MCQ Quiz-Creating a Patient Medication Record-List

MCQ Quiz: Creating an Effective Patient Medication Record

by

The Personal Medication Record (PMR), or medication list, is a vital tool for patient safety and empowerment. It serves as the single source of truth for a patient’s regimen and is a cornerstone of Medication Therapy Management. For PharmD students, learning to meticulously gather information, reconcile discrepancies, and create a clear, patient-friendly PMR is a foundational skill. This quiz tests your knowledge on the key components and processes involved in creating a high-quality medication record.

1. What is the primary purpose of creating a Personal Medication Record (PMR) for a patient?

  • To serve as a legal document for the pharmacy’s records.
  • To provide the patient with a comprehensive, up-to-date list of their medications to manage their health and share with other providers.
  • To track the pharmacy’s inventory of dispensed drugs.
  • To create a bill for the patient’s insurance company.

Answer: To provide the patient with a comprehensive, up-to-date list of their medications to manage their health and share with other providers.

2. A PMR should include medications from which of the following sources?

  • Prescription medications from your pharmacy only.
  • All prescription medications, over-the-counter (OTC) products, herbal supplements, and vitamins.
  • Only medications that are covered by the patient’s insurance.
  • Only medications the patient takes on a daily basis.

Answer: All prescription medications, over-the-counter (OTC) products, herbal supplements, and vitamins.

3. When creating a PMR, which of the following is the most reliable source for determining a patient’s actual medication-taking behavior?

  • The physician’s electronic health record (EHR).
  • The pharmacy’s dispensing records.
  • A thorough patient interview.
  • The patient’s insurance claim data.

Answer: A thorough patient interview.

4. Which of the following is an essential data field for each medication listed on a PMR?

  • The medication’s wholesale acquisition cost.
  • The indication, or reason for use.
  • The date the medication was approved by the FDA.
  • The name of the manufacturer.

Answer: The indication, or reason for use.

5. A patient brings in all their medication bottles, including some from other pharmacies, for you to review. This process is commonly known as a:

  • Formulary review.
  • Therapeutic interchange.
  • Brown bag review.
  • Dispensing audit.

Answer: A brown bag review.

6. The process of comparing a patient’s medication orders to all of the medications that the patient has been taking to avoid errors is called:

  • Drug Utilization Review (DUR).
  • Medication Reconciliation.
  • Adverse Drug Event Reporting.
  • Formulary Management.

Answer: Medication Reconciliation.

7. You notice a patient’s pharmacy profile lists a medication that the patient states they stopped taking two months ago. This is an example of a(n):

  • Adverse drug reaction.
  • Discrepancy that needs to be resolved.
  • Unnecessary medication.
  • Dosing error.

Answer: Discrepancy that needs to be resolved.

8. What is the best course of action when a discrepancy is found during medication reconciliation?

  • Ignore the discrepancy and use the pharmacy profile data.
  • Assume the patient is correct and change the record without further action.
  • Clarify the discrepancy with the patient and/or contact the prescriber to confirm the current regimen.
  • Tell the patient to stop taking all their medications until the discrepancy is fixed.

Answer: Clarify the discrepancy with the patient and/or contact the prescriber to confirm the current regimen.

9. In addition to medication name and strength, what other key information should be on the PMR for each entry?

  • The expiration date of the current bottle.
  • Dosage form and route of administration.
  • The color and shape of the tablet/capsule.
  • The pharmacy’s phone number.

Answer: Dosage form and route of administration.

10. When listing the indication for a medication on a PMR, it is best to use:

  • Complex medical terminology.
  • Abbreviations that only a pharmacist would understand.
  • Patient-friendly language (e.g., “for high blood pressure” instead of “for hypertension”).
  • The billing code for the associated disease state.

Answer: Patient-friendly language (e.g., “for high blood pressure” instead of “for hypertension”).

11. Why is it critical to include a patient’s medication allergies and experienced adverse reactions on the PMR?

  • It is required for marketing purposes.
  • It helps ensure future prescribing and dispensing is done safely.
  • It determines the cost of the medication.
  • It is only necessary for hospitalized patients.

Answer: It helps ensure future prescribing and dispensing is done safely.

