Pharmacy and Medication Services Flashcards

A surveyor observes that a facility has no written policy for disposing of unused or expired controlled substances. What is the most appropriate survey finding?

Answer: Deficiency, because DEA and state regulations require facilities to have documented procedures for controlled substance disposal

DEA regulations and state pharmacy laws require facilities to maintain written policies for the disposal of controlled substances, including return, destruction, or DEA Form 41 procedures.

Which action by a surveyor best addresses a concern about residents' rights related to medications in a long-term care setting?

Answer: Interviewing residents about whether they were informed of their medications and possible side effects

Residents have a right to be informed about their medications; surveyor interviews can reveal whether staff are educating residents about drug names, purposes, and potential side effects.

A facility pharmacist identifies that a resident has been on a proton pump inhibitor (PPI) for three years without documented clinical indication. What survey concern does this raise?

Answer: Potentially unnecessary drug use requiring documented indication and ongoing clinical review

Long-term PPI use without documented indication or periodic review is flagged during surveys as potentially unnecessary drug use under 42 CFR §483.45.

When a surveyor reviews a hospital's high-alert medication policy, which class of drugs would they most expect to see listed?

Answer: Anticoagulants, concentrated electrolytes, insulin, and opioids

ISMP's high-alert medication list includes anticoagulants, concentrated electrolytes, insulin, opioids, and other drugs with a high risk of causing significant patient harm if misused.

A nursing facility uses a single shared medication cart key kept at the nurses' station accessible to all staff. What survey deficiency does this most likely represent?

Answer: Inadequate controlled substance security, as medications must be accessible only to authorized personnel

Federal regulations require that medications, especially controlled substances, be stored securely with access limited to authorized licensed personnel.

A surveyor notes that a physician wrote an order for 'aspirin as needed for pain' without specifying dose, route, or frequency. How should this finding be evaluated?

Answer: A deficiency because medication orders must include dose, route, frequency, and indication to be complete and safe

Complete medication orders must specify the drug name, dose, route, frequency, and indication; incomplete orders create ambiguity that can lead to medication errors.

During a hospital survey, a surveyor finds that a patient received a double dose of warfarin because the day-shift and night-shift nurses both administered the evening dose. Which system failure does this best illustrate?

Answer: Failure of medication administration documentation and handoff communication

Double dosing due to a shift change indicates a failure in real-time medication administration documentation and structured handoff communication between nurses.