Pharmacology Connections to Nursing Practice 3rd Edition By Adams – Test Bank

Pharmacology Connections to Nursing Practice 3rd Edition By Adams – Test Bank

Adams and Urban, Pharmacology: Connections to Nursing Practice, 3e Test Bank

Chapter 6

Question 1

Type: MCMA

The nursing instructor teaches the students how medication errors can occur. Which common causes of errors will the instructor discuss?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. The nurse does not validate a written order with the health care provider.
2. The nurse administers the incorrect drug.
3. The nurse miscalculates the medication dose.
4. The nurse misinterprets a health care provider’s order.
5. The nurse does not check the client’s identification band.

Correct Answer: 2,3,4,5

Rationale 1: As long as the health care provider’s order is clear, there is no need to validate a written order.

Rationale 2: Medication errors can be related to misadministration.

Rationale 3: Medication errors can be related to miscalculations.

Rationale 4: Medication errors can be related to misinterpretations.

Rationale 5: Not correctly identifying a client may lead to giving the wrong client the medication.

Global Rationale: Medication errors can be related to misadministration, miscalculations, and misinterpretations. Not correctly identifying a client may lead to giving the wrong client the medication. As long as the health care provider’s order is clear, there is no need to validate a written order.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality

AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6-1 Critique the following statement: “All medication errors can be prevented.”

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 2

Type: MCSA

Drug administration is a multiple, complex process that involves more than one person. The potential for a medication error can occur during any step in that process. Which individual would not be involved in the process?

1. Pharmacist
2. Health care provider
3. Client
4. Nurse manager

Correct Answer: 4

Rationale 1: The pharmacist is always involved in the process.

Rationale 2: The health care provider is always involved in the process.

Rationale 3: The client is always involved in the process.

Rationale 4: The nurse manager would only be involved in the process if there were a problem on the unit with medication administration.

Global Rationale: The nurse manager would only be involved in the process if there were a problem on the unit with medication administration. The pharmacist, health care provider, ad client are always involved in the process.

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality

AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 6-1 Critique the following statement: “All medication errors can be prevented.”

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 3

Type: MCMA

The nurse makes a medication error, but the client is not harmed. The client’s family asks the nurse manager what is considered a medication error. Which are potential responses by the nurse manager?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Failure to follow health care provider’s orders
2. Failure to give the right medication
3. Failure to give a medication at the ordered time
4. Failure to call the pharmacy and report that the medication has been given
5. Failure to give the right dose of the medication

Correct Answer: 1,2,3,5

Rationale 1: In this medication error, the client does not receive the drug as the health care provider intended it to be given.

Rationale 2: In this medication error, the client does not receive the drug the health care provider intended to be given.

Rationale 3: In this medication error, the client does not receive the drug at the time the health care provider intended it to be given.

Rationale 4: The delivery of the medication is recorded on the medical administration record (MAR); the nurse does not report to the pharmacy each time a medication has been given.

Rationale 5: In this medication error, the client does not receive the dose of the drug the health care provider intended to be given.

Global Rationale: Medication errors include the wrong drug being administered, the wrong route being used, the wrong time, and the wrong dose. The delivery of the medication is recorded on the medical administration record (MAR); the nurse does not report to the pharmacy each time a medication has been given.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality

AACN Essential Competencies: II.7. Promote factors that create a culture of safety and caring

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6-3 Using specific examples, analyze major types of medication errors and how they can be prevented.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 4

Type: MCSA

The nurse in the emergency department miscalculates, and administers the wrong dosage of an antibiotic to a 9-month-old baby. As a result, the baby suffers permanent brain damage. Which factor most likely contributed to the error?

1. Lack of adequate oral or written communication
2. Name confusion involving similar-sounding drugs
3. Mislabeled products
4. Human factors

Correct Answer: 4

Rationale 1: Lack of communication is not indicated in the scenario.

Rationale 2: There is no indication of name confusion.

Rationale 3: There is no indication the products were inappropriately labeled.

Rationale 4: This was a human factor. The dosage was miscalculated.

Global Rationale: This was a human factor. The dosage was miscalculated. Lack of communication is not indicated in the scenario. There is no indication of name confusion or that the products were inappropriately labeled.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality

AACN Essential Competencies: II.7. Promote factors that create a culture of safety and caring

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 6-3 Using specific examples, analyze major types of medication errors and how they can be prevented.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 5

Type: MCSA

The FDA uses the information reported to it on specific types and incidences of medication errors to determine contributing factors. Which factor would be included on this list?

1. Never taking a verbal or phone order without receiving a written order before administering the drug
2. Performing an agency system check
3. Failure to account for client variables
4. Following the rights of drug administration

Correct Answer: 3

Rationale 1: Taking a verbal or phone order without receiving a written order before administering the drug would be incorrect procedure.

Rationale 2: Performing an agency system check is correct procedure.

