ISMP Safe Medication I 5

Question 1

A home health nurse finds a patient storing multiple medications in unlabeled containers 'to save space.' What is the primary safety risk per ISMP guidelines?

Accepted Answer

Risk of taking the wrong medication due to loss of identifying label information

Answer

Removing labels eliminates critical information such as drug name, dose, and expiration date, creating significant risk of medication mix-up and error.

Question 2

Which practice does ISMP identify as a root cause of errors related to oral liquid dosing in pediatric patients at home?

Accepted Answer

Using household teaspoons, which are inaccurate and variable in volume

Answer

Household teaspoons vary significantly in actual volume (2–10 mL), making them unreliable for medication dosing; oral syringes or dosing cups should be used instead.

Question 3

During a medication administration, a nurse scans the patient's armband and receives an alert that the medication is not due for another 2 hours. According to ISMP bar-code medication administration (BCMA) principles, what should the nurse do?

Accepted Answer

Assess the clinical reason for the alert, consult the prescriber if appropriate, and document the decision

Answer

Alerts from BCMA systems should not be routinely overridden; each alert requires clinical assessment and documentation to maintain the safety benefit of the system.

Question 4

An order is written for 'Celebrex (celecoxib) 200 mg PO daily.' A nurse unfamiliar with the drug confuses it with 'Cerebyx (fosphenytoin).' What ISMP strategy would most directly prevent this error?

Accepted Answer

Using the generic name in the order alongside the brand name to reduce reliance on brand-name recognition alone

Answer

ISMP recommends including the generic name on all orders so clinicians are not solely reliant on brand names that may be confused with similar-sounding products.

Question 5

A patient with renal impairment (CrCl 20 mL/min) is ordered the standard adult dose of a renally cleared antibiotic. What is the medication safety principle being violated?

Accepted Answer

Failure to adjust dose for organ function, which can cause drug accumulation and toxicity

Answer

Many drugs require dose reduction or interval extension in renal impairment to prevent toxic accumulation; this is a standard component of safe prescribing.

ISMP - Institute for Safe Medication Practices Practice Test

ISMP - Institute for Safe Medication Practices Practice Test

ISMP Safe Medication I 5