CSLB General Building (B) — All Questions

A medication aide is about to give a scheduled tablet. Which action correctly verifies the 'right patient'?

• a.Ask the resident's roommate to confirm the resident's name
• b.Check two identifiers such as the name and date of birth on the wristband against the MAR✓
• c.Give the medication to whoever is sitting in the resident's usual chair
• d.Match only the room number to the medication cart drawer

The right patient is confirmed using at least two identifiers (for example name and date of birth) matched to the MAR, never the room number or bed location alone. Relying on location, chairs, or roommates can lead to giving medication to the wrong person.

The 'rights' of medication administration include the right patient, drug, dose, route, and time. Which additional rights are commonly added to make eight rights?

• a.Right pharmacy, right insurance, right copay
• b.Right color, right smell, right shape
• c.Right documentation, right reason, and right response✓
• d.Right nurse, right shift, right cart

The eight rights expand the classic five (patient, drug, dose, route, time) with right documentation, right reason (indication), and right response (monitoring the effect). These extra rights reduce errors and confirm the medication is working as intended.

A resident is ordered a medication 'PC.' When should the aide plan to give it?

• a.After meals✓
• b.Before meals
• c.At bedtime
• d.Only when the resident asks

PC (post cibum) means after meals, while AC (ante cibum) means before meals. Timing abbreviations affect drug absorption and tolerance, so the aide must interpret them correctly against the MAR.

An order reads 'give at HS.' What does HS indicate?

• a.Every hour
• b.At bedtime (hour of sleep)✓
• c.Half strength
• d.As needed for pain

HS means hour of sleep, or bedtime. Misreading it as 'half strength' or 'every hour' could cause a serious dosing error, so standard abbreviations must be memorized.

A resident refuses her morning blood pressure pill. What is the correct action for the medication aide?

• a.Hide the pill in food without telling her
• b.Force the resident to swallow it for her safety
• c.Skip documentation since the pill was not given
• d.Respect the refusal, document it, and notify the nurse✓

Residents have the right to refuse medication. The aide honors the refusal, documents it on the MAR, and reports it to the supervising nurse so the refusal can be evaluated and the physician notified if needed.

Which route delivers medication under the tongue for rapid absorption into the bloodstream?

• a.Buccal
• b.Sublingual✓
• c.Topical
• d.Otic

Sublingual means under the tongue, where rich blood supply allows rapid absorption (for example nitroglycerin). Buccal placement is between the cheek and gum, which is a different route.

When instilling eye (ophthalmic) drops, where should the drop be placed?

• a.Directly onto the pupil
• b.On the outer corner near the ear
• c.Into the lower conjunctival sac after pulling down the lower lid✓
• d.On the closed eyelid so it soaks through

Ophthalmic drops go into the lower conjunctival sac formed by gently pulling down the lower lid, avoiding the cornea to prevent injury and blinking. Dropping directly on the pupil is uncomfortable and may cause the drop to be blinked out.

A resident needs otic (ear) drops. For an adult, how should the ear canal be positioned?

• a.Pull the pinna up and back to straighten the canal✓
• b.Pull the earlobe down and forward
• c.Push the tragus inward firmly
• d.Tilt the head so the affected ear faces down

In adults the pinna is pulled up and back to straighten the ear canal so drops reach the correct area; in young children it is pulled down and back. The resident should remain with the ear up for a few minutes afterward.

Before giving a transdermal patch, the aide should:

• a.Apply it over the previous patch to double the dose
• b.Remove the old patch, clean the area, and rotate to a new dry hairless site✓
• c.Cut the patch in half to reduce the dose
• d.Place it over a skin fold or irritated area

The previous patch must be removed and disposed of, the skin cleaned and dried, and a new non-irritated, hairless site chosen to ensure proper absorption. Leaving old patches on can cause an accidental overdose, and patches should never be cut.

Why should most extended-release or enteric-coated tablets not be crushed?

• a.Crushing changes the pill color
• b.It makes them taste better
• c.Crushing has no effect on how the drug works
• d.Crushing can release the full dose at once or destroy the protective coating✓

Extended-release and enteric-coated forms are designed to release slowly or protect the drug/stomach; crushing can cause a dangerous rapid dose or stomach irritation. The aide should check whether a medication may be crushed and consult the nurse or pharmacist if unsure.

A resident is scheduled for a medication 'daily' but the aide finds the pill was already initialed as given by the prior shift. What should the aide do?

• a.Do not give it again and verify with the nurse to prevent a double dose✓
• b.Give it anyway to be safe
• c.Give half the dose as a compromise
• d.Erase the previous initials and re-document

Giving a second dose could cause an overdose, so the aide must not re-administer and should confirm with the nurse. Documentation must never be erased or altered because the MAR is a legal record.

