Ambulatory Care Test Medication Management and Reconciliation 1 — Questions and Answers
Question 1: What is the primary goal of medication reconciliation in the ambulatory care setting?
- To reduce overall medication costs for patients
- To identify and resolve discrepancies in a patient's medication list across care transitions (Correct answer)
- To eliminate the need for physician medication orders
- To ensure patients refill prescriptions on time
Correct answer: To identify and resolve discrepancies in a patient's medication list across care transitions
Medication reconciliation aims to create an accurate, complete medication list and resolve any discrepancies that occur when patients move between care settings.
Question 2: According to The Joint Commission, medication reconciliation MUST occur at which point in patient care?
- Only at initial patient registration
- At care transitions, including admission, transfer, and discharge (Correct answer)
- Only when a patient reports a new allergy
- Only during annual wellness visits
Correct answer: At care transitions, including admission, transfer, and discharge
The Joint Commission's National Patient Safety Goals require medication reconciliation at all care transitions—admission, transfer, and discharge—to prevent errors.
Question 3: Which of the following is the BEST source for obtaining an accurate medication history during reconciliation?
- The patient's electronic health record from the last visit only
- The pharmacy dispensing records combined with direct patient interview (Correct answer)
- A family member's verbal account of medications
- The physician's most recent prescription pad notes
Correct answer: The pharmacy dispensing records combined with direct patient interview
Pharmacy dispensing records combined with a direct patient interview provide the most accurate picture of actual medication use, including OTC drugs and supplements.
Question 4: Polypharmacy in the ambulatory care setting is most commonly defined as a patient taking how many or more concurrent medications?
- Three or more
- Five or more (Correct answer)
- Eight or more
- Ten or more
Correct answer: Five or more
Polypharmacy is most widely defined as the concurrent use of five or more medications, which significantly increases the risk of adverse drug interactions and events.
Question 5: A patient taking warfarin asks if it is safe to take ibuprofen for back pain. What is the ambulatory care nurse's best response?
- Ibuprofen is safe as long as it is taken with food
- Ibuprofen can increase bleeding risk when taken with warfarin and should be avoided (Correct answer)
- Ibuprofen has no interaction with warfarin
- Ibuprofen can be taken safely up to 400 mg per dose
Correct answer: Ibuprofen can increase bleeding risk when taken with warfarin and should be avoided
NSAIDs like ibuprofen inhibit platelet aggregation and can displace warfarin from protein-binding sites, significantly increasing bleeding risk.
Question 6: Which abbreviation represents the comprehensive medication history obtained directly from the patient upon care contact?
- MAR
- BPMH (Correct answer)
- PRN
- ADR
Correct answer: BPMH
BPMH stands for Best Possible Medication History, a systematic process of collecting the most accurate medication list directly from the patient, often at care entry.
Question 7: When conducting medication reconciliation, the nurse notes the patient is taking St. John's Wort along with sertraline. What is the primary concern?
- Increased risk of hypertension
- Increased risk of serotonin syndrome (Correct answer)
- Decreased absorption of sertraline
- Increased risk of renal toxicity
Correct answer: Increased risk of serotonin syndrome
St. John's Wort has serotonergic properties, and combining it with an SSRI like sertraline can precipitate serotonin syndrome, a potentially life-threatening condition.
Ambulatory Care Test Medication Management and Reconciliation 1
What is the primary goal of medication reconciliation in the ambulatory care setting?