CSA Medication Management Oversight 2 — Questions and Answers
Question 1: Under federal regulations, controlled substances in a long-term care facility must be stored in a:
- Locked cabinet accessible only to licensed nurses
- Double-locked storage area with restricted key access (Correct answer)
- Refrigerator separate from other medications
- Cabinet secured with a combination shared among all staff
Correct answer: Double-locked storage area with restricted key access
Federal regulations require controlled substances to be stored in a double-locked storage area with access restricted to authorized personnel.
Question 2: When a medication order is received verbally by phone, the nurse must:
- Begin administration immediately and document later
- Read back the order to the prescriber for confirmation before documenting (Correct answer)
- Wait for a written order before any documentation
- Notify the administrator before accepting the order
Correct answer: Read back the order to the prescriber for confirmation before documenting
Safe medication practice requires a read-back verification of all verbal/telephone orders to the prescribing provider before the order is carried out.
Question 3: A facility administrator discovers that a resident's medication label does not match the prescriber's current order. The FIRST action should be to:
- Dispose of the incorrectly labeled medication immediately
- Hold the medication and contact the pharmacy to clarify (Correct answer)
- Administer the medication as labeled and note the discrepancy
- Document the discrepancy in the resident's chart without further action
Correct answer: Hold the medication and contact the pharmacy to clarify
When a label discrepancy is identified, the medication should be held and the pharmacy contacted immediately to resolve the error before administration.
Question 4: Which of the following is a requirement for medication storage temperature monitoring in a long-term care facility?
- Temperature logs must be reviewed annually by the pharmacist
- Refrigerator temperatures must be checked and documented daily (Correct answer)
- Room temperature medications need no documented monitoring
- Temperature checks are only required for controlled substances
Correct answer: Refrigerator temperatures must be checked and documented daily
Medications requiring refrigeration must have temperatures checked and recorded daily to ensure medications remain within the required range (36–46°F).
Question 5: A facility's medication pass observation program is primarily designed to:
- Evaluate individual nurses for disciplinary purposes
- Identify medication administration errors and training needs (Correct answer)
- Reduce the number of medications prescribed per resident
- Monitor controlled substance diversion by staff
Correct answer: Identify medication administration errors and training needs
Medication pass observations are a quality assurance tool used to identify errors, unsafe practices, and staff education needs.
Question 6: When a resident refuses a prescribed medication, the correct response is to:
- Administer the medication covertly in food or drink
- Document the refusal and notify the prescriber if clinically significant (Correct answer)
- Discharge the resident for non-compliance
- Override the refusal if the physician deems the medication essential
Correct answer: Document the refusal and notify the prescriber if clinically significant
Residents have the right to refuse medications; refusals must be documented and the prescriber notified when the refusal may affect clinical outcomes.
Question 7: The purpose of a medication reconciliation process upon a resident's return from hospitalization is to:
- Bill insurance for any new medications added during hospitalization
- Compare pre-hospital and post-hospital medication orders to identify changes and prevent errors (Correct answer)
- Ensure the pharmacy delivers new medications within 24 hours
- Transfer all prior medication orders to the new admission record unchanged
Correct answer: Compare pre-hospital and post-hospital medication orders to identify changes and prevent errors
Medication reconciliation compares the current and prior medication orders to identify discrepancies, omissions, or additions that could lead to adverse events.
CSA Medication Management Oversight 2
Under federal regulations, controlled substances in a long-term care facility must be stored in a: