MACE Medication Aide Certification Exam — Questions and Answers

Question 1: Whose medical information is the responsibility of the medication assistant?

All residents at their place of employment
All residents on the unit or floor
Residents assigned to their supervising nurse
Residents he/she is assigned to (Correct answer)

Correct answer: Residents he/she is assigned to

A medication assistant's responsibility for medical information is limited to the residents he or she is specifically assigned to. This ensures clear accountability and allows the assistant to focus on the accurate and safe medication administration for their designated patients. It is not their role to manage information for all residents in the facility or those assigned to other staff.

Question 2: Which of these vitamins is deficient in pernicious anemia?

Vitamin B12 (Correct answer)
Vitamin B9
Vitamin C
Vitamin D

Correct answer: Vitamin B12

Pernicious anemia is an autoimmune condition characterized by a deficiency in Vitamin B12 (cobalamin). This deficiency occurs because the body fails to produce intrinsic factor, a protein essential for the absorption of Vitamin B12 in the small intestine. Without adequate Vitamin B12, the body cannot properly produce healthy red blood cells, leading to anemia and potential neurological issues.

Question 3: A medication aide discovers a medication error made by the previous shift. What should they do?

Administer an extra dose to compensate for the missed medication
Document the error in their personal notes only
Do nothing if the resident appears unaffected
Report the error immediately to the supervising nurse (Correct answer)

Correct answer: Report the error immediately to the supervising nurse

Any discovered medication error must be reported immediately to the supervising nurse regardless of when it occurred.

Question 4: A technician receives a prescription for Lisinopril. This drug belongs to which class?

Calcium channel blocker
ARB
ACE inhibitor (Correct answer)
Beta blocker

Correct answer: ACE inhibitor

Lisinopril is an ACE inhibitor that blocks the conversion of angiotensin I to angiotensin II, lowering blood pressure.

Question 5: What is lanolin?

Water removable
An adsorption base (Correct answer)
None of these
Hydrocarbon

Correct answer: An adsorption base

Lanolin is classified as an adsorption base because it can absorb a significant amount of water or aqueous solutions without losing its greasy consistency or separating. This property makes it highly valuable in pharmaceutical and cosmetic formulations for incorporating water-soluble ingredients into oil-based ointments and creams. It forms a stable emulsion that can hold moisture.

Question 6: Which of the following medications is commonly used to treat Type 2 diabetes by stimulating insulin secretion from the pancreas?

Metformin (a biguanide)
Sitagliptin (a DPP-4 inhibitor)
Glipizide (a sulfonylurea) (Correct answer)
Canagliflozin (an SGLT2 inhibitor)

Correct answer: Glipizide (a sulfonylurea)

Sulfonylureas like glipizide stimulate the pancreatic beta cells to release more insulin.

Question 7: Before giving medication, it is necessary to verify the patient's identity using all of the following sources, except:

Patient's Identification Bracelet
Patient's room/bed number (Correct answer)
Ask the patient
Patient's chart

Correct answer: Patient's room/bed number

Relying solely on a patient's room or bed number is an unreliable method for identity verification because patients can be moved or rooms reassigned. Healthcare professionals must use at least two direct patient identifiers, such as their name, date of birth, or identification bracelet, and cross-reference this information with the patient's chart to ensure medication safety.

Question 8: Which of the following is a benzodiazepine used to treat anxiety and seizures?

Buspirone
Hydroxyzine
Zolpidem
Lorazepam (Correct answer)

Correct answer: Lorazepam

Lorazepam is a benzodiazepine that enhances GABA activity and is used for anxiety, seizures, and sedation.

Question 9: The medication aide is preparing to apply a nitroglycerin ointment. Which personal protective measure is essential?

Wearing gloves to avoid absorbing the medication through their own skin (Correct answer)
Wearing goggles to protect from splashing
Wearing a gown and face shield
No protective equipment is needed for topical medications

Correct answer: Wearing gloves to avoid absorbing the medication through their own skin

Nitroglycerin is absorbed through the skin, so the medication aide must wear gloves to prevent inadvertent self-administration through skin contact.

