Chapter 5: Medication Safety Practices

Question 1

The first point in the medication-use process where the perioperative registered nurse can participate in is:
A. Procuring 
B. Prescribing 
C. Dispensing 
D. Administering

Answer 1

A. Procuring

Question 2

A patient safety strategy that reduces the opportunities for medication errors is:
A. Obtaining all medications from a single vendor
B. Storing chemicals, solutions, and medications in the same room
C. Arranging products in alphabetical order
D. Tracing the origin and insertion of all tubes and catheters

Answer 2

D. Tracing the origin and insertion of all tubes and catheters

Question 3

Medications listed on preference cards are not considered to be standing orders unless they have been reviewed and signed by the prescriber.
A. True
B. False

Answer 3

A. True

Question 4

When a perioperative registered nurse receives a verbal order, the first action would be to:
A. Copy the order onto a white board
B. Confirm by reading back the order to the prescriber
C. Enter the order in an electronic order system
D. Update the preference card

Answer 4

B. Confirm by reading back the order to the prescriber

Question 5

Pharmacists should become involved in medication safety:
A. From the beginning when the safety plan is being created
B. When facilities design new forms
C. During the medication reconciliation process
D. In all of the above situations

Answer 5

D. In all of the above situations

From the beginning when the safety plan is being created, when facilities design new forms, and during the medication reconciliation process

Question 6

Which of the following statements describe an important value of the medication reconciliation process?
A. The patient is the sole source of information
B. The patient’s list of medications can help identify underlying patient conditions
C. The patient’s literacy level is documented during discharge teaching
D. The patient’s weight in kilograms is obtained for medication calculations

Answer 6

B. The patient’s list of medications can help identify underlying patient conditions

Question 7

Which one of the following is an important component of the nursing medication plan?
A. The plan begins when health care providers bring the patient into the room
B. The plan assists health care providers with planning for preprocedural antibiotic administration
C. The plan directs health care providers how to order home care
D. The plan directs health care providers how to obtain all medications for all patients at one time in the medication room

Answer 7

B. The plan assists health care providers with planning for pre-procedural antibiotic administration

Question 8

Key points for implementing safe practices include:
A. Obtaining medications for only one patient at a time
B. Avoiding distractions and interruptions when preparing medications
C. Preparing the medication as close as possible to the time of administration
D. Using safe injection practices
E. All of the above practices

Answer 8

E. All of the above practices

Obtaining medications for only one patient at a time, avoiding distractions and interruptions when preparing medications, preparing the medication as close as possible to the time of administration, and using safe injection practices

Question 9

Points at which the perioperative RN should verify the medication product include:
A. At the point when the medication is being retrieved using the original order
B. At the point when the RN circulator is ready to pass the medication to the scrub person
C. At the point when each product is being placed on the sterile field
D. All of the above situations

Answer 9

D. All of the above situations

At the point when the medication is being retrieved using the original order, at the point when the RN circulator is ready to pass the medication to the scrub person, and at the point when each product is being placed on the sterile field

Question 10

Safe injection practices:
A. Are only applicable when medications are given intravenously
B. Are only applicable to local anesthetics
C. Include using one syringe per injection
D. Require that all health care workers receive the hepatitis B vaccination series

Answer 10

C. Include using one syringe per injection

Question 11

After the patient undergoes cataract surgery, the unused portion of any eye drops should be:
A. Saved for the next procedure
B. Sent home with the patient
C. Sent home with the patient after being sent to the pharmacy for proper labeling
D. Returned to the stock room

Answer 11

C. Sent home with the patient after being sent to the pharmacy for proper labeling

Question 12

Unused solutions should be:
A. Poured down the drain with two witnesses
B. Returned to pharmacy for relabeling for the next procedure
C. Secured in a manner to prevent municipal water contamination
D. Retained for risk management personnel because unused solutions at the end of a procedure indicates that an error has occurred

Answer 12

C. Secured in a manner to prevent municipal water contamination

Question 13

The 6 Phases of the Medication Use Process are:

Answer 13

1. Procuring
2. Prescribing
3. Transcribing/Documenting
4. Dispensing
5. Administering
6. Monitoring

Question 14

List/describe at least one medication error that could happen in each phase and how it could be avoided.

Procuring

Answer 14

inaccurately placing meds in the storage in a wrong manner

To rectify:
compare the list of look alike and sound alike to that of medication inventory

Question 15

List/describe at least one medication error that could happen in each phase and how it could be avoided.

Prescribing

Answer 15

each provider has their own different way of prescribing meds which can be very dangerous whether it be written or verbal orders

To rectify:

• Providers should know their pt well including allergies, past medical history
• Providers should use Beers criteria or other tools to identify meds that are inappropriate in certain age groups such as the elderly
• Medication orders in preprinted forms, standing orders, and preference cards should be reviewed annually
• Limit verbal orders

Question 16

List/describe at least one medication error that could happen in each phase and how it could be avoided.

Transcribing/Documenting

Answer 16

During the administering phase, a medication could go to the wrong person or receive the wrong dose if it was transcribed/recorded incorrectly
*Omission error: medication is not transcribed therefore the patient has no record of receiving this medication

To rectify:
Double check all orders, transmit them to pharmacy to double check and document in real time when a medication is given

Question 17

List/describe at least one medication error that could happen in each phase and how it could be avoided.

Dispensing

Answer 17

if the wrong med is dispensed and not double checked with the order, the patient could be administered wrong med

To rectify:

• use automated dispensing storage systems
• pharmacists should be actively involved and reviewing orders to approve medications

Question 18

List/describe at least one medication error that could happen in each phase and how it could be avoided.

Administering

Answer 18

Could give the wrong medication to the wrong patient if you’re in a hurry and don’t double check

To rectify:

• only remove meds for 1 pt only
• verify that you have pulled put the correct meds by looking at the medication order
• prepare meds as close as possible to the time of administering it.
• use the seven rights of administering meds

Question 19

List/describe at least one medication error that could happen in each phase and how it could be avoided.

Monitoring

Answer 19

not evaluating the effects of the medications on patient
not documenting adverse effects immediately as they occur

To rectify:
Do timely assessments of patients as needed