Rationale 3: Variables such as age, body size, and renal and hepatic function must be assessed and taken into account when administrating medications.

Rationale 4: Following the rights of drug administration is correct procedure.

Global Rationale: Variables such as age, body size, and renal and hepatic function must be assessed and taken into account when administrating medications. Taking a verbal or phone order without receiving a written order before administering the drug would be incorrect procedure. Performing an agency system check is correct procedure. Following the rights of drug administration is correct procedure

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality

AACN Essential Competencies: II.7. Promote factors that create a culture of safety and caring

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 6-3 Using specific examples, analyze major types of medication errors and how they can be prevented.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 6

Type: MCSA

The FDA uses the information reported to it on specific types and incidences of medication errors to determine contributing factors. What is a common factor involving the client or caregiver?

1. Taking medications as the practitioner has ordered
2. Never trading drugs with anyone
3. Taking drugs prescribed by more than one practitioner
4. Filling prescriptions at several pharmacies

Correct Answer: 4

Rationale 1: Taking medications as the practitioner has ordered is correct procedure.

Rationale 2: Never trading drugs with anyone is correct procedure.

Rationale 3: It is safe for the client to take drugs prescribed by more than one practitioner as long as each practitioner is aware of all the drugs the client is taking.

Rationale 4: Pharmacists are the key members of the health care team who can recognize potential drug interactions and adverse effects.

Global Rationale: Pharmacists are the key members of the health care team who can recognize potential drug interactions and adverse effects. Taking medications as the practitioner has ordered and never trading medications with anyone are both correct procedure. It is safe for the client to take drugs prescribed by more than one practitioner as long as each practitioner is aware of all the drugs the client is taking.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality

AACN Essential Competencies: II.7. Promote factors that create a culture of safety and caring

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 6-3 Using specific examples, analyze major types of medication errors and how they can be prevented.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 7

Type: MCSA

The nurse administers an evening medication to the client in the morning. The medication did go to the correct client. What is the nurse’s best course of action at this time?

1. Notify the health care provider to ask if any further action needs to be taken.
2. Notify the health care provider about the error, and complete an incident report.
3. Tell the evening nurse to hold the evening dose just for tonight.
4. Change the medication administration time to the morning.

Correct Answer: 2

Rationale 1: There is no need to ask the health care provider if any further action needs to be taken. An incident report must be completed.

Rationale 2: The health care provider must be notified of the medication error and an incident report must be completed.

Rationale 3: The health care provider will decide if the evening dose should be held.

Rationale 4: The time for medication administration cannot be changed without an order from the health care provider.

Global Rationale: The health care provider must be notified of the medication error and an incident report must be completed. There is no need to ask the health care provider if any further action needs to be taken. The health care provider will decide if the evening dose should be held. The time for medication administration cannot be changed without an order from the health care provider.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.B.2 Demonstrate effective use of strategies to reduce risk of harm to self or others

AACN Essential Competencies: IV.1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6-4 Describe procedures for reporting and documenting medication errors and incidents.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 8

Type: MCSA

The nurse commits a medication error. The nurse documents the error in the client’s record and completes the incident report. What does the nurse recognize as the primary reason for this action?

1. To protect the nurse from liability
2. To verify that the client’s safety was protected
3. To protect the client from further harm
4. To protect the healthcare facility from litigation

Correct Answer: 2

Rationale 1: Documentation of an error does not necessarily protect the nurse from liability.

Rationale 2: Documentation in the client’s medical record and completion of an incident report verify that the client’s safety was protected.

Rationale 3: The client has been harmed; the documentation will not protect the client from further harm.

Rationale 4: Documentation of an error does not necessarily protect the healthcare facility from litigation.

Global Rationale: Documentation in the client’s medical record and completion of an incident report verify that the client’s safety was protected. Documentation of an error does not necessarily protect the nurse from liability. The client has been harmed; the documentation will not protect the client from further harm. Documentation of an error does not necessarily protect the healthcare facility from litigation.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

QSEN Competencies: V.B.2 Demonstrate effective use of strategies to reduce risk of harm to self or others

AACN Essential Competencies: IV.1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 6-4 Describe procedures for reporting and documenting medication errors and incidents.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 9

Type: MCSA

The nurse assesses an adverse effect of a medication that has been administered. No medication error was committed. To which federal database would the nurse report the adverse effect?

1. The Food and Drug Administration’s (FDA) Safe Medicine
2. The Food and Drug Administration’s (FDA) MedWatch
3. The Food and Drug Administration’s (FDA) Institute for Safe Medication Practices (ISMP)
4. The Centers for Disease Control (CDC)

Correct Answer: 2

Rationale 1: Safe Medicine is a consumer newsletter produced by the ISMP.

Rationale 2: Adverse events with medication should be reported to the FDA’s Safety Information and Adverse Event Reporting Program, known as MedWatch.

