. You never approximate or guess the amount of medication to administer.

A

When should medications be signed off on the MAR? A. After a resident has been observed to actually take the medication B. After all the residents have been administered their medications and observed to actually take the medications C. After the medication label is checked with the MAR D. Before the county or state visits the home.

A

Which of the following is TRUE when prepouring or preparing medications in advance: A. Oral solid medications (tablets and capsules) for routine administration may be prepared within 24 hours of the prescribed time for administration. B. PRN medications may be prepared in advance. C. Medications may be crushed at the time the medications are prepoured or prepared in advance. D. A, B, and C are true.

A

"Ambien 5mg po as needed for sleep": A. is a complete medication order B. is an incomplete order

B

A medication that is ordered sublingually may be chewed or swallowed. A. True B. False

B

A milliliter is the same as a milligram. A. True B. False

B

All of the following are examples of medication errors EXCEPT one. Which one of the following is NOT a medication error? A. the omission of a prescribed medication. B. the refusal of a medication by a resident. C. failing to perform any of the six rights of medication administration. D. administering medications that have not been prescribed including OTCs or nonprescription medications.

B

Before administering a "PRN" medication, you need to: A. Know the reason the medication is being requested and ask the resident when the medication was last administered. B. Know the reason the medication is being requested and look at the MAR to see when the medication was last administered.

B

If you are not sure of an abbreviation, it is O.K. to guess A. True B. False

B

If you question a dosage, give the medication then call the pharmacy. A. True B. False

B

Labels Group Care Pharmacy 701 Barbour Drive Raleigh, NC 27603 919-855-3765 Rx 200000 01/03/03 Jim Barefoot Take one tablet by mouth three times daily before meals and at bedtime. Metoclopramide 10mg #30 tablets Dsp. By J. Brickley, RPh. Dr. Doug Fitzgerald Refills: 0 Exp. 01/30/04 According to the prescription label, there are no refills for the medication. Which of the following statements is true? A. The medication should be discontinued after the 30 tablets are administered. B. The physician should be contacted regarding the refills, before all the medication is administered.

B

Mr. Jones, a resident of an adult care home, is going to visit his family for the week. The proper way to prepare Mr. Jones' prescription medications to take with him would be to: A. Remove the amount of medications needed for the week from the resident's supply of medication, place the medications in labeled containers and document the medications sent on the appropriate facility form. B. Send the medications in containers that have been filled and labeled by a pharmacist and document the medications sent on the appropriate facility form.

B

On 02/09/00, the physician discontinued Lasix 40mg by mouth once daily and ordered Lasix 40mg by mouth twice daily. Were the orders for Lasix transcribed correctly on the MAR? A.Yes B. No

B

Unlicensed staff in adult care homes may administer intramuscular (IM) injections and subcutaneous (SQ) injections. A. True B. False

B

When a resident has difficulty swallowing, the resident is at risk for: A. Asthma B. Aspiration C. Arrhythmia D. Arthritis

B

When administering medications this morning, Mrs. Walls is extremely difficult to wake up. She is having difficulty with swallowing her medications. You should: A. Crush her medications so she will be able to swallow the medications and then notify your supervisor, nurse or physician. B. Hold her medications at this time and immediately notify your supervisor, nurse or physician.

B

When administering medications, it is O.K. to leave a resident's medication at the bedside if the resident is present. A. True B. False

B

When medications are stored in a refrigerator that is accessible to residents, the medications are to be: A. Stored in a separate container in the refrigerator. B. Stored in a separate locked container in the refrigerator.

B

When you are administering a medication and the order on the MAR does not match the directions on the medication label, you should: A. Administer the medication according to the MAR. B. Notify the supervisor, nurse or pharmacist and/or look in the resident's record for the current medication order. C. Administer the medications according to the directions on the medication label. D. Omit the medication and leave a note for the next shift.

B

Which of the following statement is NOT true about allergies and medications? A. An allergy is a reaction that occurs as the result of an unusual sensitivity to a medication or other substance. B. Allergic reactions can include rashes, swelling, itching but are never life threatening. C. Document all allergies in the resident's record, or document "No Known Allergies", if the resident does not have any allergies. D. All allergic reactions or suspected reactions should be reported promptly to the supervisor, nurse, physician or pharmacist according to facility policy.

