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Patient Safety and Quality Assurance — All Questions

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Patient Safety and Quality Assurance — All Questions

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Question 1 of 792

1. Question

Category: Patient Safety and Quality Assurance: Error Prevention

Which of the following is the primary purpose of Tall Man lettering in pharmacy practice?

To distinguish look-alike drug names and reduce confusion
Correct Incorrect Correct answer

To highlight brand-name drugs over generic equivalents
Correct Incorrect Correct answer

To indicate medications that require refrigeration
Correct Incorrect Correct answer

To identify drugs that are available only by prescription
Correct Incorrect Correct answer

Correct

Incorrect
Question 2 of 792

2. Question

Category: Patient Safety and Quality Assurance: Error Prevention

According to the ISMP List of Error-Prone Abbreviations, why should the abbreviation ‘U’ for units be avoided on medication orders?

It can be mistaken for a zero, the number 4, or 'cc'
Correct Incorrect Correct answer

It conflicts with the metric system prefix for micro
Correct Incorrect Correct answer

It is not recognized by pharmacy billing software
Correct Incorrect Correct answer

It does not specify the route of administration
Correct Incorrect Correct answer

Correct

Incorrect
Question 3 of 792

3. Question

Category: Patient Safety and Quality Assurance: Error Prevention

Which rule applies to the correct use of decimal points in medication dosing to prevent errors?

Always use a leading zero before a decimal point and never use a trailing zero
Correct Incorrect Correct answer

Always use both a leading zero and a trailing zero for clarity
Correct Incorrect Correct answer

Never use a leading zero but always include a trailing zero
Correct Incorrect Correct answer

Avoid all decimal points by converting to smaller units
Correct Incorrect Correct answer

Correct

Incorrect
Question 4 of 792

4. Question

Category: Patient Safety and Quality Assurance: Error Prevention

What does the Swiss cheese model of error prevention illustrate?

Errors occur when failures align across multiple layers of defense
Correct Incorrect Correct answer

A single point of failure is always the root cause of medication errors
Correct Incorrect Correct answer

Automated systems eliminate all possible medication errors
Correct Incorrect Correct answer

Only human factors contribute to errors in the medication use process
Correct Incorrect Correct answer

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Question 5 of 792

5. Question

Category: Patient Safety and Quality Assurance: Error Prevention

Which abbreviation is on the ISMP List of Error-Prone Abbreviations because it can be confused with ‘every day’?

QOD, meaning every other day
Correct Incorrect Correct answer

BID, meaning twice daily
Correct Incorrect Correct answer

PRN, meaning as needed
Correct Incorrect Correct answer

TID, meaning three times daily
Correct Incorrect Correct answer

Correct

Incorrect
Question 6 of 792

6. Question

Category: Patient Safety and Quality Assurance: Error Prevention

What is the primary goal of root cause analysis (RCA) following a medication error?

To identify system-level factors that contributed to the error
Correct Incorrect Correct answer

To determine which individual staff member was at fault
Correct Incorrect Correct answer

To calculate the financial cost of the error to the pharmacy
Correct Incorrect Correct answer

To establish grounds for disciplinary action against personnel
Correct Incorrect Correct answer

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Question 7 of 792

7. Question

Category: Patient Safety and Quality Assurance: Error Prevention

Why is the abbreviation ‘MS’ considered error-prone and included on the ISMP List of Error-Prone Abbreviations?

It can be confused with morphine sulfate or magnesium sulfate
Correct Incorrect Correct answer

It refers to a discontinued medication no longer in formulary
Correct Incorrect Correct answer

It is an outdated abbreviation for a measurement unit
Correct Incorrect Correct answer

It conflicts with the abbreviation for the metric system
Correct Incorrect Correct answer

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Question 8 of 792

8. Question

Category: Patient Safety and Quality Assurance: Error Prevention

Which pair of drugs is an example from the FDA-approved Tall Man lettering list?

hydrOXYzine and hydrALAZINE
Correct Incorrect Correct answer

amoxicillin and ampicillin
Correct Incorrect Correct answer

lisinopril and losartan
Correct Incorrect Correct answer

metformin and metoprolol
Correct Incorrect Correct answer

Correct

Incorrect
Question 9 of 792

9. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A technician receives a prescription written as ‘.5 mg’ of a medication. What is the correct way to enter this dose into the pharmacy system?

Enter it as 0.5 mg with a leading zero
Correct Incorrect Correct answer

Enter it as 5 mg since the decimal was likely an error
Correct Incorrect Correct answer

Enter it exactly as written without adding a leading zero
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Enter it as 0.50 mg to add both a leading and trailing zero
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Question 10 of 792

10. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician notices that hydroxyzine and hydralazine are stored next to each other on the shelf. What is the most appropriate action?

Separate the two medications and place them in different shelf locations
Correct Incorrect Correct answer

Place a warning label only on the faster-moving product
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Keep them together but file an incident report about the arrangement
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Alphabetize them together and rely on bar code scanning alone
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Question 11 of 792

11. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A technician scanning a medication bar code at the point of dispensing receives a mismatch alert. What should the technician do first?

Stop the dispensing process and verify the correct product was selected
Correct Incorrect Correct answer

Override the alert and continue dispensing if the label looks correct
Correct Incorrect Correct answer

Ask the patient to confirm the medication name before dispensing
Correct Incorrect Correct answer

Document the alert in a log and dispense the medication as prepared
Correct Incorrect Correct answer

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Question 12 of 792

12. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A prescription is received with the directions ‘take 1 tab QD.’ How should the technician process this order?

Clarify with the prescriber since 'QD' is an error-prone abbreviation
Correct Incorrect Correct answer

Enter the directions as 'take one tablet four times daily'
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Enter the directions as written since 'QD' is a standard abbreviation
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Change the directions to 'take one tablet at bedtime' for safety
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Question 13 of 792

13. Question

Category: Patient Safety and Quality Assurance: Error Prevention

An automated dispensing cabinet (ADC) has a feature that requires the user to select a patient profile before accessing any medication. What safety purpose does this feature serve?

It helps ensure medications are dispensed for the correct patient
Correct Incorrect Correct answer

It tracks medication costs for billing the correct insurance plan
Correct Incorrect Correct answer

It limits access to only controlled substance medications
Correct Incorrect Correct answer

It prevents the cabinet from needing regular inventory counts
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Question 14 of 792

14. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A technician is preparing an IV admixture of heparin, which is classified as a high-alert medication. What additional verification step should be performed before dispensing?

An independent double-check by a second qualified staff member
Correct Incorrect Correct answer

A review of the patient's insurance authorization for the drug
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Confirmation that the medication was ordered from the primary wholesaler
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Verification that the patient has signed a consent form for IV therapy
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Question 15 of 792

15. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy receives two patients with the same last name. Which method best prevents dispensing a prescription to the wrong patient?

Verify using at least two patient identifiers such as name and date of birth
Correct Incorrect Correct answer

Ask the patient to state only their first name at the pickup window
Correct Incorrect Correct answer

Dispense to whichever patient arrives first and flag the second order
Correct Incorrect Correct answer

Use the prescription number alone to match the patient to their order
Correct Incorrect Correct answer

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Question 16 of 792

16. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A technician is stocking an automated dispensing cabinet and notices that metformin 500 mg and metoprolol 50 mg are assigned to adjacent pockets. What action should the technician take?

Notify the pharmacist and request reassignment to non-adjacent pockets
Correct Incorrect Correct answer

Stock them as assigned since the cabinet uses bar code verification
Correct Incorrect Correct answer

Place handwritten warning notes inside both pockets as a reminder
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Swap the two medications into each other's pockets to create contrast
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Question 17 of 792

17. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A prescription reads ‘insulin 10.0 units subcutaneously at bedtime.’ What error risk does this order present?

The trailing zero could cause the dose to be misread as 100 units
Correct Incorrect Correct answer

The route of administration is missing from the prescription
Correct Incorrect Correct answer

The prescriber should have used the abbreviation 'U' instead of 'units'
Correct Incorrect Correct answer

Insulin should never be prescribed for bedtime administration
Correct Incorrect Correct answer

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Question 18 of 792

18. Question

Category: Patient Safety and Quality Assurance: Error Prevention

During an independent double-check of a chemotherapy preparation, the verifying pharmacist should perform the check in which manner?

Independently, without knowledge of the preparing person's calculations
Correct Incorrect Correct answer

By reviewing only the final product label after preparation is complete
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By watching the preparing technician work and confirming each step verbally
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By comparing the preparation to a photo of a previously made batch
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Question 19 of 792

19. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A technician is filling a prescription and the bar code on the stock bottle does not scan. What is the most appropriate next step?

Manually verify the NDC number against the prescription label before dispensing
Correct Incorrect Correct answer

Dispense the medication and note the scanning issue in the pharmacy log
Correct Incorrect Correct answer

Return the stock bottle to the shelf and tell the patient the drug is unavailable
Correct Incorrect Correct answer

Use a different manufacturer's product without checking the NDC number
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Question 20 of 792

20. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy experiences a dispensing error in which predniSONE was dispensed instead of prednisoLONE. A root cause analysis reveals that both products were stored alphabetically on the same shelf. Which corrective action would most effectively address the root cause?

Physically separating the two products and applying Tall Man lettering shelf labels
Correct Incorrect Correct answer

Requiring all staff to complete a general medication safety training course
Correct Incorrect Correct answer

Adding an extra pharmacist verification step at the dispensing window
Correct Incorrect Correct answer

Issuing a written warning to the technician who selected the wrong product
Correct Incorrect Correct answer

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Incorrect
Question 21 of 792

21. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A hospital pharmacy discovers that a nurse overrode an automated dispensing cabinet alert to remove a medication that had not been ordered for the patient. Using the Swiss cheese model, which layer of defense failed in this scenario?

The procedural safeguard requiring order verification before medication removal
Correct Incorrect Correct answer

The initial prescribing decision made by the attending physician
Correct Incorrect Correct answer

The drug manufacturer's quality control during production
Correct Incorrect Correct answer

The patient's ability to self-identify the correct medication at the bedside
Correct Incorrect Correct answer

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Incorrect
Question 22 of 792

22. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy’s root cause analysis of a dosing error involving a pediatric patient reveals that the prescriber wrote ‘5.0 mg’ and the technician entered 50 mg. Which systemic change would best prevent this type of error from recurring?

Implementing a computerized prescriber order entry system that rejects trailing zeros
Correct Incorrect Correct answer

Requiring pediatric patients to have a parent confirm the dose at pickup
Correct Incorrect Correct answer

Training prescribers to use larger handwriting on pediatric prescriptions
Correct Incorrect Correct answer

Assigning only senior technicians to process pediatric prescriptions
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Question 23 of 792

23. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A hospital reports that bar code medication administration (BCMA) scanning compliance dropped to 70%, and medication error rates increased during the same period. Which analysis best explains the relationship between these findings?

Decreased scanning compliance reduced the effectiveness of a critical verification barrier
Correct Incorrect Correct answer

The BCMA system software likely became outdated and produced false alerts
Correct Incorrect Correct answer

The medication errors were unrelated to scanning and caused by new staff hiring
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Bar code scanning only prevents controlled substance errors, not general errors
Correct Incorrect Correct answer

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Question 24 of 792

24. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician performs an independent double-check on an insulin drip by asking the preparing technician, ‘You used 100 units of insulin in 100 mL of normal saline, right?’ Why does this approach fail to meet the standard for an independent double-check?

The verifier was led by the preparer's information instead of checking independently
Correct Incorrect Correct answer

Technicians are never permitted to perform double-checks on insulin drips
Correct Incorrect Correct answer

The verifier should have used a calculator rather than asking a verbal question
Correct Incorrect Correct answer

The check was invalid because it was done before the product was fully prepared
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Question 25 of 792

25. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy conducts a failure mode and effects analysis (FMEA) on its dispensing workflow and identifies that look-alike drug pairs stored together, lack of bar code scanning, and inadequate pharmacist verification staffing all present risks. Using the Swiss cheese model framework, what does this combination of findings represent?

Multiple aligned weaknesses across separate defense layers that could allow an error to reach a patient
Correct Incorrect Correct answer

A single root cause that can be resolved by addressing only the staffing shortage
Correct Incorrect Correct answer

Evidence that only technology-based solutions are needed to prevent dispensing errors
Correct Incorrect Correct answer

Proof that the current system is functioning as designed with acceptable risk levels
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Question 26 of 792

26. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Which organization publishes a list of high-alert medications for both community and acute care settings?

Institute for Safe Medication Practices (ISMP)
Correct Incorrect Correct answer

Food and Drug Administration (FDA)
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Centers for Disease Control and Prevention (CDC)
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The Joint Commission (TJC)
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Question 27 of 792

27. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Which of the following insulin types has the longest duration of action?

Insulin degludec (Tresiba)
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Insulin lispro (Humalog)
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Regular insulin (Humulin R)
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Insulin NPH (Humulin N)
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Question 28 of 792

28. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Concentrated potassium chloride injection is classified as a high-alert medication primarily because of the risk of which adverse outcome?

Fatal cardiac arrhythmia if administered undiluted or too rapidly
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Severe allergic reaction requiring epinephrine administration
Correct Incorrect Correct answer

Irreversible hepatotoxicity requiring liver transplantation
Correct Incorrect Correct answer

Permanent renal failure requiring lifelong dialysis treatment
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Correct

Incorrect
Question 29 of 792

29. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Which class of medications requires auxiliary warning labels indicating the product is a paralytic agent and can cause respiratory arrest?

Neuromuscular blocking agents
Correct Incorrect Correct answer

Benzodiazepine sedatives
Correct Incorrect Correct answer

Opioid analgesic agents
Correct Incorrect Correct answer

Inhaled corticosteroids
Correct Incorrect Correct answer

Correct

Incorrect
Question 30 of 792

30. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Which anticoagulant requires regular INR monitoring to ensure therapeutic dosing and prevent bleeding complications?

Warfarin (Coumadin)
Correct Incorrect Correct answer

Apixaban (Eliquis)
Correct Incorrect Correct answer

Rivaroxaban (Xarelto)
Correct Incorrect Correct answer

Dabigatran (Pradaxa)
Correct Incorrect Correct answer

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Incorrect
Question 31 of 792

31. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Hydromorphone is frequently confused with morphine due to similar names. How does hydromorphone compare to morphine in potency?

Hydromorphone is approximately 4 to 7 times more potent than morphine
Correct Incorrect Correct answer

Hydromorphone is approximately equal in potency to morphine
Correct Incorrect Correct answer

Hydromorphone is approximately half as potent as morphine
Correct Incorrect Correct answer

Hydromorphone is approximately 100 times more potent than morphine
Correct Incorrect Correct answer

Correct

Incorrect
Question 32 of 792

32. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Which of the following is a correct safety practice for storing neuromuscular blocking agents in a hospital pharmacy?

Store them in a separate, clearly labeled location away from other medications
Correct Incorrect Correct answer

Store them alphabetically alongside other injectable medications
Correct Incorrect Correct answer

Store them in the same bin as sedative medications for convenience
Correct Incorrect Correct answer

Store them on open shelving to allow quick identification by staff
Correct Incorrect Correct answer

Correct

Incorrect
Question 33 of 792

33. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

On the ISMP high-alert medication list for community/ambulatory settings, which category of oral medications is included due to the risk of hypoglycemia?

Oral hypoglycemic agents (sulfonylureas)
Correct Incorrect Correct answer

Proton pump inhibitor agents
Correct Incorrect Correct answer

Statin cholesterol-lowering agents
Correct Incorrect Correct answer

Angiotensin-converting enzyme inhibitor agents
Correct Incorrect Correct answer

Correct

Incorrect
Question 34 of 792

34. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is filling a prescription for insulin glargine (Lantus) but notices the shelf also contains insulin lispro (Humalog). Both vials have similar packaging. What is the most important action to prevent a dispensing error?

Verify the product by checking the NDC number against the prescription label before dispensing
Correct Incorrect Correct answer

Dispense whichever insulin vial is closest to its expiration date first
Correct Incorrect Correct answer

Ask the patient which type of insulin they normally use at home
Correct Incorrect Correct answer

Place both insulin products in the same bag for the pharmacist to sort
Correct Incorrect Correct answer

Correct

Incorrect
Question 35 of 792

35. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A physician orders heparin 25,000 units in 500 mL of D5W to infuse at 1,000 units per hour. A pharmacy technician notices the order was handwritten as ‘heparin 25,000 u.’ What safety concern should the technician report to the pharmacist?

The abbreviation 'u' for units can be misread as a zero, leading to a tenfold overdose
Correct Incorrect Correct answer

The heparin concentration ordered is not commercially available in premixed bags
Correct Incorrect Correct answer

The infusion rate of 1,000 units per hour exceeds the maximum recommended dose
Correct Incorrect Correct answer

Heparin should only be ordered in prefilled syringes rather than intravenous bags
Correct Incorrect Correct answer

Correct

Incorrect
Question 36 of 792

36. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is preparing a chemotherapy order in the pharmacy. Which of the following represents the correct safety precaution for handling this medication?

Prepare the medication in a biological safety cabinet using closed-system transfer devices
Correct Incorrect Correct answer

Prepare the medication on the regular pharmacy counter using standard nitrile gloves
Correct Incorrect Correct answer

Prepare the medication in a laminar airflow workbench used for sterile compounding
Correct Incorrect Correct answer

Prepare the medication in the anteroom while wearing a standard surgical face mask
Correct Incorrect Correct answer

Correct

Incorrect
Question 37 of 792

37. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A hospital pharmacy receives an order for a fentanyl transdermal patch 75 mcg/hr for a patient who has never taken opioids before. What should the pharmacy technician do?

Alert the pharmacist because fentanyl patches are contraindicated in opioid-naive patients
Correct Incorrect Correct answer

Fill the order as written since the prescriber has approved the dose
Correct Incorrect Correct answer

Substitute the patch with an equivalent dose of oral fentanyl citrate
Correct Incorrect Correct answer

Dispense the patch with instructions to cut it in half for a lower dose
Correct Incorrect Correct answer

Correct

Incorrect
Question 38 of 792

38. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is filling a prescription for warfarin 5 mg tablets. The patient also has a new prescription for fluconazole. What action should the technician take?

Flag the interaction for the pharmacist to review before dispensing both medications
Correct Incorrect Correct answer

Dispense both prescriptions since they are prescribed by the same physician
Correct Incorrect Correct answer

Hold the warfarin prescription and dispense only the fluconazole to the patient
Correct Incorrect Correct answer

Substitute the fluconazole with a topical antifungal cream without consulting the pharmacist
Correct Incorrect Correct answer

Correct

Incorrect
Question 39 of 792

39. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician discovers that concentrated sodium chloride 23.4% injection vials are stored next to normal saline (0.9%) flush syringes on a nursing unit. What is the appropriate response?

Remove the concentrated sodium chloride from the nursing unit and notify the pharmacist immediately
Correct Incorrect Correct answer

Relabel the concentrated sodium chloride vials with a brighter colored auxiliary label
Correct Incorrect Correct answer

Move the concentrated sodium chloride to a different shelf on the same nursing unit
Correct Incorrect Correct answer

Leave the vials in place and remind nurses to check the label before administration
Correct Incorrect Correct answer

Correct

Incorrect
Question 40 of 792

40. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician receives a prescription for U-500 regular insulin for a patient with severe insulin resistance. Which safety measure is most critical when dispensing this product?

Ensure the prescription label clearly states the concentration is U-500 (500 units/mL)
Correct Incorrect Correct answer

Dispense the U-500 insulin with a standard U-100 insulin syringe for convenience
Correct Incorrect Correct answer

Convert the dose to U-100 equivalent volume without notifying the patient
Correct Incorrect Correct answer

Store the U-500 insulin on the shelf next to U-100 insulin for easy access
Correct Incorrect Correct answer

Correct

Incorrect
Question 41 of 792

41. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A community pharmacy technician receives a prescription for methotrexate 2.5 mg tablets with directions to take one tablet daily. The technician knows this medication is typically dosed weekly for rheumatologic conditions. What should the technician do?

Bring the dosing frequency to the pharmacist's attention before filling the prescription
Correct Incorrect Correct answer

Fill the prescription as written because the prescriber determined the dosing schedule
Correct Incorrect Correct answer

Change the directions to weekly dosing and process the prescription for dispensing
Correct Incorrect Correct answer

Dispense a 30-day supply with daily dosing since the dose per tablet is low
Correct Incorrect Correct answer

Correct

Incorrect
Question 42 of 792

42. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

During an automated dispensing cabinet (ADC) restock, a pharmacy technician notices that vecuronium vials are loaded in a pocket adjacent to midazolam vials. Both have similar vial sizes. What is the safest course of action?

Relocate the vecuronium to a separate, clearly labeled section and notify the pharmacist
Correct Incorrect Correct answer

Add a small sticker to the vecuronium vials to differentiate them from midazolam
Correct Incorrect Correct answer

Leave the vials in their current positions since the ADC screen displays the drug name
Correct Incorrect Correct answer

Replace the vecuronium vials with a different manufacturer's product of a different size
Correct Incorrect Correct answer

Correct

Incorrect
Question 43 of 792

43. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is compounding an IV magnesium sulfate infusion for a patient with preeclampsia. The order calls for 40 g of magnesium sulfate in 1,000 mL of normal saline. What should the technician recognize about this order?

The dose is unusually high and should be verified with the pharmacist before preparation
Correct Incorrect Correct answer

The order is standard for preeclampsia and should be compounded without delay
Correct Incorrect Correct answer

Magnesium sulfate is incompatible with normal saline and requires dextrose instead
Correct Incorrect Correct answer

The technician should substitute magnesium oxide tablets since they are interchangeable
Correct Incorrect Correct answer

Correct

Incorrect
Question 44 of 792

44. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A technician is processing a new prescription for apixaban (Eliquis) 5 mg twice daily. The patient profile shows the patient weighs 55 kg, is 82 years old, and has a serum creatinine of 1.6 mg/dL. Why might the pharmacist need to evaluate this prescription?

The patient may meet criteria for a reduced dose of 2.5 mg twice daily based on age, weight, and renal function
Correct Incorrect Correct answer

Apixaban is contraindicated in patients over the age of 75 years regardless of renal function
Correct Incorrect Correct answer

Apixaban requires weekly INR monitoring in patients with elevated serum creatinine levels
Correct Incorrect Correct answer

The patient should be switched to warfarin because apixaban is not approved for elderly patients
Correct Incorrect Correct answer

Correct

Incorrect
Question 45 of 792

45. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician receives an order for morphine sulfate 2 mg IV push for a pediatric patient. The pharmacy stocks morphine in 10 mg/mL vials. What is the primary safety concern the technician should recognize?

The small volume required (0.2 mL) increases the risk of a measurement error causing an overdose
Correct Incorrect Correct answer

Morphine sulfate is not approved for use in any pediatric patient population
Correct Incorrect Correct answer

The 10 mg/mL concentration must be returned to the manufacturer for a recall
Correct Incorrect Correct answer

Morphine IV push is prohibited by federal law and must be given intramuscularly
Correct Incorrect Correct answer

Correct

Incorrect
Question 46 of 792

46. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A hospital pharmacy is reviewing its high-alert medication safety protocols. Incident data shows three near-miss events in the past month: two involved heparin vial mix-ups between 1,000 units/mL and 10,000 units/mL concentrations, and one involved a nurse selecting a vecuronium vial instead of a reversal agent. Which combination of interventions would most effectively address both types of errors?

Standardize heparin to a single concentration and segregate neuromuscular blockers in the ADC with warning alerts
Correct Incorrect Correct answer

Require double signatures on all medication orders and increase pharmacy staffing during peak hours
Correct Incorrect Correct answer

Implement barcode scanning at the bedside only and add colored caps to all injectable vials
Correct Incorrect Correct answer

Mandate annual competency testing for nurses and conduct monthly inventory audits of all medications
Correct Incorrect Correct answer

Correct

Incorrect
Question 47 of 792

47. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy and therapeutics committee is evaluating whether to add tall man lettering to the labels of certain drug pairs in the hospital formulary. Which pair of medications would benefit most from this strategy?

HYDROmorphone and morphine
Correct Incorrect Correct answer

Amoxicillin and azithromycin
Correct Incorrect Correct answer

Lisinopril and losartan
Correct Incorrect Correct answer

Metformin and metoprolol
Correct Incorrect Correct answer

Correct

Incorrect
Question 48 of 792

48. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is reviewing three medication orders for a newly admitted patient: (1) enoxaparin 40 mg subcutaneously daily, (2) warfarin 5 mg orally daily, and (3) ibuprofen 800 mg orally three times daily. Which combination of factors creates the greatest bleeding risk for this patient?

The concurrent use of two anticoagulants with an NSAID significantly compounds the bleeding risk
Correct Incorrect Correct answer

The enoxaparin dose is too high for prophylaxis, but the warfarin and ibuprofen are acceptable
Correct Incorrect Correct answer

The ibuprofen interacts only with warfarin, so the enoxaparin does not add additional risk
Correct Incorrect Correct answer

The warfarin and enoxaparin are both anticoagulants, but the ibuprofen has no effect on bleeding
Correct Incorrect Correct answer

Correct

Incorrect
Question 49 of 792

49. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A hospital is implementing a new chemotherapy safety program. Which set of controls represents the most comprehensive approach to reducing chemotherapy preparation errors by pharmacy technicians?

Independent double-checks at each preparation step, standardized order sets, and preparation verification using gravimetric analysis
Correct Incorrect Correct answer

Single pharmacist verification of the final product, verbal confirmation of the drug name, and standard gloving procedures
Correct Incorrect Correct answer

Annual technician competency exams, use of pre-printed labels, and visual inspection of the completed IV bag
Correct Incorrect Correct answer

Mandatory overtime restrictions for technicians, color-coded syringes for each drug, and weekly staff meetings
Correct Incorrect Correct answer

Correct

Incorrect
Question 50 of 792

50. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

An error report reveals that a patient received a 10 mg/hr continuous morphine infusion instead of the prescribed 1 mg/hr rate due to a programming error on a standard infusion pump. The hospital is evaluating strategies to prevent this type of error in the future. Which strategy would provide the most effective safeguard?

Implement smart infusion pumps with dose-error reduction software that includes opioid-specific dose limits
Correct Incorrect Correct answer

Require all nurses to attend a one-hour lecture on opioid safety and infusion pump programming
Correct Incorrect Correct answer

Mandate that two nurses independently verify the pump rate after the infusion has been running for one hour
Correct Incorrect Correct answer

Switch all opioid infusions from continuous infusions to intermittent intravenous push doses
Correct Incorrect Correct answer

Correct

Incorrect
Question 51 of 792

51. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A community pharmacy has experienced two dispensing errors in the past year involving hydroxyzine and hydralazine. The pharmacy manager asks the technician team to recommend a multi-layered prevention strategy. Which approach best addresses the root cause of look-alike/sound-alike errors?

Separate the medications physically on the shelf, apply tall man lettering to shelf labels, and configure the dispensing software to display alert warnings
Correct Incorrect Correct answer

Require all technicians to spell out the drug name aloud before selecting it from the shelf
Correct Incorrect Correct answer

Replace one of the two medications with a therapeutic alternative from a different manufacturer
Correct Incorrect Correct answer

Add fluorescent stickers to the hydroxyzine bottles and move hydralazine to a locked cabinet
Correct Incorrect Correct answer

Correct

Incorrect
Question 52 of 792

52. Question

Category: Patient Safety and Quality Assurance: Event Reporting

Which federal program is specifically designed to collect reports of adverse events following immunizations?

VAERS
Correct Incorrect Correct answer

MedWatch
Correct Incorrect Correct answer

ISMP MERP
Correct Incorrect Correct answer

REMS
Correct Incorrect Correct answer

Correct

Incorrect
Question 53 of 792

53. Question

Category: Patient Safety and Quality Assurance: Event Reporting

What is the FDA’s voluntary safety reporting program for adverse events related to medications and medical devices?

MedWatch
Correct Incorrect Correct answer

VAERS
Correct Incorrect Correct answer

OSHA Incident Reporting
Correct Incorrect Correct answer

Sentinel Initiative
Correct Incorrect Correct answer

Correct

Incorrect
Question 54 of 792

54. Question

Category: Patient Safety and Quality Assurance: Event Reporting

Which type of medication event occurs when a patient receives a drug intended for a different individual?

Wrong patient error
Correct Incorrect Correct answer

Wrong drug error
Correct Incorrect Correct answer

Wrong dose error
Correct Incorrect Correct answer

Wrong route error
Correct Incorrect Correct answer

Correct

Incorrect
Question 55 of 792

55. Question

Category: Patient Safety and Quality Assurance: Event Reporting

What is the primary purpose of root cause analysis (RCA) in a pharmacy setting?

To identify underlying system factors that contributed to an error
Correct Incorrect Correct answer

To determine which staff member should be disciplined
Correct Incorrect Correct answer

To calculate the financial cost of a medication error
Correct Incorrect Correct answer

To fulfill state board documentation requirements
Correct Incorrect Correct answer

Correct

Incorrect
Question 56 of 792

56. Question

Category: Patient Safety and Quality Assurance: Event Reporting

In a just culture environment, how are honest medication errors typically handled?

As opportunities for system improvement without individual punishment
Correct Incorrect Correct answer

As grounds for immediate termination of the involved staff
Correct Incorrect Correct answer

As incidents requiring mandatory retraining and probation
Correct Incorrect Correct answer

As events that should be concealed to protect the organization
Correct Incorrect Correct answer

Correct

Incorrect
Question 57 of 792

57. Question

Category: Patient Safety and Quality Assurance: Event Reporting

What term describes a medication error that is caught and corrected before it reaches the patient?

Near-miss event
Correct Incorrect Correct answer

Sentinel event
Correct Incorrect Correct answer

Adverse drug reaction
Correct Incorrect Correct answer

Medication misadventure
Correct Incorrect Correct answer

Correct

Incorrect
Question 58 of 792

58. Question

Category: Patient Safety and Quality Assurance: Event Reporting

Which organization operates the Medication Errors Reporting Program (MERP) and publishes safety alerts for healthcare professionals?

Institute for Safe Medication Practices (ISMP)
Correct Incorrect Correct answer

Centers for Disease Control and Prevention (CDC)
Correct Incorrect Correct answer

Drug Enforcement Administration (DEA)
Correct Incorrect Correct answer

American Pharmacists Association (APhA)
Correct Incorrect Correct answer

Correct

Incorrect
Question 59 of 792

59. Question

Category: Patient Safety and Quality Assurance: Event Reporting

What does continuous quality improvement (CQI) primarily aim to achieve in pharmacy practice?

Ongoing systematic enhancement of processes to reduce errors
Correct Incorrect Correct answer

One-time correction of a single identified problem
Correct Incorrect Correct answer

Annual compliance review of pharmacy staff credentials
Correct Incorrect Correct answer

Monthly inventory audits of controlled substances
Correct Incorrect Correct answer

Correct

Incorrect
Question 60 of 792

60. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician notices that a prescription label shows amoxicillin 500 mg but the vial contains amoxicillin 250 mg capsules. The prescription has not been picked up by the patient. What should the technician do first?

Alert the pharmacist and prevent the prescription from being dispensed
Correct Incorrect Correct answer

Discard the vial and refill the prescription independently
Correct Incorrect Correct answer

Contact the patient to inform them of a potential delay
Correct Incorrect Correct answer

File an incident report and place the prescription back on the shelf
Correct Incorrect Correct answer

Correct

Incorrect
Question 61 of 792

61. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A patient reports developing a widespread rash and difficulty breathing within 30 minutes of receiving a flu vaccine at a pharmacy. Which reporting system should the pharmacy use to document this event?

VAERS
Correct Incorrect Correct answer

MedWatch
Correct Incorrect Correct answer

Poison Control Center
Correct Incorrect Correct answer

State prescription monitoring program
Correct Incorrect Correct answer

Correct

Incorrect
Question 62 of 792

62. Question

Category: Patient Safety and Quality Assurance: Event Reporting

During an RCA meeting following a wrong-drug dispensing error, the team discovers that two look-alike medications were stored next to each other on the shelf. Which corrective action best addresses the root cause?

Separate the look-alike medications and add shelf alert labels
Correct Incorrect Correct answer

Require the involved technician to complete additional training
Correct Incorrect Correct answer

Add a second pharmacist verification step for all prescriptions
Correct Incorrect Correct answer

Mandate that all staff review the error report within one week
Correct Incorrect Correct answer

Correct

Incorrect
Question 63 of 792

63. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician receives a bottle of metformin tablets that appears to have a broken seal and unusual discoloration of some tablets. What is the most appropriate action?

Quarantine the product and report the issue to the pharmacist for a MedWatch submission
Correct Incorrect Correct answer

Return the product to the wholesaler without further documentation
Correct Incorrect Correct answer

Dispense only the tablets that appear normal in color
Correct Incorrect Correct answer

Place the bottle on the shelf and note the issue in the daily log
Correct Incorrect Correct answer

Correct

Incorrect
Question 64 of 792

64. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy has seen a pattern of wrong-time administration errors in its long-term care facility clients over the past quarter. Which CQI step should the pharmacy take next?

Analyze the error data to identify common contributing factors
Correct Incorrect Correct answer

Immediately change all medication administration schedules
Correct Incorrect Correct answer

Terminate the staff members associated with the most errors
Correct Incorrect Correct answer

Stop accepting new long-term care clients until errors decrease
Correct Incorrect Correct answer

Correct

Incorrect
Question 65 of 792

65. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A technician filling a prescription for lisinopril 10 mg accidentally selects lisinopril 20 mg from the shelf. The pharmacist catches the error during final verification. How should this event be classified?

Near-miss involving a wrong dose selection
Correct Incorrect Correct answer

Adverse drug event requiring immediate FDA notification
Correct Incorrect Correct answer

Sentinel event requiring external reporting to the state board
Correct Incorrect Correct answer

Medication misadventure with confirmed patient injury
Correct Incorrect Correct answer

Correct

Incorrect
Question 66 of 792

66. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy implements a new barcode scanning system at the filling station. Three months later, wrong-drug dispensing errors have decreased by 40%. This outcome is best described as a result of which initiative?

Continuous quality improvement program
Correct Incorrect Correct answer

Root cause analysis of a single incident
Correct Incorrect Correct answer

Mandatory staff disciplinary process
Correct Incorrect Correct answer

Annual state board compliance audit
Correct Incorrect Correct answer

Correct

Incorrect
Question 67 of 792

67. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician discovers that an IV admixture was prepared using the wrong diluent but has not yet left the pharmacy. What documentation should the technician prioritize completing?

An internal incident report describing the near-miss event
Correct Incorrect Correct answer

A MedWatch form submitted directly to the FDA
Correct Incorrect Correct answer

A formal letter to the prescribing physician about the error
Correct Incorrect Correct answer

A controlled substance discrepancy log entry
Correct Incorrect Correct answer

Correct

Incorrect
Question 68 of 792

68. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy’s error-trending data reveals that most dispensing errors occur between 5:00 PM and 7:00 PM on weekdays. Which factor is most likely contributing to this pattern?

High prescription volume combined with reduced staffing during that period
Correct Incorrect Correct answer

Increased availability of look-alike sound-alike medications
Correct Incorrect Correct answer

Changes in wholesaler delivery schedules during evening hours
Correct Incorrect Correct answer

Higher rates of controlled substance prescriptions in the evening
Correct Incorrect Correct answer

Correct

Incorrect
Question 69 of 792

69. Question

Category: Patient Safety and Quality Assurance: Event Reporting

In a punitive reporting culture, which outcome is most likely when a pharmacy technician makes a dispensing error?

The technician avoids reporting the error out of fear of consequences
Correct Incorrect Correct answer

The technician immediately files a detailed incident report
Correct Incorrect Correct answer

The pharmacy gains valuable data for process improvement
Correct Incorrect Correct answer

The technician collaborates with management to redesign the workflow
Correct Incorrect Correct answer

Correct

Incorrect
Question 70 of 792

70. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A patient calls the pharmacy to report that the tablets in their prescription bottle look different from their usual medication and have a strange odor. What should the pharmacy technician do?

Ask the patient to bring the medication back and alert the pharmacist to investigate a possible product integrity issue
Correct Incorrect Correct answer

Tell the patient the appearance change is likely due to a manufacturer switch and is safe
Correct Incorrect Correct answer

Advise the patient to continue taking the medication and monitor for side effects
Correct Incorrect Correct answer

Instruct the patient to dispose of the tablets and call their doctor for a new prescription
Correct Incorrect Correct answer

Correct

Incorrect
Question 71 of 792

71. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy’s CQI data shows that wrong-drug errors decreased after implementing tall man lettering but wrong-dose errors remained unchanged. What does this finding suggest about the pharmacy’s error reduction strategy?

Tall man lettering addresses look-alike drug name confusion but does not target dose-selection errors
Correct Incorrect Correct answer

The tall man lettering was implemented incorrectly and should be removed
Correct Incorrect Correct answer

Wrong-dose errors are impossible to reduce through process improvements
Correct Incorrect Correct answer

Staff are ignoring the tall man lettering labels entirely during dispensing
Correct Incorrect Correct answer

Correct

Incorrect
Question 72 of 792

72. Question

Category: Patient Safety and Quality Assurance: Event Reporting

An RCA team investigating a wrong-route error in an IV room identifies the following factors: illegible prescriber handwriting, absence of a second technician check, and a noisy work environment. Which approach would be most effective to prevent recurrence?

Implement electronic order entry, add a second verification step, and reduce environmental distractions
Correct Incorrect Correct answer

Retrain the technician who made the error and issue a written warning
Correct Incorrect Correct answer

Require all prescribers to undergo handwriting improvement classes
Correct Incorrect Correct answer

Increase pharmacy technician wages to improve job satisfaction and focus
Correct Incorrect Correct answer

Correct

Incorrect
Question 73 of 792

73. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A hospital pharmacy reports 15 near-miss events and 2 actual dispensing errors over a six-month period. A comparable facility with a known punitive culture reports 0 near-misses and 3 actual errors during the same period. What is the most likely explanation for the difference in near-miss reporting?

The punitive culture discourages staff from reporting near-miss events
Correct Incorrect Correct answer

The punitive facility has better dispensing processes that prevent near-misses
Correct Incorrect Correct answer

The first hospital has less experienced staff making more mistakes
Correct Incorrect Correct answer

Near-miss events only occur in facilities with informal reporting systems
Correct Incorrect Correct answer

Correct

Incorrect
Question 74 of 792

74. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy’s error-trending report shows that wrong-patient errors spike during the first week a new pharmacy technician starts. An RCA team is formed. Which root cause is most consistent with this trend?

Insufficient orientation and training on patient identification verification procedures
Correct Incorrect Correct answer

The pharmacy software automatically assigns prescriptions to incorrect patient profiles
Correct Incorrect Correct answer

Experienced technicians deliberately create errors to test new staff
Correct Incorrect Correct answer

New technicians are more likely to report errors that experienced staff would overlook
Correct Incorrect Correct answer

Correct

Incorrect
Question 75 of 792

75. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy receives a cluster of MedWatch reports from patients describing unusual side effects from a specific lot number of a brand-name medication. The pharmacy also has remaining stock from that lot. What action should take priority?

Quarantine the remaining stock from that lot and notify the pharmacist to contact the manufacturer
Correct Incorrect Correct answer

Continue dispensing from the lot while waiting for the FDA to issue an official recall
Correct Incorrect Correct answer

Return the remaining stock to the wholesaler for credit without notifying anyone
Correct Incorrect Correct answer

Advise patients currently taking that lot to double their dose to counteract the side effects
Correct Incorrect Correct answer

Correct

Incorrect
Question 76 of 792

76. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy’s CQI committee reviews quarterly data and finds that medication error rates have plateaued despite multiple interventions over the past year. Which strategy is most appropriate for the committee to pursue next?

Re-examine the error data for new contributing factors that current interventions do not address
Correct Incorrect Correct answer

Conclude that the current error rate is acceptable and discontinue further analysis
Correct Incorrect Correct answer

Repeat the same interventions with greater enforcement to achieve better compliance
Correct Incorrect Correct answer

Replace all pharmacy technician staff with more experienced personnel
Correct Incorrect Correct answer

Correct

Incorrect
Question 77 of 792

77. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

According to proper handwashing technique, how long should a pharmacy technician scrub their hands with soap and water?

At least 20 seconds
Correct Incorrect Correct answer

At least 10 seconds
Correct Incorrect Correct answer

At least 45 seconds
Correct Incorrect Correct answer

At least 60 seconds
Correct Incorrect Correct answer

Correct

Incorrect
Question 78 of 792

78. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

What is the minimum ISO classification required for the primary engineering control (PEC) used in sterile compounding under USP 797?

ISO Class 5
Correct Incorrect Correct answer

ISO Class 3
Correct Incorrect Correct answer

ISO Class 7
Correct Incorrect Correct answer

ISO Class 8
Correct Incorrect Correct answer

Correct

Incorrect
Question 79 of 792

79. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

Which cleaning agent is most commonly used to disinfect laminar airflow workbench surfaces before sterile compounding?

Sterile 70% isopropyl alcohol
Correct Incorrect Correct answer

Hydrogen peroxide 3% solution
Correct Incorrect Correct answer

Povidone-iodine 10% solution
Correct Incorrect Correct answer

Denatured ethanol 95% solution
Correct Incorrect Correct answer

Correct

Incorrect
Question 80 of 792

80. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

What type of airflow does a horizontal laminar airflow workbench (LAFW) provide?

HEPA-filtered air blowing from the back toward the operator
Correct Incorrect Correct answer

HEPA-filtered air blowing from the top downward toward the work surface
Correct Incorrect Correct answer

Unfiltered room air circulating in a horizontal pattern
Correct Incorrect Correct answer

HEPA-filtered air blowing from the front toward the back wall
Correct Incorrect Correct answer

Correct

Incorrect
Question 81 of 792

81. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

Under USP 800, what is the required glove practice when handling hazardous drugs?

Double gloving with chemotherapy-tested gloves
Correct Incorrect Correct answer

Single pair of standard latex examination gloves
Correct Incorrect Correct answer

Single pair of chemotherapy-tested gloves
Correct Incorrect Correct answer

Double gloving with standard nitrile examination gloves
Correct Incorrect Correct answer

Correct

Incorrect
Question 82 of 792

82. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

Which piece of personal protective equipment is donned last during the garbing process for sterile compounding?

Sterile gloves
Correct Incorrect Correct answer

Hair cover
Correct Incorrect Correct answer

Shoe covers
Correct Incorrect Correct answer

Face mask
Correct Incorrect Correct answer

Correct

Incorrect
Question 83 of 792

83. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

What is the primary purpose of a biological safety cabinet (BSC) in a pharmacy setting?

To protect both the product and the operator from contamination and exposure
Correct Incorrect Correct answer

To protect only the sterile product from microbial contamination
Correct Incorrect Correct answer

To protect only the operator from chemical exposure
Correct Incorrect Correct answer

To maintain room temperature stability during compounding
Correct Incorrect Correct answer

Correct

Incorrect
Question 84 of 792

84. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

How often must floors in the buffer area of a cleanroom be cleaned according to USP 797?

Daily
Correct Incorrect Correct answer

Weekly
Correct Incorrect Correct answer

Every 30 days
Correct Incorrect Correct answer

After each compounding session
Correct Incorrect Correct answer

Correct

Incorrect
Question 85 of 792

85. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician just counted tablets of amoxicillin on a counting tray. What must they do before counting the next medication?

Clean the counting tray with 70% isopropyl alcohol
Correct Incorrect Correct answer

Rinse the counting tray with warm tap water
Correct Incorrect Correct answer

Wipe the counting tray with a dry lint-free cloth
Correct Incorrect Correct answer

Use the other side of the counting tray without cleaning
Correct Incorrect Correct answer

Correct

Incorrect
Question 86 of 792

86. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is preparing to compound a hazardous drug in the cleanroom. Which engineering control should they use?

A Class II biological safety cabinet with vertical airflow
Correct Incorrect Correct answer

A horizontal laminar airflow workbench with HEPA filtration
Correct Incorrect Correct answer

A standard fume hood with no HEPA filtration
Correct Incorrect Correct answer

A compounding aseptic isolator without exhaust filtration
Correct Incorrect Correct answer

Correct

Incorrect
Question 87 of 792

87. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A technician accidentally sticks themselves with a needle that was used to draw up a non-hazardous medication. What is the first step they should take?

Wash the affected area immediately with soap and water
Correct Incorrect Correct answer

Apply a tourniquet above the puncture site
Correct Incorrect Correct answer

Report to their supervisor before doing anything else
Correct Incorrect Correct answer

Apply sterile 70% isopropyl alcohol directly to the wound
Correct Incorrect Correct answer

Correct

Incorrect
Question 88 of 792

88. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician notices a small spill of a non-hazardous liquid medication on the pharmacy countertop. What is the appropriate cleanup method?

Wipe the spill with absorbent material, then clean the area with 70% isopropyl alcohol
Correct Incorrect Correct answer

Place a hazardous drug spill kit over the area and evacuate the immediate vicinity
Correct Incorrect Correct answer

Cover the spill with a dry towel and allow it to air dry overnight
Correct Incorrect Correct answer

Flush the area with large volumes of sterile water and allow it to air dry
Correct Incorrect Correct answer

Correct

Incorrect
Question 89 of 792

89. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

While garbing for sterile compounding, a technician touches their face after already putting on their sterile gown. What should they do?

Remove the gown and restart the garbing process from that point
Correct Incorrect Correct answer

Continue garbing since the gown is still considered sterile
Correct Incorrect Correct answer

Spray the area they touched with 70% isopropyl alcohol and continue
Correct Incorrect Correct answer

Put on a second gown over the potentially contaminated one
Correct Incorrect Correct answer

Correct

Incorrect
Question 90 of 792

90. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is about to clean the interior of a horizontal laminar airflow workbench. In which direction should they wipe the surfaces?

From back to front, side to side, using overlapping strokes
Correct Incorrect Correct answer

From front to back in straight lines without overlapping
Correct Incorrect Correct answer

In circular motions starting from the center outward
Correct Incorrect Correct answer

From top to bottom in a single continuous stroke
Correct Incorrect Correct answer

Correct

Incorrect
Question 91 of 792

91. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy receives a new chemotherapy drug for compounding. According to USP 800, where should this drug be stored?

In a designated negative-pressure area separate from non-hazardous drugs
Correct Incorrect Correct answer

On the same shelf as other injectable medications in the main pharmacy
Correct Incorrect Correct answer

In a positive-pressure clean room alongside sterile compounding supplies
Correct Incorrect Correct answer

In a locked cabinet within the general pharmacy storage area
Correct Incorrect Correct answer

Correct

Incorrect
Question 92 of 792

92. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A technician is preparing to count methotrexate tablets at the pharmacy counter. Which precaution is required for this medication?

Use a dedicated counting tray designated for hazardous drugs
Correct Incorrect Correct answer

Count the tablets by hand while wearing a single pair of latex gloves
Correct Incorrect Correct answer

Use the standard counting tray after cleaning it with soap and water
Correct Incorrect Correct answer

Pour the tablets directly from the stock bottle into the dispensing vial
Correct Incorrect Correct answer

Correct

Incorrect
Question 93 of 792

93. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

During sterile compounding, a technician needs to introduce a new vial into the laminar airflow workbench. How should they position the vial relative to other items in the hood?

At least six inches inside the hood and away from other objects to avoid disrupting airflow
Correct Incorrect Correct answer

As close as possible to other items to minimize the work area used
Correct Incorrect Correct answer

At the very front edge of the hood for easy access during compounding
Correct Incorrect Correct answer

Directly adjacent to the HEPA filter to maximize sterile air contact
Correct Incorrect Correct answer

Correct

Incorrect
Question 94 of 792

94. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is handling a closed-system transfer device (CSTD) for a hazardous drug preparation. What is the primary purpose of this device?

To prevent the escape of hazardous drug vapor or aerosol during transfer
Correct Incorrect Correct answer

To increase the speed of drug reconstitution and preparation
Correct Incorrect Correct answer

To allow the reuse of needles safely between multiple vials
Correct Incorrect Correct answer

To eliminate the need for personal protective equipment during compounding
Correct Incorrect Correct answer

Correct

Incorrect
Question 95 of 792

95. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A technician has just counted sulfamethoxazole-trimethoprim tablets. A patient with a documented sulfa allergy has a prescription to be filled next. What action is most important before counting the next prescription?

Thoroughly clean the counting tray with 70% isopropyl alcohol to remove sulfa residue
Correct Incorrect Correct answer

Proceed to count the next prescription since the allergen risk is minimal
Correct Incorrect Correct answer

Switch to a different brand of counting spatula before continuing
Correct Incorrect Correct answer

Notify the pharmacist that the sulfa prescription was counted first
Correct Incorrect Correct answer

Correct

Incorrect
Question 96 of 792

96. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy is found to have an ISO Class 7 reading inside the primary engineering control where sterile compounding takes place. What is the significance of this finding?

The PEC does not meet USP 797 requirements and sterile compounding must stop until ISO Class 5 is restored
Correct Incorrect Correct answer

The reading is acceptable because ISO Class 7 is sufficient for sterile compounding
Correct Incorrect Correct answer

The reading indicates the anteroom needs attention but the PEC can continue operating
Correct Incorrect Correct answer

The facility must upgrade the entire cleanroom to ISO Class 3 within 30 days
Correct Incorrect Correct answer

Correct

Incorrect
Question 97 of 792

97. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy is designing a new sterile compounding area. The architect proposes placing the buffer room at positive pressure relative to the anteroom, and the anteroom at positive pressure relative to the general pharmacy. However, the pharmacy also compounds hazardous drugs. What is the problem with this design?

The hazardous drug compounding area must be at negative pressure relative to surrounding areas to contain hazardous particles
Correct Incorrect Correct answer

The anteroom should be at negative pressure relative to both the buffer room and general pharmacy
Correct Incorrect Correct answer

The buffer room pressure must match the anteroom pressure exactly for proper airflow
Correct Incorrect Correct answer

The general pharmacy must be at positive pressure relative to the anteroom to prevent contamination
Correct Incorrect Correct answer

Correct

Incorrect
Question 98 of 792

98. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is observed placing supplies on top of the HEPA filter grille inside a vertical laminar airflow workbench to save space. Why is this practice a serious concern?

Blocking the HEPA filter disrupts unidirectional airflow and compromises the ISO Class 5 environment
Correct Incorrect Correct answer

The weight of supplies may physically damage the workbench motor
Correct Incorrect Correct answer

The supplies will absorb filtered air and reduce the volume available for compounding
Correct Incorrect Correct answer

Static electricity from the HEPA filter will degrade the medication being prepared
Correct Incorrect Correct answer

Correct

Incorrect
Question 99 of 792

99. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacist reviews a hazardous drug spill report and finds that the technician cleaned up the spill using paper towels and standard glass cleaner, then disposed of the waste in the regular trash. Which aspects of this cleanup were incorrect?

A hazardous drug spill kit should have been used, and waste should have been placed in a designated hazardous waste container
Correct Incorrect Correct answer

Paper towels were acceptable, but the waste should have been placed in a sharps container
Correct Incorrect Correct answer

The glass cleaner was appropriate, but the technician should have worn two pairs of shoe covers
Correct Incorrect Correct answer

The cleanup method was correct, but the technician should have filed the report within 48 hours
Correct Incorrect Correct answer

Correct

Incorrect
Question 100 of 792

100. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy undergoes an inspection and is cited because its ante-area has an ISO Class 9 particulate count. The buffer room meets ISO Class 7 standards. What does this finding indicate about the facility’s compliance?

The ante-area fails to meet the USP 797 requirement of ISO Class 8 or better, creating a contamination risk for the buffer room
Correct Incorrect Correct answer

The facility is fully compliant because only the buffer room classification matters for sterile compounding
Correct Incorrect Correct answer

The ante-area must match the buffer room at ISO Class 7 for the facility to pass inspection
Correct Incorrect Correct answer

The finding is acceptable because the ante-area is not required to meet any ISO classification
Correct Incorrect Correct answer

Correct

Incorrect
Question 101 of 792

101. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician performing media-fill testing fails the test for the second consecutive time. According to USP 797 guidelines, what action should be taken?

The technician must be retrained in aseptic technique and successfully pass the media-fill test before resuming sterile compounding
Correct Incorrect Correct answer

The technician may continue compounding under direct pharmacist supervision until the next scheduled test
Correct Incorrect Correct answer

The technician should repeat the test immediately without additional training until they pass
Correct Incorrect Correct answer

The technician's competency is automatically reinstated after a 30-day waiting period
Correct Incorrect Correct answer

Correct

Incorrect
Question 102 of 792

102. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician receives a drug utilization review (DUR) alert for a duplicate therapy. What is the technician’s most appropriate action?

Refer the alert to the pharmacist for clinical evaluation
Correct Incorrect Correct answer

Override the alert and continue processing the prescription
Correct Incorrect Correct answer

Contact the prescriber directly to request a therapy change
Correct Incorrect Correct answer

Discontinue the older medication in the patient profile
Correct Incorrect Correct answer

Correct

Incorrect
Question 103 of 792

103. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient asks the pharmacy technician to recommend an OTC cough suppressant that will not interact with their current antidepressant. What should the technician do?

Refer the patient to the pharmacist for a recommendation
Correct Incorrect Correct answer

Suggest any OTC cough suppressant since they are safe with antidepressants
Correct Incorrect Correct answer

Look up the interaction and recommend a product without dextromethorphan
Correct Incorrect Correct answer

Tell the patient to ask their physician at their next appointment
Correct Incorrect Correct answer

Correct

Incorrect
Question 104 of 792

104. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

Which type of DUR alert is generated when a prescription is checked against a patient’s existing medication list at the time of dispensing?

Prospective drug utilization review
Correct Incorrect Correct answer

Retrospective drug utilization review
Correct Incorrect Correct answer

Concurrent drug utilization review
Correct Incorrect Correct answer

Formulary compliance review
Correct Incorrect Correct answer

Correct

Incorrect
Question 105 of 792

105. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

While entering a prescription for warfarin, the pharmacy software generates an interaction alert with the patient’s current fluconazole prescription. What should the technician do?

Flag the interaction and notify the pharmacist before proceeding
Correct Incorrect Correct answer

Process the prescription since both medications were prescribed by the same provider
Correct Incorrect Correct answer

Reduce the warfarin dose to prevent an adverse reaction
Correct Incorrect Correct answer

Call the prescriber to cancel the fluconazole prescription
Correct Incorrect Correct answer

Correct

Incorrect
Question 106 of 792

106. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician notices a patient has been refilling alprazolam every 20 days on a 30-day supply and also picks up oxycodone from the same pharmacy. Which combination of findings should prompt the technician to alert the pharmacist?

The early refill pattern combined with concurrent use of a benzodiazepine and opioid
Correct Incorrect Correct answer

The concurrent use of two controlled substances prescribed by the same physician
Correct Incorrect Correct answer

The early refill pattern only, since the opioid prescription is clinically appropriate
Correct Incorrect Correct answer

The benzodiazepine prescription only, since benzodiazepines require prior authorization
Correct Incorrect Correct answer

Correct

Incorrect
Question 107 of 792

107. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

Which of the following is an example of an adverse drug event (ADE) that a technician should immediately report to the pharmacist?

A patient reports developing a rash after starting a new antibiotic
Correct Incorrect Correct answer

A patient requests a refill two days before the scheduled refill date
Correct Incorrect Correct answer

A patient asks about the proper storage temperature for insulin
Correct Incorrect Correct answer

A patient wants to know if a generic substitution is available
Correct Incorrect Correct answer

Correct

Incorrect
Question 108 of 792

108. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A prescriber calls the pharmacy and requests that the technician switch a patient’s atorvastatin to rosuvastatin due to insurance formulary requirements. What is the technician’s appropriate response?

Inform the prescriber that the pharmacist must handle the therapeutic substitution
Correct Incorrect Correct answer

Process the change immediately since the prescriber authorized it verbally
Correct Incorrect Correct answer

Verify the patient's insurance formulary and make the switch in the system
Correct Incorrect Correct answer

Document the request and fill the rosuvastatin without pharmacist involvement
Correct Incorrect Correct answer

Correct

Incorrect
Question 109 of 792

109. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient picking up metformin tells the technician they have been skipping doses because the medication causes stomach upset. What should the technician do?

Refer the patient to the pharmacist for adherence counseling
Correct Incorrect Correct answer

Advise the patient to take the medication with food to reduce stomach upset
Correct Incorrect Correct answer

Suggest the patient reduce the dose until the side effects resolve
Correct Incorrect Correct answer

Tell the patient the side effects are normal and will go away over time
Correct Incorrect Correct answer

Correct

Incorrect
Question 110 of 792

110. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

After a patient receives a vaccination at the pharmacy, what is the minimum observation period typically recommended for monitoring adverse reactions?

15 minutes
Correct Incorrect Correct answer

5 minutes
Correct Incorrect Correct answer

30 minutes
Correct Incorrect Correct answer

60 minutes
Correct Incorrect Correct answer

Correct

Incorrect
Question 111 of 792

111. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient with a documented penicillin allergy presents a prescription for cephalexin. What should the technician do when the allergy alert is triggered?

Alert the pharmacist to evaluate the cross-sensitivity risk before dispensing
Correct Incorrect Correct answer

Override the alert since cephalosporins are a different drug class
Correct Incorrect Correct answer

Refuse to fill the prescription and ask the patient to contact the prescriber
Correct Incorrect Correct answer

Substitute the cephalexin with azithromycin to avoid the allergy risk
Correct Incorrect Correct answer

Correct

Incorrect
Question 112 of 792

112. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician notices that a regular patient who typically fills lisinopril, amlodipine, and metoprolol has not picked up any of their medications in over 45 days. What is the most appropriate action?

Notify the pharmacist so they can follow up on the patient's adherence
Correct Incorrect Correct answer

Remove the patient's profile from the automatic refill program
Correct Incorrect Correct answer

Call the patient and remind them to pick up their medications
Correct Incorrect Correct answer

Contact the prescriber to report the patient's nonadherence
Correct Incorrect Correct answer

Correct

Incorrect
Question 113 of 792

113. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician is working at the drive-through window when a patient asks which OTC sleep aid would be safest with their current prescription for trazodone. What should the technician do?

Ask the patient to wait and refer the question to the pharmacist
Correct Incorrect Correct answer

Recommend melatonin since it is a natural supplement with no drug interactions
Correct Incorrect Correct answer

Suggest diphenhydramine because it is commonly used as an OTC sleep aid
Correct Incorrect Correct answer

Tell the patient that any OTC sleep aid is safe to take with trazodone
Correct Incorrect Correct answer

Correct

Incorrect
Question 114 of 792

114. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

While processing a prescription for a pediatric patient, the technician notices the prescribed dose of amoxicillin appears to exceed the typical weight-based dosing range. What should the technician do?

Flag the prescription and refer it to the pharmacist for dose verification
Correct Incorrect Correct answer

Adjust the dose to match standard pediatric dosing guidelines
Correct Incorrect Correct answer

Fill the prescription as written since the prescriber determined the dose
Correct Incorrect Correct answer

Contact the prescriber to request a lower dose for the patient
Correct Incorrect Correct answer

Correct

Incorrect
Question 115 of 792

115. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient in the pharmacy waiting area who just received a flu vaccine begins experiencing difficulty breathing and facial swelling. What should the technician do first?

Immediately alert the pharmacist and call 911
Correct Incorrect Correct answer

Offer the patient an OTC antihistamine while waiting for symptoms to resolve
Correct Incorrect Correct answer

Document the reaction in the patient profile and file a VAERS report
Correct Incorrect Correct answer

Ask the patient to sit down and monitor them for 15 more minutes
Correct Incorrect Correct answer

Correct

Incorrect
Question 116 of 792

116. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

What is the primary purpose of a drug utilization review (DUR) performed by pharmacy software?

To identify potential drug therapy problems before dispensing
Correct Incorrect Correct answer

To verify the patient's insurance coverage for the medication
Correct Incorrect Correct answer

To confirm the pharmacy has adequate inventory of the medication
Correct Incorrect Correct answer

To check the prescriber's DEA registration status for controlled substances
Correct Incorrect Correct answer

Correct

Incorrect
Question 117 of 792

117. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient asks the technician if they can take ibuprofen with their prescribed warfarin for a headache. How should the technician respond?

Direct the patient to speak with the pharmacist about safe pain relief options
Correct Incorrect Correct answer

Recommend the patient take acetaminophen instead since it does not interact with warfarin
Correct Incorrect Correct answer

Tell the patient ibuprofen is safe to take occasionally with warfarin
Correct Incorrect Correct answer

Advise the patient to take a lower dose of ibuprofen to minimize risk
Correct Incorrect Correct answer

Correct

Incorrect
Question 118 of 792

118. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician reviews a patient’s refill history and notices the patient fills hydrocodone-acetaminophen at the current pharmacy and also receives oxycodone from a different pharmacy, as shown in the state PDMP database. What should the technician do?

Report the finding to the pharmacist for further investigation of possible misuse
Correct Incorrect Correct answer

Fill the prescription since the medications come from different prescribers
Correct Incorrect Correct answer

Contact the other pharmacy to verify the oxycodone prescription details
Correct Incorrect Correct answer

Refuse to dispense the hydrocodone and notify the patient of the reason
Correct Incorrect Correct answer

Correct

Incorrect
Question 119 of 792

119. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient presents a new prescription for an ACE inhibitor. Upon checking the patient profile, the technician sees a documented allergy to another ACE inhibitor. What should the technician do?

Notify the pharmacist of the allergy before the prescription is filled
Correct Incorrect Correct answer

Fill the prescription since the specific ACE inhibitor prescribed is different
Correct Incorrect Correct answer

Change the medication to an ARB as a therapeutic alternative
Correct Incorrect Correct answer

Contact the prescriber to inform them of the allergy documentation
Correct Incorrect Correct answer

Correct

Incorrect
Question 120 of 792

120. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

Which of the following signs observed by a technician should be reported to the pharmacist as a possible indicator of prescription drug misuse?

A patient frequently reports lost or stolen controlled substance prescriptions
Correct Incorrect Correct answer

A patient consistently picks up refills on the exact date they are due
Correct Incorrect Correct answer

A patient requests a generic substitution to reduce medication costs
Correct Incorrect Correct answer

A patient asks for information about the side effects of their medication
Correct Incorrect Correct answer

Correct

Incorrect
Question 121 of 792

121. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician enters a new prescription for lithium and the pharmacy software generates a DUR alert indicating the patient is also taking hydrochlorothiazide. Why should the pharmacist review this combination?

Thiazide diuretics can decrease lithium excretion and increase lithium toxicity risk
Correct Incorrect Correct answer

Hydrochlorothiazide reduces the therapeutic effectiveness of lithium
Correct Incorrect Correct answer

Lithium counteracts the blood pressure-lowering effects of hydrochlorothiazide
Correct Incorrect Correct answer

Both medications cause hyperkalemia when taken together
Correct Incorrect Correct answer

Correct

Incorrect
Question 122 of 792

122. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician is processing a prescription for a 70-year-old patient for digoxin 0.5 mg daily. The patient’s profile indicates they also take amiodarone and have a documented estimated GFR of 35 mL/min. Which factor is the most critical reason to alert the pharmacist?

The combination of renal impairment, amiodarone interaction, and a high digoxin dose increases toxicity risk
Correct Incorrect Correct answer

The patient's age alone requires automatic dose reduction for all cardiac medications
Correct Incorrect Correct answer

Amiodarone is contraindicated in patients over age 65 with reduced kidney function
Correct Incorrect Correct answer

Digoxin 0.5 mg is below the therapeutic dose and may be ineffective for the patient
Correct Incorrect Correct answer

Correct

Incorrect
Question 123 of 792

123. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient who received a shingles vaccine 10 minutes ago tells the technician they feel dizzy and lightheaded. What is the technician’s most appropriate action?

Have the patient sit or lie down and immediately notify the pharmacist
Correct Incorrect Correct answer

Tell the patient to drink water and wait for the symptoms to pass on their own
Correct Incorrect Correct answer

Document the reaction and send the patient home with instructions to rest
Correct Incorrect Correct answer

Advise the patient to return to the pharmacy if symptoms worsen later
Correct Incorrect Correct answer

Correct

Incorrect
Question 124 of 792

124. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

When a pharmacy technician identifies a potential adverse drug event reported by a patient, which healthcare professional is responsible for evaluating the clinical significance?

The pharmacist
Correct Incorrect Correct answer

The pharmacy technician who received the report
Correct Incorrect Correct answer

The pharmacy manager on duty
Correct Incorrect Correct answer

The patient's insurance case manager
Correct Incorrect Correct answer

Correct

Incorrect
Question 125 of 792

125. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician reviews a new prescription for clonidine 0.3 mg twice daily for a patient with no prior history of clonidine use in their profile. What aspect of this prescription should prompt the technician to flag it for pharmacist review?

The initial dose is higher than the typical starting dose for a new clonidine patient
Correct Incorrect Correct answer

Clonidine requires prior authorization from all insurance plans before dispensing
Correct Incorrect Correct answer

Twice-daily dosing is not an approved frequency for clonidine administration
Correct Incorrect Correct answer

Clonidine is a controlled substance that requires a DEA number on the prescription
Correct Incorrect Correct answer

Correct

Incorrect
Question 126 of 792

126. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

What does the acronym LASA stand for in the context of medication safety?

Look-Alike Sound-Alike
Correct Incorrect Correct answer

Licensed Automated Safety Assessment
Correct Incorrect Correct answer

Label Accuracy and Storage Alignment
Correct Incorrect Correct answer

Laboratory Assay Standardization Act
Correct Incorrect Correct answer

Correct

Incorrect
Question 127 of 792

127. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

Which organization maintains a widely referenced list of confused drug names that includes LASA medication pairs?

Institute for Safe Medication Practices (ISMP)
Correct Incorrect Correct answer

Food and Drug Administration (FDA)
Correct Incorrect Correct answer

Drug Enforcement Administration (DEA)
Correct Incorrect Correct answer

United States Pharmacopeia (USP)
Correct Incorrect Correct answer

Correct

Incorrect
Question 128 of 792

128. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

Tall Man lettering is a strategy that uses uppercase letters to highlight the differences between which type of medication names?

Look-alike/sound-alike (LASA) drug names
Correct Incorrect Correct answer

Brand name and generic name equivalents
Correct Incorrect Correct answer

Controlled substance schedule designations
Correct Incorrect Correct answer

Medications with similar therapeutic uses
Correct Incorrect Correct answer

Correct

Incorrect
Question 129 of 792

129. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

Which LASA medication pair involves two chemotherapy agents where a mix-up could result in a fatal dosing error?

vinCRIStine and vinBLAStine
Correct Incorrect Correct answer

metFORMIN and metroNIDAZOLE
Correct Incorrect Correct answer

predniSONE and prednisoLONE
Correct Incorrect Correct answer

DOBUTamine and DOPamine
Correct Incorrect Correct answer

Correct

Incorrect
Question 130 of 792

130. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

What is a primary purpose of physically separating LASA medications on pharmacy shelves?

To reduce the likelihood of selecting the wrong medication during dispensing
Correct Incorrect Correct answer

To comply with controlled substance storage regulations from the DEA
Correct Incorrect Correct answer

To maintain proper temperature requirements for each medication
Correct Incorrect Correct answer

To ensure medications from different manufacturers are grouped together
Correct Incorrect Correct answer

Correct

Incorrect
Question 131 of 792

131. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

Which of the following is a recognized LASA pair on the ISMP list of confused drug names?

predniSONE and prednisoLONE
Correct Incorrect Correct answer

amoxicillin and azithromycin
Correct Incorrect Correct answer

lisinopril and losartan
Correct Incorrect Correct answer

metformin and pioglitazone
Correct Incorrect Correct answer

Correct

Incorrect
Question 132 of 792

132. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician is stocking the shelves and notices that metFORMIN 500 mg tablets and metroNIDAZOLE 500 mg tablets are placed next to each other. What is the most appropriate action?

Separate the two medications by placing unrelated products between them on the shelf
Correct Incorrect Correct answer

Leave them in place since they are arranged in correct alphabetical order
Correct Incorrect Correct answer

Move both medications to the controlled substance storage area for safety
Correct Incorrect Correct answer

Relabel the metroNIDAZOLE bottles with a different color cap for distinction
Correct Incorrect Correct answer

Correct

Incorrect
Question 133 of 792

133. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A prescription is received for DOBUTamine for a patient with heart failure. The pharmacy technician retrieves a vial labeled DOPamine from the shelf. What should the technician do next?

Return the vial and retrieve DOBUTamine, recognizing these are two different medications
Correct Incorrect Correct answer

Dispense the DOPamine since it is also used for cardiac conditions
Correct Incorrect Correct answer

Ask the patient if DOPamine would be an acceptable substitute for DOBUTamine
Correct Incorrect Correct answer

Contact the insurance company to verify which medication is covered for this patient
Correct Incorrect Correct answer

Correct

Incorrect
Question 134 of 792

134. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician scans a bottle of hydrOXYzine during the filling process, but the barcode scan returns an alert indicating a mismatch with the prescription for hydrALAZINE. What does this alert indicate?

The wrong medication was selected and the technician picked hydroxyzine instead of hydralazine
Correct Incorrect Correct answer

The barcode scanner needs recalibration because the two drugs are interchangeable
Correct Incorrect Correct answer

The medication is expired and needs to be removed from the active inventory
Correct Incorrect Correct answer

The prescription requires a prior authorization before the medication can be dispensed
Correct Incorrect Correct answer

Correct

Incorrect
Question 135 of 792

135. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy is implementing new safety measures after a near-miss involving predniSONE and prednisoLONE. Which combination of strategies would be most effective for preventing future LASA errors with this pair?

Applying Tall Man lettering on shelf labels and physically separating the two products
Correct Incorrect Correct answer

Ordering both products from the same manufacturer to ensure consistent packaging
Correct Incorrect Correct answer

Storing both medications in the same bin to facilitate direct comparison during selection
Correct Incorrect Correct answer

Training staff to rely on the color of the manufacturer label to distinguish the products
Correct Incorrect Correct answer

Correct

Incorrect
Question 136 of 792

136. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician is entering a new prescription into the computer system and types ‘chlor’ into the search field. The system returns both chlorproMAZINE and chlorproPAMIDE. What should the technician do to ensure the correct medication is selected?

Verify the drug name, strength, and indication against the original prescription before proceeding
Correct Incorrect Correct answer

Select whichever medication appears first in the search results for efficiency
Correct Incorrect Correct answer

Choose the medication based on which one the pharmacy has in stock at the time
Correct Incorrect Correct answer

Pick the less expensive option to help reduce the cost for the patient
Correct Incorrect Correct answer

Correct

Incorrect
Question 137 of 792

137. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

During a pharmacy inventory audit, a technician discovers that ceREBYX (fosphenytoin) and ceLEBREX (celecoxib) are stored in the same bin. Which action best addresses this LASA risk?

Relocate one product to a different storage area and add auxiliary alert labels to both bins
Correct Incorrect Correct answer

Document the finding in the inventory log but leave the medications in their current location
Correct Incorrect Correct answer

Remove ceREBYX from stock since it is used less frequently than ceLEBREX
Correct Incorrect Correct answer

Place a note on the bin reminding staff to check for the correct medication at pickup
Correct Incorrect Correct answer

Correct

Incorrect
Question 138 of 792

138. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician receives a verbal order from a nurse requesting ‘Losec’ for a patient. The technician is aware that Losec sounds similar to Lasix. What is the most appropriate response?

Ask the nurse to spell the medication name and confirm the indication before processing
Correct Incorrect Correct answer

Dispense Lasix since it is more commonly prescribed in the hospital setting
Correct Incorrect Correct answer

Fill the order for Losec immediately to avoid delays in patient care
Correct Incorrect Correct answer

Substitute a therapeutically equivalent medication to prevent any confusion
Correct Incorrect Correct answer

Correct

Incorrect
Question 139 of 792

139. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A retail pharmacy fills approximately 400 prescriptions daily. The pharmacy manager asks the technician team to identify LASA pairs in the current inventory to improve safety. Which approach is the best starting point?

Cross-reference the pharmacy inventory against the ISMP list of confused drug names
Correct Incorrect Correct answer

Reorganize the entire inventory into therapeutic class groupings rather than alphabetical order
Correct Incorrect Correct answer

Replace all generic medications with their brand name equivalents to reduce name similarity
Correct Incorrect Correct answer

Assign one technician to memorize the complete list of LASA pairs in the pharmacy inventory
Correct Incorrect Correct answer

Correct

Incorrect
Question 140 of 792

140. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician notices that a newly hired technician consistently reaches for buPROPion when filling prescriptions for busPIRone. What is the most appropriate action to take?

Report the pattern to the pharmacist and suggest adding alert stickers to both medication bins
Correct Incorrect Correct answer

Move buPROPion to a locked cabinet so the new technician cannot access it directly
Correct Incorrect Correct answer

Allow the new technician to continue since the pharmacist will catch errors during verification
Correct Incorrect Correct answer

Switch to a single manufacturer for both products so the packaging is easier to differentiate
Correct Incorrect Correct answer

Correct

Incorrect
Question 141 of 792

141. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A hospital pharmacy is updating its automated dispensing cabinet (ADC) to reduce LASA errors. Which feature would be most effective for preventing selection of the wrong LASA medication?

Requiring barcode scanning of the medication vial before the cabinet drawer opens
Correct Incorrect Correct answer

Increasing the font size of all medication labels within the cabinet display
Correct Incorrect Correct answer

Grouping LASA pairs in the same drawer for easier side-by-side comparison
Correct Incorrect Correct answer

Removing override access so that all medications require pharmacist approval first
Correct Incorrect Correct answer

Correct

Incorrect
Question 142 of 792

142. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician is processing a prescription for aMILoride 5 mg daily. While retrieving the medication, the technician pulls amLODIPine 5 mg from the shelf. At what point should this error ideally be caught?

During the barcode scan verification step before the medication is placed in the dispensing vial
Correct Incorrect Correct answer

When the patient picks up the prescription and reviews the medication name on the label
Correct Incorrect Correct answer

During the next monthly inventory count when stock levels do not match expected quantities
Correct Incorrect Correct answer

When the patient experiences unexpected side effects and contacts the pharmacy afterward
Correct Incorrect Correct answer

Correct

Incorrect
Question 143 of 792

143. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician is preparing medications for a patient and must fill prescriptions for both traMADol and traZODone. What is the best practice when filling both prescriptions simultaneously?

Fill each prescription separately, verifying each product individually against its prescription label
Correct Incorrect Correct answer

Place both medications in the same bag to ensure the patient receives them together
Correct Incorrect Correct answer

Fill both prescriptions at the same time to streamline workflow and reduce processing delays
Correct Incorrect Correct answer

Use only the NDC number from memory to select each product without scanning the barcode
Correct Incorrect Correct answer

Correct

Incorrect
Question 144 of 792

144. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A community pharmacy reports three near-miss events over one month involving glipiZIDE and glyBURIDE. The pharmacy currently stores these medications alphabetically, uses Tall Man lettering on shelf labels, and requires barcode scanning. Which additional analysis should be performed to determine the root cause of these recurring near-misses?

Review whether the near-misses occurred during specific shifts, times, or with specific staff members to identify contributing workflow factors
Correct Incorrect Correct answer

Discontinue Tall Man lettering since it has not prevented the errors from occurring so far
Correct Incorrect Correct answer

Switch both medications to brand name only dispensing to eliminate generic name confusion entirely
Correct Incorrect Correct answer

Remove barcode scanning requirements to speed up workflow and reduce technician fatigue that may contribute to errors
Correct Incorrect Correct answer

Correct

Incorrect
Question 145 of 792

145. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A hospital pharmacy committee is evaluating LASA error prevention strategies. Data shows that 60% of LASA errors occur during the medication selection step, 25% during order entry, and 15% during labeling. Where should the committee focus its primary intervention efforts for the greatest impact?

Implement barcode verification and enhanced shelf labeling at the medication selection step
Correct Incorrect Correct answer

Focus resources on improving the labeling process since it is the final step before patient delivery
Correct Incorrect Correct answer

Address order entry errors first because they occur earlier in the dispensing workflow sequence
Correct Incorrect Correct answer

Distribute efforts equally across all three areas regardless of where errors most frequently occur
Correct Incorrect Correct answer

Correct

Incorrect
Question 146 of 792

146. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician identifies that the pharmacy stocks both vinCRIStine and vinBLAStine. Considering the severity of potential harm from a mix-up, which comprehensive safety strategy provides the strongest protection for this high-risk LASA pair?

Store them in separate locations with warning labels, require independent double-checks, and use barcode verification at every dispensing step
Correct Incorrect Correct answer

Apply Tall Man lettering to shelf labels and rely on the pharmacist final check as the primary safety barrier
Correct Incorrect Correct answer

Store them next to each other with different colored bins so staff can quickly compare the products during selection
Correct Incorrect Correct answer

Restrict vinBLAStine to the central pharmacy only and allow vinCRIStine to be stocked in automated dispensing cabinets
Correct Incorrect Correct answer

Correct

Incorrect
Question 147 of 792

147. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy receives a new generic medication whose packaging closely resembles an existing product that is also a LASA name pair. The pharmacy manager must decide whether to continue stocking both products from the same manufacturer. Which factor should carry the most weight in this decision?

The combined risk of both name similarity and packaging similarity significantly increases the likelihood of a selection error
Correct Incorrect Correct answer

The cost savings from purchasing both products from a single manufacturer outweigh the safety concerns
Correct Incorrect Correct answer

The manufacturer is responsible for ensuring its packaging is sufficiently different between products
Correct Incorrect Correct answer

Pharmacy technicians can be trained to recognize the subtle packaging differences with minimal effort
Correct Incorrect Correct answer

Correct

Incorrect
Question 148 of 792

148. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy has implemented Tall Man lettering, physical separation of LASA pairs, and barcode scanning, yet a dispensing error involving SUFentanil and fentaNYL still reached a patient. Which systemic factor most likely contributed to the failure of these existing safeguards?

The barcode was scanned after the label was already applied, creating confirmation bias that led the pharmacist to verify against the label rather than the original order
Correct Incorrect Correct answer

Tall Man lettering was applied incorrectly by using all capital letters for both medication names on shelf labels
Correct Incorrect Correct answer

The medications were stored in separate locations but the technician forgot which location held each product
Correct Incorrect Correct answer

The pharmacy did not stock SUFentanil and the error actually involved two different strengths of fentaNYL
Correct Incorrect Correct answer

Correct

Incorrect
Question 149 of 792

149. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy quality team reviews error data and finds that LASA errors involving clomiPHENE and clomiPRAMINE occur most frequently when prescriptions are received via telephone rather than electronically. Which analysis best explains this pattern?

Telephone orders rely on auditory discrimination of similar-sounding names, which eliminates the visual differentiation that electronic prescriptions provide
Correct Incorrect Correct answer

Electronic prescriptions always include the medication indication, which telephone orders never include by regulation
Correct Incorrect Correct answer

Telephone orders are only taken by pharmacy technicians who receive less training on LASA medications than pharmacists
Correct Incorrect Correct answer

Prescribers are more likely to prescribe the wrong medication verbally because they do not use reference materials during phone calls
Correct Incorrect Correct answer

Correct

Incorrect
Question 150 of 792

150. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

Which type of prescription error occurs when a medication is prescribed to be given intravenously but should be given orally?

Wrong route of administration
Correct Incorrect Correct answer

Wrong dose error
Correct Incorrect Correct answer

Wrong drug error
Correct Incorrect Correct answer

Wrong frequency error
Correct Incorrect Correct answer

Correct

Incorrect
Question 151 of 792

151. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

What are the two patient identifiers most commonly required before dispensing a medication?

Patient name and date of birth
Correct Incorrect Correct answer

Patient name and phone number
Correct Incorrect Correct answer

Patient address and date of birth
Correct Incorrect Correct answer

Patient name and insurance ID number
Correct Incorrect Correct answer

Correct

Incorrect
Question 152 of 792

152. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

Which element, if missing from a prescription, requires the pharmacy technician to seek clarification before processing?

Drug strength
Correct Incorrect Correct answer

Prescriber phone number
Correct Incorrect Correct answer

Diagnosis code
Correct Incorrect Correct answer

Refill authorization
Correct Incorrect Correct answer

Correct

Incorrect
Question 153 of 792

153. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A transcription error in pharmacy most commonly refers to which of the following?

A mistake made when transferring prescription information into the pharmacy system
Correct Incorrect Correct answer

A prescriber writing the wrong drug name on a prescription pad
Correct Incorrect Correct answer

A patient misunderstanding the directions on a medication label
Correct Incorrect Correct answer

A manufacturer labeling a product with incorrect information
Correct Incorrect Correct answer

Correct

Incorrect
Question 154 of 792

154. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

Which of the following is a red flag for a potentially forged prescription?

The prescription has no DEA number or an invalid DEA number format
Correct Incorrect Correct answer

The prescription is written on a preprinted prescription pad
Correct Incorrect Correct answer

The prescription includes the patient's date of birth
Correct Incorrect Correct answer

The prescription is written for a 30-day supply of medication
Correct Incorrect Correct answer

Correct

Incorrect
Question 155 of 792

155. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

When a pharmacy technician identifies a potential prescription error, what is the appropriate first step?

Notify the pharmacist immediately
Correct Incorrect Correct answer

Contact the patient to verify the prescription details
Correct Incorrect Correct answer

Call the prescriber's office to request a correction
Correct Incorrect Correct answer

Refuse to fill the prescription and return it to the patient
Correct Incorrect Correct answer

Correct

Incorrect
Question 156 of 792

156. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

Which type of error is most likely to occur when two patients in the pharmacy system share the same last name?

Wrong patient error
Correct Incorrect Correct answer

Wrong drug error
Correct Incorrect Correct answer

Wrong dose error
Correct Incorrect Correct answer

Wrong route error
Correct Incorrect Correct answer

Correct

Incorrect
Question 157 of 792

157. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A prescription is received for amoxicillin 500 mg capsules, #30, with directions to take one capsule three times daily. The technician enters a quantity of 300 into the computer system. What type of error has occurred?

Transcription error in the quantity field
Correct Incorrect Correct answer

Wrong drug selection error
Correct Incorrect Correct answer

Incorrect days supply calculation
Correct Incorrect Correct answer

Wrong dose entry error
Correct Incorrect Correct answer

Correct

Incorrect
Question 158 of 792

158. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A prescription is received for methotrexate 2.5 mg with directions to take 2.5 mg daily. What should the pharmacy technician do?

Alert the pharmacist because methotrexate for non-oncologic use is typically dosed weekly, not daily
Correct Incorrect Correct answer

Fill the prescription as written since the dose is within normal range
Correct Incorrect Correct answer

Change the directions to weekly dosing and process the prescription
Correct Incorrect Correct answer

Contact the prescriber directly to request a new prescription
Correct Incorrect Correct answer

Correct

Incorrect
Question 159 of 792

159. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A prescription is received for a 6-month-old infant for amoxicillin suspension 400 mg/5 mL, with directions to give 10 mL (800 mg) three times daily. The infant weighs 8 kg. The recommended pediatric dose is 25 to 45 mg/kg/day divided into two or three doses. What is the maximum recommended daily dose for this infant?

360 mg per day
Correct Incorrect Correct answer

200 mg per day
Correct Incorrect Correct answer

800 mg per day
Correct Incorrect Correct answer

2400 mg per day
Correct Incorrect Correct answer

Correct

Incorrect
Question 160 of 792

160. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A prescription reads: “Lisinopril 10 mg, take 1 tablet by mouth daily, #90, 3 refills.” The technician notices the patient profile already has an active prescription for enalapril 20 mg. What concern should the technician bring to the pharmacist?

Therapeutic duplication because both medications are ACE inhibitors
Correct Incorrect Correct answer

Drug interaction because lisinopril and enalapril are chemically incompatible
Correct Incorrect Correct answer

The lisinopril dose is too high for a patient already taking enalapril
Correct Incorrect Correct answer

The quantity of 90 tablets exceeds the maximum allowed for ACE inhibitors
Correct Incorrect Correct answer

Correct

Incorrect
Question 161 of 792

161. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A prescription for gabapentin 300 mg TID is received for an elderly patient with a documented creatinine clearance of 20 mL/min. The recommended dose for patients with CrCl 15 to 29 mL/min is 100 to 300 mg once daily. What should the technician do?

Alert the pharmacist that the prescribed frequency may be too high for this patient's renal function
Correct Incorrect Correct answer

Fill the prescription as written because 300 mg is within the recommended dose range
Correct Incorrect Correct answer

Reduce the frequency to once daily and process the prescription
Correct Incorrect Correct answer

Substitute a different medication that does not require renal adjustment
Correct Incorrect Correct answer

Correct

Incorrect
Question 162 of 792

162. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A technician is processing a prescription for a controlled substance and notices that the written quantity says “thirty” but the numeric quantity field shows “130.” How should the technician handle this discrepancy?

Alert the pharmacist to the discrepancy between the written and numeric quantities
Correct Incorrect Correct answer

Dispense 130 units because the numeric quantity takes precedence
Correct Incorrect Correct answer

Dispense 30 units because the written quantity always takes precedence
Correct Incorrect Correct answer

Average the two quantities and dispense 80 units
Correct Incorrect Correct answer

Correct

Incorrect
Question 163 of 792

163. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician receives a handwritten prescription that appears to read “Celebrex 200 mg.” However, the patient states they were told they would receive a seizure medication. Which medication was most likely intended?

Celexa (citalopram) is not a seizure medication, so the prescriber likely intended Cerebyx (fosphenytoin)
Correct Incorrect Correct answer

Celebrex (celecoxib) is correct because it is also used off-label for seizures
Correct Incorrect Correct answer

Celexa (citalopram) because it is commonly confused with Celebrex
Correct Incorrect Correct answer

Cerezyme (imiglucerase) because it is used for neurological conditions
Correct Incorrect Correct answer

Correct

Incorrect
Question 164 of 792

164. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A prescription for a 70 kg adult reads: “Vancomycin 15 mg/kg IV every 12 hours.” The pharmacy has vancomycin 1 g vials for reconstitution. What is the correct single dose for this patient?

1050 mg
Correct Incorrect Correct answer

1500 mg
Correct Incorrect Correct answer

750 mg
Correct Incorrect Correct answer

700 mg
Correct Incorrect Correct answer

Correct

Incorrect
Question 165 of 792

165. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A prescription for prednisone taper reads: “Take 6 tablets day 1, 5 tablets day 2, 4 tablets day 3, 3 tablets day 4, 2 tablets day 5, 1 tablet day 6.” Using 10 mg tablets, what total quantity should be dispensed?

21 tablets
Correct Incorrect Correct answer

18 tablets
Correct Incorrect Correct answer

30 tablets
Correct Incorrect Correct answer

24 tablets
Correct Incorrect Correct answer

Correct

Incorrect
Question 166 of 792

166. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician notices that a prescription for oxycodone 30 mg #120 appears to have been altered: the quantity originally looked like “#12” with a “0” added. What should the technician do?

Alert the pharmacist about the suspected alteration immediately
Correct Incorrect Correct answer

Fill the prescription for 12 tablets since that appears to be the original quantity
Correct Incorrect Correct answer

Call the patient to ask if the quantity is correct
Correct Incorrect Correct answer

Fill the prescription for 120 tablets since the current quantity is clearly written
Correct Incorrect Correct answer

Correct

Incorrect
Question 167 of 792

167. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A prescription is received for potassium chloride 40 mEq to be administered as an IV push. Why should this order be flagged?

Undiluted IV push potassium chloride can cause fatal cardiac arrhythmias
Correct Incorrect Correct answer

Potassium chloride is only available in oral formulations
Correct Incorrect Correct answer

The dose of 40 mEq exceeds the maximum lifetime dose
Correct Incorrect Correct answer

Potassium chloride cannot be mixed with any IV fluids
Correct Incorrect Correct answer

Correct

Incorrect
Question 168 of 792

168. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A technician enters a prescription for “hydroxyzine 25 mg” but accidentally selects hydralazine 25 mg from the drug database dropdown. What type of error is this?

Wrong drug selection error due to look-alike drug names
Correct Incorrect Correct answer

Wrong dose error because hydralazine doses differ from hydroxyzine
Correct Incorrect Correct answer

Therapeutic duplication because both drugs treat the same condition
Correct Incorrect Correct answer

Wrong route error because hydralazine is injectable only
Correct Incorrect Correct answer

Correct

Incorrect
Question 169 of 792

169. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician processes a prescription for warfarin 5 mg daily for a new patient. The patient profile shows the patient is also taking fluconazole 200 mg daily. The technician notices the system generates a severe drug interaction alert. Which outcome is the most significant concern with this drug combination?

Increased risk of bleeding because fluconazole inhibits warfarin metabolism
Correct Incorrect Correct answer

Decreased effectiveness of fluconazole due to warfarin induction
Correct Incorrect Correct answer

Increased risk of fungal infection due to reduced fluconazole absorption
Correct Incorrect Correct answer

Decreased anticoagulant effect requiring a higher warfarin dose
Correct Incorrect Correct answer

Correct

Incorrect
Question 170 of 792

170. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy receives a prescription for a 4-year-old child weighing 18 kg for ibuprofen suspension 100 mg/5 mL with directions to give 15 mL (300 mg) every 6 hours. The recommended pediatric dose is 5 to 10 mg/kg every 6 to 8 hours, with a maximum single dose of 400 mg. What is the appropriate assessment of this prescription?

The prescribed dose of 300 mg exceeds the maximum recommended single dose of 180 mg for this child
Correct Incorrect Correct answer

The prescribed dose is within normal range and the prescription can be filled as written
Correct Incorrect Correct answer

The prescribed dose is below the therapeutic range and would be ineffective
Correct Incorrect Correct answer

The concentration of 100 mg/5 mL is inappropriate for a child of this age
Correct Incorrect Correct answer

Correct

Incorrect
Question 171 of 792

171. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician is reviewing a prescription for insulin glargine with directions reading “inject 40 units subcutaneously at bedtime.” The patient’s profile shows they have been receiving insulin lispro 10 units with meals. The new prescription does not discontinue the insulin lispro. What should the technician consider?

This may be an intentional basal-bolus regimen, but the pharmacist should verify the prescriber's intent
Correct Incorrect Correct answer

This is therapeutic duplication and one insulin must be discontinued immediately
Correct Incorrect Correct answer

Insulin glargine and insulin lispro cannot be used together under any circumstances
Correct Incorrect Correct answer

The insulin glargine should be given with meals instead of at bedtime
Correct Incorrect Correct answer

Correct

Incorrect
Question 172 of 792

172. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician discovers that a prescription error resulted in a patient receiving the wrong strength of lisinopril for two months. The patient was supposed to receive 10 mg but received 40 mg. After the pharmacist is notified and the patient is contacted, what documentation is required?

An incident report detailing the error, how it was discovered, and the actions taken to address it
Correct Incorrect Correct answer

A note in the patient profile that the wrong strength was dispensed, with no further action
Correct Incorrect Correct answer

A letter to the prescriber apologizing for the error, with no internal documentation
Correct Incorrect Correct answer

A verbal report to the pharmacy manager with no written documentation required
Correct Incorrect Correct answer

Correct

Incorrect
Question 173 of 792

173. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy fills approximately 400 prescriptions daily. Over the past month, 12 near-miss errors were identified during pharmacist verification, and 8 of them involved incorrect quantities entered during data entry. A root cause analysis would most likely identify which contributing factor?

Workflow issues during data entry, such as high volume and inadequate double-check processes
Correct Incorrect Correct answer

Pharmacist inattention during clinical review of new prescriptions
Correct Incorrect Correct answer

Software malfunction causing automatic quantity changes in the system
Correct Incorrect Correct answer

Patient interference during the intake process at the drop-off window
Correct Incorrect Correct answer

Correct

Incorrect
Question 174 of 792

174. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

An 82-year-old patient weighing 50 kg presents a new prescription for gentamicin 350 mg IV every 8 hours. The standard dose for gentamicin is 1 to 2.5 mg/kg/dose every 8 hours, and the drug requires monitoring due to nephrotoxicity and ototoxicity risk in elderly patients. What is the most appropriate concern about this prescription?

The prescribed dose of 7 mg/kg greatly exceeds the standard dose range and poses serious toxicity risk
Correct Incorrect Correct answer

The prescribed dose is within the normal range for conventional gentamicin dosing
Correct Incorrect Correct answer

The frequency should be changed to every 4 hours for adequate coverage
Correct Incorrect Correct answer

Gentamicin is contraindicated in patients over 80 years of age
Correct Incorrect Correct answer

Correct

Incorrect
Question 175 of 792

175. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is preparing a total parenteral nutrition (TPN) order and notices the calcium and phosphate concentrations appear unusually high. What is the primary safety concern the technician should alert the pharmacist about?

Calcium phosphate precipitation can form and cause fatal pulmonary embolism
Correct Incorrect Correct answer

The TPN will expire sooner due to excessive electrolyte content
Correct Incorrect Correct answer

High calcium levels will degrade the amino acid solution over time
Correct Incorrect Correct answer

Phosphate concentrations above normal will cause the bag to leak
Correct Incorrect Correct answer

Correct

Incorrect
Question 176 of 792

176. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A hospital pharmacy receives orders for both vincristine for IV administration and methotrexate for intrathecal administration for the same oncology patient. Which practice is specifically required to prevent fatal vincristine administration errors?

Vincristine must be dispensed in a small-volume IV bag, never in a syringe
Correct Incorrect Correct answer

Vincristine must be compounded using a 0.22 micron filter to ensure sterility
Correct Incorrect Correct answer

Vincristine and methotrexate must be delivered to the floor at the same time
Correct Incorrect Correct answer

Vincristine must be labeled with a yellow auxiliary sticker indicating cytotoxic waste
Correct Incorrect Correct answer

Correct

Incorrect
Question 177 of 792

177. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is stocking an automated dispensing cabinet in the ICU and notices neuromuscular blocking agents stored alongside sedatives. What is the most appropriate action?

Notify the pharmacist that neuromuscular blockers should be segregated with warning labels from other medications
Correct Incorrect Correct answer

Place the neuromuscular blockers in alphabetical order next to the sedatives
Correct Incorrect Correct answer

Move the sedatives to a different drawer but keep the same access level
Correct Incorrect Correct answer

Add an auxiliary label to the sedatives indicating they are not paralytics
Correct Incorrect Correct answer

Correct

Incorrect
Question 178 of 792

178. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A dialysis unit nurse reports that a patient received heparin 25,000 units instead of 2,500 units during hemodialysis. Which root cause is most consistent with this type of tenfold dosing error?

Availability of multiple heparin concentrations in the dialysis unit without standardization
Correct Incorrect Correct answer

Failure to check the patient's allergy profile before administration
Correct Incorrect Correct answer

Use of an incorrect dialysis membrane during the procedure
Correct Incorrect Correct answer

Administration of heparin through the wrong access site on the patient
Correct Incorrect Correct answer

Correct

Incorrect
Question 179 of 792

179. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is asked to compound a cardioplegic solution for use during open-heart surgery. Which verification step is most critical before compounding begins?

An independent double check of all ingredients and concentrations by a second person
Correct Incorrect Correct answer

Confirming the solution will be stored at room temperature until use
Correct Incorrect Correct answer

Verifying that the solution container is amber to protect from light
Correct Incorrect Correct answer

Ensuring the patient has signed a consent form for the surgical procedure
Correct Incorrect Correct answer

Correct

Incorrect
Question 180 of 792

180. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

When verifying a TPN order, the pharmacist asks the technician to confirm the final dextrose concentration. The order calls for 500 mL of dextrose 70% in a total volume of 2,000 mL. What is the final dextrose concentration?

17.5%
Correct Incorrect Correct answer

35%
Correct Incorrect Correct answer

7%
Correct Incorrect Correct answer

25%
Correct Incorrect Correct answer

Correct

Incorrect
Question 181 of 792

181. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician scanning a prescription barcode for clopidogrel receives an alert that the scanned product is actually clonidine. What does this scenario best illustrate about barcode verification systems?

Barcode scanning serves as a critical independent check that catches LASA selection errors before dispensing
Correct Incorrect Correct answer

Barcode systems are unreliable and should not be used as a safety measure
Correct Incorrect Correct answer

The pharmacy software database has an incorrect NDC linked to clopidogrel
Correct Incorrect Correct answer

Clopidogrel and clonidine are therapeutically interchangeable medications
Correct Incorrect Correct answer

Correct

Incorrect
Question 182 of 792

182. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician bypasses a barcode scan by manually entering the NDC number because the barcode on a stock bottle will not scan properly. Which risk does this workaround behavior introduce?

It eliminates the independent verification that the correct product was selected from the shelf
Correct Incorrect Correct answer

It causes the pharmacy software to generate a duplicate prescription record
Correct Incorrect Correct answer

It automatically triggers a recall alert for the unscanned product
Correct Incorrect Correct answer

It prevents the prescription from being billed to the patient's insurance
Correct Incorrect Correct answer

Correct

Incorrect
Question 183 of 792

183. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

An automated dispensing cabinet (ADC) is programmed to display an alert when a nurse selects buPROPion, warning that busPIRone is also stocked in the same cabinet. What type of safety strategy does this alert represent?

A LASA alert that uses Tall Man lettering to highlight name differences at the point of selection
Correct Incorrect Correct answer

A therapeutic duplication warning that prevents dispensing two antidepressants simultaneously
Correct Incorrect Correct answer

A formulary restriction alert indicating buPROPion requires prior authorization
Correct Incorrect Correct answer

A drug interaction alert warning that these two medications cannot be taken together
Correct Incorrect Correct answer

Correct

Incorrect
Question 184 of 792

184. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A hospital pharmacy committee is developing a facility-specific LASA list in addition to the ISMP confused drug names list. Which factor is most important for the committee to consider when building this list?

Actual near-miss and error data from the facility's own dispensing and administration records
Correct Incorrect Correct answer

The total number of medications on the hospital formulary regardless of confusion history
Correct Incorrect Correct answer

Whether the medications are available in both brand and generic formulations
Correct Incorrect Correct answer

The cost difference between the two potentially confused medications
Correct Incorrect Correct answer

Correct

Incorrect
Question 185 of 792

185. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy receives a handwritten prescription for “Hydroxyzine 25 mg.” The technician is uncertain whether the prescriber intended hydroxyzine hydrochloride (Atarax) or hydroxyzine pamoate (Vistaril). What is the best course of action?

Alert the pharmacist to contact the prescriber for clarification before dispensing
Correct Incorrect Correct answer

Dispense hydroxyzine hydrochloride because it is the more commonly prescribed salt form
Correct Incorrect Correct answer

Dispense hydroxyzine pamoate because it has fewer side effects than the hydrochloride salt
Correct Incorrect Correct answer

Fill the prescription with whichever salt form is currently in stock at the pharmacy
Correct Incorrect Correct answer

Correct

Incorrect
Question 186 of 792

186. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician in an international mail-order pharmacy notices that a medication labeled as “paracetamol 500 mg” from a foreign manufacturer looks identical to the domestic acetaminophen 500 mg tablets. What LASA risk does this situation present?

Patients unfamiliar with the international name may take both products simultaneously, causing a double dose
Correct Incorrect Correct answer

Paracetamol is a different chemical entity than acetaminophen and should never be substituted
Correct Incorrect Correct answer

International medications are always counterfeit and should be reported to the DEA
Correct Incorrect Correct answer

The pharmacy must relabel the product with the brand name Tylenol before dispensing
Correct Incorrect Correct answer

Correct

Incorrect
Question 187 of 792

187. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A printed prescription label reads “metFORMIN 500 mg” using Tall Man lettering. A pharmacy technician accidentally selects a bottle of metroNIDAZOLE 500 mg from an adjacent shelf location. Which systemic failure most directly contributed to this error despite the Tall Man lettering strategy?

Storing LASA medications in adjacent shelf locations negated the visual differentiation strategy
Correct Incorrect Correct answer

The Tall Man lettering was ineffective because both medications share the prefix "met"
Correct Incorrect Correct answer

The prescription should have used the brand name instead of the generic name
Correct Incorrect Correct answer

The technician should have memorized the entire ISMP confused drug names list
Correct Incorrect Correct answer

Correct

Incorrect
Question 188 of 792

188. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A hospital pharmacy implements a policy requiring that concentrated potassium chloride injection is only available in premixed IV bags from the manufacturer rather than concentrated vials on nursing units. This strategy is best described as which type of error-prevention approach?

A forcing function that makes it physically difficult to commit the error
Correct Incorrect Correct answer

A checklist-based approach that relies on staff memory to select the correct product
Correct Incorrect Correct answer

A counseling intervention that educates nurses about potassium toxicity
Correct Incorrect Correct answer

A retrospective review process that identifies errors after they occur
Correct Incorrect Correct answer

Correct

Incorrect
Question 189 of 792

189. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician is filling prescriptions during a busy period and selects atenolol 50 mg instead of amlodipine 5 mg for a patient. The technician later states they were confident they grabbed the right bottle. Which cognitive bias most likely contributed to this error?

Confirmation bias, where the technician saw what they expected to see on the label
Correct Incorrect Correct answer

Anchoring bias, where the technician fixated on the price of the medication
Correct Incorrect Correct answer

Recency bias, where the technician selected the last medication they had dispensed
Correct Incorrect Correct answer

Sunk cost bias, where the technician refused to recount tablets after investing time
Correct Incorrect Correct answer

Correct

Incorrect
Question 190 of 792

190. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A hospital standardizes all heparin drip concentrations to 25,000 units in 500 mL across every unit in the facility. Which error-prevention principle does this best represent?

Standardization of concentrations to reduce calculation errors and wrong-product selection
Correct Incorrect Correct answer

Computerized prescriber order entry to eliminate handwriting legibility issues
Correct Incorrect Correct answer

Independent double-check procedures to catch errors at the point of administration
Correct Incorrect Correct answer

Failure mode and effects analysis to identify potential points of failure prospectively
Correct Incorrect Correct answer

Correct

Incorrect
Question 191 of 792

191. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy discovers that technicians have been placing partially used multidose vials back in general inventory rather than labeling them with a beyond-use date and storing them separately. This practice is an example of which type of safety concern?

A workaround behavior that bypasses the established safety procedure
Correct Incorrect Correct answer

A sentinel event requiring immediate reporting to The Joint Commission
Correct Incorrect Correct answer

A formulary violation requiring removal of the medication from stock
Correct Incorrect Correct answer

A controlled substance diversion that must be reported to the DEA
Correct Incorrect Correct answer

Correct

Incorrect
Question 192 of 792

192. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy implements a sterile compounding checklist that requires technicians to verify each ingredient against the master formulation record before adding it to the final preparation. This is an example of which human factors engineering strategy?

A checklist that structures a task to reduce reliance on memory
Correct Incorrect Correct answer

A root cause analysis conducted after a compounding error is discovered
Correct Incorrect Correct answer

A just culture framework that determines accountability for errors
Correct Incorrect Correct answer

A failure mode and effects analysis used to evaluate risk before implementation
Correct Incorrect Correct answer

Correct

Incorrect
Question 193 of 792

193. Question

Category: Patient Safety and Quality Assurance: Error Prevention

In the context of human factors engineering, what term describes the design of a system so that errors are either impossible to make or are immediately obvious when they occur?

Forcing function
Correct Incorrect Correct answer

Risk assessment
Correct Incorrect Correct answer

Sentinel event
Correct Incorrect Correct answer

Root cause analysis
Correct Incorrect Correct answer

Correct

Incorrect
Question 194 of 792

194. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician consistently fills prescriptions faster than colleagues but has a higher error rate detected at pharmacist verification. Analysis reveals the technician skips the barcode scan step to save time. From an error-prevention systems perspective, what is the most effective intervention?

Redesign the workflow so the barcode scan is required before the system allows the next step to proceed
Correct Incorrect Correct answer

Provide the technician with additional training on the importance of barcode scanning
Correct Incorrect Correct answer

Post a reminder sign at the filling station about barcode scanning requirements
Correct Incorrect Correct answer

Issue a verbal warning and place a note in the technician's personnel file
Correct Incorrect Correct answer

Correct

Incorrect
Question 195 of 792

195. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician processing a new prescription for simvastatin 40 mg notices the patient’s profile already contains atorvastatin 20 mg. What type of alert should the technician bring to the pharmacist’s attention?

Duplicate therapy alert, as both medications are HMG-CoA reductase inhibitors
Correct Incorrect Correct answer

Drug interaction alert, as these two statins produce a toxic metabolite when combined
Correct Incorrect Correct answer

Allergy alert, as statin sensitivity means the patient cannot tolerate either drug
Correct Incorrect Correct answer

Step therapy alert, as the patient must try simvastatin before atorvastatin
Correct Incorrect Correct answer

Correct

Incorrect
Question 196 of 792

196. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

While entering a prescription for linezolid, the pharmacy system generates a severe interaction alert because the patient takes sertraline daily. What is the basis for this contraindicated combination?

Both medications increase serotonin activity, creating a risk of serotonin syndrome
Correct Incorrect Correct answer

Linezolid inhibits the renal clearance of sertraline, causing toxic accumulation
Correct Incorrect Correct answer

Sertraline reduces the antibacterial effectiveness of linezolid through enzyme induction
Correct Incorrect Correct answer

Both medications prolong the QT interval and increase the risk of cardiac arrhythmia
Correct Incorrect Correct answer

Correct

Incorrect
Question 197 of 792

197. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient presents a prescription for adalimumab (Humira). The pharmacy system flags that the insurance plan requires the patient to have tried and failed methotrexate before adalimumab will be covered. What type of utilization management requirement does this represent?

Step therapy, which requires trial of a preferred first-line agent before approval
Correct Incorrect Correct answer

Prior authorization, which requires clinical documentation before any prescription can be filled
Correct Incorrect Correct answer

Quantity limit, which restricts the number of units dispensed per fill
Correct Incorrect Correct answer

Formulary exclusion, which means the drug cannot be covered under any circumstances
Correct Incorrect Correct answer

Correct

Incorrect
Question 198 of 792

198. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

During a vaccine screening, a pharmacy technician asks a patient about egg allergies before administering the influenza vaccine. The patient reports a history of hives after eating eggs. What should the technician communicate to the pharmacist?

The patient reports egg allergy with hives, and the pharmacist should determine if the vaccine can be given with appropriate monitoring
Correct Incorrect Correct answer

The patient cannot receive any influenza vaccine formulation this season due to the egg allergy
Correct Incorrect Correct answer

The patient should receive the vaccine without any special precautions since hives are mild
Correct Incorrect Correct answer

The technician should administer the vaccine and observe the patient for exactly 30 minutes afterward
Correct Incorrect Correct answer

Correct

Incorrect
Question 199 of 792

199. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician notices that a prescriber has ordered both lisinopril and sacubitril/valsartan (Entresto) for the same patient. Why should the technician flag this for pharmacist intervention?

Concurrent use of an ACE inhibitor and sacubitril/valsartan is contraindicated due to increased risk of angioedema
Correct Incorrect Correct answer

Both medications are from the same drug class and represent unnecessary duplicate therapy
Correct Incorrect Correct answer

Sacubitril/valsartan can only be prescribed by cardiologists, not general practitioners
Correct Incorrect Correct answer

Lisinopril must be discontinued at least 72 hours after starting sacubitril/valsartan
Correct Incorrect Correct answer

Correct

Incorrect
Question 200 of 792

200. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician receives a new prescription for a brand-name medication that requires prior authorization. The insurance claim rejects with a message indicating PA is required. What is the technician’s most appropriate next step?

Notify the pharmacist and provide the prescriber's office with the prior authorization request form
Correct Incorrect Correct answer

Dispense the generic equivalent without notifying the pharmacist or prescriber
Correct Incorrect Correct answer

Tell the patient to contact their insurance company directly to resolve the issue
Correct Incorrect Correct answer

Override the insurance rejection and bill the medication at the cash price
Correct Incorrect Correct answer

Correct

Incorrect
Question 201 of 792

201. Question

Category: Patient Safety and Quality Assurance: Event Reporting

What is the primary purpose of a Patient Safety Organization (PSO) as established by the Patient Safety and Quality Improvement Act?

To collect and analyze patient safety data in a protected, non-punitive environment
Correct Incorrect Correct answer

To license and credential pharmacy technicians in each state
Correct Incorrect Correct answer

To conduct on-site inspections of pharmacy compounding facilities
Correct Incorrect Correct answer

To adjudicate malpractice claims between patients and healthcare providers
Correct Incorrect Correct answer

Correct

Incorrect
Question 202 of 792

202. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy manager reviews aggregate medication error data and finds that 40% of dispensing errors occur between 2:00 PM and 4:00 PM, coinciding with the highest prescription volume. Which quality improvement action is most appropriate based on this analysis?

Adjust staffing levels or workflow processes to provide additional support during peak hours
Correct Incorrect Correct answer

Discipline all technicians who made errors during those hours for lack of attention
Correct Incorrect Correct answer

Close the pharmacy during peak hours to reduce the number of prescriptions processed
Correct Incorrect Correct answer

Remove the error data from reports because it only reflects high volume, not poor performance
Correct Incorrect Correct answer

Correct

Incorrect
Question 203 of 792

203. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A hospital administers an annual safety culture survey to pharmacy staff. Results show that 65% of technicians believe they will face punishment if they report a medication error. What does this finding primarily indicate about the organization?

The organization lacks a just culture environment, which likely suppresses voluntary error reporting
Correct Incorrect Correct answer

The technicians need additional training on how to fill out incident report forms
Correct Incorrect Correct answer

The pharmacy has an unusually high rate of medication errors compared to national benchmarks
Correct Incorrect Correct answer

The survey results are unreliable because technicians do not understand the questions
Correct Incorrect Correct answer

Correct

Incorrect
Question 204 of 792

204. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacist discovers that a patient received the wrong medication due to a dispensing error. The patient experienced no harm. In addition to filing an internal incident report, the pharmacist decides to disclose the error to the patient. What is the primary reason for this disclosure?

Transparent communication with patients about errors is an ethical obligation and supports patient trust
Correct Incorrect Correct answer

Disclosure is only required if the patient experienced a serious adverse outcome
Correct Incorrect Correct answer

The pharmacist must disclose the error to avoid being reported to the state board by the patient
Correct Incorrect Correct answer

Federal law mandates verbal disclosure of every dispensing error directly to the patient
Correct Incorrect Correct answer

Correct

Incorrect
Question 205 of 792

205. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician who made a dispensing error that harmed a patient is experiencing significant emotional distress, insomnia, and guilt. The pharmacy manager refers the technician to a peer support program. What concept does this scenario illustrate?

Second victim support, which addresses the emotional impact on healthcare workers involved in errors
Correct Incorrect Correct answer

Progressive discipline, which assigns escalating consequences for repeated errors
Correct Incorrect Correct answer

Sentinel event review, which focuses on identifying system failures after serious harm
Correct Incorrect Correct answer

Mandatory reporting, which requires the technician to file a state board complaint
Correct Incorrect Correct answer

Correct

Incorrect
Question 206 of 792

206. Question

Category: Patient Safety and Quality Assurance: Event Reporting

Which type of patient safety data submitted to a Patient Safety Organization (PSO) receives federal legal protection from being used in civil litigation?

Patient safety work product
Correct Incorrect Correct answer

Medical records maintained in the patient's chart
Correct Incorrect Correct answer

Prescription records required by state pharmacy law
Correct Incorrect Correct answer

Controlled substance dispensing logs mandated by the DEA
Correct Incorrect Correct answer

Correct

Incorrect
Question 207 of 792

207. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A prescription for amoxicillin suspension for a pediatric patient reads: “40 mg/kg/day divided three times daily.” The child weighs 33 pounds. The pharmacy stocks amoxicillin 250 mg/5 mL. What is the correct volume per dose?

4 mL per dose
Correct Incorrect Correct answer

5 mL per dose
Correct Incorrect Correct answer

8 mL per dose
Correct Incorrect Correct answer

10 mL per dose
Correct Incorrect Correct answer

Correct

Incorrect
Question 208 of 792

208. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician notices that two different medications have nearly identical packaging: both are white tablets in similar-sized amber bottles with comparable label layouts from the same manufacturer. A dispensing error occurs when the wrong product is selected. What type of error is this classified as?

A look-alike packaging error caused by similarities in product appearance and labeling
Correct Incorrect Correct answer

A sound-alike error caused by similarities in the pronunciation of drug names
Correct Incorrect Correct answer

A prescribing error caused by the physician selecting the wrong medication in the EHR
Correct Incorrect Correct answer

A compounding error caused by using the wrong ingredient during preparation
Correct Incorrect Correct answer

Correct

Incorrect
Question 209 of 792

209. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A nurse calls the pharmacy with a verbal order for “morphine 4 milligrams IV push every 4 hours as needed for pain.” According to safe practice standards, what must the pharmacy technician or pharmacist do before entering this order?

Read the complete order back to the nurse and receive verbal confirmation that it is correct
Correct Incorrect Correct answer

Enter the order immediately since verbal orders from nurses do not require verification
Correct Incorrect Correct answer

Refuse to accept the order and require the physician to call the pharmacy directly
Correct Incorrect Correct answer

Ask the nurse to send the order by fax before it can be entered into the system
Correct Incorrect Correct answer

Correct

Incorrect
Question 210 of 792

210. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A hospital pharmacy’s data shows that clinical pharmacists override 85% of drug interaction alerts in the computerized prescriber order entry system. Which safety concern does this high override rate most directly indicate?

Alert fatigue is causing clinicians to dismiss clinically significant warnings along with irrelevant ones
Correct Incorrect Correct answer

The pharmacy software is outdated and must be replaced with a newer system immediately
Correct Incorrect Correct answer

All 85% of overridden alerts represent clinically insignificant interactions that should be removed
Correct Incorrect Correct answer

The pharmacists lack adequate training in drug interaction management
Correct Incorrect Correct answer

Correct

Incorrect
Question 211 of 792

211. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician receives a prescription for vancomycin for a pediatric patient that reads “15 mg/kg IV every 6 hours.” The patient’s weight is documented as 22 kg in one system and 22 pounds in another. What should the technician do before processing the order?

Alert the pharmacist to verify the patient's correct weight before calculating the dose
Correct Incorrect Correct answer

Use the higher weight value to ensure the patient receives an adequate dose
Correct Incorrect Correct answer

Average the two weight values and calculate the dose using that number
Correct Incorrect Correct answer

Use 22 kg because metric units are standard in pharmacy calculations
Correct Incorrect Correct answer

Correct

Incorrect
Question 212 of 792

212. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A physician calls in a telephone order for “fifteen milligrams” of a medication. The pharmacy technician writes down “50 mg” because “fifteen” sounded like “fifty” over the phone. Which error-prevention strategy would have caught this mistake?

Read-back verification, where the technician repeats the order back to the prescriber for confirmation
Correct Incorrect Correct answer

Requiring all telephone orders to include the patient's diagnosis for reference
Correct Incorrect Correct answer

Having a second technician listen to the call on speakerphone simultaneously
Correct Incorrect Correct answer

Recording all telephone orders on a voice-activated recording system for later review
Correct Incorrect Correct answer

Correct

Incorrect
Question 213 of 792

213. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

Which of the following is the most common type of error associated with weight-based dosing in pediatric patients?

Using the patient's weight in pounds instead of kilograms in the dose calculation
Correct Incorrect Correct answer

Selecting the wrong route of administration for the weight-based medication
Correct Incorrect Correct answer

Calculating the dose using the patient's height instead of weight
Correct Incorrect Correct answer

Rounding the patient's weight down to the nearest whole number
Correct Incorrect Correct answer

Correct

Incorrect
Question 214 of 792

214. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician performing environmental monitoring in the cleanroom collects air samples using both a viable particle sampler and a nonviable particle counter. What is the primary difference between these two types of monitoring?

Viable sampling detects living microorganisms, while nonviable counting measures total airborne particles regardless of viability
Correct Incorrect Correct answer

Viable sampling measures particles larger than 5 microns, while nonviable counting measures particles smaller than 0.5 microns
Correct Incorrect Correct answer

Viable sampling is performed weekly, while nonviable counting is performed annually
Correct Incorrect Correct answer

Viable sampling uses chemical reagents, while nonviable counting uses ultraviolet light sterilization
Correct Incorrect Correct answer

Correct

Incorrect
Question 215 of 792

215. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

Under the revised USP 797 standards, a compounded sterile preparation (CSP) assigned to Category 1 has a shorter beyond-use date (BUD) than one assigned to Category 2. What is the primary factor that determines whether a CSP is classified as Category 1 or Category 2?

The conditions under which the CSP is compounded, including whether it is prepared in an ISO Class 5 environment within a classified cleanroom suite
Correct Incorrect Correct answer

The number of ingredients in the formulation, with single-ingredient CSPs as Category 1
Correct Incorrect Correct answer

Whether the CSP contains a controlled substance that requires additional security measures
Correct Incorrect Correct answer

The therapeutic class of the final preparation, with chemotherapy agents always classified as Category 2
Correct Incorrect Correct answer

Correct

Incorrect
Question 216 of 792

216. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

What is the purpose of the bacterial endotoxin test (BET) in sterile compounding?

To detect pyrogens produced by gram-negative bacteria that can cause fever and sepsis if injected
Correct Incorrect Correct answer

To measure the total viable organism count on compounding surfaces
Correct Incorrect Correct answer

To verify that the compounding technician's garbing technique is aseptic
Correct Incorrect Correct answer

To confirm that the final preparation has the correct pH and osmolality
Correct Incorrect Correct answer

Correct

Incorrect
Question 217 of 792

217. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is preparing to perform sterile compounding and must work within the primary engineering control (PEC). Which of the following best describes the function of the PEC in infection prevention?

The PEC provides an ISO Class 5 environment with HEPA-filtered unidirectional airflow to protect the sterile preparation
Correct Incorrect Correct answer

The PEC is a locked cabinet that restricts access to controlled substances during compounding
Correct Incorrect Correct answer

The PEC is a temperature-controlled unit that maintains medications at the required storage temperature
Correct Incorrect Correct answer

The PEC is a ventilation system that removes hazardous drug vapors from the buffer room
Correct Incorrect Correct answer

Correct

Incorrect
Question 218 of 792

218. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

During routine environmental monitoring, a cleanroom air sample yields a viable particle count that exceeds the action level for the ISO Class 7 buffer room. Which response is required?

Investigate the source of contamination, take corrective action, and document the event and remediation steps
Correct Incorrect Correct answer

Continue compounding but increase the frequency of hand hygiene for the remainder of the shift
Correct Incorrect Correct answer

Close the cleanroom permanently until the state board of pharmacy conducts an inspection
Correct Incorrect Correct answer

Discard only the CSPs that were compounded within one hour of the sample collection
Correct Incorrect Correct answer

Correct

Incorrect
Question 219 of 792

219. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is processing a prescription for a patient who currently takes both lisinopril and spironolactone. A new order arrives for oral potassium chloride 20 mEq daily. Which high-alert concern should the technician flag for the pharmacist before dispensing?

Risk of hyperkalemia from combining potassium supplementation with two potassium-sparing agents
Correct Incorrect Correct answer

Risk of hypoglycemia from the interaction between potassium and lisinopril
Correct Incorrect Correct answer

Risk of hepatotoxicity from potassium chloride when taken with spironolactone
Correct Incorrect Correct answer

Risk of hypotension from the additive diuretic effects of potassium and spironolactone
Correct Incorrect Correct answer

Correct

Incorrect
Question 220 of 792

220. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician receives an order for a patient-controlled analgesia (PCA) pump containing hydromorphone 0.2 mg/mL. The technician notices the concentration on the shelf label reads hydromorphone 10 mg/mL. What is the most appropriate action?

Verify the correct concentration with the pharmacist before preparing the PCA syringe
Correct Incorrect Correct answer

Use the 10 mg/mL vial and adjust the pump rate to deliver the correct dose
Correct Incorrect Correct answer

Substitute morphine at an equivalent concentration to avoid using the wrong vial
Correct Incorrect Correct answer

Prepare the PCA using the available concentration and note the change on the label
Correct Incorrect Correct answer

Correct

Incorrect
Question 221 of 792

221. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A hospital pharmacy is reviewing three recent incidents: (1) a vasopressin drip was prepared at twice the intended concentration, (2) an oral diabetes medication was dispensed in the wrong strength, and (3) a topical antifungal cream was labeled with the wrong patient name. Which incident involves a high-alert medication and carries the greatest risk of patient harm?

The vasopressin drip prepared at twice the intended concentration
Correct Incorrect Correct answer

The oral diabetes medication dispensed in the wrong strength
Correct Incorrect Correct answer

The topical antifungal cream labeled with the wrong patient name
Correct Incorrect Correct answer

The oral diabetes medication and the topical antifungal carry equal high-alert risk
Correct Incorrect Correct answer

Correct

Incorrect
Question 222 of 792

222. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is restocking an automated dispensing cabinet in the neonatal intensive care unit. The technician has vials of both heparin 10 units/mL (flush strength) and heparin 10,000 units/mL (therapeutic strength). Which safety measure is most critical during this restocking process?

