MTM Chronic Disease Management 3

Question 1

A patient with rheumatoid arthritis on methotrexate reports new onset of cough and shortness of breath. The pharmacist's FIRST concern should be:

Accepted Answer

Methotrexate-induced pneumonitis requiring immediate evaluation

Answer

Methotrexate-induced pneumonitis is a serious, potentially life-threatening adverse effect that must be ruled out whenever a patient on MTX develops new respiratory symptoms.

Question 2

Which self-monitoring goal for fasting blood glucose is recommended by the ADA for most non-pregnant adults with diabetes?

Accepted Answer

80–130 mg/dL

Answer

ADA Standards of Care recommend a fasting/preprandial glucose target of 80–130 mg/dL for most non-pregnant adults with diabetes.

Question 3

A 68-year-old patient with COPD and atrial fibrillation requires anticoagulation. Which factor should be assessed before prescribing a DOAC?

Accepted Answer

Creatinine clearance to determine appropriate dosing

Answer

DOACs require dose adjustment or are contraindicated in severe renal impairment, so creatinine clearance must be calculated before initiation and monitored periodically.

Question 4

In patients with chronic heart failure, daily weight monitoring is recommended to detect:

Accepted Answer

Fluid retention indicating potential decompensation

Answer

A weight gain of 2–3 pounds overnight or 5 pounds in a week signals fluid accumulation and possible decompensation, prompting early intervention.

Question 5

Which oral diabetes medication should be held 24–48 hours before and after administration of iodinated contrast media?

Accepted Answer

Metformin

Answer

Metformin is held around iodinated contrast procedures because contrast-induced nephropathy can reduce metformin clearance, increasing the risk of lactic acidosis.

(MTM) Medication Therapy Management Board Certification Practice Test

(MTM) Medication Therapy Management Board Certification Practice Test

MTM Chronic Disease Management 3