Pharm Practice Final

(T/F) All medications have a generic drug name, but not all medications are available as a generic

True

(T/F) Nonprescription medications are available without a prescription because it has been determined they are safe and have no potential for misuse.

False

(T/F) All medications have a generic drug name, but not all medications are available as a generic

True

(T/F) Nonprescription medications are available without a prescription because it has been determined they are safe and have no potential for misuse.

False

(T/F) Herbal medications and supplements are safe because they are all-natural products.

False

(T/F) Directions on the drug vial label should be as close as possible to those written by the prescriber; however, the pharmacist may clarify instructions as long as it does not change the prescriber's intent.

True

Which of the following is the part of the prescription that refers to the directions for the patient?

signa

When dispensing a drug from which of the following categories, it is very important to counsel patients appropriately since this DEA schedule has the highest potential for abuse with a possibility for severe psychological or physical dependence?

C-II (Schedule II)

You are checking a patient's electronic health record to verify that a medication was administered at 9:30 pm. What time are you expecting to see displayed?

2130

Which of the following are complete directions for the patient to be included on the prescription vial label?

Place 2 drops in each eye

2 capsules by mouth once daily for 3 days

Give Haden 5 mL by mouth once daily

Take 1 by mouth twice daily after meals

None of these are complete

Give Haden 5 mL by mouth once daily

Examples of professional writing for pharmacists

Resume
Journal article
Pharmacy newsletter
Documentation in a patient chart
Presentation slides
E-mail

An example of unsafe and inappropriate documentation of a medication and one dose

• 1000mg. Metformin
• 40 mcg dopamine
• 5-mL Augmentin oral suspension, 400 mg per 5 mL 
• carafate 1 g

1000 mg. Metformin

Which of the following sentence uses the correct word (says precisely what is intended)?

She advanced farther in her career than he did.

That experience positively affected my mood.

I will site that author in my report.

I could not decide among apple or orange juice.

That experience positively affected my mood.

(T/F) Most of the time spent on a writing assignment should be dedicated to writing a good first draft. If more time is spent writing, less time is needed for revising which should result in a better paper and better communication

False

(T/F) Writing to the general public and a colleague need to be worded differently for your audience to clearly understand you

True

(T/F) Acronyms should be spelled out when first used in a document, and it is recommended to avoid beginning a sentence with an acronym.

True

(T/F) Contractions should not be used in professional writing

True

Example of correctly writing out a number and when to use numerals in professional writing.

• The patient's wife picked up four prescriptions for him and two prescriptions for herself.
• The pharmacist measured out fifteen mL of the drug solution to fill the prescription. 
• The thief robbed the pharmacy and got away with six hundred dollars.
• During the convention, we stayed on the twenty-third floor. 

The patient's wife picked up four prescriptions for him and two prescriptions for herself.

(T/F) Both brand and generic drug names should always be capitalized.

False

Which of the following is a safe, complete, and appropriate documentation of a medication and dose in a patient chart which is considered professional writing?
Lovenox 60.0 mg/6mls sq daily

Nitro 100. mg IV once

10000gms po

digoxin 0.25-mg tablet taken once daily

digoxin 0.25-mg tablet taken once daily

(T/F) Cassettes for capillary cholesterol screenings must be brought to room temperature for 10 minutes prior to use.

True

(T/F) Multi-use lancets can be used during patient screening events.

False

(T/F) When taking a blood pressure, you place the stethoscope over the carotid artery.

False

(T/F) Following the appropriate fasting requirements for cholesterol screenings will provide the most accurate test results.

True

(T/F) Cholestrol values are reported as mg/dL

True

(T/F) A "near miss" or "good catch" is a medication error, even if that error does not reach the patient.

True

A medication error can occur while the medication is being controlled by whom?

Prescriber
Pharmacist
Pharmacy technician or intern
Patient
Caregiver to the patient

What term refers to when one sees what one expects to see or what is more common, rather than what is actually there?

confirmation bias

What is the name of the non-profit organization dedicated to the collaborative development, education, and advocacy of safe medication practices?

Institute for Safe Medication Practices

Which of the following is NOT recommended to prevent errors with look-alike, sound-alike (LASA) medications?

