Pharmacy and Medication Services Flashcards

During a survey, you observe that a nurse administered a medication two hours after the scheduled time without documentation. What is the primary concern?

Answer: Failure to follow the prescribed medication schedule and lack of documentation

Surveyors cite facilities when medications are not administered per the physician's order and when deviations are not documented in the medical record.

A surveyor finds that a facility's drug storage room is kept at 80°F consistently. Which regulation is most likely violated?

Answer: USP storage temperature requirements for room-temperature medications

USP standards require most medications labeled 'store at room temperature' to be kept between 68°F and 77°F (20°C–25°C), so 80°F is out of range.

Under the Medicare Conditions of Participation for long-term care, how often must pharmacists conduct drug regimen reviews for residents?

Answer: At least monthly

42 CFR §483.45(c) requires a licensed pharmacist to review each resident's drug regimen at least once a month.

A surveyor observes unlabeled syringes prefilled with insulin sitting on a medication cart. What is the most critical immediate concern?

Answer: Risk of wrong-patient or wrong-dose medication error due to missing identification

Unlabeled medications or syringes create a serious risk of medication errors, including administration to the wrong patient or at the wrong dose.

When surveying medication reconciliation practices at a hospital, which patient transition is most associated with high-risk medication errors?

Answer: Admission from home to the hospital

Admission from home is a high-risk transition because complete and accurate home medication lists are often unavailable, leading to omissions or duplications.

A facility's policy allows nursing staff to accept verbal orders for Schedule II controlled substances. How should a surveyor evaluate this practice?

Answer: A deficiency because DEA regulations prohibit verbal orders for Schedule II substances except in emergencies

DEA regulations generally prohibit verbal (phone) orders for Schedule II controlled substances except in genuine emergency situations with immediate follow-up written order.

During observation, a surveyor notices a CNA crushing a tablet that is labeled 'do not crush.' What regulation or standard is most directly implicated?

Answer: Medication administration standards requiring medications to be given in the form prescribed

Crushing a 'do not crush' medication (e.g., extended-release tablets) alters the dose form and delivery, violating medication administration standards and potentially harming the resident.