MACE Medication Aide Certification Exam — Questions and Answers

Question 1: Which situation requires the medication aide to obtain a new authorization before proceeding?

Documenting a routine medication after administration
Administering a medication that the nurse has just verbally added without updating the MAR (Correct answer)
Giving a scheduled medication at its documented time
Administering a medication that has been on the MAR for two weeks

Correct answer: Administering a medication that the nurse has just verbally added without updating the MAR

A medication aide cannot administer a medication based on a verbal addition alone; the MAR must be updated by the nurse before the aide can legally proceed.

Question 2: Which term describes a diminished drug response after repeated administration, requiring higher doses for the same effect?

Cumulative toxicity
Tolerance (Correct answer)
Sensitization
Dependence

Correct answer: Tolerance

Tolerance is the phenomenon where repeated drug exposure leads to a decreased effect, requiring dose escalation to achieve the original response.

Question 3: A resident's medication should be given 'AC.' When should this medication be administered?

Before meals (Correct answer)
After meals
Every morning
At bedtime

Correct answer: Before meals

The abbreviation 'AC' stands for the Latin 'ante cibum,' meaning before meals.

Question 4: Which drug-drug interaction occurs when two medications together produce a greater effect than either drug alone?

Tachyphylaxis
Antagonism
Tolerance
Synergism (Correct answer)

Correct answer: Synergism

Synergism (potentiation) occurs when two drugs together produce an effect greater than the sum of their individual effects.

Question 5: When pouring liquid medication, the medication aide should read the dose at which point on the cup?

The top of the meniscus
The middle of the cup
The bottom of the meniscus (Correct answer)
At eye level from above

Correct answer: The bottom of the meniscus

Liquid medications are measured at the bottom of the meniscus (curved surface) at eye level for accuracy.

Question 6: The medication aide must verify which three identifiers before giving medication to a resident?

Diagnosis, allergies, and insurance information
Physician name, pharmacy name, and medication cost
Name, date of birth, and photo ID or wristband (Correct answer)
Room number, bed number, and floor

Correct answer: Name, date of birth, and photo ID or wristband

Using at least two or three patient identifiers (name, date of birth, ID band/photo) is standard practice to prevent medication errors.

Question 7: After administering a new antibiotic to a resident, which of the following signs should the Medication Aide immediately report to the nurse as a possible allergic reaction?

An increase in appetite at the next meal.
Sudden onset of hives, rash, or difficulty breathing. (Correct answer)
A complaint of a mild headache.
Feeling slightly more tired than usual.

Correct answer: Sudden onset of hives, rash, or difficulty breathing.

Sudden hives, rash, and especially difficulty breathing are classic signs of an allergic or anaphylactic reaction, which can be life-threatening. These symptoms require immediate reporting and intervention by a licensed nurse.

Question 8: An adult patient's injection of the Hepatitis B vaccine is authorized. These areas are possible for administering this injection:

Abdomen
Back of the upper outer arm
Antecubital vein
Anterolateral upper thigh (vastus lateralis) or outer upper arm (Deltoid) (Correct answer)

Correct answer: Anterolateral upper thigh (vastus lateralis) or outer upper arm (Deltoid)

For adult intramuscular injections, such as the Hepatitis B vaccine, the deltoid muscle in the outer upper arm is a common and preferred site due to its accessibility and adequate muscle mass. The vastus lateralis muscle in the anterolateral upper thigh is another appropriate site, especially if the deltoid is unsuitable or for larger injection volumes.

Question 9: A resident tells the medication aide that a new medication makes them feel dizzy. What is the aide's role?

Call the physician directly to request a medication change
Stop the medication permanently without consulting the nurse
Advise the resident to push through the side effect
Withhold the medication, report the complaint to the supervising nurse, and document it (Correct answer)

Correct answer: Withhold the medication, report the complaint to the supervising nurse, and document it

The medication aide must report observed or reported side effects to the nurse immediately and document them; only the nurse or physician can adjust the medication.

Question 10: Which medication is a calcium channel blocker (CCB) used for hypertension and angina?

Carvedilol
Clonidine
Losartan
Amlodipine (Correct answer)

Correct answer: Amlodipine

Amlodipine is a dihydropyridine calcium channel blocker that relaxes vascular smooth muscle to lower blood pressure.

Question 11: The prefix 'poly-' means:

One
Many (Correct answer)
None
Two

Correct answer: Many

Poly- means many or much, as in polyuria (excessive urination).

