A. By looking at the MAR: The Medication Administration Record (MAR) is primarily for documenting medications administered, and while it may note some allergies, it is not a comprehensive source for a patient's allergy history.

B. By asking the patient: Directly inquiring about a patient's allergies is one of the most effective methods to gather accurate and specific information. Patients can detail their allergies to medications, foods, and other substances, which might not be documented elsewhere.

C. By looking at the patient's allergy bracelet: An allergy bracelet provides immediate visual identification of known allergies. It serves as an important safety mechanism for healthcare providers to avoid administering any allergens.

D. By looking at the front of the chart or in the patient's electronic health record (EHR): This is a reliable way to find documented allergies. The front of the chart or the EHR often contains essential information about a patient's allergies, which helps inform safe medication administration and treatment planning.

E. By administering a dose and monitoring the patient's response: This method is unsafe and inappropriate. Administering a medication without prior knowledge of allergies could lead to serious and potentially life-threatening reactions. It is critical to know allergy history before any medication administration

A. The right patient: Identifying the correct patient is crucial to prevent medication errors. This typically involves using at least two identifiers, such as the patient's name and date of birth, to ensure the right person receives the medication.

B. The right MAR: While the Medication Administration Record (MAR) is essential for tracking medication administration, it is not classified as one of the six rights.

C. The right route: Administering medication via the appropriate route (e.g., oral, intravenous) is vital for the drug's effectiveness. Different routes can affect absorption and efficacy, making this a key component of safe medication administration.

D. The right expiration date: Although checking the expiration date is important for safety, it is not part of the core six rights of medication administration.

E. The right health care provider: While appropriate prescribing is important, this does not fall under the six rights of medication administration.

F. The right dose: Confirming the correct dose is essential to avoid potential toxicity or ineffective treatment. Dosage calculations must be precise, considering the patient's age, weight, and clinical condition.

G. The right documentation: Accurate documentation of medication administration is crucial for continuity of care. It helps ensure that all healthcare providers are informed of what medications have been given, thereby preventing duplicate doses or missed medications.

H. The right conversion factor: While conversions may be necessary for dosing, this is not considered one of the six rights.

I. The right medication: Verifying the correct medication is fundamental to patient safety. This involves checking the medication label against the MAR to prevent administering the wrong drug, which could have serious consequences.

J. The right time: Administering medications at the correct scheduled times is essential for maintaining therapeutic drug levels in the body. Timely administration helps ensure that the medication works effectively and enhances patient adherence to their treatment plan.

A) Three times a day: This option suggests administering medication at intervals that would total three doses in a 24-hour period. However, "BID" specifically refers to taking a medication twice a day, typically at evenly spaced intervals.

B) Twice a day: The abbreviation "BID" stands for "bis in die," which is Latin for "twice a day." This means that the patient will receive the medication two times within a 24-hour period, often recommended to maintain consistent therapeutic levels.

C) After meals: While some medications are taken after meals for better absorption or to minimize gastrointestinal side effects, the term "BID" does not specify timing relative to meals. Therefore, this option does not accurately describe the frequency of administration.

D) Four times a day: This option indicates administering medication four times within a 24-hour period, which would be represented by the abbreviation "QID" (quater in die) rather than "BID." Thus, it does not align with the definition of taking medication twice daily

A) 2: Administering 2 mL of Compazine would provide a total dose of 10 mg (since the concentration is 5 mg/mL), which exceeds the ordered dose of 2.5 mg. This option is incorrect as it would administer too much medication.

B) 1.5: This option suggests giving 1.5 mL, which would equate to 7.5 mg (1.5 mL x 5 mg/mL). This dosage also exceeds the ordered 2.5 mg and is therefore not appropriate.

C) 1: Administering 1 mL would deliver 5 mg of Compazine. This amount is higher than the prescribed 2.5 mg and is not the correct dose.

D) 0.5: This option is correct. Administering 0.5 mL of Compazine would provide a dose of 2.5 mg (0.5 mL x 5 mg/mL). This matches the ordered dosage perfectly, ensuring that the patient receives the correct amount of medication.

A) Use an automated medication dispensing system: While automated systems can enhance efficiency and reduce the risk of errors, they are not foolproof. Errors can still occur due to incorrect entries or malfunctions, so reliance solely on technology without further precautions may not be sufficient.

B) Avoid distractions and take time to prepare medications: Reducing distractions is important for maintaining focus during medication preparation. However, it is just one aspect of a comprehensive approach to medication safety. This practice alone does not encompass the necessary protocols that ensure the correct medication is administered.

C) Adhere to the 6 rights of medication administration: Following the 6 rights—right patient, right drug, right dose, right route, right time, and right documentation—is the most effective strategy for preventing medication errors. This systematic approach provides a framework for nurses to ensure accuracy and accountability in every medication administration.

D) Only give medications to patients who are alert and oriented: While it’s important to assess a patient's alertness before administering medications, this criterion alone does not address the various factors that can lead to medication errors. Patients may require medications even when not fully alert, and it is the nurse's responsibility to ensure safety through proper protocols rather than simply limiting administration based on alertness.

