The MACE is a 60-question, 120-minute exam that certifies you to give medications under a nurse’s supervision. Most of the test — 60% of it — is medication administration, observation, and reporting, so that is where your study time should go. Here is a practical plan built around how the exam is actually weighted.
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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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The MACE has 60 questions (50 scored, 10 unscored pretest) across three areas: Medication Administration, Observation & Reporting (60%), Medication Concepts & Measurements (24%), and Authorized Duties (16%). Because administration is more than half the exam, master the six rights, routes, and what to observe and report before anything else.
Where do most people lose points?
Two places: dosage and measurement conversions, and knowing the limits of the medication aide role — when you must stop and hand off to the nurse. Practice conversions until they are automatic, and learn the tasks a medication aide may not perform.
How long should I study?
Most candidates are ready in three to four weeks studying a little each day: one week on administration and the six rights, one on concepts and measurements, one on authorized duties and legal/ethical limits, then timed full-length practice at the real 60-question, 120-minute pace.
Start by finding your gaps
Every honest study plan starts with knowing what you don't know. Try three practice questions.
Question 1
A Medication Aide is preparing for a busy morning medication pass. To save time, the aide considers placing the 8:00 AM oral medications for three different residents into separate, labeled medication cups on the cart before going to their rooms. Which statement correctly describes this practice?
▸ Why B is the answer
To ensure safety and adhere to the Six Rights, a Medication Aide must prepare and administer medications for only one resident at a time. Pre-pouring or 'batching' medications is strictly prohibited. Labeling cups might seem like a safe workaround, but pre-pouring medications for multiple residents at once is an unsafe practice that significantly increases the risk of mixing up medications. Administering within the one-hour time window is a requirement for the Right Time, but meeting this rule does not justify the unsafe practice of pre-pouring medications for multiple people. Seeking nurse approval is usually the right step when unsure, but a delegating nurse cannot authorize a Medication Aide to violate fundamental, non-negotiable medication safety standards.
Question 2
A resident is ordered to receive albuterol (a bronchodilator) and fluticasone (a corticosteroid) via metered-dose inhalers at 0800. How should the Medication Aide administer these medications?
▸ Why C is the answer
Administering the albuterol first opens the airways (bronchodilation), allowing the fluticasone (corticosteroid) to penetrate deeper into the lungs. Waiting 1 to 5 minutes between different inhalers is the standard practice to allow the first drug to act. This is incorrect because administering the corticosteroid first does not allow the airways to open up, reducing the effectiveness of the second medication. This is tempting because mouth rinsing is associated with inhalers, but the resident should rinse their mouth after the corticosteroid is administered to prevent oral thrush, not between the two inhalers. This is incorrect because administering puffs without waiting prevents optimal absorption of the medications.
Question 3
The MAR instructs the Medication Aide to administer digoxin 0.125 mg orally and to "hold for heart rate less than 60." The MA-C takes Mr. Harrison's radial pulse and counts 56 beats per minute. What is the MA-C's best action?
▸ Why D is the answer
When a vital sign falls outside the ordered parameters, the MA-C must withhold the dose and immediately report the finding to the delegating nurse for further assessment and instruction. This is incorrect because it directly violates the ordered parameter to hold the medication if the heart rate is below 60. This is tempting because the medication should be held, but the resident did not refuse the medication, and it is outside the MA-C's scope to notify the physician directly; the MA-C must report to the nurse. This is a common clinical trap, as resting heart rates fluctuate. However, the MA-C must follow the parameter at the time of administration and lacks the scope to independently decide to delay and re-evaluate without nurse direction.
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