Medication Reconciliation And Safety - NCLEX-PN
Card 1 of 25
What is the correct trailing-zero practice to prevent tenfold dosing errors?
What is the correct trailing-zero practice to prevent tenfold dosing errors?
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Do not use trailing zeros (write $1$ mg, not $1.0$ mg). Trailing zeros can obscure decimals, causing errors like reading 1.0 mg as 10 mg.
Do not use trailing zeros (write $1$ mg, not $1.0$ mg). Trailing zeros can obscure decimals, causing errors like reading 1.0 mg as 10 mg.
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Which teaching point is essential when discharging a patient with a new medication list?
Which teaching point is essential when discharging a patient with a new medication list?
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Explain which meds to start, stop, continue, and why, using a written list. Clear instructions promote adherence and understanding, reducing post-discharge errors through education and documentation.
Explain which meds to start, stop, continue, and why, using a written list. Clear instructions promote adherence and understanding, reducing post-discharge errors through education and documentation.
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What is the correct leading-zero practice for doses less than $1$ to prevent decimal errors?
What is the correct leading-zero practice for doses less than $1$ to prevent decimal errors?
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Use a leading zero (example: $0.5$ mg), never $.5$ mg. Leading zeros prevent misreading decimals, such as interpreting .5 mg as 5 mg, avoiding overdose.
Use a leading zero (example: $0.5$ mg), never $.5$ mg. Leading zeros prevent misreading decimals, such as interpreting .5 mg as 5 mg, avoiding overdose.
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Which instruction best reduces LASA errors when documenting or transcribing medication names?
Which instruction best reduces LASA errors when documenting or transcribing medication names?
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Use Tall Man lettering and avoid ambiguous abbreviations. Tall Man lettering highlights differences in similar names, while avoiding abbreviations reduces misinterpretation in orders.
Use Tall Man lettering and avoid ambiguous abbreviations. Tall Man lettering highlights differences in similar names, while avoiding abbreviations reduces misinterpretation in orders.
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Which statement best defines a "look-alike/sound-alike" (LASA) medication risk?
Which statement best defines a "look-alike/sound-alike" (LASA) medication risk?
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Different drugs with similar names or packaging increase selection errors. LASA medications pose risks due to confusion in selection, leading to wrong-drug errors in storage or dispensing.
Different drugs with similar names or packaging increase selection errors. LASA medications pose risks due to confusion in selection, leading to wrong-drug errors in storage or dispensing.
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What is the safest nursing action when a medication allergy is listed but the reaction is undocumented?
What is the safest nursing action when a medication allergy is listed but the reaction is undocumented?
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Clarify the reaction history before administration. Undocumented reactions may indicate true allergies or intolerances, requiring clarification to avoid potentially life-threatening administration.
Clarify the reaction history before administration. Undocumented reactions may indicate true allergies or intolerances, requiring clarification to avoid potentially life-threatening administration.
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Which high-alert medication class requires independent double-checks per facility policy?
Which high-alert medication class requires independent double-checks per facility policy?
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Insulin (high-alert medication). High-alert medications like insulin have narrow therapeutic indices, necessitating double-checks to prevent severe harm from errors.
Insulin (high-alert medication). High-alert medications like insulin have narrow therapeutic indices, necessitating double-checks to prevent severe harm from errors.
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Identify the discrepancy type: the inpatient order duplicates a home medication with the same therapeutic effect.
Identify the discrepancy type: the inpatient order duplicates a home medication with the same therapeutic effect.
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Therapeutic duplication. Duplication increases risk of overdose or adverse effects by ordering equivalent therapies redundantly.
Therapeutic duplication. Duplication increases risk of overdose or adverse effects by ordering equivalent therapies redundantly.
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Identify the discrepancy type: a patient home medication is not ordered on admission with no reason documented.
Identify the discrepancy type: a patient home medication is not ordered on admission with no reason documented.
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Omission. Omission occurs when a necessary medication is unintentionally excluded from the inpatient regimen without justification.
Omission. Omission occurs when a necessary medication is unintentionally excluded from the inpatient regimen without justification.
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Which action best prevents contamination when preparing and administering injectable medications?
Which action best prevents contamination when preparing and administering injectable medications?
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Use aseptic technique and scrub the vial or port per policy. Aseptic technique and scrubbing maintain sterility, reducing infection risk during preparation and injection.
Use aseptic technique and scrub the vial or port per policy. Aseptic technique and scrubbing maintain sterility, reducing infection risk during preparation and injection.
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Identify the required documentation after administering a PRN analgesic for pain rated $8$ out of $10$.
Identify the required documentation after administering a PRN analgesic for pain rated $8$ out of $10$.
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Document dose given and reassess and document response within ordered timeframe. Documentation captures administration details and evaluates effectiveness, ensuring accountability and guiding further care.
Document dose given and reassess and document response within ordered timeframe. Documentation captures administration details and evaluates effectiveness, ensuring accountability and guiding further care.
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Which medication category is commonly missed in reconciliation and must be asked about explicitly?
Which medication category is commonly missed in reconciliation and must be asked about explicitly?
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Over-the-counter drugs, herbals, and supplements. These non-prescription items can interact with prescribed drugs, leading to omissions if not specifically queried.
Over-the-counter drugs, herbals, and supplements. These non-prescription items can interact with prescribed drugs, leading to omissions if not specifically queried.
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Which abbreviation should be avoided because it can be misread as "0" or "4"?
