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 D

Explanation

Choice A rationale:

Aspirin is known as a salicylate and a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking a certain natural substance in your body to reduce pain and swelling. However, one of the key reasons aspirin is administered to a patient with a history of myocardial infarction (MI) is due to its antiplatelet aggregate properties. This effect reduces the risk of stroke and heart attack. If a patient has recently had surgery on clogged arteries (such as bypass surgery, carotid endarterectomy, coronary stent), doctors may direct them to use aspirin in low doses as a “blood thinner” to prevent blood clots.

Choice B rationale:

While aspirin does have analgesic properties, meaning it can relieve mild to moderate pain from conditions such as muscle aches, toothaches, common cold, and headaches, this is not the primary reason it would be administered to a patient with a history of MI. The main goal in this context is to prevent further cardiac events, which is achieved through aspirin’s antiplatelet effects.

Choice C rationale:

Aspirin does have anti-inflammatory properties and it may be used to reduce pain and swelling in conditions such as arthritis. However, in the context of a patient with a history of MI, the anti-inflammatory property is not the primary reason for administering aspirin. The key purpose is to leverage its antiplatelet effects to prevent further cardiac events.

Choice D rationale:

Aspirin can be used to reduce fever, which is what the term ‘antipyretic’ refers to. However, similar to the analgesic and antiinflammatory properties, the antipyretic property is not the primary reason for administering aspirin to a patient with a history of MI. The main goal is to prevent further cardiac events through its antiplatelet effects.

A. WBC count of 16,000/mm B. BUN level of 42 mg/dl C. Blood pressure reading of 95/64 D. Body temperature of 101.8F

Correct Answer is ["A","C","D"]

Explanation

Choice A rationale:

A WBC count of 16,000/mm is higher than the normal range of 5,000 to 10,000 cells/mm. This indicates that the body is fighting an infection, which is a common reason for prescribing Vancomycin. Therefore, a high WBC count could indicate a therapeutic response to the medication as it suggests that the body’s immune system is actively fighting the infection.

Choice B rationale:

A BUN level of 42 mg/dl is higher than the normal range of 7 to 20 mg/dL3456. Elevated BUN levels can indicate kidney damage or disease, which is not a desired therapeutic response to Vancomycin. Vancomycin can be nephrotoxic, and its use requires careful monitoring of kidney function. Therefore, a high BUN level does not indicate a therapeutic response to the medication. Choice C rationale:

A blood pressure reading of 95/64 is considered normal. Maintaining normal blood pressure is important for overall health and can indicate that the patient’s body is responding well to the medication. Therefore, a blood pressure reading within the normal range could indicate a therapeutic response to Vancomycin.

Choice D rationale:

A body temperature of 101.8F is considered a fever14. Fever is a common response to infection and can indicate that the body is fighting off an infection, which is a common reason for prescribing Vancomycin. Therefore, a high body temperature could indicate a therapeutic response to the medication as it suggests that the body’s immune system is actively fighting the infection.

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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

When a patient is undergoing aminoglycoside therapy, which indicators should the nurse monitor for potential toxicity?

Correct Answer is D

Explanation

Examine the following patient data for a patient who has been prescribed vancomycin. The nurse is evaluating a patient after administering several doses of Vancomycin IV. Which of the following changes would indicate a therapeutic response to the medication? (Select all that apply)

Correct Answer is ["A","C","D"]

Explanation

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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”?