PEBC (Quality and Safety) Sample Questions
Categories: PEBC Canada
Ques. Which of the following is the most appropriate quality assurance measure to assess the competency of a staff pharmacist?
a. Rapid turnaround time on dispensing of medications
b. Documented "catches" of near miss medication errors
c. No patient complaints received by the pharmacy manager
d. Number of continuing education sessions attended
Answer: (b)
Ques. Which of the following is NOT a benefit of performing medication reconciliation activities in a hospital setting?
a. Reduction of medication errors
b. Reduction of inventory pilferage
c. Reduction of preventable adverse effects
d. Assessment of patient adherence to therapy
Answer: (b)
Ques. An attending physician used the computerized practitioner order entry (CPOE) system in the hospital to order a single bolus infusion of 1 L Ringer's lactate solution to be administered over one hour to a patient. The evening pharmacist validated the electronic order without a stop date, and the nurse verified the pharmacist's entry. The medication administration record displayed an ongoing order of 1 L Ringer's lactate to be given every hour, which the nurses administered. The patient received an excess 9 L of Ringer's lactate in error. The unit pharmacist detected the error in the morning and notified the physician. The patient had pleural effusions requiring transfer to the ICU. The pharmacist submits an incident report in the hospital's confidential internal safety incident reporting system. Whose identity is the most appropriate to be documented in this report?
a. The attending physician
b. The pharmacist who validated the order
c. The nurse who verified the order
d. The nurses who administered the Ringer's lactate
Answer: (a)
Ques. A hospital's cardiac arrest committee decided to add epinephrine (for anaphylaxis) to all cardiac arrest carts. The epinephrine to be used for anaphylaxis (given either subcutaneously or intramuscularly) was labelled and stored outside of, but adjacent to, the cardiac arrest drug tray. This was done to avoid any confusion with the epinephrine to be used for cardiac arrest (given intravenously), stored within the drug tray.
After this change occurred, a patient, AH, developed hypotension after receiving a radiocontrast agent for a CT scan. AH required intubation, which was done with difficulty due to tongue swelling. It took the cardiac arrest team over one hour to stabilize and transfer her to the ICU. When AH was transferred to ICU, she was found to be profoundly hypotensive. AH's family requested a safety review of this incident. Which of the following is the most likely reason to explain AH's condition? The cardiac arrest team:
a. lacked awareness that epinephrine for anaphylaxis was stored outside of the drug tray.
b. could only find the intravenous epinephrine, which cannot be used for anaphylaxis.
c. administered epinephrine intravenously, which is ineffective for the management of anaphylaxis.
d. did not recognize the signs and symptoms of anaphylaxis in AH.
Answer: (d)
The questions below include examples of a case scenario format, consisting of two or more questions in sequence, with patient information given in bold) Stem information is shown at the top of the case.
In these questions inclusive refer to the following:
PB is a 70 year old female who is on the final day of a 10-day course of cotrimoxazole (sulfamethoxazole/trimethoprim) DS, i po bid for mild pyelonephritis. PB's medical conditions include hypertension and osteoarthritis, for which she takes enalapril 5 mg po bid and acetaminophen 650 mg po qid. PB has been feeling unwell for the past two days, complaining of abdominal pain, diarrhea, and muscle weakness. She presents to the emergency department, where it is discovered that her serum potassium level is 5.9 mmol/L (normal: 3.5-5.0 mmol/L) and her estimated creatinine clearance is 70 mL/min.
Ques. What drug therapy problem is PB currently experiencing?
a. Her dosage of cotrimoxazole is too low.
b. Her dosage of cotrimoxazole is too high.
c. She is experiencing a drug interaction between enalapril and cotrimoxazole.
d. She is experiencing a drug interaction between acetaminophen and cotrimoxazole.
Answer: (c)
Ques. PB's hyperkalemia puts her at risk for developing which of the following?
a. Arrhythmias
b. Renal failure
c. Rhabdomyolysis
d. Metabolic alkalosis
Answer: (a)
Ques. One month later, PB returns to her family physician with symptoms of another urinary tract infection (UTI). When hospitalized last month, her urinalysis showed resolution of the original UTI. This is now PB's third UTI in the past six months. She is still taking enalapril and acetaminophen as before, and she has no known allergies. After resolution of the current infection, which of the following is the most appropriate regimen for UTI prophylaxis for PB?
a. Cotrimoxazole
b. Trimethoprim
c. Nitrofurantoin
d. Prophylaxis is not indicated for PB.
Answer: (c)