Legal Control of Drugs
Controlled Substances
Controlled Substance Counts & Discrepancies
Six Rights of Medication Administration
Medication Safety & Abbreviations
Medication Safety Protocols
When Med Errors Happen
NCLEX Scenarios
100

The federal agency responsible for enforcing controlled substance laws and regulating controlled substances in the United States.

 What is the DEA (Drug Enforcement Administration)?

100

These medications require additional security, documentation, and accountability because of their potential for misuse or diversion.

What are controlled substances?

100

Controlled substances are counted to ensure this.

What is accurate medication accountability?

100

he medication is being given to the correct person. Which Right?

What is the Right Patient?

100

This abbreviation means "by mouth."

What is PO?

100

The nurse should verify the medication order before doing this.

What is administering the medication?

100

A medication error occurs. What is the nurse's FIRST priority?

Assess the patient.

100

A nurse is preparing to administer a medication. The patient's name on the medication label does not match the patient's identification band. 

What should the nurse do?

Answer: Do not administer the medication. Stop and verify the medication and patient identification.

200

These laws establish the legal framework for regulating controlled substances according to their potential for abuse and accepted medical use.

What are the Controlled Substances Act and related regulations?

200

Morphine, fentanyl, and oxycodone are examples of medications in this broad category.

What are opioids?

200

A controlled substance count should match the amount documented in this.

What is the controlled substance record/administration record?

200

The nurse verifies that the medication matches the provider's order. Which Right?

What is the Right Medication?

200

This abbreviation means "intramuscular."

What is IM?

200

If the medication label is unclear or unreadable, the nurse should do this.

Do not administer it; obtain a properly labeled medication.

200

After assessing the patient, the nurse should notify the appropriate healthcare provider and follow this.

What is facility policy?

200

A nurse receives a verbal medication order but is unsure whether the dose was 10 mg or 100 mg. 

What is the best action?

Clarify the order before administering the medication.

300

A medication that has a high potential for abuse, no currently accepted medical use in the United States, and a lack of accepted safety under medical supervision belongs to this schedule.

What is Schedule I?

300

A controlled substance is commonly stored in this type of secure location.

What is a locked/secure medication storage area?

300

The nurse discovers that the controlled substance count is incorrect. What should the nurse do FIRST?

Recount and verify the medication, documentation, and calculations according to facility policy.

300

The nurse verifies that the amount being administered matches the prescribed amount. Which Right?

What is the Right Dose?

300

Why should nurses be cautious about medication abbreviations?

Because misinterpretation can lead to medication errors.

300

A nurse discovers that a medication is expired. What should the nurse do?

Do not administer it and follow facility policy for removing/replacing the medication.

300

Why should a medication error never be hidden?

Because patient safety requires appropriate assessment, treatment, monitoring, reporting, and documentation.

300

During a narcotic count, the nurse discovers one fewer tablet than documented.

What should the nurse do?

A. Replace the tablet
B. Ignore the discrepancy
C. Recount and report according to policy
D. Ask another nurse to sign the count

C. Recount and report according to policy

400

Controlled substances are classified into schedules based primarily on factors such as abuse potential, medical use, and this additional concern.

What is potential for dependence?

400

Why are controlled substances subject to stricter documentation requirements?

Because of their potential for abuse, diversion, misuse, and dependence.

400

After recounting, the controlled substance count is still incorrect. What should the nurse do?

Immediately report the discrepancy according to facility policy and complete required documentation.

400

The nurse confirms when the medication should be administered. Which Right?

What is the Right Time?

400

Which is safer to write: "5.0 mg" or "5 mg"?

5 mg

A trailing zero can be misread and result in a tenfold dosing error.

400

A nurse is interrupted while preparing medications. What is the safest action?

Stop and re-verify the medication/order before continuing.

400

A nurse realizes that the wrong medication was administered. The patient currently has no symptoms. Should the nurse simply document that the patient is fine and continue the shift?

No. The patient must be assessed and the appropriate provider/supervisor notified according to policy. The patient may require monitoring even without immediate symptoms.

400

A nurse accidentally administers a medication to the wrong patient. The patient appears stable.

What should the nurse do FIRST?

A. Complete an incident report
B. Notify the pharmacy
C. Assess the patient
D. Document the error

C. Assess the patient

500

A nurse is asked to administer a medication that is not ordered by an authorized prescriber. What should the nurse do?

Do not administer it. Verify that there is a valid medication order and clarify the order with the appropriate healthcare professional before administration.

500

A nurse notices that a coworker appears to be removing controlled medication for personal use. What is the priority?

Follow facility policy and immediately report suspected diversion to the appropriate supervisor/authority. Do not ignore or conceal the discrepancy.

500

A nurse notices that the narcotic count is short by one tablet. The previous nurse has already left the unit. What should the nurse do?

Secure the medication, verify the count and records, notify the appropriate supervisor immediately, and follow the facility's discrepancy/diversion reporting procedure.

500

The nurse documents the medication administration and evaluates the patient's response. Which medication administration rights are being demonstrated?

Right Documentation and Right Response/Reason.

500

Which is safer: ".5 mg" or "0.5 mg"?

Answer: 0.5 mg

A leading zero should be used for doses less than 1.

500

A provider gives a medication order that seems unusually high compared with the usual dose. What should the nurse do?

Hold administration and clarify the order with the appropriate prescriber/pharmacist before administering it.

500

Put these actions in the safest general sequence after discovering a medication error:

  1. Notify appropriate individuals
  2. Assess the patient
  3. Document according to policy
  4. Implement interventions/orders
  5. Complete required incident/event reporting

Answer: Assess → Notify → Intervene/follow orders → Document → Complete required event reporting, while following facility policy and applicable law.

500

A nurse is preparing medications for a patient. The nurse notices that:

  • The patient's allergy list includes the medication.
  • The dose on the order seems unusually high.
  • The medication label has an abbreviation that the nurse does not recognize.
  • The patient says, "I've never taken that medication before."

What should the nurse do?

STOP the medication administration and verify everything before giving the medication.

The nurse should:

  1. Verify the patient's allergies.
  2. Verify the medication order and dose.
  3. Clarify the unfamiliar abbreviation.
  4. Verify the medication with a reliable drug reference/pharmacist as appropriate.
  5. Confirm the indication and patient's understanding.
  6. Do not administer until the concerns are resolved.