B

You are with a resident at a doctor's appointment. The physician writes an order for Amoxicillin and you know the chart is flagged "Allergic to Amoxicillin". You should: A. Administer the medicine as ordered, the physician knows best. B. Remind the physician of the allergy warning. C. Pull the allergy label off the record.

B

"As needed" (PRN) medications must be administered according to: A. The facility's administration time schedule for medications. B. The resident's choice of time and frequency. C. The reason and frequency of administration specified in the physician's order. D. The family's request on how often the medication can be given and for what reasons.

C

A medication arrives from the pharmacy, and there is no order for the medication on the MAR, you should: A. Copy the directions on the medication label onto the MAR. B. Administer the medication according to the directions on the medication label. C. Look in the resident's record for an order and/or notify the supervisor, nurse, or pharmacist before administering the medication. D. Omit the medication and write a note for the next shift to check on it.

C

A medication order is transcribed onto the MAR: A. Only after the medication arrives from the pharmacy. B. Only after the family brings in the medication C. Only after a physician's order for the medication is received by the facility. D. All of the above.

C

A resident has just returned to the facility from the hospital and the medication order on the FL-2 is "Continue previous medications". You should: A. Ask the resident or family if there were any medication changes. B. Administer the medications that the resident was receiving prior to hospitalization. C. Contact the resident's physician for medication orders.

C

A resident returns from a home visit and the resident's mother brings an over-thecounter medication that she purchased and asks you to administer it for cold symptoms, you should: A. Give the medication as requested. B. Refuse and throw the medication away. C. Explain to the mother that even over-the-counter medications require a physician's order.

C

All of the following are considered reasons for medication errors, EXCEPT: A. Transcribing information incorrectly onto the MAR. B. Administering medications by the directions on the medication label without using the MAR. C. Checking the medication label with the MAR when administering medications. D. Administering medications by memory.

C

How many minutes should a medication prescribed "before meals" be administered prior to eating? A. 15 minutes B. 5 minutes C. 30 minutes D. 60 minutes

C

If a prescription label becomes soiled or directions change, you should: A. Write the directions on the medication label so everyone can read the directions. B. Call the pharmacy for a new label and tape the new label over the soiled or incorrect label. C. Report it to the supervisor, nurse or pharmacist.

C

If the resident expresses concern about a medication you are about to administer: A. give it anyway. B. walk away and document "refused". C. double check the medication and dosage information. D. give it to his roommate.

C

If you have to calculate dosages, it is best to: A. ask the resident the correct dosage. B. do your best calculations and administer the medication. C. ask the supervisor, nurse or the pharmacist to calculate the dosage with you.

C

In order for a medication to be administered you must have: A. permission from the family B. a drug handout of information from the pharmacist C. a physician's order

C

Labels Group Care Pharmacy 701 Barbour Drive Raleigh, NC 27603 919-855-3765 Rx 200000 01/03/03 Jim Barefoot Take one tablet by mouth three times daily before meals and at bedtime. Metoclopramide 10mg #30 tablets Dsp. By J. Brickley, RPh. Dr. Doug Fitzgerald Refills: 0 Exp. 01/30/04 The order on the MAR for the above resident is: "Propulsid 10mg one tablet three times daily before meals and at bedtime." The medication container received from the pharmacy is labeled as indicated above. You should: A. Give the medication received from the pharmacy three times daily before meals and at bedtime. B. Not give the medication and leave a note for staff on the next shift. C. Not give the medication and notify the supervisor, pharmacist, nurse or physician according to the facility's policy.

C

Mrs. Smith has an order for Darvocet N-100 1 tablet every 4 hours as needed for pain. According to the MARs, she has been taking the Darvocet at 8AM, 12PM, 4PM and 8PM every day for the past 2 months. Which of the following statement is correct? A. Schedule the Darvocet for 8AM, 12PM, 4 PM and 8PM on the (MAR) B. Just continue to administer the medication when Mrs. Smith requests the Darvocet. C. Mrs. Smith's physician should be contacted about how often Mrs. Smith is taking the Darvocet.

