A nurse is caring for four clients. After administering morning medications, she realizes that the nifedipine (Procardia) prescribed for one client was inadvertently administered to another client. Which of the following actions should the nurse take first?

Choice A rationale Checking the client's vital signs, especially the blood pressure and heart rate, is the most immediate priority action. Nifedipine is a calcium channel blocker used to lower blood pressure, and an accidental dose could cause a significant, rapid drop in blood pressure and reflex tachycardia in the wrong client, leading to an immediate safety risk. Assessing the physiological status must precede all other steps. Choice B rationale Notifying the client's provider is a crucial step after recognizing a medication error, but it is secondary to ensuring the client's immediate physiological stability and safety. The nurse must first gather objective data, such as vital signs and a physical assessment, to accurately inform the provider of the client's current status and the potential severity of the adverse reaction. Choice C rationale Administering the medication to the correct client, while necessary, must wait until the immediate safety and stability of the client who received the wrong medication have been fully assessed and addressed. Medication administration to the correct client becomes a secondary concern after the error is managed and the affected client is stable, preventing further potential harm. Choice D rationale Filing an occurrence (incident) form is a critical administrative step for quality improvement, documentation, and risk management following any medication error. However, this is a documentation task and does not constitute a direct intervention to ensure the client's immediate safety. Client safety and assessment take precedence over non-emergent paperwork.