Effective self-care consultation is a cornerstone of community pharmacy practice, empowering patients to manage common ailments safely and effectively. The “Transcending Concept of Self-Care,” a principle reinforced throughout the PharmD curriculum in courses like Patient Care 1 and Patient Care 3, moves beyond simple product recommendation. It involves a structured patient assessment, often using a specific questioning technique like SCHOLAR-MAC , to gather evidence, identify exclusions for self-treatment, and provide appropriate counseling. This quiz focuses on Self Care 2: Cough & Cold, a topic that demands sharp clinical decision-making from every future pharmacist.
1. A patient asks for a recommendation for a cough. What is the most important first question to ask to characterize the cough?
- a. “How much does it cost?”
- b. “Is the cough productive (wet) or non-productive (dry)?”
- c. “Do you want a brand name or generic?”
- d. “Have you tried anything for it yet?”
Answer: b. “Is the cough productive (wet) or non-productive (dry)?”
2. In the SCHOLAR-MAC acronym for patient assessment, what does the “A” in SCHOLAR stand for?
- a. Action
- b. Assessment
- c. Aggravating factors
- d. Allergies
Answer: c. Aggravating factors
3. Dextromethorphan is an over-the-counter medication used to treat:
- a. A productive cough, by thinning mucus.
- b. A non-productive cough, by acting as a cough suppressant (antitussive).
- c. Nasal congestion.
- d. A sore throat.
Answer: b. A non-productive cough, by acting as a cough suppressant (antitussive).
4. What is the primary mechanism of action of guaifenesin?
- a. It suppresses the cough reflex in the brainstem.
- b. It acts as a protussive or expectorant, helping to thin and loosen mucus.
- c. It constricts blood vessels in the nasal passages.
- d. It blocks histamine receptors.
Answer: b. It acts as a protussive or expectorant, helping to thin and loosen mucus.
5. Which of the following is an exclusion for self-treatment of a cough, warranting a referral to a physician?
- a. A cough that has lasted for 3 days.
- b. A cough accompanied by a sore throat.
- c. A cough that produces thick, yellow or green phlegm.
- d. A dry, hacking cough.
Answer: c. A cough that produces thick, yellow or green phlegm.
6. Pseudoephedrine and phenylephrine are oral decongestants that work by:
- a. Blocking histamine-1 receptors.
- b. Acting as alpha-adrenergic agonists to constrict blood vessels in the nasal mucosa.
- c. Thinning respiratory secretions.
- d. Suppressing the cough reflex.
Answer: b. Acting as a alpha-adrenergic agonists to constrict blood vessels in the nasal mucosa.
7. A patient with which of the following conditions should use an oral decongestant like pseudoephedrine with caution?
- a. Allergic rhinitis
- b. Uncontrolled hypertension
- c. Osteoarthritis
- d. Gout
Answer: b. Uncontrolled hypertension
8. Rhinitis medicamentosa, or rebound congestion, is a potential side effect of using a topical decongestant like oxymetazoline for more than:
- a. 1 day
- b. 3-5 days
- c. 2 weeks
- d. 1 month
Answer: b. 3-5 days
9. When using the SCHOLAR-MAC questioning technique, asking “What makes your headache feel worse?” corresponds to which letter?
- a. S – Symptoms
- b. H – History
- c. O – Onset
- d. A – Aggravating factors
Answer: d. A – Aggravating factors
10. Why are first-generation antihistamines (e.g., diphenhydramine) sometimes included in nighttime cold products?
- a. For their potent decongestant effects.
- b. For their sedative and anticholinergic (drying) properties.
- c. To treat the underlying viral infection.
- d. To thin mucus.
Answer: b. For their sedative and anticholinergic (drying) properties.
11. The common cold is caused by:
- a. Bacteria
- b. A virus, most commonly rhinovirus.
- c. Fungi
- d. Exposure to cold weather.
Answer: b. A virus, most commonly rhinovirus.
12. The “M” in SCHOLAR-MAC stands for:
- a. Medications
- b. Main Complaint
- c. Medical History
- d. Management
Answer: a. Medications
13. Which of the following non-pharmacologic recommendations is appropriate for both a cough and a cold?
- a. Avoiding all fluids.
- b. Ensuring adequate hydration with fluids like water.
- c. Strenuous exercise.
- d. Taking a hot shower with no ventilation.
Answer: b. Ensuring adequate hydration with fluids like water.
14. A patient asking for a recommendation for their cough and cold symptoms is an example of a:
- a. Prescription fulfillment request.
- b. Self-care consultation.
- c. Medication reconciliation.
- d. Compounding request.
Answer: b. Self-care consultation.
15. A key difference between the symptoms of a common cold and allergic rhinitis is that:
- a. Allergic rhinitis typically involves a fever, while a cold does not.
- b. A cold is associated with itchy, watery eyes, while allergies are not.
- c. A cold has a sudden onset and resolves in 7-10 days, while allergies can be seasonal or perennial.
- d. Only colds cause sneezing.
Answer: c. A cold has a sudden onset and resolves in 7-10 days, while allergies can be seasonal or perennial.
16. What is the primary role of zinc and vitamin C in managing the common cold?
- a. They are proven to cure the viral infection.
- b. They are FDA-approved decongestants.
- c. Some evidence suggests they may modestly reduce the duration of symptoms, but evidence is inconsistent.
- d. They are effective cough suppressants.
Answer: c. Some evidence suggests they may modestly reduce the duration of symptoms, but evidence is inconsistent.
17. “Self-Care for Cough & Cold” is a specific transcending concept in the Patient Care 3 course.
- a. True
- b. False
Answer: a. True
18. A patient is looking for an expectorant to help with a “chesty” cough. Which active ingredient should they look for?
- a. Dextromethorphan
- b. Phenylephrine
- c. Guaifenesin
- d. Diphenhydramine
Answer: c. Guaifenesin
19. Providing counseling to a patient or caregiver seeking self-care is a core learning objective for student pharmacists.
- a. True
- b. False
Answer: a. True
20. A patient reports a cough that has persisted for 3 weeks. What is the appropriate recommendation?
- a. Recommend a higher dose of dextromethorphan.
- b. Recommend combination therapy with guaifenesin and a decongestant.
- c. Refer the patient to a physician, as a cough lasting >7-10 days is an exclusion for self-care.
- d. Recommend a non-pharmacologic remedy like honey.
Answer: c. Refer the patient to a physician, as a cough lasting >7-10 days is an exclusion for self-care.
21. The “C” in SCHOLAR-MAC stands for:
- a. Cause
- b. Conditions
- c. Cost
- d. Compliance
Answer: b. Conditions
22. Which of the following is NOT a first-line agent for treating allergic rhinitis?
- a. Intranasal corticosteroids (e.g., fluticasone)
- b. Second-generation oral antihistamines (e.g., loratadine)
- c. Oral decongestants (e.g., pseudoephedrine)
- d. Allergen avoidance
Answer: c. Oral decongestants (e.g., pseudoephedrine)
23. Why is it important to ask about a patient’s current medications during a self-care consult?
- a. To identify potential drug interactions with OTC products.
- b. To determine if the patient can afford the medication.
- c. To see if they are taking any brand name drugs.
- d. It is not important to ask about their medications.
Answer: a. To identify potential drug interactions with OTC products.
24. The primary goal of a pharmacist during a self-care consultation is to:
- a. Make a definitive diagnosis.
- b. Sell the most expensive product.
- c. Gather sufficient information to determine if the patient is a candidate for self-care and recommend an appropriate course of action.
- d. Write a prescription for the patient.
Answer: c. Gather sufficient information to determine if the patient is a candidate for self-care and recommend an appropriate course of action.
25. A parent asks for a cough and cold product for their 3-year-old child. The pharmacist should:
- a. Recommend a product containing dextromethorphan and pseudoephedrine.
- b. Inform the parent that cough and cold products are not recommended for children under 4 years old and suggest non-pharmacologic options.
- c. Tell the parent to give half the adult dose.
- d. Recommend a first-generation antihistamine.
Answer: b. Inform the parent that cough and cold products are not recommended for children under 4 years old and suggest non-pharmacologic options.
26. The “H” in the SCHOLAR assessment acronym stands for:
- a. Hydration status
- b. Heart rate
- c. History of what has been done so far
- d. How much it hurts
Answer: c. History of what has been done so far
27. Non-medicated lozenges and hard candies can help a sore throat and cough primarily by:
- a. Numbing the throat.
- b. Killing viruses.
- c. Increasing saliva production and soothing irritated tissues.
- d. Thinning mucus.
Answer: c. Increasing saliva production and soothing irritated tissues.
28. A patient complains of a stuffy nose and wants the “strongest” decongestant. Which product is kept behind the pharmacy counter and requires an ID to purchase due to its use in the illicit manufacturing of methamphetamine?
- a. Phenylephrine
- b. Oxymetazoline
- c. Guaifenesin
- d. Pseudoephedrine
Answer: d. Pseudoephedrine
29. The “onset” of a patient’s symptoms helps the pharmacist differentiate between:
- a. A cheap and an expensive product.
- b. An acute condition (like a cold) and a chronic one.
- c. A productive and a non-productive cough.
- d. A viral and a fungal infection.
Answer: b. An acute condition (like a cold) and a chronic one.
30. Collecting evidence from a patient seeking self-care is a key skill practiced in the Professional Practice Skills Lab II.
- a. True
- b. False
Answer: a. True
31. Which of the following is a non-sedating, second-generation antihistamine?
- a. Diphenhydramine
- b. Chlorpheniramine
- c. Doxylamine
- d. Fexofenadine
Answer: d. Fexofenadine
32. The primary difference between a productive and non-productive cough is:
- a. The time of day it occurs.
- b. The presence or absence of phlegm or mucus (“wet” vs “dry”).
- c. How loud the cough is.
- d. The duration of the cough.
Answer: b. The presence or absence of phlegm or mucus (“wet” vs “dry”).
33. In the SCHOLAR-MAC acronym, what does “Location” refer to?
- a. Where the patient lives.
- b. Where the symptom is located on the body.
- c. The location of the pharmacy.
- d. Where the patient purchased previous medications.
Answer: b. Where the symptom is located on the body.
34. The main treatment approach for the common cold is:
- a. Curative therapy with antivirals.
- b. Prophylactic therapy with antibiotics.
- c. Symptomatic relief of the patient’s complaints.
- d. Vaccination during the illness.
Answer: c. Symptomatic relief of the patient’s complaints.
35. A patient with a cough lasting more than 7 days should be referred to a physician because:
- a. The OTC products stop working after 7 days.
- b. A persistent cough may indicate a more serious underlying condition that is not appropriate for self-treatment.
- c. The patient will develop tolerance.
- d. All OTC cough products are only sold in a 7-day supply.
Answer: b. A persistent cough may indicate a more serious underlying condition that is not appropriate for self-treatment.
36. “Remitting factors” in a patient assessment are:
- a. Things that make the symptom worse.
- a. Things that have been tried that make the symptom better.
- c. The reason the patient is seeking care.
- d. A list of the patient’s other medical conditions.
Answer: b. A list of the patient’s other medical conditions.
37. