KAPS Patient Assessment and Evaluation 3 — Questions and Answers
Question 1: A pharmacist uses the Cockcroft-Gault equation to estimate creatinine clearance. Which patient characteristic most significantly affects this calculation?
- Age, sex, weight, and serum creatinine (Correct answer)
- Height and blood pressure
- Urine output and serum albumin
- Body surface area and hemoglobin
Correct answer: Age, sex, weight, and serum creatinine
The Cockcroft-Gault equation uses age, sex, weight, and serum creatinine to estimate creatinine clearance for drug dosing.
Question 2: When assessing adherence in a patient with uncontrolled hypertension on amlodipine 10 mg and lisinopril 40 mg, the MOST direct assessment approach is:
- Reviewing pharmacy refill history and using a validated adherence questionnaire (Correct answer)
- Increasing both medications without assessing adherence
- Switching to a combination pill without evaluating current adherence
- Referring the patient to cardiology first
Correct answer: Reviewing pharmacy refill history and using a validated adherence questionnaire
Pharmacy refill records combined with a validated tool like the Morisky scale provide objective and subjective adherence data before escalating therapy.
Question 3: A patient with asthma reports using their albuterol rescue inhaler more than 2 times per week. Based on NAEPP guidelines, this indicates:
- Asthma is not well-controlled and step-up therapy should be evaluated (Correct answer)
- Optimal asthma management with appropriate rescue use
- The patient needs a higher dose albuterol inhaler only
- Rescue inhaler use frequency is not a control indicator
Correct answer: Asthma is not well-controlled and step-up therapy should be evaluated
NAEPP classifies asthma as not well-controlled when rescue inhaler use exceeds 2 days per week, indicating a need for step-up therapy.
Question 4: During patient assessment, a pharmacist notes a patient's total cholesterol is 240 mg/dL, HDL is 35 mg/dL, and LDL is 165 mg/dL. The patient has Type 2 diabetes. Using ACC/AHA guidelines, what is the most appropriate assessment?
- High-intensity statin therapy is indicated due to diabetes as a major ASCVD risk enhancer (Correct answer)
- No statin is needed unless 10-year ASCVD risk exceeds 20%
- Only lifestyle modification is recommended at this LDL level
- Fibrate therapy should be initiated first to target triglycerides
Correct answer: High-intensity statin therapy is indicated due to diabetes as a major ASCVD risk enhancer
ACC/AHA guidelines recommend high-intensity statin therapy for diabetic patients aged 40–75 regardless of LDL level due to elevated ASCVD risk.
Question 5: Which finding on patient assessment is MOST consistent with digoxin toxicity?
- Bradycardia, nausea, vomiting, and yellow-green visual disturbances (Correct answer)
- Tachycardia, dry mouth, urinary retention, and flushing
- Muscle weakness, hyperkalemia, and metabolic alkalosis
- Hypotension, bronchoconstriction, and wheezing
Correct answer: Bradycardia, nausea, vomiting, and yellow-green visual disturbances
Classic digoxin toxicity presents with bradycardia, GI symptoms, and xanthopsia (yellow-green vision), especially when serum levels exceed 2 ng/mL.
Question 6: A pharmacist assessing a patient's pain using the PQRST mnemonic asks about 'T.' What does this represent?
- Timing — when the pain started, how long it lasts, and whether it is constant or intermittent (Correct answer)
- Treatment — medications previously tried for the pain
- Temperature — whether heat or cold changes pain
- Tolerance — patient's self-reported pain threshold
Correct answer: Timing — when the pain started, how long it lasts, and whether it is constant or intermittent
In the PQRST assessment, 'T' stands for Timing, covering onset, duration, and pattern of the pain.
Question 7: A patient on chronic prednisone 20 mg/day presents for a routine assessment. Which monitoring parameter is MOST critical to evaluate?
- Fasting blood glucose and bone density (DEXA) (Correct answer)
- Serum potassium and PT/INR
- Renal function panel and serum iron
- Thyroid function and CBC with differential
Correct answer: Fasting blood glucose and bone density (DEXA)
Chronic corticosteroid use causes hyperglycemia and accelerated bone loss, making glucose and bone density priority monitoring parameters.
KAPS Patient Assessment and Evaluation 3
A pharmacist uses the Cockcroft-Gault equation to estimate creatinine clearance.
Which patient characteristic most significantly affects this calculation?