Chapter 1 —Medication Orders & Tablet
Calculations
Stem: A nurse is preparing medication and follows the “five
rights” before administration. Which statement best describes
the purpose of the five rights?
A. To shift legal liability away from prescribers and onto nurses
B. To provide a checklist that guarantees zero medication errors
C. To guide verification steps that reduce the risk of
administration errors
D. To replace independent pharmacist checks in all settings
Correct Answer: C
,Rationales:
Correct (C): The five rights (right patient, right drug, right dose,
right route, right time) act as verification steps to reduce
administration errors. They are a safety goal, not an absolute
guarantee. Institute for Healthcare Improvement+1
A: Incorrect — the five rights are patient-safety tools, not legal
shifting devices.
B: Incorrect — the five rights reduce risk but do not guarantee
zero errors; systems and checks are also needed. PMC
D: Incorrect — they complement, not replace, other system
checks like pharmacy verification.
Teaching Point: The five rights guide safe checks but don’t
eliminate system safeguards.
Item 2
Chapter 1 – Section: Patient Identification — Safety in
Medication Administration
Stem: Which of the following is the best practice for verifying a
patient’s identity before medication administration?
A. Ask the patient “Are you [name]?” and proceed if they
confirm
B. Match two unique identifiers (e.g., name and date of birth)
with the MAR or wristband
C. Use room number only because it’s faster and less disruptive
D. Verify identity by asking a family member at the bedside
,Correct Answer: B
Rationales:
Correct (B): Best practice is to use two unique patient
identifiers (name and DOB or unique ID) and match them to the
MAR/wristband. This is standard patient-safety guidance.
World Health Organization
A: Incorrect — a simple yes/no from the patient alone may be
unreliable (e.g., cognitive impairment).
C: Incorrect — room number is insufficient because patients
may be moved.
D: Incorrect — family confirmation does not replace formal
two-identifier verification.
Teaching Point: Always use two unique patient identifiers
matched to MAR/wristband.
Item 3
Chapter 1 – Section: The Medication Order — Safety in
Medication Administration
Stem: Order: Digoxin 0.125 mg PO daily. Available tablets: 0.25
mg. How many tablets should the nurse give? (Assume pill can
be halved.)
A. 1 tablet
B. 0.5 tablet
C. 0.25 tablet
D. 2 tablets
, Correct Answer: B
Rationales:
Correct (B) — Calculation: Required dose ÷ tablet strength =
0.125 mg ÷ 0.25 mg/tablet = 0.5 tablet. Nurse prepares a half
tablet if allowed.
A: Incorrect — 1 tablet = 0.25 mg (two times the ordered 0.125
mg).
C: Incorrect — 0.25 tablet = 0.0625 mg, half the ordered dose
(decimal misplacement error).
D: Incorrect — 2 tablets = 0.5 mg, four times the ordered dose.
Teaching Point: Divide required dose by strength (0.125 ÷ 0.25
= 0.5 tablet).
Item 4
Chapter 1 – Section: Decimal and Zero Use — Safety in
Medication Administration
Stem: Which written form of a dose is safest and follows
common “do not use” guidance?
A. .5 mg
B. 0.5 mg
C. 0.50 mg
D. ½ mg
Correct Answer: B
Calculations
Stem: A nurse is preparing medication and follows the “five
rights” before administration. Which statement best describes
the purpose of the five rights?
A. To shift legal liability away from prescribers and onto nurses
B. To provide a checklist that guarantees zero medication errors
C. To guide verification steps that reduce the risk of
administration errors
D. To replace independent pharmacist checks in all settings
Correct Answer: C
,Rationales:
Correct (C): The five rights (right patient, right drug, right dose,
right route, right time) act as verification steps to reduce
administration errors. They are a safety goal, not an absolute
guarantee. Institute for Healthcare Improvement+1
A: Incorrect — the five rights are patient-safety tools, not legal
shifting devices.
B: Incorrect — the five rights reduce risk but do not guarantee
zero errors; systems and checks are also needed. PMC
D: Incorrect — they complement, not replace, other system
checks like pharmacy verification.
Teaching Point: The five rights guide safe checks but don’t
eliminate system safeguards.
Item 2
Chapter 1 – Section: Patient Identification — Safety in
Medication Administration
Stem: Which of the following is the best practice for verifying a
patient’s identity before medication administration?
A. Ask the patient “Are you [name]?” and proceed if they
confirm
B. Match two unique identifiers (e.g., name and date of birth)
with the MAR or wristband
C. Use room number only because it’s faster and less disruptive
D. Verify identity by asking a family member at the bedside
,Correct Answer: B
Rationales:
Correct (B): Best practice is to use two unique patient
identifiers (name and DOB or unique ID) and match them to the
MAR/wristband. This is standard patient-safety guidance.
World Health Organization
A: Incorrect — a simple yes/no from the patient alone may be
unreliable (e.g., cognitive impairment).
C: Incorrect — room number is insufficient because patients
may be moved.
D: Incorrect — family confirmation does not replace formal
two-identifier verification.
Teaching Point: Always use two unique patient identifiers
matched to MAR/wristband.
Item 3
Chapter 1 – Section: The Medication Order — Safety in
Medication Administration
Stem: Order: Digoxin 0.125 mg PO daily. Available tablets: 0.25
mg. How many tablets should the nurse give? (Assume pill can
be halved.)
A. 1 tablet
B. 0.5 tablet
C. 0.25 tablet
D. 2 tablets
, Correct Answer: B
Rationales:
Correct (B) — Calculation: Required dose ÷ tablet strength =
0.125 mg ÷ 0.25 mg/tablet = 0.5 tablet. Nurse prepares a half
tablet if allowed.
A: Incorrect — 1 tablet = 0.25 mg (two times the ordered 0.125
mg).
C: Incorrect — 0.25 tablet = 0.0625 mg, half the ordered dose
(decimal misplacement error).
D: Incorrect — 2 tablets = 0.5 mg, four times the ordered dose.
Teaching Point: Divide required dose by strength (0.125 ÷ 0.25
= 0.5 tablet).
Item 4
Chapter 1 – Section: Decimal and Zero Use — Safety in
Medication Administration
Stem: Which written form of a dose is safest and follows
common “do not use” guidance?
A. .5 mg
B. 0.5 mg
C. 0.50 mg
D. ½ mg
Correct Answer: B
