Question 1

A nurse was involved in a medication error a week ago that caused an adverse effect on the client. The nurse manager has asked her to participate in a multidisciplinary group looking at the circumstances around the error. The nurse states that she met her responsibility by completing the incident report. How does the nurse respond to the RN?

A) " If you do not attend, it will be reflected on your file."
B) "I will get someone to relieve you while you attend."
C) "Your union steward is welcome to attend with you."
D) " It's part of your ethical responsibilities to help prevent similar errors."

" It's part of your ethical responsibilities to help prevent similar errors."

Accepted Answer

Rationale 1. This is a punitive statement and reflects an attitude of blame. Promoting a blame free system is a principle of many multidisciplinary organizations working together to prevent medication errors
Rationale 2. This statement does not address the RN's belief that she has met her obligations.
Rationale 3. This is a punitive statement as well and implies that discipline for the error is forthcoming.
Rationale 4. This is the best statement. The nurse must understand that when an error occurs, it is their ethical responsibility to take part in any interventions that may prevent similar errors from occurring.

Question 2

The nursing instructor teaches the students how medication errors can occur. Which common errors will the instructor discuss?&#10;A) Failure to validate a written order with the health care provider.&#10;B) The nurse administers the incorrect drug.&#10;C) The nurse miscalculates the medication dose.&#10;D) The nurse misinterprets a health care provider's order.&#10;E) The nurse does not check the client's identification band.&#10;

Accepted Answer

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.

Question 3

following a class on adverse drug reactions and medication errors, the students are asked to document the causes of errors. Which of the following does a student include in her list?&#10;A) Failure to follow health care provider's orders&#10;B) Failure to assess for allergies.&#10;C) Failure to give a medication at the ordered time&#10;D) Failure to clarify orders with the pharmacy&#10;E) Failure to give the right dose of the medication&#10;

Accepted Answer

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: Failure to assess for allergies could result in a fatal reaction to a medication ordered.
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: Order clarification if necessary would be with the health care provider that ordered the medication, not pharmacy.
Rationale 5: In this medication error, the client does not receive the dose of the drug the health care provider intended to be given.

Question 4

The student has just completed a class on factors that affect medication errors. Which statement by the student indicates understanding of the material?&#10;A) &#34;I will validate all orders with another nurse prior to administration of medications.&#34;&#10;B) &#34;I will assess for patient variables such as age, weight, and diagnostic lab studies prior to administration.&#34;&#10;C) &#34;I will tell health care providers that verbal orders will not be accepted.&#34;&#10;D) &#34;I will always check the client's identification band prior to administration of medications.&#34;&#10;E) &#34;I will record the medication on the MAR immediately after pouring the medication.'&#10;

Accepted Answer

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 will address one of the 10 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.

Question 5

The nurse is instructing a client about how to prevent medication errors after discharge from the hospital. What recommendations should the nurse include in her instructions?&#10;A) Ask questions about drug safety. Health care providers should be partners in maintaining safe medication principles.&#10;B) Remember that OTC and herbal supplements are not considered medications. They are available this way cannot cause any harm.&#10;C) It is okay to use household utensils to measure medications. These devices yield the same measurements that are used by professionals.&#10;D) Do not use more than one pharmacy to fill your prescriptions, this does not provide the pharmacist will all necessary information when dispensing your medication.&#10;

Accepted Answer

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 utensils and metric measures are not the same. Using household measures could result in medication errors.
Rationale 4: Using more than one pharmacy to dispense medications will not allow the pharmacist to tract all the client's medications and leaves them unable to prevent drug interactions and errors.

Question 6

The nurse is on a multidisciplinary committee to reduce medication errors in a large healthcare facility. The committee is considering new strategies to prevent medication errors.Which of the following strategies have been found to reduce medication errors?

A) Use robots to prepare all medications for administration by the nurse.
B) Use automated, computerized cabinets on all nursing units.
C) Designate nurses whose only function is to administer medication.
D) Train medication technicians to administer medications.
E) Use of up to date handheld electronic resources for access by nurses.

Accepted Answer

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: This strategy may actually increase the incidence of errors.
Rationale 4: Medication administration is complex and requires knowledge from many disciplines. Medication technicians are not being used in healthcare facilities.
Rationale 5. Electronic devices such as smart phones or personal digital assistants may provide up to date accurate information on the medications that the nurse is giving.

Question 7

A community health nurse is preparing a teaching plan regarding medications and safety for a new parent class. Which topics should be addressed?&#10;A) Parents should maintain a list of current medications for each child.&#10;B) Parents should be aware of each child's medication allergies.&#10;C) Parents should know what the child's prescribed medication is for, how it should be administered.&#10;D) Parents should be aware that any leftover medication should be appropriately disposed of, not saved for future use.&#10;E) 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.&#10;

Accepted Answer

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.
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.

Question 8

A community health nurse working with a group of migrant workers is reinforcing safe medication practices. What should the nurse encourage clients to do in order to avoid medication errors?&#10;A) Have all medications filled at the same pharmacy.&#10;B) Let the health care provider know if they have difficulty acquiring their medications.&#10;C) Ask questions about how and when to take medications if they are unsure.&#10;D) Take all the medication as directed, and not to save the medication for a future illness.&#10;E) Ask family if they have any of the same medication and are willing to share to save expenses.&#10;

Accepted Answer

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.

Question 9

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?&#10;A) The client should use only one pharmacy to fill prescriptions.&#10;B) The client should keep a list of all medications for easy accessibility.&#10;C) Polypharmacy is a common cause of medication errors in older clients.&#10;D) Polypharmacy is unique to older clients and is the most common cause of medication errors.&#10;E) The client should be aware of each prescribed medication, the dose, and possible side effects.&#10;

Accepted Answer

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.

Deck 5: Medication Incidents and Risk Reduction