CMA PRACTICE MEDICATION PASS

Eleanor Jones

Maple Grove Home Plus • Resident Simulation Packet

Educational simulation only — fictional orders and resident data for supervised CMA practice.

1. Resident Care Plan

Active Diagnoses

Congestive heart failure (CHF)

Type 2 diabetes mellitus

Atrial fibrillation (AFib)

Mild osteoarthritis

Mild hearing loss

Wears glasses

Baseline / Person-Centered Care

What Helps Eleanor

Ask before helping; Eleanor prefers to do as much as she safely can.

Face her when speaking, reduce background noise, and speak clearly without shouting.

Explain medications and assessments before beginning; do not talk over her.

Give her time to make choices and participate in her own care.

Watch for changes in breathing, swelling, weight, pulse, bleeding, or activity tolerance.

CMA Safety Focus

CHF: compare weight, breathing, edema, and activity tolerance with baseline and report meaningful changes.

AFib/rate-control medication: obtain pulse as ordered; follow written hold parameters and notify the licensed nurse.

Anticoagulant safety: observe for unusual bruising, bleeding, blood in urine/stool, or black/tarry stool and report promptly.

Diabetes medication: verify meal/intake and glucose information required by the care plan/order; report significant changes.

Diuretic/electrolyte medications: give exactly as ordered and report dehydration, weakness, cramps, or major weight/fluid changes.

2. Medication Profile

Use this page to review each medication before beginning the simulation.

3. Provider Medication Orders

Resident: Eleanor Jones • DOB: 03/22/1940 • Room: Bedroom 1 • Allergies: NKDA

Student Order Check

Resident / identifiers verified

Allergies reviewed

Order compared with MAR

Medication labels compared with MAR

Questions or discrepancies identified before preparation

4. Simulation MAR — 08/17/2026

Resident: Eleanor Jones • Room: Bedroom 1 • Allergies: NKDA

SIMULATION LEGEND: Initial only after administration. If a medication is not given, document the reason and licensed-nurse notification according to facility policy. PRN medications require an indication and follow-up response.

5. Student Scenario — Morning Medication Pass

Start of Shift: 0910

You are the CMA assigned to Eleanor for the morning medication pass. Before entering her room, you review the MAR.

Eleanor’s morning weight is 123.2 lb. Yesterday’s documented weight was 119.0 lb.

She has new 2+ ankle edema and says, “I got more winded walking to breakfast than I usually do.”

BP 112/68 mmHg; apical pulse 54 bpm and irregular; SpO₂ 93% on room air. Her usual SpO₂ is 94–97%.

Eleanor reports one black, tarry stool this morning. She denies bright-red bleeding but has a new large bruise on her left forearm.

Blood glucose before breakfast was 142 mg/dL. She ate about 75% of breakfast, and the 0800 metformin is already documented as given.

She reports hand pain 1/10 and does not request pain medication.

Student Tasks

Student Work Space

6. Medication-Pass Performance Checklist

SBAR Practice

S — Situation

B — Background

A — Assessment

R — Recommendation / Request

INSTRUCTOR KEY — REMOVE BEFORE STUDENT USE

CMA PRACTICE MEDICATION PASS

Frank Miller

Maple Grove Home Plus • Resident Simulation Packet

Educational simulation only — fictional orders and resident data for supervised CMA practice.

1. Resident Care Plan

Active Diagnoses

Alzheimer's disease

Hypertension

Hyperlipidemia (high cholesterol)

Osteoarthritis

Chronic constipation

Hearing loss

Baseline Information

Person-Centered Care

Approach from the front, identify yourself, and use short, simple explanations.

Do not argue with memory errors; redirect gently using familiar routines.

Offer one step at a time and allow extra time to respond.

If Frank refuses medication, do not force or hide it in food; report and document according to policy.

Watch for changes in behavior, bowel pattern, pain, swallowing, or level of alertness.

2. CMA Safety Focus

What This Resident Is Designed to Teach

Dementia-sensitive communication during medication administration.

Resident right to refuse medication.

How to respond when a resident says a medication was already given but the MAR is blank.

Routine versus PRN bowel medications and ordered administration times.

Recognition that atorvastatin is a bedtime medication, not a morning medication.

PRN pain assessment, last-dose review, maximum daily acetaminophen awareness, and response documentation.

Key Practice Principles

Verify before re-dosing. A resident statement alone does not confirm administration, and a blank MAR does not prove a dose was missed.

Do not argue about incorrect memories. Calmly redirect and continue with clear, simple choices.

Medication refusal is not a medication-administration failure. It is a resident-rights situation requiring appropriate documentation and nurse notification.

A PRN indication does not give the CMA permission to change a specifically ordered administration time.

Document only what actually occurred.

3. Medication Profile

Review each medication before beginning the simulation.

4. Provider Medication Orders

Resident: Frank Miller • Room: Bedroom 4 • Allergies: NKDA

Student Order Check

Resident / identifiers verified

Allergies reviewed

Order compared with MAR

Medication labels compared with MAR

Questions or discrepancies identified before preparation

5. Simulation MAR — 08/17/2026

Resident: Frank Miller • Room: Bedroom 4 • Allergies: NKDA

SIMULATION LEGEND: Initial only after administration. If a medication is refused, held, not due, or not given, document the reason and licensed-nurse notification according to facility policy. PRNs require indication and follow-up.

6. Student Scenario — Morning Medication Pass

Start of Shift: 0915

You are the CMA assigned to Frank for the morning medication pass.

Frank is seated at the dining table after breakfast. He is pleasant but mildly confused and asks twice where his wife is.

BP 138/76 mmHg; pulse 72 bpm; respirations 18; SpO₂ 95% on room air.

When you explain that it is time for his morning medications, Frank says, “No, I already took those pills. Helen gave them to me.” His wife died several years ago.

The MAR has no initials for the 0900 medications.

Frank reports knee pain 2/10 and says it is “not bad.” He does not request pain medication.

The bowel record shows no bowel movement for 3 days. Frank denies severe abdominal pain, nausea, or vomiting.

After you calmly redirect and explain the medications one at a time, he agrees to take the losartan and docusate but pushes the memantine cup away and says, “I don’t want that one.”

Student Tasks

7. Student Work Space & Performance Checklist

Performance Checklist

8. SBAR Practice

S — Situation

B — Background

A — Assessment

R — Recommendation / Request

INSTRUCTOR KEY — REMOVE BEFORE STUDENT USE

CMA PRACTICE MEDICATION PASS

George Carter

Maple Grove Home Plus • Resident Simulation Packet

Educational simulation only — fictional orders and resident data for supervised CMA practice.

1. Resident Care Plan

Active Diagnoses

Hypertension

Hyperlipidemia (high cholesterol)

Osteoarthritis

Chronic low back pain

Hearing loss

Baseline Information

Person-Centered Care

Face George when speaking and make sure his hearing aid is in place; speak clearly without shouting.

Explain medications briefly and directly. George likes to know what each medication is for.

Include him in decisions and allow him to take medications from the cup himself while you remain present.

Do not leave medications at the bedside or on the table for later unless an authorized self-administration plan specifically allows it.

Ask about pain, mobility changes, dizziness, swelling, and skin condition before relevant medications.

2. CMA Safety Focus

What This Resident Is Designed to Teach

Balancing resident independence with medication-administration safeguards.

Using the actual provider order and assessment findings instead of inventing medication hold parameters.

Correct topical-medication administration, including site verification and skin assessment.

Recognizing a bedtime cholesterol medication that is not part of the morning pass.

PRN pain assessment, last-dose review, ordered interval, total daily acetaminophen awareness, and response documentation.

Communication adaptations for a resident with hearing loss.

Key Practice Principles

Support independence without abandoning medication safety. George may take pills from the medication cup himself, but the CMA remains responsible for the pass.

Do not invent hold parameters. Use the current order, resident assessment, facility policy, and licensed-nurse direction.

Topical medications require the same medication rights as oral medications plus correct site, skin assessment, measurement, and infection-control technique.

A PRN medication is not available simply because the resident has the symptom; the ordered dosing interval must also be met.

Document only what actually occurred, including the site of topical medication and any dose not administered.

3. Medication Profile

Review each medication before beginning the simulation.

4. Provider Medication Orders

Resident: George Carter • Room: Bedroom 14 • Allergies: NKDA

Student Order Check

Resident / identifiers verified

Allergies reviewed

Order compared with MAR

Medication labels compared with MAR

Questions or discrepancies identified before preparation

5. Simulation MAR — 08/17/2026

Resident: George Carter • Room: Bedroom 14 • Allergies: NKDA

SIMULATION LEGEND: Initial only after administration. If a medication is refused, held, not due, or not given, document the reason and licensed-nurse notification according to facility policy. PRNs require indication, timing verification, and follow-up.

6. Student Scenario — Morning Medication Pass

Start of Shift: 0910

You are the CMA assigned to George for the morning medication pass.

George is seated at the table working on a crossword. His hearing aid is in place. He is alert, oriented, and tells you he likes to know what each medication is for.

