Medication Errors and How to Avoid Them

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. What was the error in Case No. 2?

a) The transcribing nurse wrote the order on the wrong MAR.
b) The medication nurse switched the drug from one patient’s bin to another.
c) The nurse did not compare the drug with the patient’s diagnosis.
d) all of the above

2. One way to avoid inadvertent allergic reactions in a patient is to ask the patient if he or she is allergic to the drug being administered.

a) True
b) False

3. Case No. 8. What is the accepted abbreviation for “subcutaneously”?

a) “s.c.”
b) “sub q.”

4. In Case No. 9, the medication error can be attributed to the

a) nurse
b) physician
c) pharmacist
d) patient

5. In Case No. 10, the error could have been avoided by

a) having the nurse supervisor check the order;
b) checking with the prescribing physician;
c) calling the pharmacy;
d) repeating back the information just given by the technician.

6. Case No. 11. What is the normal dosage of Lanoxin?

a) 0.25 mg., q.i.d.
b) 0.25 mg., q.d.
c) 0.25 mg. daily
d) b and c

7. A prescription for a drug that needs to be given once daily should read

a) q.d
b) q.i.d.
c) daily

8. The error that happened in Case No. 15 is less likely to happen with one of the following machines:

a) nonvolumetric infusion controller with macrodrip tubing
b) nonvolumetric infusion controller with microdrip tubing
c) volumetric gravity-dependent rate controller

9. The best way to avoid the kind of error that occurred in Case No. 16 is to avoid stocking concentrated lidocaine syringes at all.

a) True
b) False

10. Who was responsible for the error in Case No. 17?

a) prescribing physician
b) nurse
c) head nurse
d) intern
e) all of the above

11. How was the error in Case No. 18 avoided?

a) by listening to the patient
b) by checking the doctor’s original order
c) by checking with the doctor on call the night before

12. Case No. 20. In this case the doctor intended “D/C med” to mean

a) discontinue the medicine.
b) medication upon discharge.

13. Case No. 22. Which of the following is a preferred way to write the prescription for the bronchodilator?

a) Terbutaline .5 mg
b) Terbutaline 0.5 mg

14. Case No. 23. Sustained release or enteric-coated tablets should not be crushed.

a) True
b) False

15. Case No. 25. When should the drug label be checked?

a) when your remove the drug from a supply drawer or medication cart
b) before you administer it to the patient
c) before you discard its container
d) all of the above three times

16. In Case No. 40, what was the source of the error?

a) medication came from a source other than the pharmacy
b) medication was left for a patient to take later
c) medication did not match the patient’s diagnosis

17. Case No. 56. What is the correct way to say “every other day”?

a) q.o.d.
b) q.i.d.
c) every other day

18. Case No. 57. Folic acid and folinic acid mean the same drug.

a) True
b) False

19. What was the source of error in Case No. 84?

a) storage problem
b) symbol misinterpretation
c) drug name confusion
d) verification failure

20. What was the source of error in Case No. 98?

a) abbreviation misinterpretation
b) drug name confusion
c) unfamiliarity and carelessness
d) protocol violation

21. Case No. 105. For drug doses which system of measurement is outdated?

a) apothecary
b) metric

22. Case No. 108. In this case the doctor used the abbreviation “O.D.” to mean

a) right eye
b) once daily
c) overdose
d) outside diameter

23. Case No. 111. The better way to say “I.U.” is

a) international units.
b) units.

24. Case No. 112. What is the normal serum potassium level?

a) 2.4 mEq/liter
b) 3.8 to 5.5 mEq/liter
c) 6.6 mEq/liter
d) 60 mEq/liter

25. How would you classify the error in Case No. 116?

a) incorrect medicine
b) incomplete order–did not specify after which meal
c) incorrect route of administration
d) drug interaction

26. In Case No. 116 who was primarily responsible for the drug error?

a) nurse
b) doctor
c) pharmacist
d) patient

27. In Case No. 120 who was responsible for the drug error?

a) nurse
b) doctor
c) pharmacist
d) patient

28. Case No. 126. The proper way to prescribe the common AIDS drug is by using one of the following:

a) AZT
b) azidothymidine
c) Zidovudine
d) Azathioprine

29. Case No. 127. An experienced nurse would interpret “M.S. 5 mg” to mean

a) magnesium sulfate 5 mg
b) morphine sulfate 5 mg

30. Case No. 131. To avoid a ghastly medication error, dropper bottles of SSKI should be

a) labeled “For oral use only.”
b) labeled “Do not use in eyes.”
c) prediluted.
d) all of the above

31. Case No. 134 is a good example of why you should rely on only one health care professional to interpret a drug order.

a) true
b) false

32. Case No. 146. What is the best way of avoiding medication errors arising out of abbreviations?

a) Do not use abbreviation; write out the words.
b) Use only the JCAHO-approved list of abbreviations.
c) If not sure, ask the doctor or the pharmacist.

33. Case No. 146. Which of the following abbreviations should be avoided?

a) q. n.
b) h. s.
c) nightly

34. Case No. 156. Two doses of vitamin B6 equal one dose of vitamin B12.

a) true
b) false

35. The source of error in Case No. 157 was

a) abbreviation misinterpretation
b) dosage error
c) insulin error
d) storage problem

36. Case No. 161. The abbreviation “5-ASA” stands for

a) five aspirin tablets
b) 5-aminosalicyclic acid

37. What was the outcome of the error in Case No. 163?

a) The error was harmless.
b) The error was detected before the medication was administered.
c) The patient died due to the error.

38. How many medication errors were committed in Case. No. 169?

a) 1
b) 2
c) more than 2

39. Case No. 172. When you see “IV” on a label of a drug such as paraldehyde, diazepam or phenobarbital, the symbol stands for

a) Roman numeral four.
b) intravenous.

40. In Case No. 175, the prescription read “6-thioguanine, 160 mg P.O.” What was the dosage to be administered?

a) 160 mg
b) 960 mg

41. Case No. 182. What is the highest recommended daily dosage of gentamicin for patients with normal renal function?

a) 5 mg/kg
b) 60 mg
c) 360 mg

42. Case No. 185. When more than a single tablet or capsule is needed for a dose how many lines should be used in the MAR to transcribe the order?

a) one
b) two
c) three

43. Case No. 189. Midnight is

a) 12 p.m.
b) 12 a.m.
c) 0000 (military time)
d) 2400
e) b and c

44. Case No. 191. Current medicine practice is based on apothecary system and its abbreviations.

a) true
b) false

45. Case No. 193. If you find yourself needing to give more than one or two capsules of a drug, it should raise a red flag in your mind as a possible medication error.

a) true
b) false

46. In Case No. 196, what was the source of error?

a) administration route not specified
b) equipment misuse
c) MAR misuse
d) syringe and Tubex problem