5 Rights
Medication Administration Rights
Five checks before every dose — no shortcuts.
On the AANP exam, medication errors are tested as system failures, and the 5 Rights are the irreducible verification loop every nurse and NP runs before a dose. Right patient (two identifiers), right drug (label match), right dose (calculated, double-checked for high-alert meds), right route (PO, IV, SC, IM, sublingual), right time (frequency, lookback for last dose). Some institutions add right documentation, indication, and response — useful, but the original five are what boards tests. AANP vignettes will hand you a near-miss and ask what step would have prevented it. The answer almost always lives inside the 5 Rights.
- 1Right patientTwo identifiers (name + DOB or MRN); check the wristband.
- 2Right drugName matches the order; not a look-alike/sound-alike.
- 3Right doseCalculated; matches the order; pediatric mg/kg double-checked.
- 4Right routePO vs IV vs IM vs SQ vs PR — never assume.
- 5Right timeScheduled vs PRN; frequency not exceeded; hold parameters checked.
Clinical Context
Foundational safety check for every medication administration. An error on any right causes a med error — the big ones to never skip are patient and dose, especially for high-alert meds (insulin, heparin, opioids, chemo, concentrated electrolytes).
Modern expansions add Right documentation, Right reason, Right response, and Right to refuse — but the classic 5 are non-negotiable. AANP tests this under nursing/professional-role questions: the stem describes a scenario where one right is violated and you identify which.
Practice Questions
The MAR for a 64-year-old man lists metoprolol tartrate (Lopressor) 25 mg PO every 12 hours. The nurse picks up the patient's scheduled dose and notices that the pharmacy has dispensed 50 mg tablets rather than 25 mg. Instead of splitting the tablet, the nurse administers the full 50 mg tablet. Which of the 5 Rights of Medication Administration was most directly violated?
Related Mnemonics
Sources
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