During the morning medication pass, a client with dementia becomes tearful and keeps asking where her husband is. Her husband died several years ago. Which response by the medication aide is most appropriate?

Acknowledge her feelings and gently redirect her

Remind her firmly that her husband died several years ago

Leave the room and skip her medications for this pass

Tell her that her husband is coming to visit after lunch

Controlled substance count, end of day shift Medication Count on record Count in drawer Oxycodone 5 mg tablets 18 18 Lorazepam 0.5 mg tablets 12 11 Hydrocodone/acetaminophen 5/325 mg 20 20 The medication aide and the oncoming staff member find the counts shown above. What should the medication aide do?

Report the lorazepam discrepancy to the licensed nurse before leaving

Change the record to 11 so the count matches the drawer

Sign the count and leave the nurse a written note about the missing lorazepam

Recount alone after the oncoming staff member leaves

Which technique is correct when the medication aide instills eye drops for a client?

Drop it into the lower lid pocket without touching the eye

Drop the medication directly onto the center of the cornea

Ask the client to blink hard several times right after the drop

Rest the dropper tip on the lower lashes to steady it

Right after giving a client her morning tablets, the medication aide realizes the medication cup belonged to the client's roommate, who has the same last name. What should the medication aide do FIRST?

Stay with the client, check how she is, and call the licensed nurse

Complete an incident report before the end of the medication pass

Give the roommate's tablets to the roommate so her dose is on time

Call the client's family to explain the mistake

A newly admitted client speaks very little English, and the medication aide needs to explain that a new tablet has been added to her morning medications. Her 10-year-old grandson is visiting. What is the most appropriate way to communicate?

Use the facility's approved interpreter service

Ask the grandson to translate for his grandmother

Give the tablet without explaining it to avoid confusion

Speak slowly and loudly in English and use gestures

Controlled substance record, tramadol 50 mg tablets Time Entry Amount Balance 0700 Shift count 24 0900 Given to client 1 tablet 23 1300 Given to client 2 tablets 21 1500 End-of-shift count in drawer 20 The medication aide reviews the record shown above. Which statement is correct?

The drawer is 1 tablet short and must be reported to the nurse

The drawer has 1 extra tablet that should be recounted

The record and drawer match, so both staff members can sign the count

The drawer is 3 tablets short of the starting count

MAR excerpt Medication Route Time eye drops both eyes 2100 eye ointment both eyes 2100 Both medications are due at the same time. What is the correct way for the medication aide to give them?

Give the drops first, wait several minutes, then apply the ointment

Apply the ointment first so the drops mix into it

Mix the drops and ointment together in a cup before applying them to both eyes

Give the drops and ointment at once, one in each eye

At the start of her shift, the medication aide notices that a client's 0600 dose was left blank on the MAR by the aide who worked the night shift. The medicine is still in that day's blister pack. What should the medication aide do?

Report the blank entry and the unused dose to the licensed nurse

Initial the 0600 box, assuming the dose was given

Call the night-shift aide at home to ask what happened

Give the missed 0600 dose now along with the client's morning medications

Twenty minutes after a resident takes a newly ordered medication, the medication aide notices hives on her neck and hears her wheezing. She says her throat feels tight. How should this reaction be classified?

An adverse effect that needs the nurse immediately

A therapeutic effect showing the drug is absorbed

A mild side effect to note at the end of the shift

A cumulative effect that will fade in a few doses

MACE – Medication Aide Certification Exam

Free MACE Practice Questions

10 sample questions for the MACE – Medication Aide Certification Exam, with the correct answer and an explanation for each. No account needed. Try each one before you open the answer.

Sections covered on the exam: Authorized Duties, Medication Administration, Observation and Reporting, Medication Concepts and Measurements.

