MACE Practice Questions

The abbreviation 'q.d.' is prohibited because it can be easily misread as 'q.i.d.' if the period after the 'd' is mistaken for an 'i'. This could lead to a four-fold overdose of the medication. The correct practice is to write out 'daily' or 'once daily' to avoid any confusion.

A suspension is a type of liquid medication in which the drug particles are not dissolved but are suspended in the liquid. Over time, these particles settle at the bottom. To ensure the resident receives the correct dose, the bottle must be shaken well immediately before pouring to evenly redistribute the medication throughout the liquid.

Standard documentation for any medication includes the exact time of administration.

For PRN (as needed) medications, it is crucial to document the outcome or the resident's response to the medication. This helps the healthcare team assess the effectiveness of the treatment plan.

When a PRN medication is ineffective, this is a significant clinical finding that must be reported to the nurse. Documenting that this communication occurred is a key part of the legal and clinical record.

Controlled substances are subject to strict federal and state regulations to prevent diversion. Disposal (wasting) of these medications must be done according to specific facility policies and legal requirements, which almost always involves a second person, typically a licensed nurse, to witness the disposal and co-sign the documentation.

Residents have the right to refuse medication. While it is appropriate for the MA to inquire about the reason for refusal and provide education, they cannot coerce or repeatedly attempt administration. The refusal should be reported to the supervising nurse promptly and documented according to facility policy. The nurse may then attempt to intervene, but the MA's primary responsibility is to respect the refusal and report/document it.

A resident's religious beliefs can strongly influence their healthcare decisions, particularly regarding treatments they are willing to accept or refuse (e.g., blood products for Jehovah's Witnesses). Being aware of their faith is crucial for respecting their right to informed consent and their right to refuse specific treatments that may conflict with their beliefs. The MA-C must respect these decisions and ensure the nursing staff is aware.

Digoxin slows the heart rate. A key safety precaution is to check the apical pulse for one full minute before administration. A heart rate below 60 beats per minute (bradycardia) is a common parameter for holding the dose, as administering it could dangerously slow the heart further. This finding must be reported to the nurse immediately.

The correct procedure for transdermal patch administration is to remove the old patch before applying the new one to prevent overdose. The old site should be cleansed to remove any residual medication. The new patch should then be applied to a different, clean, dry, and hairless site as ordered to avoid skin irritation and ensure proper absorption.

Extended-release (ER) medications must not be crushed, chewed, or dissolved as this would destroy the time-release mechanism, potentially leading to a toxic dose being absorbed all at once. The correct and safe action for a Medication Aide is to recognize this limitation, hold the dose, and immediately report the situation to the supervising nurse, who can then contact the prescriber for an alternative formulation, such as a liquid or powder.

Patient assessment, such as checking skin turgor, requires the clinical judgment of a licensed nurse and is outside the MA-C's scope of practice.

Administering medication based on an informal assessment by a family member, even a nurse, without a valid order and proper assessment by facility staff is a violation of the MA-C's role. It constitutes practicing nursing without a license and medication administration without a proper order.