Verify each vial's concentration against the cabinet pocket label using an independent barcode scan
Correct Incorrect Correct answer

Place both concentrations in the same pocket to ensure nurses have quick access
Correct Incorrect Correct answer

Stock only the 10,000 units/mL vials since they can be diluted as needed
Correct Incorrect Correct answer

Rely on the color difference of the vial caps to distinguish between concentrations
Correct Incorrect Correct answer

Correct

Incorrect
Question 223 of 792

223. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A community pharmacy technician reviews three new prescriptions for an elderly patient: (1) dabigatran 150 mg twice daily, (2) amlodipine 5 mg daily, and (3) omeprazole 20 mg daily. The patient’s profile shows a current prescription for rivaroxaban 20 mg daily. Which combination represents the highest-alert safety concern?

The new dabigatran prescription combined with the existing rivaroxaban prescription
Correct Incorrect Correct answer

The new omeprazole prescription combined with the existing rivaroxaban prescription
Correct Incorrect Correct answer

The new amlodipine prescription combined with the new dabigatran prescription
Correct Incorrect Correct answer

The new omeprazole prescription combined with the new dabigatran prescription
Correct Incorrect Correct answer

Correct

Incorrect
Question 224 of 792

224. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is preparing total parenteral nutrition (TPN) for a critically ill patient. The order includes dextrose 50%, amino acids, lipids, and multiple electrolyte additives. What makes TPN a high-alert preparation?

The complexity of multi-component compounding increases the risk of calculation and preparation errors that can cause serious harm
Correct Incorrect Correct answer

TPN solutions must be refrigerated at all times, making storage errors the primary risk
Correct Incorrect Correct answer

TPN contains controlled substances that require additional documentation and verification
Correct Incorrect Correct answer

TPN must be filtered through a 0.22-micron filter, which frequently causes contamination
Correct Incorrect Correct answer

Correct

Incorrect
Question 225 of 792

225. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A hospital pharmacy receives three stat orders simultaneously: (1) epinephrine 1:1,000 injection for anaphylaxis, (2) acetaminophen 650 mg oral for mild fever, and (3) albuterol nebulizer for asthma exacerbation. The technician must prioritize preparation. Considering high-alert status and clinical urgency, which order should be prepared first?

Epinephrine 1:1,000 injection for anaphylaxis
Correct Incorrect Correct answer

Albuterol nebulizer for asthma exacerbation
Correct Incorrect Correct answer

Acetaminophen 650 mg oral for mild fever
Correct Incorrect Correct answer

All three should be prepared simultaneously by splitting the work among technicians
Correct Incorrect Correct answer

Correct

Incorrect
Question 226 of 792

226. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician is entering a prescription for traMADol 50 mg for a patient with moderate pain. The pharmacy software auto-populates traZODone 50 mg instead. What is the most important reason this error could cause patient harm?

TraZODone is a sedating antidepressant that would not treat the patient's pain and could cause excessive drowsiness
Correct Incorrect Correct answer

TraZODone is a controlled substance that requires additional DEA documentation
Correct Incorrect Correct answer

TraZODone must be taken with food, making the directions incompatible with the prescription
Correct Incorrect Correct answer

TraZODone is only available as a liquid, so the dosage form would not match the prescription
Correct Incorrect Correct answer

Correct

Incorrect
Question 227 of 792

227. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician receives a prescription for buPROPion XL 300 mg once daily for smoking cessation. While pulling the medication, the technician notices busPIRone 10 mg tablets are stored in the adjacent bin. What characteristic of these two medications makes this a high-risk LASA pair?

They have similar spelling and pronunciation but completely different therapeutic indications and dosing
Correct Incorrect Correct answer

They are both Schedule IV controlled substances requiring the same level of DEA oversight
Correct Incorrect Correct answer

They both cause the same adverse effects, making detection of a dispensing error unlikely
Correct Incorrect Correct answer

They are both manufactured by the same company and have identical tablet markings
Correct Incorrect Correct answer

Correct

Incorrect
Question 228 of 792

228. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy tracks LASA near-miss events and identifies the following three pairs causing the most confusion over the past quarter: (1) clomiPHENE/clomiPRAMINE, (2) dimenhyDRINATE/diphenhydrAMINE, and (3) enalapril/Edarbyclor. The pharmacy can only implement one new safety measure this quarter. Which strategy would address the broadest range of these LASA errors?

Implementing auxiliary alert stickers on shelf bins for all identified LASA pairs
Correct Incorrect Correct answer

Separating clomiPHENE and clomiPRAMINE alphabetically since they cause the most errors
Correct Incorrect Correct answer

Removing dimenhyDRINATE from the formulary to eliminate one confusing pair entirely
Correct Incorrect Correct answer

Changing the generic drug supplier for enalapril to alter its packaging appearance
Correct Incorrect Correct answer

Correct

Incorrect
Question 229 of 792

229. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

Which of the following correctly represents a LASA medication pair where both drugs are used for cardiovascular conditions but have different mechanisms of action?

Metoprolol and metolazone
Correct Incorrect Correct answer

Metoprolol and metformin
Correct Incorrect Correct answer

Lisinopril and lansoprazole
Correct Incorrect Correct answer

Atenolol and acetaminophen
Correct Incorrect Correct answer

Correct

Incorrect
Question 230 of 792

230. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy quality team examines dispensing error reports and finds that errors involving LASA pairs occur most often during three specific workflow points: order entry, shelf picking, and final verification. Data shows 50% of LASA errors are caught at final verification, 30% are caught at shelf picking, and 20% reach the patient. Which conclusion best supports improving LASA safety at this pharmacy?

The pharmacy should strengthen upstream safeguards at order entry and shelf picking since relying on final verification alone allows 20% of errors to reach patients
Correct Incorrect Correct answer

The pharmacy should eliminate final verification and redirect those resources to order entry
Correct Incorrect Correct answer

The 50% catch rate at final verification indicates the current system is working adequately
Correct Incorrect Correct answer

The pharmacy should focus exclusively on shelf picking since it catches fewer errors than verification
Correct Incorrect Correct answer

Correct

Incorrect
Question 231 of 792

231. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician is filling a prescription for sulfaSALAzine 500 mg for a patient with ulcerative colitis. The technician accidentally grabs sulfADIAZINE 500 mg from the shelf. At what point in the workflow is this error most likely to be detected?

During the pharmacist's final product verification when comparing the filled product to the prescription
Correct Incorrect Correct answer

During the initial prescription intake when the patient drops off the prescription
Correct Incorrect Correct answer

During insurance adjudication when the claim is transmitted to the payer
Correct Incorrect Correct answer

During patient pickup when the patient reads the medication guide
Correct Incorrect Correct answer

Correct

Incorrect
Question 232 of 792

232. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician is processing a prescription that reads ‘take 1 tablet PO BID PRN pain.’ The technician notices the prescription does not include a maximum daily dose. What is the most appropriate action?

Refer the prescription to the pharmacist to clarify the maximum daily dose with the prescriber
Correct Incorrect Correct answer

Dispense the prescription as written since PRN medications do not require a maximum dose
Correct Incorrect Correct answer

Add a maximum dose of two tablets per day based on the BID frequency
Correct Incorrect Correct answer

Contact the patient to determine how many tablets they typically take per day
Correct Incorrect Correct answer

Correct

Incorrect
Question 233 of 792

233. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy has implemented three error-prevention strategies: (1) mandatory barcode scanning at dispensing, (2) physical separation of LASA drugs, and (3) technician training on error-prone abbreviations. After six months, wrong-drug errors decreased by 40%, but wrong-strength errors remained unchanged. Which additional intervention would most directly target the persistent wrong-strength errors?

Implementing automated dose-range checking alerts in the pharmacy software
Correct Incorrect Correct answer

Adding more LASA drug pairs to the physical separation protocol
Correct Incorrect Correct answer

Requiring technicians to complete additional error-prone abbreviation training
Correct Incorrect Correct answer

Increasing the frequency of barcode scanning to twice per prescription
Correct Incorrect Correct answer

Correct

Incorrect
Question 234 of 792

234. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician is filling a prescription for levothyroxine and notices the pharmacy stocks seven different strengths, many with similar tablet colors. The technician selects the bottle, but the tablet color appears slightly different from what they expected. What should the technician do?

Compare the NDC number on the bottle to the NDC listed in the pharmacy computer system before proceeding
Correct Incorrect Correct answer

Proceed with filling since slight color variations are common among generic manufacturers
Correct Incorrect Correct answer

Choose a different bottle from the same shelf that appears to match the expected color
Correct Incorrect Correct answer

Contact the prescriber to confirm the intended strength based on the tablet color
Correct Incorrect Correct answer

Correct

Incorrect
Question 235 of 792

235. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician is working during a high-volume period and a coworker asks them to quickly count a prescription while simultaneously answering the phone. The technician is concerned about making an error. What is the best error-prevention approach?

Complete one task at a time, finishing the prescription count before answering the phone
Correct Incorrect Correct answer

Ask the caller to hold while counting, then switch attention between both tasks
Correct Incorrect Correct answer

Count the prescription quickly to save time and then give full attention to the phone call
Correct Incorrect Correct answer

Ask another technician to answer the phone while continuing to count at a faster pace
Correct Incorrect Correct answer

Correct

Incorrect
Question 236 of 792

236. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A hospital pharmacy reviews quarterly data and finds that medication errors peak during shift changes at 7 AM and 7 PM. The errors involve incomplete medication reconciliation and missed doses. The pharmacy manager is considering three interventions: (1) overlap shifts by 30 minutes, (2) add a printed handoff checklist, and (3) increase staffing during peak hours. Which combination would most effectively address the root cause?

Overlapping shifts combined with a printed handoff checklist to ensure complete information transfer
Correct Incorrect Correct answer

Increasing staffing during peak hours alone since more staff will catch more errors
Correct Incorrect Correct answer

Adding a printed handoff checklist alone since it standardizes the communication process
Correct Incorrect Correct answer

Overlapping shifts combined with increased staffing to provide maximum coverage
Correct Incorrect Correct answer

Correct

Incorrect
Question 237 of 792

237. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician observes that a coworker consistently overrides barcode scan mismatches by entering the NDC manually, stating the scanner is ‘glitchy.’ Over the past week, two near-miss events were linked to this practice. What systemic issue does this behavior reveal?

A workaround culture where staff bypass safety technology rather than reporting equipment problems for repair
Correct Incorrect Correct answer

A training deficiency where the coworker does not understand how to operate the scanner
Correct Incorrect Correct answer

A software limitation where the barcode system generates too many false-positive alerts
Correct Incorrect Correct answer

A staffing shortage where the coworker feels pressured to fill prescriptions faster
Correct Incorrect Correct answer

Correct

Incorrect
Question 238 of 792

238. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy implements a ‘read-back’ policy requiring technicians to verbally confirm prescription details with the pharmacist before labeling. A technician reads back ‘metformin 500 mg, one tablet twice daily, quantity 60’ and the pharmacist confirms. Which type of error-prevention strategy does this represent?

A verification checkpoint that uses verbal redundancy to catch transcription errors
Correct Incorrect Correct answer

A forcing function that prevents the technician from proceeding without authorization
Correct Incorrect Correct answer

A root cause analysis technique used to identify the source of past errors
Correct Incorrect Correct answer

An automation strategy that replaces manual processes with technology-based checks
Correct Incorrect Correct answer

Correct

Incorrect
Question 239 of 792

239. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician is processing a new prescription for fluoxetine 20 mg daily for a patient whose profile shows they currently take sumatriptan as needed for migraines. The pharmacy software generates an interaction alert. What should the technician do?

Alert the pharmacist to the potential drug interaction between fluoxetine and sumatriptan before continuing
Correct Incorrect Correct answer

Override the alert since sumatriptan is only used as needed and poses minimal risk
Correct Incorrect Correct answer

Discontinue the sumatriptan from the patient's profile and process the fluoxetine
Correct Incorrect Correct answer

Contact the prescriber directly to recommend switching sumatriptan to a different migraine medication
Correct Incorrect Correct answer

Correct

Incorrect
Question 240 of 792

240. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician receives a prescription for ciprofloxacin 500 mg twice daily for 7 days. While entering the prescription, the technician notices the patient’s profile shows they take calcium carbonate 600 mg twice daily. Why should the technician flag this for the pharmacist?

Calcium can significantly reduce ciprofloxacin absorption if taken at the same time, requiring dose separation counseling
Correct Incorrect Correct answer

Calcium carbonate is contraindicated with all fluoroquinolone antibiotics
Correct Incorrect Correct answer

Ciprofloxacin increases calcium levels in the blood, leading to hypercalcemia
Correct Incorrect Correct answer

Calcium carbonate neutralizes ciprofloxacin in the stomach, making it completely ineffective
Correct Incorrect Correct answer

Correct

Incorrect
Question 241 of 792

241. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient presents three prescriptions from two different prescribers: (1) alprazolam 1 mg TID from a psychiatrist, (2) oxycodone 10 mg Q6H PRN from an orthopedic surgeon, and (3) carisoprodol 350 mg TID from the same orthopedic surgeon. The technician notes that all three are controlled substances. Which combination of factors creates the most significant safety concern requiring pharmacist intervention?

The concurrent use of a benzodiazepine, an opioid, and a muscle relaxant creates additive CNS depression risk
Correct Incorrect Correct answer

Having prescriptions from two different prescribers suggests the patient is doctor shopping
Correct Incorrect Correct answer

The combined quantity of three controlled substances exceeds the monthly DEA limit per patient
Correct Incorrect Correct answer

Carisoprodol and alprazolam are in the same drug class and represent therapeutic duplication
Correct Incorrect Correct answer

Correct

Incorrect
Question 242 of 792

242. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician receives a new prescription for carbamazepine 200 mg twice daily for a female patient. The patient’s profile indicates she takes norgestimate/ethinyl estradiol (an oral contraceptive). What should the technician bring to the pharmacist’s attention?

Carbamazepine is a strong enzyme inducer that can reduce oral contraceptive effectiveness
Correct Incorrect Correct answer

Carbamazepine and oral contraceptives both cause liver toxicity when used together
Correct Incorrect Correct answer

Oral contraceptives increase carbamazepine levels to toxic concentrations
Correct Incorrect Correct answer

Carbamazepine is contraindicated in women of childbearing age regardless of contraceptive use
Correct Incorrect Correct answer

Correct

Incorrect
Question 243 of 792

243. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician reviews a patient profile for an 80-year-old woman weighing 45 kg with a documented creatinine clearance of 25 mL/min. A new prescription arrives for metformin 1000 mg twice daily. The technician knows metformin is renally cleared. What is the most appropriate reason to alert the pharmacist?

The patient's severely reduced renal function increases the risk of lactic acidosis from metformin accumulation
Correct Incorrect Correct answer

Metformin is contraindicated in patients over age 75 regardless of kidney function
Correct Incorrect Correct answer

The patient's low body weight means the dose should be calculated based on milligrams per kilogram
Correct Incorrect Correct answer

Metformin requires hepatic metabolism, and elderly patients typically have reduced liver function
Correct Incorrect Correct answer

Correct

Incorrect
Question 244 of 792

244. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician is processing a prescription for a new patient and asks about allergies during intake. The patient states, ‘I get a rash from sulfa drugs.’ The prescription is for sulfamethoxazole/trimethoprim DS twice daily. What should the technician do with this information?

Document the sulfa allergy in the patient profile and immediately notify the pharmacist of the allergy conflict
Correct Incorrect Correct answer

Dispense the prescription since a rash is a minor reaction that does not constitute a true allergy
Correct Incorrect Correct answer

Document the allergy and fill the prescription since the pharmacist will review it at final check
Correct Incorrect Correct answer

Advise the patient to take diphenhydramine before each dose to prevent the allergic reaction
Correct Incorrect Correct answer

Correct

Incorrect
Question 245 of 792

245. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician reviews a patient’s medication history and finds the following active prescriptions: lisinopril 20 mg daily, metoprolol 50 mg twice daily, furosemide 40 mg daily, and potassium chloride 20 mEq daily. A new prescription arrives for losartan 50 mg daily. Which clinical concern should the technician flag for pharmacist review?

Losartan and lisinopril both act on the renin-angiotensin system, creating therapeutic duplication with increased risk of hyperkalemia and renal impairment
Correct Incorrect Correct answer

Losartan and metoprolol are both antihypertensives, so adding losartan creates a three-drug blood pressure regimen that is unsafe
Correct Incorrect Correct answer

Losartan will counteract the effects of furosemide, making the diuretic therapy completely ineffective
Correct Incorrect Correct answer

Losartan is contraindicated with potassium chloride supplementation under all circumstances
Correct Incorrect Correct answer

Correct

Incorrect
Question 246 of 792

246. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician discovers that a compounded IV bag was prepared with normal saline instead of the ordered dextrose 5% in water. The bag has not been sent to the nursing unit. Which type of event should this be classified as for reporting purposes?

A near-miss event because the error was caught before reaching the patient
Correct Incorrect Correct answer

An adverse drug event because the wrong solution was used in the preparation
Correct Incorrect Correct answer

A sentinel event because it involved an IV preparation error
Correct Incorrect Correct answer

A medication variance that does not require reporting since it was caught internally
Correct Incorrect Correct answer

Correct

Incorrect
Question 247 of 792

247. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician learns that a patient developed a severe skin reaction after taking a newly marketed antibiotic dispensed by their pharmacy. The pharmacist asks the technician to assist with reporting. Which reporting program should be used to submit this adverse event report for a drug product?

FDA MedWatch for reporting adverse events associated with marketed drug products
Correct Incorrect Correct answer

VAERS for reporting any adverse reaction associated with a healthcare product
Correct Incorrect Correct answer

The DEA Suspicious Order Reporting System for reporting harmful drug effects
Correct Incorrect Correct answer

The state board of pharmacy complaint form for documenting patient harm from a drug
Correct Incorrect Correct answer

Correct

Incorrect
Question 248 of 792

248. Question

Category: Patient Safety and Quality Assurance: Event Reporting

What is the primary purpose of trending medication error data in a pharmacy’s quality assurance program?

To identify recurring patterns and systemic weaknesses that can be addressed through process changes
Correct Incorrect Correct answer

To identify individual staff members who make the most errors for disciplinary action
Correct Incorrect Correct answer

To calculate the total financial losses from medication errors for insurance purposes
Correct Incorrect Correct answer

To meet the minimum annual error quota required by state pharmacy regulations
Correct Incorrect Correct answer

Correct

Incorrect
Question 249 of 792

249. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy’s CQI committee reviews error reports from the past year and finds that 60% of wrong-drug errors involved fast-mover medications stored in open bins near the dispensing counter. Meanwhile, 25% involved medications retrieved from the automated dispensing system, and 15% involved compounded preparations. Which intervention would have the greatest impact based on this data?

Redesigning the fast-mover bin area with better labeling, physical barriers, and mandatory scanning before picking
Correct Incorrect Correct answer

Replacing the automated dispensing system with a newer model that has improved accuracy
Correct Incorrect Correct answer

Adding a second pharmacist to verify all compounded preparations before dispensing
Correct Incorrect Correct answer

Implementing monthly competency testing for all pharmacy staff on drug identification
Correct Incorrect Correct answer

Correct

Incorrect
Question 250 of 792

250. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A hospital pharmacy implements an anonymous error-reporting system. In the first quarter, 45 near-miss reports are submitted. In the second quarter, after a staff meeting emphasizing the importance of reporting, 120 near-miss reports are submitted. The actual dispensing error rate reaching patients remained the same in both quarters. What does the increase in near-miss reporting most likely indicate?

Improved reporting culture and staff willingness to report, which provides more data for safety improvement
Correct Incorrect Correct answer

A significant decline in pharmacy safety standards that requires immediate regulatory intervention
Correct Incorrect Correct answer

The anonymous system is being misused by staff to inflate near-miss numbers
Correct Incorrect Correct answer

The staff meeting caused technicians to become anxious and make more errors than before
Correct Incorrect Correct answer

Correct

Incorrect
Question 251 of 792

251. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician is filling out an internal medication error report after a wrong-strength dispensing event. Which of the following elements is most important to include to support the pharmacy’s quality improvement process?

A factual description of what happened, contributing factors, and the outcome for the patient
Correct Incorrect Correct answer

The name of the technician who made the error and a recommendation for their retraining schedule
Correct Incorrect Correct answer

A comparison of the error to similar errors made by other staff members that month
Correct Incorrect Correct answer

An apology letter to the patient drafted by the technician who made the error
Correct Incorrect Correct answer

Correct

Incorrect
Question 252 of 792

252. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician receives a prescription for amoxicillin 250 mg/5 mL suspension with directions to ‘take 500 mg three times daily for 10 days’ for a 3-year-old child weighing 14 kg. The typical pediatric dose of amoxicillin for this indication is 25 to 45 mg/kg/day divided three times daily. What should the technician recognize about this prescription?

The prescribed dose of 1500 mg/day exceeds the maximum recommended pediatric dose for this patient's weight
Correct Incorrect Correct answer

The prescription is appropriate because 500 mg three times daily is a standard adult dose also safe for children
Correct Incorrect Correct answer

The suspension concentration should be changed to 400 mg/5 mL to reduce the volume the child must take
Correct Incorrect Correct answer

The frequency of three times daily is incorrect for amoxicillin in pediatric patients
Correct Incorrect Correct answer

Correct

Incorrect
Question 253 of 792

253. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician receives a prescription for atenolol 50 mg with directions to ‘take 1 tablet twice daily.’ The patient’s profile shows they have asthma documented in their medical history. What potential prescribing error should the technician flag?

Atenolol is a beta-blocker that can worsen bronchospasm in patients with asthma
Correct Incorrect Correct answer

Atenolol 50 mg is only available as a once-daily formulation and cannot be dosed twice daily
Correct Incorrect Correct answer

Atenolol interacts with all inhaled asthma medications, making combination therapy unsafe
Correct Incorrect Correct answer

Atenolol is a controlled substance that requires additional verification for asthma patients
Correct Incorrect Correct answer

Correct

Incorrect
Question 254 of 792

254. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician processes a prescription for phenytoin 300 mg daily for a patient transferring from a hospital. The hospital discharge summary shows the patient was taking fosphenytoin 300 mg PE IV daily during their stay. The technician notices the prescriber wrote ‘continue current dose’ on the outpatient prescription. What error should the technician identify?

Fosphenytoin doses expressed in PE (phenytoin equivalents) are equivalent to phenytoin, so the dose is correct, but the technician should verify the route change from IV to oral was intentional
Correct Incorrect Correct answer

Fosphenytoin 300 mg PE is a different dose than phenytoin 300 mg, requiring recalculation
Correct Incorrect Correct answer

Phenytoin cannot be given orally and must always be administered intravenously
Correct Incorrect Correct answer

The prescription should be rejected because fosphenytoin and phenytoin are different drug classes
Correct Incorrect Correct answer

Correct

Incorrect
Question 255 of 792

255. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

Which type of prescription error occurs when a pharmacy technician enters a prescription into the computer system and accidentally types the wrong drug strength?

Data entry error
Correct Incorrect Correct answer

Monitoring error
Correct Incorrect Correct answer

Prescribing error
Correct Incorrect Correct answer

Administration error
Correct Incorrect Correct answer

Correct

Incorrect
Question 256 of 792

256. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician receives a prescription for a patient that reads ‘Lasix 40 mg, take 1 tablet daily.’ The technician types ‘furosemide 40 mg’ into the system. The software returns two results: furosemide 40 mg tablet and furosemide 40 mg/5 mL oral solution. The prescription does not specify a dosage form. What should the technician do?

Select the tablet formulation since the directions say 'take 1 tablet' and verify with the pharmacist
Correct Incorrect Correct answer

Select the oral solution since liquid formulations are always preferred for accuracy
Correct Incorrect Correct answer

Dispense whichever formulation is currently in stock to avoid delays
Correct Incorrect Correct answer

Contact the patient to ask which dosage form they prefer
Correct Incorrect Correct answer

Correct

Incorrect
Question 257 of 792

257. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician receives a new prescription for a 72-year-old patient: ‘digoxin 0.25 mg daily.’ The patient’s current medications include amiodarone 200 mg daily, which was started two weeks ago. The technician recalls that digoxin has a narrow therapeutic index. Which analysis best explains why this prescription warrants pharmacist review?

Amiodarone inhibits digoxin clearance, potentially raising digoxin levels to toxic concentrations at the prescribed dose
Correct Incorrect Correct answer

Digoxin and amiodarone cannot be prescribed by the same physician due to formulary restrictions
Correct Incorrect Correct answer

Amiodarone enhances digoxin elimination, requiring a higher dose than 0.25 mg daily
Correct Incorrect Correct answer

Digoxin 0.25 mg is always too high for any patient over age 65, regardless of other medications
Correct Incorrect Correct answer

Correct

Incorrect
Question 258 of 792

258. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy receives a prescription for ‘Norvasc 5 mg, take 1 tablet daily’ for a new patient. During data entry, the technician accidentally selects ‘Navane 5 mg’ from the dropdown menu. The pharmacist catches the error during final verification. Which factor most contributed to this specific type of error?

The similar appearance of drug names in an alphabetical dropdown list during computer entry
Correct Incorrect Correct answer

The prescription was written using the brand name instead of the generic name
Correct Incorrect Correct answer

The patient did not provide a complete medication history at intake
Correct Incorrect Correct answer

The pharmacy did not have Norvasc in stock, forcing a therapeutic substitution
Correct Incorrect Correct answer

Correct

Incorrect
Question 259 of 792

259. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

According to the revised USP 797 (2023), what is the maximum beyond-use date (BUD) for a Category 1 compounded sterile preparation stored at controlled room temperature?

12 hours
Correct Incorrect Correct answer

24 hours
Correct Incorrect Correct answer

48 hours
Correct Incorrect Correct answer

72 hours
Correct Incorrect Correct answer

Correct

Incorrect
Question 260 of 792

260. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is preparing to compound a sterile IV admixture and notices a small crack in the glass vial of the drug to be used. The vial seal appears intact and the solution looks clear. What should the technician do?

Discard the vial and obtain a new intact vial before proceeding with compounding
Correct Incorrect Correct answer

Use the vial since the solution appears clear and the seal is intact
Correct Incorrect Correct answer

Filter the solution through a 0.22-micron filter to remove any potential contaminants
Correct Incorrect Correct answer

Inspect the vial under UV light to determine if microbial contamination is present
Correct Incorrect Correct answer

Correct

Incorrect
Question 261 of 792

261. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is cleaning the direct compounding area (DCA) of a compounding aseptic isolator (CAI) between preparations. The next preparation involves a different antibiotic than the previous one. What is the correct cleaning procedure for the DCA?

Wipe all surfaces of the DCA with sterile 70% isopropyl alcohol using overlapping strokes moving from clean to dirty areas
Correct Incorrect Correct answer

Spray the DCA with tap water to remove residue and then allow it to air dry
Correct Incorrect Correct answer

Wipe only the areas that appear visibly soiled with a dry lint-free cloth
Correct Incorrect Correct answer

Apply household bleach solution to all surfaces and rinse with non-sterile water
Correct Incorrect Correct answer

Correct

Incorrect
Question 262 of 792

262. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A hospital pharmacy’s environmental monitoring results show that the ISO Class 5 primary engineering control (PEC) passed all viable and nonviable particle testing. However, the ISO Class 7 buffer room failed viable air sampling with colony counts above action levels. The pharmacy has compounded sterile preparations awaiting release. What is the most appropriate course of action?

Quarantine unreleased CSPs prepared during the failed sampling period, investigate the contamination source, and re-clean and retest the buffer room
Correct Incorrect Correct answer

Release the CSPs since the PEC passed testing, which is the only requirement that affects product sterility
Correct Incorrect Correct answer

Discard only the CSPs that were compounded in the buffer room and release those compounded in the PEC
Correct Incorrect Correct answer

Continue normal operations and schedule the buffer room for recleaning during the next routine cleaning cycle
Correct Incorrect Correct answer

Correct

Incorrect
Question 263 of 792

263. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

What is the primary purpose of performing fingertip sampling as part of a pharmacy technician’s competency assessment for sterile compounding?

To verify that the technician's aseptic hand and finger technique prevents microbial contamination of sterile preparations
Correct Incorrect Correct answer

To ensure the technician is not carrying any communicable diseases that could affect patients
Correct Incorrect Correct answer

To test whether the sterile gloves used by the pharmacy are free of manufacturing defects
Correct Incorrect Correct answer

To measure the effectiveness of the hand sanitizer dispensers located in the ante-area
Correct Incorrect Correct answer

Correct

Incorrect
Question 264 of 792

264. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician in a pediatric hospital is preparing an IV insulin drip for a 3-year-old patient weighing 14 kg. The order reads insulin regular 0.05 units/kg/hr. The standard adult concentration is 1 unit/mL, but the pediatric protocol requires a concentration of 0.1 units/mL to reduce the risk of accidental overdose. What should the technician prepare?

Insulin regular in a concentration of 0.1 units/mL, with the infusion rate calculated based on the pediatric protocol
Correct Incorrect Correct answer

Insulin regular in the standard adult concentration of 1 unit/mL to simplify rate calculations
Correct Incorrect Correct answer

Insulin regular at 0.5 units/mL as a compromise between adult and pediatric concentrations
Correct Incorrect Correct answer

Insulin regular at 0.1 units/mL but only after the attending physician confirms the weight verbally
Correct Incorrect Correct answer

Correct

Incorrect
Question 265 of 792

265. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

During a code blue event in a hospital, the pharmacy technician is asked to retrieve emergency medications from the crash cart. The code team leader requests epinephrine for cardiac arrest. The crash cart contains both epinephrine 1:1,000 (1 mg/mL) for IM injection and epinephrine 1:10,000 (0.1 mg/mL) for IV push. Which formulation should the technician hand to the nurse for IV administration?

Epinephrine 1:10,000 (0.1 mg/mL) prefilled syringe for IV push
Correct Incorrect Correct answer

Epinephrine 1:1,000 (1 mg/mL) vial diluted at the bedside before IV push
Correct Incorrect Correct answer

Epinephrine 1:1,000 (1 mg/mL) vial administered undiluted via IV push
Correct Incorrect Correct answer

Either concentration since the total dose of 1 mg remains the same regardless of route
Correct Incorrect Correct answer

Correct

Incorrect
Question 266 of 792

266. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A hospital pharmacy reviews its controlled substance dispensing data and identifies that fentanyl patch usage on one nursing unit has increased 40% over three months while patient census and acuity levels have remained stable. Waste documentation shows consistent two-nurse witnessing, but override pulls from the automated dispensing cabinet have tripled. Which pattern most strongly suggests potential diversion?

The significant increase in override pulls, which bypass standard verification and may indicate unauthorized access to controlled substances
Correct Incorrect Correct answer

The 40% increase in overall fentanyl patch usage, which alone confirms that diversion is occurring
Correct Incorrect Correct answer

The consistent two-nurse waste witnessing, which suggests that waste documentation is being falsified
Correct Incorrect Correct answer

The stable patient census, which means the pharmacy should reduce fentanyl patch par levels immediately
Correct Incorrect Correct answer

Correct

Incorrect
Question 267 of 792

267. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A neonatal intensive care unit pharmacy technician receives an order for caffeine citrate 20 mg/kg loading dose for a premature infant weighing 1.2 kg. The available concentration is caffeine citrate 20 mg/mL (equivalent to caffeine base 10 mg/mL). The technician notices the prescriber wrote the order specifying caffeine citrate. What volume should the technician prepare for the loading dose?

1.2 mL of caffeine citrate 20 mg/mL
Correct Incorrect Correct answer

2.4 mL of caffeine citrate 20 mg/mL
Correct Incorrect Correct answer

0.6 mL of caffeine citrate 20 mg/mL
Correct Incorrect Correct answer

1.2 mL drawn from two separate vials to ensure accuracy
Correct Incorrect Correct answer

Correct

Incorrect
Question 268 of 792

268. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A hospital pharmacy is implementing a new oncology drug verification workflow. Currently, chemotherapy orders are verified by one pharmacist before preparation. After reviewing ISMP recommendations, the pharmacy director proposes changes. Which workflow modification would most effectively reduce the risk of chemotherapy preparation errors?

Implementing independent double-checks where a second pharmacist verifies the original order, calculated dose, and prepared product separately from the first verification
Correct Incorrect Correct answer

Requiring the same pharmacist to verify the order twice at different times during the shift to catch initial oversights
Correct Incorrect Correct answer

Adding a barcode scan of the final product label only, since barcode technology eliminates the need for manual checks
Correct Incorrect Correct answer

Having the preparing technician verbally read back the drug name and dose to the verifying pharmacist before compounding
Correct Incorrect Correct answer

Correct

Incorrect
Question 269 of 792

269. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is preparing medications for a patient being transferred from the ICU to a general medical floor. The patient’s ICU medication list includes a vasopressin drip at 0.04 units/min, norepinephrine drip at 2 mcg/min (being weaned), and oral metoprolol 25 mg twice daily. The transfer orders only include metoprolol 25 mg twice daily. What should the technician do regarding the vasopressin and norepinephrine?

Alert the pharmacist that the high-alert IV drips on the current medication list do not appear in the transfer orders and need reconciliation
Correct Incorrect Correct answer

Discontinue both drips in the system since they were not reordered for the general medical floor
Correct Incorrect Correct answer

Continue dispensing both drips at current rates until the receiving floor nurse confirms discontinuation
Correct Incorrect Correct answer

Transfer the remaining IV bags with the patient to the general floor to avoid medication waste
Correct Incorrect Correct answer

Correct

Incorrect
Question 270 of 792

270. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A telepharmacy site serves a rural critical access hospital. During an overnight shift when the remote pharmacist’s video connection drops for 15 minutes, a nurse requests an urgent neuromuscular blocking agent (rocuronium) for a patient requiring emergency intubation. The pharmacy technician on-site has access to the automated dispensing cabinet. What is the most appropriate action?

Use the emergency override function on the ADC to retrieve rocuronium while simultaneously attempting to restore the pharmacist connection for verification
Correct Incorrect Correct answer

Refuse to allow access to the medication until the telepharmacy connection is fully restored and the pharmacist verifies the order
Correct Incorrect Correct answer

Dispense the medication directly to the nurse without documentation since it is an emergency situation
Correct Incorrect Correct answer

Contact a pharmacist at the nearest non-telepharmacy hospital to provide verbal authorization before releasing the drug
Correct Incorrect Correct answer

Correct

Incorrect
Question 271 of 792

271. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is verifying inventory in the oncology satellite pharmacy and finds two vials side by side: vinCRIStine 1 mg/mL for IV use and vinBLAStine 1 mg/mL for IV use. Both are stored in the same bin in the refrigerator. Based on ISMP safety recommendations for these specific medications, what storage change should be implemented?

Separate the two medications into different storage locations with prominent warning labels distinguishing each product
Correct Incorrect Correct answer

Store both vials together but add a single shared warning label noting that two different vinca alkaloids are present
Correct Incorrect Correct answer

Remove vinCRIStine from the satellite pharmacy entirely and dispense it only from the central pharmacy in a minibag
Correct Incorrect Correct answer

Place both medications in sequentially numbered bins to maintain alphabetical order while adding auxiliary stickers
Correct Incorrect Correct answer

Correct

Incorrect
Question 272 of 792

272. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician working in a long-term care pharmacy receives an order for risperiDONE 0.5 mg at bedtime for a 78-year-old patient with dementia-related agitation. The pharmacy also stocks rOPINIRole 0.5 mg for Parkinson’s disease. During the filling process, the barcode scanner malfunctions and the technician must manually select the product. Which action best prevents a LASA dispensing error in this situation?

Manually verify the full drug name, strength, and NDC number against the original order before proceeding without the barcode scanner
Correct Incorrect Correct answer

Select the medication based on the shelf location since LASA pairs are always stored in separate areas of the pharmacy
Correct Incorrect Correct answer

Choose the product that appears first alphabetically in the computer system to ensure consistency
Correct Incorrect Correct answer

Ask another technician to select the product since a second person eliminates the risk of LASA errors
Correct Incorrect Correct answer

Correct

Incorrect
Question 273 of 792

273. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A community pharmacy’s quarterly error report reveals three near-miss events involving hydrOXYzine and hydrALAzine over the past 90 days. Two occurred during high-volume afternoon shifts, and one occurred when a float technician was working. The pharmacy currently uses Tall Man lettering on shelf labels. Which combination of interventions would most effectively address the root causes identified in this pattern?

Physically separate the two medications on different shelves and add a LASA alert in the dispensing software that triggers during order entry for either drug
Correct Incorrect Correct answer

Replace Tall Man lettering with color-coded shelf labels since color differentiation is more effective than letter-based strategies
Correct Incorrect Correct answer

Restrict float technicians from filling prescriptions for either medication and limit dispensing to permanent staff only
Correct Incorrect Correct answer

Increase Tall Man lettering font size on shelf labels and post a reminder sign near the dispensing counter
Correct Incorrect Correct answer

Correct

Incorrect
Question 274 of 792

274. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician is processing discharge prescriptions for a patient leaving a rehabilitation facility. The discharge summary lists clonIDine 0.1 mg twice daily for blood pressure management. The patient’s pre-admission medication list shows cloNAZepam 0.5 mg twice daily for seizure disorder, which was held during the inpatient stay. The discharge orders do not include cloNAZepam. What should the technician recognize about this situation?

The omission of cloNAZepam from the discharge orders may be a medication reconciliation error that should be flagged for pharmacist review
Correct Incorrect Correct answer

The prescriber intentionally replaced cloNAZepam with clonIDine since both medications treat similar conditions
Correct Incorrect Correct answer

The cloNAZepam was appropriately discontinued because benzodiazepines should not be used long-term in rehabilitation patients
Correct Incorrect Correct answer

The two medications are interchangeable, so only one needs to appear on the discharge medication list
Correct Incorrect Correct answer

Correct

Incorrect
Question 275 of 792

275. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A telepharmacy technician is entering e-prescriptions remotely and encounters an order for ‘Zantac 150 mg twice daily.’ The technician knows that ranitidine (Zantac) was withdrawn from the market. The prescriber likely intended a different medication for acid reflux. The patient’s profile shows a recent diagnosis of GERD. Which medication is most likely what the prescriber intended?

Famotidine 20 mg twice daily, since it is the most common H2 blocker replacement after ranitidine's market withdrawal
Correct Incorrect Correct answer

Omeprazole 20 mg twice daily, since all acid reflux medications are interchangeable at equivalent doses
Correct Incorrect Correct answer

Cetirizine 10 mg twice daily, since H2 blockers and antihistamines share receptor activity
Correct Incorrect Correct answer

Sucralfate 1 g twice daily, since it is the direct therapeutic equivalent of ranitidine
Correct Incorrect Correct answer

Correct

Incorrect
Question 276 of 792

276. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A children’s hospital pharmacy identifies that errors involving oral liquid medications have increased, particularly between prednisoLONE 15 mg/5 mL oral solution and predniSONE 5 mg/5 mL oral solution. Analysis shows errors occur most frequently when verbal orders are received by phone from pediatric urgent care providers. Which systemic change would most effectively reduce these specific errors?

Require all prednisolone and prednisone orders to be transmitted electronically with mandatory generic name and concentration fields rather than accepted verbally
Correct Incorrect Correct answer

Stock only one corticosteroid formulation in the pharmacy to eliminate the possibility of selecting the wrong product
Correct Incorrect Correct answer

Require nurses to spell out the medication name letter by letter during every verbal order to prevent sound-alike confusion
Correct Incorrect Correct answer

Add Tall Man lettering to the pharmacy labels only, since the point of dispensing is where errors originate
Correct Incorrect Correct answer

Correct

Incorrect
Question 277 of 792

277. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician receives a prescription for a patient being discharged from a psychiatric facility. The order reads ‘QUEtiapine 200 mg at bedtime.’ The patient’s medication history shows they previously took gabaPENTin 300 mg three times daily before admission. The technician notices that the automated dispensing system shows a pick-list with QUEtiapine, gaBAPentin, and tiZANidine appearing consecutively. What is the primary LASA concern in this scenario?

The pick-list proximity of similarly formatted drug names increases the risk of selecting the wrong medication during order entry
Correct Incorrect Correct answer

QUEtiapine and gabaPENTin are therapeutically equivalent, so selecting either would not cause patient harm
Correct Incorrect Correct answer

The Tall Man lettering displayed in the pick-list eliminates any risk of selection error between these medications
Correct Incorrect Correct answer

The primary concern is that the patient is taking two sedating medications rather than a LASA selection risk
Correct Incorrect Correct answer

Correct

Incorrect
Question 278 of 792

278. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A hospital pharmacy conducts a proactive risk assessment of its automated dispensing cabinets and finds that DOBUTamine and DOPamine are loaded in adjacent pockets in five ICU cabinets. Both medications are used as continuous infusions in critical care. Despite Tall Man lettering on vial labels, two near-miss events occurred in the past quarter. Which analysis best explains why Tall Man lettering alone was insufficient?

In high-stress ICU environments, cognitive load and urgency reduce the effectiveness of visual differentiation strategies, requiring physical separation as an additional barrier
Correct Incorrect Correct answer

Tall Man lettering only works for oral medications and has no demonstrated benefit for injectable products
Correct Incorrect Correct answer

The near-misses occurred because the Tall Man lettering font was too small to read on the vial labels
Correct Incorrect Correct answer

ICU nurses are not trained to recognize Tall Man lettering conventions, making the strategy ineffective in that setting
Correct Incorrect Correct answer

Correct

Incorrect
Question 279 of 792

279. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy’s computerized physician order entry (CPOE) system goes offline unexpectedly during the evening shift. Physicians begin writing paper orders, and the pharmacy must process these manually. The pharmacy has a downtime procedure policy. What is the technician’s most important action during this technology failure?

Follow the documented downtime procedures, including using preprinted order forms and maintaining a manual log of all orders processed for later system entry
Correct Incorrect Correct answer

Wait for the CPOE system to come back online before processing any orders to avoid manual entry errors
Correct Incorrect Correct answer

Process orders from memory based on common medication regimens for each patient to maintain workflow speed
Correct Incorrect Correct answer

Enter all orders into the backup personal computer spreadsheet that each technician maintains independently
Correct Incorrect Correct answer

Correct

Incorrect
Question 280 of 792

280. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A community pharmacy implements a new workflow where one technician enters prescriptions, a different technician fills them, and a third technician performs a final product check before pharmacist verification. After six months, error rates for wrong-drug dispensing have decreased, but wrong-strength errors have increased by 15%. Which analysis best explains this unexpected outcome?

The multiple-technician workflow may create diffusion of responsibility, where each technician assumes another person will catch strength discrepancies during their step
Correct Incorrect Correct answer

The third technician performing the product check is likely undertrained and should be replaced with a more experienced staff member
Correct Incorrect Correct answer

Wrong-strength errors always increase when workflow volume increases, regardless of the number of technicians involved
Correct Incorrect Correct answer

The new workflow introduced too many handoffs, and returning to a single-technician model would resolve both error types
Correct Incorrect Correct answer

Correct

Incorrect
Question 281 of 792

281. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician is preparing medications for an interdisciplinary team rounding session in a teaching hospital. The medical team includes a physician, nurse practitioner, clinical pharmacist, social worker, and charge nurse. The pharmacist asks the technician to compile a list of patients with renal dose adjustments needed. Which approach best supports multi-disciplinary team communication for error prevention?

Generate a report from the pharmacy system listing patients with elevated creatinine values alongside their current renally-cleared medications and recommended dose adjustments
Correct Incorrect Correct answer

Verbally inform the pharmacist of each patient's renal function during rounds so the team can make immediate changes
Correct Incorrect Correct answer

Print each patient's complete medication administration record and distribute copies to all team members without highlighting specific concerns
Correct Incorrect Correct answer

Email the charge nurse a list of patient names who may need dose changes and let nursing communicate the details to the team
Correct Incorrect Correct answer

Correct

Incorrect
Question 282 of 792

282. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A hospital pharmacy analyzes medication errors over the past year and finds that 35% of errors occurred during patient handoffs between shifts, 25% during new admission order entry, 20% during discharge, and 20% at other times. The pharmacy director wants to implement a targeted intervention. Which strategy addresses the highest-risk period identified in the data?

Implement a standardized shift handoff communication tool such as SBAR that includes pending medication orders, dose changes, and unresolved clinical questions
Correct Incorrect Correct answer

Focus resources on improving the admission medication reconciliation process since new orders carry the greatest inherent risk
Correct Incorrect Correct answer

Install additional barcode scanning stations to increase verification capacity during all shift periods equally
Correct Incorrect Correct answer

Hire additional pharmacists for the discharge process since patients leaving the hospital face the most complex medication changes
Correct Incorrect Correct answer

Correct

Incorrect
Question 283 of 792

283. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician is compounding a batch of pediatric oral suspensions when a coworker interrupts to ask about a stat order. After the interruption, the technician returns to compounding but is unsure whether the last ingredient was already added. The pharmacy has no compounding checklist in place. What is the safest course of action?

Discard the current preparation and start the compounding process over from the beginning to ensure accuracy
Correct Incorrect Correct answer

Add the ingredient in question since it is better to have a slightly higher concentration than to miss a component entirely
Correct Incorrect Correct answer

Estimate based on the volume already in the container whether the ingredient was likely added
Correct Incorrect Correct answer

Complete the preparation and label it with a note indicating that one ingredient may have been doubled
Correct Incorrect Correct answer

Correct

Incorrect
Question 284 of 792

284. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician is processing a discharge prescription for warfarin 5 mg daily for a patient who was stabilized on this dose during hospitalization. The technician notices the pharmacy stocks warfarin in 1 mg, 2 mg, 2.5 mg, 5 mg, and 10 mg tablet strengths, and the 5 mg tablets are currently out of stock. The technician considers dispensing a combination of other strengths to equal 5 mg. What is the appropriate action?

Alert the pharmacist about the stock-out and let the pharmacist determine the safest combination or alternative, since warfarin strength tablets are color-coded and mixing strengths can confuse patients
Correct Incorrect Correct answer

Dispense one 2.5 mg tablet and one 2 mg tablet plus one 0.5 mg tablet daily, noting the combination on the label
Correct Incorrect Correct answer

Dispense 10 mg tablets with instructions to break each tablet in half to achieve the 5 mg dose
Correct Incorrect Correct answer

Substitute the 5 mg dose with the nearest available single strength of 2.5 mg until stock is replenished
Correct Incorrect Correct answer

Correct

Incorrect
Question 285 of 792

285. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A hospital pharmacy’s smart infusion pump library is configured with hard maximum dose limits for opioids. Over the past month, nurses have reported 47 hard-limit alerts for hydromorphone, and investigation reveals that 45 of these were due to a programming error where nurses entered the dose in milligrams per hour instead of milligrams per dose. The pharmacy informatics team is asked to address this. Which intervention best targets the root cause?

Redesign the pump interface to clearly display the expected unit of measure and add a confirmation screen when the entered value is near the hard limit threshold
Correct Incorrect Correct answer

Raise the hard maximum dose limit for hydromorphone to reduce the number of alerts nurses encounter during programming
Correct Incorrect Correct answer

Remove hydromorphone from the smart pump drug library and require manual pump programming for all opioid infusions
Correct Incorrect Correct answer

Send an email reminder to all nurses explaining the correct unit of measure to use when programming hydromorphone
Correct Incorrect Correct answer

Correct

Incorrect
Question 286 of 792

286. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician working in a closed-door long-term care pharmacy is packaging medications into multi-dose compliance packs for a nursing facility. The technician notices that a resident’s medication profile includes both amlodipine 5 mg daily and felodipine 5 mg daily, both calcium channel blockers. What should the technician do before packaging these medications?

Flag the potential therapeutic duplication to the pharmacist for review before packaging the compliance pack
Correct Incorrect Correct answer

Package both medications as ordered since the prescriber is responsible for therapeutic decisions
Correct Incorrect Correct answer

Remove the felodipine and only package the amlodipine since it is the more commonly prescribed calcium channel blocker
Correct Incorrect Correct answer

Contact the nursing facility directly to ask the charge nurse whether both medications should be administered
Correct Incorrect Correct answer

Correct

Incorrect
Question 287 of 792

287. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician receives a new prescription for metformin 1000 mg twice daily for a 68-year-old patient. While entering the prescription, the technician reviews the patient’s profile and notices a recent lab result showing an eGFR of 28 mL/min/1.73m2. The technician understands that metformin has renal dosing considerations. What is the appropriate next step?

Alert the pharmacist to the low eGFR value so the pharmacist can evaluate whether metformin is contraindicated or requires dose adjustment at this level of renal function
Correct Incorrect Correct answer

Fill the prescription as written since the prescriber has access to the same lab results and made an informed decision
Correct Incorrect Correct answer

Reduce the metformin dose to 500 mg twice daily based on the renal function value and process the adjusted prescription
Correct Incorrect Correct answer

Place the prescription on hold and contact the patient to recommend they see a nephrologist before starting metformin
Correct Incorrect Correct answer

Correct

Incorrect
Question 288 of 792

288. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician processing prescriptions for a 45-year-old female patient notices the following active medications: sertraline 100 mg daily, sumatriptan 50 mg as needed, and a new prescription for tramadol 50 mg every 6 hours as needed. The technician recalls that certain combinations of serotonergic medications can be dangerous. Which clinical concern should prompt a pharmacist intervention?

The combination of sertraline, sumatriptan, and tramadol creates an elevated risk of serotonin syndrome due to three concurrent serotonergic agents
Correct Incorrect Correct answer

Sumatriptan and tramadol are both controlled substances and cannot legally be prescribed to the same patient simultaneously
Correct Incorrect Correct answer

Sertraline reduces the effectiveness of tramadol, so the pain medication will not work and needs to be changed to a different opioid
Correct Incorrect Correct answer

The maximum number of as-needed medications a patient can have on their profile is two, requiring one to be discontinued
Correct Incorrect Correct answer

Correct

Incorrect
Question 289 of 792

289. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician enters a prescription for azithromycin 500 mg on day 1, then 250 mg on days 2 through 5 for a patient whose profile shows they are currently taking amiodarone 200 mg daily. The dispensing system generates a severe drug interaction alert. What type of interaction should the technician expect the pharmacist to address with the prescriber?

An increased risk of QT prolongation and potentially fatal cardiac arrhythmias from the combination of azithromycin and amiodarone
Correct Incorrect Correct answer

A pharmacokinetic interaction where azithromycin significantly increases amiodarone serum levels requiring therapeutic drug monitoring
Correct Incorrect Correct answer

An antagonistic interaction where azithromycin reduces the antiarrhythmic effectiveness of amiodarone
Correct Incorrect Correct answer

A hepatotoxicity risk requiring baseline liver function tests before the azithromycin course can begin
Correct Incorrect Correct answer

Correct

Incorrect
Question 290 of 792

290. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician working in a community pharmacy receives a new prescription for allopurinol 300 mg daily for a patient with gout. The patient mentions she was recently told she has stage 3 chronic kidney disease. The technician also notices a current prescription for azathioprine 50 mg daily on the patient’s profile for an autoimmune condition. What should the technician flag for the pharmacist?

The combination of allopurinol and azathioprine requires pharmacist review because allopurinol inhibits the metabolism of azathioprine, increasing the risk of severe bone marrow suppression
Correct Incorrect Correct answer

The allopurinol dose is too low for a patient with stage 3 kidney disease and should be increased to compensate for reduced clearance
Correct Incorrect Correct answer

Azathioprine must be discontinued before starting allopurinol because the two medications cannot legally be dispensed concurrently
Correct Incorrect Correct answer

The patient needs to stop taking azathioprine for 48 hours before and after each dose of allopurinol to prevent crystalluria
Correct Incorrect Correct answer

Correct

Incorrect
Question 291 of 792

291. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician reviews a medication therapy management (MTM) referral list generated by the pharmacy system. One patient is flagged for having 14 active medications, a recent hospitalization, and three prescribers. The technician prepares the patient’s comprehensive medication list for the pharmacist’s MTM session. During preparation, the technician identifies that the patient takes both clopidogrel 75 mg daily and omeprazole 20 mg daily. Why is this combination significant for the MTM review?

Omeprazole inhibits CYP2C19, which is required to convert clopidogrel to its active metabolite, potentially reducing its antiplatelet effectiveness
Correct Incorrect Correct answer

Clopidogrel increases the gastric acid suppression of omeprazole, leading to dangerously low stomach pH levels
Correct Incorrect Correct answer

Omeprazole and clopidogrel compete for the same absorption sites in the small intestine, reducing both drugs' bioavailability
Correct Incorrect Correct answer

The combination is only a concern in patients over age 75, and the MTM referral does not specify the patient's age
Correct Incorrect Correct answer

Correct

Incorrect
Question 292 of 792

292. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician receives a prescription for ciprofloxacin 750 mg twice daily for 14 days for a urinary tract infection. The patient is a 72-year-old male whose profile shows he takes tizanidine 4 mg at bedtime for muscle spasms. The pharmacy system generates a contraindicated interaction alert. What should the technician communicate to the pharmacist?

Ciprofloxacin is contraindicated with tizanidine because ciprofloxacin dramatically increases tizanidine levels, which can cause severe hypotension and excessive sedation
Correct Incorrect Correct answer

The ciprofloxacin dose exceeds the maximum recommended dose for a patient over 70 years old and needs age-based adjustment
Correct Incorrect Correct answer

Tizanidine must be temporarily discontinued during the ciprofloxacin course and restarted 24 hours after the antibiotic is completed
Correct Incorrect Correct answer

Ciprofloxacin and tizanidine share the same renal elimination pathway, requiring both doses to be reduced by 50%
Correct Incorrect Correct answer

Correct

Incorrect
Question 293 of 792

293. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician working at a specialty pharmacy receives a new prescription for tofacitinib 5 mg twice daily for a patient with rheumatoid arthritis. The patient’s profile shows they recently completed treatment with a live varicella-zoster vaccine three weeks ago and are also taking methotrexate 15 mg weekly. Which safety concern requires the most urgent pharmacist intervention before dispensing?

Tofacitinib is an immunosuppressant that should not be started within a specific timeframe after live vaccine administration due to the risk of vaccine-strain infection
Correct Incorrect Correct answer

Methotrexate and tofacitinib cannot be used concurrently under any circumstances for rheumatoid arthritis treatment
Correct Incorrect Correct answer

The varicella-zoster vaccine is contraindicated in all patients with rheumatoid arthritis regardless of their medication regimen
Correct Incorrect Correct answer

Tofacitinib requires a negative tuberculosis test before initiation, and the vaccine may cause a false-positive result
Correct Incorrect Correct answer

Correct

Incorrect
Question 294 of 792

294. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician processes a prescription transfer request for a patient moving to a new city. The transferring pharmacy sends over four medications: lisinopril 20 mg daily, metformin 500 mg twice daily, atorvastatin 40 mg at bedtime, and potassium chloride 20 mEq daily. The technician notices the patient’s new prescriber has also sent in a prescription for losartan 50 mg daily. What should the technician flag for the pharmacist before completing the transfer?

The patient would have both lisinopril (transferred) and losartan (new prescription) active, which represents a duplicate therapy concern with two renin-angiotensin system blockers
Correct Incorrect Correct answer

The potassium chloride transfer requires a new prescription from the receiving prescriber since supplements cannot be transferred between states
Correct Incorrect Correct answer

The metformin dose is subtherapeutic and should be automatically increased to 1000 mg twice daily during the transfer process
Correct Incorrect Correct answer

The atorvastatin bedtime dosing should be changed to morning dosing based on current prescribing guidelines for the new state
Correct Incorrect Correct answer

Correct

Incorrect
Question 295 of 792

295. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician discovers that a medication error reached a patient but did not cause harm. The patient received metoprolol succinate 50 mg instead of the prescribed metoprolol tartrate 50 mg. The patient took one dose before the error was identified during a refill visit. According to the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) index, how should this event be categorized?

Category C: an error occurred that reached the patient but did not cause harm
Correct Incorrect Correct answer

Category A: circumstances or events that have the capacity to cause error but no error actually occurred
Correct Incorrect Correct answer

Category D: an error occurred that reached the patient and required monitoring or intervention to preclude harm
Correct Incorrect Correct answer

Category E: an error occurred that resulted in temporary harm requiring additional treatment
Correct Incorrect Correct answer

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Incorrect
Question 296 of 792

296. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A hospital pharmacy’s continuous quality improvement (CQI) committee reviews 12 months of medication error reports and discovers that voluntary error reporting dropped by 60% after a technician was publicly reprimanded for a dispensing error six months ago. Reported errors that quarter were exclusively submitted by pharmacists, with no technician-submitted reports. Which organizational factor most directly explains this reporting decline?

The punitive response to the error created a chilling effect that discouraged technicians from reporting errors, undermining the just culture necessary for effective safety reporting
Correct Incorrect Correct answer

Technicians stopped making errors after witnessing the consequences, so there were genuinely fewer events to report
Correct Incorrect Correct answer

Pharmacists assumed full reporting responsibility after the incident, making technician reports redundant
Correct Incorrect Correct answer

The reporting system was likely changed after the incident, creating a technical barrier that prevented technician submissions
Correct Incorrect Correct answer

Correct

Incorrect
Question 297 of 792

297. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician witnesses a near-miss event where a nurse almost administered IV potassium chloride 40 mEq at an infusion rate double what was ordered. The smart pump alarmed and prevented the error. No patient harm occurred. The technician is unsure whether near-miss events require documentation. What is the correct reporting action?

Report the near-miss event through the facility's incident reporting system because near-miss data provides valuable information for preventing future errors that may reach patients
Correct Incorrect Correct answer

Do not report the event because the smart pump successfully prevented patient harm and the safety system worked as intended
Correct Incorrect Correct answer

Report the event only to the nurse's supervisor verbally since it was a nursing error and not a pharmacy event
Correct Incorrect Correct answer

Document the event only in the patient's medical record since no formal incident report is needed for prevented errors
Correct Incorrect Correct answer

Correct

Incorrect
Question 298 of 792

298. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A community pharmacy submits medication error data to a Patient Safety Organization (PSO) and receives a benchmarking report showing their dispensing error rate is 2.8 per 1,000 prescriptions while the national average for similar pharmacies is 1.5 per 1,000. The pharmacy manager reviews the data and notices that 70% of their reported errors involve incorrect quantity dispensed. Which next step aligns with the purpose of PSO benchmarking data?

Conduct a focused analysis of the quantity-dispensing workflow to identify specific process failures contributing to the above-average error rate and implement targeted improvements
Correct Incorrect Correct answer

Reduce the number of errors submitted to the PSO to bring the reported rate closer to the national benchmark
Correct Incorrect Correct answer

Switch to a different PSO that uses a more favorable methodology for calculating error rates
Correct Incorrect Correct answer

Accept the higher error rate as an inevitable consequence of the pharmacy's prescription volume
Correct Incorrect Correct answer

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Incorrect
Question 299 of 792

299. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician at a hospital completes a medication error report for an incident where a patient received vancomycin 1 g IV instead of the ordered vancomycin 750 mg IV. The technician includes the date, time, patient identifiers, medication details, and contributing factors. The pharmacy manager asks the technician to also include a recommendation for system improvement. What type of information should the technician provide?

A description of what workflow or system changes could prevent a similar error in the future, such as adding a weight-based dosing alert for vancomycin in the pharmacy system
Correct Incorrect Correct answer

The name of the staff member who made the error so that individual can receive targeted retraining to prevent recurrence
Correct Incorrect Correct answer

A detailed legal analysis of the pharmacy's liability exposure from the dosing error to protect the organization
Correct Incorrect Correct answer

A comparison of the error to similar events at competing hospitals to provide context for the severity
Correct Incorrect Correct answer

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Incorrect
Question 300 of 792

300. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician identifies that a medication error resulted in a patient being hospitalized. The error involved a community pharmacy dispensing the wrong strength of a blood thinner, leading to a bleeding event. The state board of pharmacy requires mandatory reporting of errors causing serious patient harm. To which entities should this error be reported?

The state board of pharmacy as required by law, the pharmacy's internal incident reporting system, and optionally to the FDA MedWatch or ISMP Medication Errors Reporting Program
Correct Incorrect Correct answer

Only the state board of pharmacy, since mandatory reporting to the board satisfies all legal and professional obligations
Correct Incorrect Correct answer

Only the pharmacy's internal incident reporting system, since external reporting is always voluntary and optional
Correct Incorrect Correct answer

The DEA and state board of pharmacy jointly, since blood thinners are classified as controlled substances requiring dual reporting
Correct Incorrect Correct answer

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Incorrect
Question 301 of 792

301. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A hospital pharmacy’s annual safety report shows the following trend: voluntary medication error reports increased from 120 in year one to 340 in year two after implementing a non-punitive reporting policy and simplifying the reporting form. The actual dispensing error rate (detected through independent audits) remained stable at approximately 1.2%. How should the CQI committee interpret the increase in reports?

