During morning medication administration, the nurse discovered an error on the electronic Medication Administration Record (MAR) before the medication was given.
What is the appropriate action for this “near-miss”?

Report the near-miss using the facility’s recommended protocol, and correct the error on the MAR

Report the near-miss to the next shift before the next dose is due

Correct the MAR error but say nothing because nothing happened

Notify the pharmacy about the error they almost caused .

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Reporting a near-miss using the facility’s recommended protocol and correcting the error on the MAR is the appropriate action. A “near-miss” in healthcare is a situation where an error could have happened, but didn’t, either by chance or timely intervention. It’s crucial to report these incidents as they provide valuable information for risk management and quality improvement. By analyzing near-misses, healthcare facilities can identify potential hazards and take preventive measures to ensure patient safety. Correcting the error on the MAR is also important to prevent the same mistake from happening in the future.

Choice B rationale:

Reporting the near-miss to the next shift before the next dose is due is not the best course of action. While it’s important to communicate any potential issues to the next shift, it’s more crucial to report the incident immediately using the facility’s recommended protocol. This allows for a timely investigation and corrective action. Waiting until the next shift could delay these processes and potentially put patient safety at risk.

Choice C rationale:

Correcting the MAR error but saying nothing because nothing happened is not an appropriate response. Even though the error did not result in any harm, it’s still important to report it. Near-misses are often indicators of underlying system issues that need to be addressed. By not reporting the incident, the opportunity to improve patient safety and prevent future errors is lost.

Choice D rationale:

Notifying the pharmacy about the error they almost caused is not the most appropriate action. While it’s important to communicate with the pharmacy if they were involved in the error, the first step should always be to report the near-miss using the facility’s recommended protocol. This ensures that the incident is properly documented and investigated, and that appropriate corrective actions are taken.

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Correct Answer is C

Explanation

Choice A rationale:

The client stating, “I haven’t had anything to eat or drink since last night” is not a cause for concern. This is because patients are often advised to fast before undergoing certain medical procedures or tests, including an intravenous pyelogram (IVP).

Fasting helps to ensure that the test results are accurate and not influenced by recent food or drink consumption.

Choice B rationale:

The client expressing that “The last time I voided it was painful” could be related to their recurrent kidney stones. Kidney stones can cause discomfort or pain during urination. However, this statement does not necessarily require additional data collection in the context of an IVP. The pain could be a symptom of the kidney stones rather than a contraindication for the IVP1.

Choice C rationale:

The statement “I took my metformin before breakfast” is of concern. Metformin is a medication used to treat type 2 diabetes. It is important for the nurse to collect additional data about this statement because metformin can potentially interact with the iodine-based contrast dye used in an IVP. This interaction can increase the risk of lactic acidosis, a serious and potentially lifethreatening condition. Therefore, patients are often advised to stop taking metformin before and for a couple of days after having an IVP12. Choice D rationale:

The client mentioning, “I took a laxative yesterday” is not necessarily alarming. Laxatives are often used before an IVP to clear the bowels, which helps to ensure clear images during the procedure. Therefore, this statement does not require additional data collection in the context of an IVP1.

A. Liothyronine (Cytomel) B. Liotrix (Thyrolar) C. Levothyroxine (Synthroid) D. Propylthiouracil (Propacil)

Correct Answer is D

Explanation

Choice A rationale:

Liothyronine (Cytomel) is a type of thyroid hormone used to treat an underactive thyroid (hypothyroidism). It replaces or provides more thyroid hormone, which is normally produced by the thyroid gland. However, it is not typically used to treat hyperthyroidism.

Choice B rationale:

Liotrix (Thyrolar) is a combination of two thyroid hormones, levothyroxine (T4) and liothyronine (T3), used to treat hypothyroidism, and to prevent and treat goiter. Similar to Liothyronine, it is not typically used to treat hyperthyroidism. Choice C rationale:

Levothyroxine (Synthroid) is used to treat an underactive thyroid (hypothyroidism). It replaces or provides more thyroid hormone, which is normally produced by the thyroid gland. Low thyroid hormone levels can occur naturally or when the thyroid gland is injured by radiation/medications or removed by surgery. Having enough thyroid hormone helps maintain normal mental and physical activity. In children, having enough thyroid hormone helps them grow and learn normally.

Choice D rationale:

Propylthiouracil (Propacil) is an antithyroid agent used in the treatment of hyperthyroidism. It works by decreasing the amount of thyroid hormone produced by the thyroid gland. This helps to prevent the excessive heat, rapid heart rate, and nervousness caused by too much thyroid hormone in the body.

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During morning medication administration, the nurse discovered an error on the electronic Medication Administration Record (MAR) before the medication was given. What is the appropriate action for this “near-miss”?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has recurrent kidney stones and a history of diabetes mellitus. The client is scheduled for an intravenous Pyelogram (IVP). The nurse should collect additional data about which of the following statements made by the client?

Correct Answer is C

Explanation

Which of the following medications is typically prescribed for the treatment of hyperthyroidism?

Correct Answer is D

Explanation

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A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus. The nurse determines that teaching has been effective when the client identifies which of the following manifestations of hypoglycemia? (Select all that apply.)

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During morning medication administration, the nurse discovered an error on the electronic Medication Administration Record (MAR) before the medication was given.
What is the appropriate action for this “near-miss”?