Question 1 · Authorized Duties
During the morning medication pass, a client with dementia becomes tearful and keeps asking where her husband is. Her husband died several years ago. Which response by the medication aide is most appropriate?
- A.Remind her firmly that her husband died several years ago
- B.Leave the room and skip her medications for this pass
- C.Acknowledge her feelings and gently redirect her
- D.Tell her that her husband is coming to visit after lunch
Show answer and explanation
Answer: C. Acknowledge her feelings and gently redirect her
Acknowledging the emotion and redirecting calms a client with dementia without arguing or lying, and builds the trust needed to give medications safely. Repeatedly correcting her forces her to relive the loss and usually increases agitation; promising a visit is deceptive, and skipping medications without reporting to the nurse is unsafe.
Question 2 · Medication Administration, Observation and Reporting
Controlled substance count, end of day shift
Medication Count on record Count in drawer
Oxycodone 5 mg tablets 18 18
Lorazepam 0.5 mg tablets 12 11
Hydrocodone/acetaminophen 5/325 mg 20 20
The medication aide and the oncoming staff member find the counts shown above. What should the medication aide do?
- A.Report the lorazepam discrepancy to the licensed nurse before leaving
- B.Change the record to 11 so the count matches the drawer
- C.Sign the count and leave the nurse a written note about the missing lorazepam
- D.Recount alone after the oncoming staff member leaves
Show answer and explanation
Answer: A. Report the lorazepam discrepancy to the licensed nurse before leaving
Any controlled-substance count that does not match must be reported to the licensed nurse right away, before the off-going staff leaves, so it can be investigated. Signing with a note accepts an incorrect count, and changing the record to match the drawer falsifies the record.
Question 3 · Medication Administration, Observation and Reporting
Which technique is correct when the medication aide instills eye drops for a client?
- A.Drop the medication directly onto the center of the cornea
- B.Ask the client to blink hard several times right after the drop
- C.Rest the dropper tip on the lower lashes to steady it
- D.Drop it into the lower lid pocket without touching the eye
Show answer and explanation
Answer: D. Drop it into the lower lid pocket without touching the eye
Eye drops are placed into the lower conjunctival sac, the pocket made by gently pulling down the lower lid, while the client looks up. Dropping onto the cornea is uncomfortable and triggers blinking that wastes the drop. Touching the tip to the lashes or eye contaminates the bottle, and squeezing or hard blinking pushes the medication out.
Question 4 · Medication Administration, Observation and Reporting
Right after giving a client her morning tablets, the medication aide realizes the medication cup belonged to the client's roommate, who has the same last name. What should the medication aide do FIRST?
- A.Complete an incident report before the end of the medication pass
- B.Give the roommate's tablets to the roommate so her dose is on time
- C.Stay with the client, check how she is, and call the licensed nurse
- D.Call the client's family to explain the mistake
Show answer and explanation
Answer: C. Stay with the client, check how she is, and call the licensed nurse
The client's safety comes first, so the aide observes the client and gets the licensed nurse immediately so the nurse can assess her and contact the prescriber. The incident report is completed afterward, per facility policy. Continuing the pass or calling the family delays care, and the family is informed by the nurse or according to policy.
Question 5 · Medication Concepts and Measurements
Diphenhydramine is ordered at bedtime for one resident to help with sleep and in the morning for another resident's seasonal allergies. For the resident taking it for sleep, the drowsiness it causes is best described as what?
- A.A cumulative effect
- B.A paradoxical effect
- C.A side effect
- D.A therapeutic effect
Show answer and explanation
Answer: D. A therapeutic effect
A therapeutic effect is the intended, desired action of the drug for the reason it was ordered; when diphenhydramine is given for sleep, drowsiness is that goal. For the resident taking it for allergies, the same drowsiness would be an unwanted side effect.
Question 6 · Authorized Duties
A newly admitted client speaks very little English, and the medication aide needs to explain that a new tablet has been added to her morning medications. Her 10-year-old grandson is visiting. What is the most appropriate way to communicate?
- A.Use the facility's approved interpreter service