Rationale 3: The ISMP is a nonprofit agency that helps standardize medication reporting systems and promote medication safety.

Rationale 4: The FDA, not the CDC, coordinates the reporting of medication errors at the federal level.

Global Rationale: Adverse events with medication should be reported to the FDA’s Safety Information and Adverse Event Reporting Program, known as MedWatch. Safe Medicine is a consumer newsletter produced by the ISMP. The ISMP is a nonprofit agency that helps standardize medication reporting systems and promote medication safety. The FDA, not the CDC, coordinates the reporting of medication errors at the federal level.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

QSEN Competencies: V.B.2 Demonstrate effective use of strategies to reduce risk of harm to self or others

AACN Essential Competencies: IV.1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6-4 Describe procedures for reporting and documenting medication errors and incidents.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 10

Type: MCSA

The nurse recognizes that agency system checks are in place to decrease medication errors. Who commonly collaborates with the nurse on checking the accuracy of the medication prior to administration?

1. The nursing supervisor
2. The pharmacist
3. The health care provider
4. The nursing unit manager

Correct Answer: 2

Rationale 1: The nursing supervisor does not commonly collaborate with the nurse on the accuracy of the medication prior to administration.

Rationale 2: Pharmacists and nurses must collaborate on checking the accuracy and appropriateness of drug orders prior to client administration.

Rationale 3: The health care provider does not commonly collaborate with the nurse on the accuracy of the medication prior to administration.

Rationale 4: The nursing unit manager does not commonly collaborate with the nurse on the accuracy of the medication prior to administration.

Global Rationale: Pharmacists and nurses must collaborate on checking the accuracy and appropriateness of drug orders prior to client administration. The nursing supervisor does not commonly collaborate with the nurse on the accuracy of the medication prior to administration. The health care provider does not commonly collaborate with the nurse on the accuracy of the medication prior to administration. The nursing unit manager does not commonly collaborate with the nurse on the accuracy of the medication prior to administration.

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

QSEN Competencies: V.B.2 Demonstrate effective use of strategies to reduce risk of harm to self or others

AACN Essential Competencies: II.5. Participate in quality and patient safety initiatives, recognizing that these are complex system issues, which involve individuals, families, groups, communities, populations and other members of the healthcare team

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6-5 Explain how rules, policies, and procedures can help prevent medication errors.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 11

Type: MCSA

The nurse was very busy and unfamiliar with a new medication, but administered it anyway. Later the nurse looked up the medication. How would the nurse manager evaluate this behavior?

1. An error did occur because the nurse could have administered the medication via the incorrect route.
2. This was acceptable as long as the nurse looked up the action and side effects of the drug at some point.
3. The nurse manager was partially at fault because the nursing unit was understaffed and the nurse was too busy.
4. An error could have occurred because the nurse was unfamiliar with the medication.

Correct Answer: 4

Rationale 1: An error could have occurred, but not necessarily because of the route of administration.

Rationale 2: Nurses should never administer a medication unless they are familiar with its uses and side effects; an error could have occurred because the nurse was unfamiliar with the medication.

Rationale 3: There is no information in the question to indicate that the nursing unit was understaffed; therefore the nursing manager is not partially at fault.

Rationale 4: An error did not occur, but could have because the nurse was not familiar with the medication.

Global Rationale: An error did not occur, but could have because the nurse was not familiar with the medication. An error could have occurred, but not necessarily because of the route of administration. Nurses should never administer a medication unless they are familiar with its uses and side effects; an error could have occurred because the nurse was unfamiliar with the medication. There is no information in the question to indicate that the nursing unit was understaffed; therefore the nursing manager is not partially at fault.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

QSEN Competencies: V.B.2 Demonstrate effective use of strategies to reduce risk of harm to self or others

AACN Essential Competencies: II.9. Apply quality improvement processes to effectively implement patient safety initiatives and monitor performance measures, including nurse-sensitive indicators in the microsystem of care

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 6-6 Develop a list of strategies that the nurse can implement in practice to reduce medication errors.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 12

Type: MCSA

The nurse is preparing medications for a group of clients. Another nurse begins telling the nurse about her recent engagement. What is the best plan of action by the first nurse?

1. Tell the second nurse that the conversation is distracting and must cease while medications are being prepared.
2. Ask the second nurse to help with administering medications so they can have more time to talk.
3. Continue to prepare the medications for administration and pretend to listen to the first nurse.
4. Stop preparing medications until the first nurse has finished talking about her engagement.

Correct Answer: 1

Rationale 1: When preparing medications, the nurse must focus entirely on the task at hand, and instruct others who are talking to stop.

Rationale 2: It is inappropriate to ask another nurse to help with medications so there is more time to talk.

Rationale 3: Pretending to listen to the second nurse’s conversation would be distracting.

