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Adams and Urban, Pharmacology: Connections to Nursing Practice, 3e Test
Bank
Chapter 6
Question 1
Type: MCMA
The nursing instructor teaches the students how medication errors can occur. Which common causes of errors will
the instructor discuss?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. The nurse does not validate a written order with the health care provider.
2. The nurse administers the incorrect drug.
3. The nurse miscalculates the medication dose.
4. The nurse misinterprets a health care provider’s order.
5. The nurse does not check the client’s identification band.
Correct Answer: 2,3,4,5
Rationale 1: As long as the health care provider’s order is clear, there is no need to validate a written order.
Rationale 2: Medication errors can be related to misadministration.
Rationale 3: Medication errors can be related to miscalculations.
Rationale 4: Medication errors can be related to misinterpretations.
Rationale 5: Not correctly identifying a client may lead to giving the wrong client the medication.
Global Rationale: Medication errors can be related to misadministration, miscalculations, and misinterpretations.
Not correctly identifying a client may lead to giving the wrong client the medication. As long as the health care
provider’s order is clear, there is no need to validate a written order.
Cognitive Level: Analyzing

Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
QSEN Competencies: V.B.1 Demonstrate effective use of technology and standardized practices that support safety
and quality
AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human
growth and development, pathophysiology, pharmacology, medical management and nursing management across the
health-illness continuum, across lifespan, and in all healthcare settings
Adams and Urban, Pharmacology: Connections to Nursing Practice, 3e Test Bank

Copyright 2016 by Pearson Education, Inc.
NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe
patient care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 6-1 Critique the following statement: “All medication errors can be prevented.”
MNL Learning Outcome: 1.1.2 Apply key principles related to safe drug administration.
Page Number:
Question 2
Type: MCSA
Drug administration is a multiple, complex process that involves more than one person. The potential for a
medication error can occur during any step in that process. Which individual would not be involved in the
process?
1. Pharmacist
2. Health care provider
3. Client
4. Nurse manager
Correct Answer: 4
Rationale 1: The pharmacist is always involved in the process.
Rationale 2: The health care provider is always involved in the process.
Rationale 3: The client is always involved in the process.
Rationale 4: The nurse manager would only be involved in the process if there were a problem on the unit with
medication administration.
Global Rationale: The nurse manager would only be involved in the process if there were a problem on the unit
with medication administration. The pharmacist, health care provider, ad client are always involved in the
process.
Cognitive Level: Understanding

Client Need Sub: Pharmacological and Parenteral Therapies
and quality
AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human
growth and development, pathophysiology, pharmacology, medical management and nursing management across the
health-illness continuum, across lifespan, and in all healthcare settings
patient care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 6-1 Critique the following statement: “All medication errors can be prevented.”
Page Number:
Question 3
Type: MCMA
The nurse makes a medication error, but the client is not harmed. The client’s family asks the nurse manager what
is considered a medication error. Which are potential responses by the nurse manager?
1. Failure to follow health care provider’s orders
2. Failure to give the right medication
3. Failure to give a medication at the ordered time
4. Failure to call the pharmacy and report that the medication has been given
5. Failure to give the right dose of the medication
Rationale 1: In this medication error, the client does not receive the drug as the health care provider intended it to
be given.
Rationale 2: In this medication error, the client does not receive the drug the health care provider intended to be
given.
Rationale 3: In this medication error, the client does not receive the drug at the time the health care provider
intended it to be given.
Rationale 4: The delivery of the medication is recorded on the medical administration record (MAR); the nurse
does not report to the pharmacy each time a medication has been given.
Rationale 5: In this medication error, the client does not receive the dose of the drug the health care provider
intended to be given.
Global Rationale: Medication errors include the wrong drug being administered, the wrong route being used, the
wrong time, and the wrong dose. The delivery of the medication is recorded on the medical administration record
(MAR); the nurse does not report to the pharmacy each time a medication has been given.

and quality
AACN Essential Competencies: II.7. Promote factors that create a culture of safety and caring
patient care
Learning Outcome: 6-3 Using specific examples, analyze major types of medication errors and how they can be
prevented.
Page Number:
Question 4
Type: MCSA
The nurse in the emergency department miscalculates, and administers the wrong dosage of an antibiotic to a 9-
month-old baby. As a result, the baby suffers permanent brain damage. Which factor most likely contributed to
the error?
1. Lack of adequate oral or written communication
2. Name confusion involving similar-sounding drugs
3. Mislabeled products
4. Human factors
Correct Answer: 4
Rationale 1: Lack of communication is not indicated in the scenario.
Rationale 2: There is no indication of name confusion.
Rationale 3: There is no indication the products were inappropriately labeled.
Rationale 4: This was a human factor. The dosage was miscalculated.
Global Rationale: This was a human factor. The dosage was miscalculated. Lack of communication is not
indicated in the scenario. There is no indication of name confusion or that the products were inappropriately
labeled.

and quality
patient care
prevented.
Page Number:
Question 5
Type: MCSA
The FDA uses the information reported to it on specific types and incidences of medication errors to determine
contributing factors. Which factor would be included on this list?
1. Never taking a verbal or phone order without receiving a written order before administering the drug
2. Performing an agency system check
3. Failure to account for client variables
4. Following the rights of drug administration
Correct Answer: 3
Rationale 1: Taking a verbal or phone order without receiving a written order before administering the drug
would be incorrect procedure.
Rationale 2: Performing an agency system check is correct procedure.
Rationale 3: Variables such as age, body size, and renal and hepatic function must be assessed and taken into
account when administrating medications.
Rationale 4: Following the rights of drug administration is correct procedure.
Global Rationale: Variables such as age, body size, and renal and hepatic function must be assessed and taken
into account when administrating medications. Taking a verbal or phone order without receiving a written order
before administering the drug would be incorrect procedure. Performing an agency system check is correct
procedure. Following the rights of drug administration is correct procedure
Cognitive Level: Remembering

and quality
patient care
prevented.
Page Number:
Question 6
Type: MCSA
The FDA uses the information reported to it on specific types and incidences of medication errors to determine
contributing factors. What is a common factor involving the client or caregiver?
1. Taking medications as the practitioner has ordered
2. Never trading drugs with anyone
3. Taking drugs prescribed by more than one practitioner
4. Filling prescriptions at several pharmacies
Correct Answer: 4
Rationale 1: Taking medications as the practitioner has ordered is correct procedure.
Rationale 2: Never trading drugs with anyone is correct procedure.
Rationale 3: It is safe for the client to take drugs prescribed by more than one practitioner as long as each
practitioner is aware of all the drugs the client is taking.
Rationale 4: Pharmacists are the key members of the health care team who can recognize potential drug
interactions and adverse effects.
Global Rationale: Pharmacists are the key members of the health care team who can recognize potential drug
interactions and adverse effects. Taking medications as the practitioner has ordered and never trading medications
with anyone are both correct procedure. It is safe for the client to take drugs prescribed by more than one
practitioner as long as each practitioner is aware of all the drugs the client is taking.

and quality
patient care
prevented.
Page Number:
Question 7
Type: MCSA
The nurse administers an evening medication to the client in the morning. The medication did go to the correct
client. What is the nurse’s best course of action at this time?
1. Notify the health care provider to ask if any further action needs to be taken.
2. Notify the health care provider about the error, and complete an incident report.
3. Tell the evening nurse to hold the evening dose just for tonight.
4. Change the medication administration time to the morning.
Correct Answer: 2
Rationale 1: There is no need to ask the health care provider if any further action needs to be taken. An incident
report must be completed.
Rationale 2: The health care provider must be notified of the medication error and an incident report must be
completed.
Rationale 3: The health care provider will decide if the evening dose should be held.
Rationale 4: The time for medication administration cannot be changed without an order from the health care
provider.
Global Rationale: The health care provider must be notified of the medication error and an incident report must
be completed. There is no need to ask the health care provider if any further action needs to be taken. The health
care provider will decide if the evening dose should be held. The time for medication administration cannot be
changed without an order from the health care provider.

