APC Patient Assessment and Evaluation 3 — Questions and Answers
Question 1: A pharmacist is performing a medicines review for an elderly patient on 8 medications. Which tool is specifically designed to screen for potentially inappropriate prescribing in older adults?
- APGAR score
- Beers Criteria (Correct answer)
- Glasgow Coma Scale
- CURB-65 score
Correct answer: Beers Criteria
The Beers Criteria is an evidence-based tool specifically developed to identify medications that are potentially inappropriate in adults aged 65 and older.
Question 2: A patient presents complaining of heartburn. Which symptom would prompt the pharmacist to refer rather than recommend OTC treatment?
- Mild burning sensation after a large fatty meal
- Symptoms occurring twice a week for two weeks
- Dysphagia and unintentional weight loss over two months (Correct answer)
- Temporary relief with antacids
Correct answer: Dysphagia and unintentional weight loss over two months
Dysphagia combined with unintentional weight loss are alarm symptoms ('red flags') that may indicate esophageal malignancy requiring urgent medical investigation.
Question 3: When assessing medication adherence, which validated tool is most commonly used in pharmacy practice?
- Morisky Medication Adherence Scale (MMAS-8) (Correct answer)
- Hamilton Anxiety Rating Scale
- Pittsburgh Sleep Quality Index
- Brief Pain Inventory
Correct answer: Morisky Medication Adherence Scale (MMAS-8)
The Morisky Medication Adherence Scale (MMAS-8) is a validated, widely used self-report tool for assessing patient adherence to prescribed medications.
Question 4: A mother brings in her 4-year-old who has had a fever of 39°C for 36 hours. Which additional finding would most warrant immediate referral to an emergency department?
- Child is eating less than usual
- Mild runny nose and intermittent cough
- Neck stiffness and photophobia (Correct answer)
- Temperature that responds briefly to paracetamol
Correct answer: Neck stiffness and photophobia
Neck stiffness and photophobia in a febrile child are classic signs of meningitis, a life-threatening emergency requiring immediate referral.
Question 5: During a cardiovascular risk assessment, a pharmacist measures a patient's blood pressure as 158/96 mmHg on two occasions. According to Australian guidelines, this reading is classified as:
- Normal blood pressure
- High-normal blood pressure
- Grade 1 (mild) hypertension (Correct answer)
- Grade 3 (severe) hypertension
Correct answer: Grade 1 (mild) hypertension
A blood pressure of 158/96 mmHg meets the threshold for Grade 1 (mild) hypertension as defined by Australian cardiovascular guidelines (≥140/90 mmHg).
Question 6: A patient on methotrexate for rheumatoid arthritis presents with mouth ulcers, fatigue, and easy bruising. Which assessment is most urgently required?
- Measure body weight and BMI
- Check folic acid supplementation brand
- Request a full blood count to assess for bone marrow suppression (Correct answer)
- Review the patient's diet for vitamin B12 intake
Correct answer: Request a full blood count to assess for bone marrow suppression
The symptoms suggest methotrexate toxicity causing bone marrow suppression; an urgent FBC is required to assess for pancytopenia.
Question 7: Which component of the Pharmaceutical Care Process comes immediately AFTER patient assessment?
- Identifying the patient's drug therapy problems (Correct answer)
- Dispensing the prescribed medication
- Documenting the consultation
- Following up on previous recommendations
Correct answer: Identifying the patient's drug therapy problems
In the Pharmaceutical Care Process, identifying drug therapy problems (DTPs) follows patient assessment and precedes the development of a care plan.
APC Patient Assessment and Evaluation 3
A pharmacist is performing a medicines review for an elderly patient on 8 medications.
Which tool is specifically designed to screen for potentially inappropriate prescribing in older adults?