The hospital medication use system encompasses all the processes involved in managing medications within inpatient settings—from prescribing and verification to dispensing, administration, and monitoring. In hospitals, pharmacists play a critical role in ensuring patient safety, optimizing therapy, and coordinating with the healthcare team. This MCQ quiz will help Pharm.D. students understand the workflows, technology, and safeguards involved in hospital pharmacy operations.
1. Which of the following best describes the hospital medication use system?
- A. Community pharmacy logistics
- B. Drug development protocols
- C. Processes of prescribing, transcribing, dispensing, administering, and monitoring in hospitals
- D. Health insurance claim reviews
Correct answer: C. Processes of prescribing, transcribing, dispensing, administering, and monitoring in hospitals
2. What is the first step in the hospital medication use process?
- A. Dispensing
- B. Administration
- C. Prescribing by an authorized provider
- D. Documentation
Correct answer: C. Prescribing by an authorized provider
3. Which healthcare professional is primarily responsible for administering medications in hospitals?
- A. Physician
- B. Pharmacist
- C. Nurse
- D. Lab technician
Correct answer: C. Nurse
4. What technology is used to reduce errors during drug administration in hospitals?
- A. Automated checkout
- B. Bar code medication administration (BCMA)
- C. Fax machines
- D. Pill counters
Correct answer: B. Bar code medication administration (BCMA)
5. What is the role of computerized physician order entry (CPOE)?
- A. Increase printing efficiency
- B. Allow electronic prescription entry to reduce errors
- C. Manage nursing schedules
- D. Control inventory
Correct answer: B. Allow electronic prescription entry to reduce errors
6. What is a unit-dose system in hospitals?
- A. Dispensing medications in monthly bulk bottles
- B. Providing single-use doses labeled for individual patients
- C. Mixing IV fluids manually
- D. Distributing all meds through the OR
Correct answer: B. Providing single-use doses labeled for individual patients
7. The pharmacy and therapeutics (P&T) committee in hospitals is responsible for:
- A. Organizing events
- B. Developing treatment protocols and maintaining the formulary
- C. Marketing health services
- D. Managing employee salaries
Correct answer: B. Developing treatment protocols and maintaining the formulary
8. Medication reconciliation is performed to:
- A. Track billing codes
- B. Prevent discrepancies across transitions of care
- C. Increase sales
- D. Avoid patient communication
Correct answer: B. Prevent discrepancies across transitions of care
9. IV medications in hospitals are commonly prepared in:
- A. OR rooms
- B. Retail pharmacies
- C. Sterile compounding rooms under USP <797> standards
- D. Emergency departments
Correct answer: C. Sterile compounding rooms under USP <797> standards
10. Clinical pharmacists in hospitals often:
- A. Sell OTC products
- B. Monitor therapeutic drug levels and adjust dosing
- C. Handle billing disputes
- D. Administer vaccines
Correct answer: B. Monitor therapeutic drug levels and adjust dosing
11. Which is a common role of decentralized pharmacists in hospitals?
- A. Managing cafeteria menus
- B. Direct involvement in patient rounds and clinical decision-making
- C. Packing unit doses
- D. Filling vending machines
Correct answer: B. Direct involvement in patient rounds and clinical decision-making
12. Automated dispensing cabinets (e.g., Pyxis) are used for:
- A. Laundry delivery
- B. Secure storage and controlled dispensing of medications on nursing units
- C. Administrative file access
- D. Internet browsing
Correct answer: B. Secure storage and controlled dispensing of medications on nursing units
