| Course | NSG 124 Pharmacology |
|---|---|
| Unit | Unit 3 |
| Paper type | Medication rights walkthrough |
| Length | About 760 words, 5 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | BSN |
| Updated | October 2026 |
Free sample paper for NSG 124 Unit 3
An Order That Said Only "Metoprolol 25 mg PO": A Numbered Rights Walkthrough With the Two Stopping Points Marked Where They Occurred
Student Name
Department of Nursing, Herzing University
NSG 124: Pharmacology
Instructor Name
January 29, 2026
An Order That Said Only "Metoprolol 25 mg PO": A Numbered Rights Walkthrough With the Two Stopping Points Marked Where They Occurred
The Patient and the Order as It Arrived
The patient was a composite 74-year-old woman admitted to a medical floor with new atrial fibrillation and a rapid heart rate, now controlled after treatment in the emergency department. At 0815 a new order appeared: "Metoprolol 25 mg PO." The order gave no frequency and did not state which salt: metoprolol tartrate, an immediate-release form usually given twice daily, or metoprolol succinate, an extended-release form usually given once daily. The two are not interchangeable at the same frequency. The walkthrough below records each check in the order it was made, what it was checked against, and what would have happened if it had not matched. Stopping points are marked HALT where they occurred. The checks follow the rights framework taught in the course (Elliott & Liu, 2010).
The Walkthrough
1. Right drug, checked against the order and the pharmacy profile. The order named the drug but not the salt. The pharmacy had verified it as metoprolol tartrate, but the order text did not say so. HALT: the dose was not prepared. The prescriber was paged at 0822 to clarify the salt and the frequency. Had this step been skipped, the patient could have received the wrong release form and a dosing pattern that did not match what the prescriber intended.
2. Right time and frequency, checked against the order. No frequency was written. HALT, same page as step 1. At 0835 the prescriber clarified by a revised electronic order: metoprolol tartrate 25 mg by mouth every 12 hours, first dose now, hold for heart rate below 60 or systolic blood pressure below 100. The revised order replaced the original, which was discontinued.
3. Right patient, checked with two identifiers against the wristband and the medication record. The patient stated her full name and date of birth; both matched. Had they not matched, nothing would have been given until identity was resolved.
4. Right reason, checked against the admission note and the order. Indication: rate control for atrial fibrillation, for which beta-blockers are a first-line option in current guidance (Joglar et al., 2024). Her home medication list showed she did not already take a beta-blocker, which ruled out a duplicate.
5. Right dose, checked against the revised order and the tablet in hand. The unit-dose package was metoprolol tartrate 25 mg, one tablet. Label read three times: on removal, on preparation, and at the bedside.
6. Right route, checked against the order and the patient. By mouth; she was alert, sitting upright, had passed the floor's swallow screen, and was allowed to eat.
7. Assessment before the dose, checked against the hold parameters. Apical heart rate 88 counted for one minute, irregular; blood pressure 126/78. Both above the hold limits. Had either been below, the dose would have been held and the prescriber informed.
8. Right to refuse and to know, checked with the patient. She was told the name of the medicine, that it would slow her heart rate, and that it might make her feel tired or lightheaded at first. She asked whether it was a blood thinner; she was told it was not, and that the team would discuss blood thinners separately. She agreed to take it.
9. Right documentation, checked against the medication record. Given at 0852, with the heart rate and blood pressure recorded beside the administration, and the order clarification documented.
10. Right response, checked at 0950. Heart rate 78, blood pressure 118/74, no dizziness. Documented, with a plan to recheck before the next dose.
Why the Stops Came Where They Did
The standard teaching order begins with the right patient. In this walkthrough the first two checks were about the order itself, because the order could not be carried out as written. There was no point confirming the patient's identity for a dose that could not yet be prepared. Placing the stopping points where they occurred, rather than listing them at the end, shows that the rights are not a ritual performed in a fixed order but a set of checks, some of which can stop the process before others are reached. The distinction between the two metoprolol salts is described in the course pharmacology text (Burchum & Rosenthal, 2022), and confusion between immediate-release and extended-release forms of the same drug is a recognized source of error, which is why an order without the salt name was treated as incomplete rather than guessed at.
References
Burchum, J. R., & Rosenthal, L. D. (2022). Lehne's pharmacology for nursing care (11th ed.). Elsevier.
