Medication errors: classification, causes and prevention MCQs With Answer

Introduction

Medication errors: classification, causes and prevention MCQs With Answer is a focused quiz resource designed for M.Pharm students studying Principles of Quality Use of Medicines (MPP 201T). This set of MCQs explores core concepts including classification systems (such as the NCC MERP index), stages of the medication-use process, common human and system causes, and evidence-based prevention strategies like medication reconciliation, CPOE, barcode medication administration, and proactive risk analyses (FMEA). Questions emphasize clinical pharmacy roles, reporting culture, and high‑risk medication management to develop critical thinking for real-world quality improvement. Use these items to test knowledge, trigger discussion, and prepare for advanced coursework and examinations.

Q1. Which of the following best defines a medication error?

• An event that may or may not cause patient harm but involves a drug
• Any preventable event that may lead to inappropriate medication use or patient harm
• An adverse drug reaction occurring despite correct use
• A manufacturing defect in a drug product

Correct Answer: Any preventable event that may lead to inappropriate medication use or patient harm

Q2. In the medication-use process, which stage is most frequently associated with the occurrence of medication errors?

• Manufacturing and supply chain
• Prescribing
• Packaging and labeling
• Patient counselling

Correct Answer: Prescribing

Q3. The NCC MERP Index categorizes medication errors according to what primary criterion?

• The pharmacological class of the drug involved
• The number of doses affected
• The outcome or potential outcome for the patient (harm severity)
• The cost associated with the error

Correct Answer: The outcome or potential outcome for the patient (harm severity)

Q4. How are ‘active’ and ‘latent’ errors distinguished in human factors theory?

• Active errors are system design flaws; latent errors are frontline operator mistakes
• Active errors occur at the frontline and have immediate effects; latent errors are hidden system factors that predispose to failures
• Active errors are always intentional; latent errors are unintentional
• Active errors are financial; latent errors are clinical

Correct Answer: Active errors occur at the frontline and have immediate effects; latent errors are hidden system factors that predispose to failures

Q5. What is the best definition of a ‘near-miss’ in medication safety?

• An event that resulted in serious patient harm requiring intervention
• An event that reached the patient but did not cause harm
• An event that could have caused harm but was intercepted before reaching the patient
• An event caused by counterfeit medication

Correct Answer: An event that could have caused harm but was intercepted before reaching the patient

Q6. Which description correctly characterizes a ‘high‑alert medication’?

• A medication that is always administered intravenously
• A medication that rarely causes adverse drug reactions
• A medication with a heightened risk of causing significant patient harm when used in error
• A medication with an expensive acquisition cost

Correct Answer: A medication with a heightened risk of causing significant patient harm when used in error

Q7. Which of the following examples best illustrates a look‑alike/sound‑alike (LASA) medication error risk?

• Confusing “insulin glargine” with “insulin lispro”
• Using two different brands of ibuprofen interchangeably
• Mixing up medications due to an expired prescription
• Substituting a generic for a brand under a therapeutic interchange policy

Correct Answer: Confusing “insulin glargine” with “insulin lispro”

Q8. Which prevention strategy is most effective specifically for reducing calculation errors with high‑risk intravenous medications?

• Mandating verbal orders for IV drug changes
• Performing double independent dose calculations for high‑risk medications
• Increasing pharmacy staffing without protocol changes
• Using paper charts instead of electronic records

Correct Answer: Performing double independent dose calculations for high‑risk medications

Q9. Barcode Medication Administration (BCMA) systems primarily reduce errors at which step of the medication process?

• Prescribing
• Transcription
• Dispensing
• Medication administration at the bedside

Correct Answer: Medication administration at the bedside

Q10. What is the purpose of ‘Tall Man’ lettering in medication names?

• To indicate generic names only
• To highlight differences in look‑alike drug names using mixed-case lettering
• To prioritize brand names over generics
• To indicate a medication is restricted for special use

Correct Answer: To highlight differences in look‑alike drug names using mixed-case lettering

Q11. Root Cause Analysis (RCA) is most appropriately used for which purpose?

• Prospective identification of potential failure modes before implementation
• Investigating serious adverse events to identify underlying system causes
• Routine daily verification of medication stock levels
• Technical maintenance of dispensing equipment

Correct Answer: Investigating serious adverse events to identify underlying system causes

Q12. Failure Mode and Effects Analysis (FMEA) is best described as:

• A retrospective review of sentinel events only
• A prospective, systematic method to identify where and how a process might fail and assess the relative impact of different failures
• A mandatory regulatory inspection checklist
• An ad hoc method to punish individuals after errors

Correct Answer: A prospective, systematic method to identify where and how a process might fail and assess the relative impact of different failures

Q13. What is the primary objective of medication reconciliation during care transitions?

• To increase prescription volume for the pharmacy
• To ensure the patient receives brand-name drugs only
• To create the most cost‑effective medication regimen
• To obtain an accurate and complete list of a patient’s medications to prevent unintended discrepancies

Correct Answer: To obtain an accurate and complete list of a patient’s medications to prevent unintended discrepancies

Q14. Which clinical pharmacy intervention has the strongest evidence for reducing medication errors on hospital wards?

• Placing detailed drug monographs at the nursing station
• Prospective medication review and order verification by a clinical pharmacist
• Limiting pharmacist contact with prescribers to reduce interruptions
• Requiring nurses to verify all prescriptions without pharmacist input

Correct Answer: Prospective medication review and order verification by a clinical pharmacist

Q15. The Institute for Safe Medication Practices (ISMP) primarily provides which service?

• Drug manufacturing and distribution
• Guidance, alerts and best practices for medication safety
• Enforcement inspections with penalties
• Hospital accreditation services

Correct Answer: Guidance, alerts and best practices for medication safety

Q16. The ‘Swiss cheese’ model of error causation illustrates which principle?

• Errors result from single-point failures only
• Multiple layers of defense exist and errors occur when the holes in those layers align
• Human memory is the only reliable defense against errors
• All errors are due to individual negligence

Correct Answer: Multiple layers of defense exist and errors occur when the holes in those layers align

Q17. Which human factor is commonly cited as a major contributor to medication preparation and administration errors?

• Excessive use of electronic decision support
• Interruptions and distractions during medication preparation
• Availability of too many clinical pharmacists
• Use of standardized protocols

Correct Answer: Interruptions and distractions during medication preparation

Q18. How does the Joint Commission define a sentinel event in the context of medication safety?

• An expected adverse drug reaction documented in the medical record
• An unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof
• A minor medication discrepancy corrected before patient discharge
• A drug shortage affecting a hospital’s formulary

Correct Answer: An unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof

Q19. Which of the following is NOT an evidence‑based strategy to prevent medication errors?

• Implementing computerized prescriber order entry (CPOE) with decision support
• Establishing non‑punitive error reporting and learning systems
• Standardizing concentrations and protocols for high‑risk meds
• Blaming individual clinicians publicly to deter future mistakes

Correct Answer: Blaming individual clinicians publicly to deter future mistakes

Q20. Which cultural approach is most effective for long‑term reduction of medication errors in a healthcare organization?

• Strict punitive measures for individuals involved in errors
• Non‑punitive reporting culture combined with system redesign and continuous improvement
• Relying solely on individual vigilance without system changes
• Isolating pharmacists from multidisciplinary teams

Correct Answer: Non‑punitive reporting culture combined with system redesign and continuous improvement

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