The “Test and Treat” model represents a significant advancement in pharmacy practice, empowering pharmacists to improve public health by providing accessible care for common conditions. This involves using point-of-care tests to screen patients and, under established protocols, initiating treatment. For PharmD students, understanding the clinical, regulatory, and practical aspects of these services is crucial. This quiz will test your knowledge of the conditions, diagnostic tests, and practice framework for pharmacist-led test and treat programs.
1. A pharmacist-led “test and treat” service for common conditions is an example of:
- A traditional dispensing function.
- An expanded scope of practice aimed at improving public access to care.
- A service only available in hospitals.
- A violation of pharmacy law in all states.
Answer: An expanded scope of practice aimed at improving public access to care.
2. The legal authority for a pharmacist to initiate treatment after a positive test result is typically granted through a:
- Verbal agreement with a local physician.
- Patient’s request.
- Statewide protocol or a collaborative practice agreement (CPA).
- Manufacturer’s coupon.
Answer: Statewide protocol or a collaborative practice agreement (CPA).
3. The point-of-care tests used in these programs, such as rapid flu or strep tests, are generally:
- Highly complex tests requiring a full laboratory.
- Regulated under the Clinical Laboratory Improvement Amendments (CLIA) as “waived” tests.
- Known for having perfect accuracy.
- Developed and sold by pharmacy benefit managers.
Answer: Regulated under the Clinical Laboratory Improvement Amendments (CLIA) as “waived” tests.
4. A diagnostic test’s ability to correctly identify patients who have the disease (e.g., true positives) is known as its:
- Specificity
- Sensitivity
- Positive Predictive Value
- Negative Predictive Value
Answer: Sensitivity
5. A patient presents with a sore throat, fever, and swollen lymph nodes. A rapid antigen detection test (RADT) for Group A Streptococcus is performed. This is the “_____” part of “test and treat.”
- Test
- Treat
- Triage
- Transfer
Answer: Test
6. If a patient’s rapid strep test is positive, which of the following is the first-line antibiotic treatment for an adult with no allergies?
- Azithromycin
- Ciprofloxacin
- Penicillin or amoxicillin
- Doxycycline
Answer: Penicillin or amoxicillin
7. A patient tests positive for influenza A and presents within 36 hours of symptom onset. Which of the following would be an appropriate treatment to initiate under a protocol?
- Amoxicillin
- Oseltamivir
- Prednisone
- Albuterol inhaler
Answer: Oseltamivir
8. An important part of any test and treat program is establishing clear exclusion criteria. An example of a patient who should be referred to a physician instead of being treated by the pharmacist is:
- A healthy 30-year-old with classic flu symptoms.
- A pregnant patient with symptoms of a urinary tract infection.
- A 10-year-old child with a sore throat.
- An adult patient requesting a flu shot.
Answer: A pregnant patient with symptoms of a urinary tract infection.
9. The ability of a diagnostic test to correctly identify patients who do not have the disease (e.g., true negatives) is its:
- Sensitivity
- Predictive Value
- Accuracy
- Specificity
Answer: Specificity
10. Before performing any point-of-care test, what is the first crucial step a pharmacist must take with the patient?
- Collect payment for the test.
- Obtain informed consent from the patient.
- Swab the patient’s nose or throat.
- Prepare the prescription for a positive result.
Answer: Obtain informed consent from the patient.
11. Advocating for legislation that expands pharmacists’ scope of practice to include test and treat authority is a form of:
- Patient advocacy
- Professional advocacy
- Public health advocacy
- All of the above
Answer: All of the above
12. The primary public health benefit of accessible pharmacist-led test and treat services for influenza is:
- Increased sales of antiviral medications.
- Early initiation of treatment, which can reduce symptom duration and prevent further spread.
- Reduced workload for physicians.
- Higher profits for pharmacies.
Answer: Early initiation of treatment, which can reduce symptom duration and prevent further spread.