Which abbreviation should be avoided because it can be misread as "0" or "4"?
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Avoid "U" for units; write "units". "U" is error-prone as it resembles numerals, potentially causing tenfold dosing mistakes like confusing 10U with 100.
Avoid "U" for units; write "units". "U" is error-prone as it resembles numerals, potentially causing tenfold dosing mistakes like confusing 10U with 100.
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What is the single most important action when a home medication order is unclear or incomplete?
What is the single most important action when a home medication order is unclear or incomplete?
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Hold the dose and clarify the order with the prescriber or pharmacist. Clarification prevents potential harm from incorrect administration, prioritizing patient safety over assumption.
Hold the dose and clarify the order with the prescriber or pharmacist. Clarification prevents potential harm from incorrect administration, prioritizing patient safety over assumption.
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Which three points in care most require medication reconciliation to reduce errors?
Which three points in care most require medication reconciliation to reduce errors?
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Admission, transfer, and discharge. These transition points are high-risk for discrepancies due to changes in providers, settings, or patient status.
Admission, transfer, and discharge. These transition points are high-risk for discrepancies due to changes in providers, settings, or patient status.
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What key elements must be documented for each medication during reconciliation?
What key elements must be documented for each medication during reconciliation?
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Name, dose, route, frequency, indication, and last dose time. These elements ensure comprehensive documentation to prevent errors in prescribing, dispensing, and administering medications.
Name, dose, route, frequency, indication, and last dose time. These elements ensure comprehensive documentation to prevent errors in prescribing, dispensing, and administering medications.
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Which patient sources must be used first to obtain the Best Possible Medication History (BPMH)?
Which patient sources must be used first to obtain the Best Possible Medication History (BPMH)?
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Patient or caregiver interview plus medication bottles or an up-to-date list. Primary sources provide the most reliable, patient-specific information for an accurate BPMH, reducing reliance on secondary data.
Patient or caregiver interview plus medication bottles or an up-to-date list. Primary sources provide the most reliable, patient-specific information for an accurate BPMH, reducing reliance on secondary data.
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What is the correct immediate action if a patient experiences suspected anaphylaxis after a medication dose?
What is the correct immediate action if a patient experiences suspected anaphylaxis after a medication dose?
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Stop the medication and initiate emergency response per protocol. Immediate cessation and protocol activation address life-threatening reactions to minimize harm and stabilize the patient.
Stop the medication and initiate emergency response per protocol. Immediate cessation and protocol activation address life-threatening reactions to minimize harm and stabilize the patient.
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Identify the safest action when a patient states a home medication was stopped, but it remains on the record.
Identify the safest action when a patient states a home medication was stopped, but it remains on the record.
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Verify with prescriber or pharmacy and update the active medication list. Verification confirms accuracy of the record, preventing unnecessary continuation or errors in ongoing care.
Verify with prescriber or pharmacy and update the active medication list. Verification confirms accuracy of the record, preventing unnecessary continuation or errors in ongoing care.
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Which action is required when a barcode scan alerts "wrong medication" at the bedside?
Which action is required when a barcode scan alerts "wrong medication" at the bedside?
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Stop and verify medication, order, and patient before proceeding. Alerts indicate potential mismatches, requiring verification to ensure the right medication reaches the correct patient.
Stop and verify medication, order, and patient before proceeding. Alerts indicate potential mismatches, requiring verification to ensure the right medication reaches the correct patient.
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Which abbreviation should be avoided because it can be misread as "daily"?
Which abbreviation should be avoided because it can be misread as "daily"?
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Avoid "QOD"; write "every other day". "QOD" may be confused with "QD," leading to incorrect daily dosing instead of alternate days.
Avoid "QOD"; write "every other day". "QOD" may be confused with "QD," leading to incorrect daily dosing instead of alternate days.
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Which action is required before administering any medication when two patient identifiers do not match?
Which action is required before administering any medication when two patient identifiers do not match?
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Do not administer; resolve the identification discrepancy first. Mismatched identifiers risk wrong-patient errors, so resolution ensures positive identification before proceeding.
Do not administer; resolve the identification discrepancy first. Mismatched identifiers risk wrong-patient errors, so resolution ensures positive identification before proceeding.
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What does the "rights of medication administration" concept primarily ensure?
What does the "rights of medication administration" concept primarily ensure?
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Correct patient, medication, dose, route, time, documentation, reason, response. These rights provide a systematic checklist to verify accuracy and appropriateness, minimizing administration errors.
Correct patient, medication, dose, route, time, documentation, reason, response. These rights provide a systematic checklist to verify accuracy and appropriateness, minimizing administration errors.
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Identify the discrepancy type: the ordered dose differs from the home dose without clinical justification.
Identify the discrepancy type: the ordered dose differs from the home dose without clinical justification.
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Dose discrepancy. Unjustified dose changes can lead to subtherapeutic effects or toxicity, requiring reconciliation to align with patient needs.
Dose discrepancy. Unjustified dose changes can lead to subtherapeutic effects or toxicity, requiring reconciliation to align with patient needs.
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What is the primary purpose of medication reconciliation during transitions of care?
What is the primary purpose of medication reconciliation during transitions of care?
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Prevent medication errors by ensuring an accurate, complete medication list. Medication reconciliation identifies and resolves discrepancies to maintain continuity and avoid adverse events during care changes.
Prevent medication errors by ensuring an accurate, complete medication list. Medication reconciliation identifies and resolves discrepancies to maintain continuity and avoid adverse events during care changes.
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