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Delights Test Banks
Lilley Pharmacology Ch 6: 250 Medication Error NCLEX
Questions + NGN Cases | Textbook-Aligned Rationales w/ Page
References | High-Yield Safety & Prevention
Master Nursing’s #1 Risk Area with 100% Lilley 10th Ed. Coverage – High-Alert
Drugs, Error Response, ISMP Protocols & Future Tech Scenarios
, 2
Delights Test Banks
Question 1
Scenario: A nurse administers IV vancomycin infused over 30 minutes instead of
60 minutes as ordered.
Q: Which "Right of Medication Administration" was violated?
A) Right Drug
B) Right Dose
C) Right Time
D) Right Patient
Rationale (Lilley p. 98):
"The Right Time includes correct timing, frequency, and infusion rate."
Clinical Impact: Rapid infusion → "Red Man Syndrome" (flushing, hypotension,
cardiac arrest).
Prevention (Lilley p. 105): Always program infusion pumps to match ordered
duration and use barcode scanning (BCMA) to flag rate deviations.
NCLEX: Safety & Infection Control (Analyze)
Question 2
Scenario: A patient's warfarin dose was reduced from 5 mg to 2.5 mg. The nurse
administers 5 mg.
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Delights Test Banks
Q: What error type does this represent?
A) Wrong Route
B) Wrong Dose
C) Wrong Time
D) Omission
Rationale (Lilley p. 97):
"A dose error occurs when the amount given is more than 10% above or
below the prescribed dose."
Clinical Impact: ↑ INR → life-threatening hemorrhage (Lilley Table 6-4: High-Alert
Drug Risks).
Distractor Analysis:
• A: Wrong Route = Incorrect administration path (e.g., IV vs. IM)
• D: Omission = Dose not given at all
Prevention (Lilley p. 103): Independent double-check for anticoagulants
using preprinted protocols.
Question 3
Scenario: A physician orders "Insulin 5 units SQ stat." The nurse documents: "5u
insulin given."
Q: What documentation flaw violates Lilley's safety standards?
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Delights Test Banks
A) Missing patient name
B) Use of 'u' for 'units'
C) Lack of nurse signature
D) Omitting the injection site
Rationale (Lilley p. 109):
"**Abbreviations like 'u' (units) are error-prone and banned by ISMP. Always write
'units' fully."*
Clinical Impact: Misinterpretation as "0" → 50 units given (10-fold overdose).
Prevention (Lilley Fig 6-3): Apply ISMP's Do Not Use list in all documentation.
NCLEX: Reduction of Risk Potential (Apply)
Question 4
Scenario: A nurse prepares hydroXYZine 25 mg PO. The pharmacy label says
"hydrALAzine 25 mg."
Q: Which strategy prevents this look-alike/sound-alike error?
A) Verify expiration date
B) Use TALLman lettering
C) Check drug indications
D) Confirm pill color
Rationale (Lilley p. 108):
Delights Test Banks
Lilley Pharmacology Ch 6: 250 Medication Error NCLEX
Questions + NGN Cases | Textbook-Aligned Rationales w/ Page
References | High-Yield Safety & Prevention
Master Nursing’s #1 Risk Area with 100% Lilley 10th Ed. Coverage – High-Alert
Drugs, Error Response, ISMP Protocols & Future Tech Scenarios
, 2
Delights Test Banks
Question 1
Scenario: A nurse administers IV vancomycin infused over 30 minutes instead of
60 minutes as ordered.
Q: Which "Right of Medication Administration" was violated?
A) Right Drug
B) Right Dose
C) Right Time
D) Right Patient
Rationale (Lilley p. 98):
"The Right Time includes correct timing, frequency, and infusion rate."
Clinical Impact: Rapid infusion → "Red Man Syndrome" (flushing, hypotension,
cardiac arrest).
Prevention (Lilley p. 105): Always program infusion pumps to match ordered
duration and use barcode scanning (BCMA) to flag rate deviations.
NCLEX: Safety & Infection Control (Analyze)
Question 2
Scenario: A patient's warfarin dose was reduced from 5 mg to 2.5 mg. The nurse
administers 5 mg.
, 3
Delights Test Banks
Q: What error type does this represent?
A) Wrong Route
B) Wrong Dose
C) Wrong Time
D) Omission
Rationale (Lilley p. 97):
"A dose error occurs when the amount given is more than 10% above or
below the prescribed dose."
Clinical Impact: ↑ INR → life-threatening hemorrhage (Lilley Table 6-4: High-Alert
Drug Risks).
Distractor Analysis:
• A: Wrong Route = Incorrect administration path (e.g., IV vs. IM)
• D: Omission = Dose not given at all
Prevention (Lilley p. 103): Independent double-check for anticoagulants
using preprinted protocols.
Question 3
Scenario: A physician orders "Insulin 5 units SQ stat." The nurse documents: "5u
insulin given."
Q: What documentation flaw violates Lilley's safety standards?
, 4
Delights Test Banks
A) Missing patient name
B) Use of 'u' for 'units'
C) Lack of nurse signature
D) Omitting the injection site
Rationale (Lilley p. 109):
"**Abbreviations like 'u' (units) are error-prone and banned by ISMP. Always write
'units' fully."*
Clinical Impact: Misinterpretation as "0" → 50 units given (10-fold overdose).
Prevention (Lilley Fig 6-3): Apply ISMP's Do Not Use list in all documentation.
NCLEX: Reduction of Risk Potential (Apply)
Question 4
Scenario: A nurse prepares hydroXYZine 25 mg PO. The pharmacy label says
"hydrALAzine 25 mg."
Q: Which strategy prevents this look-alike/sound-alike error?
A) Verify expiration date
B) Use TALLman lettering
C) Check drug indications
D) Confirm pill color
Rationale (Lilley p. 108):
