As future pharmacists, managing the medication of psychiatric patients goes beyond understanding pharmacology; it requires a deep appreciation for the behavioral challenges that impact treatment. This quiz explores the critical concepts surrounding behavioral issues in psychiatric care, a key topic in the Patient Care curriculum. Questions will cover topics such as the behavioral challenges to successful treatment, communication with patients in crisis, the impact of health disparities, and the pharmacist’s role in promoting adherence and safety. Developing skills in these areas is essential for delivering effective, patient-centered care and collaborating as a member of an interprofessional team.
1. Which of the following is a common behavioral challenge to successful treatment in patients with psychiatric illnesses?
- A. Medication non-adherence
- B. Over-enthusiasm for complex regimens
- C. Refusal to accept a diagnosis
- D. Both A and C
Answer: D. Both A and C
2. A key transcending concept in patient care involves communicating with patients who have mental health problems, which includes specific strategies for:
- A. Talking about the cost of medications only.
- B. Working with patients in crisis and discussing suicide.
- C. Avoiding all direct questions about mood.
- D. Sharing personal stories to build rapport.
Answer: B. Working with patients in crisis and discussing suicide.
3. Anosognosia, the lack of insight into one’s own illness, is a significant behavioral barrier to treatment adherence primarily associated with which type of disorder?
- A. Anxiety disorders
- B. Somatic symptom disorders
- C. Psychotic spectrum disorders
- D. Sleep-wake disorders
Answer: C. Psychotic spectrum disorders
4. When a pharmacist is “Working with Patients in Crisis,” what is a primary objective of their communication?
- A. To solve all of the patient’s life problems.
- B. To ensure the patient takes their medication immediately.
- C. To de-escalate the situation and ensure the patient’s immediate safety.
- D. To obtain a complete medication history for the record.
Answer: C. To de-escalate the situation and ensure the patient’s immediate safety.
5. Social and health disparities can be a major behavioral factor in psychiatric care. These disparities can impact:
- A. Access to care
- B. Stigma associated with mental illness
- C. Quality of care received
- D. All of the above
Answer: D. All of the above
6. A patient with schizophrenia frequently forgets to take their medication. This is an example of which type of behavioral issue affecting treatment?
- A. Intentional non-adherence
- B. Unintentional non-adherence
- C. A pharmacological side effect
- D. A drug-drug interaction
Answer: B. Unintentional non-adherence
7. Displaying empathy and using open-ended questions are communication techniques that help a pharmacist to:
- A. Make the consultation go faster.
- B. Establish a therapeutic relationship and gather better information.
- C. Avoid discussing difficult topics.
- D. Assert authority over the patient.
Answer: B. Establish a therapeutic relationship and gather better information.
8. Which of the following is a “red flag” behavior that might indicate prescription drug misuse?
- A. Asking appropriate questions about side effects.
- B. Requesting early refills multiple times.
- C. Picking up a prescription on the day it is due.
- D. Using a mail-order pharmacy.
Answer: B. Requesting early refills multiple times.
9. Stigma associated with psychiatric illness can lead to what patient behavior?
- A. Eagerness to discuss their condition publicly.
- B. A delay in seeking treatment.
- C. Perfect medication adherence.
- D. Increased engagement with healthcare providers.
Answer: B. A delay in seeking treatment.
10. A patient states, “I don’t need this medication anymore, I feel fine.” This statement represents a behavioral challenge related to:
- A. A lack of understanding about the chronic nature of their illness.
- B. A drug-seeking behavior.
- C. A side effect of the medication.
- D. A desire for a more expensive treatment.
Answer: A. A lack of understanding about the chronic nature of their illness.
11. Motivational interviewing is a communication technique that can help manage behavioral issues by:
- A. Arguing with the patient to prove they are wrong.
- B. Helping the patient explore and resolve their own ambivalence about change.
- C. Providing a list of reasons why the patient must change.
- D. Using scare tactics to force adherence.
Answer: B. Helping the patient explore and resolve their own ambivalence about change.
12. A patient with depression also has a substance use disorder. This co-occurrence is an example of:
- A. A rare clinical situation.
- B. A common comorbidity that complicates treatment.
- C. A contraindication to all antidepressant therapy.
- D. An issue best ignored by the pharmacist.
Answer: B. A common comorbidity that complicates treatment.
13. When managing behavioral issues, it is critical for a pharmacist to embody professional attitudes, values, and behaviors. This includes:
- A. Sharing patient information with friends and family.
- B. Maintaining appropriate professional boundaries.
- C. Judging the patient for their lifestyle choices.
- D. Arguing with the patient if they disagree with the treatment plan.
Answer: B. Maintaining appropriate professional boundaries.
14. A patient is prescribed a long-acting injectable antipsychotic. The primary behavioral issue this formulation is designed to address is:
- A. Fear of needles.
