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NCLEX RN Exam Bank: Medication Administration
Errors, Halting & Reporting
Table of Contents
Subtopic 1: Identifying and Preventing Medication Administration Errors........................... 2
Subtopic 2: Legal and Ethical Responsibilities in Medication Error Reporting ................... 10
Subtopic 3: Communication and Teamwork in Managing Medication Errors .................... 19
Subtopic 4: Technology and Documentation in Error Detection and Prevention ............... 28
Subtopic 5: High-Alert Medications and Double-Check Protocols................................... 36
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Subtopic 1: Identifying and Preventing Medication
Administration Errors
Question 1
A nurse is administering digoxin to a patient. Before giving the dose, the nurse realizes the
apical pulse is 50 beats per minute. What is the nurse’s best action?
A. Administer the medication and document the pulse
B. Withhold the medication and notify the provider
C. Recheck the pulse after giving the medication
D. Ask the patient if they have taken digoxin at home
Correct Answer: B
Rationale: Digoxin is withheld if the apical pulse is below 60 bpm in adults. Administering it
can lead to bradycardia or toxicity.
Question 2
Which of the following is the most common cause of medication administration errors in
hospitals?
A. Inadequate pharmacological knowledge
B. Distractions and interruptions during medication administration
C. Lack of access to drug references
D. Improper hand hygiene
Correct Answer: B
Rationale: Distractions during medication preparation or administration significantly
increase the risk of errors.
Question 3
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A nurse gives a patient another patient’s medication. What is the nurse’s immediate next
step?
A. Complete an incident report
B. Assess the patient for adverse reactions
C. Notify the nursing supervisor
D. Contact the prescribing physician
Correct Answer: B
Rationale: Patient safety comes first. Assessing for adverse effects is essential before
moving on to reporting or notifying.
Question 4
What is the best method to prevent a wrong-route medication error with intravenous (IV)
medications?
A. Dilute all medications before administration
B. Administer via central line only
C. Label all lines and double-check routes before administration
D. Use a larger gauge needle
Correct Answer: C
Rationale: Clear labeling and route verification prevent wrong-route errors, especially with
similar-looking lines (e.g., IV vs. arterial).
Question 5
A nurse discovers a medication error occurred during the previous shift but was not
reported. What should the nurse do?
A. Ignore the error as it wasn’t their shift
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B. Report the error immediately and assess the patient
C. Inform the charge nurse and take no further action
D. Wait until the physician makes rounds
Correct Answer: B
Rationale: Medication errors must be reported, regardless of who made them. Ensuring
patient safety is a shared responsibility.
Question 6
Which of the following is not one of the "Five Rights" of medication administration?
A. Right time
B. Right insurance
C. Right patient
D. Right dose
Correct Answer: B
Rationale: The "Five Rights" are: right patient, right drug, right dose, right route, and right
time. Insurance is unrelated.
Question 7
The nurse is interrupted three times during preparation of a high-alert medication. What is
the safest action?
A. Proceed carefully
B. Restart the entire preparation process
C. Ask another nurse to administer it
D. Save the prepared dose and administer later
NCLEX RN Exam Bank: Medication Administration
Errors, Halting & Reporting
Table of Contents
Subtopic 1: Identifying and Preventing Medication Administration Errors........................... 2
Subtopic 2: Legal and Ethical Responsibilities in Medication Error Reporting ................... 10
Subtopic 3: Communication and Teamwork in Managing Medication Errors .................... 19
Subtopic 4: Technology and Documentation in Error Detection and Prevention ............... 28
Subtopic 5: High-Alert Medications and Double-Check Protocols................................... 36
, 2
Subtopic 1: Identifying and Preventing Medication
Administration Errors
Question 1
A nurse is administering digoxin to a patient. Before giving the dose, the nurse realizes the
apical pulse is 50 beats per minute. What is the nurse’s best action?
A. Administer the medication and document the pulse
B. Withhold the medication and notify the provider
C. Recheck the pulse after giving the medication
D. Ask the patient if they have taken digoxin at home
Correct Answer: B
Rationale: Digoxin is withheld if the apical pulse is below 60 bpm in adults. Administering it
can lead to bradycardia or toxicity.
Question 2
Which of the following is the most common cause of medication administration errors in
hospitals?
A. Inadequate pharmacological knowledge
B. Distractions and interruptions during medication administration
C. Lack of access to drug references
D. Improper hand hygiene
Correct Answer: B
Rationale: Distractions during medication preparation or administration significantly
increase the risk of errors.
Question 3
, 3
A nurse gives a patient another patient’s medication. What is the nurse’s immediate next
step?
A. Complete an incident report
B. Assess the patient for adverse reactions
C. Notify the nursing supervisor
D. Contact the prescribing physician
Correct Answer: B
Rationale: Patient safety comes first. Assessing for adverse effects is essential before
moving on to reporting or notifying.
Question 4
What is the best method to prevent a wrong-route medication error with intravenous (IV)
medications?
A. Dilute all medications before administration
B. Administer via central line only
C. Label all lines and double-check routes before administration
D. Use a larger gauge needle
Correct Answer: C
Rationale: Clear labeling and route verification prevent wrong-route errors, especially with
similar-looking lines (e.g., IV vs. arterial).
Question 5
A nurse discovers a medication error occurred during the previous shift but was not
reported. What should the nurse do?
A. Ignore the error as it wasn’t their shift
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B. Report the error immediately and assess the patient
C. Inform the charge nurse and take no further action
D. Wait until the physician makes rounds
Correct Answer: B
Rationale: Medication errors must be reported, regardless of who made them. Ensuring
patient safety is a shared responsibility.
Question 6
Which of the following is not one of the "Five Rights" of medication administration?
A. Right time
B. Right insurance
C. Right patient
D. Right dose
Correct Answer: B
Rationale: The "Five Rights" are: right patient, right drug, right dose, right route, and right
time. Insurance is unrelated.
Question 7
The nurse is interrupted three times during preparation of a high-alert medication. What is
the safest action?
A. Proceed carefully
B. Restart the entire preparation process
C. Ask another nurse to administer it
D. Save the prepared dose and administer later
