CCP Patient Assessment and Monitoring 2

Question 1

An 82-year-old nursing home resident has a serum creatinine of 0.7 mg/dL. Which method is most appropriate for estimating her renal function for drug dosing?

Accepted Answer

Apply the Cockcroft-Gault equation using actual body weight

Answer

Use raw serum creatinine as a marker of normal renal function

Answer

Use the CKD-EPI equation alone without adjusting for low muscle mass

Answer

Assume normal renal function since creatinine is within normal range

Question 2

A consultant pharmacist reviews a patient's medication list and finds duplicate therapy with two ACE inhibitors prescribed by different providers. What is the best initial action?

Accepted Answer

Contact the prescribers to clarify intent and reconcile the medication list

Answer

Discontinue both and start an ARB

Answer

Continue both since ACE inhibitors have complementary mechanisms

Answer

Add a potassium supplement to counteract hyperkalemia risk

Question 3

Which validated tool is specifically designed to screen for depression in elderly patients in long-term care settings?

Accepted Answer

Geriatric Depression Scale (GDS)

Answer

PHQ-9

Answer

Beck Depression Inventory

Answer

Columbia Suicide Severity Rating Scale

Question 4

A patient receiving warfarin has an INR of 4.8 with no signs of bleeding. What is the most appropriate pharmacist recommendation?

Accepted Answer

Hold warfarin for 1-2 doses and recheck INR

Answer

Administer vitamin K 10 mg IV immediately

Answer

Continue current dose and recheck INR in 1 week

Answer

Switch to direct oral anticoagulant immediately

Question 5

Which of the following best describes the purpose of a comprehensive medication review (CMR) in the Medicare Part D Medication Therapy Management program?

Accepted Answer

To conduct a structured, interactive patient interview to optimize drug therapy

Answer

To audit pharmacy billing practices

Answer

To identify medications eligible for generic substitution only

Answer

To verify that all prescriptions are covered under the patient's formulary

Question 6

A nursing home patient on long-term opioid therapy for chronic pain appears sedated and has a respiratory rate of 10 breaths/min. What is the consultant pharmacist's priority assessment?

Accepted Answer

Assess for opioid toxicity and consider naloxone administration

Answer

Check for constipation as the cause of sedation

Answer

Increase the opioid dose to improve pain control

Answer

Order a sleep study to evaluate for sleep apnea

Question 7

When monitoring a patient on methotrexate for rheumatoid arthritis, which laboratory finding would indicate the need to hold the medication?

Accepted Answer

ALT three times the upper limit of normal

Answer

Serum albumin of 3.8 g/dL

Answer

Hemoglobin of 12.5 g/dL

Answer

Creatinine clearance of 55 mL/min