- B. Medication non-adherence.
- C. First-pass metabolism.
- D. Drug-food interactions.
Answer: B. Medication non-adherence.
15. If a pharmacist suspects a patient is in immediate suicidal crisis, what is the most important first step?
- A. Ask them to come back tomorrow.
- B. Ensure the patient is in a safe place and get immediate help (e.g., call 911 or a crisis line).
- C. Dispense a one-day supply of their medication.
- D. Document the conversation and do nothing else.
Answer: B. Ensure the patient is in a safe place and get immediate help (e.g., call 911 or a crisis line).
16. The “pharmacist’s corresponding responsibility” for controlled substance prescriptions involves evaluating the prescription for legitimacy. This requires assessing for behavioral red flags for:
- A. Therapeutic appropriateness only.
- B. Potential diversion or abuse.
- C. Cost-effectiveness.
- D. The patient’s insurance coverage.
Answer: B. Potential diversion or abuse.
17. A patient being treated for depression reports they have started using St. John’s Wort. This behavior is a concern because of:
- A. The high cost of the supplement.
- B. The potential for drug-drug interactions (e.g., serotonin syndrome).
- C. The lack of availability.
- D. The fact it is not an approved medication.
Answer: B. The potential for drug-drug interactions (e.g., serotonin syndrome).
18. What is a key behavioral issue related to the side effects of second-generation antipsychotics like olanzapine?
- A. Patients often enjoy the side effects.
- B. The side effects are not noticeable.
- C. Weight gain and metabolic changes can lead to non-adherence.
- D. They cause less sedation than older agents.
Answer: C. Weight gain and metabolic changes can lead to non-adherence.
19. A patient’s cultural beliefs about mental illness may lead them to:
- A. Prefer medication over all other treatments.
- B. Be more open to discussing their symptoms.
- C. Have different explanations for their symptoms and prefer traditional or family-based support.
- D. Always adhere perfectly to the prescribed regimen.
Answer: C. Have different explanations for their symptoms and prefer traditional or family-based support.
20. A caregiver for a patient with Alzheimer’s disease reports the patient is “spitting out” their pills. This is an example of a behavioral issue that could be managed by:
- A. Increasing the dose of the current medication.
- B. Switching to a different dosage form, like a patch or liquid.
- C. Discontinuing the medication.
- D. Admonishing the patient.
Answer: B. Switching to a different dosage form, like a patch or liquid.
21. A patient with a history of substance abuse reports their pain medication was stolen and requests an early refill. This behavior requires the pharmacist to:
- A. Refill the prescription immediately without any questions.
- B. Refuse the refill and discharge the patient from the pharmacy.
- C. Exercise due diligence, verify the patient’s story where possible, and communicate with the prescriber.
- D. Tell the patient to purchase the medication illegally.
Answer: C. Exercise due diligence, verify the patient’s story where possible, and communicate with the prescriber.
22. De-escalation of a stressful encounter with an agitated psychiatric patient involves which communication strategy?
- A. Speaking loudly and quickly to assert control.
- B. Standing very close to the patient and making intense eye contact.
- C. Using a calm tone, validating their feelings, and setting clear boundaries.
- D. Ignoring the patient until they calm down.
Answer: C. Using a calm tone, validating their feelings, and setting clear boundaries.
23. “Doctor shopping” is a behavioral pattern where a patient:
- A. Seeks out the most qualified specialist for their condition.
- B. Visits multiple prescribers to obtain prescriptions for controlled substances without their knowledge of the other prescriptions.
- C. Changes doctors because they moved to a new city.
- D. Looks for a doctor who accepts their insurance.
Answer: B. Visits multiple prescribers to obtain prescriptions for controlled substances without their knowledge of the other prescriptions.
24. The concept of a “therapeutic alliance” between a pharmacist and a psychiatric patient is crucial for managing behavioral issues. It is best described as:
- A. A one-sided relationship where the pharmacist gives orders.
- A collaborative and trusting relationship focused on achieving shared health goals.
- C. A relationship that only lasts for one prescription fill.
- D. A social friendship.
Answer: B. A collaborative and trusting relationship focused on achieving shared health goals.
25. A patient with Bipolar I Disorder may be non-adherent to a mood stabilizer like lithium during a manic episode because:
- A. The medication tastes bad.
- B. They have a lack of insight into their illness and may enjoy the euphoric feelings of mania.
- C. The medication is too expensive.
- D. They are allergic to the medication.
Answer: B. They have a lack of insight into their illness and may enjoy the euphoric feelings of mania.
26. Pharmacists can help address health disparities in psychiatric care by:
- A. Refusing to serve patients from different cultural backgrounds.
- B. Being culturally competent and aware of social determinants of health that create barriers to care.
