Management of medicines according to NABH standards MCQs With Answer

Introduction

Management of medicines according to NABH standards is a critical component of hospital pharmacy practice, emphasizing safety, quality and accountability in medication use. This set of MCQs is designed for M.Pharm students to deepen understanding of NABH requirements related to procurement, storage, dispensing, documentation, medication reconciliation, handling of high‑alert and controlled drugs, cold chain management, expiry control, incident reporting and audits. Questions focus on practical application of standards, SOPs, committee responsibilities and record-keeping to prepare graduates for compliance, quality improvement and leadership roles in hospital pharmacy services. Use these MCQs to test knowledge and identify areas for further study and clinical application.

Q1. Which committee is primarily responsible for establishing the hospital formulary and medication use policies as per NABH?

• Infection Control Committee
• Drugs and Therapeutics (D&T) Committee
• Quality Assurance Cell
• Pharmacy Purchasing Team

Correct Answer: Drugs and Therapeutics (D&T) Committee

Q2. Under NABH standards, what is the minimum documented requirement for temperature monitoring of vaccine refrigerators in the hospital pharmacy?

• Daily manual check with no record retention
• Continuous temperature monitoring with daily review and records retained as per policy
• Weekly temperature checks with verbal confirmation
• Monthly calibration only when a problem occurs

Correct Answer: Continuous temperature monitoring with daily review and records retained as per policy

Q3. Which practice is required by NABH to prevent dispensing errors at the point of issue?

• Allowing any staff to dispense without verification if busy
• Two‑person verification for high‑risk medications and barcode scanning where available
• Relying solely on handwritten prescriptions without review
• Dispensing medications directly from manufacturer boxes without labeling

Correct Answer: Two‑person verification for high‑risk medications and barcode scanning where available

Q4. According to NABH, what documentation is essential when a drug recall is received from a manufacturer?

• Verbal notification to wards only
• Written record of recall receipt, actions taken, quarantined stock details and communication to stakeholders
• No action if stock appears intact
• Returning stock without documenting batch or quantity

Correct Answer: Written record of recall receipt, actions taken, quarantined stock details and communication to stakeholders

Q5. Which of the following is a NABH‑recommended step for handling expired or unusable medicines?

• Placing them back on shelf after discarding outer packaging
• Segregating, labeling as ‘Do not use’, documenting and disposing per policy
• Donating expired medicines to charitable organizations
• Mixing expired tablets with active stock to dilute errors

Correct Answer: Segregating, labeling as ‘Do not use’, documenting and disposing per policy

Q6. Medication reconciliation as required by NABH primarily aims to:

• Reduce pharmacy inventory levels
• Ensure continuity and accuracy of the medication list during transitions of care
• Replace clinician prescribing duties
• Increase medication administration speed without review

Correct Answer: Ensure continuity and accuracy of the medication list during transitions of care

Q7. Which action aligns with NABH standards for managing high‑alert medications?

• Storing high‑alert meds with all other stock without special labeling
• Implementing specific storage, clear labeling, standardized order sets, and staff competency checks
• Allowing unsupervised access to high‑alert meds by all staff
• Ignoring special protocols if rarely used

Correct Answer: Implementing specific storage, clear labeling, standardized order sets, and staff competency checks

Q8. What is the NABH expectation regarding supplier evaluation for procurement of medicines?

• Procure from any supplier offering lowest price only
• Conduct supplier qualification including GMP compliance, quality records and performance monitoring
• Accept verbal assurances from new suppliers without documentation
• Rotate suppliers randomly without assessment

Correct Answer: Conduct supplier qualification including GMP compliance, quality records and performance monitoring

Q9. For controlled substances, NABH requires documentation that includes:

• Only the monthly stock level
• Records of receipt, issue, dispensing, wastage, and physical inventory reconciliations
• No special records beyond routine invoices
• Electronic records only without periodic physical counts

Correct Answer: Records of receipt, issue, dispensing, wastage, and physical inventory reconciliations

Q10. Which practice is consistent with NABH standards for medication storage organization?