Question 12: Which root word refers to the kidney?

Hepat/o
Gastr/o
Cardi/o
Nephr/o (Correct answer)

Correct answer: Nephr/o

Nephr/o is the root for kidney, as in nephrology (the study of kidneys).

Question 13: How would you characterize the brand name for ondansetron?

Zoloft
Zofran (Correct answer)
Tasmar
Ultram

Correct answer: Zofran

The brand name for ondansetron is Zofran. Ondansetron is a serotonin 5-HT3 receptor antagonist primarily used to prevent nausea and vomiting caused by chemotherapy, radiation therapy, or surgery. Zofran is widely recognized as its trade name in clinical practice.

Question 14: Which statement best describes the legal concept of negligence in medication administration?

Documenting a medication before it is given
Refusing to administer a medication without a nurse present
Failing to meet the standard of care, resulting in resident harm (Correct answer)
Intentionally giving the wrong drug to harm a resident

Correct answer: Failing to meet the standard of care, resulting in resident harm

Negligence occurs when a medication aide fails to meet the expected standard of care and that failure causes harm to a resident.

Question 15: The prefix 'intra-' means:

Within (Correct answer)
Between
After
Outside

Correct answer: Within

Intra- means within or inside, as in intravenous (within a vein).

Question 16: What does the prefix 'anti-' mean?

Before
Against or opposing (Correct answer)
After
Within

Correct answer: Against or opposing

Anti- means against or opposing, as in antibiotic (against bacteria).

Question 17: If a medication aide makes a medication error, what is the correct immediate action?

Notify the nurse immediately and document the error (Correct answer)
Do nothing if the resident seems fine
Tell the next shift aide to monitor the resident
Wait to see if the resident has any symptoms

Correct answer: Notify the nurse immediately and document the error

Medication errors must be reported to the nurse immediately so the resident can be assessed and an incident report filed.

Question 18: A medication aide overhears a nurse instruct another aide to skip the identity verification step to save time. The aide should:

Document the shortcut and report it at next month's staff meeting
Follow the same shortcut to keep pace with the team
Report the instruction to the charge nurse or supervisor (Correct answer)
Confront the nurse publicly during the medication pass

Correct answer: Report the instruction to the charge nurse or supervisor

Identity verification is a safety-critical step; instructions to skip it are unsafe and must be escalated to the charge nurse immediately.

Question 19: Which resident right is MOST directly related to the medication aide's duty during medication administration?

The right to decorate their room
The right to vote in facility elections
The right to be informed about and refuse medications (Correct answer)
The right to choose their own physician

Correct answer: The right to be informed about and refuse medications

Residents have the right to be informed about their medications and to refuse them, which medication aides must respect and document.

Question 20: Which medication classification includes drugs like metformin used to manage blood glucose levels?

Antidepressants
Antidiabetics (Correct answer)
Antihypertensives
Anticoagulants

Correct answer: Antidiabetics

Metformin is an antidiabetic (biguanide) medication used to lower blood glucose in type 2 diabetes.

Question 21: Which drug is a first-generation cephalosporin antibiotic commonly used for skin infections?

Cefepime
Ceftriaxone
Cephalexin (Correct answer)
Ceftazidime

Correct answer: Cephalexin

Cephalexin is a first-generation cephalosporin with excellent gram-positive coverage, commonly used for skin and soft tissue infections.

Question 22: Which of the following is the primary purpose of 'five rights' verification in medication administration?

To verify the physician's credentials
To document billing information
To prevent medication errors and ensure resident safety (Correct answer)
To confirm the resident's insurance coverage

Correct answer: To prevent medication errors and ensure resident safety

The five rights (right resident, drug, dose, route, time) are a safety checklist designed to prevent medication administration errors.

Question 23: Which drug class is most commonly associated with causing a dry, persistent cough as a side effect?

Calcium channel blockers
Thiazide diuretics
Beta-blockers
ACE inhibitors (Correct answer)

Correct answer: ACE inhibitors

ACE inhibitors cause bradykinin accumulation in the lungs, leading to a characteristic dry cough.

Question 24: What does the term 'dysphagia' mean?

Difficulty speaking
Difficulty breathing
Difficulty urinating
Difficulty swallowing (Correct answer)

Correct answer: Difficulty swallowing

Dysphagia combines dys- (difficulty) and -phagia (swallowing).

Question 25: Which drug class do medications ending in '-sartan' belong to?

