If a PRN medication shows no benefit after a reasonable trial, what is the appropriate next step?

• A. Document lack of effect and notify the supervisor; consider alternatives.
• B. Ignore and proceed with the next scheduled dose.
• C. Discuss with the resident that PRN is not available anymore.
• D. Discontinue the medication permanently without consultation.

Answer: (C)

After a reasonable trial, if a PRN medication isn’t providing benefit, the best next step is to discuss with the resident that this PRN is no longer appropriate and to review alternative options as part of the care plan. This approach centers the resident in decisions about their comfort and symptoms, clarifies that the current PRN will not be used going forward, and sets the stage for alternatives or adjustments under supervision. It also helps prevent unnecessary dosing and aligns treatment with the resident’s goals.

Other options miss the mark because continuing to give the PRN despite no benefit doesn’t improve the resident’s condition, and removing the medication without discussion or oversight can undermine trust and safety. Simply ignoring the issue or discontinuing permanently without consultation bypasses the medical team and the resident’s input.