A) Notify the health care provider: It is essential to inform the healthcare provider if a

patient refuses a medication. This allows for a reassessment of the patient's treatment plan and ensures that any necessary follow-up or adjustments can be made based on the patient's refusal.

B) Determine the reason for refusal: Understanding why a patient refuses medication is crucial. It may be due to side effects, lack of understanding, personal beliefs, or concerns about the medication. Gathering this information can help the nurse address the patient’s concerns and educate them appropriately.

C) Administer the dose when the next dose is due: Administering a medication that the patient has refused would violate their rights and could be considered coercive. The patient has the right to refuse treatment, and the nurse should respect that decision rather than attempt to administer it later without consent.

D) Document the reason for refusal in the patient's health record: Accurate documentation is vital in healthcare. Recording the patient's refusal and the reason for it in their health record ensures continuity of care and provides information for other healthcare team members regarding the patient's preferences and concerns.

E) Mix it in a small amount of their food: This action is inappropriate and unethical. Coercively administering medication without the patient's consent undermines their autonomy and trust in the healthcare system. The nurse should always respect the patient’s right to refuse medication.

A) Only administer 40 mg: This option is not appropriate without consulting the healthcare provider. Simply administering a smaller dose without confirming the rationale behind the prescribed 120 mg could result in inadequate treatment for the patient.

B) Use at least two patient identifiers whenever administering a medication: Utilizing two patient identifiers (such as name and date of birth) is essential to ensure that the medication is administered to the correct patient. This step is a key practice in medication safety to prevent errors.

C) Read labels at least two times to make sure it is the correct medication: Carefully reading labels at least twice helps confirm that the nurse is administering the correct medication and dosage. This practice reduces the risk of errors and ensures that the right drug is given.

D) Double-check all calculations: Verifying calculations is critical, especially when dealing with high doses or unusual orders. This step ensures accuracy in the dosage administered and helps prevent medication errors that could lead to toxicity or ineffective treatment.

E) Question unusually large or small doses: It is essential to question any dosage that appears significantly outside the usual range, such as the prescribed 120 mg of Lasix, which exceeds the standard dosing guidelines. Consulting with the healthcare provider for clarification is crucial in such cases to ensure patient safety.

A) The nurse administered the medication correctly: While the nurse followed many of the correct procedures, this option overlooks the critical issue of patient identification. The nurse's adherence to the six rights is not complete without the appropriate verification of the patient’s identity.

B) The nurse did not have a second nurse verify the dose: While having a second nurse verify high-risk medications is a good practice, it is not a strict requirement for every medication. The focus should be on the established protocols for verification rather than a blanket requirement for all doses.

C) The nurse did not make the appropriate number of checks for the right drug: The nurse followed proper procedures by checking the medication label multiple times against the MAR and at the bedside. Therefore, this option does not accurately reflect any violation.

D) The nurse did not use two patient identifiers: Although the nurse asked the patient to state her name, this alone does not constitute using two identifiers. The best practice is to confirm at least two identifiers (e.g., name and date of birth) to ensure the correct patient receives the medication. This oversight is a violation of the right patient in the medication administration process.

A) "You could create problems for your family if you don't manage your health.": While this statement highlights the potential impact on family, it may not effectively address the patient's concerns or motivations. This response could come across as judgmental rather than supportive.

B) "You could possibly suffer a stroke if you don't manage your blood pressure.": Although this response underscores the seriousness of uncontrolled hypertension, it might induce fear without encouraging a constructive dialogue about the patient's reasons for discontinuing the medication.

C) "Have you had your blood pressure checked since discontinuing this medication?": This question is relevant but does not directly address the patient's decision to stop taking the medication. It misses an opportunity to explore the underlying reasons behind the patient's choice.

D) "What is the reason you are no longer taking the blood pressure medication?": This response is the most effective because it opens a dialogue for the patient to express his feelings or concerns about the medication. Understanding the patient's perspective allows the nurse to provide better education and support tailored to the patient's needs, potentially addressing any misconceptions or side effects that may have influenced the decision.

A) Administer 2.5 mL of amoxicillin per dose: This option is incorrect because administering 2.5 mL would only provide 62.5 mg of amoxicillin (since 125 mg is in 5 mL). The prescribed dose is 250 mg, so this volume is insufficient.

B) Administer 10 mL of amoxicillin per dose: This option is also incorrect. Administering 10 mL would provide 250 mg of amoxicillin (since 125 mg is in 5 mL, 10 mL equals 250 mg). However, this option may confuse the correct volume with a miscalculation if misunderstood in context, so it should not be selected without a proper calculation verification.

C) Administer the amoxicillin at 0800, 1200, and 1800: This option is correct. Administering the medication every 8 hours at these times ensures that the medication is given according to the prescribed schedule, maintaining appropriate therapeutic levels.

D) Compare the patient's name and date of birth on the armband with the MAR: This action is crucial for ensuring patient safety. Verifying patient identifiers against the MAR helps prevent medication errors and ensures that the right patient receives the correct medication.

E) Administer the medication by the parenteral route: This option is incorrect. The order specifies oral (PO) administration of amoxicillin, so administering it parenterally would not align with the prescribed route and could lead to incorrect dosing or complications.