LONG-TERM CARE CREDENTIALING
TEXAS MEDICATION AIDE A+
TEST
2026/2027
Official-Style Competency Examination for Texas Medication Aide Permit Candidates
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
■ Section 1: ROLES, LEGAL & ETHICAL RESPONSIBILITIES (12 questions)
■ Section 2: MEDICATION ADMINISTRATION SAFETY & RIGHTS (18 questions)
■ Section 3: ROUTES, FORMS & TECHNIQUES OF ADMINISTRATION (15 questions)
■ Section 4: DRUG CLASSES, ACTIONS & BODY SYSTEMS (20 questions)
■ Section 5: SPECIAL POPULATIONS, OBSERVATION & REPORTING (10 questions)
Passing Score: 80% | Question Format: Multiple Choice (A–D) | Marks: 1 per question
STUVIAACTUALEXAM
,SECTION 1: ROLES, LEGAL & ETHICAL RESPONSIBILITIES
Q1. A medication aide in a Texas nursing facility is asked by a resident’s family member to give an intramuscular
vitamin B12 injection that the physician ordered. The medication aide reviews the order and the resident’s clinical
record. What is the correct action?
A. Administer the injection after verifying the dose with the nurse
B. Refuse to administer the injection because injections are a prohibited practice
C. Have the nurse prepare the syringe and then administer it under supervision
D. Document the order and ask the charge nurse to co-sign the MAR entry
Correct Answer: B
Rationale: Under 26 TAC §557.105, medication aides are prohibited from administering any medication by injection routes (IM, IV,
SC, intradermal, or hypodermoclysis). The correct response is to decline the task and notify the licensed nurse so that an authorized
person can administer the injection.
Q2. During the evening medication pass a resident requests a dose of PRN acetaminophen for a mild headache. The
MAR shows the medication has been ordered PRN, but the resident has never received it before according to the
clinical record. What should the medication aide do?
A. Administer the first dose and document the reason on the MAR
B. Give the medication after taking and recording vital signs
C. Notify the licensed nurse because a first-time PRN dose requires nurse authorization
D. Offer a non-pharmacologic comfort measure and recheck in 30 minutes
Correct Answer: C
Rationale: Texas rules prohibit medication aides from administering previously ordered PRN medication that has not been previously
administered to that resident, except under specific nurse direction. The aide must contact the licensed nurse before giving a
first-time PRN dose.
Q3. A physician telephones the nursing unit and gives a new order for an antibiotic to a resident. The medication aide
answers the phone. What is the appropriate response?
A. Explain that medication aides may not receive verbal or telephone orders and transfer the call to the licensed nurse
B. Write the order on the physician’s order sheet and read it back for verification
C. Accept the order only if a second staff member listens on the call
D. Document the order on a temporary note and have the nurse transcribe it later
Correct Answer: A
Rationale: Medication aides are expressly prohibited from receiving or assuming responsibility for reducing to writing a verbal or
telephone order from a physician or other authorized practitioner. The call must be transferred to a licensed nurse.
Q4. A resident has difficulty swallowing a large enteric-coated tablet. The medication aide considers crushing the tablet
and mixing it with applesauce. Which statement is correct regarding crushing?
A. Crushing is permitted if the resident’s care plan lists crushing as an intervention
B. Enteric-coated tablets may be crushed as long as they are mixed with a soft food
C. Any scored tablet may be crushed without further authorization
D. Crushing may be performed only when the licensed nurse has authorized it and facility policy is followed
Correct Answer: D
Rationale: Under TAC §557.105, medication aides may crush medication only when the licensed nurse has specifically authorized
the crushing for that resident and the facility’s written policy is followed. Enteric-coated tablets generally should not be crushed
because the coating protects the stomach or ensures delayed release.
STUVIAACTUALEXAM Page 2
, Q5. After administering a newly ordered antihypertensive, a resident’s blood pressure drops and the resident reports
feeling light-headed when standing. The medication aide’s primary responsibility is to:
A. Recheck the blood pressure in 15 minutes and then decide whether to notify anyone
B. Document the findings and continue the medication pass
C. Immediately report the change in condition and possible side effect to the licensed nurse on duty or on call
D. Hold the next scheduled dose of the antihypertensive until the physician is contacted
Correct Answer: C
Rationale: Medication aides must observe and report to the licensed nurse any reactions or side effects and document them.
Assessing the significance of the change and deciding to hold medication are nursing functions; the aide’s duty is prompt reporting.
Q6. A resident states, “I don’t want that blood pressure pill today.” The medication aide has already poured the tablet.
What is the correct sequence of actions?