Rationale 4: The nurse cannot stop preparing medications; the clients must receive them on time.

Global Rationale: When preparing medications, the nurse must focus entirely on the task at hand, and instruct others who are talking to stop. It is inappropriate to ask another nurse to help with medications so there is more time to talk. Pretending to listen to the second nurse’s conversation would be distracting. The nurse cannot stop preparing medications; the clients must receive them on time.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

QSEN Competencies: V.B.2 Demonstrate effective use of strategies to reduce risk of harm to self or others

AACN Essential Competencies: II.9. Apply quality improvement processes to effectively implement patient safety initiatives and monitor performance measures, including nurse-sensitive indicators in the microsystem of care

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6-6 Develop a list of strategies that the nurse can implement in practice to reduce medication errors.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 13

Type: MCMA

The nurse is working hard to prevent medication errors. Which plans will assist the nurse in preventing most errors?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Plan to validate all orders with another nurse prior to administration of medications.
2. Plan to assess for patient variables such as age, weight, and diagnostic lab studies prior to administration.
3. Plan to tell health care providers that verbal orders will not be accepted.
4. Plan to always check the client’s identification band prior to administration of medications.
5. Plan to record the medication on the medication administration record (MAR) immediately prior to administration.

Correct Answer: 2,3,4

Rationale 1: Only high-risk drugs (e.g., insulin) need to be validated with another nurse. It is okay to validate any drug with another nurse if the nurse giving the medications wants a second opinion.

Rationale 2: Nurses should always account for patient variables such as age, weight, and any diagnostic studies that may impact the administration of medication.

Rationale 3: Requiring a written medication order also reduces the possibility of an error related to similar-sounding drug names.

Rationale 4: This is one of the five rights of drug administration to prevent errors.

Rationale 5: Medications should never be documented on the MAR until they have been administered. Documenting anything prior to the actual event is false documentation.

Global Rationale: Nurses should always account for patient variables such as age, weight, and any diagnostic studies that may impact the administration of medication. Requiring a written medication order also reduces the possibility of an error related to similar-sounding drug names. Checking the client identification band is one of the rights of drug administration to prevent errors. Only high-risk drugs (e.g., insulin) need to be validated with another nurse. It is okay to validate any drug with another nurse if the nurse giving the medications wants a second opinion. Medications should never be documented on the MAR until they have been administered. Documenting anything prior to the actual event is false documentation.

Cognitive Level: Evaluating

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.B.2 Demonstrate effective use of strategies to reduce risk of harm to self or others

AACN Essential Competencies: II.9. Apply quality improvement processes to effectively implement patient safety initiatives and monitor performance measures, including nurse-sensitive indicators in the microsystem of care

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 6-6 Develop a list of strategies that the nurse can implement in practice to reduce medication errors.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 14

Type: MCSA

The nurse is working hard to prevent medication errors. Which intervention would assist the nurse in preventing most errors using the assessment step of the nursing process?

1. Be aware of stressful situations and distractions during medication administration.
2. Assess the client for expected outcomes and determine if any adverse side effects have occurred.
3. Ask the client about food or medication allergies, including OTC medications and herbal supplements.
4. Avoid using abbreviations that could be misunderstood.

Correct Answer: 3

Rationale 1: This is part of the implementation step of the nursing process.

Rationale 2: This part of the evaluation step of the nursing process.

Rationale 3: This is part of the assessment step of the nursing process.

Rationale 4: This is part of the planning step of the nursing process.

Global Rationale: Asking the client about food or medication allergies, including OTC medications and herbal supplements, is part of the assessment step of the nursing process. The other options illustrate other steps of the nursing process, not assessment.

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: V.B.2 Demonstrate effective use of strategies to reduce risk of harm to self or others

AACN Essential Competencies: II.9. Apply quality improvement processes to effectively implement patient safety initiatives and monitor performance measures, including nurse-sensitive indicators in the microsystem of care

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 6-6 Develop a list of strategies that the nurse can implement in practice to reduce medication errors.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 15

Type: MCSA

It is common for older clients to receive multiple prescriptions that might have conflicting pharmacological actions. What is the term for keeping track of the client’s medications as the client moves through the health care system?

1. Assessment
2. Medication transition
3. Pharmacological evaluation
4. Medication reconciliation

Correct Answer: 4

Rationale 1: Assessment is the first step of the nursing process.

Rationale 2: This is not the correct term for this process.

Rationale 3: This is not the correct term for this process.

Rationale 4: Medication reconciliation is the process of tracking clients’ medications as they progress through the health care system.

Global Rationale: Medication reconciliation is the process of tracking clients’ medications as they progress through the health care system. The other terms do not describe this process.

Cognitive Level: Remembering

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality

AACN Essential Competencies: IV.3. Apply safeguards and decision making support tools embedded in patient care technologies and information systems to support a safe practice environment for both patients and healthcare workers

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6-7 Explain how medication reconciliation can lead to a reduction in medication errors.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 16

Type: MCSA

The nurse is instructing a client about how to help prevent medication errors while in the hospital. What is a priority question for the nurse to ask the client?