12. The PMR is considered a “living document.” This means:

  • It can never be printed or saved electronically.
  • It should be updated regularly whenever a medication change occurs.
  • Only the patient is allowed to make changes to it.
  • Once created, it should never be altered.

Answer: It should be updated regularly whenever a medication change occurs.

13. When interviewing a patient to create a PMR, it is important for the pharmacist to:

  • Ask only yes/no questions.
  • Build rapport and create a comfortable, non-judgmental environment.
  • Rush the patient to get through the interview quickly.
  • Focus only on the prescription medications.

Answer: Build rapport and create a comfortable, non-judgmental environment.

14. A patient reports taking an “herbal tea for their nerves.” How should this be handled for the PMR?

  • It should be ignored because it is not a pill.
  • The pharmacist should document the “tea” as specifically as possible and assess for potential interactions.
  • The patient should be told that herbal remedies are ineffective.
  • It should be documented as “unnecessary drug therapy.”

Answer: The pharmacist should document the “tea” as specifically as possible and assess for potential interactions.

15. After a PMR is created, what is the crucial final step of sharing it with the patient?

  • Mail it to the patient’s home address without discussion.
  • Have the patient sign a waiver.
  • Review the entire list with the patient to ensure accuracy and understanding.
  • File the PMR in the pharmacy’s records and give the patient a blank copy.

Answer: Review the entire list with the patient to ensure accuracy and understanding.

16. The information gathered to create a PMR is the foundation for which other MTM core element?

  • The Medication-related Action Plan (MAP).
  • The billing and reimbursement process.
  • The pharmacist’s performance review.
  • The pharmacy’s daily operations report.

Answer: The Medication-related Action Plan (MAP).

17. Including the prescriber’s name for each medication on the PMR helps with:

  • Patient adherence.
  • Care coordination and communication.
  • Lowering the cost of the medication.
  • Determining the medication’s side effects.

Answer: Care coordination and communication.

18. A patient is taking a medication PRN (as needed). How should the instructions be documented on the PMR?

  • List it as a daily medication to be safe.
  • Omit the medication since it’s not taken regularly.
  • Clearly state the dose, frequency, and specific reason for use (e.g., “Take 1 tablet by mouth as needed for headache”).
  • Write “take as directed by your doctor.”

Answer: Clearly state the dose, frequency, and specific reason for use (e.g., “Take 1 tablet by mouth as needed for headache”).

19. The layout and format of a patient’s PMR should be:

  • Dense and difficult to read to fit on one page.
  • Standardized according to a federal law.
  • Clear, organized, and easy for a patient to read and use.
  • Written in a small font to save paper.

Answer: Clear, organized, and easy for a patient to read and use.

20. A patient’s PMR from a hospital discharge summary is a valuable tool, but the community pharmacist should still:

  • Accept it as 100% accurate without question.
  • Verbally re-verify the medication list with the patient.
  • Call the hospital to complain about the patient’s care.
  • Ignore the summary and create a new list from scratch.

Answer: Verbally re-verify the medication list with the patient.

21. If a medication has been recently discontinued, it is good practice to:

  • Immediately delete it from all records as if it never existed.
  • Keep it on the PMR for a short period, clearly marked as “stopped” with the date, to provide a complete history.
  • Continue listing it as an active medication to avoid confusion.
  • Tell the patient to throw away the information.

Answer: Keep it on the PMR for a short period, clearly marked as “stopped” with the date, to provide a complete history.

22. Which of the following is an example of objective information used to create a PMR?

  • The patient’s statement that the pill makes them “feel funny.”
  • A dispensing record from the pharmacy’s computer system.
  • The patient’s report of their pain level on a scale of 1-10.
  • The patient’s belief about what the medication is for.

Answer: A dispensing record from the pharmacy’s computer system.

23. The most accurate PMR is created through:

  • Patient interview alone.
  • Pharmacy records alone.
  • Synthesis of information from multiple sources including the patient, pharmacy records, and prescribers.
  • Prescriber records alone.

Answer: Synthesis of information from multiple sources including the patient, pharmacy records, and prescribers.

24. A patient is unsure of the name of a pill but says, “it’s the little white one I take for my heart.” What is the best next step?