QSEN Competencies: V.B.2 Demonstrate effective use of strategies to reduce risk of harm to self or others
AACN Essential Competencies: IV.1. Demonstrate skills in using patient care technologies, information systems, and
communication devices that support safe nursing practice
patient care
Learning Outcome: 6-4 Describe procedures for reporting and documenting medication errors and incidents.
Page Number:
Question 8
Type: MCSA
The nurse commits a medication error. The nurse documents the error in the client’s record and completes the
incident report. What does the nurse recognize as the primary reason for this action?
1. To protect the nurse from liability
2. To verify that the client’s safety was protected

3. To protect the client from further harm
4. To protect the healthcare facility from litigation
Correct Answer: 2
Rationale 1: Documentation of an error does not necessarily protect the nurse from liability.
Rationale 2: Documentation in the client’s medical record and completion of an incident report verify that the
client’s safety was protected.
Rationale 3: The client has been harmed; the documentation will not protect the client from further harm.
Rationale 4: Documentation of an error does not necessarily protect the healthcare facility from litigation.
Global Rationale: Documentation in the client’s medical record and completion of an incident report verify that
the client’s safety was protected. Documentation of an error does not necessarily protect the nurse from liability.
The client has been harmed; the documentation will not protect the client from further harm. Documentation of an
error does not necessarily protect the healthcare facility from litigation.
Cognitive Level: Applying

patient care
Page Number:
Question 9
Type: MCSA
The nurse assesses an adverse effect of a medication that has been administered. No medication error was
committed. To which federal database would the nurse report the adverse effect?
1. The Food and Drug Administration’s (FDA) Safe Medicine
2. The Food and Drug Administration’s (FDA) MedWatch
3. The Food and Drug Administration’s (FDA) Institute for Safe Medication Practices (ISMP)
4. The Centers for Disease Control (CDC)
Correct Answer: 2

Rationale 1: Safe Medicine is a consumer newsletter produced by the ISMP.
Rationale 2: Adverse events with medication should be reported to the FDA’s Safety Information and Adverse
Event Reporting Program, known as MedWatch.
Rationale 3: The ISMP is a nonprofit agency that helps standardize medication reporting systems and promote
medication safety.
Rationale 4: The FDA, not the CDC, coordinates the reporting of medication errors at the federal level.
Global Rationale: Adverse events with medication should be reported to the FDA’s Safety Information and
Adverse Event Reporting Program, known as MedWatch. Safe Medicine is a consumer newsletter produced by the
ISMP. The ISMP is a nonprofit agency that helps standardize medication reporting systems and promote
medication safety. The FDA, not the CDC, coordinates the reporting of medication errors at the federal level.

patient care
Page Number:
Question 10
Type: MCSA
The nurse recognizes that agency system checks are in place to decrease medication errors. Who commonly
collaborates with the nurse on checking the accuracy of the medication prior to administration?
1. The nursing supervisor
2. The pharmacist
3. The health care provider
4. The nursing unit manager
Correct Answer: 2
Rationale 1: The nursing supervisor does not commonly collaborate with the nurse on the accuracy of the
medication prior to administration.
Rationale 2: Pharmacists and nurses must collaborate on checking the accuracy and appropriateness of drug
orders prior to client administration.
Rationale 3: The health care provider does not commonly collaborate with the nurse on the accuracy of the
Rationale 4: The nursing unit manager does not commonly collaborate with the nurse on the accuracy of the
Global Rationale: Pharmacists and nurses must collaborate on checking the accuracy and appropriateness of drug
orders prior to client administration. The nursing supervisor does not commonly collaborate with the nurse on the
accuracy of the medication prior to administration. The health care provider does not commonly collaborate with
the nurse on the accuracy of the medication prior to administration. The nursing unit manager does not commonly
collaborate with the nurse on the accuracy of the medication prior to administration.

AACN Essential Competencies: II.5. Participate in quality and patient safety initiatives, recognizing that these are complex
system issues, which involve individuals, families, groups, communities, populations and other members of the healthcare
team
patient care

Learning Outcome: 6-5 Explain how rules, policies, and procedures can help prevent medication errors.
Page Number:
Question 11
Type: MCSA
The nurse was very busy and unfamiliar with a new medication, but administered it anyway. Later the nurse
looked up the medication. How would the nurse manager evaluate this behavior?
1. An error did occur because the nurse could have administered the medication via the incorrect route.
2. This was acceptable as long as the nurse looked up the action and side effects of the drug at some point.
3. The nurse manager was partially at fault because the nursing unit was understaffed and the nurse was too busy.
4. An error could have occurred because the nurse was unfamiliar with the medication.
Correct Answer: 4
Rationale 1: An error could have occurred, but not necessarily because of the route of administration.
Rationale 2: Nurses should never administer a medication unless they are familiar with its uses and side effects;
an error could have occurred because the nurse was unfamiliar with the medication.

Rationale 3: There is no information in the question to indicate that the nursing unit was understaffed; therefore
the nursing manager is not partially at fault.
Rationale 4: An error did not occur, but could have because the nurse was not familiar with the medication.
Global Rationale: An error did not occur, but could have because the nurse was not familiar with the medication.
An error could have occurred, but not necessarily because of the route of administration. Nurses should never
administer a medication unless they are familiar with its uses and side effects; an error could have occurred
because the nurse was unfamiliar with the medication. There is no information in the question to indicate that the
nursing unit was understaffed; therefore the nursing manager is not partially at fault.

AACN Essential Competencies: II.9. Apply quality improvement processes to effectively implement patient safety
initiatives and monitor performance measures, including nurse-sensitive indicators in the microsystem of care
patient care
Learning Outcome: 6-6 Develop a list of strategies that the nurse can implement in practice to reduce medication
errors.
Page Number:
Question 12
Type: MCSA
The nurse is preparing medications for a group of clients. Another nurse begins telling the nurse about her recent
engagement. What is the best plan of action by the first nurse?
1. Tell the second nurse that the conversation is distracting and must cease while medications are being prepared.
2. Ask the second nurse to help with administering medications so they can have more time to talk.
3. Continue to prepare the medications for administration and pretend to listen to the first nurse.
4. Stop preparing medications until the first nurse has finished talking about her engagement.
Correct Answer: 1
Rationale 1: When preparing medications, the nurse must focus entirely on the task at hand, and instruct others
who are talking to stop.
Rationale 2: It is inappropriate to ask another nurse to help with medications so there is more time to talk.
Rationale 3: Pretending to listen to the second nurse’s conversation would be distracting.
Rationale 4: The nurse cannot stop preparing medications; the clients must receive them on time.
Global Rationale: When preparing medications, the nurse must focus entirely on the task at hand, and instruct
others who are talking to stop. It is inappropriate to ask another nurse to help with medications so there is more
time to talk. Pretending to listen to the second nurse’s conversation would be distracting. The nurse cannot stop
preparing medications; the clients must receive them on time.

patient care
errors.
Page Number:
Question 13
Type: MCMA
The nurse is working hard to prevent medication errors. Which plans will assist the nurse in preventing most
errors?
1. Plan to validate all orders with another nurse prior to administration of medications.
2. Plan to assess for patient variables such as age, weight, and diagnostic lab studies prior to administration.
3. Plan to tell health care providers that verbal orders will not be accepted.
4. Plan to always check the client’s identification band prior to administration of medications.
5. Plan to record the medication on the medication administration record (MAR) immediately prior to
administration.
Correct Answer: 2,3,4
Rationale 1: Only high-risk drugs (e.g., insulin) need to be validated with another nurse. It is okay to validate any
drug with another nurse if the nurse giving the medications wants a second opinion.
Rationale 2: Nurses should always account for patient variables such as age, weight, and any diagnostic studies
that may impact the administration of medication.

