Deck 14: Medication Safety and Error Prevention

Question 1

The most important aspect of dealing with errors is:

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

Answer 1

B
The most important aspect of dealing with errors is the reporting process.

Question 2

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

A)Aspirin
B)Nonsteroidal antiinflammatory drugs (NSAIDs)
C)Acetaminophen
D)A and B

Answer 2

D
Warfarin can increase the risk of bleeding if taken with aspirin or NSAIDs.

Question 3

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

Answer 3

A
A prescribing error has occurred when a prescriber orders a medication that is incorrect (e.g., incorrect usage, dosage form, route, concentration, rate of infusion) or is incorrectly selected based on indications or contraindications (e.g., allergies, existing condition) and the medication reaches the patient.

Question 4

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 5

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 6

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

Question 7

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 8

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 9

Which of the following patient errors are likely to be made at home?

A)Taking the wrong amount of medication
B)Taking a medication at the wrong time
C)Taking an over-the-counter (OTC) medication that interacts with his or her prescribed medication(s)
D)All of the above

Question 10

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 11

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 12

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 13

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 14

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

Question 15

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

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

Question 16

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 17

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 18

What is an ADR?

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

Question 19

Medication errors frequently involve which of the following?

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

Question 20

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 21

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 22

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 23

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 24

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 25

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 26

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 27

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 28

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 29

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

Question 30

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.