• Install pop-up alerts in the computer when a LASA medication is selected
• Store two similar looking medications next to each other to promote awareness of the similarities
• Order similar looking medications from different manufacturers so the bottles/labels appear differently
• Communicate LASA drug names using both generic and brand names

Store two similar looking medications next to each other to promote awareness of the similarities

What is it called when part of a drug's name appears in upper case letters to help distinguish look-alike, sound-alike drugs from one another in order to avoid medication errors? For example: HydrOXYzine and HydrALAzine

Tall Man Lettering

Which of the following is NOT considered a medication error

• An intern takes a phoned-in prescription. Even though he hears the prescription clearly, he utilizes the verbal-order-read-back practice to ensure he has the right information. The nurse confirms he read the prescription back correctly.
• A pharmacist failed to counsel the patient to take the medication at bedtime. The patient took the medication in the morning and eventually stopped taking it since it made her feel sleepy all day. 
• The cream dosage form of a topical medication was prescribed, but the ointment dosage form was filled and dispensed. When the patient commented on the difference from her previous prescription, she mentioned she prefers the ointment. The pharmacist called the prescriber who authorized the switch. 
• A pharmacy technician selecting hydralazine off the shelf instead of the prescribed hydroxyzine but realizing the mistake when scanning the NDC code of the bottle and receiving an error message. 

An intern takes a phoned-in prescription. Even though he hears the prescription clearly, he utilizes the verbal-order-read-back practice to ensure he has the right information. The nurse confirms he read the prescription back correctly.

Order the following steps of the medication use process:
1 Administration
2 Transcribing
3 Prescribing
4 Dispensing
5 Monitoring

3
2
4
1
5

Which of the following is NOT considered one of the 5 R's for proper drug administration?
Right patient
Right route
Right drug
Right result
Right dose

Right result

(T/F) In regards to the article, Your Personal Error Rate: Checkpoints and Reality Checks, the use of technology always prevents medication errors.

False

(T/F) Tobacco use is the actual leading cause of death in the US

True

A person's health and wellbeing are dependent on a good start, good future, good care and support. These influences, social, economic, physical and environmental factors are known as:

Social determinants of health

Social determinants of health are _

• factors beyond an individual's control that affects health status
• factors that have no effect on life expectancy
• factors that anyone can overcome
• none of the above

factors beyond an individual's control that affects health status

Which of the following is not a biological or genetic factor impacting health?
Carrying the BRAC1 gene

Age

Tobacco use

Sex

Tobacco use

The water crisis in Flint Michigan, is an example or which type of determinant of health?
Health behaviors

Physical environment

Social environment

Access to care

Physical environment

(T/F) Individual behaviors are strongly influenced by social, cultural and physical environment.

True

Which of the following is a health disparity?

• The prevalence of HIV infection among Blacks doubled in the last decade while remaining stable among whites.
• Rates of herpes are about the same in whites and hispanics
• Women are more likely to die during childbirth than men
• None of the above

The prevalence of HIV infection among Blacks doubled in the last decade while remaining stable among whites.

What is an area where mainstream grocery stores are either totally absent or inaccessible to low-income shoppers.

• food swamp
• food gap
• food desert
• food barrier

Food desert

(T/F) The income gap is decreasing between Whites and Blacks in the United States.

False

Whites have the lowest unemployment rates compared to the other races in the United States.

False

Pharmacists provide pharmaceutical care utilizing the Pharmacists' Patient Care Process (PPCP). Number the following steps in this process in order from 1-5 for an interaction with a patient for the first time.
____ Follow-up
____ Assess
____ Plan
____ Collect
____ Implement

4
2
3
5
1

(T/F) The Pharmacists' Patient Care Process is applicable to any practice setting where pharmacists provide patient care and for any patient care service provided by pharmacists.

True

(T/F) According to the ACCP definition in the article posted, Clinical Pharmacists can only care for patients in the hospital setting.

False

Which of the following is FALSE regarding the Pharmacist's Patient Care Process (PPCP)?

• It was developed by the Joint Commission of Pharmacy Practitioners
• It enhances consistency within the profession regarding the approach to delivering services
• It is utilized only in the clinic or ambulatory care setting
• It increases awareness to those external to the profession that pharmacists utilize a consistent patient care process that relies on their unique training and expertise
• Its overall goal as a standardized process is to provide high quality, cost-effective and accessible health care for patients through team-based patient-centered care

It is utilized only in the clinic or ambulatory care setting.

In which situation is a pharmacist practicing patient-centered care?

• The pharmacists recommends Prilosec for anyone complaining of heartburn since it is the most frequently requested OTC and people are familiar with that medication thanks to all the commercials.
• The pharmacist inquires about the patient's health beliefs to determine if the patient would be interested in starting a pro-biotic with their antibiotic therapy to prevent diarrhea. The benefits and costs are explained and the pharmacist allows the patient to choose whether or not the additional therapy is right for them.
• The pharmacist and provider determine a cancer treatment regimen for the patient which is aggressive in order to provide the best chance of survival despite the overwhelming expense and risk of debilitating side effects. The patient is only provided this option to move forward with treatment. 
• A pharmacist notes the patient's allergy to a medication, but continues to fill it without notifying the patient since the reaction was only upset stomach and the pharmacist knows that is the best treatment option for that indication. 

