those daggone tricky questions!!

I think that they should have stated that you are already in the pt.'s room.

Besides it's not always a good idea to ask a patient to state his or her name. But I guess they ASSUME everyone is able to state their own name, which is not always the case. I guess you didn't do too well in Mind-reading. :uhoh3: Me neither!

If you are in the room, then having the pt state his/her name is the best answer among the choices given, but the location of the nurse was not made clear in the question. I think that one could be argued if enough people in the class got it wrong.

Forgive me... it's been a few years since Nursing School... Don't those "5 R's" start with Right Patient? My instructors always used to hammer that kind of thing into my head... that the first thing you need to do before doing ANYTHING with or for a patient was to be sure you had the right patient. Seemed extraneous at the time, but man, have I seen/heard about some doozy mistakes!

That was a kind of test-taking skill... break it down and don't read too much into the question.

Hard to know what the person writing the question has in mind exactly, but I leaned away from answer C simply because I think it would be preferable to check an armband.

What do we want to test that the student knows? For patient safety, a nurse should always check that the dosage is correct and the nurse should always verify who the patient is. To be efficient, the nurse should make sure that the med is available to give when at the ordered time. So what exactly is this question testing?

Is the student seriously supposed to look at this question and think... "it says 'when administering' and that must mean I already have the med ready and have checked the dosage so those two important steps aren't 'priorities' now because they've already been done and so right now, the 'priority' is to verify the patient identity which I can do by having the patient state their name, thus answer C is correct."

It may be testing one's ability to choose the "best" answer with uncertainty and incomplete information. In this case, we have to interpert that "when administering the medication" means that the nurse is already at the bedside and assume that the previous important steps have already been taken. That's a rather pointless exercise since as the nurse you have to make sure the med is in the med cart, check that the ordered dosage is correct and verify the patient identity. They are all "a priority" at some point in the process.

Heck, I could argue that it's ALWAYS "a priority" to check the correct dosage but that the patient can't always state their name (eg a baby, an unresponsive patient). Thus, answer "c" can't be correct because that's not ALWAYS "a priority."

Also, just to be nitpicky, the five rights of medication administration includes verifying "right dosage" so it's rather contradictory if the instructor is asking the student to assume that the nurse in this question is already at the bedside having already checked the dosage.

Perhaps the point of this question is that even if you're positive you know the patient (as you've been working with them all day) that you still should ask them state their name. The problem here is that we can't even tell what the question is testing.

Thanks guys, the teacher said the point was "when administrating" the med. That is funny you guys mentioned 5 patient rights. We were taught to remember this way: TPRMD = Right Time, Right Patient, Right Route, Right Medication, Right Dose.

Always a learning experience!

Hard to know what the person writing the question has in mind exactly, but I leaned away from answer C simply because I think it would be preferable to check an armband.

Yeah, but I had a patient a couple years ago who had been in the hospital for more than 24 hours... and when I checked his wristband IT WAS WRONG. This was a walkie-talkie -- he just hadn't looked at it, and apparently neither had any of the staff before I got there.

I've taught clinicals for many years as an adjunct at both the ADN and BSN levels and we always explain the rationale to the student. Check the meds, dose route of admin etc prior to even going in to the patient room, or you will have to take the cart with you as you leave the room to contact the pharmacy and this effects productivity. At the patient bedside the most important thing to do is to identify the correct patient and the most prudent way to do this is to ask the patient his or her name as well as check their armband as a back-up. As nurses it is incumbent upon us to provide safety to our patients.

I still don't see that "administering the medication" necessarily means that you've already checked and prepared the medication and are just about to give it to the patient. The term "medication administration" often includes the preparation phase - as on these websites

http://www.mapharm.com/safety_guides.htm

http://www.massnurses.org/nurse_practice/sixrights.htm

The question asks what's "a priority" when administering. Checking the dosage and having the patient state their name (if possible) are each "a priority" in their own right.

This seems like a better question: What would a priority be when administering any medication to an alert and oriented patient?

A. Bringing fresh water for the patient

B. Having the patient state their name

C. Documenting patient input and output

D. Taking patient blood pressure

All of those tasks are important, but only one is the correct answer to that question.

Here's another angle. When the instructor wrote "is the dosage ordered correct"? maybe he/she meant to imply that the nurse was stepping beyond their scope as the nurse can't definitively say if the dosage ordered is correct. The nurse needs to notice if a dosage ordered seems too high or too low and should check it with the physician before giving the medication. So the nurse's role is to check with the physician if the order seems wrong but it's not the nurses' role to ultimately decide if the dosage is correct or not. After all, it could be a unique situation with an unsual dosage. The point of checking the dosage is that the nurse should always check if something doesn't seem right and not just blindly follow orders.

Still, if scope of practice is the point of the question or where in the process of the administration the nurse is, then couldn't one argue that answer "C" is incorrect because some patients can't state their name?