BP 154/86 mmHg; pulse 70 bpm; respirations 18; SpO₂ 97% on room air. He denies headache, chest pain, dizziness, weakness, or shortness of breath.

George reports right-knee pain 6/10 after walking to breakfast. The skin over the knee is intact with no redness, open areas, or drainage.

The MAR shows acetaminophen 1000 mg was administered at 0400. The order is every 8 hours PRN; the next eligible dose is 1200.

When you bring the scheduled medications, George says, “Just leave the pills and that Tylenol here. I’ll take them when I finish this puzzle.”

He is not on an authorized self-administration plan in this simulation.

Atorvastatin is present on his medication profile but is scheduled for 2100.

Student Tasks

7. Student Work Space & Performance Checklist

Performance Checklist

8. SBAR Practice

S — Situation

B — Background

A — Assessment

R — Recommendation / Request

INSTRUCTOR KEY — REMOVE BEFORE STUDENT USE

CMA PRACTICE MEDICATION PASS

Harold Thompson

Maple Grove Home Plus • Resident Simulation Packet

Educational simulation only — fictional orders and resident data for supervised CMA practice.

1. Resident Care Plan

Active Diagnoses

Type 2 Diabetes Mellitus

Chronic Obstructive Pulmonary Disease (COPD)

Hypertension

Mild Osteoarthritis

Hearing loss

History of falls

Baseline Information

Person-Centered Care

Include Harold in decisions and explain what each medication is for; he strongly values independence.

Speak clearly and face him; do not rush him in the morning.

Allow extra time for inhaled-medication technique and coach one step at a time when needed.

Encourage him to sit for the medication pass if he is short of breath or lightheaded because of his fall history.

He likes strong coffee, but medication timing and ordered administration instructions still come first.

2. CMA Safety Focus

What This Resident Is Designed to Teach

COPD: distinguish a maintenance inhaler from a rescue inhaler and assess/report changes in breathing.

Tiotropium HandiHaler: the 18 mcg capsule is for inhalation through the device and must not be swallowed.

PRN albuterol: verify the indication, previous dose, ordered interval, and response; follow written notification parameters.

Metformin is an oral diabetes medication. No injectable medication is included in Harold’s simulated pass.

Blood-glucose testing is treated as a delegated nursing procedure in this scenario rather than an automatic CMA task.

Resident choice and fall safety remain part of medication administration.

Key Practice Principles

Use the medication order exactly as written. Do not change the dose, route, interval, or create an unwritten hold parameter.

Know the difference between maintenance and rescue respiratory medications. Tiotropium is scheduled maintenance; albuterol is PRN rescue therapy.

A capsule can still be an inhaled medication. The tiotropium capsule belongs in the HandiHaler device — never in the resident’s mouth to swallow.

For a PRN respiratory medication, assess the symptom, verify the last dose and interval, administer correctly, and reassess/document the response.

Kansas regulations allow certain nursing procedures outside the CMA curriculum to be delegated by a licensed nurse when delegation requirements are met. Do not assume an extra procedure is automatically within CMA scope.

3. Medication Profile

Review each medication before beginning the simulation.

4. Provider Medication Orders

Resident: Harold Thompson • Room: Bedroom 3 • Allergies: NKDA

Student Order Check

Resident / identifiers verified

Allergies reviewed

Order compared with MAR

Medication labels compared with MAR

Questions or discrepancies identified before preparation

5. Simulation MAR — 08/17/2026

Resident: Harold Thompson • Room: Bedroom 3 • Allergies: NKDA

SIMULATION LEGEND: Initial only after administration. For PRNs, verify indication, last dose/interval, and response. Follow written notification parameters. Do not perform non-curriculum nursing procedures unless properly delegated, trained, and documented.

6. Student Scenario — Morning Medication Pass

Start of Shift: 0910

You are the CMA assigned to Harold for the morning medication pass.

Harold is sitting at the dining table after breakfast with his coffee. He is alert, oriented, and joking with you. He prefers to do as much for himself as possible.

BP 126/72 mmHg; pulse 84 bpm; respirations 22/min. After walking back from breakfast, he says, “I’m a little more winded than usual.”

You hear mild expiratory wheezing. SpO₂ is 91% on room air; Harold’s documented usual SpO₂ is 93–95%.

His albuterol order is 2 puffs every 4 hours PRN wheezing/shortness of breath. The MAR shows the last dose at 0445, so the ordered interval has been met.

The albuterol order says to notify the licensed nurse for SpO₂ below 92%, worsening breathing, chest pain, or symptoms not relieved after treatment.