Question 10: A resident who recently started an antipsychotic medication is holding his neck in an awkward twisted position and appears distressed. This most likely indicates:

Voluntary muscle spasm from activity
A sign of dehydration
A seizure requiring CPR
Acute dystonia, an extrapyramidal side effect (Correct answer)

Correct answer: Acute dystonia, an extrapyramidal side effect

Acute dystonia (involuntary muscle contractions causing abnormal posturing) is a well-known extrapyramidal side effect of antipsychotic medications.

Question 11: A medication aide is responsible for reporting which of the following to the supervising nurse?

Only medication errors that cause visible harm
Only errors involving controlled substances
Any medication error, near-miss, or unexpected resident change after administration (Correct answer)
Errors only if the resident or family asks about them

Correct answer: Any medication error, near-miss, or unexpected resident change after administration

All errors, near-misses, and post-administration changes must be reported so the nurse can assess, intervene, and complete an incident report.

Question 12: When administering eye drops to a resident, where should the drop be placed?

On the inner corner of the eye near the nose
Directly on the center of the cornea (pupil)
In the lower conjunctival sac (pocket) while the resident looks up (Correct answer)
On the eyelid margin so it drips in naturally

Correct answer: In the lower conjunctival sac (pocket) while the resident looks up

Eye drops should be instilled into the lower conjunctival sac to allow the medication to spread across the eye without touching the cornea.

Question 13: A medication aide notices that two residents have the same last name. What is the safest practice before administering medications?

Use two resident identifiers, such as name and date of birth (Correct answer)
Rely on the room number as the sole identifier
Administer medications based on physical appearance
Ask nearby staff which resident is which

Correct answer: Use two resident identifiers, such as name and date of birth

Using at least two identifiers (e.g., full name and date of birth) prevents medication errors caused by similar names.

Question 14: A resident is prescribed sustained-release morphine 30 mg PO q12h. What action by the medication aide is CONTRAINDICATED?

Documenting the administration time
Administering the medication with water
Checking the resident's allergy band before giving the dose
Crushing the tablet for easier swallowing (Correct answer)

Correct answer: Crushing the tablet for easier swallowing

Crushing extended-release morphine destroys the controlled-release mechanism, potentially causing a dangerous dose dump.

Question 15: What is the primary purpose of the Medication Administration Record (MAR)?

To record the resident's dietary preferences
To provide a legal, chronological record of all medications given to a resident (Correct answer)
To list the medications stocked in the facility pharmacy
To document physician orders for laboratory tests

Correct answer: To provide a legal, chronological record of all medications given to a resident

The MAR is a legal document that tracks every medication administered, the time given, and who gave it.

Question 16: Which route of administration bypasses the digestive system and delivers medication directly into the bloodstream?

Oral
Sublingual
Intravenous (Correct answer)
Rectal

Correct answer: Intravenous

The intravenous (IV) route delivers medication directly into the bloodstream, completely bypassing the gastrointestinal system.

Question 17: The suffix '-ectomy' refers to which type of procedure?

Surgical removal (Correct answer)
Surgical repair
Incision into
Visual examination

Correct answer: Surgical removal

-Ectomy means surgical removal or excision of a structure.

Question 18: What does pathology mean?

The study of disease (Correct answer)
The study of the human brain
The study of blood
The study of bones

Correct answer: The study of disease

Pathology is derived from the Greek words 'pathos' meaning disease or suffering, and '-logia' meaning the study of. Therefore, it literally translates to the study of disease. This medical field focuses on understanding the causes, development, and effects of diseases on the body, often through laboratory analysis of tissues and fluids.

Question 19: A medication label indicates the drug should be stored at 2–8°C. Where should this medication be kept?

In the refrigerator (Correct answer)
In a locked cabinet at any temperature
At room temperature
In the freezer

Correct answer: In the refrigerator

2–8°C corresponds to standard refrigerator temperature (approximately 36–46°F), the required storage condition for this medication.

Question 20: Which of these pairs of generic and brand-name medications is incorrect?

