Risk Management And Error Prevention Practice Test

In a hospital pharmacy, a 6-year-old female (20 kg) is prescribed IV morphine for post-operative pain: morphine 0.05 mg/kg IV every 2 hours as needed. Current medications: acetaminophen 15 mg/kg PO every 6 hours, ondansetron 0.15 mg/kg IV every 8 hours PRN. Allergies: none. Labs: SCr 0.4 mg/dL, AST 26 U/L, ALT 18 U/L, A1c not applicable, INR 1.0. A nurse requests a morphine dose from an adult vial concentration (10 mg/mL), creating a high-alert pediatric dosing and concentration error risk. Which action should the pharmacist take to mitigate this risk?

In an anticoagulation clinic, a 71-year-old male (78 kg) on warfarin for atrial fibrillation has a new prescription for trimethoprim-sulfamethoxazole (TMP-SMX) DS 1 tablet PO BID for 7 days for cellulitis. Current medications: warfarin 4 mg PO daily, amlodipine 5 mg PO daily, simvastatin 20 mg PO nightly. Allergies: none. Labs today: INR 2.6 (therapeutic goal 2–3), SCr 1.1 mg/dL, AST 20 U/L, ALT 22 U/L, A1c 6.9%. TMP-SMX can significantly increase INR and bleeding risk. Which monitoring parameter is critical to prevent adverse events?