Tiotropium is due at 0900. Harold looks at the capsule and asks, “That tiny thing is my breathing pill? Do I just swallow it?”

Metformin 500 mg and losartan 50 mg are due. Harold ate about 75% of breakfast. Nursing already documented a glucose of 132 mg/dL earlier this morning.

Student Tasks

7. Student Work Space & Performance Checklist

Performance Checklist

8. SBAR Practice

S — Situation

B — Background

A — Assessment

R — Recommendation / Request

INSTRUCTOR KEY — REMOVE BEFORE STUDENT USE

CMA PRACTICE MEDICATION PASS

Maggie Redbird

Maple Grove Home Plus • Resident Simulation Packet

Educational simulation only — fictional orders and resident data for supervised CMA practice.

1. Resident Care Plan

Active Diagnoses

Type 2 Diabetes Mellitus

Hypertension

Hyperlipidemia (high cholesterol)

Osteoarthritis

Mild hearing loss

Wears glasses

Baseline Information

Person-Centered Care

Approach calmly, speak clearly, and give Maggie time to think and respond.

Ask rather than assume; Maggie values privacy, personal space, and being treated as an adult.

Explain medications and choices without rushing or talking over her.

Family, faith, quiet time, crafts, reading, and familiar routines are important to her.

She enjoys herbal tea, but only medications/supplements on the current order may be administered.

2. CMA Safety Focus

What This Resident Is Designed to Teach

Diabetes: connect oral diabetes medication timing with meal availability and written blood-glucose parameters.

Glipizide ER: extended-release tablets must be swallowed whole; do not crush, chew, or split.

Transdermal/topical medication: verify the old lidocaine patch is removed before applying a new patch; assess intact skin and document site/time.

Hypertension: use the actual lisinopril order and assessment findings; do not create an unwritten hold parameter.

Kansas scope: use only medications and procedures within CMA training/delegation requirements; no injectable medication is included in this simulation.

Resident choice and fall safety remain part of medication administration.

Key Practice Principles

Use the medication order exactly as written. Do not change the dose, route, interval, or create an unwritten hold parameter.

Follow written medication parameters exactly. A scheduled medication may still need to be held when the order’s hold criteria are met.

Dosage form matters. Extended-release glipizide must be swallowed whole — never crush, chew, or split it.

For a medication patch, verify the previous patch is off before applying a new one; inspect skin and document the site and time.

Kansas regulations allow certain nursing procedures outside the CMA curriculum to be delegated by a licensed nurse when delegation requirements are met. Do not assume an extra procedure is automatically within CMA scope.

3. Medication Profile

Review each medication before beginning the simulation.

4. Provider Medication Orders

Resident: Maggie Redbird • Room: Bedroom 8 • Allergies: NKDA

Student Order Check

Resident / identifiers verified

Allergies reviewed

Order compared with MAR

Medication labels compared with MAR

Questions or discrepancies identified before preparation

5. Simulation MAR — 08/17/2026

Resident: Maggie Redbird • Room: Bedroom 8 • Allergies: NKDA

SIMULATION LEGEND: Initial only after administration. Follow written hold/notification parameters. For PRNs, verify indication, last dose/interval, and response. For patches, verify prior patch removal and document site/time. Do not crush extended-release tablets.

6. Student Scenario — Morning Medication Pass

Start of Shift: 0915

You are the CMA assigned to Maggie for the morning medication pass.

Maggie is sitting near the window with a cup of herbal tea. She is alert, calm, and asks you to explain what each medication is for.

BP 134/74 mmHg; pulse 72 bpm. She denies dizziness, weakness, chest pain, or shortness of breath.

A nurse-documented blood glucose at 0855 is 78 mg/dL. Maggie’s breakfast tray has been delayed and has not arrived.

Glipizide ER 2.5 mg is due at 0900 with breakfast. The provider order says HOLD if BG is below 80 mg/dL OR if the meal is unavailable/refused, and notify the licensed nurse.

Maggie looks at the glipizide ER tablet and asks, “That one is hard for me to swallow. Can you crush it into my tea?”

A lidocaine 5% patch is due for her right knee. Maggie says, “I think yesterday’s patch is still there.” You can see an old patch still attached.

Lisinopril 10 mg is due at 0900. Rosuvastatin 10 mg is scheduled for 2100, not this morning. Maggie reports right-knee pain 3/10 and declines PRN acetaminophen.

Student Tasks

7. Student Work Space & Performance Checklist

Performance Checklist

8. SBAR Practice

S — Situation

B — Background

A — Assessment

R — Recommendation / Request

INSTRUCTOR KEY — REMOVE BEFORE STUDENT USE