MCQ Quiz: Patient Safety

Patient safety is the foundational principle of all healthcare practice. For pharmacists, this translates to a specialized focus on medication safety—designing and managing systems to prevent harm from medications. This is a “transcending concept” in the PharmD curriculum, with dedicated modules in Patient Care 3 and *Patient Care 5* covering key tools like Root Cause Analysis and health informatics. This quiz will test your knowledge of the systems-based approach to safety, common error types, and the strategies used to create a safer medication-use process.

. The modern approach to patient safety focuses on:

• a. Finding and punishing the individual responsible for an error.
• b. Understanding that most errors are caused by flaws in systems and processes.
• c. Accepting that a certain number of errors are unavoidable.
• d. Focusing only on errors that cause permanent harm.

Answer: b. Understanding that most errors are caused by flaws in systems and processes.

2. A “near miss” is an event that:

• a. Reached the patient and caused harm.
• b. Reached the patient but did not cause harm.
• c. Did not reach the patient because it was caught by a detection barrier.
• d. Is not considered a medication error.

Answer: c. Did not reach the patient because it was caught by a detection barrier.

3. The “Swiss Cheese Model” of accident causation suggests that:

• a. Errors are caused by a single, catastrophic failure.
• b. Systems have multiple defensive layers, and errors occur when the holes in these layers align.
• c. All systems are foolproof.
• d. Only one defensive layer is needed for safety.

Answer: b. Systems have multiple defensive layers, and errors occur when the holes in these layers align.

4. A Root Cause Analysis (RCA) is a ____ tool used to analyze an error that _____.

• a. proactive, might happen
• b. reactive, has already occurred
• c. financial, costs money
• d. prospective, will happen in the future

Answer: b. reactive, has already occurred

5. Which of the following is considered the STRONGEST and most effective type of safety intervention?

• a. Educating staff to “be more careful.”
• b. A policy requiring a double check.
• c. A forcing function or automation that makes the error difficult or impossible.
• d. Placing a warning sticker on a product.

Answer: c. A forcing function or automation that makes the error difficult or impossible.

6. The “Medication Safety” module is a specific learning module in which course?

• a. PHA5787C Patient Care 5
• b. PHA5104 Sterile Compounding
• c. PHA5703 Pharmacy Law and Ethics
• d. PHA5784C Patient Care 4

Answer: a. PHA5787C Patient Care 5

7. A pharmacist receives a prescription for “hydralazine” but accidentally dispenses “hydroxyzine.” This is an example of what type of error?

• a. A wrong dose error
• b. A look-alike, sound-alike (LASA) error
• c. A wrong route error
• d. A wrong time error

Answer: b. A look-alike, sound-alike (LASA) error

8. “Tall Man Lettering” (e.g., hydrOXYzine vs. hydrALAZINE) is a strategy used to:

• a. Make labels more difficult to read.
• b. Reduce the risk of LASA errors.
• c. Fulfill a legal requirement for controlled substances.
• d. Save ink on labels.

Answer: b. Reduce the risk of LASA errors.

9. “High-alert medications” are drugs that:

• a. Are most frequently involved in errors.
• b. Bear a heightened risk of causing significant patient harm when they are used in error.
• c. Are the most expensive.
• d. Are always controlled substances.

Answer: b. Bear a heightened risk of causing significant patient harm when they are used in error.

10. Which of the following is a classic example of a high-alert medication?

• a. Acetaminophen
• b. Ibuprofen
• c. Insulin
• d. Docusate

Answer: c. Insulin

11. The “Patient Safety/Med Errors: Root Cause Analysis” is a “Transcending Concept” in the Patient Care 3 curriculum.

• a. True
• b. False

Answer: a. True

12. Computerized Provider Order Entry (CPOE) is a health information technology that primarily reduces errors at which stage of the medication-use process?

• a. Prescribing and Transcribing
• b. Dispensing
• c. Administration
• d. Monitoring

Answer: a. Prescribing and Transcribing

13. Barcode Medication Administration (BCMA) is used at the bedside to verify the “five rights,” which helps prevent:

• a. Prescribing errors
• b. Dispensing errors
• c. Administration errors
• d. Monitoring errors

Answer: c. Administration errors

14. A “Just Culture” is an environment that:

• a. Has a zero-tolerance policy for all errors.
• b. Holds individuals accountable for their actions while encouraging error reporting and distinguishing between human error, at-risk behavior, and reckless conduct.
• c. Does not hold anyone accountable for their actions.
• d. Focuses on blaming individuals to set an example.