A. Dispose of or return the poured medication per policy, document the refusal, and notify the licensed nurse
B. Explain the importance of the medication and insist the resident take it
C. Leave the medication at the bedside and return later to try again
D. Crush the tablet, mix it with pudding, and administer it without further discussion
Correct Answer: A
Rationale: Residents have the right to refuse medication. The aide must respect the refusal, properly dispose of or return the
prepared dose according to facility policy, document the refusal on the MAR, and notify the licensed nurse so the refusal can be
evaluated.
Q7. While reviewing the medication cart, a medication aide notices that a controlled substance count is short by one
tablet compared with the previous shift’s count. The correct immediate action is to:
A. Document the discrepancy and continue the medication pass
B. Report the discrepancy to the licensed nurse and follow facility controlled-substance procedures
C. Replace the missing tablet from the emergency supply and note it later
D. Ask the previous shift’s medication aide to explain the shortage before reporting
Correct Answer: B
Rationale: Any discrepancy in controlled-substance counts must be reported immediately to the licensed nurse. Facility policy and
state regulations require prompt investigation and documentation; the medication aide does not independently resolve or conceal the
shortage.
Q8. A medication aide is asked to calculate a new dose of liquid digoxin because the pharmacy supplied a different
concentration. The aide should:
A. Perform the calculation using a standard formula and administer the dose
B. Ask another medication aide to verify the calculation before giving the dose
C. Administer the volume that was previously given and note the concentration change
D. Refuse to calculate the dose and request that the licensed nurse determine the correct volume
Correct Answer: D
Rationale: Medication aides are prohibited from calculating residents’ medication doses. Dose calculation is a licensed nursing
responsibility. The aide must obtain the correct volume from the licensed nurse before administration.
Q9. During an emergency when the licensed nurse is not immediately available, a resident develops acute shortness of
breath. Facility policy permits emergency oxygen. The medication aide may:
A. Apply oxygen by nasal cannula or non-sealing mask, notify the licensed nurse at once, and document the action
B. Start oxygen by any available delivery device and wait for the nurse to arrive
C. Administer oxygen only after obtaining a new physician order
D. Provide oxygen by a sealing mask or mechanical ventilator circuit if available
Correct Answer: A
Rationale: Texas rules allow medication aides to administer oxygen by nasal cannula or non-sealing face mask only in an
emergency. Immediate verbal notification of the licensed nurse and documentation are required. Other delivery methods are outside
the medication aide’s scope.
STUVIAACTUALEXAM Page 3
TEXAS MEDICATION AIDE A+
TEST
2026/2027
Official-Style Competency Examination for Texas Medication Aide Permit Candidates
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
■ Section 1: ROLES, LEGAL & ETHICAL RESPONSIBILITIES (12 questions)
■ Section 2: MEDICATION ADMINISTRATION SAFETY & RIGHTS (18 questions)
■ Section 3: ROUTES, FORMS & TECHNIQUES OF ADMINISTRATION (15 questions)
■ Section 4: DRUG CLASSES, ACTIONS & BODY SYSTEMS (20 questions)
■ Section 5: SPECIAL POPULATIONS, OBSERVATION & REPORTING (10 questions)
Passing Score: 80% | Question Format: Multiple Choice (A–D) | Marks: 1 per question
STUVIAACTUALEXAM
,SECTION 1: ROLES, LEGAL & ETHICAL RESPONSIBILITIES
Q1. A medication aide in a Texas nursing facility is asked by a resident’s family member to give an intramuscular
vitamin B12 injection that the physician ordered. The medication aide reviews the order and the resident’s clinical
record. What is the correct action?
A. Administer the injection after verifying the dose with the nurse
B. Refuse to administer the injection because injections are a prohibited practice
C. Have the nurse prepare the syringe and then administer it under supervision
D. Document the order and ask the charge nurse to co-sign the MAR entry
Correct Answer: B
Rationale: Under 26 TAC §557.105, medication aides are prohibited from administering any medication by injection routes (IM, IV,
SC, intradermal, or hypodermoclysis). The correct response is to decline the task and notify the licensed nurse so that an authorized
person can administer the injection.
Q2. During the evening medication pass a resident requests a dose of PRN acetaminophen for a mild headache. The
MAR shows the medication has been ordered PRN, but the resident has never received it before according to the
clinical record. What should the medication aide do?
A. Administer the first dose and document the reason on the MAR
B. Give the medication after taking and recording vital signs
C. Notify the licensed nurse because a first-time PRN dose requires nurse authorization
D. Offer a non-pharmacologic comfort measure and recheck in 30 minutes
Correct Answer: C
Rationale: Texas rules prohibit medication aides from administering previously ordered PRN medication that has not been previously
administered to that resident, except under specific nurse direction. The aide must contact the licensed nurse before giving a
first-time PRN dose.
