ADMINISTERING
MEDICATIONS: 2025 RELEASE
• AUTHOR(S)DONNA
GAUWITZ
TEST BANK
1)
Reference: Ch. 1 — Utilizing eMAR Technology / Drug Names
Stem: During medication administration, you scan a patient’s
wristband and the eMAR displays an alert: “Scanned medication
does not match eMAR entry.” The scanned vial label reads
metoprolol tartrate 25 mg, but the eMAR shows metformin 500
mg PO before meals. The patient reports a history of diabetes
and hypertension. What is the most appropriate immediate
nursing action?
A. Administer the scanned metoprolol—patient has
hypertension and needs it.
,B. Hold both medications and contact the prescriber and
pharmacy for clarification before administering any med.
C. Document the discrepancy and proceed with the eMAR-listed
metformin because eMAR takes precedence.
D. Ask the patient which medication they usually take and
administer that one.
Correct answer: B
Rationales — Correct (B): Verify and resolve discrepancies
between scanned medication and eMAR before administration.
Contacting prescriber/pharmacy prevents wrong-drug errors,
protects the patient from receiving an unintended medication,
and aligns with safe medication administration policies.
Rationales — Incorrect:
A. Unsafe—administering without reconciling eMAR risks
wrong-patient/wrong-drug error.
C. Inappropriate—documenting alone fails to resolve active
mismatch; eMAR is not infallible.
D. Patient recall may be unreliable and does not substitute for
verification of orders and medication labeling.
Teaching point: Always reconcile scanning/eMAR mismatches
with prescriber/pharmacy before giving medications.
Citation: Gauwitz, D. (2025). Administering Medications. Ch. 1.
2)
Reference: Ch. 1 — Brand-Name Drugs versus Generic-Name
,Drugs / Drug Standards
Stem: A stable adult outpatient has been controlled on brand-
name levothyroxine for hypothyroidism for 6 months with
therapeutic labs. The hospital pharmacy notifies you they
substituted a generic levothyroxine formulation due to supply.
The patient asks whether to accept the generic. What is your
best nursing action?
A. Encourage the patient to accept the generic; generics are
always equivalent.
B. Inform the prescriber immediately and discuss monitoring
plans before allowing the substitution.
C. Refuse the substitution—never allow generics for thyroid
medications.
D. Give the generic dose and schedule follow-up labs in 3
months without notifying the prescriber.
Correct answer: B
Rationales — Correct (B): For narrow therapeutic index drugs
like levothyroxine, substitution can affect serum levels. Notify
prescriber, document the change, and arrange monitoring. This
protects the patient and follows best practice for medication
safety.
Rationales — Incorrect:
A. Overly simplistic—generics are usually equivalent but NTI
drugs require prescriber awareness and monitoring.
C. Unnecessary—generics can be appropriate when coordinated
with prescriber and monitoring.
, D. Unsafe—changing formulation without informing prescriber
risks suboptimal dosing and lacks shared clinical oversight.
Teaching point: Notify prescribers before substituting generics
for narrow therapeutic index drugs; monitor labs.
Citation: Gauwitz, D. (2025). Administering Medications. Ch. 1.
3)
Reference: Ch. 1 — Drug References / Coping with Changing
Information
Stem: You receive a single-dose order for a medication you have
not administered before. The eMAR provides minimal info and
the patient is NPO with an active vomiting episode. Which
action demonstrates best practice?
A. Administer the medication IM as ordered without consulting
references—time-sensitive meds are priority.
B. Immediately consult an up-to-date drug reference and the
pharmacist to determine route and NPO considerations before
administration.
C. Cancel the order because the patient is vomiting—no
medication should be given.
D. Give the medication orally with antiemetic to prevent
vomiting.
Correct answer: B
Rationales — Correct (B): Using current drug references and
pharmacist consultation ensures correct route, absorption
MEDICATIONS: 2025 RELEASE
• AUTHOR(S)DONNA
GAUWITZ
TEST BANK
1)
Reference: Ch. 1 — Utilizing eMAR Technology / Drug Names
Stem: During medication administration, you scan a patient’s
wristband and the eMAR displays an alert: “Scanned medication
does not match eMAR entry.” The scanned vial label reads
metoprolol tartrate 25 mg, but the eMAR shows metformin 500
mg PO before meals. The patient reports a history of diabetes
and hypertension. What is the most appropriate immediate
nursing action?
A. Administer the scanned metoprolol—patient has
hypertension and needs it.
,B. Hold both medications and contact the prescriber and
pharmacy for clarification before administering any med.
C. Document the discrepancy and proceed with the eMAR-listed
metformin because eMAR takes precedence.
D. Ask the patient which medication they usually take and
administer that one.
Correct answer: B
Rationales — Correct (B): Verify and resolve discrepancies
between scanned medication and eMAR before administration.
Contacting prescriber/pharmacy prevents wrong-drug errors,
protects the patient from receiving an unintended medication,
and aligns with safe medication administration policies.
Rationales — Incorrect:
A. Unsafe—administering without reconciling eMAR risks
wrong-patient/wrong-drug error.
C. Inappropriate—documenting alone fails to resolve active
mismatch; eMAR is not infallible.
D. Patient recall may be unreliable and does not substitute for
verification of orders and medication labeling.
Teaching point: Always reconcile scanning/eMAR mismatches
with prescriber/pharmacy before giving medications.
Citation: Gauwitz, D. (2025). Administering Medications. Ch. 1.
2)
Reference: Ch. 1 — Brand-Name Drugs versus Generic-Name
,Drugs / Drug Standards
Stem: A stable adult outpatient has been controlled on brand-
name levothyroxine for hypothyroidism for 6 months with
therapeutic labs. The hospital pharmacy notifies you they
substituted a generic levothyroxine formulation due to supply.
The patient asks whether to accept the generic. What is your
best nursing action?
A. Encourage the patient to accept the generic; generics are
always equivalent.
B. Inform the prescriber immediately and discuss monitoring
plans before allowing the substitution.
C. Refuse the substitution—never allow generics for thyroid
medications.
D. Give the generic dose and schedule follow-up labs in 3
months without notifying the prescriber.
Correct answer: B
Rationales — Correct (B): For narrow therapeutic index drugs
like levothyroxine, substitution can affect serum levels. Notify
prescriber, document the change, and arrange monitoring. This
protects the patient and follows best practice for medication
safety.
Rationales — Incorrect:
A. Overly simplistic—generics are usually equivalent but NTI
drugs require prescriber awareness and monitoring.
C. Unnecessary—generics can be appropriate when coordinated
with prescriber and monitoring.
, D. Unsafe—changing formulation without informing prescriber
risks suboptimal dosing and lacks shared clinical oversight.
Teaching point: Notify prescribers before substituting generics
for narrow therapeutic index drugs; monitor labs.
Citation: Gauwitz, D. (2025). Administering Medications. Ch. 1.
3)
Reference: Ch. 1 — Drug References / Coping with Changing
Information
Stem: You receive a single-dose order for a medication you have
not administered before. The eMAR provides minimal info and
the patient is NPO with an active vomiting episode. Which
action demonstrates best practice?
A. Administer the medication IM as ordered without consulting
references—time-sensitive meds are priority.
B. Immediately consult an up-to-date drug reference and the
pharmacist to determine route and NPO considerations before
administration.
C. Cancel the order because the patient is vomiting—no
medication should be given.
D. Give the medication orally with antiemetic to prevent
vomiting.
Correct answer: B
Rationales — Correct (B): Using current drug references and
pharmacist consultation ensures correct route, absorption
