ISMP Safe Medication I 2

Question 1

A nurse receives a verbal order for 'hydromorphone 4 mg IV.' What is the ISMP-recommended action before administering?

Accepted Answer

Read back the order to the prescriber for confirmation

Answer

ISMP requires a read-back (repeat-back) verification for all verbal and telephone orders to catch transcription errors.

Question 2

Which ISMP-recommended strategy best reduces errors caused by look-alike/sound-alike (LASA) drug names?

Accepted Answer

Using tall-man lettering on labels and in computer systems

Answer

Tall-man (mixed-case) lettering highlights the differing portions of similar drug names, reducing confusion at the point of prescribing and dispensing.

Question 3

A patient is ordered 'metformin 500 mg twice daily.' The pharmacy dispenses metformin 1000 mg tablets with instructions to take half a tablet. What is the primary concern per ISMP guidelines?

Accepted Answer

Scored tablets may be split, but unscored tablets should not be split as dose accuracy cannot be ensured

Answer

ISMP cautions that only scored tablets are designed for splitting; unscored tablets may result in unequal doses and potential harm.

Question 4

According to ISMP, which practice increases the risk of a medication error when using automated dispensing cabinets (ADCs)?

Accepted Answer

Overriding the ADC without a pharmacist review for routine non-emergency medications

Answer

Routine overrides bypass the pharmacist safety check and are a leading cause of ADC-related medication errors.

Question 5

A prescriber writes 'morphine 2-4 mg IV q2-4h PRN pain.' Per ISMP, what is problematic about this order?

Accepted Answer

Range orders with dual ranges for both dose and interval create ambiguity that can lead to overdose

Answer

ISMP warns that range orders with variable doses AND variable intervals create confusion and risk of excessive cumulative dosing.

ISMP - Institute for Safe Medication Practices Practice Test

ISMP - Institute for Safe Medication Practices Practice Test

ISMP Safe Medication I 2