A Comprehensive Medication Review (CMR) is a systematic process and the cornerstone of Medication Therapy Management, allowing pharmacists to partner with patients to optimize their regimens. For PharmD students, understanding how to effectively collect patient information, assess for drug therapy problems, and create actionable, patient-centered plans is a critical competency. This quiz will test your knowledge of the step-by-step process of conducting a thorough CMR, from the initial interview to the final documentation and follow-up.
1. What is the first critical step a pharmacist should take before conducting a scheduled Comprehensive Medication Review (CMR)?
- Counsel the patient on a new prescription.
- Gather and review all available patient information, such as pharmacy records, medical history, and recent lab results.
- Immediately start asking the patient to list their medications.
- Prepare the billing claim for the service.
Answer: Gather and review all available patient information, such as pharmacy records, medical history, and recent lab results.
2. The “brown bag review” is a powerful tool used during the information gathering phase of a CMR. What does this process involve?
- The pharmacist pre-fills the patient’s pill box for the week.
- Reviewing a list of drugs that have been recalled.
- Having the patient bring in all of their medications, including prescriptions, OTCs, and supplements, for review.
- The pharmacist bringing a bag of medication samples for the patient.
Answer: Having the patient bring in all of their medications, including prescriptions, OTCs, and supplements, for review.
3. During a patient interview, which of the following is the best example of an open-ended question?
- “Do you take your lisinopril every day?”
- “Are you having any side effects from your medication?”
- “Can you tell me how you’ve been taking your lisinopril?”
- “Did you remember to refill your prescription?”
Answer: “Can you tell me how you’ve been taking your lisinopril?”
4. The SCHOLAR-MAC acronym is a structured method for:
- Documenting a patient encounter in a SOAP note.
- Assessing a patient’s symptoms and conditions, typically for self-care recommendations.
- Calculating a patient’s cardiovascular risk.
- Verifying a prescription during the dispensing process.
Answer: Assessing a patient’s symptoms and conditions, typically for self-care recommendations.
5. A pharmacist is conducting medication reconciliation for a patient admitted to the hospital. The primary goal of this process is to:
- Determine the cost of the patient’s home medications.
- Create the most accurate and complete list of the patient’s current medications to avoid errors.
- Educate the patient on their new hospital-prescribed medications.
- Choose which of the patient’s home medications will be continued.
Answer: Create the most accurate and complete list of the patient’s current medications to avoid errors.
6. The “Assess” step of the Pharmacists’ Patient Care Process (PPCP) during a CMR primarily involves:
- Creating the patient’s Medication-related Action Plan (MAP).
- Scheduling a follow-up appointment.
- Analyzing patient information to identify actual or potential drug therapy problems.
- Educating the patient on how to use a new device.
Answer: Analyzing patient information to identify actual or potential drug therapy problems.
7. A patient with osteoporosis is taking a bisphosphonate but is also taking a daily PPI, which can decrease calcium absorption and bone density. This is an example of which type of drug therapy problem?
- Unnecessary drug therapy
- Dosage too low
- A drug-disease interaction contributing to an adverse drug reaction
- Non-adherence
Answer: A drug-disease interaction contributing to an adverse drug reaction
8. When assessing a patient’s medication list, each medication should be evaluated for which four primary parameters?
- Brand vs. Generic, Cost, Color, and Shape
- Indication, Effectiveness, Safety, and Adherence
- Route, Frequency, Duration, and Dosage Form
- Prescriber, Pharmacy, Payer, and Patient
Answer: Indication, Effectiveness, Safety, and Adherence
9. A patient with hypertension and heart failure is prescribed lisinopril 5 mg daily. Their blood pressure remains elevated, and they still have symptoms of fluid overload. This is most likely which type of drug therapy problem?
- Unnecessary drug therapy
- Dosage too low
- Adverse drug reaction
- Needs additional drug therapy
Answer: Dosage too low
10. A patient with atrial fibrillation is not prescribed an anticoagulant, and has no documented contraindications. This represents which type of drug therapy problem?