1. “Do you know what your illness is, and if you will need surgery?”
2. “Do you have a friend to verify that you are receiving the correct medication?”
3. “Do you trust your health care provider to order the correct medication?”
4. “Do you know the names of all the medications you take?”

Correct Answer: 4

Rationale 1: Knowing the illness, and anticipating surgery, will not necessarily help prevent medication errors.

Rationale 2: It is inappropriate for friends of clients to verify medications prior to administration.

Rationale 3: This is an inappropriate question to ask the client.

Rationale 4: Knowing the names of all the medications the client is taking can help reduce medication errors when the client is admitted to the hospital.

Global Rationale: Knowing the names of all the medications the client is taking can help reduce medication errors when the client is admitted to the hospital. Knowing the illness, and anticipating surgery, will not necessarily help prevent medication errors. It is inappropriate for friends of clients to verify medications prior to administration. The other answer option is an inappropriate question to ask the client.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

QSEN Competencies: I.B.15 Communicate care provided and needed at each transition in care

AACN Essential Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6-8 Design patient teaching information that can be used to reduce medication errors.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 17

Type: MCSA

The nurse is instructing a client about how to prevent medication errors after discharge from the hospital. What is a priority recommendation the nurse should make?

1. Ask questions about drug safety. Health care providers should be partners in maintaining safe medication principles.
2. Remember that OTC and herbal supplements are not considered medications. They cannot cause any harm.
3. It is okay to use household measuring devices to measure medications. These devices yield the same measurements that are used by professionals.
4. Do not question the medications received from the pharmacist. The pharmacist is a professional and should not be questioned.

Correct Answer: 1

Rationale 1: This recommendation will help to reduce medication errors. Working together to understand information is an important process in medication reconciliation.

Rationale 2: OCT and herbal supplements are medications that can interact adversely with prescribed medications.

Rationale 3: Household measures and metric measures are not the same. Using household measures could result in medication errors.

Rationale 4: Clients should ask questions if the medications look different, or if they do not understand the instructions for taking them. This action reduces medication errors.

Global Rationale: Asking questions and working with the health care provider to understand information is an important process in medication reconciliation. OCT and herbal supplements are medications that can interact adversely with prescribed medications. Household measures and metric measures are not the same. Using household measures could result in medication errors. Clients should ask questions if the medications look different, or if they do not understand the instructions for taking them. This action reduces medication errors.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.15 Communicate care provided and needed at each transition in care

AACN Essential Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6-8 Design patient teaching information that can be used to reduce medication errors.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 18

Type: MCSA

The nurse is discharging a client from the hospital. Which is a priority intervention for the nurse at this time?

1. On discharge from the facility, the nurse should provide the client with a complete list of medications to be taken, as well as instructions on how to take any newly prescribed medications.
2. The nurse should consult the client’s pharmacy and inform the pharmacist that the client is being discharged.
3. The nurse should call a friend to come before giving discharge instructions to the client.
4. The nurse should inform the client’s primary health care provider that the client is being discharged.

Correct Answer: 1

Rationale 1: This intervention will help to reduce medication errors because the client is better informed about the medications.

Rationale 2: The nurse does not inform the client’s pharmacy of the discharge.

Rationale 3: It is inappropriate for the client’s friends to be there when discharge instructions are being given.

Rationale 4: The primary health care provider’s order would have been required to discharge the client.

Global Rationale: Providing a complete list of medications upon discharge will help to reduce medication errors because the client is better informed about the medications. The nurse does not inform the client’s pharmacy of the discharge. It is inappropriate for the client’s friends to be there when discharge instructions are being given. The primary health care provider’s order would have been required to discharge the client.

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.15 Communicate care provided and needed at each transition in care

AACN Essential Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6-8 Design patient teaching information that can be used to reduce medication errors.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 19

Type: MCSA

The nurse is working in the risk management department to examine risks and minimize the number of medication errors. Which intervention can the nurse put in place to prevent errors?

1. Make sure there is an overstock of all medications to ensure availability.
2. Remove outdated reference books.
3. Store all medication in well-lighted areas.
4. Transfer all small amounts of medications into smaller containers to save space.

Correct Answer: 2

Rationale 1: Overstocking results in an increase in expired medications.

Rationale 2: Current reference books ensure current information, reducing medication errors.

Rationale 3: Medications should not be stored in the light or in extreme temperatures.

Rationale 4: Medications must be left in their original containers to prevent mixing up medications.

Global Rationale: Current reference books ensure current information, reducing medication errors. Overstocking results in an increase in expired medications. Medications should not be stored in the light or in extreme temperatures. Medications must be left in their original containers to prevent mixing up medications.

