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MAP Knowledge Test questions
and answers CORRECT!!!
MAP Consultant - answer ✅✅A valuable medication information resource who can answer questions about specific med issues or med procedures. When you contact them, have the medication and med sheet available; contact them if there is a STAFF error or 5 rights do not agree. E.g. registered nurse, registered pharmacist, health care provider (HCP). Principles of Medication Administration - answer ✅✅1. Mindfulness
- Supporting abilities
- Communication Minfulness - answer ✅✅One of the principles of med administration that emphasizes always remaining alert and focused and thinking about what you are doing. Supporting Abiliites - answer ✅✅One of the principles of med administration that emphasizes helping the pt function as independently as possible and encouraging them to participate fully in the med admin process. Communication - answer ✅✅One of the principles of med administration that emphasizes reading the HCP order, pharmacy label, and med sheet, checking 5 rights, and talking + listening to the pt while you are administering their medication; also includes:
listening, documenting, body language, facial expression, tone of voice, speaking clearly, asking questions when needed. Respecting Rights - answer ✅✅Pts have right to:
- Confidentiality
- Know what their meds are and the reasons they are taken
- Know the risks associated with taking med
- Know the benefits of the med
- Refuse med
- Be given med only as ordered by HCP Observation - answer ✅✅The process of watching someone carefully in order to obtain information. Objective Observation - answer ✅✅Factual information you see, hear, feel, smell, or measure. Subjective Observation - answer ✅✅Observations that come from working with a person who communicates how they are feeling. Reporting - answer ✅✅Giving spoken or written information of something observed or told. I am responsible for making note of any physical or behavioral changes in pt. Immediate Reporting - answer ✅✅Reporting without delay as soon as possible after a change is observed; may prevent a small change observed from becoming a major health issue and allows the appropriate treatment to be ordered ASAP. 911 - answer ✅✅The person to call when:
-There is a math error in Countable Controlled Substance Book -The shift count pages in a Count Book are almost full -The Count Book binding is loose -A med seems to be tampered with -The med is low and I am unsure if a refill has been ordered -I cannot locate a med to administer Medication Progress Note - answer ✅✅Note that includes date, time, medication, dose, given/not given/refused, reason (for giving/not giving), results and/or response, and staff signature. Documenting - answer ✅✅Process that tells a story from start to finish. Guidelines: use ink, write clearly and in complete sentences. include: date, time, full name. Documenting an Error - answer ✅✅1. Draw a single line through the mistake (can circle as well)
- Write "error"
- Write initials
- Write what you meant to write DO NOT: scribble, mark over, erase, use white out Brand Name Medication - answer ✅✅Medication created and made by a specific pharmaceutical company, which they named. Generic Medication - answer ✅✅Medication known by the chemical name and manufactured by many different pharmaceutical companies (less expensive).
IC - answer ✅✅Abbreviation for 'interchange,' which means the generic name medication was supplied in place of the brand name medication. Controlled (Schedule VI) Medication - answer ✅✅Medication that requires a prescription, written by HCP, in order to obtain the med from pharm. Requires: HCP order, labeled and packaged by pharm, secured in locked area, tracked (using Med Ordering/Receiving Log, Med Sheet, Transfer Document, DPH Disposal Record); not counted. E.g. Antibiotics, antidepressants, antipsychotics Countable Controlled Medication (Schedule II-V) - answer ✅✅Medications that require a prescription, written by HCP, in order to obtain med from a pharmacy. Requirements include: HCP order, labeled and packaged by pharm in tamper resistant package with an identifier, secured in double locked area, tracked (using Med Ordering/Receiving log, Count Book, Med Sheet, Transfer Document, DPH Disposal Record), counted every time med storage keys change hands. On these meds, pharm will add an 'identifier' on the package such as a 'C', and Rx number that starts with a 'C,' an 'N,' or the package itself may be color coded. Sometimes called narcotics; e.g. prescription pain relievers, anti- anxiety medication. Over-the-Counter (OTC) Medication - answer ✅✅Med that may be purchased from a pharmacy without a prescription from HCP; however, MAP requires that all these meds be labeled by the pharmacy, which means that HCP must write a prescription. Requirements include: HCP order, packaged by pharm, labeled by pharm, secured in locked area, tracked using Med Ordering/Receiving log, Med Sheet, Transfer Document).
Medication Interaction - answer ✅✅A mixing of medications in the body, which will either increase or decrease the effects and/or side effects of one or both of the meds; the more meds a person takes the greater the possibility (can also occur with dietary supplements). Note: substances such as alcohol, nicotine, and caffeine have the ability to interact/interfere with absorption in the body. I must inform HCP if any of the pts I support use these substances. Sensitivity to Medication - answer ✅✅The phenomenon in which each person responds differently to the same medication. Factors include: age, weight, general health, medical history, use of other meds/dietary supplements. Preparing Pt for an HCP Appointment - answer ✅✅1. Tell pt date and time
- Discuss what will happen
- Follow any instructions ordered to prep for visit
- Think about: items to keep pt occupied, encouraging pt to wear comfortable clothes Be sure to have:
- Pt insurance card
- Copy of current medication sheets or list of medications
- HCP Encounter/Consult/Order Form
- Driving directions
- Money for parking, gas, food/drink
- Provider on-call info
- Family/Guardian info
- Name of pharmacy/phone #
- Charged phone Pt Appointment with HCP - answer ✅✅1. Assist pt if needed
- Advocate, encourage participation and support abilities
- Obtain the written results and recommendations from the apt including HCP Encounter/Consult/Order form After Appointment with HCP - answer ✅✅1. Ensure pharmacy received prescription
- Pick up new meds or check on delivery
- Bring back all forms, any prescriptions, HCP orders, and the next apt card to give to appropriate person
- Transcribe all medication orders onto the med admin sheet (Post and Verify all orders)
- Secure the medication
- Document the visit
- Communicate changes to all staff Medication Reconciliation - answer ✅✅The process of comparing an individual's new medication orders to all of the medication orders that were in place prior to the new orders (must be done during every transition of care). HCP Order by Telephone - answer ✅✅1. Record the order word-for- word on HCP Telephone Order form
- Read back the info given to me to confirm
- Ask for spelling
- Draw lines through any blank spaces
- Make sure HCP signs original order within 72 hours (I can administer medication while waiting for the signature in the first 72 hours)
- Med must remain in original, labled packaging received from pharm
- Each person must have own medical storage container with their name
- Meds separated by route (mouth separate from other routes)
- Med storage/prep area should have minimal distractions
- Meds stored away from food and/or toxic substances, excessive heat, moisture, and/or light Medication Sheet - answer ✅✅Document that tracks the administration of medications for each person who has a medication ordered; typically done on a monthly basis. Posting - answer ✅✅Documentation of the staff who completed the transcription (completed by two staff members). Helps ensure all medication orders are transcribed accurately onto medication sheets so that med is administered and ordered. Verifying - answer ✅✅Documentation by second staff member who reviews the transcription completed by the first staff, ensuring the HCP order and pharm label info was accurately transcribed onto the med sheet. PRN Medications - answer ✅✅Medications that are administered only 'as needed.' In addition to the 5 rights of med administration, these med orders must also include: -Specific target signs and symptoms for use -Measurable objective criteria (if needed) -PRN frequency -Parameters for use Note on documentation: write initials and time administered in the same med box + progress note
5 Rights of Medication Administration - answer ✅✅1. Right Person
- Right Medication
- Right Dose
- Right Time
- Right Route I Must Do This Right 3 Checks of Medication Administration - answer ✅✅1. HCP order and pharmacy label
- Pharmacy label and the medication sheet
- Pharmacy label and medication sheet Check 1 - answer ✅✅A comparison of the 5 rights between the HCP order and pharmacy label. Reasons: -Make sure there is an HCP order for the med I am going to administer -Make sure what the HCP ordered is what the pharmacy supplied -Make sure the order has not changed since the last time I administered med Check 2 - answer ✅✅A comparison of the 5 rights between the pharmacy label and the medication sheet. Reasons:
- Check for swallow
- Silent review of pharmacy label and medication sheet + notify Map Con. immediately if I realize mistake Medication Administration Process: Complete - answer ✅✅1. Document -In the medication book (place initials on med sheet) -Sign and initial on signature list -Fill out count book
- Secure the medication
- Wash hands
- Observe pt for effects of med Do Not Administer Medication - answer ✅✅What to do if: -I cannot read HCP order -There is no HCP order -I cannot read pharmacy label -There is no pharmacy label -Any concern that 5 rights do not agree -A medication seems to be tampered (altered) -A med was prepared by someone else -The pt has a serious change, has difficulty swallowing (dysphagia), refuses to take the med -The pharmacy supplied a liquid form of med, I have been giving the tablet form, and there is no change in HCP order -The medication was 'pre-poured' NEVER use another person's med to give to someone else for any reason
Liquid Medications - answer ✅✅See: p. 138-142 for liquid med instructions Medication Refusal - answer ✅✅An occurrence when a pt: -Says 'no' -Spits the medication right back out or never takes med from me -Spits the med out later -Intentionally vomits the med within half hour of taking it If person refuses, wait 15-20 minutes and offer med again. When offered a second time if the person still refuses, secure it, wait another 15-20 minutes and offer the medication a third time. When offered a third time if the person still refuses the medication, this is considered a final refusal. A person has up to three times to refuse a medication before you are to consider it a final refusal --> Report refusal to HCP Chain of Custody - answer ✅✅Unbroken documentation trail (of accountability) that ensures the physical security of a medication. Every med, from the time the med is requested from the pharmacy, either as a new medication or a medication refill, until the time the medication no longer exists in the program (administered, disposed, transferred etc.), the medication must be tracked. Medication Ordering and Receiving Log - answer ✅✅Tracking documentation that is ordered by a program and when received from the pharmacy. Must be filled out each time I: request a medication refill from the pharmacy or receive a medication refill from the pharmacy. Pharmacy Receipts - answer ✅✅Tracking documentation from the pharm of all meds dispensed to a program; whether delivered to the
- The off-going staff holds the count book and leads the count
- The on-coming staff locates the corresponding pack of meds
- The off-going staff verifies that the directions listed on the count page is accurate and that the number of pills in the 'amount left' column is the same as the number as the number counted by on- coming staff
- Both staff looks at and verifies the number of pills remaining in package and in the 'amount left' column are the same
- Process completed for each countable med
- After all countable meds have been counted both staff sign the count signature sheet
- Medication storage keys transferred to on-coming staff Two Signatures Required in the Count Book - answer ✅✅What is required when: -Adding a newly prescribed medication into count -Adding a medication refill from pharmacy into count -Disposing medication -Count sheet page is transferred, including both the bottom of the completed page and top of newly transferred page -Medications are counted each time the med storage keys change hands Leave of Absence - answer ✅✅When a medication will be administered outside of residence home and medication must be sent with the pt to be administered. Pharmacy must prepare medication if: -Scheduled ahead of time or -Greater than 72 hours
If pharmacy is unable to prepare the med, I may prepare it only if: -Unplanned (not scheduled ahead of time) and is -Less than 72 hours Possible Reasons for Medication Disposal - answer ✅✅Medication: -Was refused -Was dropped on floor -Was discontinued -Expired -Was prepared incorrectly or: -Person died -Supply of medicine in program is more than allowed -Unused LOA oral med was returned to program Situations in Which Two Certified Staff (no supervisor) May Dispose of Med - answer ✅✅If medication was: -Refused -Dropped -Prepared incorrectly
-Your supervisor is unavailable -Agency allows it Medication Disposal Procedure - answer ✅✅1. Remove medication from pharmacy packaging
Medication Occurrence Procedure - answer ✅✅1. Check to see if person is ok
- If not ok, call 911
- Call MAP Con. -Tell them: medication(s) involved, type of occurrence, date and time of occurrence
- Follow all recommendations given to you by the MAP Con.
- Notify supervisor
- Document: -What happened -Who was notified -MAP Consultant's recommendations -What I did -Sign name -Date + time
- Complete a Medication Occurrence Report (MOR) -If med occurrence is hotline, notify DPH and MAP Coordinator within 24 hours of discovery -Submit report within 7 days of discovery of the med occurrence to MAP Coordinator Discontinue - answer ✅✅When the HCP orders a medication or treatment to be stopped; abbreviated as D/C. Lot Number - answer ✅✅The number assigned to each 'batch' of medication produced; used in the event of a medication is required to be taken off the market. Omission - answer ✅✅Subcategory of wrong time medication occurrence; occurs when medication is not administered.
Types of Medication Occurrences - answer ✅✅1. Wrong Person
- Wrong Medication
- Wrong Dose
- Wrong Time
- Wrong Route