- Needs additional drug therapy
- Ineffective drug
- Non-adherence
- Dosage too high
Answer: Needs additional drug therapy
11. After identifying multiple drug therapy problems, what is the pharmacist’s next crucial step during the assessment phase?
- Address all problems at the same time with the patient.
- Prioritize the problems with the patient based on clinical significance and patient readiness.
- Document the problems and take no further action.
- Contact the patient’s insurance company to report the problems.
Answer: Prioritize the problems with the patient based on clinical significance and patient readiness.
12. The “Plan” phase of a CMR results in the creation of which two key documents?
- A prescription and a patient invoice.
- A Medication-related Action Plan (MAP) for the patient and a communication plan for the prescriber.
- A SOAP note and a pharmacy inventory report.
- A Personal Medication Record (PMR) and a prior authorization form.
Answer: A Medication-related Action Plan (MAP) for the patient and a communication plan for the prescriber.
13. A patient-centered goal within a care plan should be:
- Dictated by the pharmacist with no patient input.
- Focused only on lab values.
- Broad and unmeasurable (e.g., “be healthier”).
- Specific, measurable, achievable, relevant, and time-bound (SMART).
Answer: Specific, measurable, achievable, relevant, and time-bound (SMART).
14. The Medication-related Action Plan (MAP) is primarily a tool for the:
- Patient
- Prescriber
- Pharmacist’s records
- Insurance company
Answer: Patient
15. Which of the following is an appropriate action item for a patient’s MAP?
- “Titrate amlodipine to 10 mg daily if SBP remains >140 mmHg.”
- “Check your blood sugar every morning before breakfast and write it in this log.”
- “Discontinue atorvastatin and initiate rosuvastatin.”
- “The patient will follow up with cardiology in 2 weeks.”
Answer: “Check your blood sugar every morning before breakfast and write it in this log.”
16. The “Implement” phase of the CMR involves:
- Handing the patient the MAP and PMR with no explanation.
- Educating the patient on the care plan and communicating with other providers.
- Filing the paperwork for the encounter.
- Assessing the patient for new problems.
Answer: Educating the patient on the care plan and communicating with other providers.
17. Using the “teach-back” method during patient counseling is a way to:
- Test the patient’s memory.
- Confirm the patient understands the information provided.
- Fill time during the appointment.
- Create a legal record of the conversation.
Answer: Confirm the patient understands the information provided.
18. When communicating a recommendation to a prescriber after a CMR, it is most effective to:
- Send a vague email asking the doctor to “review the patient’s medications.”
- Call and demand that the prescriber make a change.
- Provide a concise, evidence-based recommendation to resolve a specific drug therapy problem.
- Tell the patient to relay the information to their doctor at their next visit.
Answer: Provide a concise, evidence-based recommendation to resolve a specific drug therapy problem.
19. What is the primary purpose of documenting a CMR encounter?
- To ensure continuity of care, track outcomes, and provide a basis for billing.
- To create more paperwork for the pharmacy.
- To practice writing skills.
- To meet an arbitrary quota of notes per day.
Answer: To ensure continuity of care, track outcomes, and provide a basis for billing.
20. A SOAP note is a common format for documenting clinical encounters. What does the “A” in SOAP stand for?
- Acknowledgment
- Adherence
- Action
- Assessment
Answer: Assessment
21. In which section of a SOAP note would the pharmacist’s evaluation of the patient’s drug therapy problems be placed?
- S (Subjective)
- O (Objective)
- A (Assessment)
- P (Plan)
Answer: A (Assessment)
22. Scheduling a follow-up visit is a critical part of the CMR process because it allows the pharmacist to:
- Bill for another visit.
- Finalize the initial CMR documentation.
- Monitor and evaluate the effectiveness and safety of the care plan.
- Provide the patient with a new PMR.
Answer: Monitor and evaluate the effectiveness and safety of the care plan.
23. A pharmacist discovers that a patient is using their rescue inhaler daily for asthma. This finding relates to which aspect of medication assessment?
