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1. Which of the following statements about medication errors in pediatric patients is false?

A. Pediatric patients have a three times higher risk of medication errors in the emergency room (ER) than adult patients. B. Prescribing errors for pediatric patients in the ER are estimated to be as high as 25%. C. Prescribing errors for pediatric patients in the inpatient setting have been reported to be between 5%–10%. D. Drug administration error rates have been reported to be between 0.6%–27% in the United States.

2. The American Association of Poison Control Centers analyzes exposures reported to U.S. Poison Control Centers on a regular basis. The 2019 edition reported which of the following exposure-related statistics?

A. A 1.7% increase in exposure reports from 2018 with total exposures reaching 2.14 million. B. Nearly 70% of exposures occur in those ≤19 years old. C. More exposures occur in adolescents than in children 12 years old and younger. D. Most exposures are reported from health care facilities.

3. Factors that contribute to medication-related problems in pediatric patients include all of the following except:

A. Differing stages of development of the GI, renal and hepatic systems. B. Body composition that impacts drug distribution. C. Cognitive development and issues related to communication ability. D. Blood component ratios with increased oxidation to tissues.

4. Pediatric patients are not small adults. Specific pharmacokinetic differences in pediatric patients include all of the following except:

A. Lower gastric acid and GI motility B. Reduced kidney function C. Lower total body water and greater body fat D. Reduced liver function

5. A prescription is brought to the pharmacy by MW, mother of KW, a 3-year-old male, for an ear infection. The prescription calls for amoxicillin 250 mg/5 mL with directions to give 5 mL two times a day for 10 days. What are appropriate steps to take at the drop-off window?

A. Ask MW for KW's current weight, if she responds in pounds, convert weight to kg and update KW's profile. B. Ask MW what other vitamins and OTC medications KW is taking and add these to KW's profile. C. Ask MW if KW has been on this medication before and if so, what issues occurred if any. D. All of the above.

6. KW's record is updated with his current weight in kg, 14 kg, and OTC medications (acetaminophen for fever) and vitamins (children's once a day with iron). The pharmacy technician completes data entry. What steps can be taken during data/order verification to double check if the dosage and instructions are appropriate?

A. Rely strictly on the computer system to flag if the dose is correct. B. Double check the medication labeling or another clinical resource available to see the mg/kg/day dose for amoxicillin for otitis media. C. Once the daily dose based on mg/kg/day is known, check to see if 100 mL quantity is enough for a 10-day regimen. D. B and C

7. A key challenge to pediatric medication use is that not all drugs have been tested in this population. Which of the following are legislative acts that address this issue by providing more incentive to manufacturers to conduct tests, allowing FDA to take steps to refer drugs for study and requiring manufacturers to conduct tests when it is likely a medication will be used in pediatric patients?

A. The Best Pharmaceuticals for Children Act (BPCA) B. The Pediatric Research Equity Act (PREA) C. Both A and B D. The Creative Incentives for Pediatric Testing Act (CIPTA)

8. Which of the following is an example of a pediatric medication error that occurred and was reported in a study of pharmacist liability claims?

A. Wrong flavoring agent used in antibiotic resulting in toxicity. B. Methadone 10 mg dispensed instead of methylphenidate 10 mg resulting in severe fatigue requiring emergency treatment C. Fluoxetine 10 mg dispensed instead of fluconazole 150mg in pallor and dizziness requiring hospitalization. D. Clonazepam 0.5 mg dispensed instead of montelukast resulting in stupor.

9. Contributors to wrong drug/wrong dose errors among pharmacist liability claims included all of the following except:

A. Separating look-alike, sound-alike drugs on pharmacy shelves using color and tall man letters. B. Not consulting prescribers when there were questions on medication orders. C. Not providing consulting or review of the medication with the patient and/or parent/caregiver. D. Not checking the patient's medication history/medication profile/drug therapies.

10. Which of the following strategies should NOT be employed by pharmacists to help prevent medication errors in pediatric patients?

A. Using oral syringes and dosing spoons with pediatric liquid medications. B. Educating parents/caregivers on how to use dosing devices and what to do if a dose is missed. C. Advising patients and/or parents/caregivers to share medications among siblings to improve adherence when medication cost is an issue. D. Referring patients and/or parents/caregivers to resources and tools that can improve medication safety.