Rationale 3: Requiring a written medication order also reduces the possibility of an error related to similar-
sounding drug names.
Rationale 4: This is one of the five rights of drug administration to prevent errors.
Rationale 5: Medications should never be documented on the MAR until they have been administered.
Documenting anything prior to the actual event is false documentation.
Global Rationale: Nurses should always account for patient variables such as age, weight, and any diagnostic
studies that may impact the administration of medication. Requiring a written medication order also reduces the
possibility of an error related to similar-sounding drug names. Checking the client identification band is one of the
rights of drug administration to prevent errors. Only high-risk drugs (e.g., insulin) need to be validated with
another nurse. It is okay to validate any drug with another nurse if the nurse giving the medications wants a
second opinion. Medications should never be documented on the MAR until they have been administered.
Documenting anything prior to the actual event is false documentation.
Cognitive Level: Evaluating

patient care
Nursing/Integrated Concepts: Nursing Process: Planning
errors.
Page Number:
Question 14
Type: MCSA
The nurse is working hard to prevent medication errors. Which intervention would assist the nurse in preventing
most errors using the assessment step of the nursing process?
1. Be aware of stressful situations and distractions during medication administration.
2. Assess the client for expected outcomes and determine if any adverse side effects have occurred.
3. Ask the client about food or medication allergies, including OTC medications and herbal supplements.
4. Avoid using abbreviations that could be misunderstood.
Correct Answer: 3
Rationale 1: This is part of the implementation step of the nursing process.
Rationale 2: This part of the evaluation step of the nursing process.

Rationale 3: This is part of the assessment step of the nursing process.
Rationale 4: This is part of the planning step of the nursing process.
Global Rationale: Asking the client about food or medication allergies, including OTC medications and herbal
supplements, is part of the assessment step of the nursing process. The other options illustrate other steps of the
nursing process, not assessment.

patient care
errors.
Page Number:
Question 15
Type: MCSA
It is common for older clients to receive multiple prescriptions that might have conflicting pharmacological
actions. What is the term for keeping track of the client’s medications as the client moves through the health care
system?
1. Assessment
2. Medication transition
3. Pharmacological evaluation
4. Medication reconciliation
Correct Answer: 4
Rationale 1: Assessment is the first step of the nursing process.
Rationale 2: This is not the correct term for this process.
Rationale 3: This is not the correct term for this process.
Rationale 4: Medication reconciliation is the process of tracking clients’ medications as they progress through the
health care system.

Global Rationale: Medication reconciliation is the process of tracking clients’ medications as they progress
through the health care system. The other terms do not describe this process.

Client Need: Safe Effective Care Environment
Client Need Sub: Safety and Infection Control
and quality
AACN Essential Competencies: IV.3. Apply safeguards and decision making support tools embedded in patient care
technologies and information systems to support a safe practice environment for both patients and healthcare workers
patient care
Learning Outcome: 6-7 Explain how medication reconciliation can lead to a reduction in medication errors.
Page Number:
Question 16
Type: MCSA
The nurse is instructing a client about how to help prevent medication errors while in the hospital. What is a
priority question for the nurse to ask the client?
1. “Do you know what your illness is, and if you will need surgery?”
2. “Do you have a friend to verify that you are receiving the correct medication?”
3. “Do you trust your health care provider to order the correct medication?”
4. “Do you know the names of all the medications you take?”
Correct Answer: 4
Rationale 1: Knowing the illness, and anticipating surgery, will not necessarily help prevent medication errors.
Rationale 2: It is inappropriate for friends of clients to verify medications prior to administration.
Rationale 3: This is an inappropriate question to ask the client.
Rationale 4: Knowing the names of all the medications the client is taking can help reduce medication errors
when the client is admitted to the hospital.
Global Rationale: Knowing the names of all the medications the client is taking can help reduce medication
errors when the client is admitted to the hospital. Knowing the illness, and anticipating surgery, will not
necessarily help prevent medication errors. It is inappropriate for friends of clients to verify medications prior to
administration. The other answer option is an inappropriate question to ask the client.

QSEN Competencies: I.B.15 Communicate care provided and needed at each transition in care
AACN Essential Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture,
spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care
patient care
Learning Outcome: 6-8 Design patient teaching information that can be used to reduce medication errors.
Page Number:
Question 17
Type: MCSA
The nurse is instructing a client about how to prevent medication errors after discharge from the hospital. What is
a priority recommendation the nurse should make?
1. Ask questions about drug safety. Health care providers should be partners in maintaining safe medication
principles.
2. Remember that OTC and herbal supplements are not considered medications. They cannot cause any harm.
3. It is okay to use household measuring devices to measure medications. These devices yield the same
measurements that are used by professionals.
4. Do not question the medications received from the pharmacist. The pharmacist is a professional and should not
be questioned.
Correct Answer: 1
Rationale 1: This recommendation will help to reduce medication errors. Working together to understand
information is an important process in medication reconciliation.
Rationale 2: OCT and herbal supplements are medications that can interact adversely with prescribed
medications.
Rationale 3: Household measures and metric measures are not the same. Using household measures could result
in medication errors.
Rationale 4: Clients should ask questions if the medications look different, or if they do not understand the
instructions for taking them. This action reduces medication errors.
Global Rationale: Asking questions and working with the health care provider to understand information is an
important process in medication reconciliation. OCT and herbal supplements are medications that can interact
adversely with prescribed medications. Household measures and metric measures are not the same. Using
household measures could result in medication errors. Clients should ask questions if the medications look
different, or if they do not understand the instructions for taking them. This action reduces medication errors.

patient care
Page Number:
Question 18
Type: MCSA
The nurse is discharging a client from the hospital. Which is a priority intervention for the nurse at this time?
1. On discharge from the facility, the nurse should provide the client with a complete list of medications to be
taken, as well as instructions on how to take any newly prescribed medications.
2. The nurse should consult the client’s pharmacy and inform the pharmacist that the client is being discharged.
3. The nurse should call a friend to come before giving discharge instructions to the client.
4. The nurse should inform the client’s primary health care provider that the client is being discharged.
Correct Answer: 1
Rationale 1: This intervention will help to reduce medication errors because the client is better informed about
the medications.
Rationale 2: The nurse does not inform the client’s pharmacy of the discharge.
Rationale 3: It is inappropriate for the client’s friends to be there when discharge instructions are being given.
Rationale 4: The primary health care provider’s order would have been required to discharge the client.
Global Rationale: Providing a complete list of medications upon discharge will help to reduce medication errors
because the client is better informed about the medications. The nurse does not inform the client’s pharmacy of
the discharge. It is inappropriate for the client’s friends to be there when discharge instructions are being given.
The primary health care provider’s order would have been required to discharge the client.


patient care
Page Number:
Question 19
Type: MCSA
The nurse is working in the risk management department to examine risks and minimize the number of
medication errors. Which intervention can the nurse put in place to prevent errors?
1. Make sure there is an overstock of all medications to ensure availability.
2. Remove outdated reference books.
3. Store all medication in well-lighted areas.
4. Transfer all small amounts of medications into smaller containers to save space.
Correct Answer: 2
Rationale 1: Overstocking results in an increase in expired medications.
Rationale 2: Current reference books ensure current information, reducing medication errors.
Rationale 3: Medications should not be stored in the light or in extreme temperatures.
Rationale 4: Medications must be left in their original containers to prevent mixing up medications.
Global Rationale: Current reference books ensure current information, reducing medication errors. Overstocking
results in an increase in expired medications. Medications should not be stored in the light or in extreme
temperatures. Medications must be left in their original containers to prevent mixing up medications.