  • Guess which medication it is.
  • Ask probing questions about the prescriber, the directions, and what it does, or check the dispensing record.
  • Omit the medication from the PMR.
  • Tell the patient to figure it out and call you back.

Answer: Ask probing questions about the prescriber, the directions, and what it does, or check the dispensing record.

25. When documenting directions on the PMR, the pharmacist should avoid using:

  • Vague instructions like “take as directed.”
  • Specific times of day.
  • The number of tablets to take.
  • The route of administration.

Answer: Vague instructions like “take as directed.”

26. The PMR empowers the patient primarily by:

  • Giving them a tool to actively participate in their own healthcare.
  • Providing them with complex clinical data.
  • Allowing them to bypass their physician.
  • Reducing their medication costs.

Answer: Giving them a tool to actively participate in their own healthcare.

27. A patient presents a handwritten list of medications. The pharmacist should:

  • Assume the list is completely accurate and copy it directly.
  • Use the list as a starting point and verify each item with the patient and other records.
  • Disregard the list because it was not created by a healthcare professional.
  • Input the list into the computer system without speaking to the patient.

Answer: Use the list as a starting point and verify each item with the patient and other records.

28. Why is it important to capture “start dates” for medications on a PMR when possible?

  • It helps track the duration of therapy and assess long-term effectiveness or side effects.
  • It is a legal requirement for all prescriptions.
  • It helps the pharmacist reorder the medication.
  • It is not important information.

Answer: It helps track the duration of therapy and assess long-term effectiveness or side effects.

29. A caregiver provides a medication list for a patient with dementia. The pharmacist should:

  • Thank the caregiver and use the list to create the PMR, noting the information source.
  • Insist on only speaking with the patient.
  • Tell the caregiver their information is unreliable.
  • Refuse to create the PMR.

Answer: Thank the caregiver and use the list to create the PMR, noting the information source.

30. The creation of a PMR is a core component of which MTM element?

  • Intervention and/or Referral.
  • It is its own distinct core element.
  • Documentation and Follow-up.
  • Medication Therapy Review.

Answer: It is its own distinct core element.

31. How does an accurate PMR contribute to improved continuity of care?

  • It ensures a patient gets the same pharmacist every visit.
  • It ensures all of a patient’s providers have the same, correct information, reducing errors during transitions of care.
  • It automatically sends updates to every doctor’s office.
  • It prevents the patient from seeing other specialists.

Answer: It ensures all of a patient’s providers have the same, correct information, reducing errors during transitions of care.

32. During a CMR, if a drug therapy problem is identified and resolved, how should this be reflected in the PMR?

  • The PMR should not be changed.
  • The PMR should be updated to reflect the new, correct medication regimen.
  • The old regimen should be kept, and the patient should be told to remember the change.
  • The PMR should be deleted.

Answer: The PMR should be updated to reflect the new, correct medication regimen.

33. In the context of creating a PMR, what is the value of asking about past adverse drug reactions?

  • To document information that can prevent a patient from being re-exposed to a medication that could cause harm.
  • To blame the patient for experiencing a side effect.
  • To test the patient’s long-term memory.
  • It has no value.

Answer: To document information that can prevent a patient from being re-exposed to a medication that could cause harm.

34. The skill of collecting a medication history is a foundational part of which domain in the Pharmacists’ Patient Care Process?

  • Plan
  • Implement
  • Follow-Up: Monitor and Evaluate
  • Collect

Answer: Collect

35. A PMR can help a patient avoid which common medication error?

  • Taking a discontinued medication.
  • Forgetting to take a medication.
  • Taking the wrong dose.
  • All of the above.

Answer: All of the above.

36. Including the pharmacy’s contact information on the PMR is helpful because:

  • It allows the patient to easily contact the pharmacist with questions.
  • It is a form of direct marketing.
  • It fills up empty space on the page.
  • It is required by federal law.

Answer: It allows the patient to easily contact the pharmacist with questions.

37. When a patient uses multiple pharmacies, creating a single, reconciled PMR is:

  • Less important.
  • Impossible to do.
  • Critically important to prevent fragmentation of care.
  • The responsibility of the patient’s primary care physician only.

Answer: Critically important to prevent fragmentation of care.

