ExCPT Test Medication Safety 1 — Questions and Answers
Question 1: Which of the following medications is considered a 'high-alert' drug that requires special safeguards due to its high risk of causing significant patient harm?
- Amoxicillin 500 mg
- Insulin glargine 100 units/mL (Correct answer)
- Cetirizine 10 mg
- Omeprazole 20 mg
Correct answer: Insulin glargine 100 units/mL
Insulin is classified as a high-alert medication by ISMP because dosing errors can cause severe hypoglycemia or hyperosmolar states. High-alert drugs require extra verification steps, independent double-checks, and special storage protocols.
Question 2: A pharmacy technician is filling a prescription and notices the drug name on the stock bottle looks very similar to the drug ordered but is spelled differently. This is an example of which type of drug safety concern?
- Therapeutic duplication
- Look-alike/sound-alike (LASA) drug risk (Correct answer)
- Drug-drug interaction
- Formulary substitution
Correct answer: Look-alike/sound-alike (LASA) drug risk
Look-alike/sound-alike (LASA) drugs share similar names or packaging and are a leading cause of dispensing errors. Recognizing LASA pairs and using Tallman lettering or physical separation in storage helps mitigate the risk.
Question 3: What does the abbreviation 'NCC MERP' stand for in the context of medication safety?
- National Coordinating Council for Medication Error Reporting and Prevention (Correct answer)
- National Clinical Committee for Medical Error Research and Policy
- Nationwide Compliance Council for Medication Error Reduction Programs
- National Center for Controlled Medication Error Reporting Practices
Correct answer: National Coordinating Council for Medication Error Reporting and Prevention
NCC MERP (National Coordinating Council for Medication Error Reporting and Prevention) is the organization that developed the widely used index for categorizing medication errors by severity, from Category A (no error) through Category I (patient death).
Question 4: A technician is preparing a compounded IV solution and realizes the beyond-use date (BUD) on a sterile ingredient has passed. What is the MOST appropriate action?
- Use the ingredient if it appears clear and uncontaminated
- Adjust the BUD to match the compounding date
- Discard the ingredient and obtain an unexpired one before proceeding (Correct answer)
- Complete the preparation and notify the pharmacist after dispensing
Correct answer: Discard the ingredient and obtain an unexpired one before proceeding
Expired ingredients must never be used in compounding because potency, sterility, and safety can no longer be guaranteed. The correct action is to discard the expired ingredient and use a product within its valid BUD to ensure patient safety.
Question 5: Which of the following is the BEST example of using a 'forcing function' to prevent medication errors?
- Posting a list of high-alert medications near the pharmacy counter
- Requiring technicians to verbally repeat back a prescription to the pharmacist
- Designing an IV pump that physically cannot accept a syringe larger than the maximum safe dose (Correct answer)
- Color-coding medication bins by drug category
Correct answer: Designing an IV pump that physically cannot accept a syringe larger than the maximum safe dose
A forcing function is a design constraint that physically prevents an error from occurring, making the wrong action impossible. Pump design that limits syringe size is a classic example — it eliminates the possibility of administering an overdose through that route.
Question 6: When a pharmacy technician counsels a patient picking up a new prescription, which verification step MOST directly helps catch a potential dispensing error before the patient leaves?
- Asking the patient to confirm their date of birth again at pickup
- Having the patient open the bag and describe what condition the medication is for (Correct answer)
- Reminding the patient to store the medication at room temperature
- Confirming the patient's insurance information is current
Correct answer: Having the patient open the bag and describe what condition the medication is for
Asking the patient to describe the condition being treated creates a 'closed-loop' verification — if the drug dispensed doesn't match the patient's stated condition, a dispensing error is caught before harm occurs. This technique is an important final safety check.
ExCPT Test Medication Safety 1
Which of the following medications is considered a 'high-alert' drug that requires special safeguards due to its high risk of causing significant patient harm?