MCQ Quiz: Medication Therapy Management

Medication Therapy Management (MTM) is a pharmacist-led service focused on optimizing therapeutic outcomes for patients with complex medication needs. The core of MTM is the systematic identification and resolution of Drug Therapy Problems (DTPs), a key clinical skill taught and practiced throughout the PharmD curriculum ,. This quiz will focus on the practical application of MTM, presenting clinical scenarios that require the identification and management of common DTPs.

1. A patient with hypertension and diabetes is prescribed lisinopril, metformin, and atorvastatin. This patient meets which MTM eligibility criterion under Medicare Part D?

• a. Taking multiple Part D medications.
• b. Having multiple chronic diseases.
• c. Incurring high annual drug costs.
• d. All of the above are likely criteria.

Answer: d. All of the above are likely criteria.

2. During a Comprehensive Medication Review (CMR), a patient states they only take their blood pressure medication “when they feel their pressure is high.” This is what type of Drug Therapy Problem (DTP)?

• a. Adverse drug reaction
• b. Needs additional drug therapy
• c. Non-adherence
• d. Dose too high

Answer: c. Non-adherence

3. A patient with a history of osteoporosis and a recent fracture is not taking any calcium, vitamin D, or bisphosphonate therapy. This represents which DTP?

• a. Unnecessary drug therapy
• b. Needs additional drug therapy
• c. Dose too low
• d. Ineffective drug

Answer: b. Needs additional drug therapy

4. The systematic process of identifying DTPs is a core component of which step in the Pharmacists’ Patient Care Process (PPCP)?

• a. Collect
• b. Assess
• c. Implement
• d. Follow-up

Answer: b. Assess

5. A patient is taking both lisinopril prescribed by their primary care doctor and losartan prescribed by their cardiologist. This is an example of which DTP?

• a. Adverse drug reaction
• b. Unnecessary drug therapy (specifically, therapeutic duplication).
• c. Non-adherence
• d. Dose too low

Answer: b. Unnecessary drug therapy (specifically, therapeutic duplication).

6. The “Introduction to MTM” is a specific learning module in which course?

• a. PHA5787C Patient Care 5
• b. PHA5104 Sterile Compounding
• c. PHA5703 Pharmacy Law and Ethics
• d. PHA5784C Patient Care 4

Answer: a. PHA5787C Patient Care 5

7. A patient complains of a persistent, dry cough that started after they began taking lisinopril. This is most likely which type of DTP?

• a. Ineffective drug
• b. Dose too high
• c. Needs additional drug therapy
• d. Adverse drug reaction

Answer: d. Adverse drug reaction

8. The Personal Medication Record (PMR) provided to the patient after a CMR should include:

• a. Only prescription medications.
• b. All medications, including prescriptions, OTCs, and herbals.
• c. Only controlled substances.
• d. Only medications that start with the letter “A”.

Answer: b. All medications, including prescriptions, OTCs, and herbals.

9. The Medication-related Action Plan (MAP) is a patient-centric document that contains:

• a. A list of actions for the pharmacist to complete.
• b. A list of actions for the patient to complete to help manage their health.
• c. A list of all medications that are contraindicated.
• d. The billing information for the MTM session.

Answer: b. A list of actions for the patient to complete to help manage their health.

10. A pharmacist performs an MTM session and identifies a severe drug interaction. The next step, part of the “Intervention” core element, is to:

• a. Do nothing and document it in the chart.
• b. Tell the patient to stop both medications immediately.
• c. Contact the prescriber to discuss the interaction and recommend a change.
• d. Wait until the patient’s next appointment.

Answer: c. Contact the prescriber to discuss the interaction and recommend a change.

11. Explaining the purpose of MTM services is a key objective in the Community IPPE.

• a. True
• b. False

Answer: a. True

12. A patient with an A1c of 9.5% is adherent to their metformin 1000 mg twice daily. The metformin could be considered what type of DTP in this case?

• a. Unnecessary drug therapy
• b. Ineffective drug (or dose too low, if not at max).
• c. Adverse drug reaction
• d. Needs additional drug therapy (as a separate DTP).

Answer: b. Ineffective drug (or dose too low, if not at max).

13. The “five core elements” of MTM were defined by which group?

• a. The FDA
• b. The DEA
• c. A consortium of pharmacy organizations, including APhA.
• d. The Centers for Medicare & Medicaid Services (CMS).

Answer: c. A consortium of pharmacy organizations, including APhA.

14. A patient is prescribed a medication that is contraindicated due to a drug-disease interaction noted on their profile. This represents a DTP related to:

• a. Efficacy
• b. Adherence
• c. Safety
• d. Indication

Answer: c. Safety

15. Identifying and resolving drug therapy problems is a key objective for student pharmacists.

• a. True
• b. False

Answer: a. True

16. The primary purpose of the “Collect” phase before a CMR is to:

• a. Gather all relevant subjective and objective information about the patient and their medications.
• b. Create the action plan.
• c. Bill for the service.
• d. Counsel the patient.

Answer: a. Gather all relevant subjective and objective information about the patient and their medications.

17. The PPD course series explores skills in MTM.

• a. True
• b. False

Answer: a. True

18. Which of the following is NOT a classic category of a Drug Therapy Problem?

• a. Indication
• b. Safety
• c. Efficacy
• d. Cost-effectiveness

Answer: d. Cost-effectiveness

19. A patient is prescribed an expensive brand-name statin when an equally effective generic is available on their formulary. While not a classic DTP, addressing this is part of:

• a. Creating a new DTP.
• b. Optimizing therapy and promoting cost-effective care.
• c. An ethical dilemma.
• d. Ignoring patient costs.

Answer: b. Optimizing therapy and promoting cost-effective care.

20. An active learning session on MTM is part of the Patient Care 5 course.

• a. True
• b. False

Answer: a. True

21. MTM services are required to be offered by which type of insurance plans?

• a. All private insurance plans.
• b. Medicare Part D plans.
• c. Medicaid plans only.
• d. Employer-sponsored plans only.

Answer: b. Medicare Part D plans.

22. A Comprehensive Medication Review (CMR) differs from a Targeted Medication Review (TMR) in that a CMR is:

• a. A brief review of a single medication issue.
• a. A holistic, systematic review of all of a patient’s medications.
• c. Performed by a technician.
• d. Not a billable service.

Answer: b. A holistic, systematic review of all of a patient’s medications.

23. MTM is considered a purely dispensing function.

• a. True
• b. False

Answer: b. False

24. An active learning session on MTM is part of which course?

• a. PHA5787C Patient Care 5
• b. PHA5163L Professional Skills Lab 3
• c. PHA5781 Patient Care I
• d. PHA5782C Patient Care 2

Answer: a. PHA5787C Patient Care 5

25. The final core element of the MTM service model is “Documentation and Follow-up.” The “Follow-up” step is crucial to:

• a. Ensure the pharmacist gets paid.
• b. Assess the outcomes of the interventions and make further adjustments if needed.
• c. Start the process over again.
• d. Fulfill a legal requirement only.

Answer: b. Assess the outcomes of the interventions and make further adjustments if needed.

26. A patient is prescribed a dose of lisinopril that is below the recommended therapeutic dose for hypertension. This is what type of DTP?

• a. Adverse drug reaction
• b. Dose too low
• c. Unnecessary drug therapy
• d. Needs additional drug therapy

Answer: b. Dose too low

27. The skills used in MTM are applicable to:

• a. Only the community pharmacy setting.
• b. Only the ambulatory care setting.
• c. Only the hospital setting.
• d. All pharmacy practice settings.

Answer: d. All pharmacy practice settings.

28. An active learning session on MTM is part of which course module?

• a. Module 5: Urological Disorders
• b. Module 1: Diabetes Mellitus
• c. Module 3: Women’s Health
• d. Module 6: Geriatrics

Answer: a. Module 5: Urological Disorders

29. The main difference between MTM and standard patient counseling is:

• a. MTM is a more comprehensive and systematic process of assessment and planning.
• b. Counseling is not part of MTM.
• c. MTM does not involve talking to the patient.
• d. There is no difference.

Answer: a. MTM is a more comprehensive and systematic process of assessment and planning.

30. The “Introduction to MTM” lecture is within the Patient Care 5 curriculum.

• a. True
• b. False

Answer: a. True

31. Which of the following is a key skill for a pharmacist providing MTM?

• a. Clinical problem solving.
• b. Patient-centered communication.
• c. Collaboration with other healthcare providers.
• d. All of the above.

Answer: d. All of the above.

32. A pharmacist identifies that a patient is not taking their medication because they cannot afford the copay. The pharmacist’s intervention would be to:

• a. Counsel the patient on the importance of adherence.
• b. Explore lower-cost alternatives or patient assistance programs.
• c. Tell the patient to get a better job.
• d. Do nothing.