13. Which of the following is a common CLIA-waived test that could be part of a pharmacist-led service?
- MRI Scan
- Blood glucose and A1c checks
- Complete blood count with differential
- Surgical biopsy
Answer: Blood glucose and A1c checks
14. A pharmacist uses the SCHOLAR-MAC method to interview a patient presenting with cough and cold symptoms. This is part of which step in the patient care process?
- Plan
- Implement
- Collect
- Follow-up
Answer: Collect
15. Proper documentation of a test and treat encounter, often in a SOAP note format, is critical for:
- Ensuring continuity of care and communication with the patient’s other providers.
- Justifying the pharmacist’s clinical decisions.
- Billing and reimbursement.
- All of the above.
Answer: All of the above.
16. Rapid Influenza Diagnostic Tests (RIDTs) are known to have variable:
- Cost, depending on the pharmacy.
- Colors, which indicate the strain.
- Sensitivity, meaning false negatives can occur, especially outside of peak flu season.
- Routes of administration.
Answer: Sensitivity, meaning false negatives can occur, especially outside of peak flu season.
17. What is the primary goal of treating Group A Streptococcal pharyngitis with antibiotics?
- To shorten the duration of symptoms by 1-2 days.
- To prevent the spread of the infection to others.
- To prevent the complication of acute rheumatic fever.
- All of the above.
Answer: All of the above.
18. A key operational component for a pharmacy to offer test and treat services is:
- A large waiting area.
- A private or semi-private space for patient consultation and testing.
- A drive-thru window.
- An automated dispensing machine.
Answer: A private or semi-private space for patient consultation and testing.
19. A pharmacist providing test and treat services for uncomplicated cystitis (UTI) in women would screen for “alarm symptoms” that require referral, such as:
- Mild dysuria and increased frequency.
- Fever, flank pain, and nausea/vomiting.
- A positive urine dipstick test for leukocyte esterase.
- A history of a previous UTI.
Answer: Fever, flank pain, and nausea/vomiting.
20. A patient’s “scope of practice,” which dictates whether they can legally provide test and treat services, is determined by:
- Federal law
- State law and regulations
- Their employer’s policies
- Their years of experience
Answer: State law and regulations
21. A patient tests negative for both flu and strep but has significant symptoms. The “treat” part of the encounter may involve:
- Prescribing an antibiotic just in case.
- Recommending appropriate over-the-counter products for symptom relief.
- Telling the patient there is nothing that can be done.
- Referring the patient to the emergency room.
Answer: Recommending appropriate over-the-counter products for symptom relief.
22. Running quality control checks on point-of-care testing equipment is a critical step to:
- Ensure the accuracy and reliability of the test results.
- Calibrate the machine’s screen brightness.
- Order more testing supplies.
- Clean the exterior of the device.
Answer: Ensure the accuracy and reliability of the test results.
23. Which of the following is an example of a “false positive” test result?
- The test is positive, and the patient truly has the disease.
- The test is negative, and the patient does not have the disease.
- The test is positive, but the patient does not actually have the disease.
- The test is negative, but the patient actually has the disease.
Answer: The test is positive, but the patient does not actually have the disease.
24. After treating a patient for strep throat, an important counseling point is:
- To stop the antibiotic as soon as their throat feels better.
- To complete the entire course of antibiotics to ensure eradication of the bacteria.
- That the antibiotic will also cure any viral infections they have.
- To share the antibiotic with family members who also have a sore throat.
Answer: To complete the entire course of antibiotics to ensure eradication of the bacteria.
25. A pharmacist documents a test and treat encounter in the patient’s profile and sends a notification to their primary care provider. This practice supports:
- Patient privacy violations.
- Continuity of care and interprofessional collaboration.
- Increased pharmacy profits.
- A reduction in pharmacist workload.
Answer: Continuity of care and interprofessional collaboration.
26. The APhA’s advocacy efforts for provider status are critical for the sustainability of test and treat services because they would:
- Allow pharmacists to bill payers for the clinical assessment and management involved.
