Deck 14: Medication Safety and Error Prevention

Question 1

Which one of the following is not a high-alert IV medication according to the Institute for Safe Medication Practices (ISMP)?

A) Insulin
B) Heparin
C) Potassium chloride (KCl)
D) Penicillin

Answer 1

Penicillin

Question 2

The majority of health care-associated infections (HAIs) are:

A) Urinary tract infections (UTIs)
B) Bloodstream and surgical site infections
C) Pneumonia
D) All of the above

Answer 2

All of the above

Question 3

Individuals older than 80 years of age will be in the fastest growing segment of the population for the next 40 years, which is due to:

A) Increased activity
B) Better diet
C) Improved health care
D) All of the above

Answer 3

All of the above

Question 4

Which one of the following distractions cannot be avoided in the workplace?

A) Excessive talking and laughing
B) Text messaging
C) Telephones ringing
D) Loud music

Question 5

What is an ADR?

A) Actual drug reaction
B) Adverse drug reaction
C) Adverse drug response
D) Actual drug response

Question 6

Warfarin (Coumadin) administered to prevent blood clotting can interact with:

A) Aspirin
B) Non-steroidal antiinflammatory drugs (NSAIDs)
C) Acetaminophen
D) A and B

Question 7

Pictograms are:

A) Pictures of drug products that are included in drug reference books
B) Standardized graphics that represent how to take, when to take, and how to store a medication
C) Hieroglyphics
D) Pictures that can be sent to an emergency department to identify an unknown medication

Question 8

A physician ordering an IV to run at 100 mL/hr instead of 125 mL/hr is an example of what type of error?

A) Prescribing error
B) Omission error
C) Wrong dosage form
D) Monitoring error

Question 9

A patient with diabetes is ordered intravenous (IV) cefazolin in 5% dextrose in water (D₅W) every 8 hours (q8h). What possible problem may exist with this order?

A) A patient with diabetes cannot be given cefazolin because of a possible drug interaction.
B) Cefazolin can only be given subcutaneously.
C) The dose should always be given every 12 hours.
D) D₅W may be the wrong solution because the patient has diabetes.

Question 10

Drug errors can be reported to the U.S. Food and Drug Administration (FDA) through:

A) MedWatch
B) United States Pharmacopeia (USP)
C) The Joint Commission (TJC)
D) National Association of Boards of Pharmacy (NABP)

Question 11

What type of error occurs when an IV medication, reconstituted with the incorrect diluent, is given to a patient?

A) Prescribing error
B) Wrong administration
C) Wrong drug preparation
D) Improper dose error

Question 12

Changes in labeling that drug companies are incorporating to reduce errors include:

A) Tall-man lettering
B) Color coding
C) Boldface lettering
D) All of the above

Question 13

How often is it recommended for a technician to check a medication during the filling process?

A) Twice
B) Three times
C) Only if he or she thinks something is wrong
D) As many times as he or she can

Question 14

All of the following are common causes of medication errors according to the ASHP except:

A) Drug product nomenclature
B) Improper transcription
C) Inappropriate abbreviations
D) Use of bar codes

Question 15

The most important aspect of dealing with errors is:

A) Automated systems
B) Reporting process
C) Punishment
D) Finding out who made them

Question 16

Why are IV heparin errors extremely dangerous?

A) IV heparin quickly takes effect and is not easily reversed.
B) IV heparin is available in many similar-looking strengths.
C) Flushing IV lines with a Hep-Lock solution is common, which is a very low dose of heparin that can be confused with significantly higher concentrations.
D) All of the above factors are reasons.

Question 17

Bar codes provide which of the following forms of drug identification?

A) National Drug Code (NDC) number
B) Lot number
C) Expiration date
D) All of the above

Question 18

Medication errors frequently involve which of the following?

A) Allergies
B) Multiple medications
C) OTC medications
D) All of the above

Question 19

Which one of the reasons below is not related to errors?

A) Look-alike, sound-alike drugs
B) Stress and noise levels
C) Orders arriving from different sources
D) Multitasking

Question 20

What type of error occurs when a pharmacist fails to adjust the amount of KCl to be added to a total parenteral nutrition (TPN) mixture according to the daily laboratory report?

A) Prescribing error
B) Omission error
C) Monitoring error
D) Unauthorized drug error

Question 21

Which of the following systems contribute to decreased errors?

A) Computerized physician order entry (CPOE)
B) ADS machines, coupled with bar coding
C) Medication error-reporting programs
D) All of the above

Question 22

Extended-release formulations:

A) Are designed to deliver the dose over a longer interval than an immediate-release (IR) product.
B) Can improve patient compliance and ultimately result in better health.
C) Are a cause of medication errors if crushed or administered in place of IR doses.
D) All of the above factors are related to extended-release formulations.

Question 23

In 2012, the ISMP launched the National Vaccine Error Reporting Program (ISMP VERP) to:

A) Verify the validity of error reports.
B) Collect information on vaccine errors.
C) Evaluate all errors.
D) Perform all of the above.

Question 24

Which USP Chapter addresses the problem of contamination of any type of sterile product?

A) USP <790>
B) USP <795>
C) USP <797>
D) USP <800>

Question 25

Medications requiring a medication guide to be provided to the patient can be identified by

A) Fuchisa colored symbol found on the manufacturer's container
B) Lime-green symbol found on the manufacturer's container
C) Red or yellow symbol found on the manufacturer's container
D) Pink symbol found on the manufacturer's container

Question 26

The ISMP focuses on all of the following except:

A) Type of error
B) How the error occurred
C) Recommendations on preventing a similar error
D) Placing blame on the appropriate individual

Question 27

A medication error occurred but did not reach patient is classified as a:

A) Category A error
B) Category B error
C) Category C error
D) Category D error

Question 28

Which one of the MERP error categories includes errors that contribute to the death of a patient?

A) A
B) C
C) I
D) J

Question 29

Which one of the following would not constitute a medication error?

A) An extra dose of antibiotic is given to a patient after the stop date but causes no harm to the patient.
B) A unit-dose medication is returned from the nursing floor for credit and is reused.
C) Too much heparin is given to a patient, which results in a stroke.
D) All are medication errors.

Question 30

What process identifies the most up-to date list of all of the medications a patient is currently taking?

A) Medication guide
B) Medication reconciliation
C) Medication therapy management
D) MedWatch

Question 31

All of the following are examples of automated dispensing systems used in community pharmacy except:

A) Baker cell systems
B) Kirby Lester KL20
C) Med Carousel
D) ScriptPro SP 200

Question 32

To reduce errors, pharmacies may:

A) Use an automatic dispensing system (ADS).
B) Keep high-alert medications in a separate location in the pharmacy.
C) Designate a medication safety leader.
D) Perform all of the above.

Question 33

Why does TJC require hospitals and institutions to prepack all liquid doses in oral syringes or containers?

A) Continually opening bulk containers has led to an increased risk of contamination.
B) Patient-specific instructions are not denoted on the bulk medication; therefore the likelihood of an inappropriate dose increases when nurses pour medicine from bulk containers.
C) The pharmacy must maintain control over each dose to ensure accuracy.
D) All of the above are reasons.

Question 34

Which of the following is not one of the five safety standards outlined by TJC?

A) Leadership Process and Accountability
B) Competent and Capable Workforce
C) Safe Environment for Staff and Patients
D) Clinical Care of Staff

Question 35

PTEC is the:

A) Pharmacy Trainer Education Council
B) Pharmacy Teacher Educator Council
C) Pharmacy Technician Educator's Council
D) Pharmacy Trainer's Education Committee