Texas Medication Aide Certification
EDIA DEM XT
TX HHSC Regulated — Practice Questions & State Exam Preparation
S A F E M E D I C AT I O N A D M I N I S T R AT I O N — Q U A L I T Y R E S I D E N T C A R E
MED AIDE
Medication Aide Exam Practice Questions
TEXAS HHSC REGULATIONS, DRUG CLASSIFICATIONS, ADMINISTRATION ROUTES, CALCULATIONS & SAFETY | 2026/2027
INSTITUTION Texas HHSC — Medication Aide Certification Program COURSE CODE Medication Aide Permit Exam (TX)
PROGRAM Medication Aide — Texas Health and Human Services ACADEMIC YEAR
EXAM TITLE Medication Aide State Certification Exam Practice TOTAL QUESTIONS 30 Questions
SUBJECT AREAS Regulations, Routes, Calculations, Safety, Drug Classes FORMAT Multiple Choice — Select the Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ This practice exam covers Texas HHSC regulations, medication administration routes, dosage calculations, drug classifications, infection control, and safety protocols.
▸ Know key Texas-specific regulations: HHSC employee misconduct registry, permit validity (12 months), and prohibited practices.
▸ Memorize common abbreviations (PR, SL, AD, OS, OU, QOD, QID, BID, TID, PC, AC, HS), conversions (1 oz = 30 mL, 1 tsp = 5 mL, 1 tbsp = 15 mL), and the 8 rights of medication administration.
▸ Correct answers and detailed rationales appear below each question for state certification exam review purposes.
SECTION I — TEXAS REGULATIONS, SCOPE OF PRACTICE & PERMIT REQUIREMENTS Questions 1 – 8
1. Which Texas state agency maintains the Employee Misconduct Registry (EMR)?
A. Texas Board of Nursing (BON)
B. HHSC — HEALTH AND HUMAN SERVICES COMMISSION
C. Texas Board of Pharmacy
D. Texas Department of State Health Services (DSHS)
CORRECT ANSWER B — HHSC (Health and Human Services Commission) maintains the Employee Misconduct Registry for unlicensed personnel
RATIONALE The HHSC maintains the EMR which tracks substantiated findings of abuse, neglect, exploitation, or misappropriation of property by unlicensed healthcare personnel, including
medication aides. The Nurse Aide Registry (NAR) is also under HHSC. The BON (A) regulates licensed nurses (RN, LVN). The Texas Board of Pharmacy (C) regulates pharmacists and
pharmacies. Understanding which agency governs medication aide practice is essential — the medication aide permit is issued and regulated through HHSC.
2. For how long is a medication aide permit valid in Texas?
A. 6 months
B. 12 MONTHS (1 year) — must be renewed annually
C. 24 months
D. 36 months
CORRECT ANSWER B — 12 months; the initial medication aide permit and each renewal are valid for 1 year
RATIONALE The Texas medication aide permit is valid for 12 months from the date of issuance. Medication aides must renew their permit before it expires. The permit must be renewed
through HHSC with required continuing education and demonstration of continued competency. Working with an expired permit is prohibited and can result in disciplinary
action. The medication aide must notify HHSC within 145 days of any change in medical contact information. When placed on probation, the medication aide must limit practice
to areas prescribed by HHSC.
3. Who does a medication aide function under?
A. Independently — medication aides work without supervision
B. The DIRECT SUPERVISION of a LICENSED NURSE (RN or LVN) on duty
C. The facility administrator only
D. The prescribing physician
CORRECT ANSWER B — Medication aides function under the DIRECT SUPERVISION of a licensed nurse (RN or LVN) on duty in the facility
RATIONALE Medication aides are NOT independent practitioners — they work under the delegation and supervision of a licensed nurse. The supervising nurse is responsible for: assigning
tasks within the medication aide's scope, verifying competency, and monitoring performance. Medication aides CANNOT: receive or assume responsibility for verbal or telephone
orders directly (this is a prohibited practice), change physician's orders without authorization from a licensed nurse, or administer medications that require nursing judgment.
The medication aide must immediately report side effects to the facility's charge licensed nurse.
4. Which of the following is a PROHIBITED practice for a medication aide?
A. Administering regularly prescribed oral medications
B. RECEIVING or assuming responsibility for a VERBAL or TELEPHONE ORDER from a healthcare professional
C. Documenting medications on the MAR after administration
D. Administering ophthalmic and otic medications as ordered
CORRECT ANSWER B — Medication aides CANNOT receive or accept verbal/telephone orders; only licensed nurses can accept orders
RATIONALE Prohibited practices for medication aides include: receiving verbal/telephone orders, changing physician orders without licensed nurse authorization, administering medications
not specifically permitted (IV, injectables), and independently assessing or making clinical judgments. Permitted activities: administering regularly prescribed oral, ophthalmic,
otic, nasal, vaginal, rectal, and topical medications; documenting on the MAR after administration; and crushing medications ONLY after authorization from the licensed nurse.
The medication aide must work within their defined scope at all times.
5. How should Schedule II controlled substances be stored?
A. In the regular medication cart with other medications
B. In a FIXED COMPARTMENT under DOUBLE LOCK — separately from other medications
C. At the nurse's station in an unlocked drawer
D. With the resident's personal belongings
CORRECT ANSWER B — Schedule II drugs must be stored in a permanently fixed compartment under DOUBLE LOCK for security
RATIONALE Schedule II controlled substances (morphine, oxycodone, fentanyl, methylphenidate, amphetamines) have the highest abuse potential among medications with accepted
medical use. Federal and state regulations require: (1) Double-locked storage — a fixed compartment with two separate locks. (2) Accurate count documentation at shift change
(with witness). (3) Documentation of every dose administered, wasted, or returned. (4) Wasting must be witnessed by another licensed person. (5) The medication cart must
remain LOCKED when unattended. These requirements protect residents and prevent diversion.
EDIA DEM XT
TX HHSC Regulated — Practice Questions & State Exam Preparation
S A F E M E D I C AT I O N A D M I N I S T R AT I O N — Q U A L I T Y R E S I D E N T C A R E
MED AIDE
Medication Aide Exam Practice Questions
TEXAS HHSC REGULATIONS, DRUG CLASSIFICATIONS, ADMINISTRATION ROUTES, CALCULATIONS & SAFETY | 2026/2027
INSTITUTION Texas HHSC — Medication Aide Certification Program COURSE CODE Medication Aide Permit Exam (TX)
PROGRAM Medication Aide — Texas Health and Human Services ACADEMIC YEAR
EXAM TITLE Medication Aide State Certification Exam Practice TOTAL QUESTIONS 30 Questions
SUBJECT AREAS Regulations, Routes, Calculations, Safety, Drug Classes FORMAT Multiple Choice — Select the Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ This practice exam covers Texas HHSC regulations, medication administration routes, dosage calculations, drug classifications, infection control, and safety protocols.
▸ Know key Texas-specific regulations: HHSC employee misconduct registry, permit validity (12 months), and prohibited practices.
▸ Memorize common abbreviations (PR, SL, AD, OS, OU, QOD, QID, BID, TID, PC, AC, HS), conversions (1 oz = 30 mL, 1 tsp = 5 mL, 1 tbsp = 15 mL), and the 8 rights of medication administration.
▸ Correct answers and detailed rationales appear below each question for state certification exam review purposes.
