NCLEX - Week 6 Flashcards
A nurse is preparing to administer medications. Which of the following actions by the nurse could lead to a medication error?
a. Using two client identifiers before administering medications.
b. Checking the medication label against the medication administration record (MAR) three times.
c. Taking a telephone medication order from a provider and administering it without a second nurse verifying.
d. Asking the client about medication allergies before administering.
Correct Answer: c
Rationale: A second nurse should always verify a telephone order to prevent errors.
Options a, b, and d are all safe medication practices that help prevent errors.
A nurse is reviewing a medication order that is illegible. Which of the following is the best action for the nurse to take?
a. Ask another nurse to read the order.
b. Contact the pharmacist to clarify the order.
c. Contact the provider to clarify the order.
d. Administer the medication as best as the nurse can interpret it.
Correct Answer: c
Rationale:
The best action is to contact the provider to clarify the order. Illegible prescriptions are a common cause of medication errors. The nurse should never guess what the order says or rely on someone else’s interpretation.
A nurse is administering a medication to a client and realizes that the wrong medication was given. Which of the following actions should the nurse take first?
a. Assess the client for any adverse reactions.
b. Notify the charge nurse.
c. Complete an incident report.
d. Notify the provider.
Correct Answer: a
Rationale:
The nurse’s first priority is to assess the client for any adverse reactions to the medication. After assessing the client, the nurse should notify the provider and charge nurse and complete an incident report.
Which of the following is an example of a system error that can contribute to medication errors?
a. A nurse forgetting to check the client’s allergies before administering a medication.
b. A medication being dispensed in an unlabeled container.
c. A nurse miscalculating the dosage of a medication.
d. A nurse administering a medication by the wrong route.
Correct Answer: b
Rationale: System errors are related to procedures or environmental factors that contribute to errors. A medication dispe
A nurse is preparing to administer a medication to a client who is unfamiliar with the medication. The nurse should:
a. Tell the client, “Don’t worry, this medication will make you feel better.”
b. Inform the client about the medication’s purpose, what to expect, and any potential side effects.
c. Administer the medication without explaining it to the client, as this could cause them undue stress.
d. Ask the client’s family member to explain the medication to the client.
Correct Answer: b
Rationale:
Clients have the right to be informed about their medications.
The nurse should explain the medication’s purpose, what to expect, and any potential side effects in understandable terms.
Which of the following is an example of a sentinel event related to medication administration?
a. A client develops a mild rash after receiving a medication.
b. A client refuses to take a medication.
c. A client experiences a temporary drop in blood pressure after receiving an intravenous medication.
d. A client dies after receiving an overdose of medication.
Correct Answer: d
Rationale:
A sentinel event is a patient safety incident that results in death, permanent harm, or severe temporary harm. A medication overdose causing death is an example of a sentinel event.
A nurse is aware that distractions during medication administration can increase the risk of errors. Which of the following strategies can the nurse implement to minimize distractions?
a. Answering phone calls while preparing medications.
b. Engaging in conversations with colleagues while administering medications.
c. Preparing medications one at a time in a quiet environment.
d. Multitasking by administering medications to multiple clients simultaneously.
Correct Answer: c
Rationale: Preparing medications one at a time in a quiet environment minimizes distractions.
Distractions can lead to errors, so options a, b, and d should be avoided.
A nurse is educating a client about a newly prescribed medication. Which of the following statements by the client indicates a need for further education?
a. “I understand that I should take this medication as prescribed, even if I feel better.”
b. “I will let my doctor know if I experience any unusual side effects.”
c. “It is okay to stop taking this medication once I start feeling better.”
d. “I will keep this medication out of reach of children.”
Correct Answer: c
Rationale:
Clients should be educated to take medications as prescribed, even if they start feeling better.
Stopping medications prematurely can lead to complications.
Options a, b, and d indicate good understanding.
A nurse is caring for a client who is receiving a high-alert medication. Which of the following actions is most important for the nurse to take?
a. Use two client identifiers before administering the medication.
b. Monitor the client’s vital signs every 15 minutes after administering the medication.
c. Document the medication administration immediately after giving it.
d. Ask a family member to verify the client’s identity before administering the medication.
Correct Answer: a
Rationale:
High-alert medications carry an increased risk of causing significant harm if used in error.
Using two client identifiers before administering the medication is the most important action to prevent errors
A nurse is reviewing a client’s medication list and notices that the client is prescribed two medications from the same therapeutic class. The nurse should:
a. Administer both medications as prescribed without any further action.
b. Hold both medications and notify the provider.
c. Contact the pharmacist to clarify the potential for drug interactions.
d. Ask the client if they have been taking both medications without any problems.