and quality
AACN Essential Competencies: II.11 Employ principles of quality improvement, healthcare policy, and cost-effectiveness to
assist in the development and initiation of effective plans for the microsystem and/or system-wide practice improvements
that will improve the quality of healthcare delivery
patient care
Learning Outcome: 6-9 Identify strategies
that health care agencies use to prevent medication errors.
Page Number:
Question 20
Type: MCSA
The nurse is on a committee to reduce medication errors in a large healthcare facility. Which strategy can the
nurse recommend that is being adopted in many healthcare facilities?
1. Use robots to prepare all medications for administration by the nurse.
2. Use automated, computerized cabinets on all nursing units.
3. Designate nurses whose only function is to administer medication.
4. Train medication technicians to administer medications.
Correct Answer: 2
Rationale 1: Healthcare agencies are not planning for the use of robots in medication preparation.
Rationale 2: Healthcare agencies are using automated, computerized cabinets to reduce medication errors.
Rationale 3: Healthcare agencies are not planning to designate nurses to do only medication administration.
Rationale 4: Healthcare agencies are not planning to train technicians whose sole function would be to administer
medications.
Global Rationale: Healthcare agencies are using automated, computerized cabinets to reduce medication errors.
Healthcare agencies are not planning for the use of robots in medication preparation. Healthcare agencies are not
planning to designate nurses to do only medication administration. Healthcare agencies are not planning to train
technicians whose sole function would be to administer medications.

and quality
patient care
Learning Outcome: 6-9 Identify strategies that health care agencies use to prevent medication errors.
Page Number:
Question 21
Type: MCMA
A nurse on the medical–surgical unit is caring for several very ill clients. One client says, “I was supposed to get
my medications an hour ago.” The nurse recognizes that medication errors can have what repercussions?
1. Medication errors can potentially extend the client’s length of hospital stay.
2. Medication errors can result in expensive legal costs to the facility.
3. Medication errors can damage the facility’s reputation.
4. Medication errors can be physically devastating to nurse and client.
5. Medication errors cause preventable deaths during hospitalizations.
Rationale 1: Medication errors can cause harm, which can extend the client’s length of stay.
Rationale 2: If a medication error causes harm to a client, it can result in expensive legal fees for hospital
defense.
Rationale 3: If the incidence of medication errors is publicized, it can cause the facility to be seen as unsafe or to
be delivering substandard care.
Rationale 4: Medication errors can be physically devastating to clients but would be emotionally devastating to
the nurse.
Rationale 5: Medication errors are the most common cause of morbidity and preventable death within hospitals.
Global Rationale: Medication errors can cause harm, which can extend the client’s length of stay. If a medication
error causes harm to a client, it can result in expensive legal fees for hospital defense. If the incidence of
medication errors is publicized, it can cause the facility to be seen as unsafe or to be delivering substandard care.
Medication errors are the most common cause of morbidity and preventable death within hospitals. Medication
errors can be physically devastating to clients but would be emotionally devastating to the nurse.

QSEN Competencies: II.A.2 Describe scopes of practice and roles of health care team members
AACN Essential Competencies: II.2. Demonstrate leadership and communication skills to effectively implement patient
safety and quality improvement initiatives within the context of the interprofessional team
patient care
Learning Outcome: 6-2 Describe the impact of a medication error on all aspects of health care delivery,
including patients, nurses, and health care agencies.
Page Number:
Question 22
Type: MCMA
A new nurse on the orthopedic unit makes a medication error. Which statements by the nurse manager foster a
safe environment in which nurses will report medication errors?
1. “Many of us have made a medication error in our careers. The most important issue is to identify why the error
occurred.”
2. “I know you could not feel any worse than you already do. We need to discuss how this error happened and
how we can prevent it from happening again.”
3. “It’s really good that your patient is okay and did not suffer any harmful effects of this error. We should discuss
why this error occurred and how it can be prevented in the future.”
4. “Because you are a new nurse, we should sit down and discuss the procedure you followed to see what you
could have done to prevent this error.”
5. “We need to sit down as soon as possible and write up an incident report describing everything you did
incorrectly that caused this error.”
Rationale 1: All errors should be investigated with the goal of identifying why they occurred. This investigation
should be done in a manner that is not punitive and will encourage staff to report errors without fear of
punishment.
punishment.
punishment.

punishment.
Rationale 5: An incident report will need to be written, but the nurse who made the error should feel the report
would identify factors contributing to the error rather than place blame.
Global Rationale: All errors should be investigated with the goal of identifying why they occurred. This
investigation should be done in a manner that is not punitive and will encourage staff to report errors without fear
of punishment. An incident report will need to be written, but the nurse who made the error should feel the report
would identify factors contributing to the error rather than place blame.

and quality
patient care
prevented.
Page Number:
Question 23
Type: MCMA
A community health nurse is preparing a teaching plan regarding medications and safety for a new parent class.
Which topics should be addressed?
1. Parents should maintain a list of current medications for each child.
2. Parents should be aware of each child’s medication allergies.
3. Parents should know what the child’s prescribed medication is for, how it should be administered, and when to
expect the child to feel better.
4. Parents should be aware that any leftover medication should be appropriately disposed of, not saved for future
use.
5. Parents should read the drug label for any foods the child should avoid while taking the medication and for
possible adverse effects to watch out for.
Rationale 1: Parents should make a complete list of all prescribed medications, over-the-counter drugs, and any
vitamins the child takes.
Rationale 2: It is very important that parents be aware of a child’s allergies in order to prevent an unnecessary
allergic response.
Rationale 3: Parents should know what condition the child’s medication is prescribed for, and how, when, and
how much to administer. It is also important for parents to know when to expect the child to feel better so a
follow-up visit can be made if the child is not feeling better.
Rationale 4: Parents should be aware that it is not safe to self-diagnose and treat with leftover medication.
Rationale 5: Parents should be aware the label often describes food and drinks to avoid. The label will not
describe possible adverse effects; the nurse will need to describe these to the parents.
Global Rationale: Parents should make a complete list of all prescribed medications, over-the-counter drugs, and
any vitamins the child takes. It is very important that parents be aware of a child’s allergies in order to prevent an
unnecessary allergic response. Parents should know what condition the child’s medication is prescribed for, and
how, when, and how much to administer. It is also important for parents to know when to expect the child to feel
better so a follow-up visit can be made if the child is not feeling better. Parents should be aware that it is not safe
to self-diagnose and treat with leftover medication. Parents should be aware the label often describes food and
drinks to avoid. The label will not describe possible adverse effects; the nurse will need to describe these to the
parents.

patient care
Page Number:
Question 24
Type: MCMA
A community health nurse working with a group of migrant workers is reinforcing instruction on how to avoid
medication errors. What should the nurse encourage clients to do in order to avoid medication errors?

1. Have all medications filled at the same pharmacy.
2. Let the health care provider know if they have difficulty acquiring their medications.
3. Ask questions about how and when to take medications if they are unsure.
4. Take all the medication as directed, and not to save the medication for a future illness.
5. Ask friends or family if they have any of the same medication and are willing to share it with the client.
Rationale 1: The pharmacist can recognize possible drug interactions if all medications are filled at one
pharmacy.
Rationale 2: Many indigent clients do not have the means to fill prescriptions and may be embarrassed to tell the
health care provider.
Rationale 3: Taking the wrong amount of medication at the wrong time is a very common medication error.
Rationale 4: The nurse should emphasize the importance of taking all the prescribed medication as directed.
Rationale 5: It is never safe to share medications.
Global Rationale: The pharmacist can recognize possible drug interactions if all medications are filled at one
pharmacy. Many indigent clients do not have the means to fill prescriptions and may be embarrassed to tell the
health care provider. Taking the wrong amount of medication at the wrong time is a very common medication
error. The nurse should emphasize the importance of taking all the prescribed medication as directed. It is never
safe to share medications.

patient care
Page Number:
Question 25
Type: MCMA
The nurse is preparing a teaching plan for an older adult client who is taking multiple medications. Which
principles should the nurse keep in mind during the planning phase?

