MCQ Quiz: Test and Treat

“Test and Treat” is an innovative model of care that expands the pharmacist’s role in public health by improving patient access to timely diagnosis and treatment for common, uncomplicated conditions. This practice is enabled by state-specific laws and protocols and relies on the pharmacist’s clinical expertise. This quiz will test your knowledge on the framework, common conditions, and pharmacist responsibilities related to Test and Treat services.

1. “Test and Treat” in pharmacy practice refers to the authority for a pharmacist to:

• a. Perform a point-of-care test and initiate therapy based on a collaborative practice agreement or statewide protocol.
• b. Diagnose any medical condition without testing.
• c. Dispense any medication without a prescription.
• d. Only test for a condition but not provide treatment.

Answer: a. Perform a point-of-care test and initiate therapy based on a collaborative practice agreement or statewide protocol.

2. The authority for pharmacists to perform “Test and Treat” services is determined by:

• a. Federal law only.
• b. The FDA.
• c. Individual State Boards of Pharmacy and state legislation.
• d. The CDC.

Answer: c. Individual State Boards of Pharmacy and state legislation.

3. Point-of-Care Tests (POCT) used in pharmacies, such as rapid flu or strep tests, are typically:

• a. Highly complex tests requiring a full laboratory.
• b. CLIA-waived, meaning they are simple to perform and have a low risk of erroneous results.
• c. Not accurate enough for any clinical use.
• d. More expensive than sending a sample to a lab.

Answer: b. CLIA-waived, meaning they are simple to perform and have a low risk of erroneous results.

4. To perform CLIA-waived tests, a pharmacy must obtain a:

• a. DEA license
• b. CLIA Certificate of Waiver
• c. Good Manufacturing Practices certificate
• d. A special compounding permit

Answer: b. A CLIA Certificate of Waiver

5. Which of the following is one of the most common conditions managed under a “Test and Treat” protocol in community pharmacy?

• a. Myocardial infarction
• b. Influenza
• c. Cancer
• d. Chronic kidney disease

Answer: b. Influenza

6. The management of infectious diseases like influenza and strep throat is a topic within which course?

• a. PHA5782C Patient Care 2
• b. PHA5104 Sterile Compounding
• c. PHA5703 Pharmacy Law and Ethics
• d. PHA5787C Patient Care 5

Answer: a. PHA5782C Patient Care 2

7. A patient tests positive for Influenza A via a rapid antigen test. Under a “Test and Treat” protocol, an appropriate therapy for the pharmacist to initiate would be:

• a. Amoxicillin
• b. Oseltamivir
• c. Amlodipine
• d. A cough drop

Answer: b. Oseltamivir

8. For an antiviral like oseltamivir to be most effective for influenza, it should be initiated within how long of symptom onset?

• a. 7 days
• b. 5 days
• c. 48 hours
• d. It is effective at any time.

Answer: c. 48 hours

9. A Rapid Antigen Detection Test (RADT) is used to test for which common pharyngitis pathogen?

• a. Staphylococcus aureus
• b. Streptococcus pyogenes (Group A Strep)
• c. Candida albicans
• d. Epstein-Barr virus

Answer: b. Streptococcus pyogenes (Group A Strep)

10. A patient tests positive for strep throat. What is the first-line antibiotic therapy that would be initiated under a “Test and Treat” protocol?

• a. Azithromycin
• b. Doxycycline
• c. Penicillin or Amoxicillin
• d. Levofloxacin

Answer: c. Penicillin or Amoxicillin

11. The pharmacist’s role in promoting public health is a key objective in the CIPPE course.

• a. True
• b. False

Answer: a. True

12. A “collaborative practice agreement” (CPA) is a formal agreement between:

• a. Two pharmacies.
• b. A pharmacist and a patient.
• c. A pharmacist and a technician.
• d. A pharmacist and a prescriber (like a physician).

Answer: d. A pharmacist and a prescriber (like a physician).

13. A key benefit of pharmacist-led “Test and Treat” services is:

• a. Increased patient access to timely care.
• b. Reduced burden on emergency departments and physician offices.
• c. Advancement of the pharmacy profession.
• d. All of the above.

Answer: d. All of the above.

14. Before performing any point-of-care test, the pharmacist must first:

• a. Obtain informed consent from the patient.
• b. Bill the patient’s insurance.
• c. Prepare the medication for dispensing.
• d. Call the patient’s doctor.

Answer: a. Obtain informed consent from the patient.

15. A patient presents with a sore throat, fever, and swollen lymph nodes, but their rapid strep test is negative. What is a critical counseling point?

