RPN Safe Medication Administration 2 — Questions and Answers
Question 1: A patient is prescribed metformin 500 mg PO BID. When is the best time to administer this medication?
- With meals to reduce GI upset (Correct answer)
- On an empty stomach for better absorption
- At bedtime only
- 30 minutes before meals
Correct answer: With meals to reduce GI upset
Metformin should be taken with meals to minimize gastrointestinal side effects such as nausea and diarrhea.
Question 2: Which action should the RPN take first when a medication error is discovered?
- Document the error in the patient's chart
- Assess the patient for adverse effects (Correct answer)
- Notify the pharmacy department
- Complete an incident report
Correct answer: Assess the patient for adverse effects
Patient safety is the priority; the RPN must first assess the patient for any adverse effects from the medication error.
Question 3: A nurse is preparing to administer a subcutaneous insulin injection. Which site rotation principle is most important?
- Rotate between the abdomen and thigh only
- Use the same site consistently for predictable absorption
- Rotate sites within each anatomical region before moving to another (Correct answer)
- Avoid the abdomen in all diabetic patients
Correct answer: Rotate sites within each anatomical region before moving to another
Rotating within one anatomical region before switching to another ensures consistent insulin absorption rates.
Question 4: When administering an IV piggyback medication, the RPN should verify compatibility with which primary solution first?
- Check the medication label for expiration date
- Review the pharmacy compatibility reference or pharmacist (Correct answer)
- Ask the prescribing physician
- Confirm with the charge nurse
Correct answer: Review the pharmacy compatibility reference or pharmacist
Drug compatibility must be verified through a reliable pharmacy reference or pharmacist before mixing or co-administering IV medications.
Question 5: A patient refuses a prescribed medication. What is the appropriate RPN response?
- Crush the medication and place it in food without telling the patient
- Document the refusal and notify the prescriber (Correct answer)
- Administer anyway because it was ordered
- Discharge the patient for non-compliance
Correct answer: Document the refusal and notify the prescriber
Patients have the right to refuse treatment; the nurse must document the refusal and inform the prescriber so the care plan can be adjusted.
Question 6: Which is the safest method to confirm a patient's identity before medication administration?
- Ask the patient to state their name
- Check the name on the room door
- Use two patient identifiers such as name and date of birth (Correct answer)
- Verify the bed number matches the MAR
Correct answer: Use two patient identifiers such as name and date of birth
Using two independent patient identifiers (e.g., full name and date of birth) is the standard for safe patient identification.
Question 7: An RPN prepares a dose of warfarin and notices the INR result is 4.8. What is the priority action?
- Administer the dose as prescribed and monitor
- Hold the dose and notify the prescriber immediately (Correct answer)
- Reduce the dose by half without consulting the prescriber
- Document and administer at the next scheduled time
Correct answer: Hold the dose and notify the prescriber immediately
An INR of 4.8 is supratherapeutic and indicates bleeding risk; the nurse must withhold warfarin and contact the prescriber for further orders.
RPN Safe Medication Administration 2
A patient is prescribed metformin 500 mg PO BID.
When is the best time to administer this medication?