The nurse administered a routine scheduled medication of Prozac (fluoxetine hydrochloride), an antidepressant, 20 mg PO to a patient. The nurse checked the medication label against the MAR when getting it out of the automatic dispensing system, again when placing the medication in a cup, and once more at the patient's bedside prior to administration. The label read 20 mg and contained a single capsule. The nurse asked the patient to state her name and administered the medication, offering the patient a drink of water. The nurse documented the administration of the medication. Which of the six rights of medication administration did the nurse violate?

The nurse administered the medication correctly.

The nurse did not have a second nurse verify the dose.

The nurse did not make the appropriate number of checks for the right drug.

The nurse did not use two patient identifiers.

Answer and Explanation

The Correct Answer is D

A) The nurse administered the medication correctly: While the nurse followed many of the correct procedures, this option overlooks the critical issue of patient identification. The nurse's adherence to the six rights is not complete without the appropriate verification of the patient’s identity.

B) The nurse did not have a second nurse verify the dose: While having a second nurse verify high-risk medications is a good practice, it is not a strict requirement for every medication. The focus should be on the established protocols for verification rather than a blanket requirement for all doses.

C) The nurse did not make the appropriate number of checks for the right drug: The nurse followed proper procedures by checking the medication label multiple times against the MAR and at the bedside. Therefore, this option does not accurately reflect any violation.

D) The nurse did not use two patient identifiers: Although the nurse asked the patient to state her name, this alone does not constitute using two identifiers. The best practice is to confirm at least two identifiers (e.g., name and date of birth) to ensure the correct patient receives the medication. This oversight is a violation of the right patient in the medication administration process.

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Correct Answer is ["C","D"]

Explanation

A) Administer 2.5 mL of amoxicillin per dose: This option is incorrect because administering 2.5 mL would only provide 62.5 mg of amoxicillin (since 125 mg is in 5 mL). The prescribed dose is 250 mg, so this volume is insufficient.

B) Administer 10 mL of amoxicillin per dose: This option is also incorrect. Administering 10 mL would provide 250 mg of amoxicillin (since 125 mg is in 5 mL, 10 mL equals 250 mg). However, this option may confuse the correct volume with a miscalculation if misunderstood in context, so it should not be selected without a proper calculation verification.

C) Administer the amoxicillin at 0800, 1200, and 1800: This option is correct. Administering the medication every 8 hours at these times ensures that the medication is given according to the prescribed schedule, maintaining appropriate therapeutic levels.

D) Compare the patient's name and date of birth on the armband with the MAR: This action is crucial for ensuring patient safety. Verifying patient identifiers against the MAR helps prevent medication errors and ensures that the right patient receives the correct medication.

E) Administer the medication by the parenteral route: This option is incorrect. The order specifies oral (PO) administration of amoxicillin, so administering it parenterally would not align with the prescribed route and could lead to incorrect dosing or complications.

A. By looking at the MAR B. By asking the patient C. By looking at the patient's allergy bracelet D. By looking at the front of the chart or in the patient's electronic health record (EHR) E. By administering a dose and monitoring the patient's response

Correct Answer is ["B","C","D"]

Explanation

A. By looking at the MAR: The Medication Administration Record (MAR) is primarily for documenting medications administered, and while it may note some allergies, it is not a comprehensive source for a patient's allergy history.

B. By asking the patient: Directly inquiring about a patient's allergies is one of the most effective methods to gather accurate and specific information. Patients can detail their allergies to medications, foods, and other substances, which might not be documented elsewhere.

C. By looking at the patient's allergy bracelet: An allergy bracelet provides immediate visual identification of known allergies. It serves as an important safety mechanism for healthcare providers to avoid administering any allergens.

D. By looking at the front of the chart or in the patient's electronic health record (EHR): This is a reliable way to find documented allergies. The front of the chart or the EHR often contains essential information about a patient's allergies, which helps inform safe medication administration and treatment planning.

E. By administering a dose and monitoring the patient's response: This method is unsafe and inappropriate. Administering a medication without prior knowledge of allergies could lead to serious and potentially life-threatening reactions. It is critical to know allergy history before any medication administration

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The health care provider has ordered amoxicillin 250 mg PO q8h. The drug label states 125 mg amoxicillin per 5 mL. Based on this information, which of the following would be correct actions by the nurse? (Select all that apply.)

Correct Answer is ["C","D"]

Explanation

How can the nurse determine a patient's history of allergies? (Select all that apply.)

Correct Answer is ["B","C","D"]

Explanation

The health care provider has ordered Amikin (amikacin) 500 mg, IM q8h. Drug available: The nurse should give___mL for each dose.

Identify the 6 rights of medication administration.

The health care provider has ordered prochlorperazine (Compazine) 2.5 mg IM q4h prn. The medication available is Compazine 5 mg/mL. The nurse should give ___ mL for each dose.

The health care provider has ordered allopurinol 0.05 g PO BID. Drug available: The nurse should give _____ tablet(s) for each dose.

Which of the following patients are at risk for developing drug toxicity? (Select all that apply.)

The nurse brings the patient's medications but the patient refuses to take them, stating, "I'll take them later. Right now my stomach feels a little upset. Could you please bring me some crackers?" What is the best action the nurse should take? (Select all that apply.)

The health care provider has ordered Amoxil (amoxicillin) 0.05 g, PO tid. Drug available: The nurse should give ____ mL for each dose.

The home care nurse is reviewing the patient's prescribed medications. The patient reports he doesn't take his antihypertensive (blood pressure) medication anymore. What is the best response by the nurse?