Drug therapy review basics MCQs With Answer
Introduction: Drug therapy review is a core clinical pharmacy practice skill that combines pharmacotherapy knowledge, patient assessment, and evidence-based resources to optimize medication use. This set of MCQs is designed for M.Pharm students to deepen understanding of the systematic process of reviewing medications — including identification of drug-related problems, medication reconciliation at transitions of care, prioritization of interventions, monitoring parameters, and use of clinical decision support tools. Questions emphasize critical thinking applied to real-world scenarios and guidelines (e.g., Beers, STOPP/START), documentation, interprofessional communication, and strategies to improve adherence and safety. Use these to self-assess and reinforce applied competencies.
Q1. Which of the following best describes the first step in a structured drug therapy review?
- Assessing laboratory values for toxicity
- Collecting an accurate and complete medication history
- Making therapeutic recommendations to the prescriber
- Documenting the review in the patient record
Correct Answer: Collecting an accurate and complete medication history
Q2. Which framework is commonly used to categorize drug-related problems (DRPs) during a medication review?
- SWOT analysis
- Hepler–Strand classification
- ABCDE mnemonic
- GOLD criteria
Correct Answer: Hepler–Strand classification
Q3. During a drug therapy review, which assessment question specifically addresses medication effectiveness?
- Is there a valid indication for the drug?
- Is the patient adherent to the prescribed regimen?
- Is the drug achieving the therapeutic goal for this patient?
- Are there any clinically significant drug interactions?
Correct Answer: Is the drug achieving the therapeutic goal for this patient?
Q4. Medication reconciliation is most important at which transition point?
- Annual wellness visit when nothing changes
- Admission to hospital, transfer between units, and hospital discharge
- Only when the patient reports side effects
- When new laboratory results are available
Correct Answer: Admission to hospital, transfer between units, and hospital discharge
Q5. Which resource offers evidence-graded therapeutic recommendations and is frequently used in drug therapy review?
- Local newspaper health columns
- Randomized blog posts
- UpToDate, Cochrane reviews, and clinical guidelines
- Patient social media comments
Correct Answer: UpToDate, Cochrane reviews, and clinical guidelines
Q6. Which of the following is a primary goal when identifying adverse drug reactions (ADRs) during a review?
- Determine the cost of therapy
- Establish causality and modify therapy to reduce harm
- Switch all medications to generics
- Increase dosing frequencies
Correct Answer: Establish causality and modify therapy to reduce harm
Q7. Which criterion set is specifically intended to identify potentially inappropriate medications in older adults?
- Framingham Risk Score
- Beers Criteria and STOPP/START criteria
- Ranson’s criteria
- Child-Pugh score
Correct Answer: Beers Criteria and STOPP/START criteria
Q8. In prioritizing interventions after identifying multiple DRPs, which factor is most important?
- Medication acquisition cost
- Severity and preventability of patient harm
- Number of tablets per prescription
- Patient’s preference for pill color
Correct Answer: Severity and preventability of patient harm
Q9. Which monitoring parameter is most appropriate for a patient on warfarin therapy?
- Serum creatinine only
- Prothrombin time / INR
- Blood glucose
- Serum digoxin level
Correct Answer: Prothrombin time / INR
Q10. When evaluating adherence during a drug therapy review, which technique provides objective evidence?
- Patient’s verbal claim of perfect adherence
- Medication refill records and pill counts
- Assuming adherence because therapy is necessary
- Relying solely on prescriber notes
Correct Answer: Medication refill records and pill counts
Q11. Which statement best describes therapeutic duplication identified in a medication review?
- Two drugs from different classes used for different indications
- Two or more drugs from the same therapeutic class or with similar effects used concurrently without justification
- Switching brand to generic equivalent
- Combining complementary supplements as recommended
Correct Answer: Two or more drugs from the same therapeutic class or with similar effects used concurrently without justification
Q12. Which clinical decision support tool feature most reduces prescribing errors during a medication review?
- Non-specific alerts that appear constantly
- Contextualized drug–drug interaction and allergy alerts with actionable guidance
- Alerts that only show after prescription is finalized
- Design that requires manual searching for interactions
Correct Answer: Contextualized drug–drug interaction and allergy alerts with actionable guidance
Q13. When performing a renal dose assessment, which patient parameter is most critical?
- Height only
- Estimated creatinine clearance or eGFR
- Systolic blood pressure
- Age without renal function estimate
Correct Answer: Estimated creatinine clearance or eGFR
Q14. Which documentation element is essential after making a clinical recommendation in a drug therapy review?
- Only verbal communication; no record needed
- Clear description of the problem, rationale, recommended action, and follow-up plan
- Just the drug name and dosage
- Patient’s marital status
Correct Answer: Clear description of the problem, rationale, recommended action, and follow-up plan
Q15. For therapeutic drug monitoring (TDM), which characteristic best justifies routine monitoring?
- Wide therapeutic index and no toxicity concerns
- Narrow therapeutic index, known concentration–response relationship, and available reliable assay
- Medication used for occasional symptomatic relief
- Medication with negligible interpatient variability
Correct Answer: Narrow therapeutic index, known concentration–response relationship, and available reliable assay
Q16. Which approach best helps resolve clinically significant drug–drug interactions found during a review?
- Ignore the interaction if the patient tolerates both drugs
- Assess clinical relevance, consider alternative agents or dose adjustments, and communicate with prescriber
- Automatically discontinue all interacting drugs
- Advise the patient to stop one medication without consulting prescriber
Correct Answer: Assess clinical relevance, consider alternative agents or dose adjustments, and communicate with prescriber
Q17. Which is the most appropriate way to detect a potential adverse drug reaction during review?
- Rely solely on spontaneous reporting systems
- Integrate patient symptoms, temporal relationship, dechallenge/rechallenge information, and known drug profiles
- Only check for interactions in older formularies
- Assume all new symptoms are disease progression
Correct Answer: Integrate patient symptoms, temporal relationship, dechallenge/rechallenge information, and known drug profiles
Q18. Which metric is useful to prioritize patients for comprehensive drug therapy review in a hospital setting?
- Random selection without criteria
- Polypharmacy, high-risk medications, renal impairment, recent hospitalization, and multiple prescribers
- Only those with the shortest length of stay
- Lowest medication count
Correct Answer: Polypharmacy, high-risk medications, renal impairment, recent hospitalization, and multiple prescribers
Q19. Which statement reflects an evidence-based strategy to improve medication adherence identified during a review?
- Prescribe the most expensive formulation to increase perceived value
- Simplify the regimen, use adherence aids, provide counselling, and arrange follow-up
- Replace oral therapy with multiple injections
- Provide no education to avoid confusing the patient
Correct Answer: Simplify the regimen, use adherence aids, provide counselling, and arrange follow-up
Q20. Which element is critical when communicating drug therapy review recommendations to the prescriber?
- Use vague language to avoid responsibility
- Provide concise evidence-based rationale, potential benefits/risks, and suggested monitoring or alternatives
- Only send a text message with no context
- Wait several weeks before communicating
Correct Answer: Provide concise evidence-based rationale, potential benefits/risks, and suggested monitoring or alternatives
