ALF Medication Management Principles 3 — Questions and Answers
Question 1: A med aide notices a resident on warfarin has new, unexplained bruising on both arms. The MOST appropriate action is to:
- Hold all medications until the family visits
- Report the observation promptly to the nurse or prescriber for evaluation (Correct answer)
- Apply lotion and continue the current regimen
- Increase the resident's vitamin K intake at meals
Correct answer: Report the observation promptly to the nurse or prescriber for evaluation
Unexplained bruising may indicate warfarin toxicity or bleeding risk and requires prompt clinical evaluation.
Question 2: Which of the following PRN order examples is complete enough for unlicensed staff to assist with in most states?
- Acetaminophen as needed
- Acetaminophen 500 mg by mouth every 6 hours as needed for headache, not to exceed 3,000 mg in 24 hours (Correct answer)
- Pain pill when the resident complains
- Tylenol PRN per family instructions
Correct answer: Acetaminophen 500 mg by mouth every 6 hours as needed for headache, not to exceed 3,000 mg in 24 hours
A complete PRN order specifies drug, dose, route, frequency, indication, and maximum daily amount.
Question 3: During a facility audit, the administrator finds expired medications in the med room. The correct handling is to:
- Segregate them for disposal or destruction according to state regulations and facility policy (Correct answer)
- Use them until the pharmacy delivers replacements
- Return them to the resident's room for personal storage
- Donate them to a local charity clinic
Correct answer: Segregate them for disposal or destruction according to state regulations and facility policy
Expired medications must be removed from stock and disposed of per state law and facility policy, with documentation.
Question 4: A resident who self-administers medications begins showing memory decline and missed doses. The administrator's BEST response is to:
- Immediately confiscate all medications from the room
- Arrange a re-assessment of the resident's self-administration capability (Correct answer)
- Ask the roommate to remind the resident about doses
- Wait until the annual assessment to address it
Correct answer: Arrange a re-assessment of the resident's self-administration capability
A change in condition triggers a re-assessment to determine whether the resident still qualifies for self-administration.
Question 5: Which situation represents 'borrowing' medications, a prohibited practice in assisted living?
- Giving Resident A a dose from Resident B's supply because A's refill has not arrived (Correct answer)
- Using facility stock over-the-counter medication per standing orders
- Administering a sample medication provided by the prescriber with a proper order
- Transferring a resident's own medications when they move rooms
Correct answer: Giving Resident A a dose from Resident B's supply because A's refill has not arrived
Administering one resident's prescription to another resident is prohibited borrowing and constitutes a medication error.
Question 6: The 'six rights' of medication administration include right resident, right drug, right dose, right route, right time, and:
- Right insurance
- Right documentation (Correct answer)
- Right pharmacy
- Right cost
Correct answer: Right documentation
Right documentation completes the six rights, ensuring administration is accurately recorded after it occurs.
Question 7: A hospice resident's family asks staff to give an extra dose of morphine 'to keep her comfortable' beyond the prescribed frequency. Staff should:
- Comply since the resident is on hospice
- Give half the requested extra dose as a compromise
- Decline, explain the order limits, and contact the hospice nurse or prescriber about the comfort concern (Correct answer)
- Document the family's request and take no further action
Correct answer: Decline, explain the order limits, and contact the hospice nurse or prescriber about the comfort concern
Staff may never exceed prescribed dosing, but the comfort concern should be escalated to the hospice nurse or prescriber.
ALF Medication Management Principles 3
A med aide notices a resident on warfarin has new, unexplained bruising on both arms.
The MOST appropriate action is to: