The nurse is prepared to administer a 1200 hour medication to Mr. Brown and he states that this is not his usual blood pressure medication. How does the nurse respond?
Hold the medication until the order has been clarified
Explain to Mr. Brown that his physician has ordered the medication and it is best for him to take it
Explain the purpose of the medication to Mr. Brown
Politely smile and encourage Mr. Brown to take his medications
The Correct Answer is A
A. Hold the medication until the order has been clarified: When a patient questions a medication, especially stating it is not their usual drug, the nurse must pause administration and verify the order. This aligns with the “right medication” and “right patient” principles of safe medication administration. Clarification prevents potential medication errors.
B. Explain to Mr. Brown that his physician has ordered the medication and it is best for him to take it: Simply reinforcing the provider’s authority does not address the patient’s concern and may override an important safety cue. Patients often recognize discrepancies in their usual regimen, and dismissing their concern could result in administering an incorrect medication.
C. Explain the purpose of the medication to Mr. Brown: Patient education is important; however, education should occur only after the medication has been verified as correct. Providing an explanation without confirming the accuracy of the order could inadvertently reinforce an error. Verification must precede teaching in this scenario.
D. Politely smile and encourage Mr. Brown to take his medications: Encouraging compliance without investigating the discrepancy compromises patient-centered care and medication safety. A therapeutic response requires assessment and verification rather than persuasion, particularly when a potential medication error is identified.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. The worksheet: A worksheet may help organize tasks for the shift, but it is not a legal or authoritative medication source document. Worksheets can be outdated or incomplete and should never be used as the primary reference for medication preparation or safety checks.
B. The kardex: The kardex is a summary tool used for quick reference regarding patient care needs, but it is not a legal medication record. Because it may not reflect the most current medication orders, it should not be used for final verification prior to administration.
C. The Doctor's order: The original provider order initiates the medication therapy, but once transcribed and verified, medication administration should be performed using the Medication Administration Record (MAR). The MAR consolidates active, verified orders and is designed specifically for safe administration checks.
D. The MAR: The Medication Administration Record is the primary, legally recognized document used when preparing and administering medications. It reflects verified and active orders and supports the “rights” of medication administration, including right drug, dose, route, time, and patient.
Correct Answer is C
Explanation
A. Place the wastage into the toilet: Controlled substances must never be discarded independently into the toilet or sink due to diversion risk and regulatory violations. Proper disposal requires adherence to institutional policy, which includes witnessed wasting and documentation. Unwitnessed disposal compromises accountability and legal compliance.
B. Complete a count of the medication after preparing Mr. Brown's medication: Narcotic counts are not performed after each individual administration. Counts are conducted at designated times, most commonly at shift change or when custody of the controlled substance storage changes. Performing an isolated count after one administration does not meet regulatory standards.
C. Ensure a narcotic count is completed whenever there is staff shift change: Controlled substances such as Tylenol #3 (acetaminophen with codeine) require strict inventory reconciliation. A narcotic count at every shift change ensures continuity of accountability, detects discrepancies early, and complies with legal and institutional controlled substance regulations.
D. Ensure a colleague signs the narcotic record, after telling them you have wasted 1/2 of the pill: While wasting controlled substances requires a witness, the colleague must directly observe the wastage before signing the narcotic record. Signing based solely on verbal reporting violates medication safety standards and controlled substance handling policies.
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