PEBC Patient Communication 5 — Questions and Answers
Question 1: A pharmacist discovers during counselling that a patient has been combining their prescription opioid with alcohol regularly. The MOST appropriate response includes:
- Reporting the patient to law enforcement immediately
- Providing harm reduction counselling, explaining the risk of CNS/respiratory depression, and involving the care team (Correct answer)
- Refusing to dispense the opioid until the patient stops drinking
- Documenting the disclosure and taking no further action
Correct answer: Providing harm reduction counselling, explaining the risk of CNS/respiratory depression, and involving the care team
Harm reduction counselling and interprofessional collaboration are ethical and effective responses to concurrent opioid and alcohol use.
Question 2: A patient with low health literacy is picking up a complex polypharmacy regimen. Which strategy is MOST effective?
- Provide all written materials at a Grade 12 reading level
- Use plain language, visual aids, and simplified medication schedules; confirm understanding with teach-back (Correct answer)
- Refer the patient to a pharmacist specializing in complex cases
- Read all the prescription labels aloud and ask if the patient has questions
Correct answer: Use plain language, visual aids, and simplified medication schedules; confirm understanding with teach-back
Plain language combined with visual tools and teach-back is the most effective strategy for patients with low health literacy.
Question 3: A patient discloses suicidal thoughts while picking up their antidepressant. The pharmacist's IMMEDIATE priority is to:
- Dispense the medication and call the patient's family
- Assess immediate risk, provide crisis resources, and facilitate urgent care — do not leave the patient alone if in immediate danger (Correct answer)
- Refuse to dispense the medication to prevent overdose
- Tell the patient to call their doctor first thing tomorrow
Correct answer: Assess immediate risk, provide crisis resources, and facilitate urgent care — do not leave the patient alone if in immediate danger
Immediate safety assessment and connection to crisis resources is the first priority when a patient discloses suicidal ideation.
Question 4: A patient asks the pharmacist not to tell their spouse, who is also a patient at the pharmacy, that they are taking HIV medication. The pharmacist should:
- Inform the spouse immediately to protect the household
- Respect the patient's confidentiality, as personal health information cannot be shared without consent (Correct answer)
- Suggest the patient inform their spouse themselves
- Tell the patient the spouse will find out on the pharmacy system
Correct answer: Respect the patient's confidentiality, as personal health information cannot be shared without consent
Patient confidentiality is a fundamental legal and ethical obligation; health information cannot be disclosed to third parties without explicit consent.
Question 5: When counselling a patient on a new statin, the patient says 'I heard these medications destroy your liver.' The BEST pharmacist response is:
- Agree that liver damage is common and suggest they reconsider
- Acknowledge the concern, correct the misconception with evidence, and explain the actual monitoring recommendations (Correct answer)
- Dismiss the concern and redirect to dosing instructions
- Tell the patient to discuss concerns only with their physician
Correct answer: Acknowledge the concern, correct the misconception with evidence, and explain the actual monitoring recommendations
Acknowledging and correcting health misconceptions with evidence builds trust and supports informed medication decisions.
Question 6: Which element is MOST important when documenting a patient counselling interaction in the pharmacy record?
- The duration of the counselling session
- The key information provided, patient's demonstrated understanding, and any follow-up plan (Correct answer)
- The number of refills remaining on the prescription
- The patient's satisfaction rating
Correct answer: The key information provided, patient's demonstrated understanding, and any follow-up plan
Documentation of counselling content, comprehension, and follow-up ensures continuity of care and legal accountability.
Question 7: A patient asks a pharmacist to recommend the 'best' birth control pill for them. The pharmacist's MOST appropriate response is:
- Recommend the cheapest available oral contraceptive
- Explain that pill selection should involve the prescriber, then discuss patient-specific factors such as history, lifestyle, and goals to support shared decision-making (Correct answer)
- State that contraceptive advice is outside pharmacy scope and end the discussion
- Recommend the pill with the fewest side effects for the general population
Correct answer: Explain that pill selection should involve the prescriber, then discuss patient-specific factors such as history, lifestyle, and goals to support shared decision-making
Pharmacists can play a valuable role in contraception counselling by exploring patient-specific factors and facilitating collaborative prescribing decisions.
PEBC Patient Communication 5
A pharmacist discovers during counselling that a patient has been combining their prescription opioid with alcohol regularly.
The MOST appropriate response includes: