The Six Rights of Medication Administration (MACE)

Question 1

To adhere to the "Right Documentation" principle of medication administration, at which exact point must the Medication Aide (MA-C) sign the Medication Administration Record (MAR)?

• A) Immediately after preparing the medication but before entering the resident's room.
• B) Immediately after witnessing the resident swallow or receive the medication.✓
• C) At the end of the shift, compiling all administered medications for efficiency.
• D) As soon as the resident verbally agrees to take the medication.

Question 2

The Medication Aide (MA-C) is preparing to give a routine oral medication to a resident with severe Alzheimer's disease who frequently wanders. The resident does not have a wristband on, and there is no photo in the Medication Administration Record (MAR). How must the MA-C verify the resident's identity?

• A) Ask the resident, "Are you Mrs. Mary Johnson?" and wait for a nod of agreement.
• B) Rely on the name posted on the door of the room the resident just exited.
• C) Check the resident's clothing tags for a printed name.
• D) Have a familiar licensed staff member positively identify the resident.✓

Question 3

According to standard medication safety practices, when must a Medication Aide perform the three label checks against the Medication Administration Record (MAR)?

• A) When taking the container from the supply, when removing the dose from the container, and before returning the container to storage.✓
• B) At the beginning of the shift, immediately before entering the resident's room, and at the end of the shift.
• C) When the pharmacy delivers the medication, before giving it to the resident, and after documenting the administration.
• D) Before entering the resident's room, while explaining the medication to the resident, and after the resident swallows the dose.

Question 4

Under general national medication administration standards, what is the acceptable time window for administering a time-critical scheduled medication ordered for 0800?

• A) Between 0700 and 0900.
• B) Exactly at 0800, with no allowance for deviation.
• C) Anytime before 1200, as long as it is given on the correct date.
• D) Between 0730 and 0830.✓

Question 5

When pouring a liquid medication from a multi-dose bottle into a graduated medicine cup, which technique ensures the Medication Aide measures the exact "Right Dose"?

• A) Place the cup on a flat surface, look down into the cup, and pour until the liquid touches the top edge of the line.
• B) Hold the cup at eye level and read the measurement at the lowest point of the liquid's curve (meniscus).✓
• C) Hold the cup below eye level to prevent splashing and read the measurement at the highest point of the liquid's edge.
• D) Pour the liquid into the cup while keeping the medication bottle's label facing downward to monitor the flow.

Question 6

A resident's Medication Administration Record (MAR) lists an order for "Amlodipine 10 mg by mouth daily." The Medication Aide retrieves the resident's amlodipine bottle, and the pharmacy label reads, "Amlodipine 5 mg, take one tablet by mouth daily." What is the Medication Aide's required action?

• A) Administer two of the 5 mg tablets to equal the 10 mg dose ordered on the MAR.
• B) Withhold the medication, do not administer any tablets, and immediately notify the delegating nurse.✓
• C) Administer one 5 mg tablet as directed by the pharmacy label to prevent an overdose.
• D) Ask the resident how many tablets they usually take and administer that amount.

Question 7

A resident's MAR states, "Vitamin B12 1000 mcg sublingual daily." The Medication Aide observes the resident swallow the tablet whole with a glass of water. What is the primary concern regarding the "Right Route" in this situation?

• A) The medication may be destroyed by stomach acid or poorly absorbed, reducing its effectiveness.✓
• B) The medication will be absorbed too rapidly in the stomach, causing toxicity.
• C) The resident is at a high risk for aspiration because sublingual tablets are not designed to be swallowed.
• D) The medication will cause severe gastrointestinal bleeding if it is not dissolved under the tongue first.

Question 8

According to the Six Rights of Medication Administration, which is the most reliable method for a Medication Aide to ensure they are giving a medication to the right resident in a long-term care facility?

• A) Asking the resident to clearly state their first and last name.
• B) Comparing the resident to the current photograph included in the Medication Administration Record (MAR).✓
• C) Having a certified nursing assistant (CNA) point out the resident in the dining room.
• D) Calling the resident by name and waiting for them to nod or respond.

Question 9

A resident is scheduled to receive a routine dose of docusate sodium (Colace), a stool softener. While preparing the medication, the aide notes in the resident's chart that they have had three episodes of loose, watery diarrhea this morning. What is the best action for the medication aide?

• A) Administer the docusate sodium because it is a routine, scheduled medication on the MAR.
• B) Give half of the scheduled dose to prevent worsening the diarrhea.
• C) Hold the medication and notify the delegating nurse about the resident's loose stools.✓
• D) Substitute an over-the-counter anti-diarrheal medication for the docusate sodium.

Question 10

To ensure the right medication is administered, the Medication Aide must check the medication label against the Medication Administration Record (MAR) three times. When should the third check occur?

• A) Immediately before giving the medication to the resident.✓
• B) Immediately after the resident swallows the medication.
• C) At the beginning of the shift before entering the medication room.
• D) While documenting the medication administration in the resident's chart.

Question 11

To ensure the right medication is administered, the Medication Aide must check the medication label against the Medication Administration Record (MAR) three distinct times. When should the third check occur?

• A) After documenting the administration in the resident's chart.
• B) When receiving the medication supply from the dispensing pharmacy.
• C) Right before returning the container to storage or administering the dose.✓
• D) During the change-of-shift report with the delegating nurse.

Question 12

Before administering medications to a resident in a long-term care facility who is confused and cannot state their name, how should the medication aide verify the resident's identity?

• A) Ask the resident's roommate to confirm their name.
• B) Ask the resident, 'Are you Mr. Smith?' and wait for a nod.
• C) Check the room number and bed assignment against the MAR.
• D) Check the resident's current photograph in the medication record.✓

Question 13

The Medication Administration Record (MAR) directs the aide to give a resident their morning medications by mouth (PO). The resident states they have a sore throat and asks the aide to crush the pills and administer them through their gastrostomy tube (G-tube) instead. How should the aide respond?

• A) Crush the medications, dissolve them in water, and administer them via the G-tube to ensure the resident receives the dose.
• B) Explain that medication aides cannot administer medications through feeding tubes, and notify the nurse.✓
• C) Contact the pharmacy to confirm which of the medications are safe to crush before using the G-tube.
• D) Hold the medications for the day and document that the resident was unable to swallow them.

Question 14

According to standard medication administration guidelines, what is the generally acceptable time window for a Medication Aide to administer a routine, scheduled medication?

• A) Anytime during the specific shift the medication is ordered for.
• B) Exactly at the scheduled time, with no variation allowed.
• C) Up to 2 hours before or 2 hours after the scheduled time.
• D) Within 60 minutes before or 60 minutes after the scheduled time.✓

Question 15

The Medication Aide is preparing to give morning medications to a resident with severe dementia. The resident does not wear an identification band and cannot state their name. Which method must the Medication Aide use to verify the 'Right Resident'?

• A) Compare the resident's face to the current photograph attached to the Medication Administration Record (MAR).✓
• B) Ask the resident, 'Are you Mary Smith?' and wait for a nod of agreement.
• C) Ask a certified nursing assistant (CNA) who is familiar with the resident to verbally confirm her identity.
• D) Check the name printed on the door of the resident's room and the label on the bed.