- B.Ask the grandson to translate for his grandmother
- C.Give the tablet without explaining it to avoid confusion
- D.Speak slowly and loudly in English and use gestures
Show answer and explanation
Answer: A. Use the facility's approved interpreter service
An approved interpreter conveys health information accurately and keeps it confidential. Relying on a child is inappropriate because he may misunderstand or leave things out, and giving a medication with no explanation ignores the client's right to know what she is taking.
Question 7 · Medication Administration, Observation and Reporting
Controlled substance record, tramadol 50 mg tablets
Time Entry Amount Balance
0700 Shift count 24
0900 Given to client 1 tablet 23
1300 Given to client 2 tablets 21
1500 End-of-shift count in drawer 20
The medication aide reviews the record shown above. Which statement is correct?
- A.The drawer has 1 extra tablet that should be recounted
- B.The drawer is 1 tablet short and must be reported to the nurse
- C.The record and drawer match, so both staff members can sign the count
- D.The drawer is 3 tablets short of the starting count
Show answer and explanation
Answer: B. The drawer is 1 tablet short and must be reported to the nurse
Starting with 24 and giving 1 plus 2 tablets leaves 24 - 3 = 21 on record, but the drawer holds 20, so 1 tablet is missing and must be reported to the licensed nurse right away. The drawer is 4 tablets below the starting count, but 3 of those are accounted for by documented doses.
Question 8 · Medication Administration, Observation and Reporting
MAR excerpt
Medication Route Time
eye drops both eyes 2100
eye ointment both eyes 2100
Both medications are due at the same time. What is the correct way for the medication aide to give them?
- A.Apply the ointment first so the drops mix into it
- B.Mix the drops and ointment together in a cup before applying them to both eyes
- C.Give the drops and ointment at once, one in each eye
- D.Give the drops first, wait several minutes, then apply the ointment
Show answer and explanation
Answer: D. Give the drops first, wait several minutes, then apply the ointment
Drops go in first and the aide waits several minutes before applying ointment, because ointment forms a film that keeps later drops from being absorbed. Medications are never mixed unless ordered. Both medications are ordered for both eyes, so splitting them between eyes would be an error.
Question 9 · Medication Administration, Observation and Reporting
At the start of her shift, the medication aide notices that a client's 0600 dose was left blank on the MAR by the aide who worked the night shift. The medicine is still in that day's blister pack. What should the medication aide do?
- A.Report the blank entry and the unused dose to the licensed nurse
- B.Initial the 0600 box, assuming the dose was given
- C.Call the night-shift aide at home to ask what happened
- D.Give the missed 0600 dose now along with the client's morning medications
Show answer and explanation
Answer: A. Report the blank entry and the unused dose to the licensed nurse
A blank entry with the dose still in the pack suggests an omission, and the licensed nurse needs to know so the nurse can decide what to do and follow up. An aide never initials for a medication she did not give. Giving the missed dose on her own judgment could cause a double dose or interaction.
Question 10 · Medication Concepts and Measurements
Twenty minutes after a resident takes a newly ordered medication, the medication aide notices hives on her neck and hears her wheezing. She says her throat feels tight. How should this reaction be classified?
- A.An adverse effect that needs the nurse immediately
- B.A therapeutic effect showing the drug is absorbed
- C.A mild side effect to note at the end of the shift
- D.A cumulative effect that will fade in a few doses
Show answer and explanation
Answer: A. An adverse effect that needs the nurse immediately
Hives, wheezing and throat tightness are signs of a severe allergic reaction, an adverse effect that can be life-threatening and requires the nurse at once. Calling it a mild side effect and waiting until the end of the shift could cost the resident's life.

Controlled substance count, end of day shift
Medication	Count on record	Count in drawer
Oxycodone 5 mg tablets	18	18
Lorazepam 0.5 mg tablets	12	11
Hydrocodone/acetaminophen 5/325 mg	20	20

Controlled substance record, tramadol 50 mg tablets
Time	Entry	Amount	Balance
0700	Shift count		24
0900	Given to client	1 tablet	23
1300	Given to client	2 tablets	21
1500	End-of-shift count in drawer		20

MAR excerpt
Medication	Route	Time
eye drops	both eyes	2100
eye ointment	both eyes	2100

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