13. In a hospital, high-alert medications are handled with extra precautions because they:
- A. Are more expensive
- B. Are used less frequently
- C. Have a higher risk of causing serious harm if used in error
- D. Are more common
Correct answer: C. Have a higher risk of causing serious harm if used in error
14. An example of a high-alert medication in hospitals is:
- A. Acetaminophen
- B. Furosemide
- C. Insulin
- D. Lisinopril
Correct answer: C. Insulin
15. Which method is commonly used to ensure correct patient identity before drug administration?
- A. Visual recognition
- B. Verbal agreement
- C. Use of two patient identifiers
- D. Nurse handwriting
Correct answer: C. Use of two patient identifiers
16. Which hospital document tracks all administered medications?
- A. MAR (Medication Administration Record)
- B. Invoice
- C. Budget sheet
- D. Insurance form
Correct answer: A. MAR (Medication Administration Record)
17. Pharmacokinetic dosing in hospitals is commonly used for drugs like:
- A. Metformin
- B. Vancomycin and aminoglycosides
- C. Lisinopril
- D. Acetaminophen
Correct answer: B. Vancomycin and aminoglycosides
18. Therapeutic Interchange refers to:
- A. Interchanging staff roles
- B. Switching drugs within the same class based on formulary
- C. Changing the pharmacy vendor
- D. Billing code substitution
Correct answer: B. Switching drugs within the same class based on formulary
19. What is the Joint Commission’s role in hospital medication safety?
- A. Selling medications
- B. Accrediting hospitals and setting patient safety goals
- C. Issuing manufacturer recalls
- D. Running insurance plans
Correct answer: B. Accrediting hospitals and setting patient safety goals
20. What is the purpose of tall man lettering (e.g., hydrALAZINE vs. hydrOXYzine)?
- A. Aesthetic formatting
- B. Indicating brand names
- C. Reducing look-alike/sound-alike medication errors
- D. Highlighting OTC status
Correct answer: C. Reducing look-alike/sound-alike medication errors
21. The purpose of automated IV compounding systems is to:
- A. Remove pharmacy staff
- B. Accelerate billing
- C. Improve safety and accuracy in sterile preparation
- D. Increase waste
Correct answer: C. Improve safety and accuracy in sterile preparation
22. What does “IV to PO conversion” refer to?
- A. Replacing an IV drug with a different class
- B. Switching from intravenous to oral form when appropriate
- C. Pricing difference
- D. Labeling error
Correct answer: B. Switching from intravenous to oral form when appropriate
23. Hospitals use restricted access medication policies to:
- A. Market new drugs
- B. Ensure specialized monitoring or approval before use
- C. Increase insurance coverage
- D. Reduce storage needs
Correct answer: B. Ensure specialized monitoring or approval before use
24. Which agency enforces compounding standards in hospitals?
- A. IRS
- B. USP (United States Pharmacopeia)
- C. WHO
- D. DEA
Correct answer: B. USP (United States Pharmacopeia)
25. A patient develops an adverse reaction post-administration. The pharmacist should:
- A. Disregard the note
- B. Notify the prescriber and document in the EMR
- C. Continue therapy
- D. Send it to insurance
Correct answer: B. Notify the prescriber and document in the EMR
26. Antimicrobial stewardship in hospitals aims to:
- A. Promote the use of the most expensive drugs
- B. Restrict antibiotics to outpatient use
- C. Optimize antibiotic use to reduce resistance and adverse events
- D. Eliminate pharmacy involvement
Correct answer: C. Optimize antibiotic use to reduce resistance and adverse events
27. How is emergency drug access managed in hospitals?
- A. Stored at nurses’ desks
- B. Available through crash carts and code trays
- C. Dispensed from retail stores
- D. Ordered from manufacturers
Correct answer: B. Available through crash carts and code trays
28. The role of informatics pharmacists includes:
- A. Sales analytics
- B. Managing pharmacy IT systems and EHR integration
- C. Handling inventory exclusively
- D. Conducting bench research
Correct answer: B. Managing pharmacy IT systems and EHR integration
29. Medication “time-outs” during procedures help prevent:
- A. Staff fatigue
- B. Drug diversion
- C. Wrong drug or wrong patient administration
- D. Printer delays
Correct answer: C. Wrong drug or wrong patient administration
30. Clinical decision support systems (CDSS) are used to:
- A. Replace pharmacists
- B. Flag interactions, duplicate therapies, and allergies
- C. Track deliveries
- D. Monitor technician attendance
Correct answer: B. Flag interactions, duplicate therapies, and allergies
31. Pharmacists verify orders before dispensing to:
