MISSISSIPPI INDIVIDUAL ONSITE WASTEWATER
INSTALLER LICENSING EXAMINATION
Section 1: General Principles & Legal/Ethical Issues (Questions 1-25)
1. A nurse is preparing to administer medications to a client. Which of the
following is the most critical step in the medication administration process to
prevent errors?
A) Checking the client's diagnosis.
B) Performing the "Rights" of medication administration.
C) Reviewing the client's laboratory values.
D) Assessing the client's vital signs.
Correct Answer: B
Rationale: The "Rights" (Right Patient, Drug, Dose, Route, Time,
Documentation, etc.) are the foundation of safe medication administration and
are the primary defense against errors. While the other options are important
aspects of nursing care, they do not replace the need for the Rights.
2. A nurse inadvertently administers a double dose of a blood pressure
medication to a client. What is the nurse's immediate legal and ethical
responsibility?
A) Document the error in the client's chart and wait for the next vital sign
check.
,B) Notify the physician and the charge nurse immediately, complete an
incident report, and monitor the client.
C) Administer a medication to reverse the effects and then document.
D) Only document the administration of the scheduled dose.
Correct Answer: B
Rationale: The priority is client safety. The nurse must assess the client, notify
the physician for orders, notify the charge nurse, and then complete an
incident report per facility policy. The incident report is for internal quality
improvement, not to be placed in the client's chart.
3. Which of the following is an example of a nurse practicing within their legal
scope of practice?
A) Prescribing a new medication for a client's headache.
B) Adjusting a client's insulin dose based on their blood glucose levels without
an order.
C) Administering a PRN (as needed) medication as per the physician's order.
D) Delegating the administration of IV push medications to a nursing
assistant.
Correct Answer: C
Rationale: Administering PRN medications is a standard nursing function
when a valid order exists and the medication is indicated. Prescribing and
adjusting doses without an order are functions of a physician or advanced
practice provider. Delegation must be appropriate to the unlicensed assistive
personnel's (UAP) scope.
4. The patient states, "I don't want that shot." The nurse is legally obligated to:
A) Administer the injection, explaining it is for their own good.
B) Have the patient sign a refusal form and document the refusal.
,C) Ask the family to convince the patient to take the medication.
D) Stop the procedure and notify the provider of the refusal.
Correct Answer: D
Rationale: A competent patient has the right to refuse treatment. The nurse
must stop the procedure, respect the refusal, inform the provider, and
document the refusal and any related education provided. Obtaining a
witnessed refusal form is also good practice.
5. A nurse receives a verbal order from a physician over the phone. What is
the best practice for documentation?
A) Write the order on a sticky note and transcribe it later.
B) Write the order in the chart immediately, stating it is a "verbal order," and
read it back to the physician for confirmation.
C) Ask the physician to call back later to give the order when they are less
busy.
D) Have another nurse listen to the order on speakerphone for verification.
Correct Answer: B
Rationale: Verbal or telephone orders should be minimized. When they are
necessary, they must be written on the order sheet, read back to the
prescriber to ensure accuracy, and signed by the prescriber within a specified
timeframe per facility policy (e.g., 24 hours).
6. A client is being discharged with a new prescription. Which action best
demonstrates the nurse's understanding of the ethical principle of veracity?
A) Telling the client, the medication tastes bad but is effective.
B) Ensuring the client knows all potential side effects, including less common
but severe ones.
C) Assuring the client, the medication will cure their condition completely.
, D) Withholding information about a serious side effect to prevent the client
from worrying.
Correct Answer: B
Rationale: Veracity is the ethical principle of truthfulness. Providing full,
honest, and accurate information about medications, including risks and
benefits, is essential for the patient to give informed consent and make
decisions about their care.
7. In a medication error, which part of the "Rights" is most commonly
violated?
A) Right Drug
B) Right Dose
C) Right Patient
D) Right Documentation
Correct Answer: C
Rationale: Studies have shown that the most common medication error is
administering a medication to the wrong patient, often due to a failure to use
two patient identifiers.
8. The nurse is caring for a client who is to receive a narcotic. The narcotic
count is incorrect at the beginning of the shift. What is the nurse's most
appropriate action?
A) Document the discrepancy and hope the next nurse finds the missing
medication.
B) Notify the charge nurse immediately and do not start the shift until the
discrepancy is resolved.
C) Complete the count and ignore the discrepancy to avoid conflict.