SECTION I — TEXAS REGULATIONS, SCOPE OF PRACTICE & PERMIT REQUIREMENTS Questions 1 – 8
1. Which Texas state agency maintains the Employee Misconduct Registry (EMR)?
A. Texas Board of Nursing (BON)
B. HHSC — HEALTH AND HUMAN SERVICES COMMISSION
C. Texas Board of Pharmacy
D. Texas Department of State Health Services (DSHS)
CORRECT ANSWER B — HHSC (Health and Human Services Commission) maintains the Employee Misconduct Registry for unlicensed personnel
RATIONALE The HHSC maintains the EMR which tracks substantiated findings of abuse, neglect, exploitation, or misappropriation of property by unlicensed healthcare personnel, including
medication aides. The Nurse Aide Registry (NAR) is also under HHSC. The BON (A) regulates licensed nurses (RN, LVN). The Texas Board of Pharmacy (C) regulates pharmacists and
pharmacies. Understanding which agency governs medication aide practice is essential — the medication aide permit is issued and regulated through HHSC.
2. For how long is a medication aide permit valid in Texas?
A. 6 months
B. 12 MONTHS (1 year) — must be renewed annually
C. 24 months
D. 36 months
CORRECT ANSWER B — 12 months; the initial medication aide permit and each renewal are valid for 1 year
RATIONALE The Texas medication aide permit is valid for 12 months from the date of issuance. Medication aides must renew their permit before it expires. The permit must be renewed
through HHSC with required continuing education and demonstration of continued competency. Working with an expired permit is prohibited and can result in disciplinary
action. The medication aide must notify HHSC within 145 days of any change in medical contact information. When placed on probation, the medication aide must limit practice
to areas prescribed by HHSC.
3. Who does a medication aide function under?
A. Independently — medication aides work without supervision
B. The DIRECT SUPERVISION of a LICENSED NURSE (RN or LVN) on duty
C. The facility administrator only
D. The prescribing physician
CORRECT ANSWER B — Medication aides function under the DIRECT SUPERVISION of a licensed nurse (RN or LVN) on duty in the facility
RATIONALE Medication aides are NOT independent practitioners — they work under the delegation and supervision of a licensed nurse. The supervising nurse is responsible for: assigning
tasks within the medication aide's scope, verifying competency, and monitoring performance. Medication aides CANNOT: receive or assume responsibility for verbal or telephone
orders directly (this is a prohibited practice), change physician's orders without authorization from a licensed nurse, or administer medications that require nursing judgment.
The medication aide must immediately report side effects to the facility's charge licensed nurse.
4. Which of the following is a PROHIBITED practice for a medication aide?
A. Administering regularly prescribed oral medications
B. RECEIVING or assuming responsibility for a VERBAL or TELEPHONE ORDER from a healthcare professional
C. Documenting medications on the MAR after administration
D. Administering ophthalmic and otic medications as ordered
CORRECT ANSWER B — Medication aides CANNOT receive or accept verbal/telephone orders; only licensed nurses can accept orders
RATIONALE Prohibited practices for medication aides include: receiving verbal/telephone orders, changing physician orders without licensed nurse authorization, administering medications
not specifically permitted (IV, injectables), and independently assessing or making clinical judgments. Permitted activities: administering regularly prescribed oral, ophthalmic,
otic, nasal, vaginal, rectal, and topical medications; documenting on the MAR after administration; and crushing medications ONLY after authorization from the licensed nurse.
The medication aide must work within their defined scope at all times.
5. How should Schedule II controlled substances be stored?
A. In the regular medication cart with other medications
B. In a FIXED COMPARTMENT under DOUBLE LOCK — separately from other medications
C. At the nurse's station in an unlocked drawer
D. With the resident's personal belongings
CORRECT ANSWER B — Schedule II drugs must be stored in a permanently fixed compartment under DOUBLE LOCK for security
RATIONALE Schedule II controlled substances (morphine, oxycodone, fentanyl, methylphenidate, amphetamines) have the highest abuse potential among medications with accepted
medical use. Federal and state regulations require: (1) Double-locked storage — a fixed compartment with two separate locks. (2) Accurate count documentation at shift change
(with witness). (3) Documentation of every dose administered, wasted, or returned. (4) Wasting must be witnessed by another licensed person. (5) The medication cart must
remain LOCKED when unattended. These requirements protect residents and prevent diversion.
