NOTE: This post is the second one in a series that contains medication aide practice test questions similar to the ones a test taker will most likely see on the state Medication Aide Competency Examination, or MACE for short. Answers to the practice test questions are supplied, as well as rationales. Click here to read Part One.
QUESTION: When administering oral medications to a nursing home resident who needs assistance, where should the medication aide ensure the pills, caplets or capsules are placed?
A. Onto the center of the tongue
B. Anywhere in the mouth is okay
C. Under the tongue
D. Between the inner cheek and the teeth
RATIONALE: Oral medications such as pills, capsules and caplets are to be placed on the middle of the tongue to promote greater ease with swallowing. Sublingual medications are the only type of oral drug that should be placed under the tongue. Pills and capsules that are placed between the inner cheek and teeth of a client might dissolve without ever being swallowed by the resident.
QUESTION: The medication aide is permitted to crush a client’s oral medications (e.g., pills and caplets) and mix with puddling, applesauce or jelly only if the following condition is met:
A. If the client requests the medications be crushed
B. If the medication administration record (MAR) indicates that the medications may be crushed
C. If the facility administrator requests the medications be crushed
D. If the client’s family member requests the medications be crushed
RATIONALE: A medication aide should not crush or break pills, caplets or tablets or pills, or open and empty powder out of capsules, unless a pre-existing order on the client’s medication administration record indicates that the medications may be crushed. Some types of tablets, pills and capsules will not work as directed or may actually be harmful to the client if they have been crushed or opened prior to administration.
Many medications are in extended release form. This means they the medication is released in the client’s body patient over an extended period of time, typically several hours. If the client takes an extended release medication after it is crushed, this means the medicine will be released all at one time in the body. This might lead to the medication harming the client, similar to taking too much of a dose at once.
In addition, an extended release medication might be rendered less effective than the prescriber originally intended since it is no longer medicating the client during an extended period of time. For example, the anti-diabetic medication Metformin XR (Glucophage XR) is an extended release form of Metformin that is not to be crushed because it is intended to provide control over a client’s blood glucose levels over many hours.
Also, many drugs are coated to permit them to pass through the upper gastrointestinal tract undissolved with minimal side effects so they will be released in the small intestine instead of the stomach. Crushing a coated pill or caplet may result in unwanted side effects since the protective coating has now been crushed.
QUESTION: How would a medication aide determine that a medication should be given transdermally?
A. Ask a coworker
B. Find out from the client
C. Follow the directions on the MAR
D. Ask the manager
RATIONALE: The medication aide should always follow the directions printed on the medication administration record (MAR). The MAR contains the essential components of each medication order. These components include the medication’s name, current dose, frequency to administer the drug, route of administration, and original date the drug had been ordered by the healthcare provider.
Since the MAR contains the proper route of administration, a prudent medication aide would follow the directions on the client’s MAR to determine whether the drug should be administered in transdermal form.