ISMP MCQ 2

Question 1

Which ISMP designation indicates a drug that bears a heightened risk of causing significant patient harm when used in error?

Accepted Answer

High-alert medication

Answer

Formulary drug

Answer

Controlled substance

Answer

Narrow therapeutic index drug

Question 2

A pharmacist receives an order for 'MTX 10 mg weekly.' What is the primary safety concern ISMP identifies with this order?

Accepted Answer

Methotrexate ordered daily instead of weekly can cause fatal toxicity

Answer

MTX is not available in 10 mg tablets

Answer

The abbreviation MTX may be confused with mitomycin

Answer

Methotrexate requires renal dosing adjustment

Question 3

According to ISMP, which practice best reduces errors with look-alike/sound-alike (LASA) drug names on medication labels?

Accepted Answer

Using tall man lettering to differentiate similar drug names

Answer

Listing drugs alphabetically in the pharmacy

Answer

Requiring verbal confirmation for all dispensed drugs

Answer

Storing LASA drugs in the same bin for easy identification

Question 4

ISMP's guidelines on verbal orders recommend which of the following to reduce miscommunication?

Accepted Answer

Read back and verify the complete order after receiving it verbally

Answer

Spell out all drug names letter by letter over the phone

Answer

Document verbal orders only at the end of the shift

Answer

Avoid verbal orders entirely in all clinical settings

Question 5

Which of the following is an example of an independent double-check as recommended by ISMP?

Accepted Answer

One nurse checking a drug and a second nurse independently checking the same drug without knowledge of the first check

Answer

Two nurses reviewing the same medication record at the same time together

Answer

A pharmacist and nurse verifying a drug together at the bedside

Answer

A nurse checking a medication twice before administration

Question 6

According to ISMP, which is the most error-prone method of medication administration that should be avoided when other options exist?

Accepted Answer

Compounded epidural infusions drawn from large-volume bags

Answer

IV piggyback infusions

Answer

Oral liquid medications with unit-dose cups

Answer

Pre-packaged oral solid unit-dose medications

Question 7

ISMP recommends that insulin pens used in hospitals should be labeled with which critical warning?

Accepted Answer

'For single patient use only — do not share'

Answer

'Refrigerate after opening'

Answer

'Shake well before use'

Answer

'Administer only with insulin syringes'