MCQ Quiz: Risk Management

Risk management in healthcare is a proactive and systematic process designed to identify, evaluate, and mitigate potential hazards before they cause patient harm. This concept is a cornerstone of Medication Safety, a topic covered in the Patient Care 5 curriculum “, and involves practical tools like Failure Mode and Effects Analysis (FMEA) and Root Cause Analysis (RCA). This quiz will test your knowledge on the principles of risk management, the tools used to assess risk, and the pharmacist’s integral role in creating a safer medication-use system.

1. The primary goal of risk management in pharmacy practice is to:

• a. Increase pharmacy profits.
• b. Reduce medication inventory.
• c. Prevent patient harm from medication use.
• d. Speed up the dispensing process.

Answer: c. Prevent patient harm from medication use.

2. Which of the following is a proactive risk assessment tool used to identify potential failures in a process before they occur?

• a. Root Cause Analysis (RCA)
• b. Failure Mode and Effects Analysis (FMEA)
• c. A sentinel event report
• d. A patient complaint form

Answer: b. Failure Mode and Effects Analysis (FMEA)

3. A Root Cause Analysis (RCA) is performed:

• a. Before implementing any new process.
• b. As a routine annual review.
• c. After an adverse event or close call has occurred to understand the underlying system failures.
• d. To assess the financial risk of the pharmacy.

Answer: c. After an adverse event or close call has occurred to understand the underlying system failures.

4. Medications like insulin, heparin, and chemotherapy are considered “high-alert” medications because:

• a. They are the most commonly used drugs.
• b. They have a high risk of causing significant patient harm when used in error.
• c. They are frequently involved in dispensing errors.
• d. They are very expensive.

Answer: b. They have a high risk of causing significant patient harm when used in error.

5. A key risk management strategy for high-alert medications is:

• a. Storing them next to all other medications alphabetically.
• b. Encouraging verbal orders for them.
• c. Implementing independent double-checks before dispensing or administration.
• d. Using them as frequently as possible.

Answer: c. Implementing independent double-checks before dispensing or administration.

6. The Medication Safety module is part of the Patient Care 5 curriculum.

• a. True
• b. False

Answer: a. True

7. The use of “tall man” lettering (e.g., hydrOXYzine vs. hydrALAZINE) is a risk-reduction strategy for what type of error?

• a. Wrong dose errors
• b. Look-alike, sound-alike (LASA) errors
• c. Wrong patient errors
• d. Wrong time errors

Answer: b. Look-alike, sound-alike (LASA) errors

8. The “Swiss cheese model” of accident causation illustrates that:

• a. Most errors are caused by a single, incompetent individual.
• b. Errors occur when flaws in multiple system defenses line up, allowing a hazard to reach a patient.
• c. All systems are perfect.
• d. A good defense is having as few layers as possible.

Answer: b. Errors occur when flaws in multiple system defenses line up, allowing a hazard to reach a patient.

9. From a risk management perspective, what is the value of a “near miss”?

• a. It is not valuable because no harm occurred.
• b. It provides a free lesson to identify and fix a system vulnerability before it causes patient harm.
• c. It is only useful for punishing the employee who almost made an error.
• d. It must be reported to the patient’s insurance company.

Answer: b. It provides a free lesson to identify and fix a system vulnerability before it causes patient harm.

10. A pharmacist performing a prospective drug utilization review (Pro-DUR) before dispensing is engaging in what type of activity?

• a. Inventory management
• b. A reactive risk analysis
• c. A proactive risk management activity
• d. A billing activity

Answer: c. A proactive risk management activity

11. The Root Cause Analysis is a “Transcending Concept” in the Patient Care 3 curriculum.

• a. True
• b. False

Answer: a. True

12. Which of the following is considered the strongest and most effective type of risk-reduction strategy?

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

Answer: d. A forcing function or automation that makes the error physically impossible.

13. Barcode Medication Administration (BCMA) is a technological risk-reduction tool used at what stage of the medication-use process?

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

Answer: d. Administration

14. A key part of the FMEA process is to:

• a. Rate potential failures by their severity, probability of occurrence, and detectability.
• b. Only focus on failures that have already happened.
• c. Identify a single person to blame for future errors.
• d. Be completed by one person in a single afternoon.

Answer: a. Rate potential failures by their severity, probability of occurrence, and detectability.

15. Identifying and resolving drug therapy problems is a key objective for student pharmacists and a form of risk management.

• a. True
• b. False

Answer: a. True

16. A “prescribing cascade” is a risk for geriatric patients where:

• a. A medication is prescribed correctly.
• b. A medication side effect is misinterpreted as a new medical condition, leading to the prescription of another drug.
• c. A patient takes too many medications at once.
• d. A prescription is tapered too quickly.

Answer: b. A medication side effect is misinterpreted as a new medical condition, leading to the prescription of another drug.

17. The “Introduction to Medication Errors” module is part of the Professional Practice Skills Lab II curriculum.

• a. True
• b. False

Answer: a. True

18. A key risk in any pharmacy is:

• a. Having too many staff members.
• b. Distractions and interruptions during the dispensing process.
• c. The computer system working too fast.
• d. Low prescription volume.

Answer: b. Distractions and interruptions during the dispensing process.

19. A pharmacist’s role in risk management includes:

• a. Verifying the appropriateness of a prescribed dose.
• b. Screening for drug interactions.
• c. Counseling patients on potential side effects.
• d. All of the above.

Answer: d. All of the above.

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 hospital’s P&T committee decides not to add a new “me-too” drug to the formulary to reduce the risk of selection errors with other drugs in the same class. This is an example of:

• a. Poor patient care.
• b. A risk management strategy.
• c. A financial decision only.
• d. A violation of FDA rules.