- Make all point-of-care tests free.
- Eliminate the need for collaborative practice agreements.
- Give pharmacists the authority to prescribe all medications.
Answer: Allow pharmacists to bill payers for the clinical assessment and management involved.
27. A major benefit of test and treat services from a patient’s perspective is:
- The opportunity to receive a definitive diagnosis.
- The high cost of the service.
- The long wait times compared to a doctor’s office.
- Increased convenience and timely access to care.
Answer: Increased convenience and timely access to care.
28. An understanding of biostatistics is essential for a pharmacist offering test and treat services in order to:
- Properly interpret the performance characteristics (sensitivity/specificity) of the diagnostic tests they use.
- Manage the pharmacy’s budget.
- Counsel on over-the-counter medications.
- Perform sterile compounding.
Answer: Properly interpret the performance characteristics (sensitivity/specificity) of the diagnostic tests they use.
29. The “treat” decision in a test and treat model should always be based on:
- The patient’s request for a specific antibiotic.
- Current, evidence-based clinical guidelines and the specific patient’s presentation.
- Whichever antibiotic is cheapest.
- The drug that is closest to its expiration date.
Answer: Current, evidence-based clinical guidelines and the specific patient’s presentation.
30. Before initiating a test and treat service, a pharmacy should have a clear protocol for:
- Identifying eligible patients.
- Documenting encounters.
- Referring patients with alarm symptoms or exclusion criteria.
- All of the above.
Answer: All of the above.
31. The primary role of a collaborative practice agreement (CPA) is to:
- Define the terms of a research study.
- Outline the specific conditions, medications, and activities a pharmacist is authorized to perform in conjunction with a physician.
- Serve as a contract between a pharmacy and a drug wholesaler.
- Prevent pharmacists from communicating with physicians.
Answer: Outline the specific conditions, medications, and activities a pharmacist is authorized to perform in conjunction with a physician.
32. What is a key counseling point for a patient receiving oseltamivir for influenza?
- The medication will cure them instantly.
- The medication is most effective when started within 48 hours of symptom onset and may shorten the duration of illness.
- It can be taken at any point during the illness with the same effect.
- The most common side effect is hypertension.
Answer: The medication is most effective when started within 48 hours of symptom onset and may shorten the duration of illness.
33. The development of these advanced services demonstrates a shift in the pharmacy profession’s focus towards:
- A purely product-based model.
- A more active role in public health and direct patient care.
- A reduction in pharmacist training.
- An elimination of dispensing services.
Answer: A more active role in public health and direct patient care.
34. The “Positive Predictive Value” of a test is highly dependent on the:
- Cost of the test.
- Specificity of the test.
- Prevalence of the disease in the population being tested.
- Brand name of the test kit.
Answer: Prevalence of the disease in the population being tested.
35. A pharmacist providing a test and treat service must be competent in:
- Patient assessment skills.
- Interpreting diagnostic tests.
- Pharmacotherapy for the specified conditions.
- All of the above.
Answer: All of the above.
36. Why is it important to differentiate between viral and bacterial pharyngitis?
- They are treated with the same medications.
- Antibiotics are effective for bacterial infections like strep throat but are ineffective against viruses.
- Viral infections are more serious than bacterial infections.
- A RADT can detect both viruses and bacteria.
Answer: Antibiotics are effective for bacterial infections like strep throat but are ineffective against viruses.
37. A key leadership practice for implementing a new test and treat service in a pharmacy is:
- To surprise the staff with the new workflow on the first day.
- To create a compelling vision and get buy-in from the entire pharmacy team.
- To assume the service will run perfectly without any planning.
- To delegate the entire implementation to a student pharmacist.
Answer: To create a compelling vision and get buy-in from the entire pharmacy team.
38. Which of the following conditions is generally NOT a target for community pharmacy test and treat programs due to its complexity?
