Drug therapy review basics MCQs With Answer

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

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