Answer: b. A risk management strategy.

22. Which of the following is an example of a “latent” or system-level failure?

• a. A nurse administering the wrong drug.
• b. A pharmacist grabbing the wrong bottle.
• c. Two look-alike drug boxes being stored next to each other in a chaotic work environment.
• d. A physician writing for the wrong dose.

Answer: c. Two look-alike drug boxes being stored next to each other in a chaotic work environment.

23. The “Health information and informatics” module covers technologies used for risk management.

• 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. The primary focus of a Root Cause Analysis is:

• a. The “who”
• b. The “what” and “why”
• c. The “when”
• d. The “where”

Answer: b. The “what” and “why”

26. The use of standardized order sets and protocols is a risk management strategy designed to:

• a. Increase variability in care.
• b. Reduce variability and promote evidence-based, safe practices.
• c. Make the prescribing process more difficult.
• d. Increase medication costs.

Answer: b. Reduce variability and promote evidence-based, safe practices.

27. A pharmacist who speaks up to a physician about a potentially unsafe dose is:

• a. Being insubordinate.
• b. Practicing effective risk management and interprofessional collaboration.
• c. Wasting the physician’s time.
• d. Violating hospital policy.

Answer: b. Practicing effective risk management and interprofessional collaboration.

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. The term “high reliability organization” refers to an organization that:

• a. Has never made an error.
• b. Operates in a complex, high-risk environment while maintaining a low rate of adverse events.
• c. Focuses on punishing individuals for errors.
• d. Has a very simple workflow.

Answer: b. Operates in a complex, high-risk environment while maintaining a low rate of adverse events.

30. The “Swiss cheese model” is a concept taught in medication safety.

• a. True
• b. False

Answer: a. True

31. Medication reconciliation at transitions of care is a critical risk-reduction activity.

• a. True
• b. False

Answer: a. True

32. The most effective risk management strategies focus on:

• a. Changing human behavior and telling people to be perfect.
• b. Designing safer systems that make it hard to do the wrong thing.
• c. Writing more policies and procedures.
• d. Increasing the number of manual double checks.

Answer: b. Designing safer systems that make it hard to do the wrong thing.

33. The principles of a “Just Culture” are important for risk management because:

• a. They encourage error reporting without fear of punitive action for systems-based errors.
• b. They ensure every error is punished severely.
• c. They eliminate all accountability.
• d. They only apply to physicians.

Answer: a. They encourage error reporting without fear of punitive action for systems-based errors.

34. Identifying automated systems that help decrease medication errors is an objective in the HIPPE course.

• a. True
• b. False

Answer: a. True

35. A pharmacist’s role in risk management is limited to the dispensing process.

• a. True
• b. False

Answer: b. False

36. A key risk to manage in sterile compounding is:

• a. The cost of supplies.
• b. Maintaining sterility and preventing microbial contamination.
• c. The temperature of the room.
• d. The number of technicians available.

Answer: b. Maintaining sterility and preventing microbial contamination.

37. The failure of a pharmacist to counsel a patient on a high-risk medication is a failure in what part of the medication-use system?

• a. Prescribing
• b. Dispensing
• c. Administration
• d. It is a communication and education failure that increases patient risk.

Answer: d. It is a communication and education failure that increases patient risk.

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

• a. True
• b. False

Answer: a. True

39. A pharmacy implements a new policy requiring a second pharmacist to verify all insulin doses. This is what type of risk-reduction strategy?

• a. A forcing function
• b. An independent double check
• c. Automation
• d. A “soft” reminder

Answer: b. An independent double check

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 first step in an FMEA is:

• a. To analyze the effects of the failure.
• b. To brainstorm potential failure modes in a process.
• c. To implement a solution.
• d. To calculate a risk priority number.

Answer: b. To brainstorm potential failure points in a process.

42. Which of the following is NOT a risk management strategy?

• a. Standardizing medication concentrations.
• b. Creating a formulary to limit the number of available drugs in a class.
• c. Allowing verbal orders for all chemotherapy regimens.
• d. Using clinical decision support alerts for drug interactions.

Answer: c. Allowing verbal orders for all chemotherapy regimens.

43. A proactive approach to safety is always preferable to a reactive one.

• a. True
• b. False

Answer: a. True

44. What is the pharmacist’s role in managing the risks associated with look-alike, sound-alike (LASA) drugs?

• a. To participate in selecting which drugs need “tall man” lettering.
• b. To ensure they are physically separated on pharmacy shelves.
• c. To use both the brand and generic name during prescription verification.
• d. All of the above.

Answer: d. All of the above.

45. Quality Improvement is essentially the implementation of risk management strategies.

• a. True
• b. False

Answer: a. True

46. When a medication error occurs, the primary focus should be on:

• a. The patient’s immediate safety and care.
• b. Determining who to blame.
• c. Completing the incident report.
• d. Notifying the pharmacy’s lawyer.

Answer: a. The patient’s immediate safety and care.

47. The curriculum includes a transcending concept on interprofessional communication and medication safety.

• 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 goal of risk management is to:

• a. Create a completely risk-free healthcare system.
• b. Make the healthcare system as safe as possible by identifying and mitigating risks.
• c. Eliminate the need for pharmacists.
• d. Increase the amount of documentation.

Answer: b. Make the healthcare system as safe as possible by identifying and mitigating risks.

50. The ultimate reason to learn about risk management is to:

• a. Be an active participant in creating safer medication systems for the benefit of all patients.
• b. Pass the medication safety exam.
• c. Avoid getting sued.
• d. Both a and c.

Answer: d. Both a and c.