Abacavir-Ziagen
Flucytosine-Flucon (Correct answer)
Gabapentin-Neurontin
Apomorphine-Apokyn

Correct answer: Flucytosine-Flucon

The pair Flucytosine-Flucon is incorrect. Flucytosine's brand name is Ancobon, an antifungal medication. Flucon, on the other hand, is a common misspelling or abbreviation for Diflucan, which is the brand name for fluconazole, a different antifungal drug. This highlights the importance of precise medication identification to prevent errors.

Question 21: Under HIPAA, which of the following is permitted without separate patient authorization?

Discussing patient details in a public area of the facility
Releasing records to family members without the patient's consent
Sharing information with other treating healthcare providers (Correct answer)
Sharing information with the patient's employer

Correct answer: Sharing information with other treating healthcare providers

HIPAA permits sharing patient information with other healthcare providers directly involved in that patient's treatment as part of coordinated care.

Question 22: Which action best demonstrates proper hand hygiene during medication administration?

Cleaning hands only if visibly soiled
Wearing gloves throughout the entire medication pass without hand washing
Wiping hands on a clean cloth before pouring medication
Washing hands with soap and water or using hand sanitizer before and after each resident's medications (Correct answer)

Correct answer: Washing hands with soap and water or using hand sanitizer before and after each resident's medications

Hand hygiene before and after each resident's medication pass is essential to prevent cross-contamination and infection.

Question 23: To prevent capping, one of the following punches is utilized:

Rectangular
Square
Circular
Flat (Correct answer)

Correct answer: Flat

Capping is a tablet defect where the top or bottom layer of a tablet separates horizontally during or after compression. Using a flat punch helps to distribute the compression force evenly across the tablet surface, reducing localized stress points that can lead to lamination or capping. This ensures a more robust and intact tablet structure.

Question 24: What does hemiplegia refer to?

Paralysis of the legs
Left-sided weakness
Paralysis of one side of the body (Correct answer)
Paralysis of the arms

Correct answer: Paralysis of one side of the body

Hemiplegia is a medical term composed of 'hemi-', meaning half, and '-plegia', meaning paralysis. It specifically refers to the paralysis affecting one side of the body, which can impact the arm, leg, and sometimes the face on that side. This condition is often caused by damage to the brain or spinal cord, such as from a stroke.

Question 25: When administering ear drops to an adult, the pinna (outer ear) should be pulled in which direction?

Straight out from the head
Up and back (Correct answer)
Down and back
Forward and down

Correct answer: Up and back

In adults, the pinna is pulled upward and backward to straighten the ear canal and allow drops to reach the eardrum.

Question 26: What does the prefix 'hyper-' mean?

Above normal (Correct answer)
Below normal
Without
Before

Correct answer: Above normal

Hyper- means above normal or excessive, as in hypertension (high blood pressure).

Question 27: Which of the following is the generic term for the medication Enbrel?

Rosuvastatin
Bupropion
Etanercept (Correct answer)
Adalimumab

Correct answer: Etanercept

The generic term for the medication Enbrel is etanercept. Enbrel is a biologic medication classified as a TNF-alpha inhibitor, used to treat various autoimmune diseases such as rheumatoid arthritis, psoriatic arthritis, and plaque psoriasis. Etanercept is the active pharmaceutical ingredient.

Question 28: Which of the following medications is a proton pump inhibitor (PPI) used to reduce stomach acid?

Omeprazole (Correct answer)
Famotidine
Calcium carbonate
Ranitidine

Correct answer: Omeprazole

Omeprazole is a proton pump inhibitor that irreversibly blocks the H+/K+ ATPase enzyme in gastric parietal cells.

Question 29: A medication aide may share information about a resident's medications with:

Members of the resident's care team on a need-to-know basis (Correct answer)
Anyone accompanied by a family member
Any staff member who asks
The resident's roommate

Correct answer: Members of the resident's care team on a need-to-know basis

Protected health information, including medication details, may only be shared with care team members who need it to provide care.

Question 30: Which suffix means 'surgical creation of an opening'?

-graphy
-stomy (Correct answer)
-tomy
-scopy

Correct answer: -stomy

-Stomy means surgical creation of a new opening, as in colostomy.