Correct Answer: c
Rationale:
Prescribing two medications from the same therapeutic class can increase the risk of drug interactions.
The nurse should consult the pharmacist and notify the provider if necessary. Administering the medications without clarification may not be safe.
A nurse is preparing to administer medications. Which of the following actions by the nurse could lead to a medication error?
a. Using two client identifiers before administering medications.
b. Checking the medication label against the medication administration record (MAR) three times.
c. Taking a telephone medication order from a provider and administering it without a second nurse verifying.
d. Asking the client about medication allergies before administering.
Correct Answer: c
Rationale: A second nurse should always verify a telephone order to prevent errors.
Options A, B, and D are all safe medication practices that help prevent medication errors.
A nurse is reviewing a medication order that is illegible. Which of the following is the best action for the nurse to take?
a. Ask another nurse to read the order.
b. Contact the pharmacist to clarify the order.
c. Contact the provider to clarify the order. d. Administer the medication as best as the nurse can interpret it.
c. Contact the provider to clarify the order.
Rationale: The best action is to contact the provider to clarify the order. Illegible prescriptions are a common cause of medication errors. The nurse should never guess what the order says or rely on someone else’s interpretation.
A nurse is administering a medication to a client and realizes that the wrong medication was given. Which of the following actions should the nurse take first?
a. Assess the client for any adverse reactions.
b. Notify the charge nurse.
c. Complete an incident report.
d. Notify the provider.
a. Assess the client for any adverse reactions.
Rationale:
The nurse’s first priority is to assess the client for any adverse reactions to the medication.
After assessing the client, the nurse should notify the provider and charge nurse and complete an incident report.
Which of the following is an example of a system error that can contribute to medication errors?
a. A nurse forgetting to check the client’s allergies before administering a medication.
b. A medication being dispensed in an unlabeled container.
c. A nurse miscalculating the dosage of a medication.
d. A nurse administering a medication by the wrong route.
b. A medication being dispensed in an unlabeled container.
Rationale:
System errors are procedures or environmental elements that contribute to errors.
A medication dispensed in an unlabeled container is an example of a system error.
The other options are examples of human error.
A nurse is preparing to administer a medication to a client who is unfamiliar with the medication. The nurse should:
a. Tell the client, “Don’t worry, this medication will make you feel better.”
b. Inform the client about the medication’s purpose, what to expect, and any potential side effects.
c. Administer the medication without explaining it to the client, as this could cause them undue stress.
d. Ask the client’s family member to explain the medication to the client.
b. Inform the client about the medication’s purpose, what to expect, and any potential side effects.
Rationale:
Clients have the right to be informed about their medications.
The nurse should explain the medication’s purpose, what to expect, and any potential side effects in terms the client can understand.
Which of the following is an example of a sentinel event related to medication administration?
a. A client develops a mild rash after receiving a medication.
b. A client refuses to take a medication.
c. A client experiences a temporary drop in blood pressure after receiving an intravenous medication.
d. A client dies after receiving an overdose of medication.
d. A client dies after receiving an overdose of medication.
Rationale:
A sentinel event is a patient safety event that reaches a patient and results in death, permanent harm, or severe temporary harm and intervention required to sustain life.
A client dying after receiving a medication overdose is an example of a sentinel event.
A nurse is aware that distractions during medication administration can increase the risk of errors. Which of the following strategies can the nurse implement to minimize distractions?
a. Answering phone calls while preparing medications.
b. Engaging in conversations with colleagues while administering medications.
c. Preparing medications one at a time in a quiet environment.
d. Multitasking by administering medications to multiple clients simultaneously.
c. Preparing medications one at a time in a quiet environment.
Rationale: Preparing medications one at a time in a quiet environment minimizes distractions.
Distractions can lead to errors. The other options increase distractions and should be avoided.
A nurse is educating a client about a newly prescribed medication. Which of the following statements by the client indicates a need for further education?
a. “I understand that I should take this medication as prescribed, even if I feel better.”
b. “I will let my doctor know if I experience any unusual side effects.”
c. “It is okay to stop taking this medication once I start feeling better.”
d. “I will keep this medication out of reach of children.”
c. “It is okay to stop taking this medication once I start feeling better.”
Rationale:
Clients should be educated to take medications as prescribed, even if they start feeling better.
Stopping medications prematurely can lead to complications.
Options A, B, and D all demonstrate good understanding.
