Deck 7: Medication Errors and Risk Reduction

Question 1

The nurse administers an evening medication to the client in the morning. What is the nurse's best initial course of action at this time?

A) Change the medication administration time to the morning.
B) Notify the healthcare provider about the error.
C) Tell the evening nurse to hold the evening dose just for tonight.
D) Document the incident in the client's health record.

Answer 1

Notify the healthcare provider about the error.

Question 2

A nurse manager is discussing medication errors with a group of nurses. Which statement by the nurses indicates the teaching was effective?

A) A nurse who observes the five rights will prevent all medication errors from occurring.
B) Nurses are always liable when a medication error occurs.
C) Handwritten orders are more frequently associated with medication errors than are typed orders.
D) An incorrect dose (based on weight) is ordered, dispensed, and administered to a client. The administering nurse and ordering clinician would be the only parties held accountable.

Answer 2

Handwritten orders are more frequently associated with medication errors than are typed orders.

Question 3

Medication reconciliation has been started for a newly admitted client. At which points would the nurses and others caring for this client check this list? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Each time that medications are administered to the client
B) When initial admission orders are received
C) When the client is transferred to a different unit within the hospital
D) When the client is discharged
E) If a medication error occurs

Answer 3

When initial admission orders are received
When the client is transferred to a different unit within the hospital
When the client is discharged

Question 4

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

A) Ask the second nurse to help with administering medications so they can have more time to talk.
B) Continue to prepare the medications for administration and pretend to listen to the first nurse.
C) Stop preparing medications until the second nurse has finished talking about her engagement.
D) Tell the second nurse that the conversation is distracting and she must stop talking while medications are being prepared.

Question 5

A series of category E medication errors have occurred on a hospital unit. When discussing this trend with the nursing staff, the risk manager would list which characteristics of a category E error? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The error contributed to the death of a client.
B) A client was harmed.
C) No interventions to sustain life were required as a result of the error.
D) Harm to the client was permanent.
E) The client's hospitalization was prolonged as a result of the error.

Question 6

The nursing instructor teaches the student nurses about how medication errors can occur. What information will the nursing instructor include in the presentation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The nurse miscalculates the medication dose.
B) The nurse does not check the client's identification band.
C) The nurse does not validate an order with the healthcare provider.
D) The nurse misinterprets a healthcare provider's order.
E) The nurse administers the incorrect drug.

Question 7

The nurse teaches a class to clients about how to help prevent medication errors when in the hospital. What is the most important question for the nurse to ask the clients?

A) "Do you know the names of all the medications you take?"
B) "Do you trust your healthcare provider to order the correct medication?"
C) "Do you have a friend to verify that you are receiving the correct medication?"
D) "Do you know what your illness is, and if you will need surgery?"

Question 8

A nurse is reviewing safe medication administration with a student nurse. What should the nurse plan to include in the teaching?

A) Give medications within the time frame specified by hospital policy.
B) Administer medications intramuscularly when a client refuses to take it orally.
C) Use abbreviations while charting to save time.
D) Discontinue a medication at the request of a client.

Question 9

A student nurse asks a nursing instructor which federal agency is responsible for reviewing all medication error reports. What is the nursing instructor's best response?

A) Centers for Disease Control (CDC)
B) Risk Management department at the healthcare facility in which it occurred
C) Medication errors are never acceptable. National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP)
D) FDA's Division of Medication Error Prevention and Analysis (DMEPA)

Question 10

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?

A) The nursing supervisor
B) The nursing unit manager
C) The pharmacist
D) The healthcare provider

Question 11

The nurse is on a committee to reduce medication errors in a large healthcare facility. What is a recommendation the nurse proposes that will most likely help to reduce medication errors?

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

Question 12

A nurse is planning to teach a client about a new medication. What is the best teaching method?

A) Instruct the client that their local pharmacy will teach them about this medication.
B) Give the client oral and written drug information and instructions.
C) Provide oral drug information and instructions as opposed to written.
D) Leave written drug information and instructions at the bedside.

Question 13

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

A) This was acceptable as long as the nurse looked up the action and side effects of the drug later.
B) An error could have occurred because the nurse was unfamiliar with the medication.
C) The nurse manager was partially at fault because the nursing unit was understaffed and the nurse was too busy.
D) An error did occur because the nurse could have administered the medication via the incorrect route.

Question 14

The nurse is working hard to prevent medication errors. What interventions will assist the nurse in preventing most errors? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Always check the client's identification band prior to administration of medications.
B) Open all of the medications immediately prior to administration.
C) Tell healthcare providers that verbal orders will not be accepted.
D) Record the medication on the medication administration record (MAR) immediately prior to administration.
E) Validate all orders with another nurse prior to administration of medications.

Question 15

A nurse is administering medications to a group of clients. Which situation is an example of a medication error?

A) The wrong dose of a medication is drawn up but is caught and corrected prior to administration.
B) A medication is administered to a client with no allergies, yet an anaphylactic response occurs.
C) A medication is administered in liquid form instead of tablet form due to the client's difficulty swallowing.
D) A client experiences unexpected hypotension as a result of medication administration.

Question 16

A nurse is preparing to administer a new drug that was just prescribed by the healthcare provider. The nurse recognizes that the wrong concentration of the drug was sent by the pharmacy. What is the nurse's best response?