The increase in reports reflects improved reporting culture and detection, not an increase in actual errors, since the independently audited error rate remained stable
Correct Incorrect Correct answer

The pharmacy is making nearly three times more errors than the previous year and needs immediate corrective action
Correct Incorrect Correct answer

The simplified reporting form is encouraging staff to submit false or exaggerated reports that inflate the numbers
Correct Incorrect Correct answer

The non-punitive policy has led to complacency, causing staff to make more errors because there are no consequences
Correct Incorrect Correct answer

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Incorrect
Question 302 of 792

302. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician receives an e-prescription for a 6-year-old patient weighing 20 kg. The prescription reads: amoxicillin 500 mg/5 mL suspension, take 10 mL three times daily for 10 days. The technician calculates that this dose would provide 1000 mg per dose (3000 mg/day), which equals 150 mg/kg/day. The standard pediatric dosing range for amoxicillin is 25-90 mg/kg/day. What type of prescription error has occurred?

A dosing error where the prescribed dose significantly exceeds the maximum recommended pediatric dose, likely due to selecting the wrong concentration or miscalculating the dose
Correct Incorrect Correct answer

A frequency error where the medication should be given once daily instead of three times daily for the 500 mg/5 mL concentration
Correct Incorrect Correct answer

A duration error where the 10-day course is too long for a pediatric patient and should be shortened to 5 days
Correct Incorrect Correct answer

A formulation error where the 500 mg/5 mL concentration is not available and the prescription should default to 250 mg/5 mL
Correct Incorrect Correct answer

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Question 303 of 792

303. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician receives a handwritten prescription that reads: ‘Synthroid .125 mg PO daily.’ The technician must enter this into the pharmacy system. Beyond the use of a leading decimal point without a zero, what additional concern should the technician identify about this prescription?

The missing leading zero before the decimal point (should be written as 0.125 mg) creates a risk of misreading the dose as 125 mg, which is a recognized dangerous abbreviation
Correct Incorrect Correct answer

Synthroid is only available in microgram strengths, so the prescription should read 125 mcg rather than 0.125 mg, though both are equivalent
Correct Incorrect Correct answer

The prescription must be rejected entirely because handwritten prescriptions are no longer accepted for thyroid medications
Correct Incorrect Correct answer

The brand name Synthroid cannot be used on prescriptions in states that require generic substitution by law
Correct Incorrect Correct answer

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Incorrect
Question 304 of 792

304. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician receives an e-prescription for a patient being transitioned from IV to oral antibiotics after a hospital stay. The prescription reads: ‘levofloxacin 750 mg PO BID for 7 days.’ The technician reviews the patient’s discharge instructions, which indicate the patient was receiving levofloxacin 750 mg IV once daily in the hospital. What type of error has likely occurred during the transition of care?

A frequency error where the prescriber may have inadvertently written twice daily instead of once daily, as levofloxacin 750 mg is typically dosed once daily regardless of route
Correct Incorrect Correct answer

A route conversion error where the oral dose needs to be doubled to achieve the same blood levels as the IV formulation
Correct Incorrect Correct answer

A duration error where the 7-day oral course should be extended to 14 days to account for lower oral bioavailability
Correct Incorrect Correct answer

A strength error where the oral dose should be reduced to 500 mg since the 750 mg tablet is only approved for IV administration
Correct Incorrect Correct answer

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Question 305 of 792

305. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician processes an e-prescription for a 9-month-old infant: ‘acetaminophen 160 mg/5 mL oral suspension, give 5 mL every 4 hours as needed for fever.’ The infant’s weight is documented as 8 kg. The recommended pediatric acetaminophen dose is 10-15 mg/kg/dose every 4-6 hours, with a maximum of 75 mg/kg/day. If the caregiver administers the maximum of 6 doses per day, what concern should the technician raise?

Six doses of 160 mg totals 960 mg/day (120 mg/kg/day), which significantly exceeds the maximum daily dose of 75 mg/kg/day (600 mg) for this infant
Correct Incorrect Correct answer

The per-dose amount of 160 mg (20 mg/kg) is within the acceptable single-dose range, so no concern exists about total daily intake
Correct Incorrect Correct answer

The every-4-hour frequency is too frequent for an infant under 12 months, and the minimum interval should be every 8 hours
Correct Incorrect Correct answer

Acetaminophen oral suspension is contraindicated in infants under 12 months of age and should be replaced with rectal suppositories
Correct Incorrect Correct answer

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Question 306 of 792

306. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician receives a prescription for a patient that reads: ‘Coumadin 5 mg PO QOD.’ The pharmacy’s error-prevention policy prohibits the use of certain abbreviations identified by ISMP and The Joint Commission. The technician recognizes that ‘QOD’ appears on The Joint Commission’s Official Do Not Use List and the ISMP List of Error-Prone Abbreviations. Why is this abbreviation considered dangerous?

QOD (every other day) can be misread as QD (every day) or QID (four times daily), leading to a significant dosing frequency error for a high-alert anticoagulant
Correct Incorrect Correct answer

QOD is not a recognized medical abbreviation in any standard reference and has no established meaning in pharmacy practice
Correct Incorrect Correct answer

QOD means the medication should be taken only on odd-numbered calendar days, which is confusing for patients and pharmacists
Correct Incorrect Correct answer

QOD implies the patient should take the medication every other dose rather than every other day, creating ambiguity about skipping individual tablets
Correct Incorrect Correct answer

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Incorrect
Question 307 of 792

307. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician reviews a new e-prescription for a 4-year-old patient: ‘ondansetron ODT 4 mg, dissolve on tongue every 8 hours as needed for nausea, quantity 30.’ The child weighs 16 kg. Standard pediatric ondansetron dosing for patients 4-11 years old is 4 mg three times daily. The technician notices the prescriber selected ‘ondansetron ODT 4 mg’ from the e-prescribing pick-list, but the patient’s allergy profile lists aspartame sensitivity. Why is the formulation selection clinically significant?

Ondansetron orally disintegrating tablets (ODT) contain aspartame as a sweetener, which would be contraindicated for a patient with documented aspartame sensitivity
Correct Incorrect Correct answer

ODT formulations are not approved for pediatric patients under 6 years of age regardless of allergy status
Correct Incorrect Correct answer

The 4 mg ODT strength is only available for adults, and pediatric patients must use the oral solution formulation exclusively
Correct Incorrect Correct answer

Aspartame sensitivity only affects injectable ondansetron formulations and does not apply to oral dosage forms
Correct Incorrect Correct answer

Correct

Incorrect
Question 308 of 792

308. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician in a hospital compounding room is preparing a batch of IV vancomycin doses. The technician receives a phone call about an urgent order and sets down the partially completed preparation on the counter. After a 10-minute interruption, the technician returns to the preparation. According to USP 797 principles, what should the technician evaluate before continuing?

Assess whether the partially completed preparation has been exposed to conditions outside of ISO Class 5 air quality for a duration that could compromise sterility
Correct Incorrect Correct answer

Simply resume the preparation since the 10-minute interruption falls within the acceptable one-hour window for open containers
Correct Incorrect Correct answer

Complete the preparation quickly and assign a shorter beyond-use date to compensate for the interruption
Correct Incorrect Correct answer

Discard the preparation only if the vancomycin vial was reconstituted with bacteriostatic water before the interruption
Correct Incorrect Correct answer

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Incorrect
Question 309 of 792

309. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A hospital pharmacy’s compounding quality assurance program identifies that two out of five technicians failed their semi-annual gloved fingertip sampling. Both technicians passed their garbing competency assessment and media fill tests. The failed samples showed bacterial growth consistent with skin flora. Which root cause analysis finding best explains this discrepancy?

The technicians may be performing adequate aseptic technique during media fills but are contaminating their gloves through improper hand hygiene or glove contact with non-sterile surfaces during actual compounding
Correct Incorrect Correct answer

Media fill tests are inherently less sensitive than fingertip sampling and will always produce passing results regardless of technique
Correct Incorrect Correct answer

The skin flora contamination likely originated from the cleanroom environment rather than the technicians' hands
Correct Incorrect Correct answer

The semi-annual sampling interval is too infrequent, and monthly testing would automatically resolve the contamination issue
Correct Incorrect Correct answer

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Incorrect
Question 310 of 792

310. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is preparing hazardous sterile compounds in a biological safety cabinet (BSC) located in a negative pressure room. The technician receives a simultaneous order for a non-hazardous IV antibiotic that needs to be compounded in a laminar airflow workbench (LAFW) located in a positive pressure cleanroom down the hall. What is the correct approach to handling both orders?

Complete the hazardous preparation in the BSC first, then perform proper decontamination and re-garbing procedures before entering the positive pressure cleanroom to compound the non-hazardous preparation
Correct Incorrect Correct answer

Prepare both orders in the BSC since it provides a higher level of protection than the LAFW for all types of preparations
Correct Incorrect Correct answer

Alternate between the two compounding areas freely since the garbing requirements are identical for both environments
Correct Incorrect Correct answer

Prepare the non-hazardous antibiotic first in the LAFW, then move to the BSC for the hazardous compound without changing garb
Correct Incorrect Correct answer

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Incorrect
Question 311 of 792

311. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is reviewing the beyond-use dating for compounded sterile preparations (CSPs) in the pharmacy’s refrigerator. The technician finds a batch of CSPs that were compounded 5 days ago under Category 1 conditions (as defined by revised USP 797) and stored in the refrigerator at 2-8 degrees Celsius. The CSPs were prepared from commercially available sterile ingredients using closed-system transfer. What action should the technician take regarding these CSPs?

Verify that the assigned beyond-use date on each CSP label is consistent with the Category 1 storage limits and confirm the preparations have not exceeded their labeled BUD
Correct Incorrect Correct answer

Discard all CSPs immediately since any sterile preparation older than 48 hours must be disposed of regardless of storage conditions
Correct Incorrect Correct answer

Extend the beyond-use date by an additional 7 days since refrigeration doubles the allowable storage time for all CSPs
Correct Incorrect Correct answer

Move the CSPs to room temperature storage to complete their remaining shelf life since refrigeration is only required for the first 24 hours
Correct Incorrect Correct answer

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Incorrect
Question 312 of 792

312. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A hospital pharmacy’s infection control team investigates a cluster of bloodstream infections in patients who received compounded TPN over a two-week period. Environmental monitoring results from that period were within acceptable limits, and all technicians passed their most recent media fill tests. However, investigation reveals that a single lot of sterile empty EVA bags used for TPN compounding had a manufacturing defect affecting bag seal integrity. Which quality assurance gap does this scenario highlight?

The pharmacy's quality assurance program did not include adequate visual inspection of compounding components for integrity defects before use, relying solely on environmental and personnel monitoring
Correct Incorrect Correct answer

Environmental monitoring was performed incorrectly, as the acceptable results should have detected contamination introduced through defective bags
Correct Incorrect Correct answer

The media fill tests were invalid because they did not use the same lot of EVA bags that were used for patient preparations
Correct Incorrect Correct answer

The technicians were responsible for the contamination despite passing media fill tests because aseptic technique is the only barrier to infection
Correct Incorrect Correct answer

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Question 313 of 792

313. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is preparing heparin flushes and notices two different heparin concentrations in stock: heparin 10 units/mL flush syringes and heparin 10,000 units/mL vials used for therapeutic anticoagulation. A nurse calls requesting a heparin flush for a central line. Which action best prevents a potentially fatal medication error?

Dispense the pre-filled 10 units/mL flush syringe and verify the order specifies flush, not therapeutic heparin
Correct Incorrect Correct answer

Draw up 1 mL from the 10,000 units/mL vial and label it as a flush since the volume is smaller
Correct Incorrect Correct answer

Send both concentrations to the floor and let the nurse select the correct product
Correct Incorrect Correct answer

Dilute the 10,000 units/mL vial to create a custom flush concentration for the patient
Correct Incorrect Correct answer

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Incorrect
Question 314 of 792

314. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A patient on an insulin pump is admitted to the hospital. The pharmacy receives an order to continue the patient’s home insulin pump settings using insulin lispro at a basal rate of 0.8 units/hr and bolus doses of 4 units before meals. The hospital formulary only stocks insulin aspart for pump use. The technician reviews the formulary policy and sees that rapid-acting insulin interchange requires pharmacist evaluation. Considering the clinical implications of pump therapy, why is automatic substitution of insulin aspart for insulin lispro without pharmacist review inappropriate in this scenario?

Although both are rapid-acting insulins, pump basal rates and bolus ratios may require adjustment when switching products, and the pharmacist must evaluate the interchange and coordinate with the prescriber
Correct Incorrect Correct answer

Insulin aspart has a significantly different onset of action that makes it incompatible with continuous subcutaneous infusion pumps
Correct Incorrect Correct answer

Insulin lispro is the only rapid-acting insulin FDA-approved for use in insulin pumps
Correct Incorrect Correct answer

The pump hardware is calibrated specifically for insulin lispro and cannot accurately deliver insulin aspart
Correct Incorrect Correct answer

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Incorrect
Question 315 of 792

315. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A patient currently receiving morphine 30 mg by mouth every 4 hours for cancer pain is being converted to oral hydromorphone due to renal insufficiency. Using an equianalgesic conversion and applying a 25% dose reduction for incomplete cross-tolerance, which daily hydromorphone dose is most appropriate?

27 mg of oral hydromorphone per day
Correct Incorrect Correct answer

36 mg of oral hydromorphone per day
Correct Incorrect Correct answer

45 mg of oral hydromorphone per day
Correct Incorrect Correct answer

18 mg of oral hydromorphone per day
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Question 316 of 792

316. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is verifying an IV magnesium sulfate order that reads: magnesium sulfate 2 g in 50 mL NS to infuse over 20 minutes for a patient with eclampsia. The maximum recommended infusion rate is 150 mg/min. Should this order proceed as written?

No, because 2 g over 20 minutes equals 100 mg/min, which is within the safe limit, but the technician should still verify with the pharmacist given the high-alert status of IV magnesium
Correct Incorrect Correct answer

No, because 2 g over 20 minutes exceeds the 150 mg/min maximum rate and must be slowed
Correct Incorrect Correct answer

Yes, the technician can prepare and release it without further verification since the rate is within limits
Correct Incorrect Correct answer

No, because magnesium sulfate should only be administered intramuscularly for eclampsia
Correct Incorrect Correct answer

Correct

Incorrect
Question 317 of 792

317. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A hospital pharmacy implements a new policy requiring independent double checks for all high-alert medications before dispensing. A technician prepares a chemotherapy compound and asks a nearby technician to verify the final product. The checking technician initials the label without reviewing the original order or recalculating the dose. What is the primary concern with this verification?

The independent double check was not performed correctly because the verifier must independently review the order and recalculate without relying on the preparer's work
Correct Incorrect Correct answer

Technicians are not permitted to perform independent double checks on chemotherapy products under any circumstances
Correct Incorrect Correct answer

The check is adequate since the verifier confirmed the label matched the product in the final container
Correct Incorrect Correct answer

Only pharmacists may initial high-alert medication labels, so the technician's initials are invalid
Correct Incorrect Correct answer

Correct

Incorrect
Question 318 of 792

318. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy receives an order for a heparin 25,000 units/500 mL infusion to run at 18 mL/hr. The previous nurse documented the rate as 1,800 units/hr on the medication administration record, but the pharmacist calculates the correct rate as 900 units/hr at 18 mL/hr. What is the most likely source of this discrepancy?

The nurse likely calculated using an incorrect concentration, possibly confusing the bag with a 50,000 units/500 mL product that delivers 100 units/mL instead of 50 units/mL
Correct Incorrect Correct answer

The pharmacist made an error because 25,000 units divided by 500 mL at 18 mL/hr does equal 1,800 units/hr
Correct Incorrect Correct answer

The nurse documented the loading dose rate rather than the maintenance infusion rate
Correct Incorrect Correct answer

The electronic health record auto-populated the rate from a previous admission and was not updated
Correct Incorrect Correct answer

Correct

Incorrect
Question 319 of 792

319. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A prescription is received for ceFAZolin 1 g IV every 8 hours for surgical prophylaxis. The technician pulls cefTRIAXone 1 g from the shelf. Both are cephalosporin antibiotics stored in the same refrigerator bin. What is the primary risk if this substitution goes undetected?

The patient would receive once-daily dosed cefTRIAXone at an every-8-hour frequency, resulting in excessive dosing and increased risk of adverse effects
Correct Incorrect Correct answer

CefTRIAXone has no surgical prophylaxis activity, so the patient would have no antibiotic coverage
Correct Incorrect Correct answer

CeFAZolin and cefTRIAXone are therapeutically equivalent, so there is no clinical consequence
Correct Incorrect Correct answer

CefTRIAXone requires reconstitution with a different diluent that is incompatible with standard IV lines
Correct Incorrect Correct answer

Correct

Incorrect
Question 320 of 792

320. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

During an emergency intubation, the anesthesiologist verbally orders ePHEDrine 10 mg IV push for hypotension. The pharmacy technician assisting in the OR reaches into the emergency supply and finds both ePHEDrine 50 mg/mL and EPINEPHrine 1 mg/mL vials side by side. Which safeguard would most effectively prevent a wrong-drug error in this urgent situation?

Storing ePHEDrine and EPINEPHrine in separate, clearly labeled bins within the emergency supply with differentiated cap colors or labels
Correct Incorrect Correct answer

Requiring the anesthesiologist to spell out the drug name before the technician retrieves it
Correct Incorrect Correct answer

Removing EPINEPHrine from the emergency supply entirely to eliminate the possibility of confusion
Correct Incorrect Correct answer

Using only the generic chemical names during verbal orders to avoid any brand name confusion
Correct Incorrect Correct answer

Correct

Incorrect
Question 321 of 792

321. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A patient in the emergency department presents with severe allergic urticaria and anxiety. The physician orders hydrOXYzine 50 mg IM for itching. The technician accidentally prepares hydrALAZINE 20 mg IM instead. The nurse administers it before the pharmacist can verify. What is the most serious immediate clinical concern?

Acute hypotension because hydrALAZINE is a potent vasodilator and was given instead of the antihistamine hydrOXYzine
Correct Incorrect Correct answer

Excessive sedation because hydrALAZINE has stronger CNS depressant effects than hydrOXYzine
Correct Incorrect Correct answer

Tachycardia from the anticholinergic properties shared by both hydrALAZINE and hydrOXYzine
Correct Incorrect Correct answer

Allergic reaction to hydrALAZINE since the patient already has a history of urticaria
Correct Incorrect Correct answer

Correct

Incorrect
Question 322 of 792

322. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician is filling a prescription for cloniDINE 0.1 mg tablets for hypertension. The pharmacy software displays the drug name as “clonidine” in standard lowercase. The adjacent shelf contains clonazePAM 0.5 mg tablets for seizures. Which system-level intervention would best reduce the risk of dispensing the wrong medication?

Implementing tall man lettering in the pharmacy dispensing software so the display reads cloniDINE and clonazePAM
Correct Incorrect Correct answer

Requiring patients to confirm the drug indication at pickup to catch any dispensing errors
Correct Incorrect Correct answer

Placing both medications on the same shelf alphabetically since staff will be more careful when they are together
Correct Incorrect Correct answer

Changing the shelf labels to display only the brand names to avoid generic name confusion
Correct Incorrect Correct answer

Correct

Incorrect
Question 323 of 792

323. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A technician is processing a medication order for a patient in the ICU. The order reads clonazePAM 1 mg IV for status epilepticus. The technician notices that the pharmacy stocks both clonazePAM (Klonopin) and clonaZEPAM is the same drug. However, the ICU typically uses lorAZEPam for status epilepticus. What should the technician do?

Flag the order for pharmacist review because clonazePAM is not a standard first-line agent for status epilepticus and the prescriber may have intended lorAZEPam
Correct Incorrect Correct answer

Dispense clonazePAM as ordered since the prescriber specifically wrote the drug name and dose
Correct Incorrect Correct answer

Substitute lorAZEPam automatically since it is the preferred agent for status epilepticus
Correct Incorrect Correct answer

Contact the nurse to ask whether the patient has a seizure history before processing the order
Correct Incorrect Correct answer

Correct

Incorrect
Question 324 of 792

324. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A hospital pharmacy’s purchasing department receives a shipment of cephalosporin antibiotics. The buyer notices that the manufacturer has updated packaging for ceFAZolin and cefOXitin vials, and they now share nearly identical label colors, vial sizes, and cap colors. What is the most proactive step the pharmacy should take before placing these on the shelf?

Apply auxiliary differentiation labels or shelf separators and submit an alert to ISMP about the look-alike packaging concern
Correct Incorrect Correct answer

Place both products on the same shelf to keep all cephalosporins together for efficiency
Correct Incorrect Correct answer

Return the cefOXitin to the wholesaler and switch to a different cephalosporin to avoid confusion
Correct Incorrect Correct answer

Train staff on the new packaging during the next quarterly meeting and proceed with normal shelving
Correct Incorrect Correct answer

Correct

Incorrect
Question 325 of 792

325. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A retail pharmacy receives multiple manufacturer bottles of metoprolol tartrate 25 mg and metoprolol succinate 25 mg from the same wholesaler. Both bottles have similar labeling and identical tablet sizes. What purchasing-level strategy would best reduce the chance of a stocking error?

Source the two metoprolol formulations from different manufacturers so that the bottles and tablets have visibly distinct appearances
Correct Incorrect Correct answer

Store both products next to each other so technicians compare labels side by side during stocking
Correct Incorrect Correct answer

Restrict purchases to only metoprolol succinate since it is the more commonly prescribed formulation
Correct Incorrect Correct answer

Remove NDC barcode scanning during stocking to speed up the process and reduce technician fatigue
Correct Incorrect Correct answer

Correct

Incorrect
Question 326 of 792

326. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacist counsels a patient on a new warfarin prescription and asks the patient to explain in their own words how they will take the medication, when to take it, and what signs of bleeding to watch for. This communication technique is known as which method?

Teach-back method
Correct Incorrect Correct answer

Motivational interviewing
Correct Incorrect Correct answer

SBAR communication technique
Correct Incorrect Correct answer

Show-and-tell demonstration
Correct Incorrect Correct answer

Correct

Incorrect
Question 327 of 792

327. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician is preparing weekly pillboxes for a long-term care facility. During preparation of one patient’s pillbox, the technician realizes that two different patients have the same last name, similar room numbers (204A and 204B), and both take metformin 500 mg and lisinopril 10 mg. What is the highest-priority action to prevent a wrong-patient error?

Verify each patient using at least two unique identifiers such as full name and date of birth before filling each pillbox
Correct Incorrect Correct answer

Fill both patients' pillboxes at the same time to compare them side by side and catch differences
Correct Incorrect Correct answer

Highlight the room numbers on the medication administration records to make them easier to distinguish
Correct Incorrect Correct answer

Assign a color-coded pillbox to each patient so the nursing staff can differentiate them visually
Correct Incorrect Correct answer

Correct

Incorrect
Question 328 of 792

328. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy is evaluating its workflow to reduce dispensing errors. Data shows that most errors occur during the selection step when technicians pick medications from the shelf. Which combination of safeguards provides the strongest protection at this step?

Barcode scanning at the point of selection combined with physical separation of look-alike products
Correct Incorrect Correct answer

Final pharmacist check at the verification window combined with patient counseling at pickup
Correct Incorrect Correct answer

Annual competency testing for technicians combined with mandatory continuing education
Correct Incorrect Correct answer

Automated prescription counting machines combined with electronic prescription intake
Correct Incorrect Correct answer

Correct

Incorrect
Question 329 of 792

329. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A community pharmacy’s quarterly error report reveals that 60% of dispensing errors involved medications stored in the fast-mover section, where the top 50 drugs are kept in close proximity for efficiency. The pharmacy manager wants to reduce these errors without significantly slowing workflow. Which redesign strategy best balances safety and efficiency?

Rearrange the fast-mover section so that look-alike and sound-alike drugs are not adjacent, and implement barcode scanning for every selection
Correct Incorrect Correct answer

Eliminate the fast-mover section entirely and return to full alphabetical shelving throughout the pharmacy
Correct Incorrect Correct answer

Limit fast-mover access to pharmacists only so technicians cannot make selection errors in that area
Correct Incorrect Correct answer

Add a second pharmacist verification step specifically for medications dispensed from the fast-mover section
Correct Incorrect Correct answer

Correct

Incorrect
Question 330 of 792

330. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician is filling a prescription and notices that the NDC barcode on the stock bottle does not match the NDC in the dispensing system, even though the drug name, strength, and dosage form appear correct. The product is from a different manufacturer than what is loaded in the system. What should the technician do?

Do not override the mismatch; notify the pharmacist so the correct NDC can be verified and updated in the system before dispensing
Correct Incorrect Correct answer

Override the barcode mismatch since the drug name and strength match the prescription
Correct Incorrect Correct answer

Dispense the medication and attach a note explaining the manufacturer change to the patient's bag
Correct Incorrect Correct answer

Return the bottle to the shelf and order the original manufacturer's product from the wholesaler
Correct Incorrect Correct answer

Correct

Incorrect
Question 331 of 792

331. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician is processing a refill for amoxicillin 500 mg for a patient. While updating the patient profile, the technician notices a new allergy to penicillin was documented during a recent emergency department visit. The original prescriber is not aware of this update. What is the appropriate action?

Immediately alert the pharmacist about the new penicillin allergy so they can contact the prescriber before the amoxicillin is dispensed
Correct Incorrect Correct answer

Fill the prescription and place an allergy alert sticker on the bag so the patient is aware at pickup
Correct Incorrect Correct answer

Substitute azithromycin for amoxicillin since it is a common alternative for penicillin-allergic patients
Correct Incorrect Correct answer

Call the patient to ask if the penicillin allergy is real before notifying the pharmacist
Correct Incorrect Correct answer

Correct

Incorrect
Question 332 of 792

332. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy receives an order for gabapentin 3,600 mg three times daily for a patient with postherpetic neuralgia. The maximum recommended daily dose of gabapentin is 3,600 mg per day. The technician calculates that the ordered regimen would deliver 10,800 mg per day. What should the technician do?

Flag the order for the pharmacist because the prescribed daily dose of 10,800 mg is three times the recommended maximum of 3,600 mg per day
Correct Incorrect Correct answer

Fill the order as written because the prescriber may be using an aggressive dosing strategy for severe pain
Correct Incorrect Correct answer

Reduce the dose to 1,200 mg three times daily to match the maximum and inform the patient of the change
Correct Incorrect Correct answer

Dispense a partial quantity and instruct the patient to call the prescriber for the remaining amount
Correct Incorrect Correct answer

Correct

Incorrect
Question 333 of 792

333. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician receives a new prescription for isotretinoin (Accutane) for a 22-year-old female patient. The iPLEDGE system shows that the patient’s pregnancy test results have not been entered for this dispensing window. The prescription is otherwise valid. What should the technician do?

Notify the pharmacist that the prescription cannot be dispensed until a negative pregnancy test is confirmed and entered in iPLEDGE within the required window
Correct Incorrect Correct answer

Dispense the medication with a counseling note reminding the patient to complete the pregnancy test at her next visit
Correct Incorrect Correct answer

Fill the prescription and place it on hold for 7 days while waiting for the test result to be entered
Correct Incorrect Correct answer

Contact the prescriber to request a waiver from the pregnancy testing requirement
Correct Incorrect Correct answer

Correct

Incorrect
Question 334 of 792

334. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A hospital pharmacist reviews a patient’s morning labs and finds an INR of 5.8. The patient’s current medication profile includes warfarin 7.5 mg daily, which was increased from 5 mg two weeks ago. The patient also started amiodarone 200 mg daily one week ago. Which factor most likely explains the supratherapeutic INR?

Amiodarone is a potent inhibitor of warfarin metabolism and significantly increases INR, requiring a warfarin dose reduction of 30% to 50% when the two drugs are used together
Correct Incorrect Correct answer

The warfarin dose increase from 5 mg to 7.5 mg alone is sufficient to explain the INR of 5.8
Correct Incorrect Correct answer

The patient likely missed several doses and then took them all at once, causing a transient spike in INR
Correct Incorrect Correct answer

Amiodarone increases warfarin clearance through CYP enzyme induction, and the INR will self-correct within days
Correct Incorrect Correct answer

Correct

Incorrect
Question 335 of 792

335. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician receives a prescription for lisinopril 20 mg daily for a 30-year-old female patient. While updating her profile, the patient mentions she just found out she is pregnant. The prescriber’s office is closed for the day. What should happen next?

The pharmacist should not dispense lisinopril, contact the prescriber through the after-hours service, and inform the patient that ACE inhibitors are contraindicated in pregnancy
Correct Incorrect Correct answer

Dispense a small supply of lisinopril and schedule a follow-up call with the prescriber the next business day
Correct Incorrect Correct answer

Substitute an ARB such as losartan since it is safer in pregnancy than ACE inhibitors
Correct Incorrect Correct answer

Fill the prescription and advise the patient to ask her obstetrician about continuing the medication
Correct Incorrect Correct answer

Correct

Incorrect
Question 336 of 792

336. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A clinical pharmacist reviews a patient’s labs and sees that the serum potassium has risen from 4.2 mEq/L to 6.1 mEq/L over three days. The patient’s medication list includes spironolactone 50 mg daily, lisinopril 40 mg daily, and a new prescription for potassium chloride 20 mEq twice daily that was added yesterday. Which combination of factors most directly explains the critical hyperkalemia?

The patient is on two potassium-sparing agents (spironolactone and lisinopril) and was started on supplemental potassium, creating a triple risk for hyperkalemia
Correct Incorrect Correct answer

The potassium chloride dose is excessive regardless of other medications, as 40 mEq daily exceeds the normal supplementation limit
Correct Incorrect Correct answer

Spironolactone causes potassium wasting, so it must have been discontinued, and the potassium supplement is compensating for the loss
Correct Incorrect Correct answer

Lisinopril decreases aldosterone secretion, which lowers potassium levels, and the supplement was appropriately added
Correct Incorrect Correct answer

Correct

Incorrect
Question 337 of 792

337. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician dispenses the wrong strength of atorvastatin (40 mg instead of 20 mg) to a patient. The patient takes one dose before the error is discovered during a callback verification. The patient experiences no adverse effects. Using the ISMP/NCC MERP Medication Error Index, how would this event be classified?

Category C: An error occurred that reached the patient but did not cause harm
Correct Incorrect Correct answer

Category A: Circumstances or events that have the capacity to cause error
Correct Incorrect Correct answer

Category D: An error occurred that required monitoring or intervention to preclude harm
Correct Incorrect Correct answer

Category E: An error occurred that contributed to temporary harm requiring treatment
Correct Incorrect Correct answer

Correct

Incorrect
Question 338 of 792

338. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A hospital pharmacy transitions from paper-based medication error reporting to an electronic event reporting system. After six months, the number of reported events increases by 300%, but the rate of events causing patient harm remains unchanged. The pharmacy director asks the quality team to interpret these results. What conclusion is best supported by this data?

The electronic system improved detection and reporting of near-misses and minor errors that previously went unreported, while the actual rate of harmful events was already being captured
Correct Incorrect Correct answer

The electronic system is causing more errors because the total number of reported events has tripled
Correct Incorrect Correct answer

The paper-based system was more effective at preventing harm because it had fewer total reports
Correct Incorrect Correct answer

The unchanged harm rate means the electronic system has failed to improve patient safety
Correct Incorrect Correct answer

Correct

Incorrect
Question 339 of 792

339. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A hospital’s Pharmacy and Therapeutics (P&T) committee reviews quarterly medication error data and identifies a pattern: 15 near-miss events involving confusion between DOBUTamine and DOPamine drips in the cardiac ICU. No patient harm has occurred. What is the most appropriate P&T committee action?

Implement system-level changes such as requiring premixed solutions, applying tall man lettering to all labels, and separating storage locations before a harmful event occurs
Correct Incorrect Correct answer

Take no action because no patients were harmed and near-misses do not require formal intervention
Correct Incorrect Correct answer

Require mandatory retraining for all cardiac ICU nurses and pharmacy staff involved in the near-misses
Correct Incorrect Correct answer

Remove DOBUTamine from the formulary to eliminate the possibility of confusion with DOPamine
Correct Incorrect Correct answer

Correct

Incorrect
Question 340 of 792

340. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician catches a potential tenfold dosing error on a pediatric amoxicillin suspension prescription before it reaches the patient. The pharmacist asks the technician to submit the event through the facility’s reporting system. The technician wonders why a near-miss needs to be reported since no patient was harmed. What is the best explanation?

Near-miss reports are valuable because they reveal system vulnerabilities that could lead to actual patient harm in the future, and they can be analyzed to implement preventive measures
Correct Incorrect Correct answer

Near-miss reporting is required only for controlled substance errors and is optional for all other medication classes
Correct Incorrect Correct answer

The report is needed primarily for the technician's personnel file to document their error-catching performance
Correct Incorrect Correct answer

Near-miss reports are submitted only to satisfy regulatory inspection requirements and have no practical use
Correct Incorrect Correct answer

Correct

Incorrect
Question 341 of 792

341. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy conducts a proactive risk assessment using Failure Mode and Effects Analysis (FMEA) on its automated dispensing cabinet replenishment process. During the analysis, the team identifies that the restocking step has the highest risk priority number due to the likelihood of placing the wrong medication in a pocket. Which type of safety analysis is this?

A prospective risk assessment that identifies potential failure points before errors actually occur
Correct Incorrect Correct answer

A retrospective root cause analysis that investigates an error that already harmed a patient
Correct Incorrect Correct answer

A concurrent drug utilization review that monitors active patient therapy
Correct Incorrect Correct answer

A corrective action plan developed in response to a regulatory citation
Correct Incorrect Correct answer

Correct

Incorrect
Question 342 of 792

342. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A hospital pharmacy’s error reporting data over 12 months shows 42 reported events. However, a confidential staff survey estimates that approximately 200 errors and near-misses actually occurred during the same period. The pharmacy manager wants to close this reporting gap. Which strategy is most likely to increase the reporting rate?

Share aggregate error data and resulting safety improvements with staff regularly to demonstrate that reports lead to meaningful changes, not punishment
Correct Incorrect Correct answer

Require mandatory error reporting with disciplinary consequences for staff who fail to submit reports
Correct Incorrect Correct answer

Reduce the number of reportable event categories so that only serious harm events require submission
Correct Incorrect Correct answer

Assign error reporting responsibility exclusively to pharmacists so technicians do not need to file reports
Correct Incorrect Correct answer

Correct

Incorrect
Question 343 of 792

343. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy dispensing system is configured to automatically substitute generic equivalents when brand-name medications are prescribed. A prescription for Toprol-XL (metoprolol succinate ER) 50 mg is entered, but the system auto-substitutes metoprolol tartrate 50 mg because it is the least expensive metoprolol in stock. What is the primary concern with this substitution?

Metoprolol succinate ER and metoprolol tartrate are not therapeutically equivalent because they have different release mechanisms and dosing frequencies
Correct Incorrect Correct answer

The substitution is appropriate because both are metoprolol and the same total daily dose can be maintained
Correct Incorrect Correct answer

The generic substitution law prohibits any substitution of brand-name cardiovascular medications
Correct Incorrect Correct answer

Metoprolol tartrate is a different drug entirely and belongs to a different pharmacologic class
Correct Incorrect Correct answer

Correct

Incorrect
Question 344 of 792

344. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A technician processes a prescription for levothyroxine 125 mcg, #90, with a sig of “take 1 tablet by mouth daily.” The technician notes that 90 tablets for a daily medication is a 90-day supply, which is consistent. However, the prescriber wrote the quantity as “90” but the directions say “take 1.5 tablets daily.” How many tablets should be dispensed for a 90-day supply based on the sig?

135 tablets
Correct Incorrect Correct answer

90 tablets
Correct Incorrect Correct answer

120 tablets
Correct Incorrect Correct answer

180 tablets
Correct Incorrect Correct answer

Correct

Incorrect
Question 345 of 792

345. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

An elderly patient brings in prescriptions from two different providers: her cardiologist prescribed lisinopril 20 mg daily, and her primary care physician prescribed enalapril 10 mg daily. Both are ACE inhibitors. The patient does not realize she has been prescribed two medications from the same class. What type of error does this represent?

Duplicate therapy from multiple prescribers, where two ACE inhibitors are prescribed simultaneously without coordination
Correct Incorrect Correct answer

A formulary substitution error where one provider switched the patient's ACE inhibitor without the other's knowledge
Correct Incorrect Correct answer

A therapeutic interchange that was appropriately authorized by both prescribers
Correct Incorrect Correct answer

A dosing error because the combined ACE inhibitor dose exceeds the maximum daily limit
Correct Incorrect Correct answer

Correct

Incorrect
Question 346 of 792

346. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A handwritten prescription reads: “clonidine .1 mg PO BID.” The technician is uncertain whether the dose is 0.1 mg or 1 mg because the decimal point is difficult to see. What prescribing practice should have been followed to prevent this ambiguity?

A leading zero should always precede a decimal point (written as 0.1 mg instead of .1 mg) to prevent misinterpretation
Correct Incorrect Correct answer

A trailing zero should be added after the decimal (written as .10 mg) to clarify the dose
Correct Incorrect Correct answer

The dose should be written in micrograms (100 mcg) to avoid using decimals entirely
Correct Incorrect Correct answer

The prescriber should circle the decimal point to draw attention to its presence
Correct Incorrect Correct answer

Correct

Incorrect
Question 347 of 792

347. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pediatric prescription reads: “amoxicillin suspension 25 mg/5 mL, give 250 mg PO TID x 10 days, dispense 150 mL.” The technician calculates that the patient needs 50 mL per dose (250 mg at 25 mg/5 mL = 50 mL), which would require 150 mL per day and 1,500 mL for 10 days. Which element of the prescription most likely contains the error?

The concentration is likely wrong; the prescriber probably intended 250 mg/5 mL, which would make the dose 5 mL per administration and the total quantity reasonable
Correct Incorrect Correct answer

The dose of 250 mg is too high for any pediatric patient and should be reduced to 25 mg
Correct Incorrect Correct answer

The frequency of TID is incorrect and should be once daily for amoxicillin in children
Correct Incorrect Correct answer

The quantity of 150 mL is the only error because all other elements are internally consistent
Correct Incorrect Correct answer

Correct

Incorrect
Question 348 of 792

348. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A patient’s electronic prescription for prednisone reads: “20.0 mg PO daily x 5 days, then 10.0 mg PO daily x 5 days.” The technician notices the trailing zeros. Why is this notation considered a safety risk even in electronic prescriptions?

Trailing zeros can be misread as 200 mg and 100 mg if the decimal point is not displayed clearly on printouts, labels, or when verbally communicated
Correct Incorrect Correct answer

Trailing zeros indicate the prescriber wants the dose measured to the nearest tenth of a milligram, requiring a compounded product
Correct Incorrect Correct answer

Electronic prescriptions automatically remove trailing zeros, so there is no risk in the original entry
Correct Incorrect Correct answer

Trailing zeros are only a concern for controlled substances and do not apply to prednisone
Correct Incorrect Correct answer

Correct

Incorrect
Question 349 of 792

349. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy receives an e-prescription for amlodipine 5 mg #30, sig: take 1 tablet by mouth daily. The patient’s profile shows an active prescription for amlodipine 5 mg from a different prescriber that was filled 10 days ago with 20 tablets remaining. What should the technician do before processing the new prescription?

Alert the pharmacist to the potential duplicate prescription from a different prescriber so the pharmacist can verify with both providers whether the therapy was intentionally changed or duplicated
Correct Incorrect Correct answer

Cancel the new prescription automatically because the patient already has an active supply
Correct Incorrect Correct answer

Fill the new prescription and add a note to the patient's profile indicating two active prescriptions
Correct Incorrect Correct answer

Contact the patient to ask which prescriber they prefer and cancel the other prescription
Correct Incorrect Correct answer

Correct

Incorrect
Question 350 of 792

350. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A prescription for morphine sulfate immediate-release tablets reads: “MS 15 mg PO q4h PRN pain.” A technician unfamiliar with the abbreviation “MS” selects magnesium sulfate 400 mg tablets from the shelf. Which error-prone abbreviation is the root cause of this near-miss?

The abbreviation "MS," which is on the ISMP List of Error-Prone Abbreviations because it can be confused with morphine sulfate or magnesium sulfate
Correct Incorrect Correct answer

The abbreviation "q4h," which should be written as every 4 hours to avoid misinterpretation
Correct Incorrect Correct answer

The abbreviation "PRN," which is ambiguous and should be spelled out as "as needed"
Correct Incorrect Correct answer

The abbreviation "PO," which could be confused with other routes of administration
Correct Incorrect Correct answer

Correct

Incorrect
Question 351 of 792

351. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

Under USP 795, a pharmacy compounds a non-sterile topical ointment using USP-grade ingredients with established stability data. The preparation is made with purified water as a component, and the pharmacy does not have preservative effectiveness testing for this specific formulation. What is the maximum beyond-use date (BUD) the pharmacy can assign to this aqueous preparation?

35 days when stored at controlled room temperature, unless stability data supports a longer dating
Correct Incorrect Correct answer

180 days because non-sterile compounding has no regulatory limit on beyond-use dating
Correct Incorrect Correct answer

14 days because all water-containing preparations must follow the same BUD as sterile compounding
Correct Incorrect Correct answer

90 days because USP-grade ingredients automatically qualify for extended dating
Correct Incorrect Correct answer

Correct

Incorrect
Question 352 of 792

352. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A hospital infection control audit reveals that pharmacy staff hand hygiene compliance in the IV room has dropped to 72% from the target of 95%. The most common violation is failure to perform hand hygiene before entering the buffer area. Which corrective action should be implemented first?

Post visual reminders at the entrance to the ante-area and buffer area and provide immediate real-time feedback to staff observed skipping hand hygiene
Correct Incorrect Correct answer

Schedule annual hand hygiene training for all pharmacy staff and monitor compliance at the next quarterly audit
Correct Incorrect Correct answer

Install motion-activated hand sanitizer dispensers in the buffer area to replace the need for handwashing
Correct Incorrect Correct answer

Restrict IV room access to pharmacists only until technician compliance returns to the target level
Correct Incorrect Correct answer

Correct

Incorrect
Question 353 of 792

353. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

During a USP 797 compliance inspection, an auditor observes a pharmacy technician in the buffer area wearing all required garbing except that the technician’s hair is partially exposed above the face mask. The technician is actively compounding a Category 1 CSP. What is the consequence of this garbing violation?

The CSP being prepared must be discarded, and the technician must re-garb completely before resuming any compounding activities
Correct Incorrect Correct answer

The violation can be documented but the CSP may be dispensed since low-risk preparations have a wide margin of safety
Correct Incorrect Correct answer

The technician can tuck the exposed hair under the hood and continue compounding without discarding the product
Correct Incorrect Correct answer

Only CSPs prepared for immunocompromised patients must be discarded; other products may be released
Correct Incorrect Correct answer

Correct

Incorrect
Question 354 of 792

354. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A sterile compounding pharmacy has a buffer area classified as ISO Class 5 with a primary engineering control (PEC) also rated ISO Class 5. Three additional technicians enter the buffer area to assist during a high-volume compounding period. What is the primary concern regarding air quality?

Each additional person in the buffer area introduces particulates and microorganisms that can degrade the ISO classification and increase contamination risk
Correct Incorrect Correct answer

Additional personnel have no impact on air quality as long as the HEPA filters are functioning properly
Correct Incorrect Correct answer

The ISO classification automatically adjusts upward when more personnel are present to compensate
Correct Incorrect Correct answer

Only personnel who are actively compounding affect air quality; observers do not generate significant particulates
Correct Incorrect Correct answer

Correct

Incorrect
Question 355 of 792

355. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is performing daily environmental monitoring and records the following conditions in the clean room: temperature 24 degrees Celsius (75.2 degrees Fahrenheit), humidity 63%. The facility’s USP 797 standard operating procedure requires temperature between 20 and 24 degrees Celsius and humidity below 60%. What should the technician do?

Document the out-of-range humidity reading, notify the pharmacist, and suspend compounding activities until the humidity is brought back within acceptable range
Correct Incorrect Correct answer

Continue compounding because the temperature is within range and humidity is only slightly above the limit
Correct Incorrect Correct answer

Adjust the thermostat to lower the temperature, which will automatically reduce humidity to within range
Correct Incorrect Correct answer

Record the readings and flag them for review at the next monthly quality meeting
Correct Incorrect Correct answer

Correct

Incorrect
Question 356 of 792

356. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A hospital pharmacy’s clean room layout includes an ante-area and a buffer area separated by a line of demarcation. A new technician asks why garbing must begin in the ante-area rather than in the buffer area. Which explanation best describes the rationale for this design requirement?

The ante-area serves as a transitional space where personnel perform hand hygiene, garbing, and staging activities to prevent introducing contaminants into the higher-classified buffer area
Correct Incorrect Correct answer

The ante-area is maintained at a higher ISO classification than the buffer area to protect garbing supplies from contamination
Correct Incorrect Correct answer

Garbing in the ante-area is a preference, not a requirement, and either location is acceptable under USP 797
Correct Incorrect Correct answer

The ante-area is the only location where sinks and non-shedding supplies can be stored because the buffer area prohibits all water sources
Correct Incorrect Correct answer

Correct

Incorrect
Question 357 of 792

357. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A technician opens a single-dose vial of fentanyl 100 mcg/2 mL for an IV preparation. After withdrawing the required dose, approximately 0.3 mL remains in the vial. The technician sets the open vial aside to use for the next patient’s preparation 30 minutes later. What is wrong with this practice?

Single-dose vials must be used for one patient only and discarded after the initial entry, regardless of remaining contents, to prevent contamination and cross-infection
Correct Incorrect Correct answer

Single-dose vials may be used for multiple patients within 6 hours of opening as long as they are stored properly
Correct Incorrect Correct answer

The remaining fentanyl can be used if the vial is swabbed with alcohol and a new needle is used for withdrawal
Correct Incorrect Correct answer

Only multi-dose vials have single-patient restrictions; single-dose vials have no specific usage limitations
Correct Incorrect Correct answer

Correct

Incorrect
Question 358 of 792

358. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician completes the garbing procedure and enters the buffer area. Five minutes later, the technician realizes they forgot to apply sterile gloves as the final garbing step. The technician has not yet touched the PEC or any compounding supplies but has touched the door handle and a cart in the buffer area. What is the correct course of action?

Exit the buffer area, return to the ante-area, perform hand hygiene again, apply sterile gloves, and then re-enter the buffer area
Correct Incorrect Correct answer

Apply sterile gloves immediately in the buffer area since no compounding supplies were contacted
Correct Incorrect Correct answer

Continue without sterile gloves since the inner pair of non-sterile gloves provides adequate protection for buffer area activities
Correct Incorrect Correct answer

Apply sterile gloves over the current gloves and wipe them with sterile 70% isopropyl alcohol before beginning compounding
Correct Incorrect Correct answer

Correct

Incorrect
Question 359 of 792

359. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy receives a multi-dose vial of insulin regular (10 mL, 100 units/mL) for use in the IV room. The vial is punctured for the first time on March 1 and dated accordingly. What is the maximum time this multi-dose vial may be used after the initial puncture, assuming it is stored according to manufacturer guidelines and no contamination is observed?

28 days from the date of initial puncture
Correct Incorrect Correct answer

7 days from the date of initial puncture
Correct Incorrect Correct answer

90 days from the date of initial puncture or until the manufacturer's expiration date, whichever comes first
Correct Incorrect Correct answer

The vial may be used until the manufacturer's printed expiration date regardless of when it was first punctured
Correct Incorrect Correct answer

Correct

Incorrect
Question 360 of 792

360. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A hospital pharmacy is evaluating the impact of a garbing compliance failure on the beyond-use dating of a batch of category 2 CSPs prepared under USP 797. During the batch preparation, one technician was found to have an improperly sealed hood that left a gap at the neckline. This was discovered after 12 of 24 preparations were completed. How should the pharmacy handle the 12 CSPs prepared during the garbing failure?

The 12 CSPs prepared during the garbing failure should be quarantined and not dispensed because the integrity of the controlled environment was compromised during their preparation
Correct Incorrect Correct answer

Assign a shortened BUD of 24 hours to the 12 CSPs and release them for immediate use only
Correct Incorrect Correct answer

Perform a visual inspection of the 12 CSPs and release those that appear clear and particulate-free
Correct Incorrect Correct answer

Send the 12 CSPs for sterility testing and release them if results come back negative within 14 days
Correct Incorrect Correct answer

Correct

Incorrect
Question 361 of 792

361. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A hospital pharmacy technician is preparing a heparin drip for a patient in the ICU. The order calls for heparin 25,000 units in 500 mL D5W. The technician has access to both heparin 1,000 units/mL vials and heparin 10,000 units/mL vials. Which safety practice is most important when selecting the correct vial?

Perform an independent double-check of the vial concentration and volume calculation before withdrawing heparin, as concentration mix-ups between heparin vials are a common source of fatal dosing errors
Correct Incorrect Correct answer

Select whichever vial requires the fewest number of vials to open, since minimizing waste is the primary safety concern with heparin preparation
Correct Incorrect Correct answer

Use only the 1,000 units/mL vial because the 10,000 units/mL concentration is restricted to cardiac surgery patients
Correct Incorrect Correct answer

Shake each vial vigorously before use to ensure the heparin is evenly distributed, as settling causes inconsistent dosing
Correct Incorrect Correct answer

Correct

Incorrect
Question 362 of 792

362. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is filling a prescription for warfarin and notices the pharmacy stocks warfarin tablets in multiple strengths, each with a different color. The prescription calls for warfarin 5 mg. Which color tablet corresponds to this strength, and why is color identification important for warfarin?

Warfarin 5 mg tablets are peach-colored; consistent color-coding across manufacturers helps patients and pharmacy staff identify the correct strength, reducing the risk of dispensing errors with this high-alert medication
Correct Incorrect Correct answer

Warfarin 5 mg tablets are blue; color coding is only used for aesthetic purposes and has no safety function
Correct Incorrect Correct answer

Warfarin 5 mg tablets are white; all warfarin strengths use the same white tablet and must be distinguished solely by imprint code
Correct Incorrect Correct answer

Warfarin 5 mg tablets are green; the color indicates the tablet is the extended-release formulation rather than immediate-release
Correct Incorrect Correct answer

Correct

Incorrect
Question 363 of 792

363. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician in a hospital pharmacy prepares an insulin infusion order for regular insulin 100 units in 100 mL normal saline (1 unit/mL) for a patient in diabetic ketoacidosis. The technician reaches for an insulin vial and selects U-500 regular insulin instead of U-100. If this error were not caught, what would be the consequence?

The patient would receive 5 times the intended insulin dose, causing severe life-threatening hypoglycemia, because U-500 contains 500 units per mL compared to U-100's 100 units per mL
Correct Incorrect Correct answer

The infusion would contain one-fifth the intended dose, causing persistent hyperglycemia and delayed DKA resolution
Correct Incorrect Correct answer

The U-500 insulin would precipitate in normal saline, clogging the IV tubing and preventing any insulin from reaching the patient
Correct Incorrect Correct answer

U-500 insulin has a different molecular structure than U-100, so it would be pharmacologically inactive when diluted in normal saline
Correct Incorrect Correct answer

Correct

Incorrect
Question 364 of 792

364. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is asked to restock the automated dispensing cabinet on the oncology floor with vincristine sulfate injection. The vial label states ‘For IV Use Only – Fatal If Given Intrathecally.’ What ISMP-recommended safety measure applies specifically to vincristine storage and preparation?

Vincristine should be dispensed in a small-volume IV bag (minibag) rather than a syringe to prevent accidental intrathecal administration, which is universally fatal
Correct Incorrect Correct answer

Vincristine must be stored in the refrigerator at all times and can only be removed for the 5 minutes needed to draw up each dose
Correct Incorrect Correct answer

Vincristine vials must be double-wrapped in light-protective foil because light exposure converts it to a neurotoxic isomer
Correct Incorrect Correct answer

Vincristine must be prepared in a biological safety cabinet using closed-system transfer devices to prevent aerosolization
Correct Incorrect Correct answer

Correct

Incorrect
Question 365 of 792

365. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A hospital pharmacy implements a new policy requiring independent double-checks for all neuromuscular blocking agents before dispensing. A pharmacy technician asks why these drugs require extra verification compared to other injectable medications. What is the primary safety rationale?

Neuromuscular blocking agents such as succinylcholine and vecuronium cause complete respiratory paralysis, and accidental administration to an unventilated patient results in death within minutes
Correct Incorrect Correct answer

Neuromuscular blocking agents are controlled substances with high diversion potential, requiring the same verification as Schedule II drugs
Correct Incorrect Correct answer

These agents degrade rapidly at room temperature, so double-checks ensure the medication has not expired or lost potency
Correct Incorrect Correct answer

Neuromuscular blocking agents cause irreversible nerve damage if injected into the wrong muscle group during surgery
Correct Incorrect Correct answer

Correct

Incorrect
Question 366 of 792

366. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician filling a prescription for hydroxyzine pamoate 25 mg capsules accidentally selects hydralazine 25 mg tablets from an adjacent shelf location. What strategy best prevents this type of look-alike/sound-alike (LASA) medication error?

Use tall-man lettering on shelf labels and in computer systems (hydrOXYzine vs. hydrALAZINE) and separate these medications physically on the shelf to reduce visual confusion
Correct Incorrect Correct answer

Store both medications in the same bin with a divider labeled with the generic name to keep them organized together for easy comparison
Correct Incorrect Correct answer

Rely solely on the NDC barcode scan at point of sale, since barcode scanning eliminates all possible selection errors
Correct Incorrect Correct answer

Color-code the shelf labels so all medications starting with 'hydr-' are marked with the same color for quick identification
Correct Incorrect Correct answer

Correct

Incorrect
Question 367 of 792

367. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician receives a verbal order relayed by a nurse for ‘Celebrex 200 mg daily.’ The technician enters celecoxib into the system. However, the nurse later clarifies the physician actually said ‘Cerebyx.’ What makes this LASA pair particularly dangerous, and what process failure occurred?

Celebrex (celecoxib) is an oral NSAID while Cerebyx (fosphenytoin) is an injectable antiepileptic; the error occurred because verbal orders are prone to phonetic confusion between sound-alike names, and a read-back was not performed
Correct Incorrect Correct answer

Both drugs have the same mechanism of action but different routes, so the error would cause a mild dosing issue but no significant harm
Correct Incorrect Correct answer

The error is minor because both drugs are available as oral tablets at the same strength and have similar side effect profiles
Correct Incorrect Correct answer

The nurse should have spelled the drug name rather than pronouncing it, since pharmacy technicians are not trained to recognize brand names
Correct Incorrect Correct answer

Correct

Incorrect
Question 368 of 792

368. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A community pharmacy technician is filling a prescription for predniSONE 10 mg tablets. The pharmacy’s computer system displays the name with tall-man lettering. What other medication in the pharmacy’s inventory does this tall-man formatting help distinguish predniSONE from?

PrednisoLONE, a related but distinct corticosteroid with different potency, available forms, and indications that can cause dosing errors if confused with prednisone
Correct Incorrect Correct answer

Promethazine, an antihistamine that sounds similar when spoken quickly and is stored in the same section of the pharmacy
Correct Incorrect Correct answer

Propranolol, a beta-blocker that has a similar three-syllable pattern and is commonly confused during verbal orders
Correct Incorrect Correct answer

Primidone, an anticonvulsant with a similar prefix that is frequently misfiled next to prednisone on pharmacy shelves
Correct Incorrect Correct answer

Correct

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Question 369 of 792

369. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A hospital pharmacy technician restocking an automated dispensing cabinet places metFORMIN 500 mg tablets into a pocket labeled for metroNIDAZOLE 500 mg. The error is not caught, and a nurse administers ‘metronidazole’ from the cabinet to a patient being treated for a C. difficile infection. What are the potential consequences of this LASA stocking error?

The patient receives a diabetes medication instead of the intended antibiotic, resulting in treatment failure for the C. difficile infection and potential hypoglycemia in a non-diabetic patient
Correct Incorrect Correct answer

The consequences are minimal because both medications treat gastrointestinal conditions and have overlapping therapeutic effects
Correct Incorrect Correct answer

The patient will experience an allergic cross-reaction because metformin and metronidazole share a common chemical backbone
Correct Incorrect Correct answer

The automated dispensing cabinet will automatically reject the incorrect medication through built-in weight-sensing technology
Correct Incorrect Correct answer

Correct

Incorrect
Question 370 of 792

370. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician is entering a prescription that uses the abbreviation ‘QD’ for the dosing frequency. According to the ISMP List of Error-Prone Abbreviations, why should this abbreviation not be used, and what is the preferred alternative?

QD can be misread as QID (four times daily) or QOD (every other day), leading to a fourfold overdose or underdose; the preferred wording is 'daily'
Correct Incorrect Correct answer

QD is a valid abbreviation that is universally understood; it does not appear on any error-prone abbreviation list
Correct Incorrect Correct answer

QD stands for 'quantity dispensed' in pharmacy software systems, creating confusion with billing rather than dosing
Correct Incorrect Correct answer

QD is only problematic in pediatric prescriptions; it is acceptable for adult patients without any risk of misinterpretation
Correct Incorrect Correct answer

Correct

Incorrect
Question 371 of 792

371. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician scans the barcode on a medication bottle during the filling process and the system displays a mismatch warning between the scanned product and the product entered in the prescription. What should the technician do?

Stop the filling process, re-verify the medication selected against the prescription, and resolve the discrepancy before proceeding, as barcode scanning is a critical error-prevention checkpoint
Correct Incorrect Correct answer

Override the warning and continue filling because barcode scanner errors are common and typically caused by damaged barcodes
Correct Incorrect Correct answer

Replace the barcode label on the bottle with the correct barcode from the pharmacy's label printer to match the prescription
Correct Incorrect Correct answer

Complete the fill and document the barcode mismatch in the pharmacy log for monthly quality review
Correct Incorrect Correct answer

Correct

Incorrect
Question 372 of 792

372. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A community pharmacy experiences a medication error where a patient received methotrexate 2.5 mg daily instead of weekly. During the root cause analysis, the team identifies that the prescription said ‘take one tablet daily’ but the prescriber intended weekly dosing. Which error-prevention strategy would most effectively prevent this specific type of error in the future?

Implement a clinical decision support alert that flags methotrexate prescribed at a frequency greater than weekly, since daily methotrexate dosing for non-oncologic indications is a known fatal error pattern
Correct Incorrect Correct answer

Require all methotrexate prescriptions to be filled using unit-dose packaging to limit the quantity dispensed per visit
Correct Incorrect Correct answer

Remove methotrexate from the pharmacy formulary entirely and substitute it with a safer alternative for all patients
Correct Incorrect Correct answer

Train patients to verify their own dosing schedule against an online drug database before taking each dose
Correct Incorrect Correct answer

Correct

Incorrect
Question 373 of 792

373. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician notices a prescription written for a pediatric patient that uses a trailing zero: ‘amoxicillin 5.0 mL three times daily.’ According to error-prone notation guidelines, why is the trailing zero a safety concern?

A trailing zero after a decimal point can be misread as 50 mL if the decimal point is not clearly visible, resulting in a tenfold overdose
Correct Incorrect Correct answer

Trailing zeros indicate the prescriber is uncertain about the dose and wants the pharmacist to round to the nearest whole number
Correct Incorrect Correct answer

Trailing zeros are only problematic for injectable medications and do not pose a risk for oral liquid formulations
Correct Incorrect Correct answer

The trailing zero means the dose should be measured using a different calibrated device than what is normally used
Correct Incorrect Correct answer

Correct

Incorrect
Question 374 of 792

374. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A hospital pharmacy conducts a failure mode and effects analysis (FMEA) on their chemotherapy preparation process. The team identifies that vial selection for look-alike products is a high-risk failure point. Which intervention represents the strongest type of error-prevention strategy according to safety science principles?

Implement forced-function technology such as barcode-scanning vial verification that physically prevents preparation from proceeding if the wrong vial is scanned
Correct Incorrect Correct answer

Post warning signs in the clean room reminding staff to double-check vials before use
Correct Incorrect Correct answer

Add a line item to the preparation checklist requiring staff to initial that they verified the vial
Correct Incorrect Correct answer

Conduct monthly in-service training sessions on the importance of careful vial selection during preparation
Correct Incorrect Correct answer

Correct

Incorrect
Question 375 of 792

375. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician is asked to prepare a prescription label. The prescription reads ‘Lisinopril 10mg, 1 tab PO QAM.’ To reduce the risk of misinterpretation, how should the technician enter the directions on the pharmacy label?

Write the directions in full as 'Take 1 tablet by mouth every morning' to eliminate abbreviations that could be misread by the patient or caregiver
Correct Incorrect Correct answer

Enter the directions exactly as written on the prescription using the abbreviations 'PO QAM' since patients are expected to understand standard pharmacy abbreviations
Correct Incorrect Correct answer

Write 'Take 1 tab orally once daily' and add the abbreviation 'QAM' in parentheses for prescriber reference
Correct Incorrect Correct answer

Translate only the route abbreviation and leave the frequency as 'QAM' since morning dosing abbreviations are universally understood
Correct Incorrect Correct answer

Correct

Incorrect
Question 376 of 792

376. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician enters a new prescription for amoxicillin 500 mg for a patient whose allergy profile lists a penicillin allergy with a documented reaction of anaphylaxis. The computer system generates a severe allergy alert. What is the appropriate action?

