Errors in prescription MCQs With Answer

Introduction: Errors in Prescription MCQs With Answer

Prescription errors are a major cause of preventable medication harm in clinical practice. For B. Pharm students, mastering safe prescribing principles—such as avoiding ambiguous abbreviations, managing look-alike/sound-alike (LASA) drugs, accurate dose calculation, renal/hepatic dose adjustment, and using evidence-based alerts—is essential. Key concepts include high-alert medications, the “Five Rights,” Tall Man lettering, e-prescribing/CPOE, therapeutic index, drug–drug interactions, and pharmacovigilance. Understanding transcribing, dispensing, and administration errors, along with root cause analysis (RCA) and near-miss reporting, helps build a systems approach to patient safety. This introduction emphasizes practical strategies to detect, prevent, and manage prescription errors in real-world pharmacy settings. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which statement best defines a prescription error?

• Any preventable event that may cause or lead to inappropriate medication use or patient harm at the prescribing stage
• Any adverse event occurring after drug administration regardless of cause
• Any mistake made exclusively during drug manufacturing
• Any deviation from brand substitution policy

Correct Answer: Any preventable event that may cause or lead to inappropriate medication use or patient harm at the prescribing stage

Q2. At which stage do most medication errors originate?

• Prescribing
• Transcribing
• Dispensing
• Administration

Correct Answer: Prescribing

Q3. Which practice best mitigates look-alike/sound-alike (LASA) drug errors?

• Using Tall Man lettering on labels and electronic systems
• Increasing font size only
• Stocking LASA drugs together for convenience
• Relying solely on brand names

Correct Answer: Using Tall Man lettering on labels and electronic systems

Q4. Which abbreviation should be avoided to prevent dose misinterpretation?

• U for units
• mg
• mL
• units

Correct Answer: U for units

Q5. Which notation is safest for a half-milligram dose?

• .5 mg
• 0.5 mg
• 0.50 mg
• 5.0 mg

Correct Answer: 0.5 mg

Q6. Which of the following is a high-alert medication commonly associated with serious harm if misused?

• Heparin
• Paracetamol
• Cetirizine
• Docusate

Correct Answer: Heparin

Q7. For pediatric prescriptions, inclusion of which parameter most reduces dosing errors?

• Patient weight in kg
• Patient height in cm
• Patient BMI
• Patient blood group

Correct Answer: Patient weight in kg

Q8. What is the primary safety advantage of computerized provider order entry (CPOE)?

• Eliminates illegibility and supports clinical decision alerts
• Removes need for pharmacist verification
• Increases prescribing speed regardless of accuracy
• Replaces drug interaction checks

Correct Answer: Eliminates illegibility and supports clinical decision alerts

Q9. A pharmacist receives an unclear dose on a prescription. What is the most appropriate action?

• Clarify the order with the prescriber before dispensing
• Estimate the most common dose and dispense
• Ask the patient to choose the dose
• Dispense the lowest dose available

Correct Answer: Clarify the order with the prescriber before dispensing

Q10. Which instruction is safest to indicate once-daily dosing?

• QD
• OD
• Daily
• q.d.

Correct Answer: Daily

Q11. What is the recommended maximum daily dose of acetaminophen for most adults?

• 1000 mg
• 2000 mg
• 3000 mg
• 4000 mg

Correct Answer: 4000 mg

Q12. Which drug is contraindicated in pregnancy and must trigger a prescription safety check?

• Isotretinoin
• Amoxicillin
• Metformin
• Levothyroxine

Correct Answer: Isotretinoin

Q13. Which parameter is most appropriate to guide renal dose adjustment?

• Estimated glomerular filtration rate (eGFR) or creatinine clearance (CrCl)
• Serum sodium
• Liver transaminases
• Hematocrit

Correct Answer: Estimated glomerular filtration rate (eGFR) or creatinine clearance (CrCl)

Q14. Which drug has a narrow therapeutic index requiring precise dosing and monitoring?

• Lithium
• Amoxicillin
• Metformin
• Loratadine

Correct Answer: Lithium

Q15. Which dosage form should not be crushed due to altered release and safety risks?

