Adult-Gerontology Clinical Nurse Specialist (CNS) Practice Exam

Which of the following is considered a high-alert drug?

1. Antihistamines

2. Antimicrobials

3. Benzodiazepine

4. Anticoagulants

The correct answer is: Anticoagulants

High-alert drugs are those that have a heightened risk of causing significant harm when they are used in error. Anticoagulants are categorized as high-alert medications because of their critical role in managing conditions related to blood clotting, such as atrial fibrillation, deep vein thrombosis, and pulmonary embolism. These medications require careful dosing and monitoring, as even minor errors can lead to severe complications like excessive bleeding or thromboembolism. The use of anticoagulants involves monitoring laboratory values such as INR (International Normalized Ratio) to ensure therapeutic ranges are maintained, as inappropriate dosing can lead to life-threatening outcomes. Other categories of drugs, including antihistamines, antimicrobials, and benzodiazepines, while they may carry risks, do not generally have the same level of acute risk for severe harm that is typical with anticoagulants in the context of dosing errors or inadequate monitoring. Therefore, anticoagulants stand out as a distinct class of high-alert medications requiring heightened attention in prescribing, dispensing, and administration processes to prevent significant patient harm.