Question 31: A resident's daughter calls and asks about her mother's medication list. The aide should:

Verify that the resident has authorized release of information before sharing (Correct answer)
Refer the daughter to the pharmacist
Read the list aloud in the hallway so the nurse can hear
Provide the full list since it is family

Correct answer: Verify that the resident has authorized release of information before sharing

HIPAA prohibits sharing PHI with family members without the resident's authorization, regardless of the relationship.

Question 32: An anticoagulant medication is prescribed to a resident. Which observation is MOST critical to report to the nurse?

Prolonged bleeding from a small cut (Correct answer)
Occasional dry cough
Mild fatigue after meals
Slight decrease in appetite

Correct answer: Prolonged bleeding from a small cut

Anticoagulants reduce the blood's ability to clot, so prolonged bleeding from even a minor wound indicates the medication may be too potent.

Question 33: Which set of symptoms suggests serotonin syndrome in a resident taking multiple medications?

Agitation, tremor, fever, and muscle rigidity (Correct answer)
Slow heart rate, low blood pressure, and drowsiness
Weight gain, constipation, and cold intolerance
Dry skin, confusion, and polyuria

Correct answer: Agitation, tremor, fever, and muscle rigidity

Serotonin syndrome presents with neuromuscular abnormalities (tremor, rigidity), autonomic instability, and altered mental status from excess serotonergic activity.

Question 34: When a medication is to be given 'sublingually,' where should the medication aide place the tablet?

Under the tongue (Correct answer)
On the skin
Between the cheek and gum
In the rectum

Correct answer: Under the tongue

The term 'sublingual' literally means 'under the tongue.' This route allows for rapid absorption of the medication directly into the bloodstream through the mucous membranes.

Question 35: Carr's index is utilized for the assessment of

Flowability (Correct answer)
Sieve size
Elasticity
Particle size

Correct answer: Flowability

Carr's index, also known as Carr's compressibility index, is a widely used parameter in pharmaceutical manufacturing to assess the flowability of powders. It is calculated from the bulk and tapped densities of a powder and provides a quantitative measure of how easily a powder will flow. Good flowability is crucial for consistent filling of capsules and tablets.

Question 36: Which antihistamine is considered non-sedating and is commonly used for allergic rhinitis?

Diphenhydramine
Loratadine (Correct answer)
Chlorpheniramine
Promethazine

Correct answer: Loratadine

Loratadine is a second-generation antihistamine that does not cross the blood-brain barrier significantly, causing minimal sedation.

Question 37: Which of the following information must always be on a medication label before administration?

Name of the medication, dose, and expiration date (Correct answer)
Resident's Social Security number
The prescribing physician's home address
The pharmacy's profit margin information

Correct answer: Name of the medication, dose, and expiration date

A medication label must include at minimum the resident's name, medication name, dose, route, frequency, and expiration date.

Question 38: Which drug from the list below is NOT antineoplastic?

Gemcitabine
Etoposide
Carmustine
Alendronate (Correct answer)

Correct answer: Alendronate

Antineoplastic drugs are medications specifically designed to treat cancer by inhibiting the growth and spread of malignant cells. Carmustine, Gemcitabine, and Etoposide are all chemotherapy agents used in cancer treatment. Alendronate, however, is a bisphosphonate used primarily to treat osteoporosis and Paget's disease of bone, making it not an antineoplastic drug.

Question 39: A resident refuses to take their prescribed morning medications. What is the Medication Aide's most appropriate response?

Insist that the resident take the medication for their own good.
Tell the resident you will have to call their family if they don't comply.
Respect the resident's right to refuse, document the refusal, and report it to the nurse. (Correct answer)
Hide the medication in their food to ensure they receive it.

Correct answer: Respect the resident's right to refuse, document the refusal, and report it to the nurse.

Residents have the right to refuse medication. The Medication Aide must respect this right. The proper procedure is to document the refusal in the MAR according to facility policy (e.g., circling the initials and writing on the back) and promptly report the refusal and any stated reason to the supervising nurse.

Question 40: What does the combining form 'cyan/o' mean?

White
Yellow
Red
Blue (Correct answer)

Correct answer: Blue

Cyan/o means blue, as in cyanosis (bluish discoloration of the skin due to lack of oxygen).

Question 41: Which condition results from abrupt discontinuation of long-term corticosteroid therapy?

