Deck 7: Medication Errors and Risk Reduction

Question 1

Which of the following statements correctly identifies factors that contribute to medication errors?
1)A nurse who observes the five rights will prevent all medication errors from occurring.
2)Nurses are always liable when a medication error occurs.
3)Handwritten orders are more frequently associated with medication errors than are typed orders.
4)An incorrect dose (based on weight)is ordered,dispensed,and administered to a patient.The administering nurse and ordering clinician would be the only parties held accountable.

Answer 1

3

Question 2

The nursing instructor teaches the student nurses about how medication errors can occur.What information will the nursing instructor include in the presentation? Credit will be given only if all correct choices and no incorrect choices are selected.
1)The nurse miscalculates the medication dose.
2)The nurse does not check the patient's identification band.
3)The nurse does not validate an order with the physician.
4)The nurse misinterprets a physician's order.
5)The nurse administers the incorrect drug.

Answer 2

1,2,4,5

Question 3

The nurse is on a committee to reduce medication errors in a large health care facility.What is a recommendation the nurse proposes that will most likely help to reduce medication errors?
1)Train medication technicians to administer medications.
2)Use robots to prepare all medications for administration by the nurse.
3)Use automated,computerized cabinets on all nursing units.
4)Designate nurses whose only function is to administer medication.

Answer 3

3

Question 4

The nurse is preparing medications for a group of patients.Another nurse begins telling the nurse about her recent engagement.What is the best action by the first nurse?
1)Ask the second nurse to help with administering medications so they can have more time to talk.
2)Continue to prepare the medications for administration and pretend to listen to the first nurse.
3)Stop preparing medications until the first nurse has finished talking about her engagement.
4)Tell the second nurse that the conversation is distracting and must cease while medications are being prepared.

Question 5

Which of the following statements regarding medication error rates is ethically accurate?
1)Error rates are acceptable when well below the national average.
2)Error rates are acceptable when associated costs exceed the costs necessary for preventative actions.
3)Error rates are never acceptable.
4)Error rates are only acceptable when associated costs are less than 5% of the facility's yearly profit.

Question 6

The nurse manager plans to teach the graduate nurse the reason why the nursing unit has policies and procedures.What best describes the reason for policies and procedures?
1)The policies and procedures establish standards of care for the institution.
2)The policies and procedures indicate how nursing personnel are to perform skills.
3)The policies and procedures establish how the health care facility is to be run.
4)The policies and procedures indicate the steps that must be taken when a medication error occurs.

Question 7

Which of the following demonstrates ethical reporting of a medication error?
1)The nurse does not report the error,because the error was caught and corrected prior to drug administration.
2)The nurse does not report or document the error,since the error did not result in any harm to the patient.
3)The nurse reports the error to the physician and the charge nurse but does not document the error due to possible legal action.
4)The nurse informs the patient,documents the error as per hospital policy,and notifies the physician.

Question 8

Which of the following best represents adherence to a standard of care?
1)Administering a medication within the time frame specified by hospital policy
2)Administering a medication intramuscularly when a patient refuses to take it orally
3)Using abbreviations while charting to save time
4)Discontinuing a medication at the request of a patient

Question 9

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

Question 10

The nurse commits a medication error.The nurse documents the error in the patient's record and completes the incident report.What does the nurse recognize as the primary reason for doing this?
1)To verify that the patient's safety was protected
2)To protect the patient from further harm
3)To protect the health care facility from litigation
4)To protect the nurse from liability

Question 11

Which of the following is an example of a medication error?
1)The wrong dose of a medication is drawn up,but is caught and corrected prior to administration.
2)A medication is administered to a patient with no allergies,yet an anaphylactic response occurs.
3)A medication is administered in liquid form instead of tablet form due to the patient's difficulty swallowing.
4)A patient experiences unexpected hypotension as a result of medication administration.

Question 12

The nurse makes a medication error and a patient dies.In court,the attorney for the family of the deceased patient asks the nurse if she followed standards of care in administering the medication.How would the attorney phrase this ?
1)"Did you follow agency guidelines as in previous circumstances?"
2)"Did you follow the physician's orders and double-check them before administration?"
3)"Did you do the three checks and follow the five rights as taught in school?"
4)"Did you do what another nurse would have done under similar circumstances?"

