NCNZ Medication Management (NZ Regulations) — Questions and Answers
Question 1: Under the Medicines Act 1981, which schedule classification applies to prescription medicines in New Zealand?
- Prescription Medicine (formerly Rx) (Correct answer)
- Controlled Drug
- Restricted Medicine
- General Sale Medicine
Correct answer: Prescription Medicine (formerly Rx)
The Medicines Act 1981 classifies medicines as: Prescription Medicines (require a prescription from an authorised prescriber), Restricted Medicines (pharmacist sale), Pharmacy-only, and General Sale. Schedule 8 under the Misuse of Drugs Act covers controlled drugs.
Question 2: What are the 'Five Rights' of medication administration?
- Right patient, right drug, right dose, right route, right time (Correct answer)
- Right patient, right drug, right dose, right nurse, right notes
- Right drug, right dose, right route, right allergies, right documentation
- Right patient, right drug, right route, right time, right prescriber
Correct answer: Right patient, right drug, right dose, right route, right time
The Five Rights (Rights of Medication Administration) are: right patient (identify using two identifiers), right drug, right dose, right route, and right time. Some frameworks add: right reason, right documentation, right response.
Question 3: A nurse is about to administer an IV medication when they notice the patient's wristband name does not match the medication chart. What should they do?
- Stop and clarify the identity discrepancy before administering — do not proceed until verified (Correct answer)
- Administer the drug and report the discrepancy afterwards
- Ask the patient to state their name without checking the wristband
- Proceed as the doctor prescribed the medication
Correct answer: Stop and clarify the identity discrepancy before administering — do not proceed until verified
Patient identification must be verified using two independent identifiers (name, date of birth, NHI number) before any medication is given. A wristband discrepancy must be resolved before proceeding — wrong-patient administration is a serious adverse event.
Question 4: Under the Misuse of Drugs Act 1975, which of the following is a legal requirement when administering a Class B controlled drug (e.g., morphine) in a hospital?
- Two nurses must verify the drug, dose, and patient; the controlled drug register must be signed by both (Correct answer)
- One nurse may administer and sign the register alone
- No register is required for oral opioids
- Only the charge nurse may administer controlled drugs
Correct answer: Two nurses must verify the drug, dose, and patient; the controlled drug register must be signed by both
Controlled drugs require two-nurse checking (two registered health practitioners in NZ hospitals) and documentation in the controlled drugs register for each administration, including counting the remaining stock. This applies to Schedule 2 (Class B) drugs like morphine and fentanyl.
Question 5: A patient is prescribed gentamicin IV. Which monitoring parameter is most critical for detecting early toxicity?
- Renal function (serum creatinine, eGFR) and drug levels (trough/peak) (Correct answer)
- Blood glucose
- Liver function tests
- Thyroid function tests
Correct answer: Renal function (serum creatinine, eGFR) and drug levels (trough/peak)
Gentamicin is nephrotoxic and ototoxic. Renal function (creatinine, eGFR) must be monitored closely, and drug levels (trough concentration in NZ practice) are measured to ensure levels are within the therapeutic window and avoid toxicity.
Question 6: Which of the following is the correct action if a nurse suspects a patient is having an allergic reaction to a recently administered antibiotic?
- Stop the antibiotic immediately, assess the patient using ABCDE, call for help, and prepare for anaphylaxis management (Correct answer)
- Continue the antibiotic at a slower rate
- Administer oral antihistamine and continue the infusion
- Document the reaction and complete the infusion before reporting
Correct answer: Stop the antibiotic immediately, assess the patient using ABCDE, call for help, and prepare for anaphylaxis management
If an allergic or anaphylactic reaction is suspected during drug administration, the drug must be stopped immediately. The patient is assessed using ABCDE, help is called, and anaphylaxis management (adrenaline if indicated) is initiated.
NCNZ Medication Management (NZ Regulations)
Under the Medicines Act 1981, which schedule classification applies to prescription medicines in New Zealand?