How should you respond if a patient refuses a prescribed medication?

• A. Respect the patient's decision, document the refusal, note any reason if known, and inform the nurse
• B. Persuade the patient to take the medication
• C. Administer the medication secretly
• D. Remove the medication from MAR

Answer: (A)

Respecting patient autonomy and thorough documentation are essential when a patient declines a medication. If a patient refuses, you should honor their decision, document the refusal in the medical record, note any reason if the patient provides one, and inform the nurse on the care team. This approach preserves the patient’s rights, keeps the care plan accurate, and allows the team to reassess, offer information if needed, and consider alternatives or follow-up as appropriate. Documentation also helps ensure safety and accountability if there are questions later about why a medication was not given.

Avoid trying to persuade the patient to take the medication, as that can undermine autonomy and trust. Don’t administer the medication secretly, which is unsafe and unethical. Don’t remove the medication from the MAR to hide the refusal, because that would obscure the patient’s decision and could lead to unintended administration. If the patient lacks decision-making capacity, follow your facility’s policy and involve a nurse or physician to determine the appropriate next steps.