Question 13

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 nursing unit manager
3)The pharmacist
4)The physician

Question 14

The nurse is working very hard to prevent medication errors.What plan(s)will assist the nurse in preventing most errors? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Plan to always check the patient's identification band prior to administration of medications.
2)Plan to open all of the medications immediately prior to administration.
3)Plan to tell physicians that verbal orders will not be accepted.
4)Plan to record the medication on the medication administration record (MAR)immediately prior to administration.
5)Plan to validate all orders with another nurse prior to administration of medications.

Question 15

Patients who are discharged from the hospital on new medications should
1)be advised that their local pharmacy will provide them with the drug information and instructions they need.
2)be provided with oral and written drug information and instructions.
3)be provided oral drug information and instructions as opposed to written.
4)be provided with written drug information and instructions only.

Question 16

Nurses should implement strategies to prevent medication errors.Which strategies would be the most beneficial for reducing common errors?
1)Strategies to prevent wrong dosage errors
2)Strategies to prevent wrong route errors
3)Strategies to prevent wrong medication errors
4)Strategies to prevent wrong patient errors

Question 17

The nurse administers an evening medication to the patient in the morning.The medication did go to the correct patient.What is the nurse's best course of action at this time?
1)Change the medication administration time to the morning.
2)Notify the physician about the error and complete an incident report.
3)Tell the evening nurse to hold the evening dose just for tonight.
4)Notify the physician and ask if any further action needs to be taken.

Question 18

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 health care facility?
1)The professional license of the nurse will be lost.
2)The morale of the staff involved will be depleted.
3)The reputation of the health care facility will suffer.
4)The health care facility will pay a very large settlement.

Question 19

The nurse teaches a class to patients about how to help prevent medication errors when in the hospital.What is a priority for the nurse to ask the patients?
1)"Do you know the names of all the medications you take?"
2)"Do you trust your physician to order the correct medication?"
3)"Do you have a friend to verify that you are receiving the correct medication?"
4)"Do you know what your illness is,and if you will need surgery?"

Question 20

The nurse assesses an adverse effect of a medication that has been administered.No medication error was committed.What is the best plan of the nurse at this time?
1)Report the adverse effect to the Food and Drug Administration's (FDA)MedWatch Website.
2)Report the adverse effect to the Food and Drug Administration's (FDA)Adverse Event Website.
3)Report the adverse effect to the Food and Drug Administration's (FDA)Safe Medicine Website.
4)Report the adverse effect to the Food and Drug Administration's (FDA)Med MARX Website.

Question 21

The nurse is preparing a teaching plan for an older patient who is taking multiple medications.Which principles should the nurse keep in mind during the planning phase? Credit will be given only if all correct choices and no incorrect choices are selected.
1)The patient should use only one pharmacy to fill prescriptions.
2)The patient should keep a list of all medications for easy accessibility.
3)Polypharmacy is a common cause of medication errors in older patients.
4)Polypharmacy is unique to older patients and is the most common cause of medication errors.
5)The patient should be aware of each prescribed medication,the dose,and possible side effects.

Question 22

The nurse has made a medication error.The nurse manager determines the error was based on a common misinterpretation of which abbreviation? Credit will be given only if all correct choices and no incorrect choices are selected.
1)IU
2)SQ
3)Q.O.D.
4)U
5)mcg

Question 23

Which statement is accurate regarding the Institute for Safe Medication Practices (ISMP)?
1)It publishes a consumer newsletter regarding medication errors.
2)It is a governmental agency.
3)It accepts reports from anyone for a nominal fee.
4)It only accepts reports from health care professionals.

Question 24

A community health nurse is preparing a teaching plan regarding medications and safety for a new parent class.Which topics should be addressed? Credit will be given only if all correct choices and no incorrect choices are selected.
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.

Question 25

A nurse on the medical-surgical unit is caring for several very ill patients.One patient says,"I was supposed to get my medications an hour ago." The nurse recognizes that medication errors can have what repercussions? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Medication errors can potentially extend the patient'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 patient.
5)Medication errors cause preventable deaths during hospitalizations.

Question 26

The nurse makes a medication error,but the patient is not harmed.The patient's family asks the nurse manager what is considered a medication error.Which of the following are potential responses by the nurse manager? Credit will be given only if all correct choices and no incorrect choices are selected.
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

Question 27

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? Credit will be given only if all correct choices and no incorrect choices are selected.
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 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."
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."