Increased inflammation at the site of injury
Cushing's syndrome
Hyperglycemia only
Adrenal insufficiency (adrenal crisis) (Correct answer)

Correct answer: Adrenal insufficiency (adrenal crisis)

Abrupt steroid withdrawal suppresses adrenal function, causing adrenal insufficiency with fatigue, hypotension, and electrolyte imbalances.

Question 42: How frequently must a certified medication aide renew their certification in most states?

Every 1–2 years with required continuing education (Correct answer)
Every 6 months
Certification never expires once obtained
Every 5 years with no additional requirements

Correct answer: Every 1–2 years with required continuing education

Most states require periodic renewal of medication aide certification, typically every 1–2 years with continuing education hours.

Question 43: What is the mycophenolate mofetil (CellCept) mode of action?

Mycophenolate mofetil is a neurokinin-1 antagonist used to prevent chemotherapy-induced nausea and vomiting.
Mycophenolate mofetil is a 5HT3 antagonist used to prevent post-operative nausea.
Mycophenolate mofetil is a corticosteroid analog used as an immunosuppressant.
Mycophenolate mofetil is an immunosuppressant used to prevent organ rejection. (Correct answer)

Correct answer: Mycophenolate mofetil is an immunosuppressant used to prevent organ rejection.

Mycophenolate mofetil (CellCept) is a powerful immunosuppressant drug. Its primary mode of action is to inhibit the proliferation of lymphocytes, which are key cells in the immune system's response. This makes it highly effective in preventing the body's immune system from rejecting transplanted organs, its main therapeutic use.

Question 44: A medication order reads 'metoprolol 25 mg PO QD.' If available tablets are 12.5 mg, how many tablets should be given?

2 tablets (Correct answer)
0.5 tablet
1 tablet
4 tablets

Correct answer: 2 tablets

25 mg ÷ 12.5 mg per tablet = 2 tablets needed to deliver the prescribed dose.

Question 45: Which of the following acronyms is no longer advised due to the possibility of pharmaceutical errors?

IU (Correct answer)
tid
PO
iv

Correct answer: IU

The abbreviation 'IU' for International Unit is on the 'Do Not Use' list by organizations like the Institute for Safe Medication Practices (ISMP) and The Joint Commission. It is frequently mistaken for 'IV' (intravenous) or '10' (ten), leading to potentially fatal medication errors due to misinterpretation. Eliminating its use reduces the risk of such errors.

Question 46: What is the meaning of the abbreviation 'NPO' on a medication administration record?

Nothing by mouth (Correct answer)
Non-parenteral option
No physician order
Night-time prescription only

Correct answer: Nothing by mouth

NPO stands for 'nil per os,' a Latin phrase meaning nothing by mouth, including medications unless otherwise specified.

Question 47: Which suffix means 'inflammation'?

-osis
-oma
-itis (Correct answer)
-plasty

Correct answer: -itis

-Itis means inflammation, as in appendicitis or arthritis.

Question 48: Which of the following abbreviations means 'three times a day'?

TID (Correct answer)
PRN
QID
BID

Correct answer: TID

TID is the standard medical abbreviation for the Latin phrase 'ter in die,' which means three times a day. QID means four times a day, BID means twice a day, and PRN means as needed.

Question 49: Which of the following is an example of a medication interaction where one drug increases the effect of another?

Alcohol enhancing the sedative effect of benzodiazepines (Correct answer)
Antacids reducing absorption of tetracycline
Rifampin decreasing warfarin effectiveness
Vitamin C decreasing iron absorption

Correct answer: Alcohol enhancing the sedative effect of benzodiazepines

Alcohol is a CNS depressant that potentiates the sedative effects of benzodiazepines, increasing risk of respiratory depression.

Question 50: A medication aide who delegates a medication task to an unlicensed staff member is:

Only responsible if harm occurs
Practicing efficient time management
Violating state law and facility policy (Correct answer)
Acting within scope of practice guidelines

Correct answer: Violating state law and facility policy

Medication aides are not authorized to delegate medication administration to unlicensed personnel; doing so violates scope of practice laws.

