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NCLEX-RN Medication error prevention practice questions

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These are original practice items written to the NCLEX-RN blueprint (4 options, no penalty for wrong answers), not actual exam questions. Try each one before you open the answer.

What this topic covers

Medication error prevention sits inside the Safety and Infection Control category of the NCLEX-RN. Our bank holds 33 verified items tagged to it, and the 4 below are a fixed sample so the page stays the same every time you open it. Each one shows the reasoning, not just the letter.

The topic tag comes from our own items rather than from a published syllabus, so treat it as a map of what we cover. For the official category breakdown see the NCLEX-RN page.

Medication error prevention sample questions

Question 1

A 72-year-old client in a long-term care facility is prescribed metoprolol 25 mg by mouth daily. The nurse notes that the medication administration record lists 'metoprolol 25 mg IV push daily.' The client has no IV access. Which action should the nurse take first?

  1. A Call the pharmacy to verify the order
  2. B Contact the prescriber to clarify the route
  3. C Administer the oral metoprolol from the unit stock
  4. D Hold the dose and document the discrepancy
Show the answer and explanation

Correct answer: B

When the medication administration record does not match the prescription, the nurse must clarify with the prescriber before giving the drug. Only the prescriber can confirm the intended route, and 25 mg is not a usual IV push dose of metoprolol, which makes the IV entry even more suspect.

Why the other options are wrong:
A: The pharmacy can help correct the record, but only the prescriber can confirm which route was intended.
C: Giving any form of the drug before the discrepancy is resolved risks a medication error.
D: Holding and documenting without contacting the prescriber leaves the discrepancy unresolved and delays the client's medication.

Question 2

A 72-year-old client in a long-term care facility is prescribed warfarin 2 mg orally daily. The nurse notes that the pharmacy sent warfarin 5 mg tablets. Which action should the nurse take first?

  1. A Contact the pharmacist to obtain the correct 2 mg tablet before administration.
  2. B Crush the 5 mg tablet and mix it with applesauce to disguise the size.
  3. C Administer the 5 mg tablet and document the dose as given.
  4. D Hold the dose and notify the provider that the pharmacy made an error.
Show the answer and explanation

Correct answer: A

The 5-mg tablet does not match the 2-mg prescription, and a warfarin overdose can cause serious bleeding. The nurse obtains the correct strength from the pharmacist before giving the dose.

Why the other options are wrong:
B: Crushing does not change the 5-mg dose, and disguising medication is deceptive.
C: Giving 5 mg is a medication error that increases bleeding risk.
D: The pharmacist can correct the dispensing error directly, so the provider does not need to change the order.

Question 3

A nurse is administering medications to a 70-year-old client with a history of hypertension and heart failure. The nurse has the medication administration record (MAR) and the client’s wristband. Which step is most important to prevent an error?

  1. A Check the client’s room number and bed number against the MAR.
  2. B Ask the client to state their name while comparing to the MAR.
  3. C Verify the client’s name and date of birth using two identifiers.
  4. D Scan the client’s wristband barcode and the medication barcode.
Show the answer and explanation

Correct answer: C

Using two client identifiers, such as name and date of birth, checked against the MAR and wristband is the national safety standard for preventing wrong-client errors. It is the core step that must be done before any medication is given.

Why the other options are wrong:
A: Room and bed numbers are never acceptable identifiers because clients change rooms and beds.
B: The client's name alone is only one identifier and is not sufficient.
D: Barcode scanning adds a layer of safety but supplements, rather than replaces, verification with two identifiers.

Question 4

A nurse is preparing to administer an intravenous antibiotic to a 55-year-old client with pneumonia. The pharmacy label reads "Ceftriaxone 1 g in 50 mL D5W." The nurse notes that the client's wristband has a red allergy alert sticker for ceftriaxone. What should the nurse do first?

  1. A Call the pharmacy to confirm that the label is correct before giving the drug.
  2. B Administer the medication slowly over 30 minutes and observe for a rash.
  3. C Check the client's medical record for a documented history of the allergic reaction.
  4. D Hold the medication, verify the allergy with the client, and notify the prescriber.
Show the answer and explanation

Correct answer: D

An allergy alert for the exact drug being given means the order could cause a severe reaction, including anaphylaxis. The nurse must hold the dose, confirm the allergy and reaction with the client, and notify the prescriber for an alternative.

Why the other options are wrong:
A: The label may be correct; the problem is the client's allergy, which the pharmacy cannot resolve.
B: Giving a drug the client is flagged as allergic to, even slowly, risks anaphylaxis.
C: Reviewing the record is useful, but the nurse must first hold the medication and involve the prescriber.

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