• a. The patient definitely does not have a bacterial infection.
• b. A negative rapid test does not definitively rule out strep throat, and a follow-up throat culture may be needed, especially in children.
• c. The patient should take antibiotics just in case.
• d. The test was performed incorrectly.

Answer: b. A negative rapid test does not definitively rule out strep throat, and a follow-up throat culture may be needed, especially in children.

16. Defending a therapeutic plan for a bacterial infection is an objective in the skills lab curriculum.

• a. True
• b. False

Answer: a. True

17. Which of the following is an “exclusion criteria” for a self-care or “Test and Treat” protocol, meaning the patient should be referred?

• a. A mild symptom.
• b. A symptom present for less than 24 hours.
• c. Signs of a severe or systemic illness (e.g., shortness of breath, confusion).
• d. A patient who is a young adult.

Answer: c. Signs of a severe or systemic illness (e.g., shortness of breath, confusion).

18. A key part of any “Test and Treat” protocol is:

• a. The pharmacist’s ability to use their own judgment outside the protocol.
• b. Strict adherence to the pre-defined inclusion/exclusion criteria and treatment algorithm.
• c. Treating every patient who presents, regardless of symptoms.
• d. Ensuring the service is profitable.

Answer: b. Strict adherence to the pre-defined inclusion/exclusion criteria and treatment algorithm.

19. A pharmacist providing a “Test and Treat” service must:

• a. Document the encounter thoroughly.
• b. Communicate the results and treatment plan to the patient’s primary care provider.
• c. Provide patient counseling.
• d. All of the above.

Answer: d. All of the above.

20. The principles of pharmacy law provide the framework for expansions in the scope of practice.

• a. True
• b. False

Answer: a. True

21. A major challenge for implementing “Test and Treat” services in pharmacy is:

• a. The tests are too easy to perform.
• b. A lack of patient interest.
• c. Establishing a workflow that separates these clinical services from the dispensing function.
• d. The conditions are too rare.

Answer: c. Establishing a workflow that separates these clinical services from the dispensing function.

22. A pharmacist’s ability to physically assess a patient is limited. Therefore, protocols rely heavily on:

• a. The pharmacist’s best guess.
• b. Patient-reported symptoms and objective point-of-care test results.
• c. The patient’s insurance plan.
• d. The time of day.

Answer: b. Patient-reported symptoms and objective point-of-care test results.

23. Which of the following is NOT a CLIA-waived test commonly performed in a pharmacy?

• a. Blood glucose
• b. A1c
• c. Lipid panel
• d. A surgical biopsy

Answer: d. A surgical biopsy

24. A pharmacist must receive specific training on how to properly collect a specimen (e.g., a throat swab) to ensure the accuracy of a POCT.

• a. True
• b. False

Answer: a. True

25. A key counseling point after a negative flu test during peak flu season is:

• a. The patient definitely does not have the flu.
• b. The test has a significant rate of false negatives, and the patient should still monitor for worsening symptoms.
• c. The patient needs an antibiotic.
• d. The patient is now immune to the flu.

Answer: b. The test has a significant rate of false negatives, and the patient should still monitor for worsening symptoms.

26. The expansion of the pharmacist’s scope of practice, including “Test and Treat,” is primarily driven by:

• a. A desire to make more money.
• b. A public health need to improve patient access to care.
• c. A surplus of pharmacists.
• d. A lack of effective medications.

Answer: b. A public health need to improve patient access to care.

27. What is the pharmacist’s responsibility if a patient’s symptoms are outside the scope of the “Test and Treat” protocol?

• a. To treat the patient anyway.
• b. To refer the patient to a more appropriate level of care, such as their primary care provider or an urgent care center.
• c. To tell the patient there is nothing wrong with them.
• d. To refuse to speak with the patient.

Answer: b. To refer the patient to a more appropriate level of care, such as their primary care provider or an urgent care center.

28. An active learning session on infectious diseases is part of which course?

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

Answer: a. PHA5782C Patient Care 2

29. The term “protocol” in this context refers to:

• a. A loose set of suggestions.
• a. A detailed, written plan that outlines the steps for patient assessment, testing, and treatment.
• c. The pharmacist’s personal preference.
• d. An unwritten understanding.

Answer: b. A detailed, written plan that outlines the steps for patient assessment, testing, and treatment.

30. The “Principles of Pharmacy Law and Ethics” course is foundational for understanding scope of practice.

• a. True
• b. False

Answer: a. True

31. A patient with a sore throat and a negative rapid strep test is prescribed amoxicillin by their physician. The pharmacist should:

• a. Refuse to fill the prescription because the test was negative.
• b. Recognize that the physician may be treating based on clinical judgment or suspicion of a false negative, and dispense the prescription.
• c. Call the physician to argue about the diagnosis.
• d. Switch the antibiotic to azithromycin.