A nurse is caring for a client who is receiving a high-alert medication. Which of the following actions is most important for the nurse to take?
a. Use two client identifiers before administering the medication.
b. Monitor the client’s vital signs every 15 minutes after administering the medication.
c. Document the medication administration immediately after giving it. d. Ask a family member to verify the client’s identity before administering the medication.
a. Use two client identifiers before administering the medication.
Rationale:
High-alert medications carry an increased risk of causing significant patient harm when used in error.
Using two client identifiers before administering the medication is the most important action to prevent medication errors.
The nurse should also monitor vital signs, document administration, and educate the patient, but the priority is to correctly identify the client.
A nurse is preparing to administer a medication that is available in both oral and intravenous forms. Which of the following is essential for the nurse to verify before administering the medication?
a. The client’s preferred route of administration.
b. The provider’s prescribed route of administration.
c. The availability of the medication in the medication room.
d. The cost-effectiveness of the different routes of administration.
b. The provider’s prescribed route of administration.
Rationale:
The nurse must verify the provider’s prescribed route of administration. Administering a medication by the wrong route can have serious consequences. While the client’s preference and medication availability are factors, they are not as essential as verifying the prescribed route.
A nurse is reviewing a client’s medication administration record (MAR). The nurse notes that the client is prescribed a medication that is known to prolong the QT interval. The nurse should:
a. Administer the medication as prescribed without any further action.
b. Monitor the client’s electrocardiogram (ECG) for any changes.
c. Hold the medication and notify the provider immediately.
d. Ask the client if they have a history of cardiac arrhythmias.
b. Monitor the client’s electrocardiogram (ECG) for any changes.
Rationale:
Medications that prolong the QT interval can increase the risk of serious dysrhythmias.
The nurse should monitor the client’s ECG for any changes and report them to the provider.
While holding the medication may be necessary in some cases, the nurse should first monitor the client’s ECG.
Which of the following factors is most likely to contribute to medication errors in a busy hospital setting?
a. Adequate staffing levels and nurse-to-patient ratios.
b. Frequent interruptions and distractions during medication administration.
c. A well-organized and well-stocked medication dispensing system.
d. Clear and legible medication orders from providers.
b. Frequent interruptions and distractions during medication administration.
Rationale: Frequent interruptions and distractions are known human factors that significantly increase the risk of medication errors.
Adequate staffing, well-organized systems, and clear orders help prevent errors.
A nurse is caring for a client who has a history of adverse drug reactions. Which of the following actions by the nurse is most important?
a. Encourage the client to avoid taking any medications.
b. Carefully review the client’s medication history for potential interactions.
c. Tell the client that adverse drug reactions are unavoidable.
d. Administer medications without monitoring for adverse effects.
b. Carefully review the client’s medication history for potential interactions.
Rationale:
Carefully reviewing the client’s medication history for potential interactions and allergies is most important to prevent adverse drug reactions.
Avoiding all medications is not practical, and while some reactions are unavoidable, many can be prevented with careful monitoring and medication selection.
A nurse witnesses another nurse preparing to administer a medication to the wrong client. Which of the following is the most appropriate action for the nurse to take?
a. Ignore the situation and assume the other nurse knows what they are doing.
b. Report the incident to the nurse manager after the medication has been administered.
c. Immediately intervene and stop the other nurse from administering the medication.
d. Discuss the incident with the other nurse during their next break.
c. Immediately intervene and stop the other nurse from administering the medication.
Rationale: The nurse has an ethical and professional responsibility to intervene immediately to prevent potential harm to the client.
Ignoring the situation, reporting it later, or discussing it casually can jeopardize client safety.
A nurse is orienting a newly licensed nurse on the importance of medication reconciliation. Which of the following statements by the newly licensed nurse indicates an understanding of the concept?
a. “Medication reconciliation is only necessary for clients who are admitted to the hospital.”
b. “Medication reconciliation involves comparing a client’s current medication list with any new medications ordered or prescribed.”
c. “Medication reconciliation is the sole responsibility of the physician.”
d. “Medication reconciliation is a time-consuming process that is not essential to client safety.”
b. “Medication reconciliation involves comparing a client’s current medication list with any new medications ordered or prescribed.”
Rationale:
Medication reconciliation is the process of comparing a client’s current medication list with any new medications ordered or prescribed to avoid errors such as omissions, duplications, dosing errors, or drug interactions.
It is necessary at all transitions of care, a collaborative process involving the entire healthcare team, and is vital to patient safety.
