Controlled Drugs Scenario Questions

Controlled drugs, such as strong opioids, carry extra rules because of their potential for harm and misuse. The CBT tests whether you know those rules: the register, the checks, the storage, and what to do when something does not add up.

The register and the running balance

Every controlled drug is accounted for exactly. Stock is recorded in the controlled drugs register, and each administration is entered at the time it is given, with the running balance updated. This means the number of ampoules or tablets in the cabinet should always match the register. Recording later from memory, or in batches, undermines the whole point, which is a stock you can trace at any moment.

Two-person checking

Because of the risk, controlled drugs are usually prepared, checked and administered with a second person, one of whom is registered. The second person verifies the drug, the dose, and the stock balance, and witnesses what is given. A single unwitnessed nurse, or asking untrained people to co-sign, does not meet the standard.

Storage and wastage

Controlled drugs are kept in a dedicated, secure, locked CD cabinet, not in an ordinary trolley, fridge or drawer. And wastage is handled carefully: if a patient needs only part of an ampoule, the remainder is disposed of and the wastage recorded and witnessed, so the full amount is still accounted for. Saving a part-dose for someone else, or discarding it without a record, breaks the accounting.

When it does not add up

The scenario that appears most often is a discrepancy between the stock and the register. This is never something you quietly correct or ignore. An unexplained difference could mean an error or diversion, so you report it immediately to the person in charge and it is investigated before anything else happens. Altering the register to fit the stock is exactly the wrong response, and the exam is checking that you know it. Next: injection technique and routes. Five controlled drugs scenarios first.