- C. Assuming all patients have the same beliefs and resources.
- D. Providing the same written information to all patients regardless of health literacy levels.
Answer: B. Being culturally competent and aware of social determinants of health that create barriers to care.
27. A patient is hesitant to start an SSRI because a family member told them “those drugs are addictive.” The pharmacist should address this behavioral barrier by:
- A. Dismissing the patient’s concern as silly.
- B. Providing accurate information that SSRIs are not addictive in the same way as substances of abuse, but can cause a discontinuation syndrome.
- C. Agreeing that the medication is addictive.
- D. Refusing to dispense the medication.
Answer: B. Providing accurate information that SSRIs are not addictive in the same way as substances of abuse, but can cause a discontinuation syndrome.
28. A patient is consistently taking their antidepressant but shows no improvement. Before considering the issue to be treatment resistance, what behavioral factor must be ruled out?
- A. The patient is secretly taking a higher dose.
- B. Covert non-adherence (the patient claims to be taking it but is not).
- C. The patient is exercising too much.
- D. The patient is getting too much sleep.
Answer: B. Covert non-adherence (the patient claims to be taking it but is not).
29. The term “means restriction” in suicide prevention refers to the behavior of:
- A. Restricting a patient’s access to financial resources.
- B. Counseling patients to limit their access to lethal methods of self-harm.
- C. Restricting the number of therapy sessions a patient can have.
- D. Limiting the dose of an antidepressant to sub-therapeutic levels.
Answer: B. Counseling patients to limit their access to lethal methods of self-harm.
30. Pharmacists play a role in managing tobacco use in patients with psychiatric illness. This is important because this population has a:
- A. Lower rate of smoking than the general population.
- B. Higher rate of smoking, and tobacco can induce CYP1A2, affecting the metabolism of some psychiatric medications.
- C. Nicotine allergy that is common in psychiatric patients.
- D. Complete lack of interest in quitting.
Answer: B. Higher rate of smoking, and tobacco can induce CYP1A2, affecting the metabolism of some psychiatric medications.
31. A patient complains that their medication “makes them feel like a zombie.” This subjective report is a key behavioral reason for non-adherence and should prompt the pharmacist to:
- A. Tell the patient to ignore the feeling.
- B. Explore the specific side effects with the patient and communicate these concerns to the prescriber.
- C. Immediately discontinue the medication.
- D. Double the dose.
Answer: B. Explore the specific side effects with the patient and communicate these concerns to the prescriber.
32. A core component of professionalism when dealing with challenging patient behaviors is:
- A. Emotional reactivity and arguing.
- B. Self-awareness of one’s own biases and emotional state.
- C. Avoiding the patient.
- D. Immediately calling security.
Answer: B. Self-awareness of one’s own biases and emotional state.
33. The pharmacist’s patient care process (PPCP) is a continuous cycle. After implementing a plan to address a behavioral issue (e.g., non-adherence), what is the crucial next step?
- A. Assume the problem is solved permanently.
- B. Discharge the patient from the pharmacy.
- C. Follow-up to monitor and evaluate the effectiveness of the plan.
- D. Start the process over from the beginning with a new plan.
Answer: C. Follow-up to monitor and evaluate the effectiveness of the plan.
34. A behavioral issue like cognitive impairment, common in some psychiatric or neurodegenerative disorders, may require what intervention from the pharmacist?
- A. Using complex medical jargon.
- B. Providing all instructions verbally with no written material.
- C. Simplifying medication regimens and using adherence aids like pillboxes.
- D. Refusing to dispense to the patient without a court-appointed guardian present.
Answer: C. Simplifying medication regimens and using adherence aids like pillboxes.
35. A patient with schizophrenia is socially withdrawn and has poor motivation. These are known as:
- A. Positive symptoms.
- B. Negative symptoms, which are behavioral deficits that can be a major challenge to psychosocial functioning.
- C. Anticholinergic side effects.
- D. Manic symptoms.
Answer: B. Negative symptoms, which are behavioral deficits that can be a major challenge to psychosocial functioning.
36. When a patient refuses to take medication due to a belief it is poison, this is likely a:
- A. Simple preference.
- B. Behavioral manifestation of a paranoid delusion.
- C. Sign of drug-seeking behavior.
- D. Harmless complaint.
Answer: B. Behavioral manifestation of a paranoid delusion.
37. Addressing behavioral issues often requires an interprofessional approach. This means the pharmacist should:
- A. Work in isolation and never speak to the patient’s doctor or therapist.
- B. Communicate and collaborate with other members of the healthcare team to provide integrated care.
- C. Tell the patient to choose between their pharmacist and their doctor.
- D. Only manage the medication-related aspects and ignore all behavioral context.
Answer: B. Communicate and collaborate with other members of the healthcare team to provide integrated care.