Elliott, M., & Liu, Y. (2010). The nine rights of medication administration: An overview. British Journal of Nursing, 19(5), 300-305. https://doi.org/10.12968/bjon.2010.19.5.47064
Joglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., Chyou, J. Y., Cronin, E. M., Deswal, A., Eckhardt, L. L., Goldberger, Z. D., Gopinathannair, R., Gorenek, B., Hess, P. L., Hlatky, M., Hogan, G., Ibeh, C., Indik, J. H., Kido, K., Kusumoto, F., Link, M. S., ... Van Wagoner, D. R. (2024). 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 149(1), e1-e156. https://doi.org/10.1161/CIR.0000000000001193
What the NSG 124 Unit 3 instructions ask for
Unit 3 asks you to walk through the rights of medication administration for a specific order and patient. Expect to describe the patient and order, number each right with what was checked and found, mark any point where you stopped and explain why. Many versions ask how many rights to use and what to do with an incomplete order. Check whether your section uses five, six or more rights. An incomplete order is a stop, not a guess; clarify with the prescriber. Assessment before giving a drug, such as heart rate before a beta blocker, is a right in many lists. Documentation and the patient's right to refuse also count. Explain why the stops fell where they did.
Inside the NSG 124 Unit 3 example
The walkthrough opens with the patient and the order exactly as it arrived. Each right is numbered and records what was checked, the source and the result. The first stop is marked clearly, with what was missing and the call made to the prescriber. The second stop records the heart rate check and the decision. Remaining rights, such as right patient with two identifiers and right documentation, are completed after the order is clarified. The final section explains that the stops came where the missing information mattered, not in textbook order. Read together, the steps show rights used as a thinking process rather than recited from memory.
Where the points sit in the NSG 124 Unit 3 rubric
Herzing's rubric for a rights walkthrough usually covers the patient and order, completeness of rights, accuracy of checks, recognition of stops, actions at each stop and documentation. Recognizing when to stop carries the most weight: an incomplete or unsafe order must be caught, never completed by assumption. Completeness points reward every right in the course list. Accuracy criteria look for correct sources, such as the pharmacy profile and the medication administration record. Action points go to clarifying with the prescriber and documenting the clarification. Assessment before the dose, such as heart rate before a beta blocker, is often credited. Two identifiers are expected. The patient's right to refuse earns credit when addressed. Numbered steps help the grader follow. The walkthrough draws on ISMP safe practice guidance.
NSG 124 Unit 3 help: mistakes that cost points
Rights walkthroughs in Unit 3 often slip by reciting the rights without checking anything specific. Another frequent problem is completing an incomplete order by guessing the frequency. Students often skip assessment before a drug with hold parameters. Two identifiers are reduced to one. Documentation is missing or does not mention the clarification call. The patient's right to refuse is ignored. Metoprolol tartrate and succinate are treated as interchangeable, though their dosing differs. Stops are not marked, so the reader cannot see where judgment was used. Allergies are checked against memory rather than the record. Finally, stop when information is missing, because graders reward a walkthrough that treats an unclear order as a reason to call, not a puzzle to solve alone.
Get a NSG 124 Unit 3 example written to your instructions
Send the Unit 3 instructions and the rubric from your NSG 124 classroom, and say which checks the walkthrough has to cover. We write a custom example that opens on the order, gives every step a verification source, places the stops where they would occur and keeps the record as its own step. First custom sample free, back in 24 to 48 hours.
More NSG 124 papers and BSN samples
- NSG 124 Unit 1: Route and form comparison
- NSG 124 Unit 2: Dose calculation worksheet
- NSG 124 Unit 4: Pre-dose assessment record
- NSG 124 Unit 5: Monitoring and counseling brief
- NSG 124 Unit 6: Adverse effect escalation chart
- NSG 124 Unit 7: High alert medication file
- NSG 124 Unit 8: Drug classification table
- NSG 121 Unit 3: Expected versus unexpected findings chart
- NSG 122 Unit 3: Measurable goal and outcome sheet
- NSG 123 Unit 3: Nursing intervention rationale
- NSG 126 Unit 3: Standards of practice review
NSG 124 Unit 3 questions, answered
Is this something I could follow on a real unit?
No, and the example says so on the page. What a nurse actually does at each check is set by the facility, by current policy and by the licensed staff supervising, and none of that is what a classroom sample carries. The walkthrough is an academic record of one composite pass, written to show a reader that the writer understands where a check becomes a decision.
How many stops should the walkthrough contain?
One or two usually reads better than none and better than six. A sequence with no interruption at all suggests the writer treated the checks as a formality, while a pass that halts at every step tends to read as constructed. Where your instructions name a scenario, let the stops come out of it rather than adding them for effect.
Can I use a medication pass from my clinical hours?
No. Assemble the pass from details common to many patients and note in a line that nobody in it is real. Your clinical hours, your check-offs and any pass performed on a live person stay inside that placement and belong to the patient concerned, while a built pass can carry exactly the checks your walkthrough needs.
Where can I find a free NSG 124 Unit 3 sample paper?
This page shows the whole NSG 124 Unit 3 rights walkthrough for free, each right numbered with the two stops marked. A walkthrough for a different order can be written on request.
What should a nurse do with an incomplete medication order?
Stop and clarify with the prescriber before giving the drug, then document the clarification. This sample stops at a metoprolol order with no frequency, since the two forms of metoprolol are dosed differently.