1. The client should use only one pharmacy to fill prescriptions.
2. The client should keep a list of all medications for easy accessibility.
3. Polypharmacy is a common cause of medication errors in older clients.
4. Polypharmacy is unique to older clients and is the most common cause of medication errors.
5. The client should be aware of each prescribed medication, the dose, and possible side effects.
Rationale 1: It is common for older clients to have medical conditions requiring the use of multiple medications
that could have possible interactions. Using one pharmacy will ensure the pharmacist will discover any
problematic interactions between multiple drugs.
Rationale 2: Keeping a list available is important for unexpected trips to a healthcare facility.
Rationale 3: The use of multiple drugs for multiple chronic conditions is a common cause for medications errors
in older clients.
Rationale 4: Polypharmacy is not unique to older clients, although it is most often seen in this group.
Rationale 5: Knowing the names, dose, and possible side effects of medications will reduce the risk for
medication errors.
Global Rationale: It is common for older clients to have medical conditions requiring the use of multiple
medications that could have possible interactions. Using one pharmacy will ensure the pharmacist will discover
any problematic interactions between multiple drugs. Keeping a list available is important for unexpected trips to
a healthcare facility. The use of multiple drugs for multiple chronic conditions is a common cause for medications
errors in older clients. Knowing the names, dose, and possible side effects of medications will reduce the risk for
medication errors. Polypharmacy is not unique to older clients, although it is most often seen in this group.

patient care
Page Number:
Question 26
Type: MCMA
During a staff meeting, a nurse asks how risk management reduces medication errors in the facility. Which
statements by the director of the risk management department accurately describe its functions?
1. “We examine each reported incident to determine risks that could have contributed to the error.”
2. “We investigate each incident report to determine strategies that may be helpful to decrease the risk for
medication errors.”
3. “We use data from reported incidences to identify common themes that may increase the risk for medication
errors.”
4. “We use data to make changes in policies and procedures that may prevent medication errors.”
5. “We track data to determine if specific nurses are making errors so we can notify the nursing board.”
Rationale 1: Risk management personnel investigate reported incidents to determine the cause or causes for
medication errors.
Rationale 2: Risk management personnel use data from incident reports to recommend strategies that may
decrease medication errors.
Rationale 3: Risk management personnel use the information from incident reports to identify common factors
that increase the risk for medication errors.
Rationale 4: Risk management personnel recommend strategies to decrease medication errors based on
information gained during the investigation.
Rationale 5: Risk management personnel use data from the investigation to recommend strategies to prevent
medication errors, not to report nurses to the nursing board.
Global Rationale: Risk management personnel investigate reported incidents to determine the cause or causes for
medication errors; use data from incident reports to recommend strategies that may decrease medication errors;
use the information from incident reports to identify common factors that increase the risk for medication errors;
recommend strategies to decrease medication errors based on information gained during the investigation. Risk
management personnel use data from the investigation to recommend strategies to prevent medication errors, not
to report nurses to the nursing board.

and quality
patient care
Learning Outcome: 6-9 Identify strategies that health care agencies use to prevent medication errors
Page Number:
Question 27
Type: MCMA
A new nurse on the pediatric unit is very nervous about making a medication error. Which statements by a more
experienced nurse are accurate?
1. “One of the main causes of medication errors is the human factor. So, just be sure you ask for help if you are
not sure about a dosage calculation.”
2. “If you are not sure you are reading an order correctly, always call the provider and ask. This will keep you
from misinterpreting an order.”
3. “Our facility has a list of drugs that have similar names that have contributed to medication errors in the past.
You might want to take a look at those so you will be aware of them.”
4. “You really don’t have to look at the diagnostic lab work from yesterday. It has been charted in the nurse’s
notes.”
5. “As long as two nurses take a phone order, it does not have to be written by the health care provider.”
Rationale 1: It is important to double-check any calculations that the nurse may be unsure about with another
nurse or the pharmacist.
Rationale 2: The nurse must always call the health care provider to confirm or clarify any orders that may be in
question.
Rationale 3: Medications with similar names are a common cause for medication errors. If the facility has a list, it
would be good for the new nurse to see what they are.

Rationale 4: Nurses should always review recent diagnostic lab work. The previous nurse could have misread the
lab work.
Rationale 5: Orders must be in writing before any medication can be administered.
Global Rationale: It is important to double-check any calculations that the nurse may be unsure about with
another nurse or the pharmacist. The nurse must always call the health care provider to confirm or clarify any
orders that may be in question. Medications with similar names are a common cause for medication errors. If the
facility has a list, it would be good for the new nurse to see what they are. Nurses should always review recent
diagnostic lab work. The previous nurse could have misread the lab work. Orders must be in writing before any
medication can be administered.

patient care
errors.
Page Number:
Question 28
Type: MCMA
A nurse preparing to give medications to clients in the emergency department avoids making medication errors by
following drug administration rights. Which “rights” did the nurse use?
1. Evaluating the client following drug administration.
2. Assessing the client prior to administering any drug.
3. Documenting all medications immediately following administration.
4. Educating the client regarding medications.
5. Administering prescribed medication even if the client refuses it.
Rationale 1: Right evaluation following drug administration is one of the 10 rights of drug administration.
Rationale 2: Right assessment prior to drug administration is one of the 10 rights of drug administration.
Rationale 3: Right documentation is one of the 10 rights of drug administration.
Rationale 4: Right client education is one of the 10 rights of drug administration.
Rationale 5: All clients have the right to refuse medication. This is one of the 10 rights of drug administration.
Global Rationale: Right evaluation following drug administration, right assessment, right documentation, and
right client education are all one of the 10 rights of drug administration. All clients have the right to refuse
medication. This is also one of the 10 rights of drug administration.

patient care
errors.
Page Number:
Question 29
Type: MCMA
The nurse makes a medication error. The nurse manager determines the error was based on a common
misinterpretation of which abbreviation?
1. IU
2. SQ
3. Q.O.D.
4. U
5. mcg

Rationale 1: This is the abbreviation for international unit but can be mistaken for IV or 10. The prescriber
should write out “international unit.”
Rationale 2: This is the abbreviation for subcutaneous but can be mistaken for 5q or 5 every. The prescriber
should write out “subcutaneous.”
Rationale 3: This is the abbreviation for every other day but can be mistaken for every day or four times a day.
The prescriber should write out “every other day.”
Rationale 4: This is the abbreviation for unit but can be mistaken for 4. The prescriber should write out “unit.”
Rationale 5: This abbreviation for microgram is not commonly misinterpreted.
Global Rationale: IU is the abbreviation for international unit but can be mistaken for IV or 10. The prescriber
should write out “international unit.” SQ is the abbreviation for subcutaneous but can be mistaken for 5q or 5
every. The prescriber should write out “subcutaneous.” Q.O.D. is the abbreviation for every other day but can be
mistaken for every day or four times a day. The prescriber should write out “every other day.” U is the
abbreviation for unit but can be mistaken for 4. The prescriber should write out “unit.” Mcg is abbreviation for
microgram is not commonly misinterpreted.

initiatives and monitor performance measures, including nurse-sensitive indicators in the microsystem of care.
patient care
errors.
Page Number:
Question 30
Type: MCMA
The nurse has returned from an in-service in which “high-alert” drugs were discussed. For which drugs should the
nurse be particularly alert?
1. IV epinephrine
2. Heparin
3. Digoxin
4. IV morphine
5. Oral propranolol
Rationale 1: An incorrect dose of IV epinephrine can result in a dangerous dysrhythmia.
Rationale 2: An incorrect dose of heparin can cause a client to hemorrhage.
Rationale 3: Digoxin has a narrow therapeutic range and is considered a high-alert drug.
Rationale 4: An incorrect dose of IV morphine can stop a client’s respirations, resulting in death.
Rationale 5: IV, not oral, propranolol is on the high-alert list. Giving an incorrect dose of propranolol IV can
result in hypotension and circulatory collapse.
Global Rationale: An incorrect dose of IV epinephrine can result in a dangerous dysrhythmia. An incorrect dose
of heparin can cause a client to hemorrhage. Digoxin has a narrow therapeutic range and is considered a high-alert
drug. An incorrect dose of IV morphine can stop a client’s respirations, resulting in death. IV, not oral,
propranolol is on the high-alert list. Giving an incorrect dose of propranolol IV can result in hypotension and
circulatory collapse.

and quality
patient care
Learning Outcome: 6-9 Identify strategies that health care agencies use to prevent medication errors.
Page Number:
Question 31
Type: MCMA
A client newly diagnosed with diabetes mellitus is being prepared for discharge. The nurse knows discharge
teaching on how to reduce the risk of at-home medication errors is successful when the client makes which
statement?