- Indication
- Effectiveness
- Safety
- Adherence
Answer: Effectiveness
24. When collecting a medication history, it is crucial to ask about over-the-counter (OTC) medications because:
- They are generally more effective than prescription drugs.
- They are covered by all insurance plans.
- They can cause significant adverse effects and drug interactions.
- They are only sold in pharmacies.
Answer: They can cause significant adverse effects and drug interactions.
25. A patient reports that they often forget to take their evening dose of medication. This is which type of drug therapy problem?
- Adverse drug reaction
- Non-adherence
- Dosage too high
- Ineffective drug
Answer: Non-adherence
26. Active listening during a CMR interview includes which of the following behaviors?
- Constantly interrupting the patient to correct them.
- Asking clarifying questions and summarizing what the patient has said.
- Looking at the computer screen the entire time.
- Thinking about the next question instead of what the patient is saying.
Answer: Asking clarifying questions and summarizing what the patient has said.
27. The most effective way to assess medication adherence is to:
- Ask a yes/no question like, “Do you take your medication every day?”
- Assume the patient is 100% adherent unless they state otherwise.
- Use non-judgmental, open-ended questions like, “How many doses would you say you miss in a typical week?”
- Check if the prescription was filled on time and assume it was taken correctly.
Answer: Use non-judgmental, open-ended questions like, “How many doses would you say you miss in a typical week?”
28. Reviewing a patient’s lab results, such as A1c or INR, falls under which category of information?
- Subjective
- Objective
- Assessment
- Plan
Answer: Objective
29. A patient’s statement, “I feel dizzy every time I take this blood pressure pill,” is what category of information?
- Subjective
- Objective
- Assessment
- Plan
Answer: Subjective
30. The Personal Medication Record (PMR) should include which of the following for each medication?
- The cost of the medication.
- The medication name, dose, indication, and directions for use.
- The date the drug was approved by the FDA.
- The name of the pharmaceutical sales representative.
Answer: The medication name, dose, indication, and directions for use.
31. What is the main difference between collecting information for a new prescription versus a CMR?
- There is no difference in the process.
- Information for a new prescription is a brief check, while a CMR is a comprehensive, holistic review of all medications and health history.
- A CMR does not require a patient interview.
- Only physicians can collect information for a CMR.
Answer: Information for a new prescription is a brief check, while a CMR is a comprehensive, holistic review of all medications and health history.
32. Empathy is a key skill in performing a CMR. It is best defined as:
- Feeling sorry for the patient.
- The ability to understand and share the feelings of another.
- Agreeing with everything the patient says.
- Solving all of the patient’s life problems.
Answer: The ability to understand and share the feelings of another.
33. An example of an intervention to improve adherence is:
- Telling the patient they must take their medication.
- Providing the patient with a weekly pill organizer.
- Switching to a more expensive brand-name drug.
- Calling the patient’s doctor to complain about non-adherence.
Answer: Providing the patient with a weekly pill organizer.
34. Identifying that a patient has a health condition (e.g., diabetes) but is not on a guideline-recommended medication (e.g., a statin) is part of which CMR step?
- Collect
- Assess
- Plan
- Implement
Answer: Assess
35. A thorough CMR requires the pharmacist to integrate knowledge from:
- Clinical sciences only.
- Foundational sciences like pharmacology and medicinal chemistry.
- Social and behavioral sciences.
- All of the above, including clinical, foundational, and social/behavioral sciences.
Answer: All of the above, including clinical, foundational, and social/behavioral sciences.
36. If a patient cannot afford a medication, the pharmacist’s plan might involve:
- Telling the patient to stop the medication.
- Suggesting a therapeutic alternative that is more affordable and discussing it with the prescriber.
- Ignoring the cost issue as it is not a clinical problem.
- Lending the patient money for the copay.
Answer: Suggesting a therapeutic alternative that is more affordable and discussing it with the prescriber.
37. The process of developing a therapeutic relationship with a patient begins:
- After the third CMR visit.
- During the initial information collection and interview.
- Only when a drug therapy problem is found.
- After the pharmacist has spoken with the doctor.