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality

AACN Essential Competencies: II.11 Employ principles of quality improvement, healthcare policy, and cost-effectiveness to assist in the development and initiation of effective plans for the microsystem and/or system-wide practice improvements that will improve the quality of healthcare delivery

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6-9 Identify strategies that health care agencies use to prevent medication errors.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 20

Type: MCSA

The nurse is on a committee to reduce medication errors in a large healthcare facility. Which strategy can the nurse recommend that is being adopted in many healthcare facilities?

1. Use robots to prepare all medications for administration by the nurse.
2. Use automated, computerized cabinets on all nursing units.
3. Designate nurses whose only function is to administer medication.
4. Train medication technicians to administer medications.

Correct Answer: 2

Rationale 1: Healthcare agencies are not planning for the use of robots in medication preparation.

Rationale 2: Healthcare agencies are using automated, computerized cabinets to reduce medication errors.

Rationale 3: Healthcare agencies are not planning to designate nurses to do only medication administration.

Rationale 4: Healthcare agencies are not planning to train technicians whose sole function would be to administer medications.

Global Rationale: Healthcare agencies are using automated, computerized cabinets to reduce medication errors. Healthcare agencies are not planning for the use of robots in medication preparation. Healthcare agencies are not planning to designate nurses to do only medication administration. Healthcare agencies are not planning to train technicians whose sole function would be to administer medications.

Cognitive Level: Remembering

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality

AACN Essential Competencies: II.11 Employ principles of quality improvement, healthcare policy, and cost-effectiveness to assist in the development and initiation of effective plans for the microsystem and/or system-wide practice improvements that will improve the quality of healthcare delivery

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 6-9 Identify strategies that health care agencies use to prevent medication errors.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 21

Type: MCMA

A nurse on the medical–surgical unit is caring for several very ill clients. One client says, “I was supposed to get my medications an hour ago.” The nurse recognizes that medication errors can have what repercussions?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Medication errors can potentially extend the client’s length of hospital stay.
2. Medication errors can result in expensive legal costs to the facility.
3. Medication errors can damage the facility’s reputation.
4. Medication errors can be physically devastating to nurse and client.
5. Medication errors cause preventable deaths during hospitalizations.

Correct Answer: 1,2,3,5

Rationale 1: Medication errors can cause harm, which can extend the client’s length of stay.

Rationale 2: If a medication error causes harm to a client, it can result in expensive legal fees for hospital defense.

Rationale 3: If the incidence of medication errors is publicized, it can cause the facility to be seen as unsafe or to be delivering substandard care.

Rationale 4: Medication errors can be physically devastating to clients but would be emotionally devastating to the nurse.

Rationale 5: Medication errors are the most common cause of morbidity and preventable death within hospitals.

Global Rationale: Medication errors can cause harm, which can extend the client’s length of stay. If a medication error causes harm to a client, it can result in expensive legal fees for hospital defense. If the incidence of medication errors is publicized, it can cause the facility to be seen as unsafe or to be delivering substandard care. Medication errors are the most common cause of morbidity and preventable death within hospitals. Medication errors can be physically devastating to clients but would be emotionally devastating to the nurse.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: II.A.2 Describe scopes of practice and roles of health care team members

AACN Essential Competencies: II.2. Demonstrate leadership and communication skills to effectively implement patient safety and quality improvement initiatives within the context of the interprofessional team

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6-2 Describe the impact of a medication error on all aspects of health care delivery, including patients, nurses, and health care agencies.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 22

Type: MCMA

A new nurse on the orthopedic unit makes a medication error. Which statements by the nurse manager foster a safe environment in which nurses will report medication errors?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. “Many of us have made a medication error in our careers. The most important issue is to identify why the error occurred.”
2. “I know you could not feel any worse than you already do. We need to discuss how this error happened and how we can prevent it from happening again.”
3. “It’s really good that your patient is okay and did not suffer any harmful effects of this error. We should discuss why this error occurred and how it can be prevented in the future.”
4. “Because you are a new nurse, we should sit down and discuss the procedure you followed to see what you could have done to prevent this error.”
5. “We need to sit down as soon as possible and write up an incident report describing everything you did incorrectly that caused this error.”

Correct Answer: 1,2,3,4

Rationale 1: All errors should be investigated with the goal of identifying why they occurred. This investigation should be done in a manner that is not punitive and will encourage staff to report errors without fear of punishment.

Rationale 2: All errors should be investigated with the goal of identifying why they occurred. This investigation should be done in a manner that is not punitive and will encourage staff to report errors without fear of punishment.

Rationale 3: All errors should be investigated with the goal of identifying why they occurred. This investigation should be done in a manner that is not punitive and will encourage staff to report errors without fear of punishment.

Rationale 4: All errors should be investigated with the goal of identifying why they occurred. This investigation should be done in a manner that is not punitive and will encourage staff to report errors without fear of punishment.