38. A patient is fearful of the side effects of a newly prescribed antipsychotic. A good behavioral management strategy is to:
- A. Dismiss their fears and tell them not to read the medication guide.
- B. Acknowledge their fears, provide balanced information on risks vs. benefits, and discuss strategies to manage potential side effects.
- C. Tell them there are no side effects.
- D. Give them a different medication without consulting the prescriber.
Answer: B. Acknowledge their fears, provide balanced information on risks vs. benefits, and discuss strategies to manage potential side effects.
39. A patient’s refusal to make eye contact or speak above a whisper could be a behavioral sign of:
- A. Anger and aggression.
- B. Severe social anxiety or depression.
- C. Deception and drug-seeking.
- D. Mania.
Answer: B. Severe social anxiety or depression.
40. The use of adherence-tracking technologies (e.g., smart pill bottles, mobile apps) is a strategy to help manage which behavioral issue?
- A. Stigma.
- B. Unintentional non-adherence or forgetfulness.
- C. Paranoid delusions.
- D. Aggression.
Answer: B. Unintentional non-adherence or forgetfulness.
41. The DESC method (Describe, Express, Specify, Consequences) is a structured communication tool that can be used to:
- A. Diagnose a psychiatric condition.
- B. Assertively and professionally address interpersonal conflicts or challenging employee behaviors.
- C. Calculate a drug’s half-life.
- D. Prescribe medications.
Answer: B. Assertively and professionally address interpersonal conflicts or challenging employee behaviors.
42. A patient states they are taking their medication, but their clinical response and lab values (if applicable) suggest otherwise. This discrepancy points to a behavioral challenge that requires:
- A. Accusing the patient of lying.
- B. A non-judgmental, collaborative conversation to identify the barriers to adherence.
- C. Immediately discharging the patient from care.
- D. Increasing the medication dose.
Answer: B. A non-judgmental, collaborative conversation to identify the barriers to adherence.
43. A core component of the “Putting Families First” IPE program is understanding how a patient’s health condition and related behaviors impact:
- A. Only the patient.
- B. The national economy.
- C. The entire family unit.
- D. The pharmacist’s daily workflow.
Answer: C. The entire family unit.
44. A patient’s erratic behavior, such as missing appointments and angry outbursts, could be a sign of:
- A. An unstable mood episode in bipolar disorder.
- B. A personality disorder.
- C. A reaction to stress or medication side effects.
- D. Any or all of the above.
Answer: D. Any or all of the above.
45. Why is it important for a pharmacist to be aware of their own feelings (self-awareness) when interacting with a patient exhibiting challenging behaviors?
- A. It is not important; the focus should only be on the patient.
- B. To prevent personal feelings or biases from negatively impacting professional judgment and patient care.
- C. To allow the pharmacist to share their own problems with the patient.
- D. To make the consultation more emotional.
Answer: B. To prevent personal feelings or biases from negatively impacting professional judgment and patient care.
46. Which behavior is a clear sign that a pharmacist needs to gather more information before dispensing a controlled substance?
- A. The patient knows their date of birth.
- B. The patient presents a prescription from a legitimate prescriber for a valid medical purpose.
- C. The patient appears sedated and mentions getting similar prescriptions from multiple other doctors.
- D. The patient pays with cash.
Answer: C. The patient appears sedated and mentions getting similar prescriptions from multiple other doctors.
47. Low health literacy is a behavioral barrier that can be addressed by the pharmacist through which action?
- A. Using complex medical terms to sound more professional.
- B. Providing only written information.
- C. Using plain language, the teach-back method, and pictures or videos.
- D. Speaking very loudly.
Answer: C. Using plain language, the teach-back method, and pictures or videos.
48. A patient’s financial situation (socioeconomic status) is a major factor that can lead to which behavior?
- A. Intentional non-adherence due to inability to afford medication.
- B. Taking more medication than prescribed.
- C. A preference for brand-name drugs only.
- D. Refusing all non-pharmacological advice.
Answer: A. Intentional non-adherence due to inability to afford medication.
49. The development of a therapeutic plan for a patient with complex behavioral issues should be:
- A. Rigid and unchangeable.
- B. Dictated solely by the pharmacist.
- C. Individualized and flexible, adapting to the patient’s changing needs and behaviors.
- D. Based on what works for the average patient, not the individual.
Answer: C. Individualized and flexible, adapting to the patient’s changing needs and behaviors.
50. Ultimately, the successful management of behavioral issues in psychiatric patients relies on a foundation of:
- A. Distrust and suspicion.
- B. Apathy and indifference.
- C. A strong, collaborative, and non-judgmental patient-provider relationship.
- D. Strict rules and penalties.
Answer: C. A strong, collaborative, and non-judgmental patient-provider relationship.

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