MTM Patient Assessment & Care Planning 3 — Questions and Answers
Question 1: A pharmacist reviews a patient's medication list and finds she is taking both warfarin and naproxen. In the care planning process, how should this interaction be classified?
- Needs additional drug therapy
- Adverse drug reaction (Correct answer)
- Wrong drug
- Dosage too high
Correct answer: Adverse drug reaction
Concurrent use of warfarin and NSAIDs like naproxen significantly increases bleeding risk, classifying this as an adverse drug reaction (drug interaction).
Question 2: Which of the following best represents an objective finding documented during a patient assessment?
- Patient reports feeling tired all the time
- Patient states she often forgets to take her evening dose
- Serum creatinine of 1.9 mg/dL obtained from lab report (Correct answer)
- Patient believes her blood pressure medication is causing headaches
Correct answer: Serum creatinine of 1.9 mg/dL obtained from lab report
Objective findings are measurable, verifiable data such as laboratory values, as opposed to patient-reported symptoms.
Question 3: A patient with CKD stage 3 is prescribed metformin at full dose. Using clinical assessment, why is this a concern?
- Metformin causes hyperglycemia in renal impairment
- Metformin is renally cleared and accumulates in CKD, increasing lactic acidosis risk (Correct answer)
- Metformin interacts with potassium in CKD patients
- Metformin is contraindicated in any patient over age 65
Correct answer: Metformin is renally cleared and accumulates in CKD, increasing lactic acidosis risk
Metformin is renally excreted; reduced clearance in CKD leads to drug accumulation and elevated risk of potentially fatal lactic acidosis.
Question 4: When assessing medication adherence during an MTM visit, which approach provides the most comprehensive picture?
- Ask one yes/no question: 'Do you take your medications as prescribed?'
- Use a validated adherence tool, pharmacy refill records, and motivational interviewing (Correct answer)
- Review only the prescription insurance claims data
- Accept the patient's word without further assessment
Correct answer: Use a validated adherence tool, pharmacy refill records, and motivational interviewing
A multi-method approach combining validated tools, refill records, and motivational interviewing yields the most accurate adherence assessment.
Question 5: Which element is essential to include when documenting a drug therapy problem in a patient care plan?
- The pharmacist's personal opinion about the prescriber
- The problem, its cause, and the desired therapeutic outcome (Correct answer)
- The cost of alternative therapies only
- The patient's employment status
Correct answer: The problem, its cause, and the desired therapeutic outcome
A well-documented drug therapy problem includes identification of the problem, the underlying cause, and the specific therapeutic goal to be achieved.
Question 6: A pharmacist determines a patient does not need a medication currently prescribed (e.g., a proton pump inhibitor with no indication). Which drug therapy problem category applies?
- Dosage too high
- Wrong drug
- Unnecessary drug therapy (Correct answer)
- Nonadherence
Correct answer: Unnecessary drug therapy
Prescribing a medication without a valid clinical indication is classified as unnecessary drug therapy.
Question 7: In MTM practice, what is the purpose of conducting a targeted medication review (TMR) compared to a CMR?
- A TMR is a full face-to-face comprehensive review required annually
- A TMR addresses specific medication-related concerns identified between CMRs (Correct answer)
- A TMR replaces the CMR in all MTM programs
- A TMR is performed exclusively by physicians
Correct answer: A TMR addresses specific medication-related concerns identified between CMRs
A TMR is an asynchronous review focused on specific drug therapy problems identified between comprehensive reviews, not a full medication reconciliation.
MTM Patient Assessment & Care Planning 3
A pharmacist reviews a patient's medication list and finds she is taking both warfarin and naproxen.
In the care planning process, how should this interaction be classified?