Dispensing of drugs to inpatients and ambulatory patients MCQs With Answer

Dispensing of drugs to inpatients and ambulatory patients MCQs With Answer

Dispensing of drugs to inpatients and ambulatory patients is a core pharmacy practice area for B. Pharm students, focusing on prescription interpretation, dosage calculation, unit-dose and IV admixture processes, labeling, storage, documentation, medication reconciliation and patient counseling. This topic covers hospital and ambulatory pharmacy workflows, medication safety strategies, controlled-substance handling, therapeutic and generic substitution, stability and compatibility issues, cold-chain management, and regulatory requirements. Mastery ensures safe, effective medication use across care settings, reduces medication errors, and improves clinical outcomes. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which element is essential on an inpatient medication administration record (MAR) to ensure accurate dosing and timing?

• Patient’s allergy history
• Prescriber’s educational degree
• Exact administration time and route
• Pharmacist’s initials only

Correct Answer: Exact administration time and route

Q2. What is the primary advantage of a unit-dose dispensing system in hospitals?

• Reduces drug cost by using bulk packaging
• Improves medication safety by minimizing dosing errors
• Eliminates need for medication reconciliation
• Allows patients to self-administer without oversight

Correct Answer: Improves medication safety by minimizing dosing errors

Q3. During discharge dispensing to ambulatory patients, which activity is most important to prevent readmission?

• Providing a 30-minute supply of medication
• Comprehensive patient counseling on new and continuing medications
• Handing over original inpatient MAR without explanation
• Only dispensing over-the-counter supplements

Correct Answer: Comprehensive patient counseling on new and continuing medications

Q4. Which practice helps prevent wrong-route medication errors for parenteral orders?

• Storing IV and oral syringes together
• Using clear labeling indicating “For IV use only”
• Administering all parenteral drugs orally in emergency
• Removing administration route from labels

Correct Answer: Using clear labeling indicating “For IV use only”

Q5. What is medication reconciliation primarily designed to achieve during transitions of care?

• Reduce pharmacy workload
• Ensure continuity and accuracy of the patient’s medication list
• Identify brand-name alternatives only
• Automatically substitute medications without prescriber approval

Correct Answer: Ensure continuity and accuracy of the patient’s medication list

Q6. For ambulatory prescriptions, which of the following is a legal requirement in many jurisdictions?

• Prescriber signature or electronic authentication
• Pharmacist’s handwritten initials on each dose
• Dispensing only in glass bottles
• Including the patient’s family history

Correct Answer: Prescriber signature or electronic authentication

Q7. Which storage condition is most critical for vaccines and some biologics during inpatient dispensing?

• Room temperature away from light
• Refrigeration within specified cold-chain range
• Keeping in the dispensing tray at bedside
• Freezing all vaccines to preserve potency

Correct Answer: Refrigeration within specified cold-chain range

Q8. In hospital pharmacy, what is the main benefit of automated dispensing cabinets (ADCs) on wards?

• They replace the need for clinical pharmacists
• They provide secure, immediate access to medications and reduce delays
• They universally prevent all medication errors
• They allow unrestricted access to controlled substances

Correct Answer: They provide secure, immediate access to medications and reduce delays

Q9. When dispensing high-alert medications to ambulatory patients, what additional measure should the pharmacist take?

• Provide no counseling to avoid alarming the patient
• Offer explicit dosing instructions, risk counseling, and a medication safety leaflet
• Reduce dose without consulting prescriber
• Only provide the medication with no written information

Correct Answer: Offer explicit dosing instructions, risk counseling, and a medication safety leaflet

Q10. Which calculation is commonly required when converting inpatient IV drug orders to oral therapy for discharge?

• Calculating tablet color differences
• Bioavailability-adjusted dose conversion
• Number of syringes used in hospital
• Prescriber’s years of experience

Correct Answer: Bioavailability-adjusted dose conversion

Q11. What documentation should accompany controlled substances dispensed to inpatients?

• No documentation is necessary for inpatients
• Controlled drug register entry with quantity dispensed and prescriber details
• Only verbal confirmation with nurse
• Patient signature only

Correct Answer: Controlled drug register entry with quantity dispensed and prescriber details

Q12. Which factor is most important when assessing compatibility for IV admixtures in inpatient care?

• Cost of the admixture
• Chemical and physical compatibility of drugs and diluents
• Manufacturer’s marketing claims
• Color preference of nursing staff

Correct Answer: Chemical and physical compatibility of drugs and diluents

Q13. What is the correct pharmacy action when a handwritten inpatient prescription is illegible?

• Dispense based on likely interpretation
• Contact the prescriber for clarification before dispensing
• Ask the patient to interpret the order
• Substitute with any available drug

Correct Answer: Contact the prescriber for clarification before dispensing

Q14. Which labeling detail is particularly important for ambulatory pediatric prescriptions?

• Number of pages in the package insert
• Weight-based dose and clear administration instructions
• Pharmacist’s favorite brand
• Color of the child’s previous medicine

Correct Answer: Weight-based dose and clear administration instructions

Q15. In inpatient settings, what is the purpose of a medication order review by a pharmacist?