Answer: During the initial information collection and interview.
38. The pharmacist’s recommendation to the physician should always be supported by:
- Personal opinion or anecdote.
- What the pharmacist thinks the doctor wants to hear.
- Evidence from clinical guidelines or primary literature.
- Information from a television commercial.
Answer: Evidence from clinical guidelines or primary literature.
39. A successful CMR from the patient’s perspective often results in:
- A simplified medication regimen.
- A better understanding of their health conditions.
- Feeling empowered to manage their own health.
- All of the above.
Answer: All of the above.
40. A pharmacist should check for duplicate therapy, which means:
- The patient has two bottles of the same medication.
- The patient is taking two or more drugs for the same indication with a similar mechanism of action.
- The patient is refilling a prescription too early.
- The patient is seeing two different doctors.
Answer: The patient is taking two or more drugs for the same indication with a similar mechanism of action.
41. During the assessment, considering a patient’s kidney or liver function is crucial for evaluating medication:
- Safety
- Effectiveness
- Adherence
- Indication
Answer: Safety
42. The “P” or “Plan” section of a SOAP note should detail:
- The patient’s list of problems.
- The pharmacist’s complete assessment of each problem.
- The specific actions that will be taken to address each problem.
- The patient’s vital signs and lab work.
Answer: The specific actions that will be taken to address each problem.
43. A pharmacist uses their knowledge of pathophysiology to:
- Understand the disease process and how a medication is intended to work.
- Perform pharmaceutical calculations.
- Interpret insurance claims.
- Manage pharmacy inventory.
Answer: Understand the disease process and how a medication is intended to work.
44. What is the most important reason to identify a patient’s health-related goals during the interview?
- To ensure the care plan is patient-centered and addresses what matters most to them.
- It is a required field in the documentation software.
- To determine if the patient is eligible for MTM.
- To create a more complex action plan.
Answer: To ensure the care plan is patient-centered and addresses what matters most to them.
45. If a pharmacist is unsure how to resolve a complex drug therapy problem, the best course of action is to:
- Guess the best answer and hope it is correct.
- Tell the patient there is no solution.
- Consult drug information resources, clinical guidelines, or a colleague.
- Ignore the problem and focus on easier ones.
Answer: Consult drug information resources, clinical guidelines, or a colleague.
46. Which of the following is an example of an “adverse drug reaction” DRP?
- A patient with an allergy to penicillin is prescribed amoxicillin.
- A patient develops a persistent dry cough after starting lisinopril.
- A patient’s blood pressure is not at goal despite taking their medication.
- A patient has not been prescribed a statin despite having diabetes and being over 40.
Answer: A patient develops a persistent dry cough after starting lisinopril.
47. Cultural competence is a key part of the CMR process because:
- It helps the pharmacist apply stereotypes to patients.
- It ensures recommendations are provided in a way that is respectful of the patient’s beliefs and background.
- It is only important when using an interpreter.
- It allows the pharmacist to ignore the patient’s personal beliefs.
Answer: It ensures recommendations are provided in a way that is respectful of the patient’s beliefs and background.
48. Why is it important to review past medical history during a CMR?
- To understand the indications for current medications and identify potential untreated conditions.
- To bill for a longer appointment.
- To make the patient feel uncomfortable.
- To confirm the patient’s date of birth.
Answer: To understand the indications for current medications and identify potential untreated conditions.
49. The monitoring plan developed in a CMR should include:
- What will be monitored, when it will be monitored, and the goal value.
- Only the name of the lab test to order.
- A plan to call the patient every day.
- A list of all possible side effects for all drugs.
Answer: What will be monitored, when it will be monitored, and the goal value.
50. The ultimate goal of performing a thorough CMR is to:
- Complete the process as quickly as possible.
- Identify and resolve drug therapy problems in partnership with the patient to optimize outcomes.
- Increase the number of prescriptions the patient is taking.
- Generate a long and detailed report for the patient’s file.
Answer: Identify and resolve drug therapy problems in partnership with the patient to optimize outcomes.

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