1. “I know all about my new medications, including their names, what they do, and how to take them.”
2. “I know what side effects need to be reported immediately to my doctor.”
3. “I have a list of all my medications right here in my wallet.”
4. “I know I can call anytime I have a question about any of my medications.”
5. “First thing in the morning, I will take all my prescriptions to the pharmacy to make sure they are safe for me to
take.”
Rationale 1: Clients should know each medication’s name, what it is for, what it does, and how to take it.
Rationale 2: It is important for clients to know what adverse effects need to be immediately reported.
Rationale 3: Clients should carry a list of all medications for quick reference or in case of an unexpected hospital
or clinic visit.
Rationale 4: Clients should be encouraged to call and ask any questions.
Rationale 5: These particular medications should be safe to take. If the client decides to add a supplement or
nutrient, that medication profile should be checked by the health care provider or pharmacist for interactions with
the other medications.
Global Rationale: Clients should know each medication’s name, what it is for, what it does, and how to take it. It
is important for clients to know what adverse effects need to be immediately reported. Clients should carry a list
of all medications for quick reference or in case of an unexpected hospital or clinic visit. Clients should be
encouraged to call and ask any questions. These particular medications should be safe to take. If the client decides
to add a supplement or nutrient, that medication profile should be checked by the health care provider or
pharmacist for interactions with the other medications.

patient care
Page Number:
Question 32
Type: MCMA
The nurse prepares to administer medications to clients on the orthopedic unit. Which outcomes will result from
following the unit’s rules, policies, and procedures?
1. Minimizing medication errors
2. Positively verifying client identification prior to medication administration
3. Guiding accurate documentation
4. Holding nurses accountable for medication errors
5. Determining which medication errors are preventable
Rationale 1: Facility rules, policies, and procedures are in place to minimize medication errors.
Rationale 2: Facility rules, policies, and procedures are in place to ensure that positive client identification occurs
prior to medication administration.
Rationale 3: Facility rules, policies, and procedures ensure accurate documentation.
Rationale 4: Facility rules, policies, and procedures do not hold nurses accountable for medication errors; the risk
management department will determine factors responsible for these errors.
Rationale 5: Facility rules, policies, and procedures do not determine which medication errors are preventable;
they are in place to prevent errors from occurring.
Global Rationale: Facility rules, policies, and procedures are in place to minimize medication errors; to ensure
that positive client identification prior to medication administration; and to guide accurate document. They are not
in place to hold nurses accountable for medication errors or to determine which medication errors are preventable.

AACN Essential Competencies: II.5. Participate in quality and patient safety initiatives, recognizing that these are complex
system issues, which involve individuals, families, groups, communities, populations and other members of the healthcare
team
patient care
Learning Outcome: 6-5 Explain how rules, policies, and procedures can help prevent medication errors.
Page Number:
Question 33
Type: MCMA
The nurse receives a verbal order for subcutaneous insulin but gives the insulin IV instead to a client in the
intensive care unit (ICU). Which medication errors have been committed?
1. Medication based on verbal order
2. Wrong route for medication
3. Stressful workplace
4. Illegible medication order
5. Failure to review diagnostic lab work
Correct Answer: 1,2
Rationale 1: Medication orders must be written prior to administration.
Rationale 2: The wrong route was used because the verbal order was misunderstood.
Rationale 3: The ICU is stressful, but there is nothing in the scenario to suggest this as a factor.
Rationale 4: The medication order was not written; it was verbal.
Rationale 5: The medication was given IV instead of subcutaneously; this did not require diagnostic lab work.
Global Rationale: Medication orders must be written prior to administration. The wrong route was used because
the verbal order was misunderstood. The ICU is stressful, but there is nothing in the scenario to suggest this as a
factor. The medication order was not written; it was verbal. The medication was given IV instead of
subcutaneously; this did not require diagnostic lab work.

and quality
patient care

prevented.
Page Number:
Question 34
Type: MCMA
The nurse in the emergency department administers an adult dose of an antibiotic to a 3-month-old baby. As a
result, the baby suffers permanent brain damage. What are the likely ramifications of this error?
1. The reputation of the healthcare facility will suffer
2. The healthcare facility may pay high legal fees and a large settlement.
3. The morale of the staff will be adversely affected.
4. The nurse will lose the professional license to practice and can never practice again.
5. The healthcare facility will lose its accreditation and may be closed.
Rationale 1: If this error is made public, the reputation of the facility may suffer.
Rationale 2: If the family sues, the facility’s legal fees and settlement conditions could be significant.
Rationale 3: An error of this nature may result in self-doubt and loss of morale.
Rationale 4: The nurse may or may not lose the license to practice, depending on the circumstance of the case.
Rationale 5: It is not likely the facility will be closed.
Global Rationale: If this error is made public, the reputation of the facility may suffer. If the family sues, the
facility’s legal fees and settlement conditions could be significant. An error of this nature may result in self-doubt
and loss of morale. The nurse may or may not lose the license to practice, depending on the circumstance of the
case. It is not likely the facility will be closed.

QSEN Competencies: II.A.2 Describe scopes of practice and roles of health care team members
AACN Essential Competencies: II.2. Demonstrate leadership and communication skills to effectively implement patient
safety and quality improvement initiatives within the context of the interprofessional team

Another Random Document on
Scribd Without Any Related Topics
Istuvat päivällispöydän ääressä ja juovat ruokaviinejä.
IMANDRA
Eikö täällä ole viiniä?
PRINSSI
Ei, mutta lähteessä on vettä. (Ammentaa vettä käteensä.)
IMANDRA
Eikö täällä ole edes kristallimaljoja?
PRINSSI
Juo minun pivostani.
IMANDRA (juo)
Oh, en olisi luullut koskaan, että vesi maistuu niin hyvälle!
PRINSSI
Ehkä se nyt maistuu paremmalle kuin viini.
IMANDRA
Mutta katso, kultakenkäni ovat ihan rikki ja pukuni repaleinen.
PRINSSI
Minä teen tuohikengät.

IMANDRA
Minä olen nyt ihan kuin ne paimentytötkin. Ei prinssikään minua

nyt tuntisi, kun en ole pessyt kasvojanikaan moneen päivään.
Varmaan nyt prinssi nauraisi minulle.
PRINSSI
Ehkä se prinssi tuntisi. Prinssi kuuluu olevan täällä

metsästämässä.
Minä menen pyytämään häneltä ruokaa?
IMANDRA
Ei, ei, minä en tahdo tavata prinssiä. Sinun täytyy hakea ruokaa
vaikka maan alta. Kuule, sinun täytyy!
PRINSSI
Nöyrin palvelijanne! Minä menen.
IMANDRA
Alatko sinäkin puhua hovikieltä — täällä metsässä. Ei, ei, älä

mene, minä pelkään olla yksin metsässä.
PRINSSI
Minun täytyy mennä, niinhän sanoit. Kerran täytyy tottua

yksinäisyyteen.
IMANDRA
Minä en ole koskaan ollut yksin.
PRINSSI
Yksin et olisi löytänyt tänne.
IMANDRA
Mitä sinä olet tehnyt! Voi, voi, kuinka minun on nälkä! Mene,
mene, tuo ruokaa, muuten minä kantelen — kyökkimestarille!
PRINSSI
Juopukat ovat huumanneet pääsi, sinä pidät kai tuota kantoa