• To delay medication administration
• To detect dosing errors, interactions, allergies, and appropriateness
• To remove therapeutic monitoring requirements
• To convert all orders to generics without review

Correct Answer: To detect dosing errors, interactions, allergies, and appropriateness

Q16. Which practice reduces look-alike, sound-alike (LASA) medication errors in dispensing?

• Storing LASA drugs together for convenience
• Using tall-man lettering, distinct labeling, and separate storage
• Removing all labels and relying on memory
• Dispensing by brand name only

Correct Answer: Using tall-man lettering, distinct labeling, and separate storage

Q17. For ambulatory care, what is a key role of the pharmacist in prescription refill management?

• Automatically refill all prescriptions indefinitely
• Verify clinical appropriateness, adherence, and need for monitoring before refill
• Charge extra for telephone counseling only
• Refuse refills without communicating with patient

Correct Answer: Verify clinical appropriateness, adherence, and need for monitoring before refill

Q18. What is the recommended action when dispensing a medication with a narrow therapeutic index to an inpatient?

• Provide routine labeling only
• Recommend therapeutic drug monitoring and document dosing rationale
• Increase the dose slightly to ensure efficacy
• Allow nonclinical staff to adjust dosing

Correct Answer: Recommend therapeutic drug monitoring and document dosing rationale

Q19. Which of the following should be included in counseling ambulatory patients receiving anticoagulants?

• That diet has no effect on therapy
• Information on bleeding risks, interactions, monitoring and when to seek help
• Only the name of the drug without precautions
• Instructions to stop medication if feeling well

Correct Answer: Information on bleeding risks, interactions, monitoring and when to seek help

Q20. Which measure helps ensure medication stability when preparing unit-dose packages for inpatients?

• Ignoring manufacturer expiration dates
• Adhering to validated packaging materials and beyond-use dating
• Leaving packages open to air
• Using any available printer for labels

Correct Answer: Adhering to validated packaging materials and beyond-use dating

Q21. When converting inpatient continuous infusion to intermittent outpatient therapy, what must the pharmacist consider?

• Infusion pump brand only
• Pharmacokinetics, dosing intervals, and patient adherence
• Patient’s preference for tablet color
• Hospital room temperature

Correct Answer: Pharmacokinetics, dosing intervals, and patient adherence

Q22. Which documentation is most useful for auditing inpatient dispensing and preventing diversion?

• Informal notes by nursing staff
• Complete transaction logs with timestamps, user IDs, and quantities
• Only verbal confirmation records
• Patient’s meal preferences

Correct Answer: Complete transaction logs with timestamps, user IDs, and quantities

Q23. For ambulatory patients, what is the pharmacist’s role in therapeutic substitution when formulary interchange is needed?

• Substitute any drug without notification
• Follow institutional formulary policies and inform prescriber/patient as required
• Always change to the cheapest drug regardless of efficacy
• Refuse to substitute under any circumstance

Correct Answer: Follow institutional formulary policies and inform prescriber/patient as required

Q24. Which calculation is essential when preparing pediatric inpatient doses from adult stock concentrations?

• Adult dose multiplied by 10
• Weight-based mg/kg calculation with concentration adjustment
• Pharmacist’s estimate without calculation
• Using adult tablet halves regardless of strength

Correct Answer: Weight-based mg/kg calculation with concentration adjustment

Q25. What is the best practice for labeling discharge medications for ambulatory patients with low literacy?

• Use medical jargon only
• Use simple language, pictograms, and clear dosing instructions
• Provide only verbal instructions without written labels
• Exclude warnings to avoid confusion

Correct Answer: Use simple language, pictograms, and clear dosing instructions

Q26. Which test is commonly recommended before dispensing aminoglycoside antibiotics for inpatient treatment?

• Complete dental exam
• Baseline renal function tests (serum creatinine) and therapeutic drug monitoring
• Skin allergy test only
• Sleep study

Correct Answer: Baseline renal function tests (serum creatinine) and therapeutic drug monitoring

Q27. In ambulatory dispensing, which intervention improves adherence for chronic disease medications?

• Providing complicated regimens without support
• Medication synchronization and adherence packaging
• Refusing early refills under all circumstances
• Switching medications weekly

Correct Answer: Medication synchronization and adherence packaging

Q28. What is a critical step when preparing sterile IV admixtures for inpatient use?

• Working in any clean area of the pharmacy
• Using aseptic technique within a validated cleanroom and laminar flow hood
• Assembling admixtures on the nursing station
• Skipping environmental monitoring

Correct Answer: Using aseptic technique within a validated cleanroom and laminar flow hood

Q29. Which information should a pharmacist verify on an ambulatory electronic prescription before dispensing controlled medication?

• Electronic signature validity, patient ID, quantity, and refill authorization
• Only the drug color
• Prescriber’s favorite font
• Whether the prescription was printed on glossy paper

Correct Answer: Electronic signature validity, patient ID, quantity, and refill authorization

Q30. What strategy reduces medication errors at the point of dispensing in both inpatient and ambulatory settings?

• Relying solely on human memory
• Implementing barcode verification, double-check processes, and independent checks
• Eliminating labels to speed up workflow
• Allowing untrained staff to perform final checks

Correct Answer: Implementing barcode verification, double-check processes, and independent checks

G S Sachin

I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.

Mail- Sachin@pharmacyfreak.com