CMA Patient Safety Protocols 2 — Questions and Answers
Question 1: A medication aide finds that a resident's MAR lists a dose that differs from the label on the pharmacy-supplied blister pack. What should the aide do first?
- Give half of each dose and document the discrepancy
- Give the dose printed on the blister pack because the pharmacy filled it
- Hold the medication and notify the charge nurse to clarify the order (Correct answer)
- Give the dose listed on the MAR because it is the legal record
Correct answer: Hold the medication and notify the charge nurse to clarify the order
Any discrepancy between the order, MAR, and label must be clarified by the licensed nurse before administration.
Question 2: Which pair of identifiers is acceptable for confirming a resident's identity before giving medications?
- Room number and bed number
- Resident's diagnosis and room number
- Name on the door and the resident nodding when called
- Full name and date of birth (Correct answer)
Correct answer: Full name and date of birth
Two person-specific identifiers such as name and birth date are required; room numbers are never acceptable identifiers.
Question 3: A resident with dementia removes her wristband and answers to any name. What is the safest way for the medication aide to verify identity?
- Ask the resident to state her name and accept whatever she says
- Compare the resident to a current photo on the MAR and confirm with a staff member who knows her (Correct answer)
- Skip her medications until a new wristband is applied tomorrow
- Use the room and bed number because she cannot respond reliably
Correct answer: Compare the resident to a current photo on the MAR and confirm with a staff member who knows her
For residents who cannot self-identify, facilities use a current photo plus confirmation by staff who know the resident.
Question 4: Before giving a scheduled dose of digoxin, the aide obtains an apical pulse of 54 beats per minute. What is the correct action?
- Give the dose because the resident has no symptoms
- Give half the dose to be safe
- Hold the dose and report the pulse to the nurse per facility parameters (Correct answer)
- Give the dose and recheck the pulse in one hour
Correct answer: Hold the dose and report the pulse to the nurse per facility parameters
Digoxin is typically held when the apical pulse is below 60, and the nurse must be notified.
Question 5: A resident tells the medication aide, "That pill looks different from the one I usually take." What should the aide do?
- Give it because the resident may be confused
- Stop, recheck the order and label, and consult the nurse or pharmacist before giving it (Correct answer)
- Reassure the resident that generic pills often look different and give it
- Document refusal and move on to the next resident
Correct answer: Stop, recheck the order and label, and consult the nurse or pharmacist before giving it
A resident questioning a medication is a safety signal that requires rechecking before administration.
Question 6: Which situation is considered a medication error that must be reported?
- Holding a medication on the nurse's instruction and documenting it
- Offering a refused medication again later per facility policy
- Giving a scheduled 9 a.m. medication at 11:30 a.m. without an approved reason (Correct answer)
- Giving a 9 a.m. medication at 9:20 a.m.
Correct answer: Giving a scheduled 9 a.m. medication at 11:30 a.m. without an approved reason
Administering a medication outside the facility's allowed time window, usually 60 minutes either side, is a wrong-time error.
Question 7: After discovering that she gave a resident another resident's morning pills, what should the medication aide do first?
- Complete an incident report before telling anyone
- Give the resident's own pills right away to make up for it
- Wait to see whether the resident has any reaction
- Assess and stay with the resident while notifying the nurse immediately (Correct answer)
Correct answer: Assess and stay with the resident while notifying the nurse immediately
Resident safety comes first: monitor the resident and notify the nurse immediately, then document.
