# A nurse is preparing to administer medications to multiple patients during the morning shift. Which action by the nurse demonstrates the most effective strategy for preventing medication errors? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=543656 > language: ko > subject: Next Gen NCLEX ## 문제 A nurse is preparing to administer medications to multiple patients during the morning shift. Which action by the nurse demonstrates the most effective strategy for preventing medication errors? ## 보기 1. Verify the patient's identity using two patient identifiers before administering each medication **✔ 정답** 2. Double-check all medication calculations with another nurse before administration 3. Review the medication administration record (MAR) at the beginning of the shift 4. Organize all medications by room number before starting medication rounds **정답: 1** ## 해설 Using two patient identifiers before each medication administration is the most critical safety measure to prevent errors, adhering to the 'Five Rights'. Other options like double-checking calculations or reviewing MAR are helpful but do not universally prevent patient misidentification errors. ## 심화 해설 Correct Answer Analysis The most effective strategy for preventing medication errors among the options provided is to verify the patient's identity using two patient identifiers before administering each medication. This action directly operationalizes the first and most foundational of the traditional "five rights" of medication administration: the right patient. The framework of medication administration rights has existed for decades as a quality measure to aid clinicians in ensuring safety [3]. The implementation project by Smith and Upchurch specifically identifies the five rights—right patient, drug, route, dose, and time—as the daily practice used by nurses to prevent patient medication errors [1]. Confirming the patient's identity is the critical initial step that anchors all subsequent safety checks; administering the correct drug via the correct route at the correct dose and time becomes irrelevant if the patient is misidentified. This practice is a direct, point-of-care behavioral intervention that intercepts errors at the moment of administration, a role for which nurses are critically positioned [2]. In-Depth Analysis of Distractors Option 2: Double-check all medication calculations with another nurse before administration. While independent double-checks are a valuable safety strategy for high-alert medications or complex calculations, mandating this for all medications is not the most effective or practical primary strategy. It addresses only the right dose component of the five rights and can create workflow inefficiencies and a false sense of security through "normalization of deviance" if applied indiscriminately. Qualitative research highlights that medication errors stem from a complex interplay of human error and systemic failures, not just calculation mistakes [4]. An over-reliance on double-checking can distract from the more fundamental and universally applicable step of verifying the right patient before every single medication pass, which is a primary, non-delegable nursing responsibility. Option 3: Review the medication administration record (MAR) at the beginning of the shift. Reviewing the MAR is an essential preparatory step for organizing care, but it is a passive, pre-administration activity. It does not constitute an active error-prevention strategy at the point of medication administration. Errors can still occur between the review and the actual administration, such as a change in patient condition, a new order, or a patient being moved to a different bed. The most effective strategy must be a real-time, point-of-care verification that interrupts the error trajectory immediately before the drug reaches the patient, which is precisely the function of verifying patient identifiers. Option 4: Organize all medications by room number before starting medication rounds. This strategy is inherently dangerous and represents a significant system failure. Organizing medications by a physical location like a room number, rather than by a patient-specific identifier, directly circumvents the right patient check and introduces a high risk of error if a patient has been transferred or the room assignment is incorrect. This practice treats the patient as a location rather than an individual, undermining the core principle of patient-centered safety. The standard operating procedures for medication rights emphasize patient-specific verification processes, such as bar coding, not location-based organization, to mitigate negative safety trends [3]. Essential Nursing Knowledge: The Five Rights as a Behavioral Framework The "five rights" are not merely a checklist but a cognitive and behavioral framework designed to intercept errors. The implementation project in an acute care hospital setting aimed to improve nurses' compliance with these very rights, demonstrating their practical application as a best practice [1]. The process begins with the right patient, which is confirmed using two approved identifiers (e.g., name and date of birth, not room number). This verification creates a mental "time out" that prepares the nurse to then confirm the right drug against the MAR, the right dose through calculation and validation, the right route based on the order and patient assessment, and the right time. This framework is so fundamental that it has been adapted for use in clinical trials to ensure the safe administration of investigational products, establishing it as a universal standard for medication safety across clinical care and research [3]. A qualitative study in Saudi hospitals further reinforces that nurses are the final safety net, actively identifying and intercepting medication-related harm, making their point-of-care verification behaviors the most critical defense [2].References (research sources) - [1]Nurses' use of the five rights of medication administration in a comprehensive care unit: a best practice implementation project.Research articleSmith JM, Upchurch L. (2026) · DOI: 10.1097/xeb.0000000000000492 - [2]"It's Not Just a System Error": A Qualitative Study of Nurses' Perspectives on Medication Safety in Saudi Hospitals.Research articleAlshammari M. (2026) · DOI: 10.3390/healthcare14131840 - [3]Development of a standard operating procedure for investigational product rights of administration in clinical trials.RCT/clinical trialHill L, Jones CT. (2025) · DOI: 10.1017/cts.2025.10181 - [4]A Qualitative Exploration of the Perspectives on Medication Error Among Healthcare Professionals.Research articleBuragohain S, Sarma I, Chakrabarty A, Saikia D, Malakar H, Lahon J. (2026) · DOI: 10.7759/cureus.106107 ## 임상 시나리오 Patient Identification for Medication SafetyThe foundational step to prevent medication errors The most critical action before any medication administration is verifying the right patient using two approved identifiers (e.g., name, date of birth, medical record number). This aligns with the first of the Five Rights. Perform this verification actively by checking the identifiers on the patient's wristband against the Medication Administration Record (MAR) at the bedside. Do not rely on room numbers or verbal confirmation alone. CautionNever use a patient's room number as an identifier. This practice is a major source of error, especially if patients are transferred or room assignments change during a shift. ## 핵심 개념 - **Patient Identifiers** — Two unique pieces of information, such as name and date of birth, used to reliably confirm a patient's identity before any intervention. - **Five Rights of Medication Administration** — A foundational nursing framework to ensure safety, consisting of the right patient, right drug, right dose, right route, and right time. - **Medication Administration Record (MAR)** — A legal document detailing all prescribed medications for a patient, their dosages, and administration times, used for documentation and reference. ## 같은 주제 문제 - [A nurse is preparing to administer medications to multiple patients during the evening shi…](https://mymerci.kr/pages/nclex_q.php?qn_id=543657) - [A nurse is preparing to administer medications to multiple patients during the evening shi…](https://mymerci.kr/pages/nclex_q.php?qn_id=543658) - [A nurse is preparing to administer medications to multiple patients on a medical-surgical …](https://mymerci.kr/pages/nclex_q.php?qn_id=543659) --- More free questions: [기출문제](https://mymerci.kr/) _학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._