Answer: b. Recognize that the physician may be treating based on clinical judgment or suspicion of a false negative, and dispense the prescription.

32. A major consideration for a pharmacy implementing “Test and Treat” services is:

• a. Having a private or semi-private area for testing and counseling.
• b. Proper disposal of biohazardous waste.
• c. Staff training and competency assessment.
• d. All of the above.

Answer: d. All of the above.

33. The main reason for treating Group A Strep pharyngitis is to:

• a. Prevent the common cold.
• b. Prevent the serious complication of acute rheumatic fever.
• c. Shorten the duration of the sore throat by one day.
• d. Prevent the patient from missing school.

Answer: b. Prevent the serious complication of acute rheumatic fever.

34. A pharmacist’s ability to provide “Test and Treat” for UTIs would be an expansion of their scope of practice.

• a. True
• b. False

Answer: a. True

35. A key part of the “Treat” portion of the service is:

• a. Dispensing the medication.
• b. Providing comprehensive counseling on the medication.
• c. Counseling on when to seek further medical attention if symptoms don’t improve.
• d. All of the above.

Answer: d. All of the above.

36. Reimbursement for “Test and Treat” services is often a significant barrier to implementation.

• a. True
• b. False

Answer: a. True

37. Which of the following is NOT a benefit of pharmacist-led “Test and Treat”?

• a. Increased convenience for patients.
• b. Reduced healthcare system costs.
• c. Improved antimicrobial stewardship.
• d. The ability to diagnose and treat complex diseases.

Answer: d. The ability to diagnose and treat complex diseases.

38. The pharmacy law course PHA5703 provides the basis for understanding CPAs.

• a. True
• b. False

Answer: a. True

39. A patient wants a rapid flu test in July. A pharmacist following a protocol should recognize that:

• a. Testing may not be appropriate outside of peak flu season due to low prevalence and a high chance of a false positive.
• b. The test is more accurate in the summer.
• c. The patient should be tested immediately.
• d. The flu vaccine causes a positive flu test.

Answer: a. Testing may not be appropriate outside of peak flu season due to low prevalence and a high chance of a false positive.

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

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

Answer: a. PHA5782C Patient Care 2

41. The role of the pharmacist in public health is a key theme in the IPPE curriculum.

• a. True
• b. False

Answer: a. True

42. Which of the following is a critical skill for a pharmacist providing “Test and Treat” services?

• a. Patient assessment.
• b. Interpretation of point-of-care test results.
• c. Clinical decision-making based on a protocol.
• d. All of the above.

Answer: d. All of the above.

43. A “protocol” for a test and treat service is often developed in collaboration with:

• a. A physician or local health department.
• b. The pharmacy’s marketing team.
• c. The pharmacy technicians.
• d. The patients.

Answer: a. A physician or local health department.

44. A patient has a sore throat, but also has difficulty breathing. This patient is:

• a. A perfect candidate for a “Test and Treat” for strep throat.
• b. Not a candidate for “Test and Treat” and should be immediately referred to a higher level of care.
• c. Should be given an OTC cough drop.
• d. Should be tested for the flu.

Answer: b. Not a candidate for “Test and Treat” and should be immediately referred to a higher level of care.

45. “Test and Treat” models of care are an example of:

• a. The expanding scope of pharmacy practice.
• b. A way for pharmacists to practice at the top of their license.
• c. A strategy to improve public health.
• d. All of the above.

Answer: d. All of the above.

46. A pharmacist’s documentation of a “Test and Treat” encounter is a legal record.

• a. True
• b. False

Answer: a. True

47. The management of common infections is a topic in the Patient Care 2 curriculum.

• a. True
• b. False

Answer: a. True

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

• a. Module 9: Infectious Diseases of the Kidney
• b. Module 1: PUD and GERD
• c. Module 4: Gastrointestinal Infections
• d. Module 5: Nutrition & Weight Management

Answer: a. Module 9: Infectious Diseases of the Kidney

49. The overall management of a “Test and Treat” service requires a strong commitment to:

• a. Quality assurance and patient safety.
• b. Selling as many tests as possible.
• c. Speed over accuracy.
• d. Only treating patients with good insurance.

Answer: a. Quality assurance and patient safety.

50. The ultimate goal of learning about “Test and Treat” models is to:

• a. Be prepared for the evolving role of the pharmacist as a more accessible healthcare provider.
• b. Pass the final exam.
• c. Decide that this is not a good model for pharmacy.
• d. Be able to perform any laboratory test.

Answer: a. Be prepared for the evolving role of the pharmacist as a more accessible healthcare provider.