Angiotensin receptor blockers (ARBs) (Correct answer)
Beta blockers
ACE inhibitors
Alpha blockers

Correct answer: Angiotensin receptor blockers (ARBs)

Medications ending in '-sartan' (e.g., losartan, valsartan) are ARBs that block the angiotensin II receptor to lower blood pressure.

Question 26: What is the legal term for performing a healthcare procedure on a patient without their consent?

Malpractice
Assault and battery (Correct answer)
Negligence
Breach of confidentiality

Correct answer: Assault and battery

Performing a procedure on a patient without consent constitutes assault (the threat) and battery (the unauthorized physical contact) under law.

Question 27: A medication aide finds an unlabeled medication cup at the bedside of a resident. What is the correct action?

Return it to the medication cart for later use
Administer it if it looks like the resident's usual medication
Discard it and notify the supervising nurse (Correct answer)
Ask the resident if they know what the medication is

Correct answer: Discard it and notify the supervising nurse

Unlabeled medications must never be administered; they should be discarded and the nurse notified immediately.

Question 28: Which trade name does not correctly match its generic counterpart?

Cialis, tadalafil
Evista, raloxifene
Bentcard, olmesartan (Correct answer)
Bactroban, mupirocin

Correct answer: Bentcard, olmesartan

The trade name Bentcard does not correctly match its generic counterpart olmesartan. The correct brand name for olmesartan, an angiotensin receptor blocker used to treat high blood pressure, is Benicar. Bentcard is not a recognized brand name for olmesartan, making this pair incorrect.

Question 29: James is going to pick up a generic Ambien prescription. Which medicine ought he to be taking?

There is no generic for Ambien
Zolpidem (Correct answer)
Trazodone
Amlodipine

Correct answer: Zolpidem

The generic name for the brand-name medication Ambien is Zolpidem. Generic medications contain the same active ingredients as their brand-name counterparts and are therapeutically equivalent. Therefore, when picking up a generic Ambien prescription, James should receive Zolpidem.

Question 30: A medication aide notices a patch from the previous day is still on the resident before applying a new one. What should they do?

Remove the old patch, then apply the new one to a different site (Correct answer)
Report to the pharmacist before doing anything
Leave both patches on to maintain therapeutic levels
Apply the new patch over the old one

Correct answer: Remove the old patch, then apply the new one to a different site

The old transdermal patch must be removed and disposed of properly before applying the new patch at a different site.

Question 31: A resident on long-term corticosteroid therapy is at increased risk for which condition?

Bradycardia
Hyperkalemia
Osteoporosis (Correct answer)
Hypoglycemia

Correct answer: Osteoporosis

Chronic corticosteroid use decreases bone density by impairing calcium absorption and increasing bone resorption.

Question 32: Which of the following is an example of a medication side effect that must be reported immediately?

Difficulty swallowing after taking an oral medication (Correct answer)
Slight dryness of the mouth after an anticholinergic
Mild drowsiness after taking an antihistamine
Temporary skin flushing after a niacin dose

Correct answer: Difficulty swallowing after taking an oral medication

Difficulty swallowing after oral medication can indicate a serious adverse reaction such as angioedema and must be reported to the nurse immediately.

Question 33: A resident is taking an NSAID for arthritis. Which side effect should the CNA monitor for and report?

Black or tarry stools (Correct answer)
Increased energy
Hair thinning
Dry mouth

Correct answer: Black or tarry stools

Black or tarry stools indicate gastrointestinal bleeding, a serious complication of NSAID use that requires immediate reporting.

Question 34: For a prolonged release, which shot is administered into the subcutaneous tissues? (Insulin)

Intradermal
Intravenous
Subcutaneous (Correct answer)
Intramuscular

Correct answer: Subcutaneous

Subcutaneous injections are administered into the fatty tissue layer just beneath the skin. This route is commonly chosen for medications like insulin because the subcutaneous tissue allows for slower, sustained absorption, resulting in a prolonged release effect. This makes it ideal for drugs requiring a gradual and consistent therapeutic action.

Question 35: Which reaction describes an unexpected and abnormal response to a medication that is not related to its dose or known pharmacologic effects?

Side effect
Toxic reaction
Idiosyncratic reaction (Correct answer)
Allergic reaction

Correct answer: Idiosyncratic reaction

An idiosyncratic reaction is an unpredictable, abnormal response to a drug that is unique to an individual and unrelated to dose or immune mechanisms.

Question 36: Which of the following is a sign of a potential allergic reaction to a medication?

Increased appetite
Improved sleep
Decreased heart rate
Urticaria (hives) and itching (Correct answer)

Correct answer: Urticaria (hives) and itching

Hives and itching are common signs of an allergic reaction and require immediate notification of the nurse.

Question 37: A resident is prescribed metformin 500 mg twice daily. When is the BEST time to administer this medication?

With meals to reduce GI side effects (Correct answer)
Any time regardless of food
On an empty stomach for best absorption
At bedtime only

Correct answer: With meals to reduce GI side effects

Metformin is administered with meals to minimize gastrointestinal side effects such as nausea and diarrhea.

Question 38: A medication aide prepares a dose and is interrupted before giving it. What is the SAFEST action?

Continue the interruption and give the medication when remembering
Ask another aide to deliver the medication
Leave the medication at the bedside and return later
Dispose of the medication and prepare a fresh dose when returning (Correct answer)

Correct answer: Dispose of the medication and prepare a fresh dose when returning

Medications prepared and left unattended may be tampered with or given to the wrong resident; a fresh preparation ensures safety.

Question 39: Which storage condition is typically required for insulin?

Stored in a warm, dry place away from light
Frozen until the day of use
Refrigerated at 36–46°F until opened, then room temperature for up to 28–30 days (Correct answer)
Always stored at room temperature

Correct answer: Refrigerated at 36–46°F until opened, then room temperature for up to 28–30 days

Unopened insulin should be refrigerated; once opened, most vials and pens can be kept at room temperature for 28–30 days depending on the product.

Question 40: Which of the following abbreviations means 'three times a day'?

QID
PRN
TID (Correct answer)
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 41: What is lanolin?

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

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 42: A medication order reads 'furosemide 40 mg IV push.' The vial contains 10 mg/mL. How many mL should be drawn up?

8 mL
2 mL
4 mL (Correct answer)
10 mL

Correct answer: 4 mL

40 mg ÷ 10 mg/mL = 4 mL to be drawn into the syringe.

Question 43: Which of the following conditions does Acyclovir best treat?

HIV
HSV 1 and 2 VZV (Correct answer)
CMV
Influenza A viruses

Correct answer: HSV 1 and 2 VZV

Acyclovir is an antiviral medication specifically effective against herpes simplex viruses (HSV-1 and HSV-2), which cause oral and genital herpes, and varicella-zoster virus (VZV), which causes chickenpox and shingles. It works by inhibiting viral DNA replication. It is not typically used for influenza, HIV, or CMV.

Question 44: How frequently must a certified medication aide renew their certification in most states?

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

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 45: Which abbreviation on a medication order means 'every 8 hours'?

BID
QID
Q8H (Correct answer)
PRN

Correct answer: Q8H

Q8H stands for 'quaque 8 hora,' meaning the medication is given every 8 hours.

Question 46: When administering eye drops, the medication aide should instill drops into which area of the eye?

The inner corner near the tear duct
The upper eyelid
The lower conjunctival sac (Correct answer)
Directly onto the cornea

Correct answer: The lower conjunctival sac

Eye drops should be placed into the lower conjunctival sac (lower lid pocket) to minimize irritation and improve absorption.

Question 47: What does the medical abbreviation 'QID' mean when referring to medication administration frequency?

Four times a day (Correct answer)
Every other day
Twice a day
Once a day

Correct answer: Four times a day

QID (quater in die) means four times daily, typically scheduled every 6 hours.

Question 48: What are the Five Rights of the Administration of Medicine?

The right patient, the right dosage, the right time, the right assessment and the right route
The right patient, the right documentation, the right time, the right drug and the right route
The right patient, the right dosage, the right time, the right drug and the right route (Correct answer)
The right patient, the right dosage, the right time, the right drug and the right documentation

Correct answer: The right patient, the right dosage, the right time, the right drug and the right route

The Five Rights of Medication Administration are fundamental safety principles designed to prevent medication errors. They ensure that the medication is given to the right patient, with the right drug, in the right dosage, at the right time, and via the right route. Adhering to these rights is crucial for patient safety and effective medication management.

Question 49: 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 the freezer
At room temperature
In a locked cabinet at any temperature

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 50: A key role of the Medication Aide is to observe residents and report any changes. Which of the following should be reported IMMEDIATELY to the supervising nurse?