• Enteric-coated tablet
• Chewable tablet
• Oral solution
• Sublingual tablet

Correct Answer: Enteric-coated tablet

Q16. Which is NOT one of the “Five Rights” of medication safety?

• Right patient
• Right dose
• Right time
• Right cost

Correct Answer: Right cost

Q17. Which scenario best illustrates duplicate therapy risk?

• Prescribing ibuprofen and naproxen together
• Prescribing metformin and insulin in diabetes
• Prescribing amlodipine and hydrochlorothiazide
• Prescribing omeprazole and sucralfate

Correct Answer: Prescribing ibuprofen and naproxen together

Q18. Which combination poses a significant drug–drug interaction increasing bleeding risk?

• Warfarin + trimethoprim–sulfamethoxazole
• Warfarin + acetaminophen 500 mg occasionally
• Metformin + lisinopril
• Aspirin low dose + atorvastatin

Correct Answer: Warfarin + trimethoprim–sulfamethoxazole

Q19. What is the primary value of reporting near-miss events?

• Identifies system vulnerabilities before patient harm occurs
• Assigns individual blame to prevent recurrence
• Reduces documentation workload
• Eliminates the need for audits

Correct Answer: Identifies system vulnerabilities before patient harm occurs

Q20. Root cause analysis (RCA) primarily aims to:

• Understand system and process failures leading to errors
• Discipline staff responsible for errors
• Increase prescription volume
• Eliminate the need for standard operating procedures

Correct Answer: Understand system and process failures leading to errors

Q21. Which pair is a classic LASA risk that warrants Tall Man lettering?

• Clonazepam and clonidine
• Metformin and metronidazole
• Amlodipine and atenolol
• Ceftriaxone and azithromycin

Correct Answer: Clonazepam and clonidine

Q22. Which is the safest way to express pediatric dosing on a prescription?

• mg/kg with the child’s weight and the concentration of liquid specified
• Teaspoons three times daily
• As directed
• One dropperful twice daily

Correct Answer: mg/kg with the child’s weight and the concentration of liquid specified

Q23. A boxed warning (black box warning) indicates:

• The highest safety alert about serious or life-threatening risks
• That the drug is safe for all populations
• A warning only about minor side effects
• Marketing restrictions without clinical implications

Correct Answer: The highest safety alert about serious or life-threatening risks

Q24. What best describes a transcription error?

• Incorrectly copying a medication order into the medication administration record
• Selecting the wrong drug during dispensing
• Administering at the wrong time
• Writing an incomplete diagnosis

Correct Answer: Incorrectly copying a medication order into the medication administration record

Q25. Which medication requires time-critical administration relative to meals to prevent errors?

• Rapid-acting insulin before meals
• Atorvastatin at night
• Metformin any time of day
• Vitamin D weekly

Correct Answer: Rapid-acting insulin before meals

Q26. Standardizing concentrations is especially important for which IV medication to reduce errors?

• Potassium chloride
• Normal saline
• Multivitamin infusion
• Glucose 5%

Correct Answer: Potassium chloride

Q27. Which statement aligns with ISMP recommendations on zero use?

• Avoid trailing zeros and use a leading zero before decimal doses
• Use trailing zeros for clarity
• Never use a leading zero
• Zeros are irrelevant to safety

Correct Answer: Avoid trailing zeros and use a leading zero before decimal doses

Q28. In medication safety, SALAD commonly refers to:

• Sound-alike look-alike drugs
• A diet plan for hypertensive patients
• A sterile compounding technique
• A type of adverse drug reaction

Correct Answer: Sound-alike look-alike drugs

Q29. Which allergy documentation is most informative for preventing prescription errors?

• Allergen and specific reaction (e.g., penicillin—anaphylaxis)
• Allergen only
• “Allergic” without details
• No known drug allergy assumed

Correct Answer: Allergen and specific reaction (e.g., penicillin—anaphylaxis)

Q30. What new risk can e-prescribing introduce despite reducing handwriting errors?

• Wrong drug selection from similar options in drop-down menus
• Increased illegibility
• Loss of interaction checking
• Elimination of clinical decision support

Correct Answer: Wrong drug selection from similar options in drop-down menus

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