D) Report the missing medication to the pharmacy only.
INSTALLER LICENSING EXAMINATION
Section 1: General Principles & Legal/Ethical Issues (Questions 1-25)
1. A nurse is preparing to administer medications to a client. Which of the
following is the most critical step in the medication administration process to
prevent errors?
A) Checking the client's diagnosis.
B) Performing the "Rights" of medication administration.
C) Reviewing the client's laboratory values.
D) Assessing the client's vital signs.
Correct Answer: B
Rationale: The "Rights" (Right Patient, Drug, Dose, Route, Time,
Documentation, etc.) are the foundation of safe medication administration and
are the primary defense against errors. While the other options are important
aspects of nursing care, they do not replace the need for the Rights.
2. A nurse inadvertently administers a double dose of a blood pressure
medication to a client. What is the nurse's immediate legal and ethical
responsibility?
A) Document the error in the client's chart and wait for the next vital sign
check.
,B) Notify the physician and the charge nurse immediately, complete an
incident report, and monitor the client.
C) Administer a medication to reverse the effects and then document.
D) Only document the administration of the scheduled dose.
Correct Answer: B
Rationale: The priority is client safety. The nurse must assess the client, notify
the physician for orders, notify the charge nurse, and then complete an
incident report per facility policy. The incident report is for internal quality
improvement, not to be placed in the client's chart.
3. Which of the following is an example of a nurse practicing within their legal
scope of practice?
A) Prescribing a new medication for a client's headache.
B) Adjusting a client's insulin dose based on their blood glucose levels without
an order.
C) Administering a PRN (as needed) medication as per the physician's order.
D) Delegating the administration of IV push medications to a nursing
assistant.
Correct Answer: C
Rationale: Administering PRN medications is a standard nursing function
when a valid order exists and the medication is indicated. Prescribing and
adjusting doses without an order are functions of a physician or advanced
practice provider. Delegation must be appropriate to the unlicensed assistive
personnel's (UAP) scope.
4. The patient states, "I don't want that shot." The nurse is legally obligated to:
A) Administer the injection, explaining it is for their own good.
B) Have the patient sign a refusal form and document the refusal.
,C) Ask the family to convince the patient to take the medication.
D) Stop the procedure and notify the provider of the refusal.
Correct Answer: D
Rationale: A competent patient has the right to refuse treatment. The nurse
must stop the procedure, respect the refusal, inform the provider, and
document the refusal and any related education provided. Obtaining a
witnessed refusal form is also good practice.
5. A nurse receives a verbal order from a physician over the phone. What is
the best practice for documentation?
A) Write the order on a sticky note and transcribe it later.
B) Write the order in the chart immediately, stating it is a "verbal order," and
read it back to the physician for confirmation.
C) Ask the physician to call back later to give the order when they are less
busy.
D) Have another nurse listen to the order on speakerphone for verification.
Correct Answer: B
Rationale: Verbal or telephone orders should be minimized. When they are
necessary, they must be written on the order sheet, read back to the
prescriber to ensure accuracy, and signed by the prescriber within a specified
timeframe per facility policy (e.g., 24 hours).
6. A client is being discharged with a new prescription. Which action best
demonstrates the nurse's understanding of the ethical principle of veracity?
A) Telling the client, the medication tastes bad but is effective.
B) Ensuring the client knows all potential side effects, including less common
but severe ones.
C) Assuring the client, the medication will cure their condition completely.
, D) Withholding information about a serious side effect to prevent the client
from worrying.
Correct Answer: B
Rationale: Veracity is the ethical principle of truthfulness. Providing full,
honest, and accurate information about medications, including risks and
benefits, is essential for the patient to give informed consent and make
decisions about their care.
7. In a medication error, which part of the "Rights" is most commonly
violated?
A) Right Drug
B) Right Dose
C) Right Patient
D) Right Documentation
Correct Answer: C
Rationale: Studies have shown that the most common medication error is
administering a medication to the wrong patient, often due to a failure to use
two patient identifiers.
8. The nurse is caring for a client who is to receive a narcotic. The narcotic
count is incorrect at the beginning of the shift. What is the nurse's most
appropriate action?
A) Document the discrepancy and hope the next nurse finds the missing
medication.
B) Notify the charge nurse immediately and do not start the shift until the
discrepancy is resolved.
C) Complete the count and ignore the discrepancy to avoid conflict.
D) Report the missing medication to the pharmacy only.