Rationale 5: An incident report will need to be written, but the nurse who made the error should feel the report would identify factors contributing to the error rather than place blame.

Global Rationale: All errors should be investigated with the goal of identifying why they occurred. This investigation should be done in a manner that is not punitive and will encourage staff to report errors without fear of punishment. An incident report will need to be written, but the nurse who made the error should feel the report would identify factors contributing to the error rather than place blame.

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality

AACN Essential Competencies: II.7. Promote factors that create a culture of safety and caring

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6-3 Using specific examples, analyze major types of medication errors and how they can be prevented.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 23

Type: MCMA

A community health nurse is preparing a teaching plan regarding medications and safety for a new parent class. Which topics should be addressed?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Parents should maintain a list of current medications for each child.
2. Parents should be aware of each child’s medication allergies.
3. Parents should know what the child’s prescribed medication is for, how it should be administered, and when to expect the child to feel better.
4. Parents should be aware that any leftover medication should be appropriately disposed of, not saved for future use.
5. Parents should read the drug label for any foods the child should avoid while taking the medication and for possible adverse effects to watch out for.

Correct Answer: 1,2,3,4

Rationale 1: Parents should make a complete list of all prescribed medications, over-the-counter drugs, and any vitamins the child takes.

Rationale 2: It is very important that parents be aware of a child’s allergies in order to prevent an unnecessary allergic response.

Rationale 3: Parents should know what condition the child’s medication is prescribed for, and how, when, and how much to administer. It is also important for parents to know when to expect the child to feel better so a follow-up visit can be made if the child is not feeling better.

Rationale 4: Parents should be aware that it is not safe to self-diagnose and treat with leftover medication.

Rationale 5: Parents should be aware the label often describes food and drinks to avoid. The label will not describe possible adverse effects; the nurse will need to describe these to the parents.

Global Rationale: Parents should make a complete list of all prescribed medications, over-the-counter drugs, and any vitamins the child takes. It is very important that parents be aware of a child’s allergies in order to prevent an unnecessary allergic response. Parents should know what condition the child’s medication is prescribed for, and how, when, and how much to administer. It is also important for parents to know when to expect the child to feel better so a follow-up visit can be made if the child is not feeling better. Parents should be aware that it is not safe to self-diagnose and treat with leftover medication. Parents should be aware the label often describes food and drinks to avoid. The label will not describe possible adverse effects; the nurse will need to describe these to the parents.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: I.B.15 Communicate care provided and needed at each transition in care

AACN Essential Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6-8 Design patient teaching information that can be used to reduce medication errors.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 24

Type: MCMA

A community health nurse working with a group of migrant workers is reinforcing instruction on how to avoid medication errors. What should the nurse encourage clients to do in order to avoid medication errors?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Have all medications filled at the same pharmacy.
2. Let the health care provider know if they have difficulty acquiring their medications.
3. Ask questions about how and when to take medications if they are unsure.
4. Take all the medication as directed, and not to save the medication for a future illness.
5. Ask friends or family if they have any of the same medication and are willing to share it with the client.

Correct Answer: 1,2,3,4

Rationale 1: The pharmacist can recognize possible drug interactions if all medications are filled at one pharmacy.

Rationale 2: Many indigent clients do not have the means to fill prescriptions and may be embarrassed to tell the health care provider.

Rationale 3: Taking the wrong amount of medication at the wrong time is a very common medication error.

Rationale 4: The nurse should emphasize the importance of taking all the prescribed medication as directed.

Rationale 5: It is never safe to share medications.

Global Rationale: The pharmacist can recognize possible drug interactions if all medications are filled at one pharmacy. Many indigent clients do not have the means to fill prescriptions and may be embarrassed to tell the health care provider. Taking the wrong amount of medication at the wrong time is a very common medication error. The nurse should emphasize the importance of taking all the prescribed medication as directed. It is never safe to share medications.

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

QSEN Competencies: I.B.15 Communicate care provided and needed at each transition in care

AACN Essential Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6-8 Design patient teaching information that can be used to reduce medication errors.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 25

Type: MCMA

The nurse is preparing a teaching plan for an older adult client who is taking multiple medications. Which principles should the nurse keep in mind during the planning phase?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. The client should use only one pharmacy to fill prescriptions.
2. The client should keep a list of all medications for easy accessibility.
3. Polypharmacy is a common cause of medication errors in older clients.
4. Polypharmacy is unique to older clients and is the most common cause of medication errors.
5. The client should be aware of each prescribed medication, the dose, and possible side effects.

Correct Answer: 1,2,3,5

Rationale 1: It is common for older clients to have medical conditions requiring the use of multiple medications that could have possible interactions. Using one pharmacy will ensure the pharmacist will discover any problematic interactions between multiple drugs.

Rationale 2: Keeping a list available is important for unexpected trips to a healthcare facility.

