A nurse prepares to administer medication but notices the dose on the prescription seems unusually high. What should be the nurse’s first action?

1. A

   Administer the medication

2. B

   Ask another nurse to give it

3. C

   Clarify the order with the physician

4. D

   Document the order

Appeared in: AIIMS Delhi NO- 2019

Explanation

• Patient safety is the highest priority; an unusually high dose represents a significant risk of harm.
• Nurses have a legal and ethical responsibility to verify any medication order that appears unclear, unsafe, or potentially erroneous.
• Clarifying the order directly with the prescriber is the only action that directly addresses the safety concern and prevents a potential medication error.
• The nurse acts as the final safeguard in the medication administration process, protecting the patient from harm.

Why Other Options Were Wrong

• Option A: Administering a medication with a suspected dose error is negligent and could cause severe patient harm or death.
• Option B: This is an abdication of professional responsibility. It does not solve the safety issue and puts a colleague and the patient at risk.
• Option D: Documentation is essential but is not the priority. The immediate need is to prevent patient harm. Action must precede documentation in this case.

Related Visual

Clinical Relevance

• Nursing practice connection: Knowing Safe Medication Administration and the Nurse's Responsibility helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
• This scenario highlights the critical role of the nurse as a patient advocate and the last line of defense against medication errors.
• Nurses are legally accountable for the medications they administer. Blindly following an incorrect order does not absolve the nurse of responsibility.
• What if the physician is unavailable or dismissive? The nurse should follow the facility's chain of command policy, which typically involves escalating the concern to a charge nurse, nursing supervisor, or pharmacist to ensure patient safety is not compromised.

How to Approach the Question

• Identify the question type: This is a priority-setting question asking for the 'first action'.
• Analyze the core problem: The central issue is a potential medication error that could harm the patient.
• Recall safety principles: The primary principle in nursing is patient safety ('do no harm').
• Evaluate the options based on the safety principle:
• Administering the drug violates safety.
• Asking another nurse to give it ignores the safety issue.

Concept Tested & Keywords

• Concept Tested: Safe Medication Administration and the Nurse's Responsibility
• Stem keywords: nurse, medication, unusually high dose, prescription, first action
• Lead-in keywords: first action
• Clinical cues: Unusually high dose is a red flag for a medication error.

Question ID

Q0QkkXo8SPDkp_osO23Wd3

Copy ID

Reference Book

E6 Nursing Fundamentals Taylor p. 847-849

E6 Pharmacology Nursing Lilley 11e Part 1 p. 26-28