- A. Meet workflow quotas
- B. Check spelling
- C. Ensure accuracy, appropriateness, and safety
- D. Review color labels
Correct answer: C. Ensure accuracy, appropriateness, and safety
32. One goal of barcode scanning at administration is to:
- A. Track expiration dates
- B. Charge patients more accurately
- C. Prevent wrong patient, wrong drug, or wrong dose
- D. Automate reminders
Correct answer: C. Prevent wrong patient, wrong drug, or wrong dose
33. Floor stock is typically limited to:
- A. OTC vitamins
- B. Commonly used, non-controlled medications
- C. Herbal products
- D. Discontinued drugs
Correct answer: B. Commonly used, non-controlled medications
34. Pharmacists in ICU settings often manage:
- A. Meal planning
- B. Electrolyte repletion protocols and sedation regimens
- C. Insurance billing
- D. Physical therapy scheduling
Correct answer: B. Electrolyte repletion protocols and sedation regimens
35. The “five rights” of medication administration are:
- A. Drug, doctor, day, dose, data
- B. Right patient, right drug, right dose, right route, right time
- C. Price, package, place, policy, person
- D. Label, lot, line, log, list
Correct answer: B. Right patient, right drug, right dose, right route, right time
36. The term “IV compatibility” refers to:
- A. Matching pharmacy technician to IV tasks
- B. Mixing drugs safely in the same IV line
- C. Reusing IV bags
- D. Administering any drug together
Correct answer: B. Mixing drugs safely in the same IV line
37. Dosing adjustments in renal impairment are critical for drugs like:
- A. Insulin
- B. Warfarin
- C. Vancomycin
- D. Loratadine
Correct answer: C. Vancomycin
38. Which of the following improves compliance with antibiotic dosing in sepsis?
- A. Nurse notes
- B. Pharmacist rounding and real-time monitoring
- C. Monthly reports
- D. Automated messaging
Correct answer: B. Pharmacist rounding and real-time monitoring
39. “Time-critical” medications should be administered:
- A. Within 1 hour
- B. Within 30 minutes before or after the scheduled time
- C. Only in emergencies
- D. With physician presence
Correct answer: B. Within 30 minutes before or after the scheduled time
40. A common cause of administration errors is:
- A. Double-checking
- B. Lack of barcode scanning
- C. Pharmacist counseling
- D. IV bag labeling
Correct answer: B. Lack of barcode scanning
41. A pharmacist-led medication safety committee typically monitors:
- A. Employee timecards
- B. Medication errors, near-misses, and adverse events
- C. Prescription costs
- D. Marketing strategies
Correct answer: B. Medication errors, near-misses, and adverse events
42. Heparin dosing in hospitals is monitored by:
- A. Heart rate
- B. ALT/AST
- C. aPTT or anti-Xa levels
- D. Blood pressure
Correct answer: C. aPTT or anti-Xa levels
43. Which policy reduces medication diversion risks?
- A. Multi-dose vial reuse
- B. Controlled substance tracking and audits
- C. Self-service dispensing
- D. Group storage
Correct answer: B. Controlled substance tracking and audits
44. Hospital formularies are managed to ensure:
- A. Brand loyalty
- B. Drug shortages
- C. Cost-effective, evidence-based therapy
- D. High markups
Correct answer: C. Cost-effective, evidence-based therapy
45. What is the purpose of a crash cart?
- A. Store PPE
- B. Provide emergency medications and equipment
- C. House educational tools
- D. Contain expired drugs
Correct answer: B. Provide emergency medications and equipment
46. Which process improves transition of care outcomes?
- A. Early discharge
- B. Pharmacy-led discharge counseling
- C. Limiting medication access
- D. Delayed documentation
Correct answer: B. Pharmacy-led discharge counseling
47. Which staff member is primarily responsible for medication preparation in sterile compounding?
- A. Nurse manager
- B. Environmental services
- C. Trained pharmacy technician under pharmacist supervision
- D. Radiologist
Correct answer: C. Trained pharmacy technician under pharmacist supervision
48. IV admixture labels must include:
- A. Patient insurance info
- B. Prescriber’s photo
- C. Drug name, concentration, diluent, expiration, and initials
- D. Batch number only
Correct answer: C. Drug name, concentration, diluent, expiration, and initials
49. When pharmacists verify orders during rounds, it is known as:
- A. Discharge planning
- B. Prospective order review
- C. Follow-up care
- D. E-prescribing
Correct answer: B. Prospective order review
50. The ultimate goal of the hospital medication use system is:
- A. Profit growth
- B. Efficient billing
- C. Safe and effective patient care
- D. Reducing pharmacist workload
Correct answer: C. Safe and effective patient care