MACE Cheat Sheet

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. Administering the medication immediately is tempting to provide prompt care, but it violates scope of practice; MA-Cs cannot give the first dose of a new medication because the resident must be monitored for initial allergic reactions or adverse effects by a nurse. Calling the pharmacy to verify instructions is tempting as a safety check, but the MA-C still cannot administer a first dose, regardless of pharmacist clarification. Asking another MA-C to double-check the label is a good general safety practice for routine meds, but two MA-Cs cannot bypass the rule requiring a nurse for a first dose.

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. Over-cautious: the nurse already set the parameters when delegating this order, so no further authorization is needed for a clear, in-parameter request. Rating the pain and judging whether it 'qualifies' is a clinical assessment beyond the aide's role — the order's parameters already define eligibility. This order does not require vital signs, and letting them gate the dose turns a simple administration into an assessment the aide should not perform.

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. A transdermal patch is a topical route, which is routinely permitted within the MA-C scope of practice. A metered-dose inhaler is an inhaled route, which MA-Cs are trained and authorized to administer. A vaginal suppository is a permitted route for an MA-C under standard delegation guidelines.