Q3. A physician telephones the nursing unit and gives a new order for an antibiotic to a resident. The medication aide
answers the phone. What is the appropriate response?
A. Explain that medication aides may not receive verbal or telephone orders and transfer the call to the licensed nurse
B. Write the order on the physician’s order sheet and read it back for verification
C. Accept the order only if a second staff member listens on the call
D. Document the order on a temporary note and have the nurse transcribe it later
Correct Answer: A
Rationale: Medication aides are expressly prohibited from receiving or assuming responsibility for reducing to writing a verbal or
telephone order from a physician or other authorized practitioner. The call must be transferred to a licensed nurse.
Q4. A resident has difficulty swallowing a large enteric-coated tablet. The medication aide considers crushing the tablet
and mixing it with applesauce. Which statement is correct regarding crushing?
A. Crushing is permitted if the resident’s care plan lists crushing as an intervention
B. Enteric-coated tablets may be crushed as long as they are mixed with a soft food
C. Any scored tablet may be crushed without further authorization
D. Crushing may be performed only when the licensed nurse has authorized it and facility policy is followed
Correct Answer: D
Rationale: Under TAC §557.105, medication aides may crush medication only when the licensed nurse has specifically authorized
the crushing for that resident and the facility’s written policy is followed. Enteric-coated tablets generally should not be crushed
because the coating protects the stomach or ensures delayed release.
STUVIAACTUALEXAM Page 2
, Q5. After administering a newly ordered antihypertensive, a resident’s blood pressure drops and the resident reports
feeling light-headed when standing. The medication aide’s primary responsibility is to:
A. Recheck the blood pressure in 15 minutes and then decide whether to notify anyone
B. Document the findings and continue the medication pass
C. Immediately report the change in condition and possible side effect to the licensed nurse on duty or on call
D. Hold the next scheduled dose of the antihypertensive until the physician is contacted
Correct Answer: C
Rationale: Medication aides must observe and report to the licensed nurse any reactions or side effects and document them.
Assessing the significance of the change and deciding to hold medication are nursing functions; the aide’s duty is prompt reporting.
Q6. A resident states, “I don’t want that blood pressure pill today.” The medication aide has already poured the tablet.
What is the correct sequence of actions?
A. Dispose of or return the poured medication per policy, document the refusal, and notify the licensed nurse
B. Explain the importance of the medication and insist the resident take it
C. Leave the medication at the bedside and return later to try again
D. Crush the tablet, mix it with pudding, and administer it without further discussion
Correct Answer: A
Rationale: Residents have the right to refuse medication. The aide must respect the refusal, properly dispose of or return the
prepared dose according to facility policy, document the refusal on the MAR, and notify the licensed nurse so the refusal can be
evaluated.
Q7. While reviewing the medication cart, a medication aide notices that a controlled substance count is short by one
tablet compared with the previous shift’s count. The correct immediate action is to:
A. Document the discrepancy and continue the medication pass
B. Report the discrepancy to the licensed nurse and follow facility controlled-substance procedures
C. Replace the missing tablet from the emergency supply and note it later
D. Ask the previous shift’s medication aide to explain the shortage before reporting
Correct Answer: B
Rationale: Any discrepancy in controlled-substance counts must be reported immediately to the licensed nurse. Facility policy and
state regulations require prompt investigation and documentation; the medication aide does not independently resolve or conceal the
shortage.
Q8. A medication aide is asked to calculate a new dose of liquid digoxin because the pharmacy supplied a different
concentration. The aide should:
A. Perform the calculation using a standard formula and administer the dose
B. Ask another medication aide to verify the calculation before giving the dose
C. Administer the volume that was previously given and note the concentration change
D. Refuse to calculate the dose and request that the licensed nurse determine the correct volume
Correct Answer: D
Rationale: Medication aides are prohibited from calculating residents’ medication doses. Dose calculation is a licensed nursing
responsibility. The aide must obtain the correct volume from the licensed nurse before administration.
Q9. During an emergency when the licensed nurse is not immediately available, a resident develops acute shortness of
breath. Facility policy permits emergency oxygen. The medication aide may:
A. Apply oxygen by nasal cannula or non-sealing mask, notify the licensed nurse at once, and document the action
B. Start oxygen by any available delivery device and wait for the nurse to arrive
C. Administer oxygen only after obtaining a new physician order
D. Provide oxygen by a sealing mask or mechanical ventilator circuit if available
Correct Answer: A
Rationale: Texas rules allow medication aides to administer oxygen by nasal cannula or non-sealing face mask only in an
emergency. Immediate verbal notification of the licensed nurse and documentation are required. Other delivery methods are outside
the medication aide’s scope.
STUVIAACTUALEXAM Page 3