C

The following statement about non-prescription (OTC) medications is FALSE: A. They may be kept in the original container with the manufacturer's label and expiration date. B. They may be packaged and labeled by a pharmacist. C. They may be administered to a resident without a physician's order. D. They can produce unwanted effects.

C

When applying a topical medication, you should wear: A. A waterproof gown. B. A mask. C. Gloves. D. A mask and gloves.

C

You remove a resident's medications from the packages or containers and the resident refuses to take his 12PM medications, you should: A. Put each medication back into the appropriate container or package that the medication came from. B. Leave the medications with the resident in case the resident decides to take the medications later. C. Dispose of the medications in accordance with the facility's policy and procedures. D. Both A and C are correct.

C

99. The physician's order is for Haldol Liquid Concentrate 2ml every 8 hours. How much would you give? A. 1 milligram (mg). B. 2 milligrams (mg). C. 5 milligrams (mg). D. None of the above are correct.

D

After the resident has received nose drops, the resident should: A. Remain with his head tilted slightly back for about 60 minutes. B. Blow his nose. C. Remain with his head tilted slightly forward for a few minutes. D. Lie down with head lower than shoulders for a few minutes.

D

Medication errors may: A. interfere with how effective the medication will be. B. produce bad reactions. C. threaten the resident's life. D. all of the above.

D

One of the best ways of identifying the correct resident is to: A. Ask another staff member. B. Ask another resident. C. Ask residents to spell their names. D. Use photographs of the residents.

D

The medication label and the MAR are compared: A. When selecting or removing the medication from the supply or storage area. B. Before pouring the medication. C. After pouring and before returning the medication to the supply or storage area. D. All of the above.

D

The physician ordered Dilantin Suspension 4ml by mouth three times daily for a resident. Which measuring device would you use to measure 4ml of Dilantin? A. Medication Cup. B. Tablespoon. C. Oral Syringe. D. Oral Dropper. E. Both A (Medication Cup) and D (Oral Dropper).

D

The physician's order is for Riopan Liquid 2 every 4 hours as needed for heartburn. How much would you give using the metric system? A. 1 ml. B. 2 teaspoons. C. 2 Tablespoons. D. Can't tell how much to give from this order.

D

The resident's physician or prescribing practitioner is to be contacted about the resident's medication orders: A. if the FL-2 is not dated and signed within 24 hours of admission to the facility. B. when the medication orders on a FL-2 and discharge summary do not match. C. if a medication order is incomplete or unclear. D. all of the above.

D

Three of the four statements below are requirements when residents administer their own medications. Which one is not a requirement for self-administration? A. A physician's order is necessary for the resident to self-administer. B. The physician is contacted if there is a change in the resident's physical or mental abilities. C. The medications are to be stored in a safe and secure manner. D. The resident has to be observed to take each dose of medication.

D

When administering medications, it is safe practice to: A. rely only on the color of the medication. B. rely only on the shape of the medication. C. rely only on the location of the container. D. read the label and the MAR each time a medication is administered.

D

You have to document on MAR when a medication is: A. Administered B. Refused C. Omitted D. All of the above.

D

Side effects of medications may include: A. Change in behavior. B. Rash. C. Change in swallowing. D. Change in mobility or walking. E. All of the above.

E

Metric System 1 ounce (oz) = 30ml 1 Tablespoon (Tbsp) = 15ml 1 teaspoon (tsp) = 5ml 1 milliliter (ml) = 1 cubic centimeter (cc)

Use the above information on the metric system to answer questions 96 through 99.

Labels Group Care Pharmacy 701 Barbour Drive Raleigh, NC 27603 919-855-3765 Rx 200000 01/03/03 Jim Barefoot Take one tablet by mouth three times daily before meals and at bedtime. Metoclopramide 10mg #30 tablets Dsp. By J. Brickley, RPh. Dr. Doug Fitzgerald Refills: 0 Exp. 01/30/04

Use the above prescription label to answer questions 100 through 103.

prn or PRN

as needed

after meals

pc

by mouth

po

Once a day

qd or QD

Every other day

qod or QOD

Subcutaneous

sq or SQ