STRTP Medication Management and Psychiatric Services 2 — Questions and Answers
Question 1: Which of the following is a key responsibility of STRTP direct care staff regarding medication side effects?
- Adjusting medication doses based on observed side effects without physician input
- Monitoring residents for side effects and promptly reporting concerns to clinical or medical staff (Correct answer)
- Discontinuing medications if a resident complains of discomfort
- Documenting side effects only in the monthly summary report
Correct answer: Monitoring residents for side effects and promptly reporting concerns to clinical or medical staff
Direct care staff must observe residents for potential medication side effects and report any concerns to clinical or medical staff promptly, as early identification can prevent serious harm.
Question 2: What action should STRTP staff take if a resident refuses to take a prescribed medication?
- Force the medication to ensure therapeutic compliance
- Document the refusal, notify clinical staff, and attempt to understand and address the resident's concerns (Correct answer)
- Discharge the resident for non-compliance
- Substitute an over-the-counter alternative without physician approval
Correct answer: Document the refusal, notify clinical staff, and attempt to understand and address the resident's concerns
Medication refusal must be documented, clinical staff notified, and efforts made to understand the resident's concerns, as residents retain the right to refuse treatment absent specific legal override.
Question 3: In an STRTP, polypharmacy concerns are addressed by ensuring that:
- All residents receive a standard medication protocol regardless of individual diagnosis
- The prescribing psychiatrist regularly reviews the necessity and interactions of each medication in the regimen (Correct answer)
- Medications from multiple prescribers are combined without cross-checking
- Families select which medications the resident will receive
Correct answer: The prescribing psychiatrist regularly reviews the necessity and interactions of each medication in the regimen
Regular psychiatric review of the full medication regimen is essential to identify unnecessary medications, duplications, or harmful drug interactions that constitute polypharmacy risks.
Question 4: What must an STRTP do with medications when a resident is discharged?
- Dispose of all medications regardless of their status
- Return unused medications to the resident or their authorized representative and document the transfer (Correct answer)
- Keep all medications for future residents with similar diagnoses
- Transfer medications directly to the next placement without notifying the resident
Correct answer: Return unused medications to the resident or their authorized representative and document the transfer
Upon discharge, STRTPs must return unused medications to the resident or authorized representative and document this transfer to maintain continuity of care and medication accountability.
Question 5: Which personnel in an STRTP is legally authorized to administer prescription medications in California?
- Any adult staff member who has received informal on-the-job training
- Licensed nurses, physicians, or staff with documented training per a physician's delegation order (Correct answer)
- Only the program director after reviewing the medication
- Any staff member holding a CPR certification
Correct answer: Licensed nurses, physicians, or staff with documented training per a physician's delegation order
In California, prescription medications must be administered by licensed health professionals or by trained, qualified staff operating under a valid physician delegation order per applicable regulations.
Question 6: A resident in an STRTP is prescribed a new antipsychotic medication. Which clinical action should occur before the medication is started?
- Baseline physical and metabolic assessment to identify pre-existing conditions (Correct answer)
- A 90-day observation period with no medication
- Approval from the resident's school district
- Review of the medication cost with the county billing department
Correct answer: Baseline physical and metabolic assessment to identify pre-existing conditions
A baseline physical and metabolic assessment (including weight, blood pressure, and labs) should be completed before initiating antipsychotic medication to monitor for metabolic side effects and establish reference points.
Question 7: What is the purpose of maintaining a 'controlled substance log' in an STRTP?
- To track all scheduled (controlled) medications and account for every dose dispensed, administered, or wasted (Correct answer)
- To record only medications that residents have refused
- To document the purchase price of medications for billing
- To list medications available for PRN use only
Correct answer: To track all scheduled (controlled) medications and account for every dose dispensed, administered, or wasted
A controlled substance log provides an accurate count of every scheduled medication, ensuring accountability and detecting any diversion, theft, or discrepancies in medication inventory.
STRTP Medication Management and Psychiatric Services 2
Which of the following is a key responsibility of STRTP direct care staff regarding medication side effects?