Answer: b. Explore lower-cost alternatives or patient assistance programs.

33. The Pharmacists’ Patient Care Process (PPCP) provides the structure for delivering MTM.

• a. True
• b. False

Answer: a. True

34. Identifying drug therapy problems is a central component of which step of the PPCP?

• a. Collect
• b. Assess
• c. Plan
• d. Implement

Answer: b. Assess

35. A patient with heart failure is prescribed an NSAID for pain. The pharmacist identifies this as a potential DTP related to:

• a. Efficacy
• b. Safety (drug-disease interaction)
• c. Adherence
• d. Indication

Answer: b. Safety (drug-disease interaction)

36. A key outcome of MTM is:

• a. Increased patient empowerment and self-management skills.
• b. An increase in the number of identified drug therapy problems.
• c. A decrease in healthcare costs.
• d. Both a and c.

Answer: d. Both a and c.

37. MTM services can only be provided face-to-face.

• a. True
• b. False

Answer: b. False

38. The lecture “Introduction to MTM” is part of which course?

• a. PHA5787C Patient Care 5
• b. PHA5163L Professional Skills Lab 3
• c. PHA5781 Patient Care I
• d. PHA5782C Patient Care 2

Answer: a. PHA5787C Patient Care 5

39. Documentation of an MTM session is critical for:

• a. Continuity of care
• b. Communicating with other providers
• c. Billing and reimbursement
• d. All of the above

Answer: d. All of the above

40. An active learning session covering MTM is part of which course?

• a. PHA5787C Patient Care 5
• b. PHA5163L Professional Skills Lab 3
• c. PHA5781 Patient Care I
• d. PHA5782C Patient Care 2

Answer: a. PHA5787C Patient Care 5

41. Which of the following best describes the “Indication” category of DTPs?

• a. The patient’s drug is not working.
• b. The patient is experiencing a side effect.
• c. The patient is taking an unnecessary drug or needs an additional drug for an untreated condition.
• d. The patient cannot afford the drug.

Answer: c. The patient is taking an unnecessary drug or needs an additional drug for an untreated condition.

42. The “Efficacy” category of DTPs includes “dose too low” and “ineffective drug.”

• a. True
• b. False

Answer: a. True

43. The “Safety” category of DTPs includes “adverse drug reaction” and:

• a. “Dose too high.”
• b. “Ineffective drug.”
• c. “Needs additional drug therapy.”
• d. “Non-adherence.”

Answer: a. “Dose too high.”

44. MTM is a cornerstone of advanced pharmacy practice.

• a. True
• b. False

Answer: a. True

45. What is the difference between MTM and disease state management?

• a. There is no difference.
• b. MTM is a broader assessment of all of a patient’s medications, while disease state management is focused on a single condition.
• c. Disease state management is more comprehensive.
• d. MTM does not involve patient counseling.

Answer: b. MTM is a broader assessment of all of a patient’s medications, while disease state management is focused on a single condition.

46. A pharmacist performing MTM must be:

• a. A skilled clinician.
• b. An effective communicator.
• c. A systematic problem-solver.
• d. All of the above.

Answer: d. All of the above.

47. Identifying and resolving DTPs is a core objective in the IPPE curriculum.

• a. True
• b. False

Answer: a. True

48. An active learning session on MTM is part of which course module?

• a. Module 5: Urological Disorders
• b. Module 1: Diabetes Mellitus
• c. Module 4: Medication Safety
• d. Module 6: Geriatrics

Answer: a. Module 5: Urological Disorders

49. The overall goal of the MTM process is to:

• a. Find as many drug problems as possible.
• b. Improve a patient’s quality of life by ensuring their medications are appropriate, effective, safe, and used correctly.
• c. Increase the number of prescriptions a patient is taking.
• d. Complete the process in under 15 minutes.

Answer: b. Improve a patient’s quality of life by ensuring their medications are appropriate, effective, safe, and used correctly.

50. The ultimate reason to learn about MTM is to:

• a. Be prepared to provide a valuable, patient-centered clinical service that is a recognized part of modern pharmacy practice.
• b. Pass the final exam.
• c. Fulfill a requirement for the PPD courses.
• d. Learn how to bill insurance companies.

Answer: a. Be prepared to provide a valuable, patient-centered clinical service that is a recognized part of modern pharmacy practice.