PEBC MCQ Ethics, Patient Safety & Quality question: patient received metoprolol

PEBC MCQEthics, Patient Safety & Quality

A pharmacist discovers that yesterday a patient received metoprolol 50 mg instead of metformin 500 mg. The patient has taken two doses and reports feeling tired. Which of the following is the most appropriate first action for the pharmacist?

a. Phone the patient to stop the tablets, saying the pharmacy is recalling a batch
b. Call the prescriber first and let the physician decide whether to tell the patient
c. Contact the patient, explain the error and assess for harm
d. Complete the incident report first, then contact the patient within the week

Show the answer and explanation

Answer: c. Contact the patient, explain the error and assess for harm

Patient safety comes first: the pharmacist should promptly contact the patient, stop further doses, assess for harm (bradycardia, hypotension, uncontrolled glucose), arrange medical follow-up as needed and replace the medication. Canadian disclosure guidelines and professional standards require honest, timely disclosure of harmful incidents to the patient. The incident is then documented, the prescriber informed and the event reported through the pharmacy's incident system for analysis. Source: Canadian Patient Safety Institute, Canadian Disclosure Guidelines (2011, updated 2022 as Healthcare Excellence Canada); NAPRA Model Standards of Practice (2022), patient safety; ISMP Canada, medication incident reporting (checked 2026).

Common mistake

Delaying or delegating disclosure of a medication error.

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Original practice material written to the public PEBC blueprint; not a past or real exam question. Not affiliated with or endorsed by The Pharmacy Examining Board of Canada (PEBC). Educational practice material for exam preparation only. Not medical advice and not a substitute for current product monographs, clinical guidelines or professional judgement. Questions have not yet been reviewed by a licensed pharmacist.