kyökkimestarina. Minä menen kysymään. Kuulkaa, herra
kyökkimestari, prinsessa käskee kattamaan pöytää.
IMANDRA
Niin, minä tunnen hanhenpaistin käryn, minä näen isoja

mesikakkuja, viinirypäleitä ja omenaleivoksia. Jos sinä voit loihtia,
niin mene heti!
PRINSSI
Minä menen. (Menee.)
IMANDRA (ottaa kirjan povestaan ja alkaa lukea maassa maaten)
"Ja vuoren julma valtias ryösti…" Uh, mikä risahti! "… ihmeen
ihanan prinsessan, mutta keskiyöllä tuli ritari Yrjänä, puhkasi
peitsellään pedon ja ryösti ryöstäjältä…"
KEPULI (pistäen päänsä pensaasta)
Hepuli! Ka, katsos, ihan ihmetty metsänneito!
HEPULI
Lumottu prinsessa!
IMANDRA (hypähtää pystyyn)
Uh, metsänpeikkoja!
KEPULI
Älkää pelätkö, emme ole peikkoja emmekä petoja.
IMANDRA
Keitä te sitten olette?
KEPULI
Maantieritareita.
IMANDRA
Valepukuisia ritareita?
HEPULI
Aivan oikein — valepukuisia, hehhee!
KEPULI
Niin, valepukuisia, hehhee! Tätä tässä sanotaankin Hepuliksi.
HEPULI
Ja tätä Kepuliksi.
IMANDRA
Hepuli ja Kepuli, kummallisia ritareita? Ja mihin olette matkalla?
HEPULI
Suvikunnan hoviin, katsomaan sitä kummallista prinsessaa.
IMANDRA
Ettehän vain aijo ryöstää sitä kummallista prinsessaa?
HEPULI
Eipä tiedä, hehee!
KEPULI
Niin. Eipä tiedä, hehee!…
IMANDRA
Mutta ehkei prinsessa huoli teistä.
KEPULI
Mitäs vikaa meissä olisi! i.

IMANDRA
Taitaa olla vikaa — jossain hattunne alla.
KEPULI
Prinsessa kuuluu olevan häijy ja ruma, niin että on luvattu puolet

valtakuntaa sille, joka hänet nai.
IMANDRA
Te, te, naisitte prinsessan! Ja puolet valtakuntaa? Ei, nyt te olette

päästänne aivan pyörällä.
HEPULI
Toiset taas sanovat, että prinsessa on vuoroin ruma, vuoroin

kaunis riippuen siitä, millä tuulella kulloinkin on.
KEPULI
Sanovat, että Kaukovallan prinssi kosi häntä ja antoi hänelle

ihmeellisen peilin.
IMANDRA
Noitapeilin?
KEPULI
Mutta prinsessa rikkoi sen peilin ja siitä asti kävi hän vain
rumemmaksi.
IMANDRA
Olisiko se totta?
KEPULI
Ja prinssi voi hänet nyt muuttaa vaikka sammakoksi.
IMANDRA
Prinsessaa ei muuta mikään.
HEPULI
Sepä olisi ikävää.
KEPULI
Sanovat myös, että hän karkasi erään paimenpojan tai

metsänvartijan kanssa.
HEPULI
Olisipa karannut minun kanssani.
KEPULI
Sinun kanssasi? Sinun kanssasi ei karkaa mikään prinsessa.

Hehhee!
HEPULI
Eikä sinunkaan kanssasi, leikkiähän minä laskin. En minä aio
kosia prinsessaa. Hehhee!
KEPULI
Enkä minä.
HEPULI
Se villikissa prinsessa kynsisi silmät päästämme, niin ettemme

näkisi enään itseämme noitapeilistäkään.
KEPULI
Paras vain pysyä kuninkaallisina koirina.
IMANDRA
Kuninkaallisina koirina?
KEPULI
Prinssillisinä prisseinä. Me olemme vain Kaukovallan prinssin

kujeilijoita. Metsässä kuuluu olevan vanha, sokea jänis, jota prinssi
nyt on tullut metsästämään. Eikä prinssillä satu olemaan koiria.
HEPULI
Me saimme jo jäniksen kiinni. Mutta kuules tyttö, älä virka siitä

mitään Suvikunnan hoviherralle.
IMANDRA
Onko hoviherra täällä?
KEPULI
On ja hovirouva myös. Tulivat prinssin vieraina jahtivaunuilla.
HEPULI
Meillä on pienet kujeet mielessä.
IMANDRA
Voi, mihinkä minä nyt menen, minä en tahtoisi nähdä hovirouvaa!
KEPULI
Kuules, ehkä sinä olet näpistänyt nämä kultakengät.
IMANDRA
En, en, mutta hovirouva ajoi minut pois, silloin kun minä olin —
tanssimassa Suvikunnan hovissa.
KEPULI
Älä pelkää, tyttöseni, hovirouva ei ole lähimainkaan niin ilkeä kuin

prinsessa.
IMANDRA
Voi, hyvät kujeilijat, minä olen vain köyhä paimenen — vaimo.

Mieheni lähti ruokaa hakemaan.
HEPULI
Voi, raukka, onko sinulla nälkä?
IMANDRA
Mitä te teette, kun teillä on nälkä?
KEPULI
Me kiristämme nälkävyötä.
IMANDRA
Mitä nälkävyötä?
HEPULI
Onhan sinulla vyö, koitahan kiristää.
IMANDRA (kiristää vyötään)
Oh, ei se auta!
HEPULI
Kun meillä ei ole reikäleipää, niin me syömme reikiä.
IMANDRA
Voi, hyvät miehet, eikö teillä ole reikäleipää!
KEPULI
Vain tyhjiä, pyöreitä reikiä kuin tämä leipälaukkumme!
(Osoittaa suutaan.)
HEPULI (kaivaa taskustaan)
Tässä on pieni pala.
IMANDRA
Oh, en olisi luullut, että reikäleipä maistuu näin hyvälle.

(Kuuluu torven ääni.)
KEPULI
Siellä on jo prinssi! Hei, Hepuli! Nyt täytyy mennä!
HEPULI
Hei, Kepuli, mennään!
(Kepuli ja Hepuli juoksevat metsään. Imandra piiloutuu näyttämöllä

näkyvän pensaan taakse. Prinssi ja Otro tulevat toiselta taholta,
puettuina metsästyspukuihin.)
PRINSSI (asettaen sormen suulleen)
Hiljaa, hän on tuolla!
IMANDRA (itsekseen)
Prinssi! Minun täytyy olla hiljaa.
OTRO
Teidän korkeutenne, miksi varjot synkistävät jaloja kasvojanne?
PRINSSI
Otro, ystäväni. Murhe murtaa nyt mieltäni. Siitä asti kuin näin
prinsessan, en saa yön unta, päivän rauhaa. Metsästyksestä koetan
nyt etsiä unhoitusta.
OTRO
Miksi niin kaunis kuori kätkee harakan sielun?
IMANDRA
Harakan sielun! Kyllä minä sinulle näytän.
PRINSSI
Niin, minä muistan, prinsessa hyppi harakkaa, ehkä tämä on joku

tauti, joka särkee hänen sielunsa niin, että hän tahtoo särkeä oman
onnensa.
OTRO
Hän särki ihmeellisen peilinne, jonka saitte vanhalta, viisaalta

tietäjältä. Mutta tähän pahaan tautiin on keksittävä parannuskeino.
(Hiljemmin.) Olkaa ryöstävinänne hänet!
PRINSSI
Sinä olet oikeassa. Ehkä hän harhaa metsiä sielutonna niinkuin

lintu.
OTRO
Tai nauraa harakan nauruaan. Se peili olisi voinut hänet parantaa

vaikka naisten peilit tavallisesti aina ovat petollisia. Ehkä hänen oma
peilinsä oli imenyt itseensä hänen sielunsa.
IMANDRA
Viekas vintiö!
PRINSSI
Mene, Otro! (Hiljemmin.) En ole tuntevinani häntä, panen hänet

