The nurse is preparing to administer a medication via an enteral tube. Which of the following preparations are appropriate to crush and administer enterally?

A. Ask the client to state his name and medical record number: Asking the client to state identifiers is appropriate; however, relying solely on verbal confirmation without cross-checking with the armband and source document does not meet full identification standards. Patients may be confused, sedated, or provide incorrect information unintentionally.

B. Check the sign above the bed to the MAR & check the armband: The sign above the bed should never be used as a primary identifier because room assignments can change. While checking the armband is essential, including the bed sign introduces risk and does not align with best-practice identification policies.

C. Compare the source document to the client's armband & ask him to state his name: Best practice requires using at least two identifiers, such as full name and medical record number, and verifying them against the armband and the MAR. Asking the client to state their name rather than confirming it ensures active participation and reduces identification errors.

D. Call the client by name on MAR and observe his response: Calling the client by name and observing a response is insufficient because patients may respond reflexively even if misidentified. This method does not fulfill the requirement of using two independent identifiers to ensure safe medication administration.

A. Report the discrepancy immediately after preparing the medication: Once a discrepancy in a controlled substance count is identified, the nurse should not continue handling or preparing the medication. Proceeding with preparation before resolving the discrepancy may further complicate accountability and chain-of-custody documentation.

B. Notify the Doctor and the Pharmacist immediately: Although pharmacy may eventually be involved in reconciliation, the first step is not to notify the physician. The appropriate immediate action is to follow institutional policy by notifying the charge nurse or supervisor responsible for controlled substance oversight rather than the prescribing provider.

C. Stop preparing the medication and notify the appropriate person immediately: A narcotic count discrepancy requires immediate action before any further medication handling occurs. Stopping preparation preserves the integrity of the count, prevents additional documentation errors, and initiates formal investigation per controlled substance regulations and facility policy.

D. Continue to pour as the count only needs to be correct at the end of the shift: Controlled substance counts must be accurate at all times, not just at shift change. Continuing to administer medication when a discrepancy exists violates legal standards, increases diversion risk, and places the nurse’s license at risk.