CCP Medication Therapy Management 3

Question 1

A consultant pharmacist reviews a nursing home resident's medication list and notes that metoclopramide has been prescribed continuously for 18 months. Which concern should be raised with the medical team?

Accepted Answer

Risk of tardive dyskinesia with long-term use beyond 12 weeks

Answer

FDA requires a black-box warning on metoclopramide for tardive dyskinesia risk with use beyond 12 weeks, making long-term prescribing a significant concern.

Question 2

During a CMR, a patient with type 2 diabetes reports that she skips her evening metformin dose 'because it upsets her stomach.' The pharmacist's BEST recommendation to improve adherence while minimizing GI side effects is:

Accepted Answer

Switch to metformin extended-release taken with the evening meal

Answer

Extended-release metformin has significantly lower GI side effects than immediate-release and, when taken with food, further reduces GI intolerance.

Question 3

In the context of MTM documentation, a 'Personal Medication Record' (PMR) differs from a 'Medication Action Plan' (MAP) in that:

Accepted Answer

The PMR lists all current medications and is for the patient's reference; the MAP lists specific actions the patient needs to take

Answer

The PMR is a comprehensive patient-held medication list, while the MAP is a patient-centered action document specifying steps the patient must take to optimize therapy.

Question 4

A pharmacist is evaluating a 70-year-old patient's medications using the Beers Criteria. Which combination of findings would be MOST consistent with Beers Criteria concerns in this population?

Accepted Answer

Diphenhydramine for sleep + oxybutynin for urge incontinence + diazepam for anxiety

Answer

Diphenhydramine, oxybutynin, and diazepam are all strongly anticholinergic or CNS-depressant agents listed as potentially inappropriate in older adults per Beers Criteria.

Question 5

An MTM pharmacist is performing a medication reconciliation for a patient transitioning from hospital to home. The patient's discharge medication list includes warfarin 5mg daily, but the pharmacist's pre-admission record shows the patient was on warfarin 2.5mg daily. The most appropriate next step is:

Accepted Answer

Contact the discharging physician to determine if the dose change was intentional

Answer

A dosage discrepancy between pre-admission and discharge records for a high-alert medication like warfarin requires immediate prescriber clarification to prevent harm.

(CCP) Certified Consultant Pharmacist Practice Test

(CCP) Certified Consultant Pharmacist Practice Test

CCP Medication Therapy Management 3