• Mixing different formulations and strengths on the same shelf without segregation
• Segregating by therapeutic class, maintaining clear labeling, expiry-first-out and controlling look‑alike/sound‑alike items
• Storing all medicines alphabetically regardless of storage conditions
• Keeping refrigerated and non‑refrigerated drugs together

Correct Answer: Segregating by therapeutic class, maintaining clear labeling, expiry-first-out and controlling look‑alike/sound‑alike items

Q11. What is the NABH‑recommended action when an adverse drug reaction (ADR) is suspected?

• Ignore if the reaction is mild
• Document the ADR, report through the hospital’s pharmacovigilance system and review medication orders
• Stop all medications without documentation
• Only inform the patient without notifying the clinical team

Correct Answer: Document the ADR, report through the hospital’s pharmacovigilance system and review medication orders

Q12. Which element is essential in pharmacy SOPs as per NABH?

• Vague statements without assignment of responsibility
• Clear scope, responsibilities, stepwise procedures, documentation requirements and review frequency
• Only a title with no procedural detail
• SOPs described verbally only

Correct Answer: Clear scope, responsibilities, stepwise procedures, documentation requirements and review frequency

Q13. What does NABH mandate regarding staff competency for medication management?

• No formal training required after hiring
• Periodic training, documented competency assessments and updates based on new protocols
• One initial orientation with no further assessment
• Only managerial staff need competency records

Correct Answer: Periodic training, documented competency assessments and updates based on new protocols

Q14. Which record retention practice for medication-related documents is generally advised under NABH?

• Destroy all records after one month
• Maintain and retain medication procurement, dispensing and audit records according to hospital policy and regulatory requirements
• Keep only electronic records without backups
• Store records informally in staff lockers

Correct Answer: Maintain and retain medication procurement, dispensing and audit records according to hospital policy and regulatory requirements

Q15. In NABH audits, which of the following is considered a critical area to inspect in pharmacy services?

• Color of staff uniforms
• Medication storage conditions, expired stock control, documentation and adverse event reporting
• Employee personal phone usage only
• Wall paint quality in the pharmacy

Correct Answer: Medication storage conditions, expired stock control, documentation and adverse event reporting

Q16. Which approach does NABH recommend to reduce look‑alike sound‑alike (LASA) medication errors?

• Keeping LASA drugs side‑by‑side for convenience
• Use of tall‑man lettering, separate storage, distinct labeling and staff education
• Rely solely on prescribers to avoid LASA errors
• Ignoring LASA as a low‑priority risk

Correct Answer: Use of tall‑man lettering, separate storage, distinct labeling and staff education

Q17. Which practice is required by NABH for emergency drug trays/kits?

• No regular checks; refill only when used
• Regular checklist-based inspections, expiry checks, standardized contents and documentation of checks
• Allowing any staff to alter contents ad hoc
• Storing them unlocked in general medication shelves

Correct Answer: Regular checklist-based inspections, expiry checks, standardized contents and documentation of checks

Q18. What is an expected pharmacy role during patient discharge under NABH medication management standards?

• Discharge without medication reconciliation or counseling
• Perform medication reconciliation, provide clear counseling, discharge medication list and document changes
• Provide medications without any labeling or instructions
• Refer all discharge counseling to non‑clinical staff

Correct Answer: Perform medication reconciliation, provide clear counseling, discharge medication list and document changes

Q19. Which measure aligns with NABH for inventory control to prevent stockouts of essential medicines?

• Maintaining no buffer stock and ordering only when zero balance
• Implementing minimum stock levels, reorder points, periodic review and emergency procurement procedures
• Relying solely on clinicians to inform pharmacy when supplies run low
• Ordering large quantities infrequently without forecasting

Correct Answer: Implementing minimum stock levels, reorder points, periodic review and emergency procurement procedures

Q20. Which action is consistent with NABH when introducing a new formulary medicine in the hospital?

• Introduce it without stakeholder consultation or training
• Evaluate evidence, obtain D&T approval, update SOPs, train staff and monitor outcomes
• Use it only in one ward without documentation
• Assume clinicians will self-educate and not provide monitoring

Correct Answer: Evaluate evidence, obtain D&T approval, update SOPs, train staff and monitor outcomes

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