Deck 6: Medication Errors and Risk Reduction

Question 1

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?
Select all that apply.

A)Failure to follow health care 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

Answer 1

Failure to follow health care provider's orders
Failure to give the right medication
Failure to give a medication at the ordered time
Failure to give the right dose of the medication

Question 2

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?

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

Answer 2

An error could have occurred because the nurse was unfamiliar with the medication.

Question 3

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?

A)Taking medications as the practitioner has ordered
B)Never trading drugs with anyone
C)Taking drugs prescribed by more than one practitioner
D)Filling prescriptions at several pharmacies

Answer 3

Filling prescriptions at several pharmacies

Question 4

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

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

Question 5

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?

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

Question 6

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

A)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.
B)The nurse should consult the client's pharmacy and inform the pharmacist that the client is being discharged.
C)The nurse should call a friend to come before giving discharge instructions to the client.
D)The nurse should inform the client's primary health care provider that the client is being discharged.

Question 7

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?

A)Make sure there is an overstock of all medications to ensure availability.
B)Remove outdated reference books.
C)Store all medication in well-lighted areas.
D)Transfer all small amounts of medications into smaller containers to save space.

Question 8

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?

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

Question 9

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?

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

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 pharmacist
C)The health care provider
D)The nursing unit manager

Question 11

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?

A)Pharmacist
B)Health care provider
C)Client
D)Nurse manager

Question 12

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?

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

Question 13

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

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

Question 14

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?

A)Never taking a verbal or phone order without receiving a written order before administering the drug
B)Performing an agency system check
C)Failure to account for client variables
D)Following the rights of drug administration

Question 15

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?

A)The Food and Drug Administration's (FDA)Safe Medicine
B)The Food and Drug Administration's (FDA)MedWatch
C)The Food and Drug Administration's (FDA)Institute for Safe Medication Practices (ISMP)
D)The Centers for Disease Control (CDC)

Question 16

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?

A)Lack of adequate oral or written communication
B)Name confusion involving similar-sounding drugs
C)Mislabeled products
D)Human factors

Question 17

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?

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

Question 18

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?

A)Assessment
B)Medication transition
C)Pharmacological evaluation
D)Medication reconciliation

Question 19

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

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

Question 20

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?

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.

Question 21

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

A)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."
B)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."
C)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."
D)You really don't have to look at the diagnostic lab work from yesterday.It has been charted in the nurse's notes."
E)As long as two nurses take a phone order,it does not have to be written by the health care provider."

Question 22

A client newly diagnosed with diabetes mellitus is being prepared for discharge.The nurse knows discharge teaching on how to reduce the risk of at-home medication errors is successful when the client makes which statement?
Select all that apply.

A)I know all about my new medications,including their names,what they do,and how to take them."
B)I know what side effects need to be reported immediately to my doctor."
C)I have a list of all my medications right here in my wallet."
D)I know I can call anytime I have a question about any of my medications."
E)First thing in the morning,I will take all my prescriptions to the pharmacy to make sure they are safe for me to take."

Question 23

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?
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 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."
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 24

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?
Select all that apply.

A)The client should use only one pharmacy to fill prescriptions.
B)The client should keep a list of all medications for easy accessibility.
C)Polypharmacy is a common cause of medication errors in older clients.
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 25

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

A)Parents should maintain a list of current medications for each child.
B)Parents should be aware of each child's medication allergies.
C)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.
D)Parents should be aware that any leftover medication should be appropriately disposed of,not saved for future use.
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.

Question 26

The nurse receives a verbal order for subcutaneous insulin but gives the insulin IV instead to a client in the intensive care unit (ICU).Which medication errors have been committed?
Select all that apply.

A)Medication based on verbal order
B)Wrong route for medication
C)Stressful workplace
D)Illegible medication order
E)Failure to review diagnostic lab work

Question 27

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 are the likely ramifications of this error?
Select all that apply.

A)The reputation of the healthcare facility will suffer
B)The healthcare facility may pay high legal fees and a large settlement.
C)The morale of the staff will be adversely affected.
D)The nurse will lose the professional license to practice and can never practice again.
E)The healthcare facility will lose its accreditation and may be closed.

Question 28

A nurse preparing to give medications to clients in the emergency department avoids making medication errors by following drug administration rights.Which rights" did the nurse use?
Select all that apply.

A)Evaluating the client following drug administration.
B)Assessing the client prior to administering any drug.
C)Documenting all medications immediately following administration.
D)Educating the client regarding medications.
E)Administering prescribed medication even if the client refuses it.

Question 29

The nurse makes a medication error.The nurse manager determines the error was based on a common misinterpretation of which abbreviation?
Select all that apply.

A)IU
B)SQ
C)Q.O.D.
D)U
E)mcg

Question 30

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?
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 31

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?
Select all that apply.

A)We examine each reported incident to determine risks that could have contributed to the error."
B)We investigate each incident report to determine strategies that may be helpful to decrease the risk for medication errors."
C)We use data from reported incidences to identify common themes that may increase the risk for medication errors."
D)We use data to make changes in policies and procedures that may prevent medication errors."
E)We track data to determine if specific nurses are making errors so we can notify the nursing board."

Question 32

The nurse prepares to administer medications to clients on the orthopedic unit.Which outcomes will result from following the unit's rules,policies,and procedures?
Select all that apply.

A)Minimizing medication errors
B)Positively verifying client identification prior to medication administration
C)Guiding accurate documentation
D)Holding nurses accountable for medication errors
E)Determining which medication errors are preventable

Question 33

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?
Select all that apply.

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

Question 34

The nurse has returned from an in-service in which high-alert" drugs were discussed.For which drugs should the nurse be particularly alert?
Select all that apply.

A)IV epinephrine
B)Heparin
C)Digoxin
D)IV morphine
E)Oral propranolol