NMBI Medication Management — Questions and Answers
Question 1: Under Irish legislation, what are 'controlled drugs' and how must they be handled by nurses?
- Drugs regulated under the Misuse of Drugs Acts that require special storage, documentation, and administration procedures including dual-nurse checking (Correct answer)
- Any drug that controls a disease
- Drugs that control blood pressure
- Drugs available without prescription
Correct answer: Drugs regulated under the Misuse of Drugs Acts that require special storage, documentation, and administration procedures including dual-nurse checking
Controlled drugs (Schedule 2 and 3 substances under the Misuse of Drugs Acts 1977-2016) require locked storage, a controlled drugs register with entries witnessed by two nurses, dual-nurse checking before administration, and regular stock balance checks.
Question 2: What should a nurse do if they discover a medication error?
- Assess the patient for harm, notify the prescriber and nurse manager, complete an incident report, document in the patient's record, and inform the patient through open disclosure (Correct answer)
- Hide the error to avoid getting into trouble
- Wait to see if the patient develops any symptoms
- Only report it if the patient is harmed
Correct answer: Assess the patient for harm, notify the prescriber and nurse manager, complete an incident report, document in the patient's record, and inform the patient through open disclosure
Immediate action includes assessing the patient and providing any necessary treatment, then notifying the prescriber and nurse manager. The incident must be formally reported, documented in the patient's record, and disclosed to the patient through the open disclosure process.
Question 3: What is the correct procedure for administering an intravenous (IV) medication?
- Verify the prescription, check the Five Rights, inspect the medication for clarity and expiry, check IV site patency, administer at the correct rate, and monitor the patient (Correct answer)
- Only check the patient's name and give the medication
- Any nurse can administer any IV medication without additional training
- IV medications do not require documentation
Correct answer: Verify the prescription, check the Five Rights, inspect the medication for clarity and expiry, check IV site patency, administer at the correct rate, and monitor the patient
IV medication administration requires verification of the prescription, Five Rights check, inspection of the medication (clarity, colour, expiry date, compatibility), assessment of the IV site for patency and signs of complications, correct rate of administration, and post-administration monitoring.
Question 4: What is the nurse's responsibility regarding medication allergies?
- To document all known allergies on the medication chart and patient record, verify allergy status before each administration, and wear an allergy alert identifier on the patient (Correct answer)
- Allergies are the doctor's responsibility only
- Only record allergies if the patient has had a severe reaction
- Allergy information is only needed for IV medications
Correct answer: To document all known allergies on the medication chart and patient record, verify allergy status before each administration, and wear an allergy alert identifier on the patient
Nurses must ask about and document all allergies (including type of reaction) on the medication prescription chart and in the patient's record. Before each medication administration, allergy status must be verified. Patients should wear allergy identification bands.
Question 5: How should medications be stored in a clinical area?
- In a locked medicine trolley or cupboard, at the correct temperature, separated by type, with controlled drugs in a separate locked cabinet, and stock regularly checked for expiry (Correct answer)
- On the patient's bedside locker for easy access
- In an unlocked cupboard in the nurses' station
- Stored with cleaning supplies to save space
Correct answer: In a locked medicine trolley or cupboard, at the correct temperature, separated by type, with controlled drugs in a separate locked cabinet, and stock regularly checked for expiry
Medications must be stored securely in locked facilities accessible only to authorised personnel. Temperature-sensitive medications require refrigeration with temperature monitoring. Controlled drugs need a separate locked cabinet. Regular expiry date checks and stock reconciliation are required.
Question 6: What is 'polypharmacy' and why is it a concern for patient safety?
- The concurrent use of multiple medications by a patient, which increases the risk of drug interactions, adverse effects, and medication errors (Correct answer)
- A type of pharmacy that sells many products
- Using generic drugs instead of branded ones
- Taking medications at multiple times during the day
Correct answer: The concurrent use of multiple medications by a patient, which increases the risk of drug interactions, adverse effects, and medication errors
Polypharmacy (typically 5+ medications) is common in older adults and patients with multiple conditions. It increases the risk of drug interactions, adverse reactions, poor adherence, falls, and hospitalisation. Nurses should be aware of polypharmacy risks and advocate for medication reviews.
NMBI Medication Management
Under Irish legislation, what are 'controlled drugs' and how must they be handled by nurses?