NUR 139 Chp 5 Review Questions and
Correct Answers
1. The nurse is reviewing medication errors. Which situation is an example of a
medication error?
a. A patient refuses her morning medications.
b. A patient receives a double dose of a medication because the nurse did not cut the
pill in half.
c. A patient develops hives after having started an IV antibiotic 24 hours earlier.
d. A patient complains of severe pain still present 60 minutes after a pain medication
was given. ✅ANS: b. A patient receives a double dose of a medication because the
nurse did not cut the
pill in half.
A medication error is defined as a preventable adverse drug event that involves
inappropriate medication use by a patient or health care provider. The other options are
not preventable. The patient's refusing to take medications and complaining of pain after
a medication is given are patient behaviors, and the development of hives is a possible
allergic reaction.
What is Just Culture? ✅An environment where after a systematic review of errors
disciplined is applied appropriately
Where do many serious medication errors occur? ✅Many serious medication errors
occur in the home.
The nurse is reviewing a list of verbal medication orders. Which is the proper notation of
the dos of the drug ordered?
a. Digoxin .125 mg
b. Digoxin .1250 mg
c. Digoxin 0.125 mg
d. Digoxin 0.1250 mg ✅ANS: C Digoxin0.125 mg
Digoxin 0.125 mg illustrates the correct notation with a leading zero before the decimal
point. Omitting the leading zero may cause the order to be misread, resulting in a large
drug overdose. Digoxin .125 mg and digoxin .1250 mg do not have the leading zero
before the decimal point. Digoxin 0.1250 mg has a trailing zero, which also is incorrect.
When given a scheduled morning medication, the patient states, ―I haven't seen that
pill before. Are you sure it's correct?‖ The nurse checks the medication administration
record and verifies that it is listed. Which is the nurse's best response?
a. ―It's listed here on the medication sheet, so you should take it.‖
b. ―Go ahead and take it, and then I'll check with your doctor about it.‖
,c. ―It wouldn't be listed here if it were not ordered for you!‖
d. ―Let me check on the order first before you take it" ✅Ans. d. ―Let me check on the
order first before you take it
When giving medications, the nurse should always listen to and honor any concerns or
doubts expressed by the patient. If the patient doubts an order, the nurse should check
the written order and/or check with the prescriber. The other options illustrate that the
nurse is not listening to the patient's concerns.
Adverse drug effect ✅Any undesirable occurrence related to administration of or failure
to administer a prescribed medication
Adverse drug reaction ✅Unexpected unintended or excessive responses to
medications given at therapeutic dosages (as opposed to overdose) one type of
adverse drug event
Allergic reaction ✅An immunologic reaction resulting from an unusual sensitivity of a
patient to certain mediation ; a type of adverse drug event and a subtype of adverse
drug reactions
Idiosyncratic reaction ✅Any abnormal and unexpected response to a mediation, other
than an allergic reaction, that is peculiar to an individual patient
Medical errors ✅A broad term used to refer to any errors at any point in patient care
that cause or have the potential to cause patient harm
"To err is human"
Medication errors ✅Any preventable adverse drug events involving inappropriate
medication used by a patient or health care professionals; they may or may not cause
the patient harm
Medication reconciliation ✅A procedure to maintain an accurate and up to date list of
medications for all patients between all phases of health care delivery.
During a period of time when the computerized medication order system was down, the
prescriber wrote admission orders, and the nurse is transcribing them. The nurse is
having difficulty transcribing one order because of the prescriber's handwriting. Which is
the best action for the nurse to take at this time?
a. Ask a colleague what the order says.
b. Contact the prescriber to clarify the order.
c. Wait until the prescriber makes rounds again to clarify the order.
d. Ask the patient what medications he takes at home. ✅ANS: B contact the prescriber
to clarify the order
,If a prescriber writes an order that is illegible, the nurse should contact the prescriber for
clarification. Asking a colleague is not useful because the colleague did not write the
order. Waiting for the prescriber to return is incorrect because it would delay
implementation of the order. Asking the patient about medications is incorrect because
this question will not clarify the current order written by the prescriber.
