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

The correct answer is Choice D.

Let’s go through the calculations step by step:

Step 1: Convert all the quantities to milliliters (mL), as the nurse needs to record the intake in mL. We know that 1 oz is approximately 29.5735 mL.

4 oz of juice = 4 × 29.5735 mL = 118.294 mL

6 oz of tea = 6 × 29.5735 mL = 177.861 mL 8 oz of broth = 8 × 29.5735 mL = 236.628 mL Step 2: Add all the quantities together:

118.294 mL (juice) + 177.861 mL (tea) + 100 mL (soda) + 150 mL (IV bolus) + 236.628 mL (broth) = 783.783 mL Step 3: Round off the total intake to the nearest whole number as required, which gives us 784 mL.

Therefore, the nurse should record 784 mL on the patient’s chart. However, this option is not available in the choices given. The closest option to this calculated value is 800 mL (Choice D).

Now, let’s discuss the rationales for each choice:

Choice A rationale:

500 mL would be an underestimate of the patient’s fluid intake. It does not account for all the fluids the patient consumed.

Choice B rationale:

600 mL, similar to Choice A, is an underestimate. It does not accurately represent the total volume of fluids the patient consumed. Choice C rationale:

700 mL is closer to the calculated intake but is still an underestimate. It does not fully account for all the fluids the patient consumed.

Choice D rationale:

800 mL is the closest option to the calculated intake of 784 mL. Although it’s slightly over the actual intake, it’s the best choice among the given options.

A. Constipation B. Weight gain C. Sensitivity to cold D. Frequent mood changes E. Frequent mood changes

Correct Answer is D

Explanation

Choice A rationale:

Constipation is not typically associated with hyperthyroidism. In fact, one of the symptoms of hyperthyroidism is increased bowel movement. This is due to the increased metabolic rate caused by the overproduction of hormones from the thyroid gland.

Choice B rationale:

Weight gain is not a common symptom of hyperthyroidism. On the contrary, weight loss is one of the symptoms of this condition. This is because hyperthyroidism speeds up the body’s metabolism, causing increased calorie burning and significant weight loss. Choice C rationale:

Sensitivity to cold is not a symptom of hyperthyroidism. Instead, individuals with hyperthyroidism often have an increased sensitivity to heat. This is due to the increased metabolic rate which can cause excessive sweating and hot flashes.

Choice D rationale:

Frequent mood changes are a common symptom of hyperthyroidism. The overproduction of hormones by the thyroid gland can lead to symptoms such as irritability and restlessness. Additionally, other symptoms such as difficulty sleeping can also contribute to mood changes.

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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”?

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Naxlex Comprehensive Predictor Exams

A nurse is documenting an 8-hour intake and output (I&O) record for a patient who consumed 4 oz of juice, 6 oz of tea, a 100 mL cup of soda, an IV bolus of 150 mL, and 8 oz of broth. How many mL of intake should the nurse record on the patient’s chart?

Correct Answer is D

Explanation

A nurse is collecting data on a patient who has hyperthyroidism. Which of the following symptoms should the nurse anticipate the patient to report?

Correct Answer is 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”?