Stop processing the prescription and immediately notify the pharmacist, as amoxicillin is a penicillin-type antibiotic and the patient has a documented history of penicillin anaphylaxis
Correct Incorrect Correct answer

Override the allergy alert because amoxicillin and penicillin are different antibiotics with no cross-reactivity
Correct Incorrect Correct answer

Dispense the amoxicillin with a note to the patient to take diphenhydramine 30 minutes before each dose as a precaution
Correct Incorrect Correct answer

Change the prescription to amoxicillin-clavulanate, which does not trigger penicillin allergy due to the clavulanate component
Correct Incorrect Correct answer

Correct

Incorrect
Question 377 of 792

377. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician reviews a prescription for gentamicin 500 mg IV every 8 hours for a 70 kg adult patient with normal renal function. The technician calculates this as approximately 7.1 mg/kg/dose. Knowing that standard gentamicin dosing for traditional dosing is 1 to 2.5 mg/kg/dose, why should the technician flag this for pharmacist intervention?

The prescribed dose of 7.1 mg/kg per dose given three times daily far exceeds standard traditional dosing parameters and could cause nephrotoxicity and ototoxicity
Correct Incorrect Correct answer

The dose is appropriate for extended-interval dosing, so no pharmacist intervention is needed
Correct Incorrect Correct answer

Gentamicin dosing is weight-independent in adults, so the mg/kg calculation is irrelevant
Correct Incorrect Correct answer

The dose is too low for gentamicin and needs to be increased to achieve bactericidal concentrations
Correct Incorrect Correct answer

Correct

Incorrect
Question 378 of 792

378. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician processing a prescription for a 4-year-old child notices the prescribed dose of azithromycin is 500 mg daily for 3 days. The child weighs 18 kg. Standard pediatric azithromycin dosing is 10 mg/kg on day 1 followed by 5 mg/kg on days 2 through 5. What should the technician do?

Alert the pharmacist because the prescribed dose of 500 mg is significantly higher than the weight-based dose of 180 mg for day 1 and 90 mg for subsequent days, suggesting an adult dose was prescribed for a child
Correct Incorrect Correct answer

Fill the prescription as written because azithromycin has a wide safety margin and overdosing in children is not clinically significant
Correct Incorrect Correct answer

Reduce the dose to 250 mg on their own, since this is closer to the correct dose and pharmacist involvement is not required for dose adjustments
Correct Incorrect Correct answer

Dispense the 500 mg dose because the Z-pack is a standard regimen that applies equally to adults and children
Correct Incorrect Correct answer

Correct

Incorrect
Question 379 of 792

379. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A long-term care pharmacy technician processes monthly medication refills and notices that a patient’s profile shows no record of an INR check in over 6 weeks. The patient is on warfarin 7.5 mg daily. What should the technician do?

Flag the prescription for pharmacist review, as warfarin requires regular INR monitoring and the absence of recent lab results may indicate a lapse in required therapeutic monitoring
Correct Incorrect Correct answer

Refill the warfarin automatically since the prescription is still active and the nursing facility is responsible for lab monitoring
Correct Incorrect Correct answer

Hold the warfarin refill until an INR result is provided, documenting the hold in the dispensing system without notifying anyone
Correct Incorrect Correct answer

Contact the nursing facility directly to request the lab results before involving the pharmacist in the decision
Correct Incorrect Correct answer

Correct

Incorrect
Question 380 of 792

380. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician receives a prescription for a patient requesting a refill of their oral contraceptive. While reviewing the profile, the technician sees that the patient was recently started on rifampin 600 mg daily for latent tuberculosis by a different provider. Why should the technician flag this for pharmacist intervention?

Rifampin is a potent CYP3A4 inducer that significantly reduces the effectiveness of hormonal contraceptives, placing the patient at risk for unintended pregnancy
Correct Incorrect Correct answer

Rifampin causes the oral contraceptive to accumulate to toxic levels by inhibiting its hepatic metabolism
Correct Incorrect Correct answer

Oral contraceptives reduce rifampin absorption, making the tuberculosis treatment ineffective
Correct Incorrect Correct answer

Both medications are hepatotoxic, and their combination is absolutely contraindicated under all circumstances
Correct Incorrect Correct answer

Correct

Incorrect
Question 381 of 792

381. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician dispenses the correct medication to a patient, but later realizes the label printed with the wrong directions: ‘Take 2 tablets twice daily’ instead of ‘Take 1 tablet twice daily.’ The patient has not yet taken any doses. How should this near-miss event be handled?

Report the near-miss through the pharmacy's internal event reporting system and contact the patient immediately to correct the label, as near-miss reports help identify system weaknesses before patient harm occurs
Correct Incorrect Correct answer

Since no harm occurred, documenting the event is unnecessary and the technician should simply correct the label at the patient's next refill
Correct Incorrect Correct answer

File the report only if the patient took the wrong dose; near-misses that are caught before reaching the patient do not require documentation
Correct Incorrect Correct answer

Report the event directly to the state board of pharmacy as a mandatory error disclosure before contacting the patient
Correct Incorrect Correct answer

Correct

Incorrect
Question 382 of 792

382. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A hospital pharmacy implements a new voluntary medication error reporting system. In the first quarter, reports increase by 300%. The pharmacy director considers this a positive outcome. Some staff members worry this reflects worsening safety. Which interpretation is more consistent with patient safety science?

Increased reporting typically indicates a healthier safety culture where staff feel comfortable reporting errors without fear of punishment, providing more data to improve systems
Correct Incorrect Correct answer

A 300% increase in reports definitively proves that medication errors are occurring more frequently due to staffing shortages
Correct Incorrect Correct answer

The increase means the new system is generating false reports and needs to be recalibrated to filter out non-significant events
Correct Incorrect Correct answer

Higher reporting rates always correlate with higher patient harm rates, so the hospital should be placed on a performance improvement plan
Correct Incorrect Correct answer

Correct

Incorrect
Question 383 of 792

383. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician witnesses a dispensing error where a patient received the wrong strength of a blood pressure medication. The pharmacist catches the error when the patient returns for a refill one month later. The pharmacist asks the technician to help complete a medication error report. Which external reporting program accepts voluntary medication error reports from pharmacy professionals?

The ISMP Medication Errors Reporting Program (MERP), which collects voluntary reports from healthcare professionals to identify national safety trends and issue alerts
Correct Incorrect Correct answer

The DEA Diversion Reporting Hotline, which tracks all medication errors involving any prescription drug
Correct Incorrect Correct answer

The CMS Hospital Compare database, which requires pharmacies to self-report all dispensing errors for public transparency
Correct Incorrect Correct answer

The USP Compounding Incident Registry, which collects reports exclusively about errors in medication compounding
Correct Incorrect Correct answer

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Incorrect
Question 384 of 792

384. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician completes a medication error report after an incorrect quantity was dispensed. The report form asks for contributing factors. The technician felt rushed due to high prescription volume during the lunch rush. Which element is most important to include in the report?

The system and environmental factors such as high workload, understaffing, time pressure, and any interruptions that contributed to the error, rather than focusing blame on individual performance
Correct Incorrect Correct answer

The name of the specific technician who made the error so management can assign individual corrective action and retraining
Correct Incorrect Correct answer

A recommendation to terminate the technician responsible, since accountability requires consequences for every error
Correct Incorrect Correct answer

Only the drug name and quantity discrepancy, because contributing factors are irrelevant to the reporting process
Correct Incorrect Correct answer

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Incorrect
Question 385 of 792

385. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician discovers that a compounded sterile preparation was made using an expired ingredient 3 days ago and has already been administered to multiple patients. None of the patients have reported adverse effects yet. Under what circumstances does this event require reporting to external agencies beyond the pharmacy’s internal system?

If any patient experiences an adverse effect from the preparation, it must be reported to the FDA through MedWatch; additionally, state board of pharmacy regulations may require mandatory reporting of the compounding deviation regardless of patient outcome
Correct Incorrect Correct answer

External reporting is only required if a patient dies; adverse effects that are non-fatal are handled exclusively through internal quality processes
Correct Incorrect Correct answer

The event does not require external reporting since the expired ingredient was used unintentionally and no federal law mandates reporting of compounding errors
Correct Incorrect Correct answer

Only the ingredient manufacturer is required to report the issue to the FDA; the pharmacy has no independent reporting obligation
Correct Incorrect Correct answer

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Incorrect
Question 386 of 792

386. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician receives a handwritten prescription for ‘Norvasc 10 mg daily.’ The technician reads the prescriber’s handwriting and initially interprets the drug name as ‘Navane.’ Before entering the prescription, the technician reconsiders. What type of prescription error risk does this scenario illustrate?

Illegible handwriting on prescriptions can cause drug name misinterpretation; Norvasc (amlodipine, an antihypertensive) and Navane (thiothixene, an antipsychotic) are different drugs with vastly different indications and side effects
Correct Incorrect Correct answer

This scenario only represents a documentation error, since both Norvasc and Navane are antihypertensives with similar safety profiles
Correct Incorrect Correct answer

Handwriting legibility is not a recognized cause of prescription errors because pharmacy software automatically corrects drug name entries
Correct Incorrect Correct answer

The technician misread the prescription due to lack of brand name familiarity, not due to actual handwriting similarity
Correct Incorrect Correct answer

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Incorrect
Question 387 of 792

387. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician receives an electronic prescription for ‘methadone 40 mg PO QID’ for a patient with chronic back pain. The patient has no prior opioid prescriptions in the state PDMP. What multiple prescription error indicators should prompt the technician to flag this for pharmacist review?

The combination of a high initial methadone dose (160 mg/day), QID frequency unusual for methadone pain management, and no prior opioid history suggests a potentially dangerous prescribing error or diversion attempt
Correct Incorrect Correct answer

The prescription is appropriate because methadone for pain is typically started at higher doses than methadone for opioid use disorder
Correct Incorrect Correct answer

Only the lack of PDMP history is concerning; the dose and frequency are within standard parameters for chronic pain patients
Correct Incorrect Correct answer

The technician should not question electronic prescriptions because e-prescribing systems prevent all dosing errors automatically
Correct Incorrect Correct answer

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Incorrect
Question 388 of 792

388. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician notices that a prescription for a 90-year-old patient includes glyburide 10 mg daily for type 2 diabetes. The American Geriatrics Society Beers Criteria lists glyburide as potentially inappropriate for elderly patients. What should the technician do?

Bring this to the pharmacist's attention so the pharmacist can evaluate whether an alternative sulfonylurea or antidiabetic agent with lower hypoglycemia risk would be more appropriate for this elderly patient
Correct Incorrect Correct answer

Dispense the prescription without comment because age alone does not affect drug selection for diabetes medications
Correct Incorrect Correct answer

Substitute glipizide for glyburide automatically since the technician recognizes them as the same drug class
Correct Incorrect Correct answer

Refuse to fill the prescription and inform the patient that glyburide is banned for use in patients over age 65
Correct Incorrect Correct answer

Correct

Incorrect
Question 389 of 792

389. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician receives a prescription for ‘Zantac 150 mg BID’ for a patient with GERD. The technician searches the pharmacy system and finds that ranitidine products were withdrawn from the US market in 2020. What type of prescribing error does this represent, and what should the technician do?

This represents a prescribing error involving a withdrawn product; the technician should alert the pharmacist so the prescriber can be contacted to select an available alternative such as famotidine
Correct Incorrect Correct answer

The technician should dispense a generic ranitidine product since only the brand Zantac was withdrawn, not the generic versions
Correct Incorrect Correct answer

The technician should substitute omeprazole 20 mg automatically since it treats the same condition and is widely available
Correct Incorrect Correct answer

This is a formulary issue rather than a prescribing error, and the technician should process the prescription using a therapeutic alternative without prescriber contact
Correct Incorrect Correct answer

Correct

Incorrect
Question 390 of 792

390. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician receives an e-prescription for ciprofloxacin 500 mg twice daily for 10 days. The patient’s profile shows the patient is a 16-year-old. The technician should flag this for review because of which concern?

Fluoroquinolones carry warnings against routine use in pediatric patients under 18 due to the risk of musculoskeletal adverse effects including tendon, joint, and cartilage damage
Correct Incorrect Correct answer

Ciprofloxacin is not available in a pediatric-friendly dosage form, so only liquid formulations can be prescribed for patients under 18
Correct Incorrect Correct answer

Ciprofloxacin has no antibacterial activity against pathogens commonly found in adolescent patients
Correct Incorrect Correct answer

The 500 mg dose exceeds the maximum pediatric dose of 250 mg regardless of the patient's weight or age
Correct Incorrect Correct answer

Correct

Incorrect
Question 391 of 792

391. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is preparing to compound a sterile IV admixture in the clean room. Before entering the ISO Class 5 primary engineering control (laminar airflow workbench), the technician must perform proper hand hygiene and garbing. What is the correct order for donning personal protective equipment?

Remove jewelry, perform hand hygiene with antimicrobial soap, don shoe covers, hair cover, face mask, and nonshedding gown, then perform antiseptic hand cleansing and don sterile gloves last
Correct Incorrect Correct answer

Don sterile gloves first to protect the hands, then put on the gown, mask, hair cover, and shoe covers in any order
Correct Incorrect Correct answer

Put on the gown first, then gloves, mask, and hair cover; shoe covers are optional for ISO Class 5 environments
Correct Incorrect Correct answer

Perform hand hygiene, don sterile gloves, then put on the gown over the gloves to maintain glove sterility during garbing
Correct Incorrect Correct answer

Correct

Incorrect
Question 392 of 792

392. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is compounding a total parenteral nutrition (TPN) solution in the laminar airflow hood. The technician notices that the HEPA filter certification tag shows the last certification was 14 months ago. USP 797 requires HEPA filter certification every 6 months. What implication does this lapsed certification have?

All sterile compounds prepared in this hood since the certification lapsed may not meet sterility assurance standards, and compounding must stop until the HEPA filter is recertified to ensure the ISO Class 5 environment is maintained
Correct Incorrect Correct answer

The hood can continue to be used if the technician performs a visual inspection and confirms there is no visible damage to the HEPA filter
Correct Incorrect Correct answer

HEPA filter recertification is recommended but not mandatory, so compounding can continue as long as cleaning protocols are followed
Correct Incorrect Correct answer

Only hazardous drug compounding requires current HEPA certification; non-hazardous sterile compounding can proceed with an expired certification
Correct Incorrect Correct answer

Correct

Incorrect
Question 393 of 792

393. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician preparing a compounded sterile preparation swabs the rubber stopper of a medication vial with 70% isopropyl alcohol. How long should the technician wait before puncturing the stopper with a needle?

Allow the alcohol to dry completely, which typically takes at least 10 seconds, because wet alcohol can carry contaminants through the needle puncture and into the vial
Correct Incorrect Correct answer

Puncture the stopper immediately while the alcohol is still wet, since the liquid alcohol provides a continuous antibacterial barrier during needle insertion
Correct Incorrect Correct answer

Wait exactly 60 seconds after swabbing, then wipe the stopper dry with a sterile gauze pad before needle insertion
Correct Incorrect Correct answer

No waiting time is required because the physical act of swabbing mechanically removes all microorganisms regardless of alcohol contact time
Correct Incorrect Correct answer

Correct

Incorrect
Question 394 of 792

394. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A hospital pharmacy technician is asked to restock single-dose vials of normal saline flush syringes for the nursing units. The technician finds several opened single-dose vials in the medication preparation area with remaining contents. According to USP 797 and CDC guidelines, what should be done with these opened single-dose vials?

Discard all opened single-dose vials because they do not contain preservatives, and once opened, they must be used within the immediate timeframe specified or discarded to prevent microbial contamination
Correct Incorrect Correct answer

Return the opened vials to the pharmacy for use in compounding since the contents are still sterile if the vial was opened within the last 24 hours
Correct Incorrect Correct answer

Label each opened vial with the date and time it was opened and allow use for up to 7 days if stored in the refrigerator
Correct Incorrect Correct answer

Combine the remaining contents from multiple opened vials into a single sterile container to minimize waste
Correct Incorrect Correct answer

Correct

Incorrect
Question 395 of 792

395. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician performing a media fill test during their annual competency assessment observes turbidity (cloudiness) in the growth media after the required incubation period. What does this result indicate, and what action is required?

Turbidity indicates microbial growth, meaning the technician's aseptic technique failed during the simulation; the technician must undergo retraining and pass a repeat media fill before resuming sterile compounding
Correct Incorrect Correct answer

Turbidity is a normal result of the incubation process and indicates the media is functioning properly for the test
Correct Incorrect Correct answer

Turbidity means the growth media expired before the test, and a new media fill should be performed with fresh media
Correct Incorrect Correct answer

Turbidity only fails the test if colony-forming units exceed 100 per plate; mild cloudiness is within acceptable limits
Correct Incorrect Correct answer

Correct

Incorrect
Question 396 of 792

396. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A hospital pharmacy technician is preparing an insulin drip for a critically ill patient. Why does ISMP classify insulin as a high-alert medication?

Errors involving insulin can cause severe hypoglycemia or hyperglycemia, leading to seizures, coma, or death
Correct Incorrect Correct answer

Insulin is classified as high-alert solely because it requires refrigerated storage
Correct Incorrect Correct answer

Insulin is high-alert because it is a controlled substance with abuse potential
Correct Incorrect Correct answer

Insulin only qualifies as high-alert when administered intravenously, not subcutaneously
Correct Incorrect Correct answer

Correct

Incorrect
Question 397 of 792

397. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is helping develop a high-alert medication protocol for a new community pharmacy. The pharmacist asks which ISMP-listed high-alert medication class poses the greatest risk in the outpatient setting. Which class is most appropriate to prioritize?

Oral anticoagulants such as warfarin, due to narrow therapeutic index and high rates of adverse drug events in ambulatory patients
Correct Incorrect Correct answer

Neuromuscular blocking agents, which cause respiratory paralysis if given incorrectly
Correct Incorrect Correct answer

Cardioplegic solutions used during cardiac surgery
Correct Incorrect Correct answer

Dialysis solutions, which can cause fatal electrolyte imbalances
Correct Incorrect Correct answer

Correct

Incorrect
Question 398 of 792

398. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A technician in a hospital pharmacy is asked to prepare a concentrated potassium chloride 2 mEq/mL IV solution. What safety concern makes concentrated electrolytes a high-alert category?

Undiluted or improperly diluted concentrated potassium chloride given IV can cause fatal cardiac arrhythmias
Correct Incorrect Correct answer

Concentrated electrolytes are high-alert only because they require special storage temperatures
Correct Incorrect Correct answer

Potassium chloride solutions are high-alert because they have a short beyond-use date after preparation
Correct Incorrect Correct answer

Concentrated electrolytes are classified as high-alert solely due to their high cost
Correct Incorrect Correct answer

Correct

Incorrect
Question 399 of 792

399. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pediatric hospital pharmacy implements an independent double-check process for certain medications. A technician asks why heparin is included. Which historical incident demonstrated the critical importance of heparin safety checks in pediatrics?

Cases of neonatal deaths from accidental administration of adult-strength heparin (10,000 units/mL) instead of the pediatric flush concentration (10 units/mL)
Correct Incorrect Correct answer

A recall of all heparin products due to contamination with oversulfated chondroitin sulfate
Correct Incorrect Correct answer

Widespread allergic reactions to heparin preservatives in premature infants
Correct Incorrect Correct answer

Reports of heparin interacting with phototherapy lights used in neonatal units
Correct Incorrect Correct answer

Correct

Incorrect
Question 400 of 792

400. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A technician is filling a prescription for hydroxyzine 25 mg and reaches for a bottle labeled hydralazine 25 mg from an adjacent shelf location. What type of medication safety issue does this represent?

A look-alike/sound-alike (LASA) error, as hydroxyzine and hydralazine have similar names and strengths but completely different indications
Correct Incorrect Correct answer

A therapeutic duplication since both medications treat the same condition
Correct Incorrect Correct answer

A dosage form error since both come in the same tablet strength
Correct Incorrect Correct answer

A dispensing error caused by alphabetical shelving, which is not a recognized safety concern
Correct Incorrect Correct answer

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Question 401 of 792

401. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A hospital pharmacy uses tall man lettering on shelf labels. The label reads ‘vinCRIStine.’ Why is it critical to distinguish this medication from vinBLAStine?

VinCRIStine is administered IV push while vinBLAStine can be given via different routes; additionally, administering vinCRIStine intrathecally is fatal
Correct Incorrect Correct answer

VinCRIStine and vinBLAStine treat different cancer types but have identical side effect profiles
Correct Incorrect Correct answer

VinBLAStine requires refrigeration while vinCRIStine is stored at room temperature
Correct Incorrect Correct answer

VinCRIStine costs significantly more, so a mix-up would cause financial loss to the hospital
Correct Incorrect Correct answer

Correct

Incorrect
Question 402 of 792

402. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician is organizing inventory and notices predniSONE 10 mg and prednisoLONE 10 mg stored next to each other. What strategy best reduces the risk of a LASA dispensing error?

Separate the two products physically on the shelf and use tall man lettering on shelf labels and bin tags
Correct Incorrect Correct answer

Store both products together alphabetically since they are in the same drug class
Correct Incorrect Correct answer

Discontinue stocking one of the two products entirely
Correct Incorrect Correct answer

Rely on barcode scanning at the point of sale as the sole safeguard
Correct Incorrect Correct answer

Correct

Incorrect
Question 403 of 792

403. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A technician fills a prescription for clonidine 0.1 mg but accidentally selects clonazepam 0.5 mg from the shelf. The pharmacist catches the error during verification. What LASA prevention strategy would have most likely prevented this selection error?

Using barcode scanning at the point of selection to verify the correct NDC before counting
Correct Incorrect Correct answer

Storing both medications in the same section with warning labels
Correct Incorrect Correct answer

Having the technician memorize the physical appearance of every tablet in the pharmacy
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Requiring the technician to read the label out loud before each fill
Correct Incorrect Correct answer

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Incorrect
Question 404 of 792

404. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A mail-order pharmacy dispenses both metFORMIN and metroNIDAZOLE. A root cause analysis reveals that three LASA near-misses occurred in one month between these medications. Which combination of system improvements would be most effective?

Implementing automated dispensing with barcode verification, tall man lettering on all labels, and physical bin separation
Correct Incorrect Correct answer

Sending a memo to all technicians reminding them to be more careful
Correct Incorrect Correct answer

Changing the font size on all bottle labels to a larger format
Correct Incorrect Correct answer

Restricting dispensing of both medications to pharmacists only
Correct Incorrect Correct answer

Correct

Incorrect
Question 405 of 792

405. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy implements a policy requiring technicians to verify medications at three points during dispensing: selection, counting, and bagging. What error prevention principle does this represent?

Redundant verification checkpoints that create multiple opportunities to catch errors before reaching the patient
Correct Incorrect Correct answer

A single-check system designed to speed up the dispensing workflow
Correct Incorrect Correct answer

A documentation requirement with no impact on error prevention
Correct Incorrect Correct answer

A regulatory mandate required by federal law for all pharmacies
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Incorrect
Question 406 of 792

406. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A hospital pharmacy’s error data shows that most dispensing errors occur during evening shift changes. The pharmacy director asks the technician team for improvement suggestions. Which intervention addresses the root cause most effectively?

Implementing a structured shift handoff protocol that includes verification of pending orders and incomplete tasks
Correct Incorrect Correct answer

Requiring all prescriptions to be held until the morning shift arrives
Correct Incorrect Correct answer

Adding overtime hours so that evening shift technicians are less rushed
Correct Incorrect Correct answer

Installing brighter lighting in the dispensing area during evening hours
Correct Incorrect Correct answer

Correct

Incorrect
Question 407 of 792

407. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A community pharmacy technician is trained to place a physical marker between counted tablets when filling a prescription to verify the count before capping the vial. What type of error prevention strategy is this?

A verification checkpoint that helps the technician confirm the count is accurate before proceeding
Correct Incorrect Correct answer

A forcing function that makes it physically impossible to dispense the wrong quantity
Correct Incorrect Correct answer

A documentation requirement for pharmacy accreditation purposes only
Correct Incorrect Correct answer

A cost-saving measure to reduce medication waste from overcounting
Correct Incorrect Correct answer

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Incorrect
Question 408 of 792

408. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy has implemented a policy that requires technicians to write the quantity counted and their initials on the prescription label before passing it to the pharmacist for verification. What safety principle does this support?

Individual accountability and documentation that allows tracing of errors to specific process steps for quality improvement
Correct Incorrect Correct answer

Legal protection for the pharmacy against malpractice lawsuits
Correct Incorrect Correct answer

A marketing strategy to demonstrate quality to patients
Correct Incorrect Correct answer

Compliance with insurance company auditing requirements only
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Incorrect
Question 409 of 792

409. Question

Category: Patient Safety and Quality Assurance: Error Prevention

After a dispensing error involving the wrong concentration of a pediatric antibiotic suspension, the pharmacy conducts a root cause analysis. The investigation reveals the technician selected the correct drug but the wrong concentration (250 mg/5 mL instead of 125 mg/5 mL). What system change would most effectively prevent recurrence?

Separating different concentrations of the same medication into distinct storage locations with prominent concentration labels
Correct Incorrect Correct answer

Requiring all technicians to complete an additional pharmacy degree
Correct Incorrect Correct answer

Banning all liquid medications from the pharmacy inventory
Correct Incorrect Correct answer

Assigning one technician exclusively to pediatric prescriptions at all times
Correct Incorrect Correct answer

Correct

Incorrect
Question 410 of 792

410. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician enters a new prescription for amoxicillin 500 mg TID for a patient whose allergy profile lists penicillin as causing anaphylaxis. What type of pharmacist intervention is needed?

Allergy intervention, as amoxicillin is a penicillin-type antibiotic contraindicated in patients with penicillin anaphylaxis
Correct Incorrect Correct answer

Drug interaction intervention since amoxicillin interacts with the allergen
Correct Incorrect Correct answer

Therapeutic substitution to a higher dose of amoxicillin that bypasses the allergy
Correct Incorrect Correct answer

No intervention is needed since amoxicillin is not identical to penicillin
Correct Incorrect Correct answer

Correct

Incorrect
Question 411 of 792

411. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician processes a prescription for azithromycin 250 mg (Z-pack) for a patient whose profile shows a QTc interval of 520 ms documented by their cardiologist. Why should this prompt a pharmacist intervention?

Azithromycin can prolong the QT interval, and a baseline QTc above 500 ms significantly increases the risk of fatal cardiac arrhythmias
Correct Incorrect Correct answer

Azithromycin is contraindicated in all patients with any cardiac history regardless of QTc
Correct Incorrect Correct answer

The Z-pack dosing schedule is incorrect for patients with cardiac conditions
Correct Incorrect Correct answer

Azithromycin requires dose adjustment in patients with QTc prolongation
Correct Incorrect Correct answer

Correct

Incorrect
Question 412 of 792

412. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician receives a prescription for metformin 1000 mg BID for a patient whose profile shows a recent serum creatinine of 2.8 mg/dL and an eGFR of 22 mL/min. What pharmacist intervention is warranted?

Metformin is contraindicated when eGFR falls below 30 mL/min due to increased risk of lactic acidosis
Correct Incorrect Correct answer

Metformin requires a dose increase when kidney function declines to maintain efficacy
Correct Incorrect Correct answer

Metformin should be switched to the extended-release formulation for patients with low eGFR
Correct Incorrect Correct answer

No intervention is needed since metformin does not require renal dose adjustment
Correct Incorrect Correct answer

Correct

Incorrect
Question 413 of 792

413. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician enters a prescription for ciprofloxacin 500 mg BID for a 14-year-old patient. The system generates an age-based alert. Why does this require pharmacist review?

Fluoroquinolones are generally avoided in patients under 18 due to risk of tendon and cartilage damage in developing joints
Correct Incorrect Correct answer

Ciprofloxacin 500 mg exceeds the maximum single dose for all pediatric patients
Correct Incorrect Correct answer

Fluoroquinolones require weight-based dosing in all patients under 21
Correct Incorrect Correct answer

Ciprofloxacin is only available in adult formulations and cannot be given to minors
Correct Incorrect Correct answer

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Incorrect
Question 414 of 792

414. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician reviewing a hospital patient’s medication list notices the patient receives both enoxaparin 40 mg subcutaneous daily and warfarin 5 mg daily, with a current INR of 3.5. The patient also has a new order for ibuprofen 400 mg TID for knee pain. What is the primary concern requiring pharmacist intervention?

Adding an NSAID to dual anticoagulation therapy creates a very high risk of serious bleeding complications
Correct Incorrect Correct answer

Ibuprofen will reduce the effectiveness of both enoxaparin and warfarin
Correct Incorrect Correct answer

The ibuprofen dose is too low to provide adequate pain relief in a hospitalized patient
Correct Incorrect Correct answer

Ibuprofen is contraindicated in the hospital setting regardless of other medications
Correct Incorrect Correct answer

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Incorrect
Question 415 of 792

415. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician processes a prescription for pregabalin 300 mg TID (900 mg daily) for a patient with diabetic neuropathy. The maximum recommended daily dose is 600 mg. What should the technician do?

Flag the above-maximum dose for pharmacist review before dispensing
Correct Incorrect Correct answer

Fill the prescription as written since the prescriber has clinical authority
Correct Incorrect Correct answer

Reduce the dose to 200 mg TID to bring it within the recommended range
Correct Incorrect Correct answer

Dispense the medication with a warning label about the high dose
Correct Incorrect Correct answer

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Incorrect
Question 416 of 792

416. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician discovers that a wrong-drug error reached a patient but caused no harm. The patient returned the medication after taking one dose with no adverse effects. Should this event be reported?

Yes, all medication errors that reach the patient should be reported regardless of whether harm occurred
Correct Incorrect Correct answer

No, reporting is only required when the patient experiences a measurable adverse outcome
Correct Incorrect Correct answer

Only if the pharmacist determines the error was caused by system failure rather than human error
Correct Incorrect Correct answer

No, since the patient voluntarily returned the medication, the error was effectively self-corrected
Correct Incorrect Correct answer

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Incorrect
Question 417 of 792

417. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A hospital pharmacy technician identifies a medication error trend: three similar wrong-dose errors for the same medication occurred in one month. The technician reports this pattern to the pharmacist. What reporting concept does identifying this trend represent?

Aggregate data analysis that reveals system-level vulnerabilities beyond what individual event reports show
Correct Incorrect Correct answer

A statistical coincidence that does not warrant further investigation
Correct Incorrect Correct answer

A single reportable event since all three errors involved the same medication
Correct Incorrect Correct answer

An individual performance issue requiring disciplinary action for the involved staff
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Question 418 of 792

418. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician wants to report a medication error to an external reporting program. Which organization operates the national voluntary medication error reporting program that pharmacies can submit reports to?

The Institute for Safe Medication Practices (ISMP) through the ISMP Medication Errors Reporting Program (MERP)
Correct Incorrect Correct answer

The Centers for Disease Control and Prevention (CDC) through its adverse event database
Correct Incorrect Correct answer

The Drug Enforcement Administration (DEA) through its controlled substance monitoring system
Correct Incorrect Correct answer

The Centers for Medicare and Medicaid Services (CMS) through its quality reporting portal
Correct Incorrect Correct answer

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Question 419 of 792

419. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A community pharmacy technician witnesses a near-miss event where the wrong patient label was printed but caught before the prescription was dispensed. The pharmacy manager asks the technician to document it. What is the primary benefit of reporting near-miss events?

Near-miss data reveals system weaknesses that can be corrected before an error actually reaches and harms a patient
Correct Incorrect Correct answer

Near-miss reports are required by federal law for all community pharmacies
Correct Incorrect Correct answer

Documenting near-misses protects the pharmacy from lawsuits if a similar error later causes harm
Correct Incorrect Correct answer

Near-miss reports are only useful for annual performance reviews of individual technicians
Correct Incorrect Correct answer

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Question 420 of 792

420. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy implements a ‘just culture’ approach to medication error reporting. A technician makes a dispensing error that was not caught during pharmacist verification. Under a just culture model, how should the organization respond?

Investigate the system factors that contributed to the error while holding individuals accountable only for reckless behavior, not honest mistakes
Correct Incorrect Correct answer

Terminate the technician immediately since errors are never acceptable in pharmacy practice
Correct Incorrect Correct answer

Ignore the error since just culture means no one is ever held responsible
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Transfer the technician to a non-dispensing role permanently without investigating the system factors
Correct Incorrect Correct answer

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Incorrect
Question 421 of 792

421. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A technician receives a prescription reading ‘Levothyroxine 0.125 mg daily.’ The technician recognizes this could be misread as 1.25 mg. What prescribing practice would have prevented this ambiguity?

Writing the dose as 125 mcg instead of 0.125 mg, avoiding the trailing decimal that can be misread
Correct Incorrect Correct answer

Writing the dose as .125 mg with no leading zero for clarity
Correct Incorrect Correct answer

Using the abbreviation 'mcg' after 0.125 for additional context
Correct Incorrect Correct answer

Spelling out the dose as 'one hundred twenty-five milligrams' on the prescription
Correct Incorrect Correct answer

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Incorrect
Question 422 of 792

422. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A hospital pharmacy receives an order written as ‘MSO4 2 mg IV Q4H PRN.’ The technician is unsure whether MSO4 refers to morphine sulfate or magnesium sulfate. What should the technician do?

Flag the order for pharmacist clarification, as MSO4 is on the ISMP List of Error-Prone Abbreviations that should not be used
Correct Incorrect Correct answer

Assume MSO4 means morphine sulfate since it is the more common medication
Correct Incorrect Correct answer

Fill the order as magnesium sulfate since MSO4 is the chemical formula for magnesium sulfate
Correct Incorrect Correct answer

Process the order using whichever medication the patient has received previously
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Incorrect
Question 423 of 792

423. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A technician enters a prescription that reads ‘Metoprolol 50 mg BID.’ The patient profile shows the patient previously took metoprolol succinate ER 50 mg daily. The new prescription does not specify salt form. What prescription error exists?

The prescription lacks the specific salt form (tartrate vs. succinate), which determines the dosing frequency and release mechanism
Correct Incorrect Correct answer

The dose is too low since metoprolol always requires at least 100 mg daily
Correct Incorrect Correct answer

BID dosing is never appropriate for any form of metoprolol
Correct Incorrect Correct answer

The prescription is complete since specifying the salt form is optional
Correct Incorrect Correct answer

Correct

Incorrect
Question 424 of 792

424. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A prescription for a pediatric patient reads ‘Amoxicillin 500 mg TID x 10 days.’ The child weighs 15 kg. The recommended dose is 25-45 mg/kg/day. What potential error should the technician identify?

The prescribed dose of 1500 mg daily exceeds the weight-based maximum of 675 mg daily for a 15 kg child, suggesting a potential adult dose was written
Correct Incorrect Correct answer

The dose is appropriate since 500 mg TID is the standard dose for all age groups
Correct Incorrect Correct answer

The TID frequency is incorrect for amoxicillin, which should only be given BID
Correct Incorrect Correct answer

The 10-day duration is too long for pediatric amoxicillin therapy
Correct Incorrect Correct answer

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Incorrect
Question 425 of 792

425. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A technician notices a prescription for ‘Prednisone 50 mg daily x 30 days’ with no taper instructions for a patient with no documented chronic condition requiring long-term steroids. Why is this concerning?

Abrupt discontinuation of high-dose corticosteroids after 30 days can cause adrenal crisis; a taper should typically be included
Correct Incorrect Correct answer

Prednisone 50 mg is above the maximum daily dose allowed for any indication
Correct Incorrect Correct answer

Prednisone should never be prescribed for more than 7 days under any circumstance
Correct Incorrect Correct answer

The daily frequency is wrong since prednisone must be given in divided doses
Correct Incorrect Correct answer

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Question 426 of 792

426. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A technician receives a handwritten prescription where the quantity appears to read either ‘#30’ or ‘#80’ due to poor handwriting. What is the appropriate action?

Do not guess the quantity; contact the prescriber's office to verify the intended amount before dispensing
Correct Incorrect Correct answer

Dispense #30 since it is the smaller and safer quantity to assume
Correct Incorrect Correct answer

Dispense #80 since it provides the patient with a larger supply
Correct Incorrect Correct answer

Ask the patient which quantity they believe the prescriber intended
Correct Incorrect Correct answer

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Incorrect
Question 427 of 792

427. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician preparing sterile IV admixtures is required to perform hand hygiene before donning gloves. According to USP , what is the minimum duration for hand washing with antimicrobial soap?

At least 30 seconds of scrubbing with antimicrobial soap and water before rinsing
Correct Incorrect Correct answer

A quick 5-second rinse under running water is sufficient before gloving
Correct Incorrect Correct answer

At least 2 minutes of scrubbing similar to a surgical hand scrub
Correct Incorrect Correct answer

Hand sanitizer alone is acceptable in place of hand washing before sterile compounding
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Incorrect
Question 428 of 792

428. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A hospital pharmacy technician is performing monthly environmental monitoring of the clean room. A viable air sampling result shows colony counts above the action level inside the ISO Class 5 primary engineering control. What is the immediate required response?

Halt compounding operations, investigate the contamination source, perform additional cleaning, and retest before resuming
Correct Incorrect Correct answer

Continue compounding but increase the frequency of air sampling to weekly
Correct Incorrect Correct answer

Document the result and retest during the next scheduled monthly monitoring
Correct Incorrect Correct answer

Replace the HEPA filter immediately without further investigation
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Incorrect
Question 429 of 792

429. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A technician is preparing chemotherapy medications in a biological safety cabinet (BSC). What is the primary purpose of using a BSC instead of a standard laminar airflow workbench for hazardous drug preparation?

The BSC provides both product protection and personnel protection by containing hazardous drug aerosols within the cabinet using negative pressure and HEPA-filtered exhaust
Correct Incorrect Correct answer

The BSC provides a higher level of sterility than a laminar airflow hood
Correct Incorrect Correct answer

The BSC is required because chemotherapy drugs must be stored at colder temperatures during preparation
Correct Incorrect Correct answer

The BSC allows multiple technicians to prepare hazardous drugs simultaneously
Correct Incorrect Correct answer

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Incorrect
Question 430 of 792

430. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician in a long-term care facility is asked about proper handling of multi-dose vials. Per CDC guidelines, what is the maximum beyond-use date for an opened multi-dose vial unless the manufacturer specifies otherwise?

28 days from the date of first puncture, with the date clearly marked on the vial
Correct Incorrect Correct answer

7 days from the date of first puncture for all multi-dose vials
Correct Incorrect Correct answer

90 days from the date of first puncture when stored in the refrigerator
Correct Incorrect Correct answer

The manufacturer expiration date applies regardless of when the vial was first opened
Correct Incorrect Correct answer

Correct

Incorrect
Question 431 of 792

431. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician notices a colleague entering the IV clean room without performing proper garbing sequence. The colleague put on gloves before the sterile gown. Why is the correct garbing order important for infection prevention?

Gloves donned before the gown can become contaminated by touching the outer surface of the gown, compromising the sterile field during compounding
Correct Incorrect Correct answer

The garbing order is a matter of personal preference and does not affect contamination rates
Correct Incorrect Correct answer

Putting gloves on first is actually the preferred method according to USP <797> guidelines
Correct Incorrect Correct answer

The gown protects the gloves from puncture damage during the dressing process
Correct Incorrect Correct answer

Correct

Incorrect
Question 432 of 792

432. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Which of the following medication classes is included on the ISMP high-alert medications list for acute care settings?

Insulin products
Correct Incorrect Correct answer

Proton pump inhibitors
Correct Incorrect Correct answer

First-generation antihistamines
Correct Incorrect Correct answer

HMG-CoA reductase inhibitors
Correct Incorrect Correct answer

Correct

Incorrect
Question 433 of 792

433. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

What is the primary purpose of an independent double-check procedure for high-alert medications?

To have a second person independently verify the drug, dose, route, and patient before administration
Correct Incorrect Correct answer

To document that two pharmacists were present during dispensing
Correct Incorrect Correct answer

To confirm the patient has provided written consent
Correct Incorrect Correct answer

To ensure the medication has not expired
Correct Incorrect Correct answer

Correct

Incorrect
Question 434 of 792

434. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Tall man lettering is a safety strategy that helps differentiate medications by doing what?

Capitalizing distinct letter portions of look-alike drug names
Correct Incorrect Correct answer

Printing the drug name in a larger font size on all labels
Correct Incorrect Correct answer

Using bold formatting for the entire generic name
Correct Incorrect Correct answer

Highlighting the brand name instead of the generic name
Correct Incorrect Correct answer

Correct

Incorrect
Question 435 of 792

435. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Which of the following is an ISMP-recommended strategy for storing high-alert medications in the pharmacy?

Segregating them from other medications and applying auxiliary warning labels
Correct Incorrect Correct answer

Storing them in unlocked bins for rapid access during emergencies
Correct Incorrect Correct answer

Placing them next to similar-sounding medications for easy comparison
Correct Incorrect Correct answer

Keeping them only in automated dispensing cabinets without additional safeguards
Correct Incorrect Correct answer

Correct

Incorrect
Question 436 of 792

436. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Anticoagulants such as heparin and warfarin are on the ISMP high-alert list primarily because errors can lead to which serious outcome?

Life-threatening hemorrhage or thromboembolic events
Correct Incorrect Correct answer

Severe hepatotoxicity requiring liver transplant
Correct Incorrect Correct answer

Irreversible renal failure
Correct Incorrect Correct answer

Permanent peripheral neuropathy
Correct Incorrect Correct answer

Correct

Incorrect
Question 437 of 792

437. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is restocking an automated dispensing cabinet and notices that concentrated potassium chloride 2 mEq/mL vials are loaded in the same drawer as potassium chloride 20 mEq/100 mL premixed bags. What is the best action?

Remove the concentrated vials from the cabinet and notify the pharmacist immediately
Correct Incorrect Correct answer

Leave both products in the drawer since they contain the same active ingredient
Correct Incorrect Correct answer

Move the premixed bags to a different drawer to keep the concentrated vials accessible
Correct Incorrect Correct answer

Label the concentrated vials with a tall man lettering sticker and keep them in the cabinet
Correct Incorrect Correct answer

Correct

Incorrect
Question 438 of 792

438. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A nurse requests a pharmacy technician to prepare an insulin drip for a critically ill patient. Before the preparation leaves the pharmacy, what safety step should occur?

An independent double-check by a second pharmacy staff member verifying the drug, concentration, and rate
Correct Incorrect Correct answer

The technician should initial the label as the sole verification step
Correct Incorrect Correct answer

The insulin should be sent immediately since the patient is critical
Correct Incorrect Correct answer

The nurse should verify the preparation upon delivery without pharmacy verification
Correct Incorrect Correct answer

Correct

Incorrect
Question 439 of 792

439. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician notices that a chemotherapy order for a pediatric patient exceeds the standard maximum dose listed in the pharmacy reference. What should the technician do?

Hold the preparation and alert the pharmacist to verify the dose with the prescriber
Correct Incorrect Correct answer

Prepare the dose as ordered since the prescriber has final authority
Correct Incorrect Correct answer

Reduce the dose to the standard maximum and prepare accordingly
Correct Incorrect Correct answer

Contact the patient's nurse to confirm the order before preparing
Correct Incorrect Correct answer

Correct

Incorrect
Question 440 of 792

440. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A technician is asked to pull a vial of vecuronium from the pharmacy refrigerator for an operating room case. The vial is stored next to vials of a similar size and shape containing a different medication. What is the most important safety action?

Read the label carefully at least three times and verify the NDC number matches the order
Correct Incorrect Correct answer

Pull whichever vial is closest since they all require refrigeration
Correct Incorrect Correct answer

Ask another technician to identify the vial by its appearance
Correct Incorrect Correct answer

Scan the barcode only after the vial has been delivered to the OR
Correct Incorrect Correct answer

Correct

Incorrect
Question 441 of 792

441. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A hospital pharmacy implements a policy requiring that all opioid PCA (patient-controlled analgesia) pumps be programmed by a pharmacist and verified by a nurse before patient use. This is an example of which safety strategy?

Independent double-check procedure
Correct Incorrect Correct answer

Tall man lettering
Correct Incorrect Correct answer

Forcing function
Correct Incorrect Correct answer

Root cause analysis
Correct Incorrect Correct answer

Correct

Incorrect
Question 442 of 792

442. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A technician discovers that two different concentrations of heparin (1,000 units/mL and 10,000 units/mL) are stored side by side on the shelf. What is the most appropriate corrective action?

Separate the two concentrations and apply distinctive auxiliary labels to each
Correct Incorrect Correct answer

Combine them into one bin since they are the same medication
Correct Incorrect Correct answer

Remove the lower concentration from stock since it is used less frequently
Correct Incorrect Correct answer

Place a sign above the shelf reminding staff to read labels carefully
Correct Incorrect Correct answer

Correct

Incorrect
Question 443 of 792

443. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy receives a new supply of look-alike insulin pen products: insulin lispro and insulin glargine in nearly identical packaging. What storage strategy best reduces the risk of a dispensing error?

Store the two products in separate, clearly labeled bins in different locations
Correct Incorrect Correct answer

Store them alphabetically next to each other for easy retrieval
Correct Incorrect Correct answer

Place both products in the same bin with a divider between them
Correct Incorrect Correct answer

Return one product to the wholesaler to avoid having both in stock
Correct Incorrect Correct answer

Correct

Incorrect
Question 444 of 792

444. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is preparing a chemotherapy admixture and realizes the vial label is partially obscured by a price sticker. What should the technician do before proceeding?

Remove the sticker to fully expose the drug name, strength, and expiration date before preparation
Correct Incorrect Correct answer

Proceed with preparation since the drug was already verified during ordering
Correct Incorrect Correct answer

Ask a coworker to confirm the drug name verbally
Correct Incorrect Correct answer

Set the vial aside and use a different vial from the same lot
Correct Incorrect Correct answer

Correct

Incorrect
Question 445 of 792

445. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

During a routine medication safety audit, a technician finds that neuromuscular blocking agents are stored in an open-access area of the pharmacy without any special labeling. Which corrective measure is most aligned with ISMP recommendations?

Move the agents to a restricted-access location and apply prominent warning labels
Correct Incorrect Correct answer

Leave them in open access but add a small cautionary note to the shelf
Correct Incorrect Correct answer

Move them to the front counter for closer pharmacist oversight
Correct Incorrect Correct answer

Discontinue stocking neuromuscular blocking agents in the pharmacy
Correct Incorrect Correct answer

Correct

Incorrect
Question 446 of 792

446. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician receives an order for morphine 15 mg oral tablets for a patient who has been taking morphine 5 mg tablets. The technician notices the threefold dose increase. What is the appropriate action?

Flag the order for pharmacist review to verify the dose increase is intentional
Correct Incorrect Correct answer

Dispense the 15 mg tablets since the prescriber authorized the change
Correct Incorrect Correct answer

Call the patient to ask if they requested a higher dose
Correct Incorrect Correct answer

Fill the prescription with the previous 5 mg strength to be safe
Correct Incorrect Correct answer

Correct

Incorrect
Question 447 of 792

447. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A hospital is implementing barcode scanning at the point of medication administration. Which high-alert medication safety benefit does this technology provide?

Verification that the correct drug and dose are being given to the correct patient at the correct time
Correct Incorrect Correct answer

Elimination of the need for pharmacist order verification
Correct Incorrect Correct answer

Automatic adjustment of medication doses based on patient weight
Correct Incorrect Correct answer

Removal of the requirement for independent double-checks of high-alert drugs
Correct Incorrect Correct answer

Correct

Incorrect
Question 448 of 792

448. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A technician is compounding a total parenteral nutrition (TPN) solution that contains concentrated dextrose 70% and potassium phosphate. Both are considered high-alert. What safety measure is most critical during preparation?

Having an independent double-check of each additive volume and concentration before mixing
Correct Incorrect Correct answer

Preparing the TPN as quickly as possible to maintain sterility
Correct Incorrect Correct answer

Using the same syringe for all additives to minimize waste
Correct Incorrect Correct answer

Verifying additives only after the TPN bag has been completed
Correct Incorrect Correct answer

Correct

Incorrect
Question 449 of 792

449. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy establishes a policy that all high-alert medication orders must include an indication for use. This policy is an example of which type of error-prevention strategy?

Forcing function that requires additional information before the order can proceed
Correct Incorrect Correct answer

Voluntary reporting mechanism for tracking near-miss events
Correct Incorrect Correct answer

Retrospective root cause analysis after an error has occurred
Correct Incorrect Correct answer

Tall man lettering convention to distinguish look-alike names
Correct Incorrect Correct answer

Correct

Incorrect
Question 450 of 792

450. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A hospital pharmacy is evaluating which medications should require mandatory independent double-checks. Which combination of factors best justifies adding a medication to the double-check list?

Narrow therapeutic index, potential for fatal outcome from dosing errors, and high frequency of use
Correct Incorrect Correct answer

Low cost, wide therapeutic index, and availability in a single concentration
Correct Incorrect Correct answer

Infrequent use, wide safety margin, and availability only as an oral formulation
Correct Incorrect Correct answer

High cost, limited formulary availability, and requirement for prior authorization
Correct Incorrect Correct answer

Correct

Incorrect
Question 451 of 792

451. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy receives reports of three near-miss events involving confusion between fentanyl 50 mcg/mL and fentanyl 100 mcg/mL vials in the past month. Which comprehensive intervention strategy would be most effective?

Separate storage locations, apply auxiliary concentration labels, limit available concentrations, and require barcode scanning before dispensing
Correct Incorrect Correct answer

Send a memo reminding staff to read labels carefully
Correct Incorrect Correct answer

Add both concentrations to the automated dispensing cabinet with identical bin locations
Correct Incorrect Correct answer

Remove the lower concentration from the formulary entirely without evaluating clinical need
Correct Incorrect Correct answer

Correct

Incorrect
Question 452 of 792

452. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy director is reviewing high-alert medication error data and finds that 60% of insulin-related errors occur during the transcription step. Which targeted intervention would most directly reduce these errors?

Implementing computerized prescriber order entry (CPOE) with clinical decision support for insulin orders
Correct Incorrect Correct answer

Requiring all nurses to attend an annual insulin administration class
Correct Incorrect Correct answer

Adding tall man lettering to all insulin vial labels
Correct Incorrect Correct answer

Increasing the frequency of pharmacist inspections on nursing units
Correct Incorrect Correct answer

Correct

Incorrect
Question 453 of 792

453. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A hospital committee is debating whether to standardize heparin drip concentrations across all units or allow each unit to stock its preferred concentration. Which argument best supports standardization from a patient safety perspective?

Standardization reduces the number of concentrations staff must manage, decreasing the likelihood of selection and calculation errors
Correct Incorrect Correct answer

Standardization is less expensive because the pharmacy can negotiate bulk pricing
Correct Incorrect Correct answer

Allowing unit preferences increases staff satisfaction and reduces turnover
Correct Incorrect Correct answer

Each unit has unique patient populations requiring different concentrations
Correct Incorrect Correct answer

Correct

Incorrect
Question 454 of 792

454. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

After a serious opioid overdose event, a root cause analysis reveals that the prescriber ordered a dose ten times higher than intended, the pharmacist approved the order during a period of high workload, and the nurse administered it without question. Which system-level factor is the most significant contributor?

Absence of dose-range checking alerts at the prescribing and verification stages
Correct Incorrect Correct answer

Inadequate nurse training on opioid administration technique
Correct Incorrect Correct answer

Failure of the patient to question the dose before taking it
Correct Incorrect Correct answer

Lack of a hospital policy requiring patient education on opioid side effects
Correct Incorrect Correct answer

Correct

Incorrect
Question 455 of 792

455. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy is evaluating the use of smart infusion pumps with dose error reduction software for all high-alert IV medications. Which outcome best demonstrates the safety value of this technology?

A measurable decrease in the rate of IV medication dosing errors reaching patients
Correct Incorrect Correct answer

Complete elimination of the need for pharmacist order review
Correct Incorrect Correct answer

A reduction in the time required to program infusion pumps
Correct Incorrect Correct answer

An increase in the number of high-alert medications stocked on nursing units
Correct Incorrect Correct answer

Correct

Incorrect
Question 456 of 792

456. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A quality committee reviews incident data and finds that chemotherapy errors are most frequent when orders are placed late Friday afternoon and prepared by weekend staff with less oncology experience. Which multi-factor intervention addresses both contributing causes?

Establishing an order submission deadline for non-urgent chemotherapy and requiring oncology-trained staff for all chemotherapy preparation shifts
Correct Incorrect Correct answer

Hiring additional weekend pharmacists regardless of specialty training
Correct Incorrect Correct answer

Prohibiting all chemotherapy orders on Fridays
Correct Incorrect Correct answer

Requiring prescribers to use pre-printed order forms without addressing staffing
Correct Incorrect Correct answer

Correct

Incorrect
Question 457 of 792

457. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy manager is deciding between two safety interventions for high-alert medications: (A) posting reminder signs at dispensing stations, or (B) implementing barcode verification at each dispensing step. Which analysis best explains why option B is generally more effective?

Barcode verification is a technology-based forcing function that does not rely on human vigilance, while signs depend on staff consistently noticing and following them
Correct Incorrect Correct answer

Barcode scanners are less expensive to implement than printed signage
Correct Incorrect Correct answer

Reminder signs have been proven to eliminate all dispensing errors in published studies
Correct Incorrect Correct answer

Barcode verification only works for controlled substances and not other high-alert drugs
Correct Incorrect Correct answer

Correct

Incorrect
Question 458 of 792

458. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

Tall man lettering for the drug pair predniSONE and prednisoLONE capitalizes which portion of each name?

The letters that distinguish one drug from the other
Correct Incorrect Correct answer

The first three letters of each drug name
Correct Incorrect Correct answer

The suffix indicating the drug class
Correct Incorrect Correct answer

The letters that are identical between the two names
Correct Incorrect Correct answer

Correct

Incorrect
Question 459 of 792

459. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

What is the primary purpose of the ISMP List of Confused Drug Names?

To identify drug name pairs that have been involved in or have the potential to cause medication errors
Correct Incorrect Correct answer

To list all medications that require prior authorization
Correct Incorrect Correct answer

To provide dosing guidelines for look-alike medications
Correct Incorrect Correct answer

To catalog medications with FDA-mandated black box warnings
Correct Incorrect Correct answer

Correct

Incorrect
Question 460 of 792

460. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

According to safe prescribing practices, what is the rule about leading zeros in medication doses?

Always use a leading zero before a decimal point (e.g., write 0.5 mg, not .5 mg)
Correct Incorrect Correct answer

Never use a leading zero because it adds unnecessary characters
Correct Incorrect Correct answer

Use a leading zero only for controlled substance prescriptions
Correct Incorrect Correct answer

Leading zeros are required only when writing doses greater than 1 mg
Correct Incorrect Correct answer

Correct

Incorrect
Question 461 of 792

461. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

Which medication pair illustrates a LASA concern involving a fertility drug and an antidepressant?

ClomiPHENE and clomiPRAMINE
Correct Incorrect Correct answer

Sertraline and cetirizine
Correct Incorrect Correct answer

Fluoxetine and fluvoxamine
Correct Incorrect Correct answer

Paroxetine and piroxicam
Correct Incorrect Correct answer

Correct

Incorrect
Question 462 of 792

462. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

What does the trailing zero rule state regarding medication dose expressions?

Never use a trailing zero after a decimal point (e.g., write 5 mg, not 5.0 mg)
Correct Incorrect Correct answer

Always add a trailing zero to show precision in dosing
Correct Incorrect Correct answer

Use trailing zeros only for IV medication concentrations
Correct Incorrect Correct answer

Trailing zeros are required on all prescription labels
Correct Incorrect Correct answer

Correct

Incorrect
Question 463 of 792

463. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician receives a verbal order that sounds like “hydroxyzine 25 mg.” Given that hydroxyzine and hydralazine sound similar, what is the safest action?

Read back the order including the drug name spelled out, indication, and dose to confirm with the prescriber
Correct Incorrect Correct answer

Dispense hydroxyzine since that is what the order sounded like
Correct Incorrect Correct answer

Ask the nurse to look up the correct spelling in the patient chart
Correct Incorrect Correct answer

Fill the order for hydralazine since it is more commonly prescribed
Correct Incorrect Correct answer

Correct

Incorrect
Question 464 of 792

464. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A technician is stocking shelves and notices that predniSONE and prednisoLONE tablets are stored in adjacent bins. What is the best action to reduce LASA error risk?

Separate the two medications to non-adjacent locations and ensure tall man lettering labels are applied
Correct Incorrect Correct answer

Leave them adjacent since they are both corticosteroids and belong together
Correct Incorrect Correct answer

Move prednisoLONE to the refrigerator to create separation
Correct Incorrect Correct answer

Place a general caution sign above both bins without moving them
Correct Incorrect Correct answer

Correct

Incorrect
Question 465 of 792

465. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A prescription is received for “clomiphene 50 mg” for a female patient undergoing fertility treatment. The pharmacy also stocks clomipramine. What verification step is most important?

Confirm the indication matches the dispensed drug by checking that clomiPHENE is selected, not clomiPRAMINE
Correct Incorrect Correct answer

Verify only the dose since 50 mg is standard for both medications
Correct Incorrect Correct answer

Check whether the patient has a clomipramine allergy on file
Correct Incorrect Correct answer

Dispense whichever product is in the bin labeled with the first six letters
Correct Incorrect Correct answer

Correct

Incorrect
Question 466 of 792

466. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician scans a medication barcode during the fill process and the system alerts that the scanned product does not match the order. The product scanned was hydrALAZINE, but the order is for hydrOXYzine. What should the technician do?

Stop the fill, retrieve the correct medication, and scan again to confirm a match
Correct Incorrect Correct answer

Override the alert since the names are similar and the system may be incorrect
Correct Incorrect Correct answer

Complete the fill and notify the pharmacist during final verification
Correct Incorrect Correct answer

Place the hydralazine back and dispense hydroxyzine without rescanning
Correct Incorrect Correct answer

Correct

Incorrect
Question 467 of 792

467. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A new pharmacy software system is being configured. The pharmacy manager asks the technician to help set up “name alert” pop-ups. What is the primary function of these alerts?

To warn users when a selected drug has a look-alike or sound-alike pair that could cause confusion
Correct Incorrect Correct answer

To notify the prescriber when a brand name drug has a generic equivalent available
Correct Incorrect Correct answer

To alert the technician when a medication requires refrigerated storage
Correct Incorrect Correct answer

To indicate when a patient has previously reported a medication allergy
Correct Incorrect Correct answer

Correct

Incorrect
Question 468 of 792

468. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A technician receives a handwritten prescription that reads “.5 mg” of a medication. Why is this dose expression dangerous, and what should the technician do?

The missing leading zero could cause the dose to be misread as 5 mg; the technician should clarify with the prescriber and enter it as 0.5 mg
Correct Incorrect Correct answer

The dose is too low to be effective, so the technician should increase it to 5 mg
Correct Incorrect Correct answer

The decimal is unnecessary, and the technician should dispense 5 mg as written
Correct Incorrect Correct answer

The prescription is valid as written, and no clarification is needed
Correct Incorrect Correct answer

Correct

Incorrect
Question 469 of 792

469. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A hospital pharmacy is implementing tall man lettering on its automated dispensing cabinet screens. Which display format correctly applies tall man lettering for the vincristine/vinblastine pair?

vinCRIStine and vinBLAStine
Correct Incorrect Correct answer

VINCRISTINE and VINBLASTINE in all capitals
Correct Incorrect Correct answer

vincristine and vinblastine in all lowercase
Correct Incorrect Correct answer

VinCristine and VinBlastine with only the first distinguishing letter capitalized
Correct Incorrect Correct answer

Correct

Incorrect
Question 470 of 792

470. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A technician filling prescriptions notices that two different manufacturers supply metFORMIN and metOPROLOL in bottles with very similar label colors and sizes. What storage strategy addresses this packaging concern?

Store the products on different shelves and apply brightly colored auxiliary labels to distinguish them
Correct Incorrect Correct answer

Request that both manufacturers change their label colors
Correct Incorrect Correct answer

Store both products in the same area since they are alphabetically close
Correct Incorrect Correct answer

Remove one product from stock and order from a different manufacturer with different packaging
Correct Incorrect Correct answer

Correct

Incorrect
Question 471 of 792

471. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician enters a prescription for “Celebrex” into the computer system, and a LASA alert pops up warning of possible confusion with “Celexa.” What is the correct response?

