A nurse is preparing to count the controlled substances in the secure cabinet. Which of the following actions should the nurse take?

Choice A rationale Verifying that the actual count of controlled substances matches the inventory record is a legal and safety requirement designed to prevent diversion and ensure accountability. This process must be performed by two nurses, typically one from the oncoming shift and one from the departing shift. Accurate record-keeping ensures that every dose is accounted for, maintaining the integrity of the medication distribution system and complying with federal regulations regarding the handling of scheduled drugs. Choice B rationale Setting aside controlled substances at the beginning of a shift is an unsafe practice that increases the risk of medication errors and drug diversion. Medications should only be removed from the secure cabinet immediately before administration to the specific client for whom they were ordered. Pre-pulling medications violates the principles of safe administration and prevents the accurate real-time tracking of drug inventory, which is essential for maintaining a secure and legal environment for narcotics. Choice C rationale Discarding partial doses of controlled substances into a sharps container without a witness is a violation of medication safety protocols. Any wasted or unused portion of a controlled substance must be witnessed by another licensed nurse and documented according to facility policy. This ensures that the medication is truly destroyed and not diverted for personal use. Proper disposal usually involves specific chemical wasting systems rather than simply placing the drug in a sharps container. Choice D rationale A nurse should never co-sign for wasting that occurred during a previous shift that they did not personally witness. Co-signing requires the nurse to attest that they actually saw the medication being discarded. Signing for past events or actions not observed undermines the legal accountability of the controlled substance record and could lead to disciplinary action. All wasting must be documented at the time it occurs with both the administering nurse and the witness present.