The pharmacist inquires about the patient's health beliefs to determine if the patient would be interested in starting a pro-biotic with their antibiotic therapy to prevent diarrhea. The benefits and costs are explained and the pharmacist allows the patient to choose whether or not the additional therapy is right for them. 

Which of the following should be included in a past medical history? Thyroid cancer 3 years ago that is resolved; Hypertension diagnosed 7 years ago; Type I Diabetes Mellitus diagnosed 12 years ago; Congestive Heart Failure for the last 2 years; All of the above should be included in past medical history

Thyroid cancer 3 years ago that is resolved

Which of the following family conditions should be included in a history? Cousin with type II diabetes mellitus diagnosed at age 30; Paternal grandmother whom died of breast cancer at age 60; Uncle with leukemia that is in remission; Adopted sibling with lymphoma diagnosed at age 30; None of the above

Paternal grandmother whom died of breast cancer at age 60

T/F: When discussing a patient's social history, it is important to ask leading questions to make it easier for the patient to tell you what they use.

False

T/F: A 25 year old male patient tells you he is allergic to metformin because he had severe diarrhea when taking it. This should be documented in the adverse drug reaction section of the medication history.

True

If you cannot obtain a height and weight for the general information part of a medication history, what is the best option?

• omit the information and leave it blank in the medication history documentation form
• write down specific numbers based off your best guess
• record that the patient denied disclosure of that information and include your own assessment such as "appears slightly overweight"
• you do not need to ask or include height or weight in the general information 

Record that the patient denied disclosure of that information and include your own assessment such as "appears slightly overweight"

T/F: By checking drug interactions of all the medications a patient takes, you will discover all current and potential drug related problems.

Flase

Which of the following is NOT a potential or actual medication related problem?

• Therapeutic duplication is present upon review of patient’s medications since the patient has multiple physicians.
• Two medications a patient is taking have drug interactions with each other causing inappropriate doses of one.
• Patient is taking appropriate medication(s) for every current disease state with no additional unnecessary therapy.
• Patient draws up an inappropriate dose of insulin due to small syringe size. 
• Patient is not taking a medication due to side effects experienced.

Patient is taking appropriate medication(s) for every current disease state with no additional unnecessary therapy.

Which of the following is a current medication related problem?

• A patient stopped eating grapefruit for breakfast because of a drug-food interaction with simvastatin that the pharmacist counseled her over.
• Levofloxacin is prescribed for a patient instead of Bactrim because the physician was aware of the patient’s sulfa allergy.
• A generic medication with equal efficacy is prescribed because the patient cannot afford the brand name alternative. 
• Patient takes an OTC sleep-aid, which has no interactions with his other medications according to his pharmacist, to counteract the insomnia experienced from his antidepressant.
• A patient takes his medication with food as instructed by the pharmacist to prevent an upset stomach, which is a well known side effect of the medication.

Patient takes an OTC sleep-aid, which has no interactions with his other medications according to his pharmacist, to counteract the insomnia experienced from his antidepressant.

T/F: When concluding your medication history, always give a brief synopsis of what you learned about the patient and allow them an opportunity to add any additional information they want you to know about.

True

Which of the following is important to include when introducing the medication history interview with a patient? Ask the patient permission to interview; Explain the purpose of obtaining the medication history; State the information is confidential between you and the patient but also list who will be provided some of the information (such as insurance); All of the above are important to include at the start of taking a medication history

All of the above are important to include at the start of taking a medication history

Who runs the SD Health Professionals Assistance Program (SDHPAP)?

Midwest Health Management Services

What is the most commonly abused substance among healthcare professionals?

Alcohol

Which of the following is a behavior that may suggest a substance abuse problem? Progressive deterioration in personal appearance and hygiene; Recurrent mood swings and lack of impulse control; Frequently missing work
Increasing personal and/or professional isolation; All of these

All of these

T/F: In addition to voluntary referrals, HPAP also provides mandated disciplinary options for licensing boards when regulated health professionals' mental health or substance use disorder requires recovery management and/or practice limitations.

True

T/F: SDSU pharmacy students are eligible to participate in the SDHPAP.

True

T/F: SDHPAP is funded by fees paid by the impaired health professionals undergoing treatment.

False

Which of the following people can refer can individual for treatment in the SDHPAP (Mark ALL that apply)? Self-referral; Coworker; Employer; SD Board of Pharmacy representative; Family member; Friend

All of them

T/F: Individualized Participant Agreements are created for participants of the program, which could include random drug screenings.

