Safe Medication Administration Flashcards

A client is prescribed warfarin 5 mg orally daily. Before administering the dose, the practical nurse notes the client's INR is 4.2. What is the most appropriate action?

Answer: Hold the dose and notify the physician/NP

An INR of 4.2 is above the therapeutic range (typically 2.0–3.0 for most indications), indicating an increased bleeding risk, so the dose should be withheld and the prescriber notified.

When preparing an intramuscular injection, the practical nurse accidentally contaminates the needle by touching the syringe barrel. What should the nurse do?

Answer: Discard the entire syringe and prepare a new one

Once sterility is compromised, the entire syringe and needle must be discarded and a new preparation made to prevent infection.

A practical nurse is administering medications to four clients. Which medication requires the nurse to perform an additional safety check by verifying apical pulse before administration?

Answer: Digoxin 0.125 mg orally

Digoxin is a cardiac glycoside; apical pulse must be counted for one full minute before administration and withheld if the rate is below 60 bpm in adults.

A client who requires a subcutaneous injection of heparin 5,000 units reports bruising at all previous injection sites on the abdomen. What is the best nursing action?

Answer: Rotate to the outer aspect of the upper arm for this injection

Rotating to an alternate approved site such as the upper arm avoids further trauma and impaired absorption at bruised abdominal sites.

The practical nurse is administering oral medications and finds that a tablet prescribed for a client is not available on the unit. What is the correct first action?

Answer: Contact the pharmacy to obtain the correct medication

The pharmacy must be contacted to supply the correct, prescribed medication; substituting from another client's supply is unsafe and unprofessional.

A practical nurse administers a medication and the client immediately develops urticaria, dyspnea, and hypotension. After calling for emergency assistance, what is the priority nursing action?

Answer: Establish IV access and prepare to administer epinephrine

Anaphylaxis requires immediate epinephrine administration, so IV access must be established while emergency assistance responds.

When reviewing a medication administration record (MAR), the practical nurse notes a medication order that is unclear due to illegible handwriting. What is the most appropriate action?

Answer: Contact the prescriber for clarification before administering the medication

Only the prescriber can clarify their own order; administering a guessed interpretation risks a medication error.