FREE NAPLEX QBANK Medication Safety and Dispensing Questions and Answers

Question 1

A pharmacist is reviewing a new electronic prescription for 'hydrALAZINE 25 mg tablets, take one tablet by mouth three times daily.' The patient's profile also shows an active prescription for 'hydrOXYzine 25 mg capsules.' Which of the following is the MOST appropriate action for the pharmacist to take to prevent a medication error?

Accepted Answer

Contact the prescriber to confirm the indication for the new prescription.

Answer

Hydralazine and hydroxyzine are a classic look-alike/sound-alike (LASA) drug pair with very different indications (hypertension vs. antihistamine/anxiolytic). The most definitive way to ensure the correct drug is being dispensed is to contact the prescriber to confirm the therapeutic intent. While asking the patient and adding a system alert are good practices, they do not replace direct verification with the prescriber, which is the most critical step to prevent potential patient harm.

Question 2

A hospital pharmacy is implementing new safety protocols for U-500 regular insulin, a high-alert medication. Which of the following strategies is the MOST critical to prevent a catastrophic dosing error?

Accepted Answer

Dispensing U-500 insulin only with U-500 specific syringes or dedicated pens.

Answer

U-500 insulin is five times more concentrated than standard U-100 insulin. The greatest risk of error comes from accidentally measuring a U-500 dose using a standard U-100 syringe, which can lead to a 5-fold overdose. Therefore, the most critical safety measure is to eliminate this possibility by dispensing U-500 insulin ONLY with syringes calibrated specifically for it or in its own dedicated pen device. While storage, education, and labels are important, they are less effective at preventing this specific, high-risk error than using the correct administration device.

Question 3

A hospital's Pharmacy and Therapeutics (P&T) committee is updating its list of approved 'Tall Man Lettering' conventions to reduce medication errors. Which of the following pairs correctly uses this technique according to ISMP/FDA recommendations?

Accepted Answer

predniSONE and prednisoLONE

Answer

Tall Man Lettering is a safety strategy that uses a mix of uppercase and lowercase letters to draw attention to the dissimilarities in look-alike drug names. The FDA and ISMP have established official lists of recommended name pairs. Among the choices, 'predniSONE' and 'prednisoLONE' is a well-established pair on these lists designed to prevent mix-ups. The other options either do not represent common look-alike pairs or do not use the standard lettering convention.

Question 4

A patient on a medical-surgical unit experienced a severe hypoglycemic event. A root cause analysis (RCA) revealed the patient received glipizide instead of glyburide, which had been ordered. The investigation found that the two drugs were stored in adjacent bins in the automated dispensing cabinet (ADC) on the nursing unit. Which of the following interventions represents the strongest system-based change to prevent this error from recurring?

Accepted Answer

Implementing barcode scanning for medication removal from the ADC and at the bedside.

Answer

While education, warnings, and double-checks are helpful, the strongest system-based intervention is one that uses a forcing function or technology to prevent the error. Implementing barcode scanning at two key points—when removing the medication from the ADC and before administration at the bedside—creates an automated check that verifies the drug against the patient's electronic medication administration record (eMAR). This is more reliable and less prone to human error than manual checks, warning labels, or education alone.

Question 5

A pharmacist receives an electronic prescription for a Schedule II controlled substance. According to federal law, which of the following is an essential responsibility of the pharmacist before dispensing?

Accepted Answer

Ensuring the prescription is for a legitimate medical purpose by a practitioner acting in the usual course of professional practice.

Answer

The fundamental responsibility of a pharmacist dispensing any controlled substance is to ensure its legitimacy. According to the Code of Federal Regulations (21 CFR), a prescription for a controlled substance must be issued for a legitimate medical purpose by a practitioner acting in the usual course of his or her professional practice. The pharmacist has a corresponding responsibility to ensure this is the case. While checking PMPs (A), understanding indications (C), and being aware of EPCS security features (B) are parts of good practice, the overarching legal and professional responsibility is to validate the prescription's overall legitimacy.

NAPLEX QBANK Practice Test

NAPLEX QBANK Practice Test

FREE NAPLEX QBANK Medication Safety and Dispensing Questions and Answers