True

T/F: Past studies have estimated that 18-21% of pharmacists have misused prescription drugs.

True

Which of the following is an example of a patient safety issue that may be caused by a healthcare professional with a substance use disorder (select ALL that apply)? Increased practice errors; Diversion of medications from patients; Improved focus; Greater patient empathy; Impaired judgement

Increased practice errors; Diversion of medications from patients; Impaired judgement

(T/F) You can lead without being in charge

True

Which leadership style encourages self-development by empowering followers to act independently, but requires the leader to be willing to let followers fail as they learn?

Coaching

(T/F) Leadership involves relationships with people

True

When free ice cream coupons are handed out to students who speak up in class, the faculty member is utilizing what type of power to influence students' behavior?

Reward

Provides support for the emotional needs of followers.

• Encourages communication, trust, independence, and satisfaction but Organizational performance may not reach its fullest potential due to overemphasis on the individual needs of the followers.

Affliative

Relies on rewards and punishments to influence followers.

• Can influence behavior quickly but may result in resentment.

Coercive

Provides each person with equal say in decisions.

• Attains buy-in and commitment from followers by demonstrating respect but can be inefficient.

Democratic

Encourages self-development and motivation by helping followers develop themselves according to their personal and career aspirations.

Coaching

Inspires others through a shared vision of the future.

Transformational

Leads by example.

• The leader can demonstrate high expectations through actions but guidelines for acceptable performance of the followers are not explicit if they are based only on actions. 

Pacesetting

Which leadership type sets expectations by example, but not words?

• coaching
• pacesetting
• transformational
• affiliative

Pacesetting

MC is a 33 year old male who has Blue Cross Blue Shield of MN. He was recently seen in the ER for a broken ankle. His bill came in the mail the following month, indicating that he owes $500. The bill indicates that the total fee for services was $1200. MC is an active guy who rarely gets sick, therefore he does not have to utilize his insurance very often. What is the best explanation for why MC only owes part of the amount on the bill?

His insurance plan most likely has a deductible of $500. He has to pay up to that amount before his insurance will kick in to pay the remaining balance

Attains buy-in and commitment from followers by demonstrating respect but can be inefficient.

Democratic

Patients who turn 65 are automatically enrolled in Medicare Part A and B.

False

Which of the following terms refers to the percent amount the patient will pay from the total cost for each prescription?

Co-Insurance

Which of the following terms refers to the out-of-pocket spending limit after which the patient pays greatly reduced co-pays

Catastrophic coverage

Which term means refers to the amount the patient must pay out-of-pocket before the insurance will pay for any prescriptions

Deductible

The leader can demonstrate high expectations through actions but guidelines for acceptable performance of the followers are not explicit if they are based only on actions.

Pacesetting

What part of Medicare would cover a colonoscopy?

Part B

encourages self-development and motivation by helping followers develop themselves according to their personal and career aspirations

Transformational, Coaching, Pacesetting, Democratic

relies on rewards and punishments to influence followers

coercive

DB is a 74 year old female new to your pharmacy. She has come to pick up a new prescription for Alendronate 70 mg #4, Take 1 tablet by mouth once weekly. She hands you her red, white, and blue card. What information do you need from her?

• Just her name and date of birth
• Nothing, this is the correct card and you have all the information you need.
• Ask her if she has a Part D insurance card
• Ask her to sign the Medicare Part B billing form

Ask if she has her part D card

provides support for the emotional needs of followers

affilative

DB is accompanied by her granddaughter, SB, who also is new to your pharmacy and has a prescription to pick up. She hands you her insurance card. What information listed on the card is not needed to bill her insurance company?

Deductible

MW is a 62 year old male. He is not yet of Medicare age but has been able to enroll due to which of the following conditions?

• diabetes
• hypertension
• required dialysis three times a week
• income meets certain requirements

Requires dialysis 3x a week

Which part covers primrose long term care nursing home facility and admission to the cardiac ICU floor of Stanford Medical Center?

Part A

Which part covers one touch ultra test strips QTY 50, mycophenolate 250 MG capsules #30 following transplantation, brovana solution for nebulization, anx influenza vaccination.

Part B

Which part covers dental appointment to get a crown fixed and hearing aids?

Part C

Which part covers Citalopram 10mg tablets #30 and Shingrix vaccination

Part D

Morality and ethics mean the same thing.

False

When was the first version of the Pharmacist Code of Ethics published?

1852

Biomedical ethics (bioethics) is a field of study that applies to develop methods and theory for appropriate healthcare practice.

Law, Ethics, and Medicine