Verify the intended medication by checking the indication and confirming celecoxib (Celebrex) is correct before proceeding
Correct Incorrect Correct answer

Dismiss the alert since the technician already knows which drug was prescribed
Correct Incorrect Correct answer

Switch to the other medication since the alert suggests it may be more appropriate
Correct Incorrect Correct answer

Delete the order and ask the patient which medication they take
Correct Incorrect Correct answer

Correct

Incorrect
Question 472 of 792

472. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A prescriber writes an order for “morphine 5.0 mg IV.” What error risk does this order present, and how should it be entered into the pharmacy system?

The trailing zero could cause a misread of 50 mg; the technician should enter it as "morphine 5 mg IV" and flag it for pharmacist review
Correct Incorrect Correct answer

The order is correctly written and should be entered exactly as written
Correct Incorrect Correct answer

The trailing zero indicates the prescriber wants extra precision, so it should be preserved
Correct Incorrect Correct answer

The dose should be rounded up to 10 mg since 5.0 mg is an unusual dose
Correct Incorrect Correct answer

Correct

Incorrect
Question 473 of 792

473. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy is conducting a LASA audit and discovers that ePHEDrine and EPINEPHrine are stored in the same medication drawer in the emergency department. What corrective action should be recommended?

Move the medications to separate drawers or compartments with tall man lettering labels on each
Correct Incorrect Correct answer

Label the drawer with a general warning and keep both medications together
Correct Incorrect Correct answer

Remove ephedrine from the emergency department formulary entirely
Correct Incorrect Correct answer

Place both medications in a locked cabinet accessible only to physicians
Correct Incorrect Correct answer

Correct

Incorrect
Question 474 of 792

474. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A patient calls the pharmacy and says the doctor prescribed “Zyrtec,” but the technician sees an active order for “Zantac” (ranitidine, now discontinued and replaced). This confusion illustrates which LASA concern?

Sound-alike brand names can cause errors when orders are communicated verbally
Correct Incorrect Correct answer

The patient is trying to obtain a medication without a valid prescription
Correct Incorrect Correct answer

Brand name medications are always more confusing than generic names
Correct Incorrect Correct answer

The prescriber intentionally ordered both medications for the patient
Correct Incorrect Correct answer

Correct

Incorrect
Question 475 of 792

475. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy intern suggests organizing all LASA medications in a single designated “caution area” of the pharmacy. Why might this approach be less effective than alternative strategies?

Grouping all LASA pairs together increases the chance of selecting a wrong drug from the concentrated collection of confusable names
Correct Incorrect Correct answer

LASA medications do not need any special storage considerations
Correct Incorrect Correct answer

Only the pharmacist should handle LASA medications, making a separate area unnecessary
Correct Incorrect Correct answer

LASA medications must always be stored in automated dispensing cabinets
Correct Incorrect Correct answer

Correct

Incorrect
Question 476 of 792

476. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

During a prescription fill, a technician notices the label prints “DOBUTamine” with certain letters capitalized. A patient asks why the name looks unusual. What is the correct explanation?

The capitalized letters are tall man lettering used to help distinguish this drug from a similar-sounding medication called DOPamine
Correct Incorrect Correct answer

The computer system randomly capitalizes letters due to a software error
Correct Incorrect Correct answer

Capital letters indicate that the medication requires refrigeration
Correct Incorrect Correct answer

The manufacturer requires this specific capitalization on all pharmacy labels
Correct Incorrect Correct answer

Correct

Incorrect
Question 477 of 792

477. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A hospital reports three LASA errors in one month involving different drug pairs. Two errors occurred during night shifts with reduced staffing. Which analysis of the contributing factors is most comprehensive?

The errors likely result from a combination of inadequate LASA safeguards, increased workload during night shifts, and fatigue-related reduction in vigilance
Correct Incorrect Correct answer

The errors are entirely due to poor individual performance by night shift staff
Correct Incorrect Correct answer

Night shifts should be eliminated to prevent all future LASA errors
Correct Incorrect Correct answer

The hospital should stop stocking all LASA medications to prevent further errors
Correct Incorrect Correct answer

Correct

Incorrect
Question 478 of 792

478. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy committee is evaluating three interventions to reduce LASA dispensing errors: (A) staff education sessions, (B) barcode scanning at every fill step, (C) tall man lettering on shelf labels. Which ranking from most to least effective reflects evidence-based safety hierarchy principles?

B, C, A: technology-based verification is strongest, followed by visual differentiation, then education
Correct Incorrect Correct answer

A, B, C: education is always the most effective starting point
Correct Incorrect Correct answer

C, A, B: visual cues are more effective than technology
Correct Incorrect Correct answer

A, C, B: staff knowledge is the foundation of all safety efforts
Correct Incorrect Correct answer

Correct

Incorrect
Question 479 of 792

479. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy discovers that vinCRIStine was accidentally dispensed instead of vinBLAStine, but the error was caught by a nurse before administration. Which factor in the error chain most likely allowed the initial dispensing error to occur?

The pharmacy verification process did not include a final check against the original order with attention to the specific vinca alkaloid
Correct Incorrect Correct answer

The nurse was responsible for catching all dispensing errors
Correct Incorrect Correct answer

The prescriber should have specified the brand name instead of the generic
Correct Incorrect Correct answer

The patient failed to verify the medication at the bedside
Correct Incorrect Correct answer

Correct

Incorrect
Question 480 of 792

480. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A hospital formulary committee is considering removing one drug from each LASA pair when a therapeutic alternative exists. What is the primary advantage and primary limitation of this approach?

Advantage: eliminates the possibility of confusion between the pair; Limitation: the removed drug may be clinically necessary for certain patients
Correct Incorrect Correct answer

Advantage: reduces pharmacy inventory costs; Limitation: requires FDA approval to remove drugs
Correct Incorrect Correct answer

Advantage: simplifies staff training; Limitation: the remaining drug may also have LASA concerns with other medications
Correct Incorrect Correct answer

Advantage: eliminates all medication errors; Limitation: patients may prefer the removed drug
Correct Incorrect Correct answer

Correct

Incorrect
Question 481 of 792

481. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy manager reviews error data and finds that 80% of LASA errors at the facility involve just five drug pairs. Which approach to resource allocation for LASA safety interventions is most efficient?

Focus the most intensive interventions on the five high-frequency pairs while maintaining baseline safeguards for all LASA medications
Correct Incorrect Correct answer

Apply all available interventions equally to every medication in the pharmacy
Correct Incorrect Correct answer

Address only the five pairs and eliminate all other LASA safety measures
Correct Incorrect Correct answer

Wait until more data accumulates before taking any corrective action
Correct Incorrect Correct answer

Correct

Incorrect
Question 482 of 792

482. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A community pharmacy technician fills a prescription for metFORMIN 500 mg but accidentally selects a bottle of metOPROLOL 50 mg. The barcode scan catches the error. If the pharmacy did not have barcode scanning, which remaining safety layer would most likely catch this error?

Pharmacist final verification comparing the physical product against the prescription
Correct Incorrect Correct answer

Patient consultation at the pickup counter
Correct Incorrect Correct answer

The prescriber calling to follow up on the prescription
Correct Incorrect Correct answer

An automated refill reminder system alerting the patient
Correct Incorrect Correct answer

Correct

Incorrect
Question 483 of 792

483. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

Two hospitals implement different LASA strategies. Hospital A uses tall man lettering only on pharmacy shelves. Hospital B uses tall man lettering on shelves, in the electronic health record, on dispensing cabinet screens, and on medication administration records. Which hospital likely achieves greater error reduction, and why?

Hospital B, because consistent tall man lettering across all touchpoints reinforces differentiation at every step in the medication use process
Correct Incorrect Correct answer

Hospital A, because limiting tall man lettering to one location reduces alert fatigue
Correct Incorrect Correct answer

Both hospitals achieve equal results because tall man lettering has the same effect regardless of implementation scope
Correct Incorrect Correct answer

Hospital B, but only because electronic systems are inherently safer than manual processes
Correct Incorrect Correct answer

Correct

Incorrect
Question 484 of 792

484. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy is evaluating whether to implement both barcode scanning and tall man lettering for LASA medications, or choose only one due to budget constraints. Which analysis best supports the decision?

Both interventions target different error points: barcode scanning verifies product identity at selection, while tall man lettering aids visual differentiation during ordering and review; implementing both provides layered protection
Correct Incorrect Correct answer

Barcode scanning alone is sufficient because it catches all possible LASA errors
Correct Incorrect Correct answer

Tall man lettering alone is sufficient because it prevents errors at the point of prescribing
Correct Incorrect Correct answer

The pharmacy should choose the less expensive option since both are equally effective
Correct Incorrect Correct answer

Correct

Incorrect
Question 485 of 792

485. Question

Category: Patient Safety and Quality Assurance: Error Prevention

Which of the following is one of the commonly recognized “five rights” of medication administration?

Right patient
Correct Incorrect Correct answer

Right pharmacy
Correct Incorrect Correct answer

Right insurance
Correct Incorrect Correct answer

Right prescriber
Correct Incorrect Correct answer

Correct

Incorrect
Question 486 of 792

486. Question

Category: Patient Safety and Quality Assurance: Error Prevention

What is the purpose of a root cause analysis (RCA) in the context of medication errors?

To identify the underlying system factors that contributed to the error and prevent recurrence
Correct Incorrect Correct answer

To determine which individual should be held accountable for the error
Correct Incorrect Correct answer

To calculate the financial cost of the medication error to the organization
Correct Incorrect Correct answer

To establish whether the error warrants a malpractice lawsuit
Correct Incorrect Correct answer

Correct

Incorrect
Question 487 of 792

487. Question

Category: Patient Safety and Quality Assurance: Error Prevention

In the “just culture” model of medication safety, how are honest human errors typically addressed?

Through system redesign and consoling of the individual, not through punishment
Correct Incorrect Correct answer

Through immediate termination of the employee involved
Correct Incorrect Correct answer

Through mandatory retraining without any system changes
Correct Incorrect Correct answer

Through public disclosure of the individual's identity and error details
Correct Incorrect Correct answer

Correct

Incorrect
Question 488 of 792

488. Question

Category: Patient Safety and Quality Assurance: Error Prevention

What is a forcing function in the context of medication error prevention?

A design feature that makes it impossible or difficult to proceed without completing a required safety step
Correct Incorrect Correct answer

A disciplinary action taken against staff who commit medication errors
Correct Incorrect Correct answer

A training exercise that forces staff to memorize drug interactions
Correct Incorrect Correct answer

A manual override that allows staff to bypass safety alerts when needed
Correct Incorrect Correct answer

Correct

Incorrect
Question 489 of 792

489. Question

Category: Patient Safety and Quality Assurance: Error Prevention

Computerized prescriber order entry (CPOE) helps prevent medication errors primarily at which stage of the medication use process?

Prescribing and order entry
Correct Incorrect Correct answer

Medication administration at the bedside
Correct Incorrect Correct answer

Drug manufacturing and packaging
Correct Incorrect Correct answer

Patient discharge and follow-up
Correct Incorrect Correct answer

Correct

Incorrect
Question 490 of 792

490. Question

Category: Patient Safety and Quality Assurance: Error Prevention

What is the purpose of a verbal order read-back procedure?

To have the receiver repeat the order back to the prescriber to confirm accuracy
Correct Incorrect Correct answer

To document that the prescriber gave the order in writing
Correct Incorrect Correct answer

To allow the pharmacist to modify the order based on professional judgment
Correct Incorrect Correct answer

To record the verbal order on the patient's voicemail
Correct Incorrect Correct answer

Correct

Incorrect
Question 491 of 792

491. Question

Category: Patient Safety and Quality Assurance: Error Prevention

Clinical decision support (CDS) systems integrated into pharmacy software can alert pharmacists to which of the following?

Drug-drug interactions, duplicate therapy, and dose-range violations
Correct Incorrect Correct answer

Patient insurance copayment amounts and coverage details
Correct Incorrect Correct answer

Drug manufacturer recall notices and supply chain disruptions
Correct Incorrect Correct answer

Pharmacy staffing schedules and technician certification dates
Correct Incorrect Correct answer

Correct

Incorrect
Question 492 of 792

492. Question

Category: Patient Safety and Quality Assurance: Error Prevention

Smart infusion pumps with dose error reduction software (DERS) help prevent which specific type of medication error?

IV medication dosing and rate errors
Correct Incorrect Correct answer

Oral medication dispensing errors at the pharmacy counter
Correct Incorrect Correct answer

Wrong patient errors during medication reconciliation
Correct Incorrect Correct answer

Transcription errors on handwritten prescriptions
Correct Incorrect Correct answer

Correct

Incorrect
Question 493 of 792

493. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician is filling a prescription and selects a bottle of atenolol 50 mg instead of atenolol 25 mg. The barcode scan generates a mismatch alert. What should the technician do?

Stop, return the incorrect bottle, select the correct strength, and scan again to verify
Correct Incorrect Correct answer

Override the alert because the drug name is correct and only the strength differs
Correct Incorrect Correct answer

Complete the fill and let the pharmacist catch the error during verification
Correct Incorrect Correct answer

Dispense the 50 mg tablets and instruct the patient to cut them in half
Correct Incorrect Correct answer

Correct

Incorrect
Question 494 of 792

494. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacist receives a phone order for “ampicillin 500 mg IV every 6 hours.” Following the read-back procedure, what should the pharmacist do?

Write down the order, then read it back to the prescriber stating "ampicillin 500 milligrams intravenously every 6 hours" and obtain confirmation
Correct Incorrect Correct answer

Enter the order directly into the computer and verify it later during order review
Correct Incorrect Correct answer

Ask the nurse to relay the order to the pharmacy in writing
Correct Incorrect Correct answer

Repeat only the drug name and hang up to save time
Correct Incorrect Correct answer

Correct

Incorrect
Question 495 of 792

495. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A hospital discovers that a wrong-patient error occurred when a nurse administered medication to a patient without scanning the patient wristband. Which technology-based safety measure was bypassed?

Barcode medication administration (BCMA) patient identification verification
Correct Incorrect Correct answer

Computerized prescriber order entry (CPOE)
Correct Incorrect Correct answer

Smart infusion pump dose error reduction software
Correct Incorrect Correct answer

Automated dispensing cabinet biometric login
Correct Incorrect Correct answer

Correct

Incorrect
Question 496 of 792

496. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician notices that a prescription label says “take 1 tablet by mouth daily” but the medication dispensed is an ophthalmic solution. What type of error does this represent?

Wrong route error, as an ophthalmic product should not be directed for oral administration
Correct Incorrect Correct answer

Wrong time error because the frequency is incorrect
Correct Incorrect Correct answer

Wrong dose error because the volume was not specified
Correct Incorrect Correct answer

Wrong drug error because the medication name is incorrect
Correct Incorrect Correct answer

Correct

Incorrect
Question 497 of 792

497. Question

Category: Patient Safety and Quality Assurance: Error Prevention

After a medication error is discovered, the pharmacy manager calls a meeting to discuss the event using a just culture approach. A technician made an honest mistake by selecting the wrong drug from a shelf where two similar products were stored adjacently. How should the manager respond?

Console the technician, analyze why the similar products were stored together, and redesign the storage layout to prevent recurrence
Correct Incorrect Correct answer

Issue a formal written warning to the technician and place it in their personnel file
Correct Incorrect Correct answer

Require the technician to write a reflective essay about the importance of careful work
Correct Incorrect Correct answer

Reassign the technician to non-dispensing duties for six months as a precaution
Correct Incorrect Correct answer

Correct

Incorrect
Question 498 of 792

498. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A new IV tubing connector system is designed so that enteral feeding tubes cannot physically connect to IV lines. This is an example of which error-prevention strategy?

Forcing function
Correct Incorrect Correct answer

Independent double-check
Correct Incorrect Correct answer

Root cause analysis
Correct Incorrect Correct answer

Tall man lettering
Correct Incorrect Correct answer

Correct

Incorrect
Question 499 of 792

499. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy implements a policy requiring that all prescriptions be verified against the original hard copy before the medication leaves the pharmacy. This step is designed to catch which types of errors?

Transcription and dispensing errors including wrong drug, wrong strength, and wrong quantity
Correct Incorrect Correct answer

Only billing and insurance coding errors
Correct Incorrect Correct answer

Only expired medication errors
Correct Incorrect Correct answer

Only controlled substance diversion
Correct Incorrect Correct answer

Correct

Incorrect
Question 500 of 792

500. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician preparing an IV admixture notices the order specifies 500 mL of normal saline but the vial of medication additive says “for IM use only.” What should the technician do?

Stop preparation and alert the pharmacist to the potential wrong-route issue before proceeding
Correct Incorrect Correct answer

Proceed with the IV preparation since the pharmacist already verified the order
Correct Incorrect Correct answer

Add the medication to the IV bag and label it "for IM use only"
Correct Incorrect Correct answer

Substitute a different formulation without consulting the pharmacist
Correct Incorrect Correct answer

Correct

Incorrect
Question 501 of 792

501. Question

Category: Patient Safety and Quality Assurance: Error Prevention

During a pharmacy workflow redesign, the team decides to add barcode scanning at three points: receiving inventory, filling prescriptions, and final verification. Which benefit does this triple-scan approach provide?

It creates multiple independent checkpoints that catch errors at different stages of the workflow
Correct Incorrect Correct answer

It eliminates the need for pharmacist involvement in the dispensing process
Correct Incorrect Correct answer

It reduces the total time required to fill each prescription
Correct Incorrect Correct answer

It satisfies a specific FDA requirement for community pharmacies
Correct Incorrect Correct answer

Correct

Incorrect
Question 502 of 792

502. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy receives a handwritten prescription for “Norvasc 10mg QD.” The technician enters it into the system as “Navane 10 mg daily.” Which error type has occurred, and what safety measure could have prevented it?

A wrong-drug transcription error; CPOE or e-prescribing would have eliminated the handwriting interpretation issue
Correct Incorrect Correct answer

A wrong-dose error; a dose-range alert would have caught it
Correct Incorrect Correct answer

A wrong-route error; barcode scanning would have prevented it
Correct Incorrect Correct answer

A wrong-time error; a frequency check would have prevented it
Correct Incorrect Correct answer

Correct

Incorrect
Question 503 of 792

503. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A technician is counting tablets at the filling station and is interrupted by a phone call. After the call, the technician loses count and estimates the quantity. What type of error is most likely to result from this scenario?

Wrong quantity error due to the interruption disrupting the counting process
Correct Incorrect Correct answer

Wrong patient error due to confusion about the prescription
Correct Incorrect Correct answer

Wrong route error due to selecting the wrong dosage form
Correct Incorrect Correct answer

Wrong drug error due to picking from the incorrect stock bottle
Correct Incorrect Correct answer

Correct

Incorrect
Question 504 of 792

504. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacist overrides a clinical decision support alert for a drug-drug interaction without reading the details because the system generates frequent alerts for minor interactions. This behavior is known as what?

Alert fatigue, where excessive warnings lead clinicians to routinely dismiss all alerts including critical ones
Correct Incorrect Correct answer

Alert compliance, where clinicians follow all system recommendations
Correct Incorrect Correct answer

Clinical autonomy, where pharmacists exercise independent professional judgment
Correct Incorrect Correct answer

System malfunction, where the alert software has stopped functioning correctly
Correct Incorrect Correct answer

Correct

Incorrect
Question 505 of 792

505. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A hospital wants to reduce wrong-time medication administration errors on the evening shift. Which intervention directly addresses this error type?

Implementing electronic medication administration records with time-window alerts that notify nurses when a dose is due
Correct Incorrect Correct answer

Adding tall man lettering to all medication labels on the evening cart
Correct Incorrect Correct answer

Requiring all evening prescriptions to be entered using CPOE only
Correct Incorrect Correct answer

Installing additional lighting in the medication preparation area
Correct Incorrect Correct answer

Correct

Incorrect
Question 506 of 792

506. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A hospital experiences a sentinel event involving a fatal wrong-drug error. The root cause analysis reveals that the error passed through prescribing, dispensing, and administration without being caught. Which analysis best describes the systemic failure?

Multiple layers of defense failed simultaneously, indicating weaknesses in the prescribing checks, pharmacy verification, and nursing administration verification processes
Correct Incorrect Correct answer

A single individual at the administration stage is responsible for the entire error
Correct Incorrect Correct answer

The error was unavoidable because it originated at the prescribing stage
Correct Incorrect Correct answer

The pharmacy was solely at fault because dispensing is the final safety checkpoint
Correct Incorrect Correct answer

Correct

Incorrect
Question 507 of 792

507. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy is ranking error-prevention strategies by effectiveness. Which ordering from most to least effective aligns with the accepted hierarchy of safety interventions?

Forcing functions and constraints, automation and computerization, standardization and protocols, education and training
Correct Incorrect Correct answer

Education and training, standardization, automation, forcing functions
Correct Incorrect Correct answer

Standardization, education, forcing functions, automation
Correct Incorrect Correct answer

Automation, forcing functions, education, standardization
Correct Incorrect Correct answer

Correct

Incorrect
Question 508 of 792

508. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A root cause analysis of a wrong-dose error reveals that the prescriber wrote “U” instead of “units” for an insulin dose, the pharmacy transcribed it as a zero (making 5 U appear as 50), and the nurse administered 50 units. Which intervention would most effectively prevent this specific error chain?

Prohibiting the abbreviation "U" for units and requiring the word "units" to be written out, combined with CPOE implementation
Correct Incorrect Correct answer

Requiring nurses to double-check all insulin doses with the patient
Correct Incorrect Correct answer

Adding a warning label to all insulin vials about potential dosing errors
Correct Incorrect Correct answer

Increasing the frequency of pharmacist audits on nursing units
Correct Incorrect Correct answer

Correct

Incorrect
Question 509 of 792

509. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A community pharmacy discovers that 70% of its dispensing errors involve look-alike medications stored on adjacent shelves. A root cause analysis should focus on which system factor?

Pharmacy shelf organization and the absence of physical separation or visual differentiation for similar products
Correct Incorrect Correct answer

Individual technician performance scores and error rates
Correct Incorrect Correct answer

The number of prescriptions filled per hour by each technician
Correct Incorrect Correct answer

Whether the pharmacy is meeting its revenue targets for the quarter
Correct Incorrect Correct answer

Correct

Incorrect
Question 510 of 792

510. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy manager notices that CDS override rates have reached 90%, meaning pharmacists dismiss 9 out of 10 alerts. Which comprehensive strategy would best address this problem?

Conduct an alert optimization review to reduce low-severity alerts, tier remaining alerts by clinical significance, and monitor override reasons
Correct Incorrect Correct answer

Disable all CDS alerts to eliminate alert fatigue entirely
Correct Incorrect Correct answer

Require pharmacists to document a reason for every override without reducing alert volume
Correct Incorrect Correct answer

Add more alerts for additional drug interactions to ensure completeness
Correct Incorrect Correct answer

Correct

Incorrect
Question 511 of 792

511. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pediatric hospital reports that most dosing errors involve weight-based calculations. The errors occur when doses are calculated manually and transcribed to the order. Which combination of interventions most directly addresses both the calculation and transcription vulnerabilities?

CPOE with integrated weight-based dosing calculators and automatic dose-range checking against the patient weight
Correct Incorrect Correct answer

Requiring nurses to independently calculate doses at the bedside before administration
Correct Incorrect Correct answer

Posting weight-based dosing charts on the wall of each patient room
Correct Incorrect Correct answer

Mandating that all pediatric patients be weighed twice daily by different staff members
Correct Incorrect Correct answer

Correct

Incorrect
Question 512 of 792

512. Question

Category: Patient Safety and Quality Assurance: Error Prevention

After implementing barcode medication administration (BCMA), a hospital sees a 50% reduction in wrong-drug and wrong-patient errors but no change in wrong-time errors. What does this finding suggest about the technology’s limitations?

BCMA verifies product and patient identity but does not inherently enforce administration timing, indicating a need for complementary time-based alerts
Correct Incorrect Correct answer

BCMA is ineffective and should be replaced with a different technology
Correct Incorrect Correct answer

Wrong-time errors are not clinically significant and do not need to be addressed
Correct Incorrect Correct answer

The system is malfunctioning because it should prevent all error types equally
Correct Incorrect Correct answer

Correct

Incorrect
Question 513 of 792

513. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy is designing a new workflow and must decide where to place the most intensive safety checks. Error data shows that 45% of errors originate at prescribing, 30% at transcription, 15% at dispensing, and 10% at administration. How should safety resources be allocated?

Invest most heavily in prescribing safeguards (CPOE, CDS) and transcription automation (e-prescribing), while maintaining checks at dispensing and administration
Correct Incorrect Correct answer

Allocate resources equally across all four stages regardless of error frequency
Correct Incorrect Correct answer

Focus exclusively on the administration stage because it is the last opportunity to catch errors
Correct Incorrect Correct answer

Invest only in dispensing since the pharmacy has direct control over that stage
Correct Incorrect Correct answer

Correct

Incorrect
Question 514 of 792

514. Question

Category: Patient Safety and Quality Assurance: Event Reporting

What is the ISMP Medication Errors Reporting Program (MERP)?

A voluntary, confidential national reporting program for medication errors and hazardous conditions
Correct Incorrect Correct answer

A mandatory state-level reporting system for all pharmacy dispensing errors
Correct Incorrect Correct answer

An FDA enforcement program that penalizes pharmacies for medication errors
Correct Incorrect Correct answer

A pharmacy accreditation requirement that tracks prescription volume
Correct Incorrect Correct answer

Correct

Incorrect
Question 515 of 792

515. Question

Category: Patient Safety and Quality Assurance: Event Reporting

FDA MedWatch is primarily used to report which of the following?

Serious adverse events, product quality problems, and therapeutic failures related to FDA-regulated products
Correct Incorrect Correct answer

Minor side effects that resolve without treatment
Correct Incorrect Correct answer

Pharmacy staffing complaints and operational issues
Correct Incorrect Correct answer

Insurance claim denials and billing errors
Correct Incorrect Correct answer

Correct

Incorrect
Question 516 of 792

516. Question

Category: Patient Safety and Quality Assurance: Event Reporting

What is a near-miss event in the context of medication safety?

An error or hazardous condition that was detected and corrected before reaching the patient
Correct Incorrect Correct answer

A medication error that caused temporary patient harm requiring intervention
Correct Incorrect Correct answer

A sentinel event resulting in patient death or permanent disability
Correct Incorrect Correct answer

A planned medication dose that was intentionally held by the prescriber
Correct Incorrect Correct answer

Correct

Incorrect
Question 517 of 792

517. Question

Category: Patient Safety and Quality Assurance: Event Reporting

What is the Vaccine Adverse Event Reporting System (VAERS)?

A national system co-managed by the FDA and CDC for reporting adverse events following vaccination
Correct Incorrect Correct answer

A pharmacy inventory system for tracking vaccine stock levels
Correct Incorrect Correct answer

A program that compensates patients for all vaccine side effects
Correct Incorrect Correct answer

A clinical trial registry for experimental vaccines
Correct Incorrect Correct answer

Correct

Incorrect
Question 518 of 792

518. Question

Category: Patient Safety and Quality Assurance: Event Reporting

What is a sentinel event as defined by The Joint Commission?

An unexpected event involving death or serious physical or psychological injury, or the risk thereof
Correct Incorrect Correct answer

Any medication error that is reported to the pharmacy manager
Correct Incorrect Correct answer

A minor dispensing error that is corrected before the patient leaves the pharmacy
Correct Incorrect Correct answer

A scheduled quality improvement review of pharmacy operations
Correct Incorrect Correct answer

Correct

Incorrect
Question 519 of 792

519. Question

Category: Patient Safety and Quality Assurance: Event Reporting

Which of the following best describes a non-punitive reporting culture?

An environment where staff can report errors and near misses without fear of disciplinary action for honest mistakes
Correct Incorrect Correct answer

A system where all reported errors are automatically forwarded to law enforcement
Correct Incorrect Correct answer

A policy that prevents any employee from being evaluated on their error history
Correct Incorrect Correct answer

A culture where medication errors are not tracked or documented
Correct Incorrect Correct answer

Correct

Incorrect
Question 520 of 792

520. Question

Category: Patient Safety and Quality Assurance: Event Reporting

What is the primary purpose of a corrective action plan following a medication error event?

To implement specific changes that address the root causes identified and prevent recurrence of similar errors
Correct Incorrect Correct answer

To assign blame to the individuals involved in the error
Correct Incorrect Correct answer

To calculate the financial liability associated with the error
Correct Incorrect Correct answer

To satisfy a requirement for public disclosure of the error details
Correct Incorrect Correct answer

Correct

Incorrect
Question 521 of 792

521. Question

Category: Patient Safety and Quality Assurance: Event Reporting

Which type of medication error reporting is required by many state pharmacy boards when patient harm occurs?

Mandatory reporting to the state board or designated state agency
Correct Incorrect Correct answer

Voluntary reporting to ISMP only
Correct Incorrect Correct answer

Internal reporting to the pharmacy manager with no external disclosure
Correct Incorrect Correct answer

Anonymous posting on pharmacy safety forums
Correct Incorrect Correct answer

Correct

Incorrect
Question 522 of 792

522. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician catches a dispensing error before the medication is given to the patient. The wrong strength was selected but was identified during the pharmacist final check. Should this event be reported?

Yes, it should be reported as a near-miss event through the internal reporting system to identify system vulnerabilities
Correct Incorrect Correct answer

No, because the error was caught before reaching the patient
Correct Incorrect Correct answer

No, because only errors causing patient harm need to be reported
Correct Incorrect Correct answer

Yes, but only if the pharmacist requests that it be documented
Correct Incorrect Correct answer

Correct

Incorrect
Question 523 of 792

523. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A patient reports experiencing an unexpected severe rash after receiving a newly approved medication. The pharmacist suspects an adverse drug reaction. Which external reporting system is most appropriate for this report?

FDA MedWatch
Correct Incorrect Correct answer

ISMP MERP
Correct Incorrect Correct answer

VAERS
Correct Incorrect Correct answer

The state board of pharmacy
Correct Incorrect Correct answer

Correct

Incorrect
Question 524 of 792

524. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacist notices that the same type of dispensing error has occurred three times in two weeks, each involving confusion between two similarly packaged medications. What reporting and follow-up action is most appropriate?

File an internal incident report for each event, conduct a focused analysis of the pattern, and report the packaging concern to ISMP
Correct Incorrect Correct answer

Report only the most recent event since the earlier ones were already resolved
Correct Incorrect Correct answer

Wait for a fourth occurrence to confirm the pattern before taking action
Correct Incorrect Correct answer

Report the issue to the drug manufacturer and take no further action
Correct Incorrect Correct answer

Correct

Incorrect
Question 525 of 792

525. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician accidentally dispenses the wrong medication to a patient, and the patient takes two doses before the error is discovered. The patient experiences no harm. What reporting steps should occur?

Complete an internal incident report, notify the pharmacist for patient follow-up, and consider reporting to the state board if required by state law
Correct Incorrect Correct answer

No reporting is needed because the patient was not harmed
Correct Incorrect Correct answer

Report only to the pharmacy manager verbally without written documentation
Correct Incorrect Correct answer

File a report only with the patient's insurance company
Correct Incorrect Correct answer

Correct

Incorrect
Question 526 of 792

526. Question

Category: Patient Safety and Quality Assurance: Event Reporting

After a patient receives a flu vaccine and develops a high fever and seizure within 24 hours, the pharmacist determines this should be reported. Which reporting system should be used?

VAERS (Vaccine Adverse Event Reporting System)
Correct Incorrect Correct answer

FDA MedWatch only
Correct Incorrect Correct answer

ISMP MERP only
Correct Incorrect Correct answer

The pharmacy's internal incident report only
Correct Incorrect Correct answer

Correct

Incorrect
Question 527 of 792

527. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy manager wants to increase the rate of error reporting among staff. Several technicians admit they do not report near misses because they fear getting in trouble. What change would most effectively increase reporting?

Implement a non-punitive reporting policy that clearly distinguishes honest errors from reckless behavior and communicate it to all staff
Correct Incorrect Correct answer

Institute a policy that requires written apology letters for all reported errors
Correct Incorrect Correct answer

Create a public leaderboard showing which staff members have the most reported errors
Correct Incorrect Correct answer

Offer financial bonuses for each error report submitted
Correct Incorrect Correct answer

Correct

Incorrect
Question 528 of 792

528. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A root cause analysis following a serious medication error reveals that the pharmacy computer system allowed an order to be processed without an allergy check. What should the corrective action plan include?

A system fix requiring mandatory allergy verification before order processing, with a timeline and responsible party for implementation
Correct Incorrect Correct answer

A memo reminding staff to manually check allergies before processing orders
Correct Incorrect Correct answer

Disciplinary action for the pharmacist who processed the order without checking allergies
Correct Incorrect Correct answer

A plan to replace the entire pharmacy computer system within the next fiscal year
Correct Incorrect Correct answer

Correct

Incorrect
Question 529 of 792

529. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy receives a report that a patient was harmed by a medication error at their facility. The state requires mandatory reporting for errors causing patient injury. What is the technician’s role in this situation?

Document the facts of the event accurately in the internal incident report and notify the pharmacist, who will handle external reporting obligations
Correct Incorrect Correct answer

File the mandatory state report directly without informing the pharmacist
Correct Incorrect Correct answer

Contact the patient's attorney to discuss the error details
Correct Incorrect Correct answer

Post about the error on a professional pharmacy forum for peer input
Correct Incorrect Correct answer

Correct

Incorrect
Question 530 of 792

530. Question

Category: Patient Safety and Quality Assurance: Event Reporting

During a quality meeting, the pharmacy team reviews incident reports from the past quarter and notices that 40% of reported errors involve the same automated dispensing cabinet. What should the team do next?

Conduct a focused investigation of that specific cabinet to identify contributing factors such as stocking errors, software issues, or workflow problems
Correct Incorrect Correct answer

Conclude that the cabinet is defective and immediately remove it from service
Correct Incorrect Correct answer

Ignore the trend since the errors were already individually addressed
Correct Incorrect Correct answer

Redistribute the medications from that cabinet to other cabinets without further analysis
Correct Incorrect Correct answer

Correct

Incorrect
Question 531 of 792

531. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacist discovers that a medication dispensed last week had been recalled by the manufacturer. The patient has already taken the medication without apparent harm. What reporting actions are appropriate?

Notify the patient and prescriber, document the event internally, and report to MedWatch if an adverse event occurred or is suspected
Correct Incorrect Correct answer

Take no action since the patient has not reported any problems
Correct Incorrect Correct answer

Report to VAERS since the medication has been recalled
Correct Incorrect Correct answer

Contact the manufacturer only and take no other action
Correct Incorrect Correct answer

Correct

Incorrect
Question 532 of 792

532. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A hospital pharmacist wants to submit a report to ISMP about a confusing medication label that nearly caused a dispensing error. What information should be included in the ISMP MERP report?

A description of the event, the products involved, the contributing factors, and the outcome, including whether harm occurred
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Only the name of the medication and the pharmacy's address
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The names of all staff involved and their licensure numbers
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A copy of the patient's complete medical record
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Correct

Incorrect
Question 533 of 792

533. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician observes a coworker bypassing the barcode scanning step during prescription filling to save time during a busy period. No error has occurred yet. Should this be reported?

Yes, this hazardous condition should be reported because bypassing a safety check creates risk even if no error has yet occurred
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No, because no actual error has happened
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No, because reporting a coworker's behavior would violate workplace trust
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Yes, but only after an error actually results from the bypassed step
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Correct

Incorrect
Question 534 of 792

534. Question

Category: Patient Safety and Quality Assurance: Event Reporting

After a medication error, a hospital conducts a root cause analysis and identifies three contributing factors. The corrective action plan addresses only one of the three factors. What concern does this raise?

The plan is incomplete and leaves two system vulnerabilities unaddressed, increasing the risk of recurrence
Correct Incorrect Correct answer

The plan is sufficient because addressing one factor will prevent all future errors
Correct Incorrect Correct answer

The plan is adequate as long as the most critical factor was addressed
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The remaining factors will resolve on their own once the first corrective action is implemented
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Correct

Incorrect
Question 535 of 792

535. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy manager receives an anonymous error report through the internal reporting system. The report lacks sufficient detail to identify the specific event but describes a general process concern. How should the manager respond?

Use the information to review the described process for potential vulnerabilities and encourage staff to provide additional details through the anonymous system
Correct Incorrect Correct answer

Discard the report because anonymous reports are unreliable
Correct Incorrect Correct answer

Launch a formal investigation to identify who submitted the anonymous report
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Require all future reports to include the reporter's name to ensure accountability
Correct Incorrect Correct answer

Correct

Incorrect
Question 536 of 792

536. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A hospital compares its medication error reporting rate with national benchmarks and finds its rate is significantly lower. The pharmacy director is concerned rather than reassured. Which analysis best explains this concern?

A low reporting rate likely indicates underreporting due to a culture of fear or lack of awareness, not an absence of errors
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The hospital genuinely has fewer errors because of superior safety systems
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The low rate proves that the hospital's error prevention strategies are working perfectly
Correct Incorrect Correct answer

National benchmarks are unreliable, so the comparison is meaningless
Correct Incorrect Correct answer

Correct

Incorrect
Question 537 of 792

537. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy analyzes its incident report data and finds that near-miss reports outnumber actual error reports by a ratio of 10:1. What does this ratio suggest about the pharmacy’s safety culture?

A high near-miss to error ratio suggests a healthy reporting culture where staff feel safe reporting events and the system catches most errors before they reach patients
Correct Incorrect Correct answer

The pharmacy has too many near misses and needs to reduce them to zero
Correct Incorrect Correct answer

The ratio indicates that staff are fabricating near-miss reports to appear vigilant
Correct Incorrect Correct answer

The pharmacy should focus only on actual errors since near misses cause no harm
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Correct

Incorrect
Question 538 of 792

538. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A state mandates reporting of all medication errors causing patient harm, while ISMP MERP accepts voluntary reports of errors, near misses, and hazardous conditions. A pharmacy experiences a near-miss event with no patient harm. Which reporting obligations apply?

The mandatory state report is not required since no harm occurred, but a voluntary ISMP MERP report is appropriate and recommended
Correct Incorrect Correct answer

Both mandatory state reporting and ISMP MERP reporting are required
Correct Incorrect Correct answer

Neither report is necessary since no harm occurred
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Only mandatory state reporting is required; ISMP MERP is not relevant
Correct Incorrect Correct answer

Correct

Incorrect
Question 539 of 792

539. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A hospital transitions from paper-based incident reporting to an electronic reporting system and sees a 300% increase in reports over six months. Which interpretation of this data is most accurate?

The electronic system reduced barriers to reporting by making it easier, faster, and more accessible, resulting in better capture of events that were previously underreported
Correct Incorrect Correct answer

The hospital suddenly became much less safe, causing a dramatic increase in actual errors
Correct Incorrect Correct answer

The electronic system is generating duplicate reports that inflate the numbers
Correct Incorrect Correct answer

Staff are submitting frivolous reports because the electronic system is easier to use
Correct Incorrect Correct answer

Correct

Incorrect
Question 540 of 792

540. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy quality committee reviews incident data and finds that 80% of reports come from only 20% of the staff. Which factor most likely explains this distribution, and what action should the committee take?

The 20% are likely the most safety-conscious reporters; the committee should investigate barriers that prevent the other 80% from reporting and provide education on reporting expectations
Correct Incorrect Correct answer

The 20% are the poorest performers and should receive additional training
Correct Incorrect Correct answer

The distribution is normal and requires no action
Correct Incorrect Correct answer

The 80% who do not report should be disciplined for non-compliance
Correct Incorrect Correct answer

Correct

Incorrect
Question 541 of 792

541. Question

Category: Patient Safety and Quality Assurance: Event Reporting

After implementing corrective actions following a root cause analysis, a hospital notices that the same type of error recurs within three months. What does this suggest about the corrective actions?

The corrective actions did not adequately address the true root causes, or they relied too heavily on human-dependent solutions that are unsustainable
Correct Incorrect Correct answer

The corrective actions were effective but need more time to show results
Correct Incorrect Correct answer

Recurrence proves that medication errors are inevitable and cannot be prevented
Correct Incorrect Correct answer

The root cause analysis was performed correctly, but the error type is resistant to all interventions
Correct Incorrect Correct answer

Correct

Incorrect
Question 542 of 792

542. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A multi-site pharmacy organization wants to compare medication error rates across its locations. Location A reports 50 errors per month and Location B reports 10 errors per month. Location A has 200 staff and Location B has 30 staff. Which conclusion is most appropriate?

Raw numbers cannot be compared directly without normalizing for volume; per-capita or per-prescription rates must be calculated before drawing conclusions about relative safety
Correct Incorrect Correct answer

Location B is significantly safer because it has fewer total errors
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Location A has a major safety problem requiring immediate intervention
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Location B should serve as the model for all other locations
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Correct

Incorrect
Question 543 of 792

543. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy is deciding whether to invest in an advanced electronic event reporting system or spend the same budget on staff safety training. Current reporting rates are very low. Which investment is more likely to improve medication safety outcomes?

The electronic reporting system, because increased reporting captures more data for identifying systemic problems, which leads to targeted safety improvements
Correct Incorrect Correct answer

Staff training alone, because well-trained staff do not make errors and reporting becomes unnecessary
Correct Incorrect Correct answer

Neither investment will impact safety outcomes meaningfully
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Both investments are equally effective regardless of the current reporting rate
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Correct

Incorrect
Question 544 of 792

544. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

USP Chapter 797 provides standards for which type of pharmacy compounding?

Sterile compounding
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Non-sterile compounding
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Hazardous drug handling
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Controlled substance dispensing
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Correct

Incorrect
Question 545 of 792

545. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

USP Chapter 795 provides standards for which type of pharmacy compounding?

Non-sterile compounding
Correct Incorrect Correct answer

Sterile compounding
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Radiopharmaceutical preparation
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Vaccine storage and handling
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Correct

Incorrect
Question 546 of 792

546. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

According to the WHO, how many moments of hand hygiene are recognized as critical points for performing hand hygiene in healthcare settings?

Five moments
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Three moments
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Seven moments
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Ten moments
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Correct

Incorrect
Question 547 of 792

547. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

What is a laminar airflow workbench (LAFW) used for in pharmacy practice?

Providing an ISO Class 5 environment with unidirectional filtered air for preparing non-hazardous sterile preparations
Correct Incorrect Correct answer

Storing non-sterile compounding ingredients at controlled humidity
Correct Incorrect Correct answer

Dispensing oral medications in a dust-free environment
Correct Incorrect Correct answer

Heating IV solutions to body temperature before administration
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Correct

Incorrect
Question 548 of 792

548. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

What is the purpose of media fill testing in sterile compounding?

To evaluate the aseptic technique of compounding personnel by using a growth medium instead of an actual drug
Correct Incorrect Correct answer

To test whether the medication in a compounded preparation is chemically stable
Correct Incorrect Correct answer

To verify that the laminar airflow workbench motor is functioning properly
Correct Incorrect Correct answer

To confirm that the cleaning solution used in the clean room is effective
Correct Incorrect Correct answer

Correct

Incorrect
Question 549 of 792

549. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

What is the purpose of garbing procedures before entering a sterile compounding area?

To minimize the introduction of particulates and microorganisms from personnel into the clean room environment
Correct Incorrect Correct answer

To protect pharmacy personnel from exposure to hazardous chemicals
Correct Incorrect Correct answer

To comply with OSHA requirements for workplace dress codes
Correct Incorrect Correct answer

To maintain a professional appearance in the pharmacy
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Correct

Incorrect
Question 550 of 792

550. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

What is a biological safety cabinet (BSC) used for in the pharmacy?

Preparing hazardous sterile preparations while protecting both the product and the compounder from exposure
Correct Incorrect Correct answer

Storing temperature-sensitive vaccines at required temperatures
Correct Incorrect Correct answer

Incubating media fill test samples for microbial growth
Correct Incorrect Correct answer

Dispensing non-hazardous oral medications in a controlled environment
Correct Incorrect Correct answer

Correct

Incorrect
Question 551 of 792

551. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is about to enter the clean room to prepare sterile IV admixtures. Which garbing sequence is correct according to USP 797 standards?

Shoe covers, hair cover, face mask, hand washing, non-shedding gown, then sterile gloves as the final step before compounding
Correct Incorrect Correct answer

Sterile gloves first, then gown, hair cover, shoe covers, and face mask
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Gown first, then gloves, shoe covers, hair cover, and hand washing last
Correct Incorrect Correct answer

Hand washing, sterile gloves, face mask, shoe covers, hair cover, then gown
Correct Incorrect Correct answer

Correct

Incorrect
Question 552 of 792

552. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician notices that the HEPA filter certification for the laminar airflow workbench expired two weeks ago. What should the technician do?

Stop using the LAFW for sterile compounding and notify the pharmacist so that recertification can be scheduled immediately
Correct Incorrect Correct answer

Continue using the LAFW since it was working fine before the certification expired
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Use the LAFW only for non-hazardous preparations until recertification occurs
Correct Incorrect Correct answer

Replace the HEPA filter without professional certification and resume compounding
Correct Incorrect Correct answer

Correct

Incorrect
Question 553 of 792

553. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A technician is compounding a non-hazardous sterile preparation in a LAFW and sneezes. What is the correct immediate action?

Step away from the LAFW, remove and replace the face mask, perform hand hygiene, don new sterile gloves, and assess whether the preparation was contaminated
Correct Incorrect Correct answer

Continue compounding since the face mask prevented contamination
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Discard the preparation immediately without further assessment
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Leave the clean room entirely and do not return for 24 hours
Correct Incorrect Correct answer

Correct

Incorrect
Question 554 of 792

554. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy is setting up a new sterile compounding facility. The buffer area where the LAFW will be placed must meet which ISO classification under USP 797?

ISO Class 7
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ISO Class 5
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ISO Class 8
Correct Incorrect Correct answer

ISO Class 9
Correct Incorrect Correct answer

Correct

Incorrect
Question 555 of 792

555. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A technician completing a media fill test observes turbidity (cloudiness) in the growth medium after the incubation period. What does this result indicate?

Microbial growth occurred, indicating a failure in aseptic technique that requires investigation and retraining
Correct Incorrect Correct answer

The test was successful because turbidity shows the medium was viable
Correct Incorrect Correct answer

The growth medium expired and the test should be repeated with fresh medium
Correct Incorrect Correct answer

The result is normal and does not require any follow-up action
Correct Incorrect Correct answer

Correct

Incorrect
Question 556 of 792

556. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is compounding a hazardous sterile preparation. Which primary engineering control should be used?

A Class II biological safety cabinet (BSC) or a compounding aseptic containment isolator (CACI)
Correct Incorrect Correct answer

A horizontal laminar airflow workbench (LAFW)
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A vertical laminar airflow workbench without containment features
Correct Incorrect Correct answer

A standard pharmacy dispensing counter with a splash guard
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Correct

Incorrect
Question 557 of 792

557. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy performs environmental monitoring of its clean room by collecting surface samples from the LAFW work surface. The results show microbial growth above acceptable limits. What action should follow?

Investigate the cleaning procedures, re-clean and re-sanitize the work surface, and resample to confirm acceptable results before resuming compounding
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Ignore the results since environmental monitoring is only advisory
Correct Incorrect Correct answer

Continue compounding but increase the frequency of hand hygiene
Correct Incorrect Correct answer

Replace the LAFW with a new unit immediately
Correct Incorrect Correct answer

Correct

Incorrect
Question 558 of 792

558. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A non-sterile compounding pharmacy is preparing a topical cream. Under USP 795, what is required regarding beyond-use dating for this preparation?

Assign a beyond-use date based on the preparation type, stability data, and USP 795 default guidelines when stability information is not available
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Assign the same expiration date as the earliest expiring ingredient
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No beyond-use date is required for non-sterile preparations
Correct Incorrect Correct answer

Use the manufacturer's expiration date for the final compounded product
Correct Incorrect Correct answer

Correct

Incorrect
Question 559 of 792

559. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A technician is cleaning the interior of a horizontal LAFW before sterile compounding. In which direction should the technician wipe the work surface?

From back to front and from the cleanest area toward the outer edge, moving in the direction of airflow
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From front to back against the direction of airflow
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In circular motions starting at the center of the work surface
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From side to side regardless of airflow direction
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Correct

Incorrect
Question 560 of 792

560. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is assigned to compound sterile preparations but has not completed a media fill test in the past 12 months. Can the technician proceed with compounding?

No; USP 797 requires personnel competency assessments including media fill testing at defined intervals, and the technician must pass before compounding
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Yes, as long as the technician has passed a written exam on aseptic technique
Correct Incorrect Correct answer

Yes, because media fill testing is only required during initial training
Correct Incorrect Correct answer

No, but the technician can compound under direct pharmacist observation instead
Correct Incorrect Correct answer

Correct

Incorrect
Question 561 of 792

561. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A Category 1 compounded sterile preparation (CSP) is prepared under conditions that meet all USP 797 requirements. What is the maximum beyond-use date for this CSP if stored at controlled room temperature?

12 hours at controlled room temperature for Category 1 CSPs prepared in accordance with USP 797
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24 hours at controlled room temperature
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48 hours at controlled room temperature
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7 days at controlled room temperature
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Correct

Incorrect
Question 562 of 792

562. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is preparing to compound in a LAFW and notices the anteroom (ISO Class 8 area) has visible dust on surfaces. What should the technician do before proceeding?

Clean the anteroom surfaces according to the facility cleaning protocol before beginning the garbing process
Correct Incorrect Correct answer

Skip the anteroom and garb directly in the buffer area
Correct Incorrect Correct answer

Proceed with garbing since the anteroom does not need to be clean for compounding
Correct Incorrect Correct answer

Report the issue but proceed with compounding to meet the preparation deadline
Correct Incorrect Correct answer

Correct

Incorrect
Question 563 of 792

563. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy needs to compound a sterile preparation that requires a 30-day beyond-use date. Under USP 797, which compounding category must be met to assign this BUD?

Category 2, which requires more stringent conditions including specific environmental monitoring and testing protocols
Correct Incorrect Correct answer

Category 1, which is sufficient for any BUD up to 90 days
Correct Incorrect Correct answer

No specific category is required if the preparation is stored refrigerated
Correct Incorrect Correct answer

The preparation cannot be compounded in a pharmacy regardless of category
Correct Incorrect Correct answer

Correct

Incorrect
Question 564 of 792

564. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician performs hand hygiene using an alcohol-based hand rub before donning sterile gloves. Under what circumstances should the technician use soap and water instead?

When hands are visibly soiled or contaminated with organic material, as alcohol-based rubs do not remove visible soil
Correct Incorrect Correct answer

When the pharmacy is out of alcohol-based hand rub
Correct Incorrect Correct answer

When the technician has just eaten lunch, regardless of visible soil
Correct Incorrect Correct answer

Soap and water should never be used before sterile compounding
Correct Incorrect Correct answer

Correct

Incorrect
Question 565 of 792

565. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A hospital pharmacy experiences a cluster of bloodstream infections traced to contaminated compounded sterile preparations. Investigation reveals that environmental monitoring had not been performed for three months. Which analysis best explains the relationship between the monitoring lapse and the infections?

Without environmental monitoring, the pharmacy could not detect deterioration in clean room air quality or surface contamination, allowing microbial contamination to go undetected until patients were infected
Correct Incorrect Correct answer

The infections were coincidental and unrelated to the monitoring lapse
Correct Incorrect Correct answer

Environmental monitoring would not have prevented the infections because it only measures air particles
Correct Incorrect Correct answer

The monitoring lapse was the sole cause, and resuming monitoring alone would prevent future infections
Correct Incorrect Correct answer

Correct

Incorrect
Question 566 of 792

566. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy is designing a new sterile compounding suite and must decide between a segregated compounding area (SCA) and a full clean room suite with anteroom and buffer room. Which analysis correctly identifies the key trade-off?

An SCA has lower construction costs but limits beyond-use dates and compounding categories, while a full suite requires higher investment but supports longer BUDs and Category 2 compounding
Correct Incorrect Correct answer

An SCA provides the same capabilities as a full clean room suite at lower cost
Correct Incorrect Correct answer

A full suite is required by law for all pharmacies that compound any sterile preparation
Correct Incorrect Correct answer

The choice has no impact on the types of preparations that can be compounded
Correct Incorrect Correct answer

Correct

Incorrect
Question 567 of 792

567. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy’s media fill failure rate increases from 2% to 15% over six months. Which comprehensive investigation approach would best identify the cause?

Review personnel technique through direct observation, assess training records, evaluate environmental monitoring trends, and inspect PEC certification status
Correct Incorrect Correct answer

Retrain all staff simultaneously without investigating the specific cause
Correct Incorrect Correct answer

Replace all primary engineering controls with new equipment
Correct Incorrect Correct answer

Suspend sterile compounding permanently until a consultant is hired
Correct Incorrect Correct answer

Correct

Incorrect
Question 568 of 792

568. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy must compound both hazardous and non-hazardous sterile preparations. The pharmacy director proposes using a single room with both a LAFW and a BSC. Which analysis identifies the primary concern with this layout?

Hazardous compounding requires a negative-pressure room to contain hazardous residues, while non-hazardous compounding requires a positive-pressure room to prevent contamination; these requirements are incompatible in a single room
Correct Incorrect Correct answer

There is no concern because both PECs provide ISO Class 5 air quality
Correct Incorrect Correct answer

The only concern is having enough counter space for both devices
Correct Incorrect Correct answer

The BSC and LAFW can share the same room if a curtain separates them
Correct Incorrect Correct answer

Correct

Incorrect
Question 569 of 792

569. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy audit reveals that technicians consistently garb in the correct sequence but frequently touch non-sterile surfaces after donning sterile gloves and before beginning compounding. Which analysis correctly identifies the risk and the most effective intervention?

Touching non-sterile surfaces contaminates the gloves and could contaminate CSPs; redesigning the workflow to eliminate the need to touch non-sterile items after gloving is the most effective intervention
Correct Incorrect Correct answer

The risk is minimal because gloves can be wiped with alcohol and reused
Correct Incorrect Correct answer

The technicians need a verbal reminder posted in the clean room
Correct Incorrect Correct answer

Glove contamination only matters for hazardous drug compounding
Correct Incorrect Correct answer

Correct

Incorrect
Question 570 of 792

570. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy discovers that its Category 2 CSPs have been assigned beyond-use dates exceeding what the facility’s testing data supports. Some preparations with 45-day BUDs were based on stability data for only 14 days. Which risk does this practice create?

Patients may receive preparations that have degraded or become contaminated beyond the period for which safety and stability have been demonstrated
Correct Incorrect Correct answer

The preparations are safe because USP 797 allows extended BUDs for all Category 2 CSPs automatically
Correct Incorrect Correct answer

The risk is limited to potency loss and does not include microbial contamination
Correct Incorrect Correct answer

The pharmacy is compliant as long as the BUD does not exceed 180 days
Correct Incorrect Correct answer

Correct

Incorrect
Question 571 of 792

571. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy director is evaluating the cost-effectiveness of implementing a comprehensive USP 797 compliance program versus outsourcing all sterile compounding to a 503B outsourcing facility. Which factors should be included in a complete analysis?

Construction and equipment costs, ongoing monitoring and testing expenses, staffing and training costs, outsourcing pricing, turnaround time, preparation availability, and the ability to customize preparations for individual patients
Correct Incorrect Correct answer

Only the direct cost comparison between in-house preparation and outsourcing unit prices
Correct Incorrect Correct answer

Only the liability exposure from each option
Correct Incorrect Correct answer

Only the preference of the pharmacy staff
Correct Incorrect Correct answer

Correct

Incorrect
Question 572 of 792

572. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

Two pharmacies prepare identical sterile products. Pharmacy A performs daily cleaning, monthly environmental monitoring, and annual personnel competency testing. Pharmacy B performs daily cleaning, weekly environmental monitoring, and semiannual personnel competency testing. Which pharmacy is more likely to detect and prevent contamination events earlier?

Pharmacy B, because more frequent environmental monitoring and competency testing provide earlier detection of contamination trends and technique degradation
Correct Incorrect Correct answer

Pharmacy A, because annual competency testing is sufficient and less disruptive to workflow
Correct Incorrect Correct answer

Both pharmacies are equally effective because daily cleaning is the most important factor
Correct Incorrect Correct answer

Neither pharmacy's frequency matters because contamination events are random and unpredictable
Correct Incorrect Correct answer

Correct

Incorrect
Question 573 of 792

573. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

Which of the following tasks requires pharmacist intervention and cannot be performed by a pharmacy technician?

Providing clinical counseling to a patient about medication side effects
Correct Incorrect Correct answer

Counting and packaging tablets for a prescription order
Correct Incorrect Correct answer

Entering patient demographic information into the pharmacy system
Correct Incorrect Correct answer

Placing stock bottles on the pharmacy shelves in the correct location
Correct Incorrect Correct answer

Correct

Incorrect
Question 574 of 792

574. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

Under OBRA 90, which requirement applies to pharmacists when dispensing medications to Medicaid patients?

Pharmacists must offer to counsel patients on new prescriptions
Correct Incorrect Correct answer

Pharmacists must provide written drug information in all cases
Correct Incorrect Correct answer

Pharmacists must verify that all medications are covered by insurance
Correct Incorrect Correct answer

Pharmacists must contact the prescriber before every new prescription
Correct Incorrect Correct answer

Correct

Incorrect
Question 575 of 792

575. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

Which DUR alert would most likely require pharmacist review before a prescription can be dispensed?

A severe drug interaction between two medications on the patient profile
Correct Incorrect Correct answer

A notification that the patient has a new insurance plan on file
Correct Incorrect Correct answer

An alert indicating the medication has a generic equivalent available
Correct Incorrect Correct answer

A reminder that the prescription was last filled more than 30 days ago
Correct Incorrect Correct answer

Correct

Incorrect
Question 576 of 792

576. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

When a patient reports a drug allergy during prescription intake, what is the appropriate action for the technician?

Document the allergy in the patient profile and alert the pharmacist
Correct Incorrect Correct answer

Determine whether the allergy is clinically significant before entering it
Correct Incorrect Correct answer

Change the prescription to a different medication that avoids the allergen
Correct Incorrect Correct answer

Advise the patient on which alternative medications would be appropriate
Correct Incorrect Correct answer

Correct

Incorrect
Question 577 of 792

577. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

What is therapeutic substitution in pharmacy practice?

Dispensing a different drug from the same therapeutic class as the prescribed medication
Correct Incorrect Correct answer

Replacing a brand name drug with its FDA-approved generic equivalent
Correct Incorrect Correct answer

Switching a patient from an oral dosage form to an injectable formulation
Correct Incorrect Correct answer

Providing a different manufacturer version of the same generic medication
Correct Incorrect Correct answer

Correct

Incorrect
Question 578 of 792

578. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

Which situation requires the pharmacist to contact the prescriber before dispensing?

A prescription with a dose that exceeds the maximum recommended daily amount
Correct Incorrect Correct answer

A prescription for a medication that is temporarily on backorder from the supplier
Correct Incorrect Correct answer

A prescription that requires reconstitution before dispensing to the patient
Correct Incorrect Correct answer

A prescription written for a patient who is new to the pharmacy location
Correct Incorrect Correct answer

Correct

Incorrect
Question 579 of 792

579. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

What is the pharmacy technician role in the prior authorization process?

Gathering required information and submitting paperwork to the insurance company
Correct Incorrect Correct answer

Making the clinical determination of whether a medication is medically necessary
Correct Incorrect Correct answer

Deciding which alternative medication should be prescribed if the request is denied
Correct Incorrect Correct answer

Approving or denying the prior authorization request on behalf of the pharmacist
Correct Incorrect Correct answer

Correct

Incorrect
Question 580 of 792

580. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

Which of the following is an example of medication therapy management (MTM)?

A pharmacist reviewing all of a patient medications to identify and resolve drug therapy problems
Correct Incorrect Correct answer

A technician counting and verifying the quantity of tablets in a prescription
Correct Incorrect Correct answer

A pharmacist ordering medications from a wholesale distributor for pharmacy stock
Correct Incorrect Correct answer

A technician processing insurance claims and resolving third-party rejections
Correct Incorrect Correct answer

Correct

Incorrect
Question 581 of 792

581. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

When can a pharmacist refuse to fill a prescription?

When the pharmacist has professional judgment concerns about patient safety
Correct Incorrect Correct answer

When the pharmacy is too busy to process additional prescriptions that day
Correct Incorrect Correct answer

When the patient does not have insurance coverage for the prescribed medication
Correct Incorrect Correct answer

When the prescribed medication is available over the counter at a lower cost
Correct Incorrect Correct answer

Correct

Incorrect
Question 582 of 792

582. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

Which activity related to vaccine administration requires direct pharmacist oversight?

Screening patients for contraindications and eligibility before immunization
Correct Incorrect Correct answer

Maintaining the vaccine inventory and monitoring storage temperatures daily
Correct Incorrect Correct answer

Scheduling patient appointments for vaccination through the pharmacy system
Correct Incorrect Correct answer

Filing insurance claims for administered vaccines through the billing software
Correct Incorrect Correct answer

Correct

Incorrect
Question 583 of 792

583. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician enters a new prescription for warfarin 5 mg daily. The DUR system alerts for a severe interaction with the patient current metronidazole prescription. What should the technician do?

Stop processing and immediately notify the pharmacist of the severe interaction alert
Correct Incorrect Correct answer

Override the alert because both medications are commonly prescribed together
Correct Incorrect Correct answer

Call the prescriber to request a dose reduction for the warfarin prescription
Correct Incorrect Correct answer

Inform the patient about the interaction and ask if they want to proceed
Correct Incorrect Correct answer

Correct

Incorrect
Question 584 of 792

584. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient drops off a prescription for amoxicillin 500 mg. During intake, the patient mentions having a penicillin allergy that causes hives. What is the correct technician response?

Document the allergy and immediately alert the pharmacist before processing the prescription
Correct Incorrect Correct answer

Inform the patient that amoxicillin is different from penicillin and proceed with filling
Correct Incorrect Correct answer

Change the prescription to azithromycin as a suitable alternative for the patient
Correct Incorrect Correct answer

Tell the patient to take an antihistamine before taking the amoxicillin to prevent hives
Correct Incorrect Correct answer

Correct

Incorrect
Question 585 of 792

585. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient asks the technician whether their new blood pressure medication can be taken with grapefruit juice. How should the technician handle this question?

Refer the patient to the pharmacist for counseling on food and drug interactions
Correct Incorrect Correct answer

Tell the patient that grapefruit juice is safe with all blood pressure medications
Correct Incorrect Correct answer

Look up the interaction and provide the patient with a detailed clinical explanation
Correct Incorrect Correct answer

Suggest the patient call their doctor to ask about grapefruit juice interactions
Correct Incorrect Correct answer

Correct

Incorrect
Question 586 of 792

586. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A prescriber calls the pharmacy requesting a therapeutic substitution of lisinopril for enalapril for a patient. Who must authorize this change in the pharmacy?

The pharmacist must evaluate and authorize the therapeutic substitution
Correct Incorrect Correct answer

The pharmacy technician can process the change with prescriber verbal approval
Correct Incorrect Correct answer

The pharmacy manager must approve all therapeutic substitutions in writing
Correct Incorrect Correct answer

The insurance company must pre-approve the substitution before it is processed
Correct Incorrect Correct answer

Correct

Incorrect
Question 587 of 792

587. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

While processing a prescription refill, a technician notices that the patient dose of metformin was recently increased from 500 mg to 1000 mg twice daily. The patient asks the technician to explain why the dose was changed. What should the technician do?

Refer the patient to the pharmacist to discuss the reason for the dose change
Correct Incorrect Correct answer

Explain that the doctor likely increased the dose because blood sugar was not controlled
Correct Incorrect Correct answer

Tell the patient to call their doctor office to ask about the dose adjustment
Correct Incorrect Correct answer

Check the patient chart to determine the clinical reason for the dose increase
Correct Incorrect Correct answer

Correct

Incorrect
Question 588 of 792

588. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician receives a prescription for a controlled substance, but the prescription lacks the prescriber DEA number. What is the appropriate course of action?

Notify the pharmacist, who will determine if the prescriber needs to be contacted
Correct Incorrect Correct answer

Fill the prescription and add the DEA number from the pharmacy records later
Correct Incorrect Correct answer

Reject the prescription and tell the patient to get a new one from the doctor
Correct Incorrect Correct answer

Look up the prescriber DEA number online and add it to the prescription
Correct Incorrect Correct answer

Correct

Incorrect
Question 589 of 792

589. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient presents a new prescription and tells the technician they recently had an allergic reaction to a sulfa drug. The new prescription is for sulfamethoxazole/trimethoprim. What should the technician do?

Alert the pharmacist immediately because the prescribed medication contains a sulfa component
Correct Incorrect Correct answer

Process the prescription because sulfamethoxazole is different from other sulfa drugs
Correct Incorrect Correct answer

Recommend the patient take diphenhydramine with the medication to prevent a reaction
Correct Incorrect Correct answer

Contact the prescriber directly to change the prescription to a non-sulfa antibiotic
Correct Incorrect Correct answer

Correct

Incorrect
Question 590 of 792

590. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient calls the pharmacy asking if they can crush their extended-release metoprolol tablets because they have difficulty swallowing. Who should address this question?

The pharmacist, because altering dosage forms requires clinical assessment
Correct Incorrect Correct answer

The technician, because this is a simple question about medication administration
Correct Incorrect Correct answer

The prescriber, because only they can authorize changes to how medications are taken
Correct Incorrect Correct answer

The insurance company, because a dosage form change may affect plan coverage
Correct Incorrect Correct answer

Correct

Incorrect
Question 591 of 792

591. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician is processing a prescription for a 4-year-old child. The prescribed dose of amoxicillin appears to be an adult dose of 500 mg three times daily. What should the technician do?

Flag the prescription for pharmacist review due to a potentially inappropriate pediatric dose
Correct Incorrect Correct answer

Fill the prescription as written because the prescriber is responsible for the dose
Correct Incorrect Correct answer

Calculate the correct pediatric dose based on the child weight and adjust accordingly
Correct Incorrect Correct answer

Contact the parent to confirm that the prescriber intended to write this dose
Correct Incorrect Correct answer

Correct

Incorrect
Question 592 of 792

592. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient with kidney disease picks up a prescription for a medication that requires renal dose adjustment. The technician notices the standard dose was prescribed. What is the appropriate action?

Notify the pharmacist to evaluate whether a dose adjustment is needed for the patient
Correct Incorrect Correct answer

Reduce the dose based on the patient estimated kidney function in the system
Correct Incorrect Correct answer

Dispense the medication as prescribed and advise the patient to take it with extra water
Correct Incorrect Correct answer

Call the prescriber directly to request a lower dose for the patient condition
Correct Incorrect Correct answer

Correct

Incorrect
Question 593 of 792

593. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

During the filling process, a technician discovers that a patient prescription for lisinopril 10 mg conflicts with a documented ACE inhibitor allergy in the patient profile. What should happen next?

The pharmacist should be notified to evaluate the allergy and determine next steps
Correct Incorrect Correct answer

The technician should override the allergy alert since the allergy may be outdated
Correct Incorrect Correct answer

The technician should substitute the medication with an ARB without pharmacist input
Correct Incorrect Correct answer

The prescription should be returned to the patient with instructions to see their doctor
Correct Incorrect Correct answer

Correct

Incorrect
Question 594 of 792

594. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician receives a verbal prescription over the phone from a nurse at a physician office. Under most state pharmacy laws, what should the technician do?

Transfer the call to the pharmacist, as only pharmacists can accept verbal prescriptions
Correct Incorrect Correct answer

Write down the prescription and have the pharmacist verify it before processing
Correct Incorrect Correct answer

Accept the prescription and enter it directly into the pharmacy computer system
Correct Incorrect Correct answer

Ask the nurse to fax the prescription instead because verbal orders are not permitted
Correct Incorrect Correct answer

Correct

Incorrect
Question 595 of 792

595. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient requests an early refill of their oxycodone prescription, stating they are going on vacation. The refill is 10 days early. What should the technician do?

Refer the request to the pharmacist for evaluation of the early refill circumstances
Correct Incorrect Correct answer

Process the early refill because the patient provided a valid reason for the request
Correct Incorrect Correct answer

Deny the refill and tell the patient they must wait until the original fill date
Correct Incorrect Correct answer

Contact the prescriber to get authorization for the early controlled substance refill
Correct Incorrect Correct answer

Correct

Incorrect
Question 596 of 792

596. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient brings in a prescription for a medication that requires a Risk Evaluation and Mitigation Strategy (REMS) program enrollment. The patient is not currently enrolled. What action is needed?

The pharmacist must verify REMS enrollment requirements before the medication can be dispensed
Correct Incorrect Correct answer

The technician can enroll the patient in the REMS program and dispense the medication
Correct Incorrect Correct answer

The medication can be dispensed with a note to enroll the patient at the next visit
Correct Incorrect Correct answer

The insurance company must authorize the REMS enrollment before dispensing can occur
Correct Incorrect Correct answer

Correct

Incorrect
Question 597 of 792

597. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician notices that a patient has been filling prescriptions for the same controlled substance at two different pharmacies based on information from the PDMP. What should the technician do?

Report the finding to the pharmacist for further review and clinical judgment
Correct Incorrect Correct answer

Refuse to fill the prescription and inform the patient of the PDMP findings
Correct Incorrect Correct answer

Contact the other pharmacy to cancel the patient prescription at that location
Correct Incorrect Correct answer

Report the patient directly to the DEA for suspected controlled substance diversion
Correct Incorrect Correct answer

Correct

Incorrect
Question 598 of 792

598. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy receives a prescription for isotretinoin for a female patient of childbearing age. The technician checks the iPLEDGE system and finds the patient pregnancy test is overdue. Which analysis best describes the situation?

The pharmacist cannot dispense until a current negative pregnancy test is confirmed through iPLEDGE
Correct Incorrect Correct answer

The technician should dispense the medication and remind the patient to get a pregnancy test
Correct Incorrect Correct answer

The pharmacist can override the iPLEDGE requirement if the patient signs a consent form
Correct Incorrect Correct answer

The prescriber must submit a new prescription with a note confirming the patient is not pregnant
Correct Incorrect Correct answer

Correct

Incorrect
Question 599 of 792

599. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient profile shows prescriptions from three different prescribers for alprazolam 1 mg, oxycodone 30 mg, and carisoprodol 350 mg. This combination is sometimes called the “holy trinity.” What is the most appropriate response?

The pharmacist should evaluate the profile for potential substance misuse before dispensing any of the medications
Correct Incorrect Correct answer

The technician should fill all three prescriptions because each was written by a licensed prescriber
Correct Incorrect Correct answer

The technician should contact all three prescribers to inform them of the other prescriptions
Correct Incorrect Correct answer

The pharmacist should dispense only two of the three medications to reduce the overall risk
Correct Incorrect Correct answer

Correct

Incorrect
Question 600 of 792

600. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician processes a prescription for methotrexate 2.5 mg with directions to take daily. The typical rheumatoid arthritis dosing for methotrexate is weekly, not daily. What is the most appropriate course of action?

Alert the pharmacist because daily methotrexate dosing for rheumatoid arthritis is a known dangerous error
Correct Incorrect Correct answer

Fill the prescription as written because the prescriber may have a specific reason for daily dosing
Correct Incorrect Correct answer

Change the directions to weekly dosing and inform the patient of the correction at pickup
Correct Incorrect Correct answer

Ask the patient whether they were told to take the medication daily or weekly by the doctor
Correct Incorrect Correct answer

Correct

Incorrect
Question 601 of 792

601. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient enrolled in medication therapy management (MTM) has a comprehensive medication review scheduled. During the appointment, the pharmacist identifies that the patient is taking three medications that are no longer indicated based on current lab values. Which action falls within the pharmacist authority?

Recommending changes to the prescriber based on the clinical assessment of the patient therapy
Correct Incorrect Correct answer

Discontinuing the unnecessary medications and documenting the changes in the patient chart
Correct Incorrect Correct answer

Prescribing replacement medications that are more appropriate for the patient current condition
Correct Incorrect Correct answer

Ordering new laboratory tests to confirm whether the medications should be continued
Correct Incorrect Correct answer

Correct

Incorrect
Question 602 of 792

602. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A technician is processing a prescription for clozapine. The patient REMS monitoring shows their absolute neutrophil count (ANC) result is below the required threshold. What should happen?

The pharmacist must not dispense the medication until an acceptable ANC result is obtained
Correct Incorrect Correct answer

The technician can dispense a partial supply while waiting for updated blood work results
Correct Incorrect Correct answer

The pharmacist can override the ANC requirement if the patient has been stable on therapy
Correct Incorrect Correct answer

The prescriber can authorize dispensing by submitting a letter of medical necessity to the pharmacy
Correct Incorrect Correct answer

Correct

Incorrect
Question 603 of 792

603. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician notices that a patient who recently had a kidney transplant is picking up a prescription for ibuprofen 800 mg prescribed by a different provider. The patient also takes tacrolimus. What makes this situation require pharmacist intervention?

NSAIDs can reduce kidney function and increase tacrolimus toxicity in transplant patients
Correct Incorrect Correct answer

Ibuprofen is a controlled substance that requires special documentation for transplant patients
Correct Incorrect Correct answer

Tacrolimus and ibuprofen are in the same drug class, creating a therapeutic duplication issue
Correct Incorrect Correct answer

Transplant patients are not permitted to take any over-the-counter medications by protocol
Correct Incorrect Correct answer

Correct

Incorrect
Question 604 of 792

604. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A prescriber sends an electronic prescription for a patient that lists “take as directed” as the only directions. The medication is a new antihypertensive for the patient. Why does this require pharmacist intervention?

The directions are insufficient for safe medication use, and the pharmacist must clarify specific dosing with the prescriber
Correct Incorrect Correct answer

Electronic prescriptions with vague directions are automatically rejected by pharmacy software
Correct Incorrect Correct answer

The pharmacist needs to add standard directions based on the drug monograph without contacting the prescriber
Correct Incorrect Correct answer

The technician can look up standard dosing and add appropriate directions to the prescription label
Correct Incorrect Correct answer

Correct

Incorrect
Question 605 of 792

605. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient presents a prescription for promethazine with codeine cough syrup. The patient is 18 months old. What critical concern should lead to pharmacist intervention?

Codeine-containing products are contraindicated in children under 12 due to the risk of fatal respiratory depression
Correct Incorrect Correct answer

Promethazine is only available as a tablet formulation and cannot be given to infants
Correct Incorrect Correct answer

Cough suppressants are never prescribed for any pediatric patients under age five years
Correct Incorrect Correct answer

Codeine requires prior authorization for patients under the age of two years old
Correct Incorrect Correct answer

Correct

Incorrect
Question 606 of 792

606. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician observes that a patient who receives monthly prescriptions for suboxone (buprenorphine/naloxone) has also presented a new prescription for oxycodone from a different provider. What makes pharmacist intervention essential?

Suboxone is used for opioid use disorder treatment, and concurrent full-agonist opioids can cause precipitated withdrawal or reduced treatment efficacy
Correct Incorrect Correct answer

Suboxone and oxycodone are the same drug class, making this only a therapeutic duplication issue
Correct Incorrect Correct answer

Oxycodone cannot be prescribed while a patient is taking any other controlled substance
Correct Incorrect Correct answer

The technician must report both prescribers to the DEA before the pharmacist can intervene
Correct Incorrect Correct answer

Correct

Incorrect
Question 607 of 792

607. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient currently taking lithium 300 mg three times daily presents a new prescription for hydrochlorothiazide 25 mg daily from a different provider. The technician flags this for the pharmacist. Why is pharmacist intervention critical in this case?

Thiazide diuretics can decrease lithium excretion, leading to elevated lithium levels and toxicity
Correct Incorrect Correct answer

Hydrochlorothiazide and lithium are both salts that compete for the same absorption pathway
Correct Incorrect Correct answer

Lithium levels are never affected by changes in other medications or fluid balance
Correct Incorrect Correct answer

The pharmacist needs to switch the patient from lithium to a safer mood stabilizer
Correct Incorrect Correct answer

Correct

Incorrect
Question 608 of 792

608. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

Which of the following is a common type of prescription error?

Dispensing the wrong drug due to similar-sounding medication names
Correct Incorrect Correct answer

Filling a prescription using the correct NDC number from the shelf
Correct Incorrect Correct answer

Verifying the patient date of birth before processing a prescription
Correct Incorrect Correct answer

Scanning the barcode on the stock bottle during the filling process
Correct Incorrect Correct answer

Correct

Incorrect
Question 609 of 792

609. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

What is the purpose of barcode scanning during the prescription filling process?

To verify that the correct medication and strength are being dispensed
Correct Incorrect Correct answer

To automatically calculate the price of the medication for the patient
Correct Incorrect Correct answer

To check whether the medication is covered by the patient insurance plan
Correct Incorrect Correct answer

To record the pharmacist initials for the final verification of the prescription
Correct Incorrect Correct answer

Correct

Incorrect
Question 610 of 792

610. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

What is a “near miss” in pharmacy practice?

An error that is caught before the medication reaches the patient
Correct Incorrect Correct answer

A prescription that is almost ready but requires one final verification step
Correct Incorrect Correct answer

A medication that is close to its expiration date but still within acceptable range
Correct Incorrect Correct answer

A patient who nearly missed their appointment for a medication consultation
Correct Incorrect Correct answer

Correct

Incorrect
Question 611 of 792

611. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

Which technology is designed to reduce prescription errors by transmitting prescriptions electronically from the prescriber to the pharmacy?

Electronic prescribing (e-prescribing)
Correct Incorrect Correct answer

Automated dispensing cabinets (ADCs)
Correct Incorrect Correct answer

Prescription drug monitoring programs (PDMPs)
Correct Incorrect Correct answer

Computerized inventory management systems
Correct Incorrect Correct answer

Correct

Incorrect
Question 612 of 792

612. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

What type of error occurs when a decimal point is misplaced, causing a patient to receive 10 times the intended dose?

A 10-fold dosing error
Correct Incorrect Correct answer

A transcription rounding error
Correct Incorrect Correct answer

A unit conversion calculation error
Correct Incorrect Correct answer

A therapeutic duplication dosing error
Correct Incorrect Correct answer

Correct

Incorrect
Question 613 of 792

613. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

Which element must be present on a prescription for a Schedule II controlled substance that is not required on non-controlled prescriptions?

The prescriber DEA registration number
Correct Incorrect Correct answer

The patient date of birth and home address
Correct Incorrect Correct answer

The name and address of the dispensing pharmacy
Correct Incorrect Correct answer

The indication or diagnosis for the prescribed medication
Correct Incorrect Correct answer

Correct

Incorrect
Question 614 of 792

614. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

What is the purpose of an independent double-check in the pharmacy?

To have a second person verify a high-risk step without knowledge of the first person work
Correct Incorrect Correct answer

To confirm that two different pharmacists have approved the same prescription order
Correct Incorrect Correct answer

To ensure that the same technician checks their own work twice before dispensing
Correct Incorrect Correct answer

To verify that the prescription was entered into the computer system without any errors
Correct Incorrect Correct answer

Correct

Incorrect
Question 615 of 792

615. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

Which of the following is a potential indicator of a forged prescription?

The prescription appears to be photocopied rather than an original document
Correct Incorrect Correct answer

The prescription is written on a standard preprinted prescription pad
Correct Incorrect Correct answer

The prescriber signature is written in cursive rather than printed text
Correct Incorrect Correct answer

The prescription includes both the brand and generic name of the medication
Correct Incorrect Correct answer

Correct

Incorrect
Question 616 of 792

616. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

What does CPOE stand for, and what is its primary purpose in reducing prescription errors?

Computerized Provider Order Entry; it allows prescribers to enter orders electronically with built-in safety checks
Correct Incorrect Correct answer

Central Pharmacy Operations Exchange; it coordinates medication ordering between multiple pharmacy locations
Correct Incorrect Correct answer

Clinical Prescription Oversight Engine; it monitors all prescriptions for regulatory compliance issues
Correct Incorrect Correct answer

Controlled Product Ordering Extension; it tracks controlled substance orders throughout the supply chain
Correct Incorrect Correct answer

Correct

Incorrect
Question 617 of 792

617. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

What is the recommended practice when a pharmacy receives a prescription with illegible handwriting?

Contact the prescriber to clarify the prescription before dispensing
Correct Incorrect Correct answer

Use the best judgment to interpret the handwriting and fill the prescription
Correct Incorrect Correct answer

Ask the patient what medication they think the prescription is for
Correct Incorrect Correct answer

Return the prescription to the patient and request a new typed version
Correct Incorrect Correct answer

Correct

Incorrect
Question 618 of 792

618. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A technician is filling a prescription for methotrexate 2.5 mg tablets. The label reads “take 3 tablets once weekly.” The technician accidentally selects methotrexate 10 mg tablets from the shelf. What type of error would this be if not caught?

A wrong-strength error that would result in the patient receiving four times the intended dose
Correct Incorrect Correct answer

A wrong-drug error because different strengths are considered different medications
Correct Incorrect Correct answer

A wrong-route error because the higher strength is intended for injection only
Correct Incorrect Correct answer

A wrong-frequency error because the 10 mg tablets should be taken daily instead
Correct Incorrect Correct answer

Correct

Incorrect
Question 619 of 792

619. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A prescription reads “Hydroxyzine 25 mg, take one tablet three times daily.” The technician reaches for hydralazine 25 mg instead. What error prevention step would most likely catch this mistake?

Barcode scanning the stock bottle during the filling process
Correct Incorrect Correct answer

Checking the patient allergy profile for relevant drug allergies
Correct Incorrect Correct answer

Verifying the prescription against the patient insurance formulary
Correct Incorrect Correct answer

Confirming the patient date of birth at the point of sale
Correct Incorrect Correct answer

Correct

Incorrect
Question 620 of 792

620. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A technician receives a prescription that reads “Amoxicillin 500 mg, #30, Sig: 1 cap TID x 10 days.” The prescription is missing the prescriber address. Can this prescription be filled?

The pharmacist should verify the prescriber identity and may need to obtain the missing information
Correct Incorrect Correct answer

The prescription cannot be filled under any circumstances until a new one is issued
Correct Incorrect Correct answer

The technician can add the prescriber address from the pharmacy database and proceed
Correct Incorrect Correct answer

The prescription is valid because the prescriber address is not a legal requirement
Correct Incorrect Correct answer

Correct

Incorrect
Question 621 of 792

621. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A prescription for a 70 kg adult reads “Vancomycin 1500 mg IV every 12 hours.” The typical dose is 15-20 mg/kg. The prescribed dose appears appropriate, but the technician notices the route is written as “PO” on the label. What type of error is this?

A wrong-route error because vancomycin for systemic infections must be given intravenously
Correct Incorrect Correct answer

A wrong-dose error because 1500 mg is too high for oral vancomycin administration
Correct Incorrect Correct answer

A wrong-frequency error because vancomycin should only be given once every 24 hours
Correct Incorrect Correct answer

A wrong-drug error because vancomycin is not available in an oral dosage formulation
Correct Incorrect Correct answer

Correct

Incorrect
Question 622 of 792

622. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

Two patients with similar names are in the pharmacy system: “John Smith, DOB 03/15/1980” and “Jon Smith, DOB 09/22/1985.” A prescription for “J. Smith” arrives without a date of birth. What should the technician do?

Verify the correct patient by confirming the date of birth and address with the prescriber or patient
Correct Incorrect Correct answer

Select the patient who most recently filled a prescription at the pharmacy
Correct Incorrect Correct answer

Enter the prescription under both patient profiles to avoid missing the correct one
Correct Incorrect Correct answer

Choose the most common spelling of the name and process the prescription
Correct Incorrect Correct answer

Correct

Incorrect
Question 623 of 792

623. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A handwritten prescription appears to read “Celexa 40 mg” but could also be interpreted as “Celebrex 400 mg.” What should the technician do?

Alert the pharmacist and contact the prescriber to clarify the medication name
Correct Incorrect Correct answer

Dispense Celexa because it is the more commonly prescribed medication of the two
Correct Incorrect Correct answer

Fill whichever medication the patient confirms they were expecting to receive
Correct Incorrect Correct answer

Check the patient profile and dispense whichever medication they have taken before
Correct Incorrect Correct answer

Correct

Incorrect
Question 624 of 792

624. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A technician is processing a prescription for insulin glargine (Lantus) but accidentally selects insulin lispro (Humalog) in the system. Both are insulin products. What type of error is this, and why is it significant?

A wrong-drug error because glargine is long-acting and lispro is rapid-acting, creating a dangerous mismatch in insulin therapy
Correct Incorrect Correct answer

A generic substitution error because both products are considered therapeutically equivalent
Correct Incorrect Correct answer

A wrong-strength error because the two insulins have different concentration units
Correct Incorrect Correct answer

A wrong-frequency error because the two insulins are dosed at different times of day
Correct Incorrect Correct answer

Correct

Incorrect
Question 625 of 792

625. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A prescription for prednisone reads “take 5 mg daily.” The technician fills it with prednisolone 5 mg oral solution. What type of error has occurred?

A wrong-drug error because prednisone and prednisolone are different corticosteroids
Correct Incorrect Correct answer

A wrong-dosage-form error because the prescribed tablet was dispensed as a liquid
Correct Incorrect Correct answer

A correct substitution because prednisone and prednisolone are generic equivalents
Correct Incorrect Correct answer

A wrong-strength error because oral solutions have different concentrations than tablets
Correct Incorrect Correct answer

Correct

Incorrect
Question 626 of 792

626. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A technician counts 30 tablets of lisinopril 10 mg for a prescription. During the pharmacist final verification, the pharmacist recounts and finds 28 tablets. What type of error prevention did this step provide?

A count verification that caught a dispensing quantity error before the medication reached the patient
Correct Incorrect Correct answer

An independent double-check that verified the medication strength was correctly selected
Correct Incorrect Correct answer

A barcode verification that confirmed the correct NDC number was used for dispensing
Correct Incorrect Correct answer

A DUR screening that identified a potential dosing concern with the prescribed quantity
Correct Incorrect Correct answer

Correct

Incorrect
Question 627 of 792

627. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A prescription is received for “Levothyroxine 0.125 mg daily.” The technician interprets this as 125 mg because the decimal point was not clearly visible. What type of error is this?

A decimal point error resulting in a 1,000-fold overdose interpretation
Correct Incorrect Correct answer

A unit conversion error from milligrams to micrograms
Correct Incorrect Correct answer

A wrong-drug error due to similar naming conventions for the medication
Correct Incorrect Correct answer

A transcription error caused by poor electronic prescription formatting
Correct Incorrect Correct answer

Correct

Incorrect
Question 628 of 792

628. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

An e-prescription arrives for a patient with directions that state “take 2 tablets by mouth twice daily for 7 days,” but the quantity field shows #14. The prescribed medication is amoxicillin 500 mg. Is the quantity correct?

No; taking 2 tablets twice daily for 7 days requires 28 tablets, not 14
Correct Incorrect Correct answer

Yes; 14 tablets is correct for a 7-day course at one tablet twice daily
Correct Incorrect Correct answer

No; the quantity should be 42 tablets for a standard antibiotic course
Correct Incorrect Correct answer

Yes; the pharmacy should dispense 14 tablets and have the patient return for more
Correct Incorrect Correct answer

Correct

Incorrect
Question 629 of 792

629. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

During prescription entry, a technician accidentally types “metformin 500 mg twice daily” instead of the prescribed “metformin 1000 mg twice daily.” At which step is this transcription error most likely to be caught?

During the pharmacist final verification when comparing the label to the original prescription
Correct Incorrect Correct answer

During the patient checkout process when the patient reviews the medication name
Correct Incorrect Correct answer

During the insurance adjudication when the claim is submitted to the third-party payer
Correct Incorrect Correct answer

During the automated refill reminder when the system generates the next refill notice
Correct Incorrect Correct answer

Correct

Incorrect
Question 630 of 792

630. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A technician receives a prescription for Adderall 30 mg that appears to have been altered. The original quantity of “30” appears to have been changed to “130” with a different ink color. What should the technician do?

Alert the pharmacist about the suspected alteration and do not process the prescription
Correct Incorrect Correct answer

Fill the prescription for 30 tablets based on what appears to be the original quantity
Correct Incorrect Correct answer

Call the patient to ask whether the prescriber wrote for 30 or 130 tablets
Correct Incorrect Correct answer

Process the prescription for 130 tablets because the most recent writing takes precedence
Correct Incorrect Correct answer

Correct

Incorrect
Question 631 of 792

631. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A prescription for a topical cream is accidentally labeled with directions to take by mouth. The pharmacist catches this during final check. What category of error was prevented?

A wrong-route error that could have caused the patient to ingest a topical product
Correct Incorrect Correct answer

A wrong-drug error because topical and oral medications are different products
Correct Incorrect Correct answer

A wrong-frequency error because topical products are applied differently than oral drugs
Correct Incorrect Correct answer

A wrong-patient error because the directions were intended for a different patient
Correct Incorrect Correct answer

Correct

Incorrect
Question 632 of 792

632. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy implements a tall man lettering system on shelf labels, displaying “hydrOXYzine” and “hydrALAzine.” What type of error is this system designed to prevent?

Wrong-drug errors caused by confusion between look-alike and sound-alike medication names
Correct Incorrect Correct answer

Wrong-strength errors caused by similar packaging between different dose formulations
Correct Incorrect Correct answer

Wrong-route errors caused by medications being available in multiple dosage forms
Correct Incorrect Correct answer

Wrong-patient errors caused by similar patient names in the pharmacy computer system
Correct Incorrect Correct answer

Correct

Incorrect
Question 633 of 792

633. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy reports 15 near-miss events in one month, all involving selection of the wrong strength of metformin (500 mg vs 1000 mg) from adjacent shelf locations. Which systemic improvement would most effectively reduce these errors?

Separating the two strengths to non-adjacent shelf locations and adding visual alerts to the bins
Correct Incorrect Correct answer

Disciplining the technicians who made the errors to encourage greater attention to detail
Correct Incorrect Correct answer

Requiring all metformin prescriptions to be verified by two pharmacists before dispensing
Correct Incorrect Correct answer

Switching to a different manufacturer of metformin that uses more distinct packaging
Correct Incorrect Correct answer

Correct

Incorrect
Question 634 of 792

634. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy experiences three wrong-patient errors in two weeks. Investigation reveals that all three errors involved patients with the same last name being served during high-volume periods. Which combination of strategies would best prevent recurrence?

Requiring verification of two patient identifiers (name and DOB) at intake, filling, and pickup
Correct Incorrect Correct answer

Limiting the number of patients the pharmacy serves during high-volume periods
Correct Incorrect Correct answer

Assigning each technician to serve only one patient at a time during their shift
Correct Incorrect Correct answer

Implementing alphabetical filling order to keep same-name prescriptions together
Correct Incorrect Correct answer

Correct

Incorrect
Question 635 of 792

635. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A technician processes a prescription for “Losartan 50 mg, take 1 tablet daily, #90, 90-day supply.” However, the prescriber intended “Losartan 50 mg, take 1 tablet twice daily, #180, 90-day supply.” The error originated from the e-prescribing system sending incorrect directions. At which point could the pharmacy have detected this error?

During pharmacist clinical review by comparing the dose to the patient diagnosis and previous fill history
Correct Incorrect Correct answer

During barcode scanning of the medication stock bottle at the filling station
Correct Incorrect Correct answer

During the insurance adjudication process when the claim was submitted for payment
Correct Incorrect Correct answer

During the patient signature collection at the point of sale checkout counter
Correct Incorrect Correct answer

Correct

Incorrect
Question 636 of 792

636. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy uses automated verification technology that photographs each filled prescription and compares the pill image to a database. This technology caught 45 errors in one quarter. What is the primary limitation of relying solely on this technology?

It cannot detect errors in directions, quantity calculations, or clinical appropriateness of the prescription
Correct Incorrect Correct answer

It requires too much time to process each prescription, slowing overall pharmacy workflow
Correct Incorrect Correct answer

It can only verify brand-name medications because generics vary in appearance by manufacturer
Correct Incorrect Correct answer

It replaces the need for pharmacist final verification, removing a critical human safety check
Correct Incorrect Correct answer

Correct

Incorrect
Question 637 of 792

637. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A patient brings in a prescription written on a plain notepad rather than a standard prescription pad. The prescription is for hydrocodone/acetaminophen, a Schedule II controlled substance. Which factors should raise concern about the validity of this prescription?

The use of non-standard paper, the controlled substance nature of the drug, and the need to verify the prescriber credentials
Correct Incorrect Correct answer

The medication being a combination product, the patient age, and the time of day the prescription was presented
Correct Incorrect Correct answer

The handwriting style of the prescriber, the color of ink used, and whether the patient has insurance
Correct Incorrect Correct answer

The brand name being used instead of generic, the quantity prescribed, and the pharmacy location
Correct Incorrect Correct answer

Correct

Incorrect
Question 638 of 792

638. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy error report shows that 60% of wrong-drug errors in the past year involved medications stored alphabetically next to each other on the shelf. Which root cause analysis finding best explains this pattern?

Alphabetical storage places look-alike and sound-alike drug names in close proximity, increasing selection errors
Correct Incorrect Correct answer

Alphabetical storage makes it harder for technicians to locate medications quickly during busy periods
Correct Incorrect Correct answer

The pharmacy does not rotate stock properly, causing expired medications to be dispensed by mistake
Correct Incorrect Correct answer

Technicians are not adequately trained on the differences between medications in the same drug class
Correct Incorrect Correct answer

Correct

Incorrect
Question 639 of 792

639. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A new pharmacy software system requires technicians to scan their badge, scan the prescription barcode, and scan the stock bottle barcode before dispensing. After implementation, dispensing errors decrease by 50%. However, technicians report frequently overriding the scanning requirement during busy periods. What is the most significant risk of this workaround?

Overriding the scanning process eliminates the primary technology-based error prevention safeguard
Correct Incorrect Correct answer

Badge scanning tracks technician productivity, and overrides may affect their performance metrics
Correct Incorrect Correct answer

The software warranty may be voided if the scanning requirements are not followed as designed
Correct Incorrect Correct answer

Insurance companies may reject claims that were processed without complete barcode documentation
Correct Incorrect Correct answer

Correct

Incorrect
Question 640 of 792

640. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A hospital pharmacy receives a handwritten order for “Vincristine 2 mg IV push.” However, the order was intended for “Vinblastine 10 mg IV infusion.” What makes this particular wrong-drug error especially dangerous?

Vincristine given by the wrong route or at wrong doses can be fatal, and these two drugs have very different dosing and administration requirements
Correct Incorrect Correct answer

Vinblastine is a controlled substance while vincristine is not, creating a regulatory compliance issue
Correct Incorrect Correct answer

The two medications are from different therapeutic classes and treat entirely unrelated conditions
Correct Incorrect Correct answer

Vincristine is only available in oral form, making IV administration physically impossible
Correct Incorrect Correct answer

Correct

Incorrect
Question 641 of 792

641. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy conducts a quarterly review and finds that prescription error rates are highest during shift changes at 3:00 PM and 11:00 PM. Which systemic factor is most likely contributing to this pattern?

Handoff communication gaps and workflow disruptions during staff transitions increase error risk
Correct Incorrect Correct answer

The pharmacy software system runs automated updates during shift changes, causing slowdowns
Correct Incorrect Correct answer

Patients tend to drop off more complex prescriptions during afternoon and evening hours
Correct Incorrect Correct answer

Insurance systems experience higher rejection rates during off-peak hours, causing distractions
Correct Incorrect Correct answer

Correct

Incorrect
Question 642 of 792

642. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy implements a new policy requiring all high-alert medication prescriptions to undergo an independent double-check before dispensing. After six months, the pharmacy has zero dispensing errors with high-alert medications but has seen an increase in errors with routine medications. What is the most likely explanation?

Staff attention and time diverted to high-alert medication checks may have reduced vigilance for routine prescriptions
Correct Incorrect Correct answer

The high-alert medication policy caused technicians to become less skilled at processing routine orders
Correct Incorrect Correct answer

Routine medication manufacturers changed their packaging, making products harder to identify correctly
Correct Incorrect Correct answer

The pharmacy software was updated to prioritize high-alert medications, causing delays in routine processing
Correct Incorrect Correct answer

Correct

Incorrect
Question 643 of 792

643. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

Which strategy does ISMP recommend as a primary method for differentiating LASA medication names on pharmacy shelf labels?

Tall Man lettering
Correct Incorrect Correct answer

Color-coded bottle caps
Correct Incorrect Correct answer

Alphabetical separation by two positions
Correct Incorrect Correct answer

Mandatory barcode placement on the front label
Correct Incorrect Correct answer

Correct

Incorrect
Question 644 of 792

644. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

Which LASA medication pair involves two IV vasopressors commonly stored near each other in critical care automated dispensing cabinets?

Dopamine and dobutamine
Correct Incorrect Correct answer

Epinephrine and norepinephrine
Correct Incorrect Correct answer

Vasopressin and oxytocin
Correct Incorrect Correct answer

Phenylephrine and phentolamine
Correct Incorrect Correct answer

Correct

Incorrect
Question 645 of 792

645. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

What does the International Nonproprietary Name (INN) system aim to provide for medications worldwide?

A unique, globally recognized generic name for each active pharmaceutical ingredient
Correct Incorrect Correct answer

A standardized brand name approved for use in all countries
Correct Incorrect Correct answer

A numerical code replacing all drug names to prevent LASA errors
Correct Incorrect Correct answer

A classification system based solely on therapeutic drug class
Correct Incorrect Correct answer

Correct

Incorrect
Question 646 of 792

646. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

Which risk factor most significantly increases the likelihood of a LASA dispensing error?

Handwritten prescriptions with unclear penmanship
Correct Incorrect Correct answer

Use of electronic prescribing with clinical decision support
Correct Incorrect Correct answer

Dispensing medications in unit-dose packaging
Correct Incorrect Correct answer

Requiring independent double-checks at each dispensing step
Correct Incorrect Correct answer

Correct

Incorrect
Question 647 of 792

647. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

What type of failure analysis proactively evaluates potential LASA errors before they occur in a pharmacy workflow?

Failure Mode and Effects Analysis (FMEA)
Correct Incorrect Correct answer

Root Cause Analysis (RCA)
Correct Incorrect Correct answer

Medication Use Evaluation (MUE)
Correct Incorrect Correct answer

Drug Utilization Review (DUR)
Correct Incorrect Correct answer

Correct

Incorrect
Question 648 of 792

648. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician receives a verbal telephone order for ‘hydroxyzine.’ Which action best prevents a LASA error with this medication?

Read back the order using the spelling and indication to confirm whether hydroxyzine HCl or hydroxyzine pamoate was intended
Correct Incorrect Correct answer

Dispense hydroxyzine HCl because it is more commonly prescribed
Correct Incorrect Correct answer

Ask the patient which form they have taken previously
Correct Incorrect Correct answer

Place the order on hold until the prescriber visits the pharmacy in person
Correct Incorrect Correct answer

Correct

Incorrect
Question 649 of 792

649. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A hospital pharmacy is redesigning its automated dispensing cabinet (ADC) layout. Which approach best reduces LASA selection errors for dopamine and dobutamine vials?

Separate the two medications into different drawers and apply auxiliary warning labels to each
Correct Incorrect Correct answer

Place both medications in the same drawer but arrange them alphabetically
Correct Incorrect Correct answer

Rely solely on barcode scanning at the point of administration
Correct Incorrect Correct answer

Remove dobutamine from the ADC entirely and require manual dispensing for all doses
Correct Incorrect Correct answer

Correct

Incorrect
Question 650 of 792

650. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician is filling a prescription for predniSONE 10 mg tablets. The shelf also contains prednisoLONE 15 mg/5 mL oral solution. Which system-level control is demonstrated by the capitalization difference on these labels?

Tall Man lettering to highlight the distinguishing portions of the drug names
Correct Incorrect Correct answer

FDA-mandated color coding for oral solid versus liquid dosage forms
Correct Incorrect Correct answer

USP labeling requirements for corticosteroid medications
Correct Incorrect Correct answer

Manufacturer-selected font styling for marketing purposes
Correct Incorrect Correct answer

Correct

Incorrect
Question 651 of 792

651. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A technician processing a handwritten prescription reads the drug name as either ‘Celebrex’ or ‘Celexa.’ Which is the most appropriate next step?

Contact the prescriber to verify the intended medication before dispensing
Correct Incorrect Correct answer

Dispense Celebrex because it is prescribed more frequently
Correct Incorrect Correct answer

Check the patient's diagnosis in the system and make a professional judgment
Correct Incorrect Correct answer

Dispense Celexa because the handwriting more closely resembles that name
Correct Incorrect Correct answer

Correct

Incorrect
Question 652 of 792

652. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

During a LASA error prevention audit, the pharmacy manager finds that epinephrine and ephedrine vials are stored side by side in the IV room refrigerator. What is the best corrective action?

Physically separate the two medications and apply prominent auxiliary warning stickers to each
Correct Incorrect Correct answer

Replace the ephedrine vials with a different manufacturer that uses a different vial color
Correct Incorrect Correct answer

Require all technicians to memorize both drug names and their indications
Correct Incorrect Correct answer

Remove both medications from the refrigerator and store at room temperature
Correct Incorrect Correct answer

Correct

Incorrect
Question 653 of 792

653. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A new pharmacy technician is orienting in a pediatric hospital. The preceptor emphasizes extra caution with LASA pairs in pediatrics. Which factor makes pediatric LASA errors particularly dangerous?

Weight-based dosing means even small concentration errors can result in significant overdoses in children
Correct Incorrect Correct answer

Pediatric patients are more likely to report the wrong medication name to staff
Correct Incorrect Correct answer

Children metabolize all medications faster than adults, amplifying any error
Correct Incorrect Correct answer

Pediatric pharmacies stock fewer medications, making LASA pairs easier to confuse
Correct Incorrect Correct answer

Correct

Incorrect
Question 654 of 792

654. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy implements a policy requiring technicians to confirm drug selection by scanning the barcode before every fill. Which limitation of this approach for LASA prevention should the pharmacy also address?

Barcode scanning only catches errors at the point of scan and does not prevent initial wrong selection from the shelf
Correct Incorrect Correct answer

Barcode scanners cannot read Tall Man lettering on manufacturer labels
Correct Incorrect Correct answer

Barcode verification is only effective for controlled substances
Correct Incorrect Correct answer

Scanning technology adds too much time to be practical in a busy pharmacy
Correct Incorrect Correct answer

Correct

Incorrect
Question 655 of 792

655. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy technician notices that two LASA medications from different manufacturers have nearly identical vial sizes, cap colors, and label layouts. Which action should the technician take first?

Report the look-alike packaging concern to the pharmacist and suggest adding alert stickers or separating shelf locations
Correct Incorrect Correct answer

Contact both manufacturers and request label redesigns
Correct Incorrect Correct answer

Remove one of the products from inventory and find an alternative supplier
Correct Incorrect Correct answer

Document the observation in a personal notebook for future reference
Correct Incorrect Correct answer

Correct

Incorrect
Question 656 of 792

656. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy receives a prescription for vinCRIStine for a pediatric oncology patient. The pharmacy also stocks vinBLAStine. Beyond Tall Man lettering, which additional safety measure is required by ISMP for these two agents?

Store vincristine and vinblastine in separate locations and dispense vincristine only in a minibag, never a syringe
Correct Incorrect Correct answer

Require the oncologist to personally hand the medication to the nurse
Correct Incorrect Correct answer

Administer both drugs only during daytime hours when staffing levels are highest
Correct Incorrect Correct answer

Use only brand names on all labels to eliminate generic name confusion
Correct Incorrect Correct answer

Correct

Incorrect
Question 657 of 792

657. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A community pharmacy technician is stocking shelves and notices that metformin 500 mg and metoprolol 50 mg tablets from the same manufacturer have similar-looking stock bottles. What is the best stocking practice?

Place the medications on separate shelves or in non-adjacent bins and verify each bottle with a barcode scan during stocking
Correct Incorrect Correct answer

Stock both medications on the same shelf in alphabetical order for efficiency
Correct Incorrect Correct answer

Turn one bottle label-side down to create a visual distinction
Correct Incorrect Correct answer

Request that the pharmacist personally stock all LASA pairs
Correct Incorrect Correct answer

Correct

Incorrect
Question 658 of 792

658. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy is implementing a new LASA alert system in its dispensing software. The system should trigger an alert when a technician selects a drug with a known LASA pair. Which database should the software reference for the most current LASA pairs?

ISMP List of Confused Drug Names
Correct Incorrect Correct answer

FDA Orange Book of Approved Drug Products
Correct Incorrect Correct answer

DEA Controlled Substances Schedule listing
Correct Incorrect Correct answer

USP Drug Information reference database
Correct Incorrect Correct answer

Correct

Incorrect
Question 659 of 792

659. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

During an IV admixture preparation, a technician selects a vial labeled ‘EPINEPHrine 1 mg/mL’ instead of ‘ePHEDrine 50 mg/mL.’ At which point in the workflow would an independent double-check most effectively catch this LASA error?

Before adding the drug to the IV solution, during the pharmacist verification of the selected vial against the order
Correct Incorrect Correct answer

After the IV bag is sealed and labeled for delivery
Correct Incorrect Correct answer

When the nurse scans the barcode at the patient bedside
Correct Incorrect Correct answer

During the monthly inventory reconciliation process
Correct Incorrect Correct answer

Correct

Incorrect
Question 660 of 792

660. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A hospital reports three LASA errors in one month involving clonidine and Klonopin (clonazepam) selections from the same ADC drawer. A root cause analysis reveals that both medications were assigned to the same matrix drawer pocket. Which systemic failure does this scenario primarily illustrate?

Inadequate physical separation of LASA pairs within the automated dispensing cabinet configuration
Correct Incorrect Correct answer

Insufficient pharmacy technician training on drug name recognition
Correct Incorrect Correct answer

Failure of the barcode scanning system at the point of administration
Correct Incorrect Correct answer

Lack of prescriber education about LASA medication names
Correct Incorrect Correct answer

Correct

Incorrect
Question 661 of 792

661. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy conducts an FMEA on its LASA dispensing process and identifies that verbal orders have a Risk Priority Number (RPN) of 320, while electronic orders score 45. Which conclusion is best supported by these findings?

Verbal orders represent the highest-risk failure mode for LASA errors and should be targeted for process redesign or elimination
Correct Incorrect Correct answer

Electronic orders are completely safe and require no further LASA safeguards
Correct Incorrect Correct answer

The pharmacy should eliminate all verbal orders regardless of clinical urgency
Correct Incorrect Correct answer

The RPN scores indicate that verbal orders cause exactly seven times more errors than electronic orders
Correct Incorrect Correct answer

Correct

Incorrect
Question 662 of 792

662. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy manager reviews LASA error data and finds that 60% of errors occur during evening shifts when staffing is reduced and float technicians are more common. Which combination of interventions would most effectively address this pattern?

Ensure float technicians complete LASA-specific orientation for that pharmacy site and implement mandatory barcode verification for all LASA pair dispensing regardless of shift
Correct Incorrect Correct answer

Hire additional permanent evening staff and eliminate all float technician assignments
Correct Incorrect Correct answer

Restrict dispensing of all LASA medications to daytime shifts only
Correct Incorrect Correct answer

Require evening technicians to call the pharmacist for every LASA medication selection
Correct Incorrect Correct answer

Correct

Incorrect
Question 663 of 792

663. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

An international hospital formulary includes both ‘acetaminophen’ (US name) and ‘paracetamol’ (INN/European name) entries for the same drug, along with multiple brand names. A technician unfamiliar with the INN name dispenses the wrong product. Which systemic approach best prevents this type of LASA/naming confusion?

Standardize the formulary to use a single approved name per active ingredient with cross-reference alerts for international equivalents
Correct Incorrect Correct answer

Require all staff to memorize both US and international names for every formulary drug
Correct Incorrect Correct answer

Remove all international name entries from the formulary
Correct Incorrect Correct answer

Allow only brand name prescribing to avoid generic name confusion entirely
Correct Incorrect Correct answer

Correct

Incorrect
Question 664 of 792

664. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A children’s hospital reports a near-miss where a technician selected chlorproMAZINE 25 mg/mL oral concentrate instead of chlorproPAMIDE 250 mg tablets for a pediatric patient. The error was caught by the pharmacist during final verification. Analysis reveals the technician relied on memory rather than scanning. Which Swiss cheese model concept does the pharmacist’s catch represent?

A defensive layer that successfully blocked the error trajectory before reaching the patient
Correct Incorrect Correct answer

The root cause of the original error in the dispensing process
Correct Incorrect Correct answer

Evidence that the pharmacy's system has no vulnerabilities
Correct Incorrect Correct answer

A reactive measure that should replace all proactive LASA controls
Correct Incorrect Correct answer

Correct

Incorrect
Question 665 of 792

665. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy’s LASA error trending report shows a spike in errors after transitioning to a new wholesaler whose product labeling uses smaller font sizes with minimal color differentiation between similar products. Which quality improvement action addresses the root cause most directly?

Work with the wholesaler to identify alternative manufacturers with more distinguishable labeling for known LASA pairs
Correct Incorrect Correct answer

Increase the number of pharmacist verification steps for all prescriptions
Correct Incorrect Correct answer

Implement a mandatory 30-second pause before each medication selection
Correct Incorrect Correct answer

Add a second barcode scanner at each dispensing station
Correct Incorrect Correct answer

Correct

Incorrect
Question 666 of 792

666. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy’s LASA committee analyzes five years of error data and discovers that despite implementing Tall Man lettering, LASA errors have not decreased for certain drug pairs stored in the same ADC pocket. Which conclusion about the limitations of Tall Man lettering is best supported?

Tall Man lettering alone is insufficient when physical proximity and similar packaging remain unchanged; multiple concurrent strategies are needed
Correct Incorrect Correct answer

Tall Man lettering is an ineffective strategy that should be abandoned
Correct Incorrect Correct answer

The errors are caused by technicians who cannot read capital letters
Correct Incorrect Correct answer

Tall Man lettering only works for brand name medications, not generic drugs
Correct Incorrect Correct answer

Correct

Incorrect
Question 667 of 792

667. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A regulatory surveyor cites a pharmacy for failing to maintain a current list of LASA medications and lacking a policy for managing newly identified LASA pairs. Which regulatory expectation does this citation primarily reflect?

Accreditation standards requiring pharmacies to maintain and regularly update LASA medication lists with defined management procedures
Correct Incorrect Correct answer

DEA requirements for tracking all medications with similar-sounding names
Correct Incorrect Correct answer

FDA mandates that all LASA medications carry black box warnings
Correct Incorrect Correct answer

State board requirements that only pharmacists may dispense LASA medications
Correct Incorrect Correct answer

Correct

Incorrect
Question 668 of 792

668. Question

Category: Patient Safety and Quality Assurance: Event Reporting

What is the primary purpose of the Patient Safety and Quality Improvement Act of 2005?

To provide federal legal protection for information reported to Patient Safety Organizations so it cannot be used in litigation
Correct Incorrect Correct answer

To establish mandatory medication error reporting for all retail pharmacies
Correct Incorrect Correct answer

To create a national database of individual prescriber error rates
Correct Incorrect Correct answer

To require pharmacies to publicly disclose all medication errors to patients
Correct Incorrect Correct answer

Correct

Incorrect
Question 669 of 792

669. Question

Category: Patient Safety and Quality Assurance: Event Reporting

Which proactive risk assessment tool uses severity, occurrence, and detectability ratings to calculate a Risk Priority Number for potential failure points?

Failure Mode and Effects Analysis (FMEA)
Correct Incorrect Correct answer

Root Cause Analysis (RCA)
Correct Incorrect Correct answer

Plan-Do-Study-Act (PDSA) cycle
Correct Incorrect Correct answer

Pareto chart analysis
Correct Incorrect Correct answer

Correct

Incorrect
Question 670 of 792

670. Question

Category: Patient Safety and Quality Assurance: Event Reporting

What is the required timeframe for healthcare providers to report adverse events following vaccination to VAERS?

Within the timeframe specified in the Vaccine Injury Table for each vaccine and event combination
Correct Incorrect Correct answer

Within 24 hours of the adverse event occurring
Correct Incorrect Correct answer

Within 30 calendar days of the vaccination date
Correct Incorrect Correct answer

Within 7 business days of the patient's next clinic visit
Correct Incorrect Correct answer

Correct

Incorrect
Question 671 of 792

671. Question

Category: Patient Safety and Quality Assurance: Event Reporting

Which root cause analysis tool visually organizes contributing factors into categories such as people, process, equipment, and environment?

Fishbone diagram (Ishikawa diagram)
Correct Incorrect Correct answer

Failure Mode and Effects Analysis worksheet
Correct Incorrect Correct answer

Gantt chart
Correct Incorrect Correct answer

Statistical process control chart
Correct Incorrect Correct answer

Correct

Incorrect
Question 672 of 792

672. Question

Category: Patient Safety and Quality Assurance: Event Reporting

What type of event report documents a medication error that reached the patient but did not cause harm?

A no-harm event (Category C or D on the NCC MERP index)
Correct Incorrect Correct answer

A near-miss report (Category A or B on the NCC MERP index)
Correct Incorrect Correct answer

A sentinel event report
Correct Incorrect Correct answer

A never event report
Correct Incorrect Correct answer

Correct

Incorrect
Question 673 of 792

673. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician discovers that a patient received methotrexate daily instead of weekly for three days before the error was caught. Which reporting action should occur first within the pharmacy?

Complete an internal incident report documenting the error details, contributing factors, and patient outcome
Correct Incorrect Correct answer

File a report with the state board of pharmacy before notifying the pharmacist
Correct Incorrect Correct answer

Submit an FDA MedWatch report within one hour of discovery
Correct Incorrect Correct answer

Contact the patient's attorney to disclose the error
Correct Incorrect Correct answer

Correct

Incorrect
Question 674 of 792

674. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy team conducts a root cause analysis after a wrong-patient dispensing error. Using the ‘5 Whys’ technique, they determine the final root cause is that the pharmacy software allows selection of patients with similar names without a secondary identifier prompt. Which type of corrective action addresses this root cause?

Modify the software to require verification of a secondary patient identifier, such as date of birth, when similar names are present
Correct Incorrect Correct answer

Retrain the individual technician who made the error
Correct Incorrect Correct answer

Post a reminder sign near the dispensing counter about patient identification
Correct Incorrect Correct answer

Require all patients to state their full name and address at pickup
Correct Incorrect Correct answer

Correct

Incorrect
Question 675 of 792

675. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A hospital pharmacy wants to use FMEA to proactively assess risks in its new automated IV compounding workflow before implementation. Which step should the team complete first?

Map out every step of the IV compounding workflow and identify all potential failure modes at each step
Correct Incorrect Correct answer

Calculate Risk Priority Numbers for the most obvious hazards
Correct Incorrect Correct answer

Assign severity ratings based on historical error data from the previous manual process
Correct Incorrect Correct answer

Report the planned workflow change to the FDA before beginning the analysis
Correct Incorrect Correct answer

Correct

Incorrect
Question 676 of 792

676. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician witnesses a medication error but is hesitant to report it because the last technician who filed a report was publicly criticized by a supervisor. Which concept in patient safety culture does this scenario violate?

A just culture that encourages reporting without fear of punitive action for honest mistakes
Correct Incorrect Correct answer

The legal requirement to report all errors to the state board within 24 hours
Correct Incorrect Correct answer

The pharmacy's policy of mandatory termination for any reported error
Correct Incorrect Correct answer

The technician's obligation to report directly to the patient
Correct Incorrect Correct answer

Correct

Incorrect
Question 677 of 792

677. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy submits a medication error report to the ISMP National Medication Errors Reporting Program (MERP). What happens to this information after submission?

ISMP analyzes the report, de-identifies the data, and may publish safety alerts or recommendations based on patterns identified across reports
Correct Incorrect Correct answer

ISMP forwards the report directly to the state board of pharmacy for regulatory action
Correct Incorrect Correct answer

The report is shared with the prescriber's employer for disciplinary review
Correct Incorrect Correct answer

ISMP files the report with the DEA for controlled substance tracking purposes
Correct Incorrect Correct answer

Correct

Incorrect
Question 678 of 792

678. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy receives notice from the FDA about a Class I recall for a contaminated injectable product. The pharmacy has already dispensed units to three patients. Which reporting obligation must the pharmacy fulfill?

Notify the affected patients and their prescribers, remove remaining stock, and document all actions in accordance with the recall notice procedures
Correct Incorrect Correct answer

Wait for the manufacturer to contact the patients directly before taking action
Correct Incorrect Correct answer

File a VAERS report for each patient who received the product
Correct Incorrect Correct answer

Report the recall to the DEA because the product is an injectable
Correct Incorrect Correct answer

Correct

Incorrect
Question 679 of 792

679. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy is developing its corrective and preventive action (CAPA) documentation for a recurring IV admixture error. Which element distinguishes a preventive action from a corrective action in CAPA documentation?

A preventive action addresses potential problems that have not yet occurred, while a corrective action addresses problems that have already happened
Correct Incorrect Correct answer

A preventive action is always more expensive to implement than a corrective action
Correct Incorrect Correct answer

A corrective action requires regulatory approval while a preventive action does not
Correct Incorrect Correct answer

A preventive action applies only to controlled substances while corrective actions apply to all medications
Correct Incorrect Correct answer

Correct

Incorrect
Question 680 of 792

680. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician notices that an automated dispensing cabinet repeatedly dispenses the wrong quantity of a high-alert medication. After reporting internally, the technician is asked to help complete a fishbone diagram. Under which category should ‘cabinet software calibration error’ be placed?

Equipment
Correct Incorrect Correct answer

People
Correct Incorrect Correct answer

Process
Correct Incorrect Correct answer

Environment
Correct Incorrect Correct answer

Correct

Incorrect
Question 681 of 792

681. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A state board of pharmacy investigation reveals that a pharmacy failed to report a dispensing error that resulted in patient hospitalization. Which consequence is the pharmacy most likely to face?

Disciplinary action from the state board, potentially including fines or license sanctions, for failure to comply with mandatory reporting requirements
Correct Incorrect Correct answer

Automatic revocation of the pharmacy's DEA registration
Correct Incorrect Correct answer

Federal criminal charges under the Patient Safety and Quality Improvement Act
Correct Incorrect Correct answer

Loss of the pharmacy's ISMP membership and reporting privileges
Correct Incorrect Correct answer

Correct

Incorrect
Question 682 of 792

682. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy wants to submit a safety concern about a confusing drug label to the FDA. Which FDA portal should the technician use?

The FDA Safety Reporting Portal (formerly MedWatch online)
Correct Incorrect Correct answer

The VAERS online reporting system
Correct Incorrect Correct answer

The DEA Diversion Control Division website
Correct Incorrect Correct answer

The USP Compounding Standards Portal
Correct Incorrect Correct answer

Correct

Incorrect
Question 683 of 792

683. Question

Category: Patient Safety and Quality Assurance: Event Reporting

After a sentinel event involving a fatal medication error, a hospital’s patient safety officer must decide whether to disclose the error to the patient’s family. Which ethical and regulatory principle supports disclosure?

Transparency and honest communication with patients and families about harmful errors, as recommended by The Joint Commission and most state disclosure laws
Correct Incorrect Correct answer

Federal law requiring public announcement of all pharmacy errors in local media
Correct Incorrect Correct answer

The pharmacy's right to withhold information to protect against malpractice claims
Correct Incorrect Correct answer

HIPAA regulations requiring all adverse events to be reported directly to CMS
Correct Incorrect Correct answer

Correct

Incorrect
Question 684 of 792

684. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician completes an event report for a near-miss error involving an incorrect drug selected but caught before dispensing. The pharmacist asks the technician to also document what systemic factors contributed. Which documentation approach best supports future quality improvement?

Describe contributing factors such as staffing levels, workflow interruptions, and system design issues rather than focusing solely on the individual who made the selection
Correct Incorrect Correct answer

Document only the technician's name and the date of the error
Correct Incorrect Correct answer

Limit the report to a description of the drug that was incorrectly selected
Correct Incorrect Correct answer

Omit contributing factors because the error did not reach the patient
Correct Incorrect Correct answer

Correct

Incorrect
Question 685 of 792

685. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A hospital pharmacy reviews 200 medication event reports from the past year and finds that 45% involved interruptions during the verification process. The pharmacy implements a ‘no interruption zone’ with visual markers around the verification area. After six months, a follow-up analysis shows only a 5% reduction in interruption-related errors. Which conclusion is most supported?

The visual markers alone are insufficient; additional interventions such as workflow redesign, staffing changes, or technology solutions are needed to significantly reduce interruptions
Correct Incorrect Correct answer

The no-interruption zone was a complete failure and should be removed
Correct Incorrect Correct answer

Interruptions are not actually a contributing factor to medication errors
Correct Incorrect Correct answer

The pharmacy should accept the 5% reduction as the maximum achievable improvement
Correct Incorrect Correct answer

Correct

Incorrect
Question 686 of 792

686. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy’s event reporting data shows a 30% increase in submitted reports after implementing a new anonymous electronic reporting system. Simultaneously, actual patient harm events decreased by 15%. How should the pharmacy safety committee interpret these combined trends?

