Florida: Reducing Medical Errors

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You must score 70% or better to pass this course. Select one answer for each question by clicking the circle at the left of your choice. To change your selection, click a different circle. Do not skip any questions.

A change was made to this test on May 17. If you printed this test before May 17, you will find that question 23 in your printed copy has been dropped from the online test below.

Test Question

1. Which of the following results in the most deaths?

a. AIDS
b. Breast cancer
c. Medical errors
d. Motor vehicle accidents

Test Question

2. In 2008, Medicare discontinued reimbursement for which of the following preventable complications incurred during an inpatient stay:

a. Viral pneumonia, hypovolemic shock
b. Pressure ulcer, foreign object left in place after surgery
c. Sinusitis, tendonitis
d. Hypertension, osteopenia

Test Question

3. The Florida Patient Safety Corporation assessment of the Code 15 program found that the program was effective in improving patient safety.

a. True
b. False

Test Question

4. Medical errors are usually the result of an individual's carelessness or misconduct.

a. True
b. False

Test Question

5. In a survey of adults in seven countries, citizens of which one of the following countries were most likely to report medical errors?

a. England
b. Japan
c. France
d. United States

Test Question

6. An adverse event is defined as:

a. The failure of a planned action to be completed as intended.
b. The use of the wrong plan to achieve a certain aim.
c. An injury caused by medical management rather than the underlying condition of the patient.
d. The need to ask why the error occurred and make changes.

Test Question

7. According to JCAHO, a sentinel event is defined as:

a. A risk-reduction meeting to come up with a corrective action plan.
b. Any unexpected occurrence involving death or serious physical or psychological injury.
c. Any error in system design, faulty installation or maintenance of equipment, or ineffective organizational infrastructure.
d. Any error that could have caused harm but didn't because someone intervened.

Test Question

8. Research on why humans make errors reveals that latent errors:

a. Often occur at the level of the individual.
b. Often originate with intake procedures.
c. Are likely to be beyond the control of the individual.
d. Arise from misuse of medical equipment.

Test Question

9. Which of the following is an example of a potential adverse event?

a. The improper marking of the surgical site leads to the amputation of the wrong foot.
b. A nurse recognizes a potential drug overdose in a prescription and calls the error to the physician's attention rather than administering the medication.
c. A dead battery on an automatic external defibrillator (AED) leads to the death of a patient.
d. An undetected design flaw in an airplane that causes the pilot to lose control of the plane.

Test Question

10. One study at the University of Pittsburgh found up to 12% of reviewed laboratory specimen pairs revealed an erroneous diagnosis, primarily due to:

a. Poor documentation.
b. Suboptimal specimen collecting.
c. Laboratory error.
d. Literacy issues.

Test Question

11. Misdiagnosis is a major factor in delayed treatment, which can be fatal.

a. True
b. False

Test Question

12. An example of an omission error is:

a. Dispensing the wrong medication strength.
b. Failure to administer an ordered medication dose.
c. Dispensing the wrong drug.
d. Dispensing a medication not authorized by the prescriber.

Test Question

13. According to the U.S. Pharmacopeia (USP), the medications most often associated with errors are:

a. Heparin, aspirin, nitroglycerine, and codeine.
b. Insulin, chemotherapy drugs, lidocaine, and Apresoline.
c. Albuterol, epinephrine, atropine, and sodium bicarbonate.
d. Insulin, heparin, warfarin, and albuterol.

Test Question

14. To prevent errors related to heparin and insulin, check the patient's diagnosis before dispensing.

a. True
b. False

Test Question

15. Patients who have surgery are at high risk for medication errors due to:

a. Pre-existing conditions such as diabetes.
b. Multiple hand-offs and lack of medication coordination throughout the perioperative experience.
c. Use of general anesthesia.
d. Lack of patient teaching.

Test Question

16. Computerized prescriber order entry (CPOE) has the potential to reduce ADEs but hospitals should continue to monitor mortality rates and ADEs after implementing these systems.

a. True
b. False

Test Question

17. What important step to improve patient safety did Florida start on July 1, 2003? The state:

a. Requires that physicians read each prescription to the patient so they know what it says in case the pharmacist asks.
b. Requires physicians in Florida to either print legibly or type prescriptions.
c. Requires that physicians, who write illegible prescriptions, be reported to their licensing board.
d. Requires the physician to check if the patient has allergies and document on the prescription.

Test Question

18. The fentanyl transdermal patch should only be prescribed for patients who have not used other opioid narcotic pain medications before.

a. True
b. False

Test Question

19. Older persons are not the only population at risk for falls.

a. True
b. False

Test Question

20. Which of the following is a way to help reduce the medical error rate?

a. Showing up for work no matter how you feel.
b. Using computerized medication ordering.
c. Working double shifts to help your agency cope with heavy patient loads.
d. Working without complaint in noisy environments despite many distractions.

Test Question

21. Cost containment is a systems-level factor that can affect medical errors, and financial pressures at hospitals are associated with an increased rate of adverse events.

a. True
b. False

Test Question

22. More than 20% of patients admitted to two ICUs at a teaching hospital experienced an adverse event (AE), almost half of which were preventable. When did most of the AEs occur?

a. Upon admission
b. During the shift change
c. During an emergency
d. During routine care

Test Question

23. Reducing medical errors in the ICU always requires a high-tech solution rather than something as simple as the use of a checklist of evidence-based procedures.

a. True
b. False

Test Question

24. The average American reads at:

a. 12th grade level.
b. College level.
c. 8th or 9th grade level.
d. 6th grade level.

Test Question

25. The principal root cause of sentinel events is:

a. Insufficient nursing staff.
b. Inadequate communication between care providers or between care providers and patients/families.
c. Substance abuse by care providers.
d. Improperly maintained surgical equipment.

Test Question

26. In the state of Florida, reporting of sentinel events is:

a. Voluntary.
b. Recommended.
c. Mandatory.
d. Not required.

Test Question

27. Florida law requires that healthcare facilities notify each patient about adverse incidents that result in serious harm to the patient, and this can be used as evidence in a court case.

a. True
b. False

Test Question

28. Root cause analysis (RCA) is:

a. An exploration of all adverse incidents and malpractice actions at a facility.
b. A preliminary analysis of serious patient injuries.
c. A process for discovering basic and contributing causes of error with the continuing goal of preventing recurrence.
d. A way of distinguishing injuries caused by medical management from all other injuries to patients.

Test Question

29. A thorough root-cause analysis must contain:

a. Final determination of who was at fault.
b. Examination of underlying cause-and-effect systems through a series of "why" questions.
c. A report to the person's licensing board.
d. Identification of others who may have contributed to the error.

Test Question

30. Which of the following would be appropriate documentation of a medication according to the JCAHO's Do-Not-Use List?

a. MS 10.0 mg
b. Morphine sulfate 10 mg
c. Regular insulin 2 U daily
d. Regular insulin 2 units QD

Test Question

31. Which of the following steps can a patient take to help prevent medical errors?

a. Assume that the pharmacist can read the physician's scribbled prescription even though you cannot.
b. When picking up medicine from the pharmacy, ask "Is this the medicine that my doctor prescribed?"
c. Take for granted that "no news is good news" if you hear nothing about the results of a test or procedure.
d. Assume that everyone who is involved in your direct treatment washed their hands prior to caring for you.

Test Question

32. One way to help ensure that a child gets the correct dose is to know his/her current weight in kilograms and confirm with the child's healthcare provider that the correct weight has been used for medication calculations.

a. True
b. False

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