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MACE Practice Questions

Practice for the MACE — the 60-question Medication Aide Certification Examination — with real questions and clear rationales. Sixty percent of the exam is medication administration, observation, and reporting, so that is where these questions start. Work through a few below, then open the full MACE simulator to practice at the real pace.

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  • 💡 Key Takeaways — the one transferable rule per question
  • 🔍 Hint highlights — the decisive cue phrases in each stem
  • 📖 Full rationales — why every option is right or wrong

Every MACE question is written to the current exam outline for quick learning and a clear pass strategy.

Written and reviewed by the LexPort exam-prep team, led by our Founder & Exam-Prep Lead. LexPort builds certification practice questions — this is exam-preparation material, not medical advice. Last reviewed August 2026.

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Test yourself: 3 MACE practice questions

Tap an answer for instant feedback and the full rationale.

Question 1

When preparing solid oral medications (pills or capsules) from a multi-dose bottle, what is the correct technique to maintain infection control?

▸ Why C is the answer

This is correct. Pouring pills into the cap and then into the medication cup prevents the caregiver's hands from touching the medication, maintaining strict infection control. Pouring into a gloved hand is tempting, but gloves can still cross-contaminate the remaining pills if you touch multiple surfaces; non-touch technique is the standard. Using bare hands is tempting if they are freshly washed, but touching medications directly with bare hands is a gross violation of infection control. Shaking the bottle directly into the cup is tempting for speed, but it often results in dispensing the wrong number of pills or spilling them.

Question 2

You are preparing to administer a routine dose of an oral antibiotic to Ms. Allen. Her MAR specifically states, "Do not give with dairy products." You notice she is currently eating a bowl of cereal with milk. What should you do?

▸ Why D is the answer

This is correct. Dairy binds with certain antibiotics, preventing absorption. The Medication Aide must hold the medication and notify the nurse when a resident is consuming contraindicated foods. Giving it immediately is tempting to stay on schedule, but the medication will still mix with the dairy in her stomach, causing the interaction. Crushing and mixing is tempting to ensure she takes it, but this directly violates the MAR instruction by forcing the medication to mix with dairy. Providing water is tempting, but because she is actively eating cereal with milk, the dairy is already in her stomach, so the interaction will still occur.

Question 3

What is the correct procedure when a Medication Aide accidentally drops a controlled substance tablet on the floor?

▸ Why B is the answer

This is correct. A dropped controlled substance is contaminated and must be wasted. Wasting a controlled substance requires a witness (usually a nurse) and specific documentation to maintain an accurate narcotic count. Disposing in the regular trash is tempting because the pill is contaminated, but controlled substances cannot be thrown in the trash due to strict tracking and diversion laws. Leaving it on the floor is tempting if the aide is in a hurry, but this creates a severe safety hazard and a high risk for drug diversion. Wiping the tablet is tempting to avoid the paperwork of a wasted narcotic, but a dropped pill is contaminated and can never be administered to a resident.

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Question 1

A resident is prescribed a new oral antibiotic for a urinary tract infection. The pharmacy has just delivered the medication. The delegating nurse is currently on a meal break. What is the Medication Aide's (MA-C) most appropriate action?

  • A) Wait for the delegating nurse to return to administer or authorize the first dose.✓
  • B) Administer the medication immediately to ensure the resident receives timely treatment.
  • C) Call the pharmacy to verify the dosage instructions and then administer the medication.
  • D) Ask another Medication Aide to double-check the medication label before administering it.
Show rationale

Waiting for the delegating nurse to return is correct because national standards dictate that a licensed nurse must administer or specifically assess and authorize the first dose of any new medication.

Question 2

Mr. Alvarez tells the Medication Aide (MA-C) he has a mild headache. His MAR shows an active, nurse-delegated order: 'Acetaminophen 500 mg PO every 4 hours PRN for mild pain.' His last dose was 6 hours ago, and he has no other acetaminophen orders. What should the MA-C do?

  • A) Withhold the medication until the delegating nurse comes to assess his pain.
  • B) Administer one 500 mg dose, then observe and document the result.✓
  • C) Ask Mr. Alvarez to rate his pain from 1 to 10 and decide whether it qualifies for the dose.
  • D) Check his blood pressure and temperature and give the dose only if they are normal.
Show rationale

Correct — the PRN order has clear objective parameters (mild pain, every 4 hours), the 6-hour interval is satisfied, and administering a delegated PRN within its stated parameters is in the MA-C's scope. The aide observes the resident and documents afterward.

Question 3

According to national Medication Aide (MA-C) scope of practice standards, which of the following medication routes is strictly prohibited for the MA-C to administer?

  • A) A transdermal patch applied to the upper arm.
  • B) A metered-dose inhaler for a resident with asthma.
  • C) An intramuscular injection of a routine vitamin B12 supplement.✓
  • D) A vaginal suppository for a localized infection.
Show rationale

An intramuscular injection is correct as the prohibited route; MA-Cs are strictly forbidden from administering medications via invasive routes, including IM, IV, and subcutaneous injections.

Question 4

While administering morning medications, the Medication Aide (MA-C) realizes they just gave Mr. Smith a blood pressure pill intended for Mr. Stevens. What is the MA-C's immediate priority?

  • A) Induce vomiting to prevent the medication from being absorbed into the resident's system.
  • B) Complete a facility incident report detailing the exact nature of the medication error.
  • C) Check Mr. Smith's blood pressure to determine if the medication has caused harm.
  • D) Notify the delegating nurse immediately so the resident can be clinically assessed.✓
Show rationale

Notifying the delegating nurse immediately is correct because the resident's safety is the top priority, and a licensed nurse must perform a clinical assessment to manage any potential adverse effects.

Question 5

A resident with dementia spits out their morning dose of donepezil and refuses to take it. The resident's daughter, who is visiting, suggests crushing the pill and hiding it in the resident's applesauce. How should the Medication Aide (MA-C) respond?

  • A) Document the refusal on the MAR and notify the delegating nurse of the situation.✓
  • B) Crush the pill and mix it in the applesauce, as the family member provided consent.
  • C) Re-administer a new pill immediately since the first one was spit out.
  • D) Ask the daughter to feed the resident the applesauce containing the crushed medication.
Show rationale

Documenting the refusal and notifying the nurse is correct; residents have the right to refuse medication, and the MA-C must report this change so the nurse can evaluate the situation and follow up.

Practice MACE by topic

4 topics covered — each with real questions, rationales, and key takeaways.

Free MACE cheat sheets

Printable quick-reference guides — study them right here or download the PDF.

Frequently Asked Questions

How many questions are on the MACE?
Sixty multiple-choice questions — 50 scored and 10 unscored pretest items — with a 120-minute time limit.
What does the MACE cover?
Three areas: Medication Administration, Observation & Reporting (60%), Medication Concepts & Measurements (24%), and Authorized Duties (16%).

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