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Safe Medication I Flashcards

7 cards from real ISMP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Safe Medication I flashcards as text

  1. A nurse is preparing an IV infusion and notices the vial label reads '0.9% Sodium Chloride' but the solution appears slightly cloudy. What is the correct ISMP-aligned action?

    Answer: Discard the vial and obtain a new one, reporting the product to the pharmacy

    Any IV solution that appears abnormal must be discarded and reported; particulate matter or cloudiness may indicate contamination or degradation.

  2. Per ISMP high-alert medication principles, which of the following drugs appears on the ISMP list of high-alert medications in community/ambulatory settings?

    Answer: Warfarin (anticoagulant)

    Warfarin is on the ISMP high-alert medication list for community settings because errors involving it can lead to serious bleeding or clotting events.

  3. Which error-prevention strategy does ISMP recommend to reduce confusion between metric units on prescriptions?

    Answer: Use only metric units (mg, mL, mcg) and avoid non-standard abbreviations and apothecary symbols

    ISMP strongly advocates for metric-only dosing to eliminate conversion errors and ambiguity caused by outdated apothecary or household measurements.

  4. A 6-year-old weighing 20 kg is prescribed amoxicillin. The prescriber writes '500 mg three times daily.' The standard pediatric dose is 25–45 mg/kg/day. What is the safety concern?

    Answer: At 1500 mg/day for a 20 kg child, this exceeds 45 mg/kg/day and warrants pharmacist clarification

    Weight-based dose verification is essential in pediatrics; 1500 mg/day ÷ 20 kg = 75 mg/kg/day, well above the recommended ceiling.

  5. According to ISMP, which abbreviation should NEVER be used on medication orders because it has been misread and caused patient harm?

    Answer: U (for units)

    ISMP's 'Do Not Use' list includes 'U' for units because it has been misread as '0' (zero), leading to tenfold overdoses.

  6. What is the primary purpose of an independent double-check for high-alert medications?

    Answer: To have a second clinician independently verify the drug, dose, route, and rate before administration

    An independent double-check means the second clinician verifies without prompting from the first, ensuring a true safety redundancy and not just a co-signature.

  7. A pharmacist receives an order for 'Zantac 150 mg PO BID.' The drug was withdrawn from the US market. What is the appropriate response?

    Answer: Contact the prescriber to recommend a safe alternative such as famotidine or omeprazole

    Ranitidine (Zantac) was recalled by the FDA due to NDMA contamination; the pharmacist must contact the prescriber to select a safe alternative.