When taking a telephone order for a medication, which action by the nurse is most
appropriate?
a. Verify the order with the charge nurse.
b. Call back the prescriber to review the order.
c. Repeat the order to the prescriber before hanging up the telephone.
d. Ask the pharmacist to double-check the order. ✅ANS: C- repeat the order to the
prescriber before hanging up the telephone
For telephone or verbal orders, repeat the order back to the prescriber before hanging
up the telephone. The other options are incorrect.
The nurse can prevent medication errors by following which principles? (Select all that
apply.)
a. Assess for allergies after giving medications.
b. Use two patient identifiers before giving medications.
c. Do not give a medication that another nurse has drawn up in a syringe.
d. Minimize the use of verbal and telephone orders.
e. Use trade names instead of generic names to avoid confusion. ✅ANS: B, C, D
Measures that prevent medication errors include using two patient identifiers, giving
only medications that you have drawn up or prepared, and minimizing the use of verbal
and telephone orders. Assessment for allergies should be done before medications are
given. Generic names should be used to avoid the many sound-alike trade names of
medications.
Levothyroxine is available in 88-mcg tablet form. Convert this dose to milligram
strength. (do not round) ✅ANS: 0.088 mg
One mg equals 1000 mcg. To convert 88 mcg to mg, divide 88 by 1000 to equal 0.088
mg, or move the decimal point to the left three spaces. Do not forget to include the
leading zero.
Digoxin is available in 0.125-mg tablet form. Convert this dose to microgram strength.
(do not round) ✅ANS: 125 mcg
One mg equals 1000 mcg. To convert 0.125 mg to mcg, multiply by 1000 to equal 125
mcg, or move the decimal point to the right three spaces.
What are the keys to prevent medication errors? ✅Report the errors
Reporting of potential errors
Non-punitive approach to error reporting or "Just Culture"
QSEN initiatives
, QSEN ✅Quality and safety education for nurses
a project preparing future nurses with knowledge, skills, and attitudes to continuously
improve the profession.
The nurse keeps in mind that which measure is used to reduce the risk of medication
errors?
a. When questioning a drug order, keep in mind that the prescriber is correct.
b. Be careful about questioning the drug order a board-certified physician has written for
a patient.
c. Always double-check the many drugs with sound-alike and look-alike names because
of the high risk of error.
d. If the drug route has not been specifies, use the oral route. ✅c. Always double-
check the many drugs with sound-alike and look-alike names because of the high risk of
error.
During the medication administration process, it is important that the nurse remembers
which guideline?
a. When in doubt about a drug, ask a colleague about it before giving the drug.
b. Ask what the patient knows about the drug before giving it.
c. When giving a new drug, be sure to read about it after giving it.
d. If a patient expresses a concern about a drug, stop, listen, and investigate the
concerns. ✅d. If a patient expresses a concern about a drug, stop, listen, and
investigate the concerns.
If a student nurse realizes that he or she has made a drug error, the instructor should
remind the student of which concept?
a. The student bears no legal responsibility when giving medications.
b. The major legal responsibility lies with the health care institution at which the student
is placed for clinical experience.
c. The major legal responsibility for drug errors lies with the faculty members.
d. Once the student has committed a medication error, his or her responsibility is to the
patient and to being honest and accountable. ✅d. Once the student has committed a
medication error, his or her responsibility is to the patient and to being honest and
accountable
The nurse is giving medications to a newly admitted patient who is to receive nothing by
mouth (NPO status) and finds an order written as follows: "Digoxin, 250 mpg stat."
Which action is appropriate?
a. Give the medication immediately (stat) by mouth because the patient has no
intravenous (IV) access at this time.
b. Clarify the order with the prescribing physician giving the drug.
c. Ask the charge nurse what route the physician meant to use.
d. Start an IV line, then give the medication IV so that it will work faster, because the
patient's status is NPO at this time. ✅b. Clarify the order with the prescribing physician
giving the drug.