A) The nurse does not report the error, because the error was caught and corrected prior to drug administration.
B) The nurse does not report or document the error, since the error did not result in any harm to the patient.
C) The nurse reports the error to the healthcare provider and the charge nurse but does not document the error due to possible legal action.
D) The nurse informs the client, documents the error as per hospital policy, and notifies the healthcare provider.

Question 17

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 doing this?

A) To verify that the client's safety was protected
B) To protect the client from further harm
C) To protect the healthcare facility from litigation
D) To protect the nurse from liability

Question 18

The nurse assesses an adverse effect of a medication that has been administered. Who should the nurse report this adverse effect to?

A) Food and Drug Administration's (FDA) MedWatch Website.
B) Food and Drug Administration's (FDA) Adverse Event Website.
C) Food and Drug Administration's (FDA) Safe Medicine Website.
D) Food and Drug Administration's (FDA) Med MARX Website.

Question 19

The nurse in the emergency department administers an adult dose of an antibiotic to a 3-month-old baby. As a result, the baby suffers permanent brain damage. What best describes the effect of this error on the healthcare facility?

A) The professional license of the nurse will be lost.
B) The morale of the staff involved will be decreased.
C) The reputation of the healthcare facility will suffer.
D) The healthcare facility will pay a very large settlement.

Question 20

The nurse makes a medication error and a client dies. In court, the attorney for the family of the deceased client asks the nurse if she followed standards of care in administering the medication. How would the attorney phrase this question?

A) "Did you follow agency guidelines as in previous circumstances?"
B) "Did you follow the healthcare provider's orders and double-check them before administration?"
C) "Did you do the three checks and follow the five rights as taught in school?"
D) "Did you do what another nurse would have done under similar circumstances?"

Question 21

The nurse is beginning medication reconciliation for a newly admitted client. What should the nurse include in this list? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The client takes ibuprofen for an occasional headache.
B) The client mixes a powdered form of vitamin C into his morning orange juice.
C) The client applies essential oils to his forehead to help with his or her allergies.
D) The client drinks milk fortified with vitamin D.
E) The client takes a prescription medication for osteoporosis once a week.

Question 22

A new nurse on the orthopedic floor 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. Select all that apply.

A) "Many of us have made a medication error in our careers. The most important issue is to identify why the error occurred."
B) "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."
C) "It's really good that your client is OK 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."
D) "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."
E) "We need to sit down as soon as possible and write up an incident report describing everything you did incorrectly that caused this error."

Question 23

A nurse is administering medications to a client. The client states, "I've never taken that yellow pill before." What should the nurse do first?

A) Tell the client that some are made by different pharmaceutical companies and may look different.
B) Reassure the client that the nurse has triple checked the drug so it is safe to take.
C) Contact the health provider to verify it is the correct medication and dose.
D) Verify the order and double-check the label.

Question 24

A community health nurse is preparing a teaching plan regarding medications and their potential adverse effects for a new parent class. The nurse should encourage parents to do which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Maintain a list of current medications for each child.
B) Be aware of each child's medication allergies.
C) Know what the child's prescribed medication is for, how it should be administered, and when to expect the child to feel better.
D) Be aware that any leftover medication should be appropriately disposed of, not saved for future use.
E) Read the prescription label for any foods the child should avoid while taking the medication and for possible adverse effects to watch out for.

Question 25

The nurse has been hired to work in the risk management office of a hospital. What situations would the nurse expect to be included in this job? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Participating in the investigation of a sentinel medication event
B) Using the computer to track data
C) Working with staff nurses to identify work flow problems
D) Meeting with the nurse executive to identify nurses who are prone to medication errors
E) Participating in a committee that will recommend changes to the policy and procedures regarding medication administration.

Question 26

The nurse is preparing a teaching plan for an older 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. Select all that apply.

A) The client should have all prescriptions filled at the same pharmacy.
B) The client should keep a list of all medications for easy accessibility.
C) Older clients often take multiple drugs which is a common cause of medication errors.
D) Polypharmacy is unique to older clients and is the most common cause of medication errors.
E) The client should be aware of each prescribed medication, the dose, and possible side effects.

Question 27

The nursing supervisor tells a nurse that the medication error the nurse made yesterday has been determined to be a sentinel event. What should the nurse expect to occur? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Her employment will be terminated.
B) Her personal malpractice insurance company will be notified.
C) An immediate investigation will occur.
D) Interventions to prevent the error from occurring again will quickly be put in place.
E) A root-cause analysis will be performed.

Question 28

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. How should the nurse manager respond? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Failure to follow healthcare provider's orders
B) Failure to give the right medication
C) Failure to give a medication at the ordered time
D) Failure to call the pharmacy and report that the medication has been given
E) Failure to give the right dose of the medication

Question 29

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 impact? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Medication errors can potentially extend the client's length of hospital stay.
B) Medication errors can result in expensive legal costs to the facility.
C) Medication errors can damage the facility's reputation.
D) Medication errors can be physically devastating to nurse and client.
E) Medication errors cause preventable deaths during hospitalizations.

Question 30

The risk management department is using a root-cause analysis to improve a nursing unit's medication administration accuracy. What questions will be used to develop this tool? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "What kind of errors are occurring?"
B) "What is the current medication administration accuracy rate?"
C) "How do the unit nurses rank in the number of errors committed?"
D) "What do the nurses think can be done to prevent errors from continuing?"
E) "What is the impact of changes made to improve accuracy?"