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1. In which year did the Institute of Medicine (IOM) issue a series of reports beginning with To Err Is Human?

A. 1969 B. 1979 C. 1999 D. 2009

2. In its Executive Summary, the IOM editors reported that deaths caused by medical errors ____________________.

A. Exceed the number attributable to the 8th-leading cause of death B. Were less than originally suspected C. Could not be accurately quantified D. Are a relatively small problem in hospitals

3. In To Err is Human, the IOM reported that more people die in a given year as a result of medical errors than from which of the following causes:

A. Motor vehicle accidents B. Breast cancer C. AIDS D. All of the above

4. The IOM went on to publish a total of 4 reports about medical, pharmacy, and medication errors. The fourth and last report in this Quality Chasm Series was about which of the following issues:

A. Surgical problems and errors B. Errors involving collaborative practices C. Preventing medication errors D. None of the above – the fourth in the series had not yet been scheduled for publication

5. The IOM report entitled Preventing Medication Errors, estimated that medication errors injure _______________ people and cost billions of dollars annually.

A. 5000 B. 40,000 C. 98,000 D. 1.5 million

6. The IOM report entitled Preventing Medication Errors, also stated as part of its report on medication errors that ___________ preventable drug-related injuries occur each year in hospitals.

A. 50,000 B. 90,000 C. 125,000 D. 400,000

7. According to the IOM report entitled Preventing Medication Errors, ___________ preventable drug-related injuries occur each year in long-term care settings.

A. 25,000 B. 75,000 C. 100,000 D. 800,000

8. According to this activity and because of the problems associated with medication errors, including the information in the IOM reports, many states took which of the following actions:

A. Passed a law requiring pharmacies to implement a system of quality management into their practices B. Directed that pharmacies were no longer required to report prescription errors C. Required accreditation D. None of the above; according to this article the states took no action based on these reports

9. What was the original error in the 3 prescriptions filled for Shari McClure?

A. The Diflucan (fluconazole) prescription was mislabeled B. The directions on the label for her Kytril (granisetron) prescription was incorrect C. The prescription for Pepcid (famotidine) 20 mg was incorrectly filled with Paxil 20 mg D. She was allergic to the Diflucan (fluconazole) prescription and had an anaphylaxis reaction

10. There was allegedly a second error made by the pharmacy in the McClure case. What was the 2nd alleged error?

A. Ms McClure was allergic to the Diflucan (fluconazole) B. The pharmacy failed to warn of a possible allergic cross-sensitivity C. The pharmacy did not consult with the physician or the family regarding steps to take to mitigate the effects of the first error D. The pharmacy should have discovered the original error earlier

11. Ms. McClure was reportedly injured in a second fall caused by the prescription error. According to some testimony in the case, the second fall resulted from which of the following:

A. The allergic reaction B. The effects of abruptly discontinuing an selective serotonin reuptake inhibitor (SSRI) C. A second medication error for a new drug D. When she returned from the retirement home, she again started taking the originally incorrectly filled prescription

12. In addition to the damages resulting from both falls, Ms McClure, now the plaintiff, asked for additional damages. What was the type of additional damages requested in the lawsuit against the pharmacy?

A. Punitive damages B. Compensatory damages C. Contractual damages D. Complex-case damages

13. The request for these additional damages claim in this case was important for what reason?

A. This is the reason the case went to the Iowa Supreme Court B. It raised the additional question of a pharmacy's duty to warn C. It allowed the plaintiff to present to the jury evidence of an additional 34 incident reports of prescription errors D. It allowed evidence of the second fall to be introduced into evidence

14. The Court allowed the additional evidence discussed in regard to the McClure case. Why did this happen?

A. To show there was a pattern of conduct B. To show proof that the pharmacy knew of problems C. To show the existence of a dangerous condition at the time of the error D. All of the above

15. The court allowed the evidence from 34 prior incidents because, it said, the evidence was relevant to the decision being litigated. According to the Iowa Supreme Court when is the evidence relevant?

A. When it has any tendency to make the existence of any fact that is of consequence to the determination of the action more probable or less probable than it would be without the evidence B. When a reasonable person might believe the probability of the truth of the consequential fact to be different if the person knew of the proffered evidence C. When the plaintiff hopes to stack as much evidence against the defendant as possible D. Both A and B

16. The Iowa Supreme Court, in regard to the McClure case, discussed the proof required to allow punitive damages. The Court said that to be awarded punitive damages, which of the following actions would have to be proven against the defendant:

A. The defendant's actions were willful and wanton (legal malice) B. The defendant's actions were negligent C. The defendant's actions violated his/her professional duty D. All of the above

17. Which of the following best supports the purpose of punitive damages:

A. To serve as a form of punishment B. To deter others from a specific conduct C. To provide an example when actual or legal malice is shown D. All of the above

18. In the McClure case, no one argued that there was any actual malice on behalf of Walgreen Company. It was alleged that legal malice was shown. What is legal malice?

A. Legal malice may include acts which amount to a reckless disregard B. Legal malice may include acts which amount to negligent action C. Legal malice may include acts which amount to a failure of recognized professional duty D. All of the above

19. The principle behind the Federal Rules of Evidence is which of the following:

A. All evidence should be admitted in a trial to guarantee fairness B. Only evidence that is relevant to the facts of the case itself should be admitted C. The jury has the collective wisdom to reject evidence that is irrelevant D. Otherwise inadmissible evidence may be presented to the jury only if the court characterizes it was such

20. The primary purpose of the Patient Safety and Quality Improvement Act of 2005 is which of the following:

A. To allow hospitals, doctors, and other health care providers to voluntarily report information to Patient Safety Organizations (PSOs), on a privileged and confidential basis, for the aggregation and analysis of patient safety events B. To improve patient safety C. To assist in the analysis of the information gathered from earlier QRE (errors and near-misses) so the pharmacy can use this information to streamline its workflow and reduce the risk of future errors D. All of the above