A nurse is administering a medication that has a black box warning. The nurse understands that this warning indicates:
a. The medication is inexpensive and readily available.
b. The medication is safe for use during pregnancy.
c. The medication has a significant risk of serious or life-threatening adverse effects.
d. The medication can be administered by any route
c. The medication has a significant risk of serious or life-threatening adverse effects.
Rationale:
A black box warning is the strongest safety warning a drug can carry.
It indicates a significant risk of serious or even life-threatening adverse effects.
The nurse must be aware of these risks and educate the patient accordingly.
A nurse is reviewing a client’s medication list and notices that the client is prescribed two medications from the same therapeutic class. The nurse should:
a. Administer both medications as prescribed without any further action.
b. Hold both medications and notify the provider.
c. Contact the pharmacist to clarify the potential for drug interactions.
d. Ask the client if they have been taking both medications without any problems.
c. Contact the pharmacist to clarify the potential for drug interactions.
Rationale:
Prescribing two medications from the same therapeutic class can increase the risk of drug interactions and adverse effects.
The nurse should contact the pharmacist to discuss the potential for interactions and seek clarification from the provider if needed.
While administering both medications may be appropriate, it’s important to ensure safety first.
Which of the following abbreviations is considered error-prone and should not be used in medication orders?
a. “mg” for milligrams
b. “mL” for milliliters
c. “QD” for every day
d. “PO” for by mouth
c. “QD” for every day
Rationale:
The abbreviation “QD” for every day is error-prone and should not be used because it can be mistaken for “QID,” which means four times a day.
Using complete words like “daily” is recommended to avoid confusion. “mg,” “mL,” and “PO” are commonly accepted abbreviations.
A nurse is reviewing the rights of medication administration. Which of the following is not a right of medication administration?
a. Right client
b. Right route
c. Right time
d. Right provider
d. Right provider
Rationale:
The rights of medication administration include right client, right medication, right dose, right route, right time, and right documentation.
The “right provider” is not part of the rights of medication administration.
A nurse is preparing to administer a medication to a pediatric client. The nurse should:
a. Administer the medication using the adult dosage.
b. Calculate the medication dosage based on the client’s weight and age.
c. Ask the client’s parent to administer the medication.
d. Crush all medications to make them easier to swallow.
b. Calculate the medication dosage based on the client’s weight and age.
Rationale:
Medication dosages for pediatric clients are calculated based on the client’s weight and age to ensure accurate and safe dosing. Using adult dosages, having parents administer medications, or crushing all medications without verifying if it is safe to do so can lead to errors.
A nurse is caring for a client who is receiving a medication through a patient-controlled analgesia (PCA) pump. The nurse should:
a. Allow the client’s visitor to push the medication button.
b. Monitor the client for respiratory depression and other side effects.
c. Increase the dosage without a provider’s order if the client reports pain.
d. Leave the PCA pump unlocked and accessible to anyone in the room
b. Monitor the client for respiratory depression and other side effects.
Rationale:
Monitoring for respiratory depression is a critical nursing responsibility when caring for clients receiving medications via PCA pumps.
Only the client should operate the PCA pump, dosage changes require a provider’s order, and the pump should be secured to prevent unauthorized access.
A nurse is educating a group of nursing students about strategies to prevent medication errors. Which of the following statements by a student indicates a need for further teaching?
a. “I will create a habit of verifying medication orders and checking medication labels three times.”
b. “I will advocate for system improvements that enhance medication safety.”
c. “I will avoid interruptions and distractions while preparing and administering medications.”
d. “I will rely on my memory and avoid using resources like drug guides or calculators.”
d. “I will rely on my memory and avoid using resources like drug guides or calculators.”
Rationale:
Relying solely on memory is risky and increases the chance of errors.
Using available resources, such as drug guides and calculators, double-checks information and reduces the likelihood of mistakes.
A nurse is working in a facility that is implementing a new electronic medication administration record (eMAR) system. The nurse understands that the primary goal of this system is to:
a. Reduce the workload for nurses by automating medication administration.
b. Increase the efficiency of medication dispensing from the pharmacy.
c. Improve client safety by reducing the risk of medication errors.
d. Eliminate the need for nurses to verify client identification before administering medications.
c. Improve client safety by reducing the risk of medication errors.
Rationale:
eMAR systems are designed to enhance medication safety by reducing the risk of errors through features like barcode scanning, dosage calculations, and alerts for potential interactions or allergies.
While they can increase efficiency and reduce workload, their primary focus is safety, not eliminating the need for essential nursing checks like client identification.