Rationale 3: The use of multiple drugs for multiple chronic conditions is a common cause for medications errors in older clients.

Rationale 4: Polypharmacy is not unique to older clients, although it is most often seen in this group.

Rationale 5: Knowing the names, dose, and possible side effects of medications will reduce the risk for medication errors.

Global Rationale: It is common for older clients to have medical conditions requiring the use of multiple medications that could have possible interactions. Using one pharmacy will ensure the pharmacist will discover any problematic interactions between multiple drugs. Keeping a list available is important for unexpected trips to a healthcare facility. The use of multiple drugs for multiple chronic conditions is a common cause for medications errors in older clients. Knowing the names, dose, and possible side effects of medications will reduce the risk for medication errors. Polypharmacy is not unique to older clients, although it is most often seen in this group.

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

QSEN Competencies: I.B.15 Communicate care provided and needed at each transition in care

AACN Essential Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 6-8 Design patient teaching information that can be used to reduce medication errors.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 26

Type: MCMA

During a staff meeting, a nurse asks how risk management reduces medication errors in the facility. Which statements by the director of the risk management department accurately describe its functions?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. “We examine each reported incident to determine risks that could have contributed to the error.”
2. “We investigate each incident report to determine strategies that may be helpful to decrease the risk for medication errors.”
3. “We use data from reported incidences to identify common themes that may increase the risk for medication errors.”
4. “We use data to make changes in policies and procedures that may prevent medication errors.”
5. “We track data to determine if specific nurses are making errors so we can notify the nursing board.”

Correct Answer: 1,2,3,4

Rationale 1: Risk management personnel investigate reported incidents to determine the cause or causes for medication errors.

Rationale 2: Risk management personnel use data from incident reports to recommend strategies that may decrease medication errors.

Rationale 3: Risk management personnel use the information from incident reports to identify common factors that increase the risk for medication errors.

Rationale 4: Risk management personnel recommend strategies to decrease medication errors based on information gained during the investigation.

Rationale 5: Risk management personnel use data from the investigation to recommend strategies to prevent medication errors, not to report nurses to the nursing board.

Global Rationale: Risk management personnel investigate reported incidents to determine the cause or causes for medication errors; use data from incident reports to recommend strategies that may decrease medication errors; use the information from incident reports to identify common factors that increase the risk for medication errors; recommend strategies to decrease medication errors based on information gained during the investigation. Risk management personnel use data from the investigation to recommend strategies to prevent medication errors, not to report nurses to the nursing board.

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety and quality

AACN Essential Competencies: II.11 Employ principles of quality improvement, healthcare policy, and cost-effectiveness to assist in the development and initiation of effective plans for the microsystem and/or system-wide practice improvements that will improve the quality of healthcare delivery

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6-9 Identify strategies that health care agencies use to prevent medication errors

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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Question 27

Type: MCMA

A new nurse on the pediatric unit is very nervous about making a medication error. Which statements by a more experienced nurse are accurate?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. “One of the main causes of medication errors is the human factor. So, just be sure you ask for help if you are not sure about a dosage calculation.”
2. “If you are not sure you are reading an order correctly, always call the provider and ask. This will keep you from misinterpreting an order.”
3. “Our facility has a list of drugs that have similar names that have contributed to medication errors in the past. You might want to take a look at those so you will be aware of them.”
4. “You really don’t have to look at the diagnostic lab work from yesterday. It has been charted in the nurse’s notes.”
5. “As long as two nurses take a phone order, it does not have to be written by the health care provider.”

Correct Answer: 1,2,3

Rationale 1: It is important to double-check any calculations that the nurse may be unsure about with another nurse or the pharmacist.

Rationale 2: The nurse must always call the health care provider to confirm or clarify any orders that may be in question.

Rationale 3: Medications with similar names are a common cause for medication errors. If the facility has a list, it would be good for the new nurse to see what they are.

Rationale 4: Nurses should always review recent diagnostic lab work. The previous nurse could have misread the lab work.

Rationale 5: Orders must be in writing before any medication can be administered.

Global Rationale: It is important to double-check any calculations that the nurse may be unsure about with another nurse or the pharmacist. The nurse must always call the health care provider to confirm or clarify any orders that may be in question. Medications with similar names are a common cause for medication errors. If the facility has a list, it would be good for the new nurse to see what they are. Nurses should always review recent diagnostic lab work. The previous nurse could have misread the lab work. Orders must be in writing before any medication can be administered.

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

QSEN Competencies: V.B.2 Demonstrate effective use of strategies to reduce risk of harm to self or others

AACN Essential Competencies: II.9. Apply quality improvement processes to effectively implement patient safety initiatives and monitor performance measures, including nurse-sensitive indicators in the microsystem of care

NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6-6 Develop a list of strategies that the nurse can implement in practice to reduce medication errors.

MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.

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