When is the correct time to document that a medication was given?

• a.Before entering the resident's room
• b.At the end of the entire shift from memory
• c.Immediately after the resident actually takes the medication✓
• d.Whenever the aide has free time

Documentation is completed right after the medication is administered, never before giving it (which would be falsifying the record) and never long after (which risks forgetting). Charting after administration keeps the MAR accurate and prevents duplicate dosing.

The MAR (Medication Administration Record) is best described as:

• a.A grocery list of the facility's supplies
• b.The legal record of every medication ordered and given to a resident✓
• c.The resident's personal diary
• d.An optional note the aide may skip

The MAR is a legal document listing each ordered medication, dose, route, time, and the initials of who administered it. Accurate MAR documentation protects the resident and the aide and supports continuity of care.

A resident is to receive a rectal suppository. Which technique is correct?

• a.Insert it with the flat end first
• b.Have the resident stand upright
• c.Keep it at room temperature so it melts in your hand
• d.Position the resident on the left side (Sims') and insert past the internal sphincter✓

A suppository is inserted with the resident in the left lateral (Sims') position, pushed past the internal anal sphincter with a lubricated gloved finger so it is retained. Keeping the suppository cool prevents premature melting.

A resident using a metered-dose inhaler should be taught to:

• a.Shake it, exhale, then inhale slowly while pressing and hold the breath about 10 seconds✓
• b.Inhale as fast and hard as possible without holding the breath
• c.Take two puffs in one single breath at the same instant
• d.Use it only after eating a full meal

Proper inhaler technique means shaking the canister, exhaling fully, then inhaling slowly during actuation and holding the breath about 10 seconds so the medication reaches the lungs. A spacer improves delivery, and waiting about a minute between puffs is recommended.

A liquid oral medication order says to give 'PRN.' This means the aide gives it:

• a.Every night automatically
• b.Only in the morning
• c.As needed, when specific criteria are met✓
• d.By intravenous route

PRN means 'as needed,' so the medication is given only when the resident meets the ordered indication (such as pain or nausea) and within the ordered frequency limits. The aide must document the reason, the time, and the resident's response.

When pouring a liquid medication into a medicine cup, the aide should read the amount at:

• a.The top edge of the fluid
• b.The bottom of the meniscus at eye level✓
• c.The highest point on the side of the cup
• d.Whatever line is easiest to see while standing

Liquid volume is measured at the bottom of the meniscus (the curved surface) with the cup held at eye level on a flat surface for accuracy. Reading from above or below the meniscus produces dosing errors.

Scenario: The aide realizes she gave a resident's 8:00 AM pill to the wrong resident. What is the FIRST priority action?

• a.Say nothing and hope no harm occurs
• b.Wait until the end of shift to mention it
• c.Blame the previous shift for a labeling problem
• d.Check on the resident who received it, notify the nurse, and complete an incident report✓

After a medication error the first priority is the safety of the resident who received the wrong drug, so the aide assesses them and notifies the nurse immediately. An honest incident report is then completed; hiding errors endangers residents and violates professional and legal duties.

A resident's order reads 'apply topically to affected area.' The aide should:

• a.Wear gloves and apply the cream to the skin as directed, avoiding broken areas unless ordered✓
• b.Have the resident swallow the cream
• c.Rub the cream into the eyes
• d.Apply it to any area the resident prefers

Topical medications are applied to the skin at the specific site ordered, using gloves to avoid absorbing the drug through the aide's own skin. It should be applied only to the ordered area and not substituted onto mucous membranes.

Why must the aide check the medication label three times before giving an oral drug?

• a.To practice reading skills
• b.To confirm the right drug and dose and prevent errors (when removing, preparing, and returning/before giving)✓
• c.Because the label changes color when correct
• d.Only new aides need to check once

The three checks (when taking the medication from storage, when preparing it, and before administering) are a core safety habit that catches wrong-drug and wrong-dose errors. Skipping checks is a leading cause of medication mistakes.

A resident has trouble swallowing a large tablet. The BEST first step for the aide is to:

• a.Crush every medication automatically
• b.Skip the dose without telling anyone
• c.Check whether the medication may be crushed or an alternate form is available, and consult the nurse✓
• d.Tell the resident to swallow it dry

Swallowing difficulty should be reported and the aide should verify whether the drug can be crushed or if a liquid form exists, because some tablets must never be crushed. The nurse coordinates a safe alternative rather than the aide deciding independently.

The 'right time' rule generally allows a scheduled medication to be given within what window around the ordered time (per most facility policies)?