A resident stating they enjoyed their lunch.
A resident experiencing sudden shortness of breath after receiving a new medication. (Correct answer)
A resident requesting to watch a different television channel.
A resident sleeping soundly in their chair.

Correct answer: A resident experiencing sudden shortness of breath after receiving a new medication.

Medication Aides are responsible for monitoring residents for adverse reactions and reporting any significant changes in their condition to the supervising nurse. Sudden shortness of breath could indicate a serious allergic reaction or adverse effect and requires immediate nursing assessment and intervention.

Question 51: The medication aide is preparing to apply a nitroglycerin ointment. Which personal protective measure is essential?

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

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 52: Which action by a CNA is APPROPRIATE when assisting with medications in a state that permits it?

Sharing one resident's medication with another resident
Observing the resident swallow the medication (Correct answer)
Deciding to omit a medication because the resident seems fine
Removing medications from their original packaging for convenience

Correct answer: Observing the resident swallow the medication

The CNA may observe and confirm that the resident has swallowed the medication and then document accordingly.

Question 53: A resident refuses to take their prescribed medication. What is the medication aide's correct first action?

Document the refusal and notify the nurse (Correct answer)
Insist the resident must take the medication
Crush the medication and hide it in food
Contact the family without notifying the nurse

Correct answer: Document the refusal and notify the nurse

Respecting a competent resident's right to refuse medication is a legal obligation; the aide must document and report to the nurse immediately.

Question 54: Which of the following is the safest method to dispose of controlled substances that are no longer needed?

Flush them down the toilet without documentation
Discard them in the regular trash after removing labels
Follow the facility's controlled substance waste procedure with a witness (Correct answer)
Return them to the pharmacy without informing the nurse

Correct answer: Follow the facility's controlled substance waste procedure with a witness

Controlled substances must be disposed of following the facility's established protocol, which requires a witness and proper documentation to maintain accountability.

Question 55: A patient is prescribed Warfarin. Which drug class does this medication belong to?

Anticoagulant (Correct answer)
Antifibrinolytic
Antiplatelet
Thrombolytic

Correct answer: Anticoagulant

Warfarin is an oral anticoagulant that works by inhibiting vitamin K-dependent clotting factors.

Question 56: When a drug order reads 'ASA 325 mg PO QID PRN pain,' what does PRN mean?

Every hour
Before meals
At bedtime
As needed (Correct answer)

Correct answer: As needed

PRN is a Latin abbreviation for 'pro re nata,' meaning as needed or when necessary.

Question 57: What is the correct technique when using a metered-dose inhaler (MDI) without a spacer?

Hold the inhaler 1-2 inches from the open mouth, exhale first, then inhale slowly while pressing (Correct answer)
Shake the inhaler, press while exhaling forcefully into the device
Hold breath for 2 seconds immediately before pressing the canister
Place the mouthpiece directly between the teeth and inhale rapidly

Correct answer: Hold the inhaler 1-2 inches from the open mouth, exhale first, then inhale slowly while pressing

The correct MDI technique is to exhale fully, hold the inhaler 1-2 inches from the open mouth, then slowly inhale while pressing the canister.

Question 58: What does 'PRN' mean on a medication administration record (MAR)?

Before meals
As needed (Correct answer)
Every night
By mouth only

Correct answer: As needed

PRN (pro re nata) means the medication is given as needed based on the resident's condition or complaint.

Question 59: The online LSCC Patient/Visitor Adverse Incident Report, found under "LSCC Forms," is used to report any medication errors, "near misses," and serious adverse reactions to a medicine or immunization while the patient is still in the clinic.

Maybe
TRUE (Correct answer)
FALSE
I Don't Know

Correct answer: TRUE

Reporting medication errors, near misses, and serious adverse reactions is essential for patient safety and continuous quality improvement. Using a specific incident report form, such as the LSCC Patient/Visitor Adverse Incident Report, provides a standardized mechanism for documenting these events. This allows for thorough analysis and the implementation of preventative measures to enhance patient care.

Question 60: A medication has been removed from a blister pack but the resident is now asleep and cannot be awakened for the dose. What should the medication aide do?

Discard the medication, document, and notify the nurse (Correct answer)
Return the medication to the blister pack for next use
Leave the medication on the bedside table for the resident to take later
Ask a family member to administer it later

Correct answer: Discard the medication, document, and notify the nurse

Once a medication is removed from its packaging, it cannot be returned; it must be discarded and the situation documented with nurse notification.

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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