koetukselle. (Äänekkäämmin.) Tahdon olla yksin suuren suruni
seurassa.
OTRO
Menen. Jos löydätte prinsessan, niin tukistakaa häntä niinkuin hän

tukisti teitä tai vitsokaa häntä! (Menee.)
IMANDRA
Piiskuri! Ihan minä pakahdun kiukusta. (Oksa —taittuu.)
PRINSSI
Mitä, rosvo! (Rientää pensaan luo ja vetää prinsessan kädestä

esille.)
Kas, kaunis paimentyttö!
IMANDRA
Armollinen herra!
PRINSSI
Kuinka olet metsään joutunut, varastatko sinä puita minun

metsästäni?
IMANDRA
En, en! Onko tämä riikin ritarin metsä?
PRINSSI
Niin, metsä, maa, kaikki koko riikin rajojen sisällä.
IMANDRA
Mutta kuka te olette…?
PRINSSI
Sano, oletko kantanut puita! Eikö metsänvartijani Metsä-Matti

paremmin vartioi metsää?
IMANDRA
Metsä-Matti, onko hän palvelijanne?
PRINSSI
Mitäs kummaa siinä…
IMANDRA
Ei mitään, muuten vaan…
PRINSSI
Tunnetko sinä Metsä-Matin?
IMANDRA
En, kyllä minä…
PRINSSI
Oletko sinä ehkä hänen morsiamensa? Kummallista, missä minä

olen sinut ennen nähnyt?
IMANDRA
Mutta minä en ole nähnyt teitä, riikin herra.
PRINSSI
Arvaas, kuka minä olen?
IMANDRA
E, en minä arvaa, ehkä joku hoviherra.
PRINSSI
Ei, paljon korkeampi, paljon korkeampi.
IMANDRA
Voi, varjele, itse prinssi!
PRINSSI
Niin, Kaukovallan hallitsija, mutta minä en aina hallitse itseäni.

Minä en hallitse untani, aikaani, ajatuksiani, sillä tiedätkös, minä
kosin kerran erästä korkeata prinsessaa, mutta hän hyppi edessäni
harakkaa. Osaatko sinä hyppiä harakkaa niinkuin Suvikunnan
prinsessa?
IMANDRA
Armollinen prinssi, en minä voi.
PRINSSI
Sinun täytyy.
IMANDRA
En minä voi, en minä osaa.
PRINSSI
No, mitä sinä osaat?
IMANDRA
En minä tiedä.
PRINSSI
Oletko sinä tehnyt mitään työtä?
IMANDRA
Minä istun lähteellä ja sidon seppeleitä.
PRINSSI
Eihän se ole mitään työtä, taidat olla laiska.
IMANDRA
Nyt minä muistan, minä osaan kutoa kaunista kangasta.
PRINSSI
Kätesi ovat liian hienot. Jos Metsä-Matti ottaa sinut vaimokseen,

niin sinun täytyy tehdä työtä aamusta iltaan.
IMANDRA
Te laskette leikkiä. Aamusta iltaan olen minä vain leikkinyt.
PRINSSI
Niin, ei työ ole leikkiä. — Anna minun leikkiä sinun kainoilla

käsilläsi. (Silittää Imandran kättä.)
IMANDRA
Ei saa, ei saa!
PRINSSI
Eihän Metsä-Matti näe, minä silitän vain hiukan, kätesi on kuin
hienointa silkkiä.
IMANDRA
Ei, ne ovat rumat kuin variksen varpaat. Minä en tahdo.
PRINSSI
Ne ovat liian kauniit Metsä-Matille.
IMANDRA
Ei ne ole kauniit Metsä-Matillekaan.
PRINSSI
Ihmeellinen impi. Et tiedä rakkaudensurun salaisuutta. Minä

tahdon sen sinulle paljastaa. Annahan, hivelen hiuksiasi.
IMANDRA
Ei saa koskea, minä tukistan.
PRINSSI (nauraa)
No tukista, sinä olet aivan kuin Suvikunnan prinsessa. Mikä on

nimesi?
IMANDRA
Minä en tukista! Ei minulla ole nimeä. Minä… Nyt muistan,

Metsä-Marjaksihan minua sanotaan.
PRINSSI
Kummallista, kuinka sinä olet prinsessan näköinen.
IMANDRA
Minäkö prinsessan näköinen?
PRINSSI
Aivan kuin hänen kuvansa. Ehkä sinä olet noita, joka muutuit
hänen peilinsä kuvaksi. Samat silmät, suu, korvat…
IMANDRA
Niin, sanovathan ihmiset, että minä ja prinsessa… meitä voisi

luulla kaksoisiksi. Mutta enhän minä sille mitään mahda.
PRINSSI
Taidat sittenkin olla pieni peikko. Etkö sinä tiedä, että noidat
pannaan vesitynnyriin?
IMANDRA
En minä ole noita, en minä tahdo vesitynnyriin.
PRINSSI
Ei sinua panna vesitynnyriin, jos sinä annat minulle suuta.
IMANDRA
Mikä prinssi lienettekin, minä en anna, kuuletteko, minä kutsun
Metsä-Mattia!
PRINSSI
Oletko sinä antanut Metsä-Matille suuta?
IMANDRA
En, en, niin kerran — erehdyksestä… en enään, en teille, en

kenellekään.
PRINSSI (tarttuu vyötäröisiin)
Mutta minä otan väkisin!
IMANDRA (antaa korvapuustin)
Tuossa!
PRINSSI
Sinä viehättävä velho! Nyt minä ryöstän sinut! (Nostaa Imandran

syliinsä.)
IMANDRA
Ei!
PRINSSI (kantaen)
Kuinka sinä olet kevyt ja kuulas kuin keijunen. Minun

metsäkyyhkyni!

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Standard Text: Select all that apply.

2. The nurse administers the incorrect drug.

3. The nurse miscalculates the medication dose.

4. The nurse misinterprets a health care provider’s order.

5. The nurse does not check the client’s identification band.

Correct Answer: 2,3,4,5

Rationale 2: Medication errors can be related to misadministration.

Rationale 3: Medication errors can be related to miscalculations.

Rationale 4: Medication errors can be related to misinterpretations.

Cognitive Level: Analyzing

Adams and Urban, Pharmacology: Connections to Nursing Practice, 3e Test Bank

2. Health care provider

Rationale 1: The pharmacist is always involved in the process.

Rationale 2: The health care provider is always involved in the process.

Rationale 3: The client is always involved in the process.

Cognitive Level: Understanding

Standard Text: Select all that apply.

1. Failure to follow health care provider’s orders

2. Failure to give the right medication

3. Failure to give a medication at the ordered time

5. Failure to give the right dose of the medication

Correct Answer: 1,2,3,5

Cognitive Level: Analyzing

1. Lack of adequate oral or written communication

2. Name confusion involving similar-sounding drugs

Rationale 1: Lack of communication is not indicated in the scenario.

Rationale 2: There is no indication of name confusion.

Rationale 3: There is no indication the products were inappropriately labeled.

Rationale 4: This was a human factor. The dosage was miscalculated.

Cognitive Level: Analyzing

2. Performing an agency system check

3. Failure to account for client variables

4. Following the rights of drug administration

Rationale 2: Performing an agency system check is correct procedure.

Rationale 4: Following the rights of drug administration is correct procedure.

Cognitive Level: Remembering

1. Taking medications as the practitioner has ordered

2. Never trading drugs with anyone

3. Taking drugs prescribed by more than one practitioner

4. Filling prescriptions at several pharmacies

Rationale 1: Taking medications as the practitioner has ordered is correct procedure.

Rationale 2: Never trading drugs with anyone is correct procedure.

Cognitive Level: Analyzing

4. Change the medication administration time to the morning.

Cognitive Level: Analyzing

1. To protect the nurse from liability

2. To verify that the client’s safety was protected

4. To protect the healthcare facility from litigation

Cognitive Level: Applying