MAP Controlled Substance Handling & Counting — Questions and Answers
Question 1: How should Schedule II controlled medications be stored in a residential program?
- In an unlocked drawer in the staff office
- Under double lock, with access limited to authorized staff (Correct answer)
- In the resident's bedroom
- In the medication cart with the other medications and no extra lock
Correct answer: Under double lock, with access limited to authorized staff
Controlled substances require secure double-lock storage with restricted access. This helps prevent theft, diversion, and accidental misuse.
Question 2: When does a count of controlled substances typically occur?
- Once a month
- At every shift change, by two authorized staff (Correct answer)
- Only when a bottle is empty
- Only when an inspector visits
Correct answer: At every shift change, by two authorized staff
Counts are done at every change of shift. The outgoing and incoming staff verify the quantity together and document it in the controlled substance log.
Question 3: At shift change, the count of a controlled medication does not match the log. What should staff do?
- Adjust the log number to match the count
- Recount, review recent entries, and if the discrepancy remains, report it immediately per policy (Correct answer)
- Ignore it until the next count
- Remove the medication from the log
Correct answer: Recount, review recent entries, and if the discrepancy remains, report it immediately per policy
A discrepancy must be rechecked and, if unresolved, reported at once. It may indicate a documentation error, a medication error, or diversion. Altering the log hides the problem.
Question 4: A resident refuses a controlled medication that was already removed from its container. What is the correct action?
- Put it back in the container
- Dispose of it per policy with a witness and document the refusal and disposal (Correct answer)
- Give it to another resident
- Take it home
Correct answer: Dispose of it per policy with a witness and document the refusal and disposal
Once removed, a controlled medication must not be returned to stock. It is disposed of as policy directs, usually with a witness, and the refusal and disposal are documented so the count stays accurate.
Question 5: Why are controlled substances tracked more closely than other medications?
- They always cost more
- They have a higher potential for abuse and diversion (Correct answer)
- They expire faster
- They can only be given by nurses
Correct answer: They have a higher potential for abuse and diversion
Controlled substances have a recognized potential for misuse, dependence, and diversion. This is why strict counting, storage, and documentation are required.
Question 6: What must be recorded each time a dose of a controlled medication is given?
- Only the staff member's name
- The date, time, dose, person, remaining count, and administering staff signature (Correct answer)
- Nothing beyond the MAR entry
- Only the remaining count
Correct answer: The date, time, dose, person, remaining count, and administering staff signature
The controlled substance record must show each dose and the updated running balance. This allows the count to be reconciled at any time.