Answer: b. Holds individuals accountable for their actions while encouraging error reporting and distinguishing between human error, at-risk behavior, and reckless conduct.

15. Reporting medication errors and near-misses is a key objective for student pharmacists in their experiential rotations.

• a. True
• b. False

Answer: a. True

16. A Failure Mode and Effects Analysis (FMEA) is a tool used to:

• a. Analyze an error after it has occurred.
• b. Proactively evaluate a process to identify where failures might occur and what their effects would be.
• c. Discipline staff members.
• d. Document patient care.

Answer: b. Proactively evaluate a process to identify where failures might occur and what their effects would be.

17. “Introduction to Medication Errors” is a module within the Professional Practice Skills Lab II curriculum.

• a. True
• b. False

Answer: a. True

18. A pharmacist failing to adjust the dose of a renally-cleared drug for a patient with CKD is an example of an error of:

• a. Commission
• b. Omission
• c. Dispensing
• d. Communication

Answer: b. Omission

19. A key role for the pharmacist on the healthcare team is to serve as the:

• a. Team leader in all situations.
• b. Medication safety expert.
• c. Primary diagnostician.
• d. Financial advisor.

Answer: b. Medication safety expert.

20. An active learning session on medication safety is part of the Patient Care 5 course.

• a. True
• b. False

Answer: a. True

21. A pharmacist receives a prescription with an unsafe abbreviation (e.g., “U” for units). The safest action is to:

• a. Interpret the abbreviation based on their best guess.
• b. Dispense the prescription as written.
• c. Contact the prescriber for clarification.
• d. Ask the patient what the prescriber meant.

Answer: c. Contact the prescriber for clarification.

22. A “forcing function” is the weakest type of safety intervention.

• a. True
• b. False

Answer: b. False

23. The “Health information and informatics” module covers technologies used to improve patient safety.

• a. True
• b. False

Answer: a. True

24. An active learning session on medication safety is part of which course?

• a. PHA5787C Patient Care 5
• b. PHA5163L Professional Skills Lab 3
• c. PHA5781 Patient Care I
• d. PHA5782C Patient Care 2

Answer: a. PHA5787C Patient Care 5

25. Medication Reconciliation is a process designed to prevent errors at:

• a. The point of prescribing only.
• b. The point of dispensing only.
• c. Transitions of care (e.g., admission, discharge).
• d. The point of administration only.

Answer: c. Transitions of care (e.g., admission, discharge).

26. In an RCA, the primary goal of asking “why” multiple times is to:

• a. Confuse the person being interviewed.
• b. Move beyond the immediate cause to find the underlying system-level factors.
• c. Assign blame to multiple people.
• d. Lengthen the investigation.

Answer: b. Move beyond the immediate cause to find the underlying system-level factors.

27. “Confirmation bias” is a cognitive bias that can lead to medication errors when a pharmacist:

• a. Double checks every prescription meticulously.
• b. Sees what they expect to see on a label or screen, rather than what is actually there.
• c. Questions every order.
• d. Refuses to dispense a medication.

Answer: b. Sees what they expect to see on a label or screen, rather than what is actually there.

28. An active learning session on medication safety is part of which course module?

• a. Module 4: Medication Safety
• b. Module 1: Diabetes Mellitus
• c. Module 3: Women’s Health
• d. Module 8: Men’s Health

Answer: a. Module 4: Medication Safety

29. Storing concentrated electrolytes like potassium chloride in patient care areas is:

• a. A recommended safety practice.
• b. A well-known risk for serious medication errors and is strongly discouraged.
• c. Required by law.
• d. A cost-saving measure.

Answer: b. A well-known risk for serious medication errors and is strongly discouraged.

30. The “Interprofessional Communication & Medication Safety” is a transcending concept in the Patient Care 5 curriculum.

• a. True
• b. False

Answer: a. True

31. Which of the following is a key component of a “culture of safety”?

• a. A non-punitive approach to error reporting.
• b. A commitment from leadership to patient safety.
• c. Collaboration across disciplines.
• d. All of the above.

Answer: d. All of the above.

32. An independent double check requires:

• a. One person checking their own work twice.
• b. Two individuals checking the work separately from each other.
• c. A pharmacist and a technician checking the work together.
• d. The patient to check the work.

Answer: b. Two individuals checking the work separately from each other.

33. The principles of a Just Culture are foundational to medication safety.

• a. True
• b. False

Answer: a. True

34. The use of a “smart pump” drug library helps prevent IV medication errors by:

• a. Automatically mixing the IV bag.
• b. Alerting the user if a programmed dose or rate is outside pre-set safety limits.
• c. Placing the IV line into the patient.
• d. Verifying the patient’s identity.

Answer: b. Alerting the user if a programmed dose or rate is outside pre-set safety limits.

35. A pharmacist who identifies and resolves a drug therapy problem during a DUR is actively:

• a. Preventing a potential medication error or adverse event.
• b. Wasting time.
• c. Performing a task outside their scope.
• d. Creating more work for the physician.

Answer: a. Preventing a potential medication error or adverse event.

36. “Alert fatigue” from a Clinical Decision Support System (CDSS) can compromise patient safety because:

• a. It can lead to clinicians ignoring important, clinically significant alerts.
• b. It means the system is working perfectly.
• c. It slows down the computer system.
• d. It causes the alerts to be more accurate.

Answer: a. It can lead to clinicians ignoring important, clinically significant alerts.

37. Which of the following is the weakest form of safety intervention?

• a. An automated forcing function.
• b. Standardizing a process.
• c. An independent double check.
• d. An educational memo telling staff to be more careful.

Answer: d. An educational memo telling staff to be more careful.

38. The RCA module is part of the Patient Care 3 curriculum.

• a. True
• b. False

Answer: a. True

39. A key to preventing administration errors in the hospital is:

• a. The patient’s family member bringing in home medications.
• b. The “five rights” (right patient, drug, dose, route, time).
• c. Using verbal orders whenever possible.
• d. Having nurses mix all IV medications at the bedside.

Answer: b. The “five rights” (right patient, drug, dose, route, time).

40. An active learning session covering medication safety is part of which course?

• a. PHA5787C Patient Care 5
• b. PHA5163L Professional Skills Lab 3
• c. PHA5781 Patient Care I
• d. PHA5782C Patient Care 2

Answer: a. PHA5787C Patient Care 5

41. The primary goal of analyzing near-miss data is to:

• a. Identify which employees are making the most mistakes.
• b. Identify system vulnerabilities before they cause harm.
• c. Fulfill a documentation requirement.
• d. Create more work for the safety officer.

Answer: b. Identify system vulnerabilities before they cause harm.

42. Which of the following is NOT an error-prone abbreviation according to ISMP?

• a. U (for units)
• b. q.d. (for once daily)
• c. mg (for milligram)
• d. MSO4 (for morphine sulfate)

Answer: c. mg (for milligram)

43. A pharmacist’s professional and ethical obligation is to report medication errors.

• a. True
• b. False

Answer: a. True

44. A patient returning a medication to the pharmacy because it’s the wrong color is an example of:

• a. A good catch by the patient that prevented an error.
• b. The patient being difficult.
• c. A problem with the manufacturer.
• d. An adherence issue.

Answer: a. A good catch by the patient that prevented an error.

45. Improving patient safety requires a ____ approach.

• a. multidisciplinary and collaborative
• b. single-discipline
• c. top-down, authoritarian
• d. blame-focused

Answer: a. multidisciplinary and collaborative

46. Effective interprofessional communication is a key strategy to improve medication safety.

• a. True
• b. False

Answer: a. True

47. The “Medication Safety” module is part of the Patient Care 5 curriculum.

• a. True
• b. False

Answer: a. True

48. An active learning session on medication safety is part of which course module?

• a. Module 4: Medication Safety
• b. Module 1: Diabetes Mellitus
• c. Module 3: Women’s Health
• d. Module 8: Men’s Health

Answer: a. Module 4: Medication Safety

49. The overall management of patient safety in a healthcare organization is the responsibility of:

• a. Only the risk management department.
• b. Only the physicians and nurses.
• c. Everyone in the organization, from leadership to front-line staff.
• d. Only the pharmacists.

Answer: c. Everyone in the organization, from leadership to front-line staff.

50. The ultimate goal of learning about patient safety is to:

• a. Understand the principles and apply the tools needed to create a safer healthcare environment for patients.
• b. Avoid being sued.
• c. Pass the final exam.
• d. Be able to correctly identify all high-alert medications.

Answer: a. Understand the principles and apply the tools needed to create a safer healthcare environment for patients.