NMC - Nursing Midwifery Council Medicines Management and Safety Questions and Answers 1 — Questions and Answers
Question 1: A nurse is preparing to administer a controlled drug to a patient on a surgical ward. According to NMC standards and UK regulations, which of the following is the most appropriate action for the nurse to take?
- Ask a healthcare assistant to observe the process and co-sign the record.
- Proceed with administration as a sole registered nurse if the situation is urgent.
- Have the administration process checked and witnessed by a second registered nurse. (Correct answer)
- Administer the drug and complete the controlled drug register at the end of the shift.
Correct answer: Have the administration process checked and witnessed by a second registered nurse.
NMC standards and the Misuse of Drugs Regulations require that the administration of a controlled drug (in most inpatient settings) is witnessed and co-signed by a second registered professional, typically another registered nurse, to ensure safety and accountability.
Question 2: A patient unexpectedly refuses to take their prescribed morning dose of an antihypertensive medication. What is the nurse's primary responsibility according to the NMC Code?
- Withhold the medication, document the refusal, and inform the prescriber. (Correct answer)
- Encourage the patient strongly to take the medication to prevent a rise in blood pressure.
- Crush the tablet and mix it with food to ensure the patient receives it.
- Document the medication as given to maintain the accuracy of the administration record.
Correct answer: Withhold the medication, document the refusal, and inform the prescriber.
The NMC standards emphasize patient-centred care and the right to refuse treatment. The nurse's professional duty is to respect the patient's autonomy, withhold the dose, accurately document the refusal and the reason (if given), and communicate this to the prescriber to ensure the patient's care plan can be reviewed.
Question 3: A newly registered nurse discovers they have administered a medication via the intramuscular route instead of the prescribed subcutaneous route. What is the immediate priority action for the nurse?
- Complete an incident report form immediately.
- Inform the ward manager and the prescriber of the error.
- Assess the patient for any adverse effects and ensure their safety. (Correct answer)
- Document the administration correctly in the patient's notes.
Correct answer: Assess the patient for any adverse effects and ensure their safety.
The absolute first priority following any medication error is to assess the patient's condition and ensure their immediate safety. While informing others, documenting, and reporting are all crucial subsequent steps, the patient's well-being takes precedence over all other actions.
Question 4: Which of the following is a key principle of medicines management as outlined in the NMC's 'The Code'?
- Administering medicines only when directly supervised by a doctor.
- Only administering medicines that the nurse has personally prescribed.
- Ensuring medication is always administered at the exact prescribed time, without deviation.
- Advising on, prescribing, or administering medicines only within the limits of your training and competence. (Correct answer)
Correct answer: Advising on, prescribing, or administering medicines only within the limits of your training and competence.
Standard 18 of 'The Code' explicitly states that nurses, midwives, and nursing associates must 'Advise on, prescribe, supply, dispense or administer medicines within the limits of your training and competence, the law, our guidance and other relevant policies, guidance and regulations'. This highlights the core principle of professional accountability and practising within one's scope.
Question 5: A nurse independent prescriber is conducting a remote consultation for a patient requesting a prescription for a non-surgical cosmetic procedure. According to the latest NMC guidance (effective June 2025), what is the mandatory requirement for this consultation?
- A video call is sufficient if the patient's identity is verified.
- The prescription can be issued if the patient provides a clear photographic history.
- A face-to-face consultation and clinical assessment must be conducted. (Correct answer)
- Remote prescribing is permitted if another healthcare professional is present with the patient.
Correct answer: A face-to-face consultation and clinical assessment must be conducted.
To enhance patient safety, the NMC guidance effective from June 1, 2025, mandates that independent nurse and midwife prescribers must conduct a face-to-face consultation and perform an appropriate clinical assessment before prescribing any products for elective non-surgical cosmetic procedures. Remote prescribing for these specific treatments is not considered appropriate.
Question 6: When a patient brings their own medicines into the hospital, what is the correct procedure a nurse should follow?
- Secure the patient's own drugs and continue administration from ward stock only.
- Send the patient's own drugs home with their family immediately to avoid confusion.
- Use the patient's own supply after they have been assessed as suitable for use by a pharmacist or according to local policy. (Correct answer)
- Combine the patient's own drugs with the ward stock of the same medication to ensure an adequate supply.
Correct answer: Use the patient's own supply after they have been assessed as suitable for use by a pharmacist or according to local policy.
Using a patient's own drugs (PODs) is encouraged to ensure continuity of care and reduce waste. However, the nurse must follow local trust policy, which typically involves the medicines being checked by a pharmacist to verify they are correct, in date, and suitable for use during the inpatient stay before they can be administered.
NMC - Nursing Midwifery Council Medicines Management and Safety Questions and Answers 1
A nurse is preparing to administer a controlled drug to a patient on a surgical ward.
According to NMC standards and UK regulations, which of the following is the most appropriate action for the nurse to take?