38. The information on a PMR should be consistent with the information on the:

  • Patient’s driver’s license.
  • Patient’s Medication-related Action Plan (MAP).
  • Pharmacy’s strategic business plan.
  • Latest drug recall list.

Answer: Patient’s Medication-related Action Plan (MAP).

39. For a medication with a complicated taper schedule, the PMR instructions should be:

  • Simplified to “take as directed.”
  • Written out clearly in a step-by-step manner.
  • Omitted to avoid confusion.
  • Communicated only verbally.

Answer: Written out clearly in a step-by-step manner.

40. The process of creating a PMR directly supports which professional attribute of a pharmacist?

  • Attention to detail and accuracy.
  • Sales and marketing skills.
  • Financial accounting.
  • Product manufacturing.

Answer: Attention to detail and accuracy.

41. How does a well-prepared PMR facilitate better interprofessional collaboration?

  • It gives the pharmacist a reason to call the doctor.
  • It provides a clear, accurate, and portable document that a physician or nurse can quickly review.
  • It proves the pharmacist knows more than the doctor.
  • It eliminates the need for any verbal communication between providers.

Answer: It provides a clear, accurate, and portable document that a physician or nurse can quickly review.

42. A patient says they take their hydrochlorothiazide “when they feel puffy.” The pharmacy label says “take one tablet daily.” This discrepancy should be:

  • Ignored.
  • Documented, and the pharmacist should use it as an opportunity to educate the patient on the purpose of the medication for blood pressure control.
  • Immediately reported to the medical board.
  • Changed on the PMR to match what the patient is doing.

Answer: Documented, and the pharmacist should use it as an opportunity to educate the patient on the purpose of the medication for blood pressure control.

43. The PMR is one of the five core elements of:

  • The FDA drug approval process.
  • The Medication Therapy Management (MTM) service model.
  • The pharmacy school curriculum.
  • The pharmaceutical supply chain.

Answer: The Medication Therapy Management (MTM) service model.

44. What is the best way to list a combination drug product like “losartan/HCTZ” on a PMR?

  • List only the brand name.
  • List both ingredients with their respective strengths (e.g., Losartan 50 mg / Hydrochlorothiazide 12.5 mg).
  • List it as “blood pressure pill.”
  • List only the primary ingredient.

Answer: List both ingredients with their respective strengths (e.g., Losartan 50 mg / Hydrochlorothiazide 12.5 mg).

45. Including a “last updated” date on the PMR is important because it:

  • Helps track the pharmacist’s workload.
  • Indicates the timeliness and relevance of the information.
  • Is required for the pharmacy’s accreditation.
  • Determines the patient’s next appointment date.

Answer: Indicates the timeliness and relevance of the information.

46. A patient who only speaks Spanish is being interviewed for a PMR. The most appropriate action is to:

  • Use a professional medical interpreter.
  • Use a family member, like a young child, to interpret.
  • Speak English slowly and loudly.
  • Use an online translation tool for complex medical concepts.

Answer: Use a professional medical interpreter.

47. If a patient cannot remember the indication for one of their medications, the pharmacist should:

  • Leave the indication field blank.
  • Research the most likely indication based on the drug and the patient’s known medical conditions and document that.
  • Make up an indication.
  • Tell the patient the medication is not important.

Answer: Research the most likely indication based on the drug and the patient’s known medical conditions and document that.

48. When creating a PMR, the pharmacist acts as a(n):

  • Investigator, gathering clues from multiple sources.
  • Educator, explaining the medications to the patient.
  • Organizer, compiling the information into a clear format.
  • All of the above.

Answer: All of the above.

49. For a patient using a sliding scale insulin regimen, the PMR instructions should:

  • State “use as needed for high blood sugar.”
  • Include the specific, detailed sliding scale chart for the patient to follow.
  • Be omitted due to complexity.
  • Only list the name of the insulin.

Answer: Include the specific, detailed sliding scale chart for the patient to follow.

50. The ultimate test of a good PMR is its:

  • Length and complexity.
  • Usefulness and ability to improve patient safety and understanding.
  • Visual appeal and graphic design.
  • Ability to generate revenue.

Answer: Usefulness and ability to improve patient safety and understanding.

Leave a Comment