Increased reporting reflects improved safety culture and detection, while decreased harm events indicate that safety interventions are effective at preventing errors from reaching patients
Correct Incorrect Correct answer

The increase in reports means more errors are occurring and the pharmacy is becoming less safe
Correct Incorrect Correct answer

The decrease in harm events means the increased reports are false or exaggerated
Correct Incorrect Correct answer

The data is contradictory and indicates the reporting system is unreliable
Correct Incorrect Correct answer

Correct

Incorrect
Question 687 of 792

687. Question

Category: Patient Safety and Quality Assurance: Event Reporting

During an FMEA of a high-alert medication dispensing process, the team identifies that the failure mode ‘wrong concentration selected’ has a severity of 9, occurrence of 4, and detectability of 7, yielding an RPN of 252. After implementing barcode verification, the detectability improves to 2. What is the new RPN, and what does this change indicate?

The new RPN is 72, indicating that barcode verification significantly reduced the overall risk by improving the likelihood of catching the error before it reaches the patient
Correct Incorrect Correct answer

The new RPN is 126, indicating a moderate reduction in risk primarily from reduced severity
Correct Incorrect Correct answer

The new RPN is 252, indicating no change because barcode verification does not affect risk scores
Correct Incorrect Correct answer

The new RPN is 15, indicating that barcode verification eliminated all risk from this failure mode
Correct Incorrect Correct answer

Correct

Incorrect
Question 688 of 792

688. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy participates in a Patient Safety Organization (PSO) and submits de-identified error data quarterly. A malpractice attorney requests these PSO submissions during discovery for a lawsuit against the pharmacy. How should the pharmacy respond?

Assert that PSO submissions are protected under the Patient Safety and Quality Improvement Act and are privileged from discovery, disclosure, or admission in legal proceedings
Correct Incorrect Correct answer

Provide all requested PSO submissions because patient safety data is always public record
Correct Incorrect Correct answer

Provide the data but redact patient names to comply with HIPAA
Correct Incorrect Correct answer

Refuse to acknowledge that the pharmacy participates in any PSO
Correct Incorrect Correct answer

Correct

Incorrect
Question 689 of 792

689. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy’s quarterly safety review reveals that 80% of reported medication errors involve only 3 of the pharmacy’s 15 workflow steps. Using quality improvement methodology, which analytical tool best displays this pattern to prioritize improvement efforts?

A Pareto chart showing that a vital few workflow steps account for the majority of errors
Correct Incorrect Correct answer

A fishbone diagram categorizing all 15 workflow steps equally
Correct Incorrect Correct answer

A run chart tracking total error counts over time without step identification
Correct Incorrect Correct answer

A pie chart showing the percentage of errors by pharmacist on duty
Correct Incorrect Correct answer

Correct

Incorrect
Question 690 of 792

690. Question

Category: Patient Safety and Quality Assurance: Event Reporting

Two pharmacies in the same health system have similar prescription volumes, but Pharmacy A reports 40 medication events per month while Pharmacy B reports only 5. Which interpretation requires the most careful investigation before drawing conclusions?

Pharmacy B may have a reporting culture problem where errors go unreported, rather than actually having fewer errors
Correct Incorrect Correct answer

Pharmacy A is clearly a more dangerous pharmacy and needs immediate regulatory intervention
Correct Incorrect Correct answer

Pharmacy B has superior staff and processes, making it the model pharmacy
Correct Incorrect Correct answer

Both pharmacies are performing equally because total prescription volume is similar
Correct Incorrect Correct answer

Correct

Incorrect
Question 691 of 792

691. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy conducts a culture of safety survey and finds that only 35% of staff agree with the statement ‘I feel comfortable reporting errors without fear of personal consequences.’ Which intervention strategy is most likely to improve this metric?

Leadership visibly responding to reports with system improvements rather than individual discipline, combined with regular feedback to reporters about outcomes of their reports
Correct Incorrect Correct answer

Implementing a policy that mandates error reporting with disciplinary consequences for failure to report
Correct Incorrect Correct answer

Eliminating the anonymous reporting option to increase personal accountability
Correct Incorrect Correct answer

Providing financial bonuses for staff who report the highest number of errors
Correct Incorrect Correct answer

Correct

Incorrect
Question 692 of 792

692. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A state requires mandatory reporting of medication errors resulting in patient death or serious injury. A pharmacy experiences an error that causes temporary, self-resolving symptoms requiring no treatment. The pharmacy’s internal policy also requires reporting to an external PSO for all errors. Which reporting obligations apply?

The error does not meet the state mandatory reporting threshold but should still be reported to the PSO under the pharmacy's internal policy and documented internally
Correct Incorrect Correct answer

The error must be reported to both the state board and the PSO because all medication errors require mandatory state reporting
Correct Incorrect Correct answer

No reporting is needed because the patient experienced only temporary symptoms
Correct Incorrect Correct answer

Only the PSO report is legally required; internal documentation is optional
Correct Incorrect Correct answer

Correct

Incorrect
Question 693 of 792

693. Question

Category: Patient Safety and Quality Assurance: Error Prevention

In the Swiss cheese model of error, what do the holes in each defensive layer represent?

Weaknesses or gaps in individual safety barriers that can align to allow an error to reach the patient
Correct Incorrect Correct answer

Intentional openings designed to speed up pharmacy workflow
Correct Incorrect Correct answer

Points where pharmacists must personally approve each medication
Correct Incorrect Correct answer

Physical ventilation holes required in cleanroom barriers
Correct Incorrect Correct answer

Correct

Incorrect
Question 694 of 792

694. Question

Category: Patient Safety and Quality Assurance: Error Prevention

What is the primary goal of a high-reliability organization (HRO) in healthcare?

To achieve consistently safe operations by anticipating failures, learning from errors, and building resilient systems
Correct Incorrect Correct answer

To eliminate all human involvement in medication dispensing processes
Correct Incorrect Correct answer

To ensure every employee receives annual certification testing
Correct Incorrect Correct answer

To maximize prescription processing speed while reducing labor costs
Correct Incorrect Correct answer

Correct

Incorrect
Question 695 of 792

695. Question

Category: Patient Safety and Quality Assurance: Error Prevention

In smart infusion pump technology, what is the difference between a hard limit and a soft limit in the drug library?

A hard limit cannot be overridden by the clinician, while a soft limit generates an alert that can be acknowledged and bypassed
Correct Incorrect Correct answer

A hard limit applies only to controlled substances, while a soft limit applies to all other medications
Correct Incorrect Correct answer

A hard limit triggers an automatic pump shutdown, while a soft limit reduces the infusion rate by 50%
Correct Incorrect Correct answer

A hard limit is set by the manufacturer and cannot be changed, while a soft limit is customized by the pharmacy
Correct Incorrect Correct answer

Correct

Incorrect
Question 696 of 792

696. Question

Category: Patient Safety and Quality Assurance: Error Prevention

What is medication reconciliation?

The process of comparing a patient's current medication orders against all medications the patient has been taking to identify and resolve discrepancies
Correct Incorrect Correct answer

The process of matching prescription insurance claims to dispensing records
Correct Incorrect Correct answer

The quarterly audit of pharmacy inventory against wholesaler invoices
Correct Incorrect Correct answer

The verification of controlled substance counts at each shift change
Correct Incorrect Correct answer

Correct

Incorrect
Question 697 of 792

697. Question

Category: Patient Safety and Quality Assurance: Error Prevention

What is alert fatigue in the context of clinical decision support systems?

A condition where clinicians become desensitized to excessive or clinically insignificant alerts, leading them to override important warnings
Correct Incorrect Correct answer

A hardware malfunction that causes the alert system to slow down during peak hours
Correct Incorrect Correct answer

A training gap where new staff do not know how to respond to clinical alerts
Correct Incorrect Correct answer

A software error that prevents alerts from appearing on the pharmacist's screen
Correct Incorrect Correct answer

Correct

Incorrect
Question 698 of 792

698. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy’s clinical decision support system generates drug interaction alerts for 85% of all prescriptions processed. Pharmacists report overriding most alerts without reading them. Which action best addresses this alert fatigue problem?

Work with the informatics team to refine alert thresholds, suppressing low-severity alerts and emphasizing only clinically significant interactions
Correct Incorrect Correct answer

Disable the clinical decision support system entirely until a better version is available
Correct Incorrect Correct answer

Require pharmacists to document a written justification for every alert override
Correct Incorrect Correct answer

Add a second alert for each interaction to ensure pharmacists notice them
Correct Incorrect Correct answer

Correct

Incorrect
Question 699 of 792

699. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A hospital pharmacy is redesigning its medication preparation area using human factors engineering principles. Which design change best reduces the risk of selecting the wrong medication during preparation?

Organize medications in the preparation area by indication or patient rather than alphabetically to reduce adjacency of look-alike products
Correct Incorrect Correct answer

Paint the walls a calming blue color to reduce technician stress
Correct Incorrect Correct answer

Install brighter overhead lighting in all areas uniformly
Correct Incorrect Correct answer

Place the most frequently used medications closest to the door for easy access
Correct Incorrect Correct answer

Correct

Incorrect
Question 700 of 792

700. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy implements an image verification system that photographs each filled prescription vial and compares the image against a reference database. Which type of error does this technology most effectively detect?

Wrong drug or wrong strength selected during filling, detected by comparing the physical appearance of the dispensed product to expected images
Correct Incorrect Correct answer

Prescribing errors made by the physician in the original order
Correct Incorrect Correct answer

Insurance billing errors related to incorrect NDC submissions
Correct Incorrect Correct answer

Patient counseling failures at the point of sale
Correct Incorrect Correct answer

Correct

Incorrect
Question 701 of 792

701. Question

Category: Patient Safety and Quality Assurance: Error Prevention

During a transition of care from hospital to home, a patient’s discharge medication list omits the patient’s home medication of levothyroxine 75 mcg daily. Which medication reconciliation step failed?

The comparison of the discharge medication list against the patient's pre-admission medication history
Correct Incorrect Correct answer

The pharmacy's inventory check for levothyroxine availability
Correct Incorrect Correct answer

The insurance prior authorization process for thyroid medications
Correct Incorrect Correct answer

The pharmacist's final counseling session with the patient
Correct Incorrect Correct answer

Correct

Incorrect
Question 702 of 792

702. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A telepharmacy serves a rural clinic where a pharmacy technician fills prescriptions under remote pharmacist verification via video. Which additional safety control is most important for this telepharmacy model?

High-resolution camera systems that allow the remote pharmacist to clearly verify drug product selection, labeling, and quantity from multiple angles
Correct Incorrect Correct answer

Requiring the technician to call the pharmacist by phone after each prescription is filled
Correct Incorrect Correct answer

Limiting the formulary to only five medications to reduce complexity
Correct Incorrect Correct answer

Allowing the technician to make independent clinical judgments when the video connection is slow
Correct Incorrect Correct answer

Correct

Incorrect
Question 703 of 792

703. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician is compounding a batch of oral suspension and accidentally uses 100 mL of vehicle instead of the required 120 mL, resulting in an incorrect concentration. Which compounding error prevention strategy would have most likely caught this mistake?

A documented compounding worksheet requiring independent verification of each measured ingredient before mixing
Correct Incorrect Correct answer

A policy requiring the technician to taste-test each compounded product
Correct Incorrect Correct answer

Storing all compounding vehicles in identical unmarked containers
Correct Incorrect Correct answer

Allowing only one technician to compound each batch without interruption
Correct Incorrect Correct answer

Correct

Incorrect
Question 704 of 792

704. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy’s smart pump committee reviews override data and discovers that nurses overrode soft limit alerts 92% of the time for a particular antibiotic. What should the committee investigate first?

Whether the current soft limit settings for that antibiotic are too conservative and do not reflect actual prescribing practices
Correct Incorrect Correct answer

Whether to convert all soft limits for that antibiotic to hard limits immediately
Correct Incorrect Correct answer

Whether to remove the antibiotic from the smart pump drug library entirely
Correct Incorrect Correct answer

Whether to discipline the nurses who overrode the alerts
Correct Incorrect Correct answer

Correct

Incorrect
Question 705 of 792

705. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy manager wants to assess whether new technicians are competent in high-alert medication dispensing before allowing them to work independently. Which assessment approach provides the most reliable competency verification?

Direct observation of the technician performing high-alert dispensing tasks using a standardized competency checklist, combined with a written knowledge assessment
Correct Incorrect Correct answer

A self-assessment questionnaire where the technician rates their own confidence level
Correct Incorrect Correct answer

Verification that the technician completed an online training module
Correct Incorrect Correct answer

A single multiple-choice test administered on the first day of employment
Correct Incorrect Correct answer

Correct

Incorrect
Question 706 of 792

706. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy identifies that most dispensing errors occur between 2:00 PM and 4:00 PM, coinciding with peak prescription volume. Which workflow redesign strategy best addresses this pattern?

Redistribute staffing to increase technician coverage during peak hours and implement batch processing to smooth prescription volume
Correct Incorrect Correct answer

Close the pharmacy during peak hours to prevent errors
Correct Incorrect Correct answer

Eliminate all verification steps during peak hours to increase speed
Correct Incorrect Correct answer

Require pharmacists to handle all dispensing tasks personally during peak hours
Correct Incorrect Correct answer

Correct

Incorrect
Question 707 of 792

707. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy implements independent double-checks for all high-alert medications. Which practice best ensures the double-check is truly independent?

The second checker performs the verification without seeing the first checker's work or knowing what result to expect
Correct Incorrect Correct answer

The same pharmacist who entered the order also performs the final verification
Correct Incorrect Correct answer

The second checker watches the first checker's process and confirms agreement
Correct Incorrect Correct answer

Two technicians fill the prescription simultaneously and compare results
Correct Incorrect Correct answer

Correct

Incorrect
Question 708 of 792

708. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A health system is evaluating whether to implement telepharmacy services for overnight coverage at a small community hospital. Which error prevention consideration is most critical to address before implementation?

Ensuring the technology infrastructure supports reliable, continuous audiovisual communication with sufficient quality for remote medication verification
Correct Incorrect Correct answer

Confirming that telepharmacy is less expensive than hiring an on-site overnight pharmacist
Correct Incorrect Correct answer

Determining whether patients prefer in-person pharmacist interactions at night
Correct Incorrect Correct answer

Verifying that the telepharmacy software is compatible with the hospital's billing system
Correct Incorrect Correct answer

Correct

Incorrect
Question 709 of 792

709. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy is designing a new workflow for hazardous drug preparation. To prevent contamination errors, which workflow design principle should take highest priority?

Separating hazardous drug preparation physically and procedurally from non-hazardous compounding to prevent cross-contamination and selection errors
Correct Incorrect Correct answer

Training all staff on hazardous drug preparation regardless of whether they will perform this task
Correct Incorrect Correct answer

Using the same workflow for hazardous and non-hazardous drugs to maintain consistency
Correct Incorrect Correct answer

Scheduling hazardous drug preparation only during the busiest shifts when more staff are available to help
Correct Incorrect Correct answer

Correct

Incorrect
Question 710 of 792

710. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A hospital pharmacy analyzes its medication error data using the Swiss cheese model and identifies that errors reaching patients always involve failures in at least three of five defensive layers: prescriber order entry, pharmacist clinical review, technician filling, barcode verification, and nurse administration check. The pharmacy can only fund improvements to two layers. Which strategic approach maximizes patient safety?

Prioritize strengthening the two layers where holes are largest (highest failure rates), as identified by error trending data, to reduce the probability of alignment across all layers
Correct Incorrect Correct answer

Randomly select two layers for improvement since all layers are equally important
Correct Incorrect Correct answer

Focus exclusively on the first and last layers because they bookend the process
Correct Incorrect Correct answer

Invest in only one layer and make it completely fail-proof rather than improving two layers partially
Correct Incorrect Correct answer

Correct

Incorrect
Question 711 of 792

711. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy’s smart pump analytics show that one nursing unit overrides hard limit alerts by disconnecting and reconnecting the pump without the drug library. Root cause analysis reveals the nurses find the drug library too restrictive for their patient population’s dosing needs. Which systemic response best addresses both safety and clinical needs?

Collaborate with the nursing unit and pharmacy committee to review and adjust the drug library limits for that patient population while reinforcing that bypassing the library is prohibited
Correct Incorrect Correct answer

Lock all smart pumps to prevent any disconnection or reconnection
Correct Incorrect Correct answer

Remove hard limits entirely and rely only on soft limits for that unit
Correct Incorrect Correct answer

Discipline the nurses and implement surveillance cameras at each pump station
Correct Incorrect Correct answer

Correct

Incorrect
Question 712 of 792

712. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy implements five new error prevention technologies simultaneously: barcode scanning, image verification, clinical decision support alerts, smart pump integration, and automated dispensing cabinets. After six months, medication errors decrease by 40%. The pharmacy director asks which technology contributed most. Which challenge does this scenario illustrate?

The inability to attribute specific outcomes to individual interventions when multiple changes are implemented simultaneously without controlled comparison
Correct Incorrect Correct answer

The certainty that all five technologies contributed equally to the 40% reduction
Correct Incorrect Correct answer

The need to remove four technologies to determine which one is effective
Correct Incorrect Correct answer

The conclusion that technology alone is responsible for all error reductions
Correct Incorrect Correct answer

Correct

Incorrect
Question 713 of 792

713. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacist reviews competency assessment data and finds that technicians who score above 90% on written assessments still make dispensing errors at rates similar to those scoring 70-80%. Which conclusion about competency assessment is best supported?

Written knowledge assessments alone do not reliably predict practical dispensing performance, and competency evaluation should include direct observation of actual work tasks
Correct Incorrect Correct answer

Written assessments are too easy and should be made more difficult
Correct Incorrect Correct answer

Technicians scoring above 90% are overconfident and therefore more careless
Correct Incorrect Correct answer

Competency assessments have no value and should be eliminated
Correct Incorrect Correct answer

Correct

Incorrect
Question 714 of 792

714. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy’s error trending reveals that 70% of wrong-drug errors involve medications stored within two shelf positions of the intended drug. The pharmacy currently organizes inventory alphabetically. Which analysis best explains this finding, and what solution does it suggest?

Alphabetical organization creates predictable adjacency of similarly named products; reorganizing by therapeutic class, dosage form, or NDC would reduce proximity-based selection errors
Correct Incorrect Correct answer

Alphabetical organization is the safest system, and the errors are caused by technician carelessness
Correct Incorrect Correct answer

The shelf spacing is too wide, causing technicians to reach past the intended product
Correct Incorrect Correct answer

Only pharmacists should be permitted to retrieve medications from shelves
Correct Incorrect Correct answer

Correct

Incorrect
Question 715 of 792

715. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A health system compares error rates between its main campus pharmacy (fully staffed, all technologies) and a rural telepharmacy site (remote verification, limited technology). The telepharmacy has higher rates of wrong-quantity errors but lower rates of wrong-drug errors. Which analysis best explains this pattern?

Remote camera verification may be less effective at confirming exact quantities but the telepharmacy's smaller formulary and simpler inventory layout reduce drug selection errors
Correct Incorrect Correct answer

Telepharmacy is inherently more dangerous than on-site pharmacy for all error types
Correct Incorrect Correct answer

The main campus pharmacy has too many technologies, creating confusion
Correct Incorrect Correct answer

The rural site has better-trained technicians than the main campus
Correct Incorrect Correct answer

Correct

Incorrect
Question 716 of 792

716. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy conducts an HRO assessment and identifies that frontline technicians rarely speak up when they notice potential safety concerns because they believe leadership will not act on their input. Which HRO principle is most deficient in this pharmacy?

Deference to expertise, which requires that frontline workers' observations and concerns are valued and acted upon regardless of their position in the hierarchy
Correct Incorrect Correct answer

Preoccupation with failure, which requires all staff to complete daily safety checklists
Correct Incorrect Correct answer

Reluctance to simplify, which requires using the most complex available technology
Correct Incorrect Correct answer

Commitment to resilience, which requires maintaining backup generators
Correct Incorrect Correct answer

Correct

Incorrect
Question 717 of 792

717. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy’s medication reconciliation audit reveals that 25% of patients admitted through the emergency department have at least one unintentional medication discrepancy on their admission orders. Further analysis shows these discrepancies are highest among elderly patients taking five or more medications. Which targeted intervention addresses the highest-risk population most effectively?

Deploy a dedicated pharmacy technician in the ED to obtain comprehensive medication histories from patients taking multiple medications, using multiple information sources
Correct Incorrect Correct answer

Require all ED physicians to complete additional pharmacology training
Correct Incorrect Correct answer

Install a medication vending machine in the ED lobby for patient self-service
Correct Incorrect Correct answer

Delay admission until a complete medication history can be obtained during regular pharmacy hours
Correct Incorrect Correct answer

Correct

Incorrect
Question 718 of 792

718. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

Under the 2023 revision of USP 797, what are the two categories that replaced the previous low-risk, medium-risk, and high-risk contamination risk levels for compounded sterile preparations?

Category 1 CSPs and Category 2 CSPs
Correct Incorrect Correct answer

Level A CSPs and Level B CSPs
Correct Incorrect Correct answer

Simple CSPs and Complex CSPs
Correct Incorrect Correct answer

Standard CSPs and Non-standard CSPs
Correct Incorrect Correct answer

Correct

Incorrect
Question 719 of 792

719. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

What is the difference between viable and nonviable environmental monitoring in a cleanroom?

Viable monitoring detects living microorganisms using growth media, while nonviable monitoring counts total airborne particles regardless of whether they are living
Correct Incorrect Correct answer

Viable monitoring uses visual inspection, while nonviable monitoring uses electronic sensors
Correct Incorrect Correct answer

Viable monitoring is performed daily, while nonviable monitoring is performed annually
Correct Incorrect Correct answer

Viable monitoring applies only to ISO 5 areas, while nonviable monitoring applies only to ISO 7 areas
Correct Incorrect Correct answer

Correct

Incorrect
Question 720 of 792

720. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

Which type of biological safety cabinet (BSC) exhausts 100% of contaminated air through a dedicated external exhaust duct, making it suitable for compounding volatile hazardous drugs?

Class II Type B2
Correct Incorrect Correct answer

Class II Type A2
Correct Incorrect Correct answer

Class I
Correct Incorrect Correct answer

Class III (glove box)
Correct Incorrect Correct answer

Correct

Incorrect
Question 721 of 792

721. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

What is the purpose of endotoxin testing using the Limulus Amebocyte Lysate (LAL) or Bacterial Endotoxins Test (BET) for compounded sterile preparations?

To detect bacterial endotoxins (pyrogens) in injectable preparations that could cause fever or sepsis if administered to patients
Correct Incorrect Correct answer

To verify the correct drug concentration in the final compounded product
Correct Incorrect Correct answer

To confirm the pH of the compounded solution is within acceptable range
Correct Incorrect Correct answer

To test for the presence of particulate matter visible to the naked eye
Correct Incorrect Correct answer

Correct

Incorrect
Question 722 of 792

722. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy is compounding a sterile IV admixture using three commercially manufactured sterile ingredients, closed-system transfer, and standard aseptic technique. Under USP 797 (2023), which category does this preparation most likely fall under?

Category 1, because it involves sterile-to-sterile transfers using closed-system technique with commercially available sterile components
Correct Incorrect Correct answer

Category 2, because any IV admixture automatically requires Category 2 conditions
Correct Incorrect Correct answer

Neither category, because commercially manufactured components are exempt from USP 797
Correct Incorrect Correct answer

Category 2, because three ingredients always require the higher category designation
Correct Incorrect Correct answer

Correct

Incorrect
Question 723 of 792

723. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is performing gloved fingertip sampling as part of initial garbing competency validation. The results show 4 colony-forming units (CFU) on one fingertip plate. According to USP 797 action levels, what is the appropriate response?

The technician fails the fingertip sampling test because the action level for gloved fingertip sampling is greater than 3 CFU per plate, and must be retrained and retested
Correct Incorrect Correct answer

The result is acceptable because the action level for gloved fingertip testing is 10 CFU per plate
Correct Incorrect Correct answer

The technician should immediately repeat the test without retraining
Correct Incorrect Correct answer

The result is acceptable because any growth is normal on initial competency testing
Correct Incorrect Correct answer

Correct

Incorrect
Question 724 of 792

724. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A hospital pharmacy is designing a new sterile compounding suite. The hazardous drug compounding room must maintain negative pressure relative to adjacent spaces. Which design feature achieves this requirement?

Configuring the HVAC system so that the hazardous drug room exhausts more air than it supplies, creating negative pressure that prevents contaminated air from escaping to surrounding areas
Correct Incorrect Correct answer

Installing additional HEPA filters in the supply air ductwork to increase airflow into the room
Correct Incorrect Correct answer

Keeping the door to the hazardous drug room open at all times to equalize pressure
Correct Incorrect Correct answer

Placing a portable air purifier inside the room to increase positive pressure
Correct Incorrect Correct answer

Correct

Incorrect
Question 725 of 792

725. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is cleaning the interior of a laminar airflow workbench (LAFW) before beginning sterile compounding. Which cleaning sequence and agent are appropriate according to USP 797?

Clean with sterile 70% isopropyl alcohol (IPA) using lint-free wipes, working from the cleanest area (back of the hood) to the dirtiest area (front edge), side to side
Correct Incorrect Correct answer

Spray the entire interior with household bleach and allow it to air dry without wiping
Correct Incorrect Correct answer

Wipe from front to back using non-sterile paper towels dampened with tap water
Correct Incorrect Correct answer

Clean only the work surface with sterile water, leaving side walls untouched
Correct Incorrect Correct answer

Correct

Incorrect
Question 726 of 792

726. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy compounds a Category 2 CSP using non-sterile ingredients that require sterilization by filtration. Which additional testing is required under USP 797 (2023) that would not be required for a Category 1 CSP?

Sterility testing and, for applicable preparations, bacterial endotoxin testing before assigning extended beyond-use dates
Correct Incorrect Correct answer

Visual inspection for particulate matter under ambient light
Correct Incorrect Correct answer

Verification of the correct drug name on the label
Correct Incorrect Correct answer

Weight verification of the final sealed container
Correct Incorrect Correct answer

Correct

Incorrect
Question 727 of 792

727. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy receives environmental monitoring results showing that the ISO 7 buffer room had viable air sampling counts of 12 CFU/m3. The USP 797 action level for an ISO 7 area is greater than 10 CFU/m3 for viable air. What action must the pharmacy take?

Investigate the cause of the elevated counts, implement corrective actions, and consider whether CSPs prepared during the affected period may have been compromised
Correct Incorrect Correct answer

Continue operations because 12 CFU/m3 is within normal variation for an ISO 7 environment
Correct Incorrect Correct answer

Immediately close the entire pharmacy, including outpatient dispensing areas
Correct Incorrect Correct answer

Replace the HEPA filters in all primary engineering controls and retest in 6 months
Correct Incorrect Correct answer

Correct

Incorrect
Question 728 of 792

728. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is garbing to enter the cleanroom for sterile compounding. Which garbing sequence is correct according to USP 797 requirements?

Remove personal outer garments; perform hand hygiene; don shoe covers, head cover, and face mask; perform antiseptic hand cleansing; don sterile gown; then don sterile gloves
Correct Incorrect Correct answer

Don sterile gloves first, then put on the gown, shoe covers, and mask in any order
Correct Incorrect Correct answer

Enter the cleanroom in street clothes and change into sterile garments inside the ISO 5 area
Correct Incorrect Correct answer

Don all garments in the buffer room after touching the LAFW surfaces
Correct Incorrect Correct answer

Correct

Incorrect
Question 729 of 792

729. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy is evaluating whether its anteroom meets USP 797 (2023) requirements. The anteroom currently maintains ISO 8 air quality. Which anteroom function is most critical for maintaining the cleanroom environment?

Serving as a transitional space where garbing occurs and where pressure differentials prevent unfiltered air from entering the buffer room
Correct Incorrect Correct answer

Providing storage space for bulk IV solution inventory
Correct Incorrect Correct answer

Serving as a break room for compounding personnel between preparations
Correct Incorrect Correct answer

Providing a staging area for completed CSPs awaiting delivery
Correct Incorrect Correct answer

Correct

Incorrect
Question 730 of 792

730. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy compounds non-sterile preparations and wants to implement water activity testing to assess microbial growth potential. Which type of non-sterile preparation would benefit most from water activity testing?

An aqueous oral suspension compounded from non-sterile bulk powders, where high water activity could support microbial growth during the assigned beyond-use period
Correct Incorrect Correct answer

A commercially manufactured tablet that is repackaged into unit-dose blister packs
Correct Incorrect Correct answer

A topical ointment compounded using only anhydrous (water-free) bases
Correct Incorrect Correct answer

A capsule compounded from dry powder ingredients with no liquid components
Correct Incorrect Correct answer

Correct

Incorrect
Question 731 of 792

731. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy must choose an appropriate disinfectant for the cleanroom floor. The area occasionally has spills of chemotherapy agents. Which agent provides both disinfection and surface decontamination appropriate for this dual-purpose use?

A sporicidal disinfectant followed by deactivation with a chemotherapy-specific surface decontamination agent per USP 800 guidelines
Correct Incorrect Correct answer

Sterile 70% isopropyl alcohol applied with a standard mop
Correct Incorrect Correct answer

Household bleach diluted to 1:100 concentration
Correct Incorrect Correct answer

Plain sterile water with a microfiber cleaning cloth
Correct Incorrect Correct answer

Correct

Incorrect
Question 732 of 792

732. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician notices that a colleague enters the cleanroom buffer room directly from the hallway without passing through the anteroom. Which immediate action should the technician take?

Alert the colleague to exit the buffer room, re-enter through the anteroom following proper garbing procedures, and report the breach to the supervising pharmacist
Correct Incorrect Correct answer

Ignore the situation because the colleague may have already garbed in another location
Correct Incorrect Correct answer

Continue compounding because the HEPA filter will remove any contaminants introduced
Correct Incorrect Correct answer

Close the LAFW sash and wait 30 minutes before resuming compounding
Correct Incorrect Correct answer

Correct

Incorrect
Question 733 of 792

733. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy is determining how frequently media fill testing must be performed for its compounding personnel under USP 797 (2023). Which schedule is required for ongoing competency?

Initially before compounding, and at least every six months thereafter for personnel who compound Category 1 or Category 2 CSPs
Correct Incorrect Correct answer

Only once during initial training, with no ongoing requirement
Correct Incorrect Correct answer

Annually for Category 1 compounders and monthly for Category 2 compounders
Correct Incorrect Correct answer

Every two years, aligned with pharmacy license renewal
Correct Incorrect Correct answer

Correct

Incorrect
Question 734 of 792

734. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy transitions from the previous USP 797 three-tier risk system to the 2023 two-category system. Several preparations previously classified as ‘low-risk with 12-hour BUD’ now fall under Category 1. How does this reclassification most significantly affect pharmacy operations?

Category 1 BUD tables may allow different beyond-use periods than the former low-risk 12-hour default, requiring the pharmacy to re-evaluate storage conditions and BUD assignments for each preparation
Correct Incorrect Correct answer

All preparations automatically receive longer BUDs under the new system
Correct Incorrect Correct answer

The pharmacy no longer needs to perform any environmental monitoring
Correct Incorrect Correct answer

Category 1 preparations are exempt from all USP 797 requirements
Correct Incorrect Correct answer

Correct

Incorrect
Question 735 of 792

735. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A hospital pharmacy’s environmental monitoring program shows consistently acceptable nonviable particle counts in the ISO 5 area but recurring viable sampling failures. Which analysis best explains this discrepancy?

Nonviable particle counts measure total particles including dust and fibers, while viable sampling detects living microorganisms; the discrepancy suggests a contamination source introducing viable organisms without significantly increasing total particle counts
Correct Incorrect Correct answer

The nonviable particle counter is malfunctioning and giving falsely low readings
Correct Incorrect Correct answer

Viable sampling is inherently unreliable and the results should be disregarded
Correct Incorrect Correct answer

The discrepancy proves that nonviable monitoring is unnecessary if viable monitoring is performed
Correct Incorrect Correct answer

Correct

Incorrect
Question 736 of 792

736. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy compounds hazardous drugs in a Class II Type A2 BSC that recirculates a portion of HEPA-filtered air back into the room. The pharmacy is considering adding volatile hazardous drugs to its formulary. Which USP 800 compliance issue does this create?

A Class II Type A2 BSC recirculates filtered air into the room, which is insufficient for volatile hazardous drugs that require a total-exhaust (Class II Type B2) BSC or a CACI with external exhaust
Correct Incorrect Correct answer

The Class II Type A2 BSC cannot accommodate the physical size of volatile drug vials
Correct Incorrect Correct answer

USP 800 allows any Class II BSC for all types of hazardous drug compounding
Correct Incorrect Correct answer

Volatile hazardous drugs only require standard chemical fume hoods, not BSCs
Correct Incorrect Correct answer

Correct

Incorrect
Question 737 of 792

737. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy’s media fill testing results show that one technician passes consistently in the morning but fails afternoon tests. Environmental monitoring results remain consistent throughout the day. Which root cause analysis is most plausible?

The technician's aseptic technique deteriorates during longer shifts due to fatigue, reduced concentration, or less meticulous garbing and hand hygiene practices later in the day
Correct Incorrect Correct answer

The growth media used in the afternoon is contaminated from the manufacturer
Correct Incorrect Correct answer

The cleanroom HEPA filters only function properly in the morning
Correct Incorrect Correct answer

Afternoon media fill tests are inherently less reliable than morning tests
Correct Incorrect Correct answer

Correct

Incorrect
Question 738 of 792

738. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy performs endotoxin testing on a batch of compounded TPN solutions using the LAL test. The results show endotoxin levels just below the action limit. The pharmacist must decide whether to release the batch. Which analysis should guide this decision?

Review the trending data for endotoxin levels across recent batches; a pattern of rising levels approaching the action limit suggests a developing contamination issue that warrants investigation before releasing the batch
Correct Incorrect Correct answer

Release the batch immediately because any result below the action limit is automatically acceptable
Correct Incorrect Correct answer

Discard the entire batch because any detectable endotoxin level is unsafe
Correct Incorrect Correct answer

Repeat the test five times and average the results to get a more favorable number
Correct Incorrect Correct answer

Correct

Incorrect
Question 739 of 792

739. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A new pharmacy cleanroom design includes both a positive-pressure non-hazardous compounding buffer room and a negative-pressure hazardous drug compounding buffer room sharing a common anteroom. What engineering challenge must the design address to maintain proper pressure relationships?

The anteroom must maintain pressure that is positive relative to the hazardous drug room (to contain hazardous vapors) and negative relative to the non-hazardous buffer room (to protect sterile compounding), requiring careful HVAC balancing
Correct Incorrect Correct answer

Both rooms should be maintained at identical positive pressure to simplify HVAC design
Correct Incorrect Correct answer

The anteroom pressure is irrelevant as long as both buffer rooms are properly pressurized
Correct Incorrect Correct answer

The hazardous and non-hazardous rooms cannot share an anteroom under any circumstances
Correct Incorrect Correct answer

Correct

Incorrect
Question 740 of 792

740. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy audit reveals that cleaning staff use the same mop heads and cleaning solutions for both the anteroom and the buffer room. Environmental monitoring subsequently shows elevated viable counts in the buffer room. Which relationship between the cleaning practice and the monitoring results is most likely?

Using the same mop heads in both areas transfers contaminants from the less clean anteroom into the buffer room, and cleaning solutions may become contaminated during anteroom use, introducing organisms into the cleaner space
Correct Incorrect Correct answer

The elevated counts are coincidental and unrelated to cleaning practices
Correct Incorrect Correct answer

Using the same mop heads is acceptable because the cleaning solution sterilizes the mop between rooms
Correct Incorrect Correct answer

The anteroom is cleaner than the buffer room, so the direction of contamination transfer is reversed
Correct Incorrect Correct answer

Correct

Incorrect
Question 741 of 792

741. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy is evaluating its personnel competency program and finds that 15% of staff consistently fail initial gloved fingertip testing but pass after a single retraining session. After six months, the same staff members fail their semi-annual retest. Which systemic issue does this pattern reveal, and what intervention is most appropriate?

The retraining corrects technique temporarily but does not produce lasting behavior change; the program should incorporate ongoing coaching, observed practice sessions, and more frequent competency checks for these individuals
Correct Incorrect Correct answer

The 15% failure rate is acceptable and no changes are needed
Correct Incorrect Correct answer

These staff members should be permanently prohibited from all cleanroom activities
Correct Incorrect Correct answer

The fingertip testing methodology is too sensitive and should use higher action levels
Correct Incorrect Correct answer

Correct

Incorrect
Question 742 of 792

742. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Digoxin is classified as a narrow therapeutic index (NTI) drug. What is the generally accepted therapeutic serum range for digoxin?

0.5 to 2.0 ng/mL
Correct Incorrect Correct answer

5 to 10 ng/mL
Correct Incorrect Correct answer

10 to 20 mcg/mL
Correct Incorrect Correct answer

0.05-0.2 ng/mL
Correct Incorrect Correct answer

Correct

Incorrect
Question 743 of 792

743. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A patient taking digoxin 0.25 mg daily presents a new prescription for amiodarone. The pharmacy technician recognizes a potential interaction. What is the primary concern with this drug combination?

Amiodarone can significantly increase digoxin serum levels, raising the risk of toxicity
Correct Incorrect Correct answer

Amiodarone decreases digoxin absorption, reducing its effectiveness
Correct Incorrect Correct answer

The combination causes rapid metabolism of digoxin, requiring higher doses
Correct Incorrect Correct answer

Amiodarone and digoxin have identical mechanisms of action, causing therapeutic duplication
Correct Incorrect Correct answer

Correct

Incorrect
Question 744 of 792

744. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

What is the therapeutic serum range for lithium, and what is a key sign of lithium toxicity?

0.6 to 1.2 mEq/L; toxicity signs include severe tremor, confusion, and vomiting
Correct Incorrect Correct answer

5 to 10 mEq/L; toxicity signs include constipation and dry mouth
Correct Incorrect Correct answer

1.5 to 3.0 mEq/L; toxicity signs include weight gain and drowsiness
Correct Incorrect Correct answer

0.1 to 0.5 mEq/L; toxicity signs include hyperactivity and insomnia
Correct Incorrect Correct answer

Correct

Incorrect
Question 745 of 792

745. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A patient on lithium therapy presents a new prescription for hydrochlorothiazide 25 mg daily. The technician flags the interaction for pharmacist review. Why is this combination concerning?

Thiazide diuretics decrease lithium excretion, increasing the risk of lithium toxicity
Correct Incorrect Correct answer

Hydrochlorothiazide accelerates lithium metabolism in the liver
Correct Incorrect Correct answer

Thiazide diuretics neutralize the therapeutic effect of lithium
Correct Incorrect Correct answer

The combination causes excessive urination, flushing lithium from the body too quickly
Correct Incorrect Correct answer

Correct

Incorrect
Question 746 of 792

746. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A technician is processing a prescription for phenytoin 300 mg daily. The patient’s profile shows they also take carbamazepine. Why does phenytoin require careful monitoring when used with carbamazepine?

Carbamazepine can induce hepatic enzymes that increase phenytoin metabolism, potentially reducing phenytoin levels
Correct Incorrect Correct answer

Carbamazepine blocks renal excretion of phenytoin, causing accumulation
Correct Incorrect Correct answer

Phenytoin and carbamazepine bind to the same receptor, causing therapeutic duplication
Correct Incorrect Correct answer

Carbamazepine converts phenytoin into a toxic metabolite
Correct Incorrect Correct answer

Correct

Incorrect
Question 747 of 792

747. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Phenytoin is considered a narrow therapeutic index (NTI) drug. Why is it important for a pharmacy technician to flag even small dose changes for pharmacist review?

Small dose changes can cause large, unpredictable changes in blood levels
Correct Incorrect Correct answer

Phenytoin is a controlled substance requiring DEA documentation
Correct Incorrect Correct answer

The drug must be compounded fresh for each patient
Correct Incorrect Correct answer

Generic substitution is always prohibited for phenytoin
Correct Incorrect Correct answer

Correct

Incorrect
Question 748 of 792

748. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

What is the therapeutic serum range for theophylline?

10 to 20 mcg/mL
Correct Incorrect Correct answer

0.5 to 2.0 mcg/mL
Correct Incorrect Correct answer

5 to 10 mEq/L
Correct Incorrect Correct answer

50 to 100 ng/mL
Correct Incorrect Correct answer

Correct

Incorrect
Question 749 of 792

749. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A patient stabilized on theophylline 300 mg twice daily receives a new prescription for ciprofloxacin for a urinary tract infection. Why should the technician flag this combination for pharmacist review?

Ciprofloxacin inhibits theophylline metabolism, increasing the risk of theophylline toxicity
Correct Incorrect Correct answer

Ciprofloxacin inactivates theophylline in the GI tract, reducing its absorption
Correct Incorrect Correct answer

Theophylline reduces ciprofloxacin's antibacterial effectiveness
Correct Incorrect Correct answer

The drugs must be separated by 4 hours due to chelation interactions
Correct Incorrect Correct answer

Correct

Incorrect
Question 750 of 792

750. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is reviewing a patient’s medication list that includes fentanyl patches and newly prescribed alprazolam. What is the primary safety concern with this combination?

Combined CNS depression can cause excessive sedation, respiratory depression, and death
Correct Incorrect Correct answer

Alprazolam accelerates fentanyl metabolism, reducing pain control
Correct Incorrect Correct answer

Fentanyl patches become less adhesive when benzodiazepines are taken concurrently
Correct Incorrect Correct answer

The combination causes serotonin syndrome
Correct Incorrect Correct answer

Correct

Incorrect
Question 751 of 792

751. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A community pharmacy wants to implement extra safeguards for high-alert medications such as warfarin, insulin, and opioids. Which of the following strategies would be most effective?

Require independent double-verification by a second pharmacy team member before dispensing
Correct Incorrect Correct answer

Store high-alert medications in a separate locked cabinet accessible only by technicians
Correct Incorrect Correct answer

Dispense high-alert medications only during peak staffing hours
Correct Incorrect Correct answer

Limit high-alert medication inventory to reduce the number of available products
Correct Incorrect Correct answer

Correct

Incorrect
Question 752 of 792

752. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

Which type of medication error occurs when a prescribed dose is not administered to a patient?

Omission error
Correct Incorrect Correct answer

Wrong time error
Correct Incorrect Correct answer

Extra dose error
Correct Incorrect Correct answer

Unauthorized drug error
Correct Incorrect Correct answer

Correct

Incorrect
Question 753 of 792

753. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A long-term care facility nurse reviews patient charts and discovers that a resident’s morning dose of levothyroxine has been consistently skipped for the past three days because it was not on the medication administration record. What type of error has occurred?

Omission error
Correct Incorrect Correct answer

Wrong dose error
Correct Incorrect Correct answer

Deteriorated drug error
Correct Incorrect Correct answer

Wrong dosage form error
Correct Incorrect Correct answer

Correct

Incorrect
Question 754 of 792

754. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A medication is prescribed to be given at 8:00 AM, but the nurse administers it at 11:30 AM because the pharmacy delivery was delayed. Assuming the facility’s policy allows a 30-minute window, what type of error does this represent?

Wrong time error
Correct Incorrect Correct answer

Omission error
Correct Incorrect Correct answer

Unauthorized drug error
Correct Incorrect Correct answer

Wrong dose error
Correct Incorrect Correct answer

Correct

Incorrect
Question 755 of 792

755. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A patient takes metformin 500 mg twice daily (8 AM and 8 PM). On Tuesday, the patient took the morning dose at 8 AM and then took the evening dose at 2 PM because they planned to be away from home. Which type of medication error best describes this situation?

Wrong time error
Correct Incorrect Correct answer

Extra dose error
Correct Incorrect Correct answer

Omission error
Correct Incorrect Correct answer

Unauthorized drug error
Correct Incorrect Correct answer

Correct

Incorrect
Question 756 of 792

756. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A nurse administered a patient’s scheduled 10 AM dose of lisinopril 10 mg. Thirty minutes later, a different nurse, unaware the dose was given, administers a second dose of lisinopril 10 mg. What type of error is this?

Extra dose error
Correct Incorrect Correct answer

Wrong dose error
Correct Incorrect Correct answer

Omission error
Correct Incorrect Correct answer

Unauthorized drug error
Correct Incorrect Correct answer

Correct

Incorrect
Question 757 of 792

757. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy technician discovers that a nurse at an assisted living facility has been giving a resident diphenhydramine 25 mg at bedtime for sleep, but the medication is not listed on the patient’s medication orders. What type of medication error does this represent?

Unauthorized drug error
Correct Incorrect Correct answer

Wrong dose error
Correct Incorrect Correct answer

Extra dose error
Correct Incorrect Correct answer

Omission error
Correct Incorrect Correct answer

Correct

Incorrect
Question 758 of 792

758. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A technician receives a prescription for amoxicillin 500 mg capsules. However, the patient’s profile shows a note from the prescriber indicating the medication was discontinued two weeks ago and replaced with azithromycin. If the technician fills the amoxicillin prescription without verification, what type of error would this be?

Unauthorized drug error
Correct Incorrect Correct answer

Wrong dose error
Correct Incorrect Correct answer

Deteriorated drug error
Correct Incorrect Correct answer

Wrong time error
Correct Incorrect Correct answer

Correct

Incorrect
Question 759 of 792

759. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

During a routine inventory check, a pharmacy technician finds a bottle of nitroglycerin sublingual tablets that expired three months ago. The bottle is still on the active dispensing shelf and several tablets have been dispensed from it recently. What type of medication error has occurred?

Deteriorated drug error
Correct Incorrect Correct answer

Omission error
Correct Incorrect Correct answer

Wrong dose error
Correct Incorrect Correct answer

Wrong dosage form error
Correct Incorrect Correct answer

Correct

Incorrect
Question 760 of 792

760. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A pharmacy receives insulin vials from a wholesaler. Upon inspection, the technician notices the cold chain indicator shows the shipment reached 28 degrees Celsius during transit. If the insulin is stocked and dispensed to patients, what type of error would this represent?

Deteriorated drug error
Correct Incorrect Correct answer

Extra dose error
Correct Incorrect Correct answer

Wrong time error
Correct Incorrect Correct answer

Omission error
Correct Incorrect Correct answer

Correct

Incorrect
Question 761 of 792

761. Question

Category: Patient Safety and Quality Assurance: Prescription Errors

A prescription calls for fluoxetine 20 mg capsules for a patient who has difficulty swallowing. The technician fills the prescription with capsules without noting the patient’s condition. The patient calls back, unable to take the medication. If the prescriber had intended the liquid formulation, what type of error does this represent?

Wrong dosage form error
Correct Incorrect Correct answer

Wrong dose error
Correct Incorrect Correct answer

Omission error
Correct Incorrect Correct answer

Unauthorized drug error
Correct Incorrect Correct answer

Correct

Incorrect
Question 762 of 792

762. Question

Category: Patient Safety and Quality Assurance: Error Prevention

Which error prevention strategy involves physically separating look-alike or sound-alike medications on pharmacy shelves?

Separating inventory of look-alike and sound-alike drug pairs
Correct Incorrect Correct answer

Tall Man lettering on shelf labels
Correct Incorrect Correct answer

Requiring independent double checks for all dispensed medications
Correct Incorrect Correct answer

Scanning barcodes at the point of dispensing
Correct Incorrect Correct answer

Correct

Incorrect
Question 763 of 792

763. Question

Category: Patient Safety and Quality Assurance: Error Prevention

Before dispensing an insulin drip, a second pharmacist independently verifies the concentration, rate, and patient information without knowledge of the original pharmacist’s findings. This process is known as which safety strategy?

Independent double check
Correct Incorrect Correct answer

Drug utilization review
Correct Incorrect Correct answer

Barcode medication administration
Correct Incorrect Correct answer

Root cause analysis
Correct Incorrect Correct answer

Correct

Incorrect
Question 764 of 792

764. Question

Category: Patient Safety and Quality Assurance: Error Prevention

An automated dispensing robot in a pharmacy counts tablets, fills vials, and labels prescriptions. What is the primary error prevention benefit of robotic dispensing systems?

Reducing counting and selection errors through automated verification
Correct Incorrect Correct answer

Eliminating the need for pharmacist verification of prescriptions
Correct Incorrect Correct answer

Allowing the pharmacy to operate without a pharmacist on duty
Correct Incorrect Correct answer

Removing the requirement for patient counseling
Correct Incorrect Correct answer

Correct

Incorrect
Question 765 of 792

765. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A pharmacy technician asks a patient for their full name and date of birth before dispensing a prescription. This practice fulfills which patient safety requirement?

Using at least two patient identifiers to verify the correct patient
Correct Incorrect Correct answer

Completing the HIPAA privacy verification process
Correct Incorrect Correct answer

Documenting the patient's allergy history
Correct Incorrect Correct answer

Satisfying the OBRA-90 counseling requirement
Correct Incorrect Correct answer

Correct

Incorrect
Question 766 of 792

766. Question

Category: Patient Safety and Quality Assurance: Error Prevention

During the prescription filling process, a pharmacy technician scans the barcode on the stock bottle and the system alerts that the NDC number does not match the prescribed product. What should the technician do?

Stop and verify the correct product before proceeding
Correct Incorrect Correct answer

Override the alert and continue filling since the drug name appears correct
Correct Incorrect Correct answer

Contact the prescriber to change the prescription to match the stock bottle
Correct Incorrect Correct answer

Dispense the medication and note the NDC mismatch in the patient profile
Correct Incorrect Correct answer

Correct

Incorrect
Question 767 of 792

767. Question

Category: Patient Safety and Quality Assurance: Error Prevention

Which of the following is an example of a label check performed during the dispensing process?

Comparing the prescription label against the original prescription for drug name, strength, and directions
Correct Incorrect Correct answer

Scanning the patient's insurance card to verify coverage
Correct Incorrect Correct answer

Checking the patient's allergy history in the pharmacy system
Correct Incorrect Correct answer

Verifying the prescriber's DEA number for a controlled substance
Correct Incorrect Correct answer

Correct

Incorrect
Question 768 of 792

768. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient asks a pharmacy technician to recommend a cough suppressant for a persistent dry cough. What is the appropriate response?

Refer the patient to the pharmacist for an OTC recommendation
Correct Incorrect Correct answer

Suggest dextromethorphan since it is available without a prescription
Correct Incorrect Correct answer

Tell the patient to see a doctor because coughs always require a prescription
Correct Incorrect Correct answer

Recommend the most popular brand of cough medicine on the shelf
Correct Incorrect Correct answer

Correct

Incorrect
Question 769 of 792

769. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

While processing a prescription for gabapentin 600 mg TID, the pharmacy computer system generates a renal dosing alert for the patient. What is the most appropriate action for the pharmacy technician?

Refer the prescription and the alert to the pharmacist for clinical review
Correct Incorrect Correct answer

Override the alert and continue filling the prescription as written
Correct Incorrect Correct answer

Contact the prescriber directly to request a dose reduction
Correct Incorrect Correct answer

Change the dose in the system to match the renal dosing recommendation
Correct Incorrect Correct answer

Correct

Incorrect
Question 770 of 792

770. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

Which federal law requires pharmacists to perform a prospective drug utilization review (DUR) before dispensing Medicaid prescriptions?

OBRA-90 (Omnibus Budget Reconciliation Act of 1990)
Correct Incorrect Correct answer

The Durham-Humphrey Amendment of 1951
Correct Incorrect Correct answer

HIPAA (Health Insurance Portability and Accountability Act)
Correct Incorrect Correct answer

The Poison Prevention Packaging Act of 1970
Correct Incorrect Correct answer

Correct

Incorrect
Question 771 of 792

771. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacist determines that a controlled substance prescription may not have been written for a legitimate medical purpose and declines to dispense it. This decision is based on which legal principle?

Corresponding responsibility, which requires the pharmacist to ensure the prescription is valid
Correct Incorrect Correct answer

The Durham-Humphrey Amendment, which defines prescription versus OTC status
Correct Incorrect Correct answer

The Combat Methamphetamine Epidemic Act, which restricts pseudoephedrine sales
Correct Incorrect Correct answer

HIPAA privacy rules, which prevent sharing prescription information
Correct Incorrect Correct answer

Correct

Incorrect
Question 772 of 792

772. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacist reviews a prescription and identifies a potentially harmful drug interaction. After contacting the prescriber, the pharmacist documents the intervention but the prescriber insists the combination is appropriate for this patient. The pharmacist decides not to fill the prescription. This is an example of which action?

Refusal to fill based on the pharmacist's professional judgment
Correct Incorrect Correct answer

A HIPAA violation for sharing patient information with the prescriber
Correct Incorrect Correct answer

An OBRA-90 violation for failing to dispense a valid prescription
Correct Incorrect Correct answer

A DEA requirement for all prescriptions with drug interactions
Correct Incorrect Correct answer

Correct

Incorrect
Question 773 of 792

773. Question

Category: Patient Safety and Quality Assurance: Event Reporting

FDA Form 3500 is used by healthcare professionals to voluntarily report which of the following?

Adverse events, product quality problems, and medication errors through the MedWatch program
Correct Incorrect Correct answer

Controlled substance theft or loss to the DEA
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Vaccine adverse events to the VAERS system
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Workers' compensation claims for pharmacy staff injuries
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Question 774 of 792

774. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician notices that a patient experienced a serious allergic reaction after taking a newly approved medication. The pharmacist decides to report this event. Which form should be used?

FDA Form 3500 submitted through the MedWatch program
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DEA Form 106 for drug loss reporting
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DEA Form 222 for controlled substance ordering
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FDA Form 3500A, which is restricted to manufacturers only
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Question 775 of 792

775. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A blame-free reporting culture in a pharmacy encourages staff to do which of the following?

Report medication errors openly without fear of punishment so that systemic improvements can be made
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Ignore minor medication errors to avoid creating unnecessary paperwork
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Blame individual staff members to ensure accountability
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Report errors only when a patient is harmed
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Question 776 of 792

776. Question

Category: Patient Safety and Quality Assurance: Event Reporting

A pharmacy technician catches a dispensing error before the medication reaches the patient. Under a blame-free reporting culture, what is the most appropriate action?

Report the near-miss event so the pharmacy can analyze the cause and implement prevention strategies
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Do not report because no patient harm occurred
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Report only to the technician's direct supervisor and no further
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Wait until a similar error actually reaches a patient before reporting
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Question 777 of 792

777. Question

Category: Patient Safety and Quality Assurance: Error Prevention

Before dispensing a prescription, a pharmacy technician should verify the patient’s identity using at least how many patient identifiers?

Two identifiers, such as full name and date of birth
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One identifier, such as the patient's last name
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Three identifiers, including photo ID, address, and phone number
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No identifiers are required if the patient is a regular customer
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Question 778 of 792

778. Question

Category: Patient Safety and Quality Assurance: Error Prevention

A patient approaches the pharmacy counter to pick up a prescription. The technician asks for the patient’s name, and it matches the label. What additional step should be taken before releasing the medication?

Verify a second identifier such as the patient's date of birth to confirm identity using two identifiers
Correct Incorrect Correct answer

No additional verification is needed since the name matches
Correct Incorrect Correct answer

Ask the patient to show their insurance card for billing verification
Correct Incorrect Correct answer

Check the patient's prescription history for the past year
Correct Incorrect Correct answer

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Question 779 of 792

779. Question

Category: Patient Safety and Quality Assurance: Error Prevention

Verifying the NDC check during the dispensing process helps prevent which type of error?

Selecting the wrong drug, strength, or dosage form
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Billing the wrong insurance company
Correct Incorrect Correct answer

Filing the prescription in the wrong patient profile
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Printing an incorrect pharmacy address on the label
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Question 780 of 792

780. Question

Category: Patient Safety and Quality Assurance: Error Prevention

While filling a prescription for metformin 500 mg tablets, a pharmacy technician scans the stock bottle and the system flags an NDC check mismatch. What should the technician do?

Stop dispensing and verify that the correct drug, strength, and dosage form have been selected
Correct Incorrect Correct answer

Override the alert and continue dispensing since metformin is a common medication
Correct Incorrect Correct answer

Change the NDC in the computer system to match the bottle scanned
Correct Incorrect Correct answer

Dispense the medication and notify the pharmacist after the patient leaves
Correct Incorrect Correct answer

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Question 781 of 792

781. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

Clozaril is a brand-name medication that is commonly included on LASA (look-alike/sound-alike) medication lists. What is its generic name?

Clozapine
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Clonazepam
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Clonidine
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Clopidogrel
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Question 782 of 792

782. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A new pharmacy technician accidentally selects Clozaril from the shelf when the prescription calls for Colazal. Which safety strategy is specifically designed to prevent this type of LASA error?

Tall Man lettering and separating look-alike medications on pharmacy shelves
Correct Incorrect Correct answer

Using child-resistant containers for all prescriptions
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Requiring two forms of patient identification at pickup
Correct Incorrect Correct answer

Implementing automatic refill reminders for chronic medications
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Question 783 of 792

783. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

Clozapine is commonly confused with which of the following look-alike/sound-alike medications?

Clonazepam
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Cephalexin
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Ciprofloxacin
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Cyclobenzaprine
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Correct

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Question 784 of 792

784. Question

Category: Patient Safety and Quality Assurance: Lasa Medications

A pharmacy uses Tall Man lettering in its computer system, displaying ‘cloZAPine’ and ‘cloNAZEPam.’ What is the primary purpose of capitalizing different letter portions?

To visually highlight the differences between clozapine and clonazepam, reducing LASA selection errors
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To indicate which portion of the drug name is the chemical salt form
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To show which syllable receives emphasis during pronunciation
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To identify the manufacturer of each generic product
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Question 785 of 792

785. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

In which pharmacy situation is a face shield most appropriate as personal protective equipment?

When compounding hazardous drugs where there is risk of splashing to the eyes and face
Correct Incorrect Correct answer

When counting tablets at the pharmacy counter
Correct Incorrect Correct answer

When stocking shelves with over-the-counter medications
Correct Incorrect Correct answer

When ringing up a customer at the cash register
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Question 786 of 792

786. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy technician is preparing to clean up a chemotherapy drug spill. Which PPE should include a face shield?

The spill cleanup PPE, which requires chemotherapy-tested gloves, gown, respiratory protection, and a face shield
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No face shield is needed; standard pharmacy gloves are sufficient for spill cleanup
Correct Incorrect Correct answer

Only a surgical mask is required for chemotherapy spill cleanup
Correct Incorrect Correct answer

Face shields are only required during IV admixture preparation, not spill cleanup
Correct Incorrect Correct answer

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Question 787 of 792

787. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

What is the primary purpose of the ante-room (ante-area) in a sterile compounding facility?

To serve as a transition area between the unclassified space and the buffer room, where garbing and hand hygiene occur
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To store finished compounded sterile preparations before distribution
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To serve as the primary compounding area for non-hazardous sterile preparations
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To provide a break room for pharmacy staff between compounding sessions
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Question 788 of 792

788. Question

Category: Patient Safety and Quality Assurance: Infection Prevention

A pharmacy is setting up a new sterile compounding area for Category 2 CSPs. What ISO classification is required for the ante-room?

ISO Class 8
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ISO Class 5
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ISO Class 7
Correct Incorrect Correct answer

No ISO classification is required for the ante-room
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Question 789 of 792

789. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

According to ISMP, which of the following is a high-alert medication class in the community setting?

Oral anticoagulants such as warfarin
Correct Incorrect Correct answer

Proton pump inhibitors such as omeprazole
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First-generation cephalosporins such as cephalexin
Correct Incorrect Correct answer

Thyroid supplements such as levothyroxine
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Question 790 of 792

790. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A community pharmacy is implementing additional safety checks for high-alert medications. According to ISMP guidelines for the community setting, which medication should be included on this list?

Metformin, which is classified as a high-alert antidiabetic agent in community pharmacy
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Amoxicillin, a commonly prescribed antibiotic
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Cetirizine, an over-the-counter antihistamine
Correct Incorrect Correct answer

Omeprazole, a proton pump inhibitor
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Question 791 of 792

791. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A pharmacy technician processes a prescription for a renally cleared medication and the patient’s profile indicates chronic kidney disease. What is the appropriate action?

Flag the prescription for the pharmacist to evaluate whether a renal adjustment to the dose is needed
Correct Incorrect Correct answer

Adjust the dose in the computer system based on the technician's judgment
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Dispense the prescription as written since dose adjustments are the prescriber's responsibility
Correct Incorrect Correct answer

Contact the patient's nephrologist directly to request a new dose
Correct Incorrect Correct answer

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Question 792 of 792

792. Question

Category: Patient Safety and Quality Assurance: Pharmacist Intervention

A patient with a documented creatinine clearance of 25 mL/min receives a prescription for gabapentin 600 mg tid. The pharmacy computer system generates a renal adjustment alert. What should happen next?

The pharmacist should review the alert and contact the prescriber to discuss a potential dose reduction based on the patient's renal function
Correct Incorrect Correct answer

The technician should override the alert since the prescriber already approved the dose
Correct Incorrect Correct answer

The prescription should be filled as written and the patient told to monitor for side effects
Correct Incorrect Correct answer

The technician should reduce the dose to 300 mg without pharmacist involvement
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