PEBC Patient Communication 4 — Questions and Answers
Question 1: A patient requests a refill of a benzodiazepine three weeks early. The pharmacist suspects misuse. What is the MOST appropriate first step?
- Dispense the full supply to avoid confrontation
- Have a private, non-judgemental conversation to understand the reason for the early request (Correct answer)
- Refuse dispensing and call the prescriber immediately
- Inform the patient that early refills are never permitted
Correct answer: Have a private, non-judgemental conversation to understand the reason for the early request
A private, empathetic inquiry allows the pharmacist to assess the situation before deciding on the appropriate action.
Question 2: During counselling, a patient repeatedly interrupts the pharmacist with unrelated questions. The BEST technique to refocus the conversation is:
- Stop the counselling session and schedule a callback
- Acknowledge the patient's questions and briefly note them, then return to the key counselling point (Correct answer)
- Ignore the interruptions and continue with the planned counselling
- Ask the patient to write their questions down and come back later
Correct answer: Acknowledge the patient's questions and briefly note them, then return to the key counselling point
Acknowledging concerns before refocusing maintains rapport while keeping the counselling structured.
Question 3: A patient asks whether it is safe to take a herbal supplement alongside their warfarin therapy. The pharmacist should:
- Tell the patient all natural products are safe
- Review the supplement for known warfarin interactions, provide evidence-based information, and recommend follow-up INR monitoring (Correct answer)
- Refuse to discuss herbal products as they are outside pharmacy scope
- Tell the patient to ask their naturopath
Correct answer: Review the supplement for known warfarin interactions, provide evidence-based information, and recommend follow-up INR monitoring
Many herbal products (e.g., St. John's Wort, ginkgo) significantly alter warfarin's anticoagulant effect.
Question 4: Which action BEST demonstrates culturally competent patient communication?
- Treating all patients identically regardless of background
- Asking about cultural or religious practices that may affect medication use and adapting counselling accordingly (Correct answer)
- Avoiding discussion of cultural practices to prevent offence
- Using cultural stereotypes to predict patient needs
Correct answer: Asking about cultural or religious practices that may affect medication use and adapting counselling accordingly
Culturally competent care involves actively exploring individual patient values and adapting communication to meet those needs.
Question 5: A patient using a metered-dose inhaler (MDI) demonstrates incorrect technique. The pharmacist's BEST response is to:
- Note the error in the chart and move on
- Demonstrate correct technique using a placebo inhaler, observe the patient's return demonstration, and provide corrective feedback (Correct answer)
- Tell the patient to watch an online video for instructions
- Contact the prescriber to switch the patient to a different device
Correct answer: Demonstrate correct technique using a placebo inhaler, observe the patient's return demonstration, and provide corrective feedback
Demonstrate-observe-feedback (show-do-review) is the gold standard for inhaler technique education.
Question 6: A patient who is deaf communicates primarily through American Sign Language (ASL). The pharmacist does not know ASL. The MOST appropriate action is to:
- Write all communication on paper and rely solely on written notes
- Arrange for a qualified ASL interpreter and, if unavailable, use a video remote interpreting service (Correct answer)
- Ask a hearing family member to interpret the conversation
- Schedule the patient for a future appointment when an interpreter is available
Correct answer: Arrange for a qualified ASL interpreter and, if unavailable, use a video remote interpreting service
Qualified ASL interpreters or video remote interpreting services ensure accurate medical communication for deaf patients.
Question 7: Which of the following BEST describes the purpose of motivational interviewing (MI) in pharmacy practice?
- To instruct patients on the correct way to take their medication
- To elicit and strengthen a patient's own motivation and commitment to behaviour change (Correct answer)
- To identify patients who are non-compliant and document refusals
- To provide standardized medication information efficiently
Correct answer: To elicit and strengthen a patient's own motivation and commitment to behaviour change
Motivational interviewing is a collaborative, patient-centred approach that helps patients explore and resolve ambivalence about change.
PEBC Patient Communication 4
A patient requests a refill of a benzodiazepine three weeks early.
The pharmacist suspects misuse.
What is the MOST appropriate first step?