ISMP High-Alert Medications 1 — Questions and Answers
Question 1: Which organization publishes the list of high-alert medications used most widely in US healthcare settings?
- FDA
- ISMP (Correct answer)
- The Joint Commission
- CMS
Correct answer: ISMP
ISMP publishes and regularly updates the list of high-alert medications that bear a heightened risk of causing significant patient harm when used in error.
Question 2: Which of the following is considered a high-alert medication by ISMP?
- Acetaminophen
- Amoxicillin
- Insulin (Correct answer)
- Ibuprofen
Correct answer: Insulin
Insulin is on the ISMP high-alert medication list because errors involving it can cause serious hypoglycemia or death.
Question 3: What is a recommended strategy for reducing errors with high-alert medications?
- Store them at the front of the medication room
- Require independent double-checks (Correct answer)
- Dispense in bulk quantities
- Allow verbal orders only
Correct answer: Require independent double-checks
ISMP recommends independent double-checks as a key safeguard for high-alert medications to catch errors before they reach patients.
Question 4: Concentrated electrolytes such as potassium chloride injection are on the ISMP high-alert list primarily because they can cause:
- Mild hypertension
- Cardiac arrest if given undiluted IV push (Correct answer)
- Skin irritation
- Nausea only
Correct answer: Cardiac arrest if given undiluted IV push
Undiluted IV potassium chloride can cause fatal cardiac arrest, which is why ISMP recommends removing concentrated KCl from floor stock.
Question 5: According to ISMP, which labeling practice helps distinguish high-alert medications from routine drugs?
- Blue labels
- Auxiliary warning labels or stickers (Correct answer)
- No labels needed
- Smaller font
Correct answer: Auxiliary warning labels or stickers
ISMP recommends using auxiliary warning labels and stickers on high-alert medications to prompt extra care during preparation and administration.
Question 6: Neuromuscular blocking agents are classified as high-alert because they can cause:
- Excessive sedation only
- Respiratory arrest when given to non-intubated patients (Correct answer)
- Anaphylaxis exclusively
- Hypertensive crisis
Correct answer: Respiratory arrest when given to non-intubated patients
Neuromuscular blockers paralyze respiratory muscles and can cause fatal respiratory arrest if given inadvertently to non-ventilated patients.
ISMP High-Alert Medications 1
Which organization publishes the list of high-alert medications used most widely in US healthcare settings?