- Influenza
- Group A Streptococcus
- Uncomplicated urinary tract infection
- Community-acquired pneumonia
Answer: Community-acquired pneumonia
39. A pharmacist’s ability to triage a patient appropriately means:
- Treating every patient who walks in the door.
- Correctly identifying patients who can be safely managed with the test and treat service versus those who need a higher level of care.
- Sending all patients with a cough to the emergency room.
- Only testing patients who have insurance.
Answer: Correctly identifying patients who can be safely managed with the test and treat service versus those who need a higher level of care.
40. To ensure the quality of a specimen for a rapid strep test, the pharmacist must:
- Swab the patient’s cheek.
- Swab both the tonsils and the posterior pharynx without touching the tongue.
- Allow the patient to perform the swab on themselves.
- Use a blood sample.
Answer: Swab both the tonsils and the posterior pharynx without touching the tongue.
41. The final step after any test and treat encounter should be:
- Discarding all documentation.
- Telling the patient to schedule a follow-up visit if their symptoms do not improve or worsen.
- Assuming the patient is cured.
- Calling the patient every day for a week.
Answer: Telling the patient to schedule a follow-up visit if their symptoms do not improve or worsen.
42. The “A” in a SOAP note for a test and treat encounter would include:
- The patient’s chief complaint.
- The result of the point-of-care test.
- The pharmacist’s assessment of the condition (e.g., “Positive for Group A Strep”).
- The prescription that was initiated.
Answer: The pharmacist’s assessment of the condition (e.g., “Positive for Group A Strep”).
43. A pharmacist’s understanding of pathophysiology is critical for test and treat services to:
- Understand the disease process and differentiate between various conditions.
- Bill for the service correctly.
- Perform quality control on the test kit.
- Counsel on the price of the medication.
Answer: Understand the disease process and differentiate between various conditions.
44. A major reason for the push to expand test and treat services is to:
- Increase the number of prescriptions for antibiotics.
- Reduce the burden on primary care offices and emergency departments for common, treatable conditions.
- Allow pharmacists to practice medicine without a license.
- Increase the sales of OTC products.
Answer: Reduce the burden on primary care offices and emergency departments for common, treatable conditions.
45. If a rapid flu test is negative, but clinical suspicion is high, what might a protocol allow?
- Prescribing oseltamivir anyway based on clinical judgment.
- Sending the patient home with no treatment or advice.
- Telling the patient the test is 100% accurate and they do not have the flu.
- Prescribing a broad-spectrum antibiotic.
Answer: Prescribing oseltamivir anyway based on clinical judgment.
46. A certificate training program for test and treat provides pharmacists with:
- The legal authority to prescribe.
- A foundational knowledge base and skills assessment needed to perform the service competently.
- A guaranteed increase in salary.
- A lifetime supply of test kits.
Answer: A foundational knowledge base and skills assessment needed to perform the service competently.
47. From a managed care perspective, payers may be interested in covering test and treat services if they:
- Are shown to be cost-effective by preventing more serious downstream complications or costly ER visits.
- Are more expensive than a traditional doctor’s visit.
- Result in more antibiotic prescriptions.
- Have no impact on patient outcomes.
Answer: Are shown to be cost-effective by preventing more serious downstream complications or costly ER visits.
48. What is a key professional skill needed for a pharmacist providing these services?
- Strong clinical assessment and decision-making skills.
- The ability to work completely alone.
- Fast dispensing speed.
- Expertise in inventory management.
Answer: Strong clinical assessment and decision-making skills.
49. Communicating the results of a test to a patient requires:
- Using complex medical terms.
- Providing the result without any context or explanation.
- Clear, empathetic communication about what the result means and the next steps.
- A written report only.
Answer: Clear, empathetic communication about what the result means and the next steps.
50. The ‘treat’ component of the model is fundamentally an application of which pharmacist skill?
- Compounding
- Evidence-based pharmacotherapy
- Inventory management
- Marketing
Answer: Evidence-based pharmacotherapy
I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.
Mail- Sachin@pharmacyfreak.com