Graduates of approved medication aide training programs must take and pass a state test called the Medication Aide Certification Examination, abbreviated as MACE for short, in order to receive a state-issued practice permit as a certified medication aide. In most states, the MACE typically consists of 100 test questions that directly pertain to safe medication therapy.
The best way to prepare for the MACE is to repeatedly answer medication aide practice test questions prior to sitting for the state exam. To prepare for this exam, a student should answer multiple practice test questions on a daily basis because repetition is the key to retaining the knowledge. In addition to answering test questions every single day, students should also review the rationales behind each answer.
QUESTION: What reason(s) should medication aides obey the six rights of medication administration each time medications are administered?
A. Recent changes might have been made on the dosage of the medication
B. Recent changes may have been made on the time the medication is to be given
C. Recent changes may have been made on the route the medication is to be given
D. All of the above
ANSWER: D
RATIONALE: Safe medication therapy involves checking the six rights of medication therapy each time medicines are administered. The six rights of medication administration include the following: 1) right patient 2) right medication 3) right dose 4) right route 5) right time, and 6) right documentation.
Due to the fact that a patient’s medication orders, times, dosages and routes often change at the physician’s discretion, adherence to the six rights of medication administration ensures patient safety in the realm of medication therapy. In addition, doctors often hold or discontinue medications, so the prudent medication aide would review the six rights of medication administration to avoid giving a medicine that the patient is no longer supposed to receive.
QUESTION: During the routine end-of-shift counting of controlled drugs, the medication aide notices that 10 pills of Xanax (Alprazolam) are missing from a prescription pill bottle. No one knows why the pills are missing. Which action should the medication aide take next?
A. Notify the charge nurse
B. Document the 10 pills as having been administered to a patient
C. Notify the administrator of the facility
D. Do nothing at the moment since 10 pills is not a large shortage
ANSWER: A
RATIONALE: The medication aide should notify the charge nurse each time the end-of-shift controlled drug medication count is inaccurate. This is true whether there is a shortage or overage of controlled medication. Controlled drugs are regulated by the Drug Enforcement Agency (DEA). Additionally, the charge nurse knows the facility policies and procedures on how to proceed if the controlled medication drug count is not accurate.
It is not usually necessary to notify the facility administrator of issues relating to controlled medications. A medication aide who falsely documents the missing pills as having been given to a patient is engaging in falsification of medical records since the medication administration record (MAR) is an official medical record.
QUESTION: The medication aide is supposed to administer Metoprolol Tartrate (Lopressor) once per day at 8:00 a.m per the doctor’s order. The medication order has parameters to “hold if the pulse is less than 60.” The patient’s pulse is 55 this morning. What action should the medication aide take next?
A. Administer it anyway since a pulse of 55 is close enough to 60
B. Hold the medication and document it
C. Hold the medication, document it and immediately notify the patient’s nurse
D. Hold the medication, document it, and recheck the patient’s pulse to see if it reaches 60 beats per minute later in the morning
ANSWER: C
RATIONALE: It is common for some doctors to include vital sign parameters when ordering cardioactive medications that affect the heart rate and/or blood pressure. If the patient’s heart rate or blood pressure readings are less than the parameters associated with a medication order, the medication aide should hold the medication, document the action, and immediately notify the nurse.
Administering the medication could harm the patient by adversely affecting the heart rate. The prudent medication aide would not simply hold a medication and just document it without notifying the nurse because a low pulse may or may not signify a change in the patient’s usual condition.
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