Question 51: A resident on an opioid analgesic has a respiratory rate of 8 breaths per minute and is difficult to arouse. The medication aide should FIRST:

Apply oxygen and wait for it to improve on its own
Administer another dose to keep the resident comfortable
Call for emergency help and stay with the resident (Correct answer)
Document and monitor for 30 minutes before reporting

Correct answer: Call for emergency help and stay with the resident

A respiratory rate of 8 with unresponsiveness indicates opioid-induced respiratory depression, a life-threatening emergency requiring immediate help.

Question 52: Which medications fall within the category of vitamin K antagonists?

Antidepressants
Anticoagulants (Correct answer)
Thiazide Diuretics
Immunosuppresants

Correct answer: Anticoagulants

Vitamin K antagonists are a class of anticoagulant medications that interfere with the liver's ability to produce vitamin K-dependent clotting factors. Warfarin is a prime example of such a drug. By reducing the synthesis of these clotting factors, they effectively thin the blood and prevent the formation of harmful blood clots.

Question 53: Which of the following is a legal requirement for medication aides in most U.S. states?

Holding a licensed practical nurse (LPN) credential
Passing the NCLEX examination
Completing a physician-approved training program
Completing a state-approved medication aide training program (Correct answer)

Correct answer: Completing a state-approved medication aide training program

Most states require medication aides to complete a state-approved training program and pass a competency exam before practicing.

Question 54: What does the prefix 'brady-' mean?

Large
Small
Fast
Slow (Correct answer)

Correct answer: Slow

Brady- means slow, as in bradycardia (slow heart rate).

Question 55: A resident's medication order reads 'acetaminophen 650 mg PO PRN for pain, not to exceed 4g/day.' How many 325 mg tablets constitute one dose?

3 tablets
4 tablets
1 tablet
2 tablets (Correct answer)

Correct answer: 2 tablets

650 mg divided by 325 mg per tablet equals 2 tablets per dose.

Question 56: Which of these medication classes is related with the side effects of hyperkalemia and persistent dry cough?

PDE5 inhibitors
Nitrates
Loop diuretics
ACE inhibitors (Correct answer)

Correct answer: ACE inhibitors

Angiotensin-Converting Enzyme (ACE) inhibitors are a class of medications used to treat conditions like hypertension and heart failure. Two common side effects associated with ACE inhibitors are a persistent, dry cough, caused by the accumulation of bradykinin, and hyperkalemia, which is an elevated potassium level due to their effect on renal potassium excretion.

Question 57: A medication label reads 'take 1 tsp TID.' How many mL should the resident receive per day?

10 mL
5 mL
20 mL
15 mL (Correct answer)

Correct answer: 15 mL

1 tsp = 5 mL; TID (three times a day) × 5 mL = 15 mL per day.

Question 58: When documenting the administration of a PRN (as-needed) medication for pain, what information is essential to record in the Medication Administration Record (MAR)?

The resident's vital signs before and after administration.
The reason for administration and the resident's response to the medication. (Correct answer)
The name of the nurse who delegated the task.
Only the time and initials of the person who administered the medication.

Correct answer: The reason for administration and the resident's response to the medication.

For PRN medications, it is critical to document not only that the medication was given but also the reason (e.g., resident reported pain level of 7/10) and the subsequent effectiveness or response (e.g., resident reported pain decreased to 3/10 after 30 minutes). This provides a complete clinical picture for the healthcare team.

Question 59: Which of the following medications requires a medication aide to check the resident's apical pulse before administration?

Omeprazole
Docusate sodium
Acetaminophen
Digoxin (Correct answer)

Correct answer: Digoxin

Digoxin is a cardiac glycoside; if the apical pulse is below 60 bpm, the dose should be withheld and the nurse notified.

Question 60: Which term describes the process by which a drug is broken down by the liver into metabolites?

Absorption
Metabolism (Correct answer)
Excretion
Distribution

Correct answer: Metabolism

Metabolism (biotransformation) is the process by which the liver enzymatically converts drugs into metabolites for easier elimination.

MACE Medication Aide Certification Exam

The MACE (Medication Aide Certification Exam) is administered by Credentia on behalf of NCSBN, certifying medication aides to safely administer medications to residents in long-term care facilities.

Questions

120 min

Time Limit

70%

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