Chapter 1 —Medication Orders & Tablet
Calculations
1. Stem: A nurse is preparing medications and remembers
that medication safety is most fundamentally supported
by which principle?
A. Speed of administration to minimize patient wait time
B. Following standardized checks and double-checks
before giving medications
C. Delegating calculations to unlicensed personnel to save
time
D. Avoiding documentation until the end of the shift to
prevent interruptions
Correct Answer: B
,Rationales:
• Correct (B): Standardized checks (rights, verification steps,
double-checks for high-risk meds) reduce errors and form
the core of medication safety.
• Incorrect (A): Prioritizing speed over safety increases error
risk; not a safety principle.
• Incorrect (C): Delegation of calculations to unlicensed staff
violates scope and increases risk.
• Incorrect (D): Delaying documentation removes the safety
net of contemporaneous verification; increases error
potential.
Teaching Point: Standardized checks and independent
verification are the foundation of medication safety.
2. Chapter 1 — Section: Rights of Medication
Administration
Stem: Which of the following is correctly listed as a formal
"right" that helps prevent medication errors?
A. Right convenience (give medication at the most
convenient time)
B. Right documentation (accurate, immediate recording of
administration)
C. Right omission (omit doses when in doubt)
D. Right guess (interpret illegible orders by best guess)
Correct Answer: B
,Rationales:
• Correct (B): Right documentation (time, dose, route, site,
patient response) is a recognized right and promotes
traceability and safety.
• Incorrect (A): “Right convenience” is not a recognized right
and could compromise dosing schedules.
• Incorrect (C): Omitting doses without clarification is
unsafe; not a right.
• Incorrect (D): Guessing illegible orders is unsafe —
clarification is required.
Teaching Point: Document immediately after medication
administration for safety and accountability.
3. Chapter 1 — Section: Patient Identification
Stem: Two patients on the unit share the same last name.
Which action best ensures the “right patient” before giving
a medication?
A. Ask the patient if their name is the same as on the chart
B. Use two approved identifiers (e.g., name and date of
birth) and scan the barcode wristband
C. Rely on the roommate’s confirmation of identity
D. Compare the room number with the medication
administration record (MAR)
Correct Answer: B
, Rationales:
• Correct (B): Using two approved identifiers (name + DOB)
and barcode scanning is the safest, facility-approved
method to ensure correct identity.
• Incorrect (A): Asking alone is less reliable than using two
identifiers and barcode scanning.
• Incorrect (C): Roommate confirmation is not a reliable
identifier.
• Incorrect (D): Room numbers can change and are not an
approved two-identifier method.
Teaching Point: Always verify two identifiers (name + DOB) and
scan wristband for patient identification.
4. Chapter 1 — Section: Look-alike / Sound-alike (LASA)
Medications
Stem: Which strategy is most effective to reduce errors
from look-alike/sound-alike drug names?
A. Use handwritten orders in block print only
B. Apply Tall Man lettering and separate storage for similar
drugs
C. Rely on phonetic spelling when reading orders aloud
D. Store LASA drugs together so staff can choose quickly
Correct Answer: B
Rationales:
Calculations
1. Stem: A nurse is preparing medications and remembers
that medication safety is most fundamentally supported
by which principle?
A. Speed of administration to minimize patient wait time
B. Following standardized checks and double-checks
before giving medications
C. Delegating calculations to unlicensed personnel to save
time
D. Avoiding documentation until the end of the shift to
prevent interruptions
Correct Answer: B
,Rationales:
• Correct (B): Standardized checks (rights, verification steps,
double-checks for high-risk meds) reduce errors and form
the core of medication safety.
• Incorrect (A): Prioritizing speed over safety increases error
risk; not a safety principle.
• Incorrect (C): Delegation of calculations to unlicensed staff
violates scope and increases risk.
• Incorrect (D): Delaying documentation removes the safety
net of contemporaneous verification; increases error
potential.
Teaching Point: Standardized checks and independent
verification are the foundation of medication safety.
2. Chapter 1 — Section: Rights of Medication
Administration
Stem: Which of the following is correctly listed as a formal
"right" that helps prevent medication errors?
A. Right convenience (give medication at the most
convenient time)
B. Right documentation (accurate, immediate recording of
administration)
C. Right omission (omit doses when in doubt)
D. Right guess (interpret illegible orders by best guess)
Correct Answer: B
,Rationales:
• Correct (B): Right documentation (time, dose, route, site,
patient response) is a recognized right and promotes
traceability and safety.
• Incorrect (A): “Right convenience” is not a recognized right
and could compromise dosing schedules.
• Incorrect (C): Omitting doses without clarification is
unsafe; not a right.
• Incorrect (D): Guessing illegible orders is unsafe —
clarification is required.
Teaching Point: Document immediately after medication
administration for safety and accountability.
3. Chapter 1 — Section: Patient Identification
Stem: Two patients on the unit share the same last name.
Which action best ensures the “right patient” before giving
a medication?
A. Ask the patient if their name is the same as on the chart
B. Use two approved identifiers (e.g., name and date of
birth) and scan the barcode wristband
C. Rely on the roommate’s confirmation of identity
D. Compare the room number with the medication
administration record (MAR)
Correct Answer: B
, Rationales:
• Correct (B): Using two approved identifiers (name + DOB)
and barcode scanning is the safest, facility-approved
method to ensure correct identity.
• Incorrect (A): Asking alone is less reliable than using two
identifiers and barcode scanning.
• Incorrect (C): Roommate confirmation is not a reliable
identifier.
• Incorrect (D): Room numbers can change and are not an
approved two-identifier method.
Teaching Point: Always verify two identifiers (name + DOB) and
scan wristband for patient identification.
4. Chapter 1 — Section: Look-alike / Sound-alike (LASA)
Medications
Stem: Which strategy is most effective to reduce errors
from look-alike/sound-alike drug names?
A. Use handwritten orders in block print only
B. Apply Tall Man lettering and separate storage for similar
drugs
C. Rely on phonetic spelling when reading orders aloud
D. Store LASA drugs together so staff can choose quickly
Correct Answer: B
Rationales:
