CSPT Medication Safety 4 — Questions and Answers
Question 1: A pharmacist discovers that a batch of compounded IV antibiotics was prepared using the wrong concentration of drug powder. What is the FIRST action that should be taken?
- Quarantine all affected units and notify the pharmacist-in-charge (Correct answer)
- Administer the product and monitor patients for adverse effects
- Dilute the product to the correct concentration before dispensing
- Document the error and continue preparing the remaining batch
Correct answer: Quarantine all affected units and notify the pharmacist-in-charge
All affected units must be immediately quarantined and the pharmacist-in-charge notified to prevent patient harm and initiate a proper investigation.
Question 2: Which of the following is the most effective strategy to prevent wrong-drug errors during compounding?
- Rely on memory for frequently used drug names
- Perform independent double-checks at each critical compounding step (Correct answer)
- Store all drug vials alphabetically in open bins
- Use verbal orders to speed up the compounding workflow
Correct answer: Perform independent double-checks at each critical compounding step
Independent double-checks by a second qualified person at each critical step are the most effective barrier against wrong-drug errors.
Question 3: A CSPT technician notices that the label on a compounded product lists a dose of '10 mcg' but the preparation record indicates '10 mg.' What should the technician do?
- Dispense the product using clinical judgment about which is correct
- Immediately hold the product and clarify the discrepancy with the pharmacist (Correct answer)
- Assume the label is correct since it was printed last
- Correct the preparation record to match the label without verification
Correct answer: Immediately hold the product and clarify the discrepancy with the pharmacist
Any discrepancy between the label and preparation record requires immediate clarification with the pharmacist before the product is dispensed.
Question 4: Which look-alike/sound-alike (LASA) drug pair poses the highest risk in sterile compounding environments?
- Acetaminophen and ibuprofen
- Epinephrine and ephedrine (Correct answer)
- Vitamin C and vitamin D
- Normal saline and lactated Ringer's
Correct answer: Epinephrine and ephedrine
Epinephrine and ephedrine are classic LASA drugs with very different potency and indications, making mix-ups potentially fatal.
Question 5: When should a compounded sterile preparation be discarded if it was prepared in a non-sterile-to-sterile compounding process?
- Only when the BUD has passed
- Whenever there is visible turbidity, particulate matter, or container damage (Correct answer)
- Only if the patient reports adverse effects
- After 30 days regardless of storage conditions
Correct answer: Whenever there is visible turbidity, particulate matter, or container damage
Any visible turbidity, particulate matter, or container damage is grounds for immediate discard regardless of the BUD.
Question 6: A technician prepares 10 syringes of morphine 2 mg/mL but realizes after labeling that morphine 20 mg/mL was used. Which of the following describes this error type?
- Near miss with no patient exposure
- Wrong drug error
- 10-fold concentration error (high-alert medication error) (Correct answer)
- Documentation error only
Correct answer: 10-fold concentration error (high-alert medication error)
Using morphine 20 mg/mL instead of 2 mg/mL creates a 10-fold concentration error involving a high-alert medication, representing a serious medication error.
Question 7: Under USP <797>, which of the following best describes the purpose of conducting ongoing competency assessments for sterile compounding personnel?
- To satisfy OSHA recordkeeping requirements
- To verify that personnel maintain the knowledge and skills needed to prevent contamination and medication errors (Correct answer)
- To determine if staff are eligible for salary increases
- To fulfill continuing education requirements for pharmacy licensure
Correct answer: To verify that personnel maintain the knowledge and skills needed to prevent contamination and medication errors
Ongoing competency assessments ensure that all personnel consistently demonstrate the skills needed to prevent contamination and medication errors in sterile compounding.
CSPT Medication Safety 4
A pharmacist discovers that a batch of compounded IV antibiotics was prepared using the wrong concentration of drug powder.
What is the FIRST action that should be taken?