ADMINISTERING
MEDICATIONS: 2025 RELEASE
• AUTHOR(S)DONNA
GAUWITZ
TEST BANK
Reference
Ch. 1 — Drug Names & Look-Alike/Sound-Alike Risks
Stem
A 68-year-old patient is prescribed metoprolol succinate 50 mg
daily for hypertension. The nurse finds the eMAR shows
"metaprolol" and the medication drawer contains both
metoprolol tartrate immediate-release 50 mg and metoprolol
succinate extended-release 50 mg. The patient reports morning
lightheadedness. Which action should the nurse take before
administering the dose?
,Options
A. Administer the immediate-release tablet now because the
dose is correct and monitor for hypotension.
B. Clarify the order with the prescribing provider and verify the
correct formulation on the eMAR.
C. Split the extended-release tablet if only immediate-release is
available to achieve the correct dose.
D. Hold the medication and document refusal because the
patient reports lightheadedness.
Correct answer
B
Rationale — Correct (B)
Clarifying with the prescriber and verifying the eMAR prevents
a formulation error (immediate vs extended-release) that can
change drug kinetics and cause harm. This action follows safe
medication administration and legal standards requiring
verification of ambiguous orders. It protects the patient by
ensuring the intended preparation is given and allows the nurse
to document the clarification.
Rationale — Incorrect
A: Giving the immediate-release without verification risks
overdose or underdosing over time and ignores formulation
differences.
C: Splitting extended-release tablets is unsafe—alters release
characteristics and can harm the patient.
D: Holding without clarification and documenting "refusal"
,misrepresents the situation and fails to resolve the potential
medication error.
Teaching point
Always clarify ambiguous orders—formulation matters for
safety and therapeutic effect.
Citation
Gauwitz, D. (2025). Administering Medications. Ch. 1.
2
Reference
Ch. 1 — Brand vs Generic Names & eMAR Documentation
Stem
A newly hired nurse notes the eMAR lists "acetaminophen
(Tylenol) 650 mg PRN" while the medication cart only lists
"paracetamol 500 mg tablets." The unit uses brand and generic
names inconsistently. The nurse must administer a PRN dose for
pain. What should the nurse do to ensure safe medication
administration?
Options
A. Administer one 500 mg paracetamol tablet and document
the dose given.
B. Contact pharmacy to obtain the 650 mg formulation or clarify
an appropriate alternative per policy.
C. Crush and combine two 500 mg tablets to approximate the
650 mg dose.
, D. Substitute ibuprofen 400 mg because it is analgesic and
easier to find on the cart.
Correct answer
B
Rationale — Correct (B)
Contacting pharmacy or following unit policy ensures the dose
matches the order and maintains safety when formulations or
strengths differ. This respects drug-name equivalence issues
(brand vs generic) and legal documentation requirements. It
prevents under/overdosing and preserves accurate eMAR
records.
Rationale — Incorrect
A: Giving 500 mg when order is 650 mg provides subtherapeutic
dosing and deviates from the prescriber’s order.
C: Combining tablets to reach nonstandard dosing without
consulting policy/pharmacy risks dosing errors and may breach
facility guidelines.
D: Substituting a different analgesic without provider
authorization risks contraindications and violates
scope/medication substitution rules.
Teaching point
When strengths differ, verify with pharmacy or prescriber—
don’t guess or substitute without authorization.
Citation
Gauwitz, D. (2025). Administering Medications. Ch. 1.
MEDICATIONS: 2025 RELEASE
• AUTHOR(S)DONNA
GAUWITZ
TEST BANK
Reference
Ch. 1 — Drug Names & Look-Alike/Sound-Alike Risks
Stem
A 68-year-old patient is prescribed metoprolol succinate 50 mg
daily for hypertension. The nurse finds the eMAR shows
"metaprolol" and the medication drawer contains both
metoprolol tartrate immediate-release 50 mg and metoprolol
succinate extended-release 50 mg. The patient reports morning
lightheadedness. Which action should the nurse take before
administering the dose?
,Options
A. Administer the immediate-release tablet now because the
dose is correct and monitor for hypotension.
B. Clarify the order with the prescribing provider and verify the
correct formulation on the eMAR.
C. Split the extended-release tablet if only immediate-release is
available to achieve the correct dose.
D. Hold the medication and document refusal because the
patient reports lightheadedness.
Correct answer
B
Rationale — Correct (B)
Clarifying with the prescriber and verifying the eMAR prevents
a formulation error (immediate vs extended-release) that can
change drug kinetics and cause harm. This action follows safe
medication administration and legal standards requiring
verification of ambiguous orders. It protects the patient by
ensuring the intended preparation is given and allows the nurse
to document the clarification.
Rationale — Incorrect
A: Giving the immediate-release without verification risks
overdose or underdosing over time and ignores formulation
differences.
C: Splitting extended-release tablets is unsafe—alters release
characteristics and can harm the patient.
D: Holding without clarification and documenting "refusal"
,misrepresents the situation and fails to resolve the potential
medication error.
Teaching point
Always clarify ambiguous orders—formulation matters for
safety and therapeutic effect.
Citation
Gauwitz, D. (2025). Administering Medications. Ch. 1.
2
Reference
Ch. 1 — Brand vs Generic Names & eMAR Documentation
Stem
A newly hired nurse notes the eMAR lists "acetaminophen
(Tylenol) 650 mg PRN" while the medication cart only lists
"paracetamol 500 mg tablets." The unit uses brand and generic
names inconsistently. The nurse must administer a PRN dose for
pain. What should the nurse do to ensure safe medication
administration?
Options
A. Administer one 500 mg paracetamol tablet and document
the dose given.
B. Contact pharmacy to obtain the 650 mg formulation or clarify
an appropriate alternative per policy.
C. Crush and combine two 500 mg tablets to approximate the
650 mg dose.
, D. Substitute ibuprofen 400 mg because it is analgesic and
easier to find on the cart.
Correct answer
B
Rationale — Correct (B)
Contacting pharmacy or following unit policy ensures the dose
matches the order and maintains safety when formulations or
strengths differ. This respects drug-name equivalence issues
(brand vs generic) and legal documentation requirements. It
prevents under/overdosing and preserves accurate eMAR
records.
Rationale — Incorrect
A: Giving 500 mg when order is 650 mg provides subtherapeutic
dosing and deviates from the prescriber’s order.
C: Combining tablets to reach nonstandard dosing without
consulting policy/pharmacy risks dosing errors and may breach
facility guidelines.
D: Substituting a different analgesic without provider
authorization risks contraindications and violates
scope/medication substitution rules.
Teaching point
When strengths differ, verify with pharmacy or prescriber—
don’t guess or substitute without authorization.
Citation
Gauwitz, D. (2025). Administering Medications. Ch. 1.