• a.Exactly to the second
• b.Any time within 8 hours
• c.Only after the physician calls
• d.Typically within 30 to 60 minutes before or after the scheduled time✓

Most facilities allow a scheduled dose to be given within about 30 to 60 minutes before or after the ordered time to be considered 'on time.' Time-critical medications (such as insulin or some antibiotics) have tighter windows and must follow specific timing.

Before administering nose (nasal) drops, the aide should have the resident:

• a.Blow the nose gently, then tilt the head back for drops✓
• b.Lie flat on the stomach
• c.Hold the breath for two minutes
• d.Sit fully upright and look down

The resident gently blows the nose to clear the passages, then tilts the head back so the drops reach the nasal membranes. Remaining in position briefly helps the medication stay in place.

A resident spits out a pill after the aide charted it as given. The aide should:

• a.Leave the documentation unchanged and ignore it
• b.Notify the nurse and follow policy for correcting the record about the dose not being taken✓
• c.Pick the pill up and put it back in the resident's mouth
• d.Give a brand-new full dose without asking anyone

If a charted dose is not actually swallowed, the aide reports it to the nurse and corrects the record according to policy so the MAR reflects reality. Whether to redose is a nursing/provider decision, not the aide's independent choice.

Which is an example of the 'right dose'?

• a.Giving the pill because it was in the drawer
• b.Guessing the amount if the label is unclear
• c.Confirming the ordered amount matches the label and calculating tablets correctly✓
• d.Giving two pills because the resident is large

The right dose means the amount given matches the physician's order and the label exactly, with any needed calculation double-checked. If the available strength differs from the order, the aide calculates carefully and verifies before giving.

A resident on the medication cart is not wearing an ID band and the aide is new and does not recognize the resident. The aide should:

• a.Give the medication based on the room number
• b.Ask another resident to identify them
• c.Guess based on the photo age
• d.Verify identity with a licensed staff member and a facility-approved identifier before giving✓

Without a reliable identifier, the aide must not administer and should confirm identity through an approved method such as a staff verification or resident photo per policy. Two identifiers protect against wrong-patient errors.

The 'right route' rule means the aide must:

• a.Give the medication by the exact route ordered, such as oral versus topical✓
• b.Choose whichever route is fastest for the aide
• c.Substitute an oral pill if a suppository is inconvenient
• d.Crush a patch and give it by mouth

Medications are formulated for specific routes, and giving a drug by the wrong route can be ineffective or dangerous. The aide follows the ordered route exactly and never converts a form to a different route on their own.

When administering multiple oral tablets from a punch (blister) card, the aide should:

• a.Empty all residents' cards into one cup
• b.Prepare and give one resident's medications at a time to avoid mix-ups✓
• c.Pre-pour every resident's pills an hour ahead into open cups
• d.Let residents pick their own pills from the cart

Preparing and administering one resident's medications at a time, kept in their original packaging until the point of use, minimizes the risk of mixing up doses. Pre-pouring for many residents ahead of time increases error risk.

A resident's oral liquid antibiotic says 'shake well before use.' If the aide does not shake it:

• a.Nothing changes about the dose
• b.It will taste sweeter
• c.The active drug may settle, causing an inaccurate dose✓
• d.The bottle will spill

Suspensions separate over time, so failing to shake the bottle can give the resident too little or too much active medication. Following label instructions such as 'shake well' is part of accurate administration.

Scenario: A resident asks the aide what a new pill is for before taking it. The BEST response is to:

• a.Refuse to answer because it is not the aide's job
• b.Make up a purpose so the resident cooperates
• c.Tell the resident to look it up themselves
• d.Provide the known purpose if within scope, and involve the nurse for detailed questions✓

Residents have a right to know what they are taking (right to information), and the aide can share the basic purpose noted on the MAR while referring complex questions to the nurse. Honest communication supports informed consent and the right to refuse.

After giving all scheduled medications, the aide notices one blister pack still has a pill for a resident charted as 'given.' The BEST action is to:

• a.Investigate immediately, determine whether the resident actually received the dose, and notify the nurse✓
• b.Assume it was given and move on
• c.Throw the extra pill away quietly
• d.Give the pill to a different resident who takes the same drug

A discrepancy between the MAR and the remaining stock signals a possible missed or double dose and must be investigated at once with the nurse. Medications are never transferred between residents, and errors are documented honestly.

The 'right documentation' includes recording a PRN medication's:

• a.Only the aide's mood
• b.Reason it was given, the time, and the resident's response✓
• c.The weather that day
• d.Nothing, since PRN drugs are optional

For PRN medications the aide documents why it was needed, when it was given, and how the resident responded (for example pain relief), which supports the right reason and right response. This record helps the care team evaluate effectiveness.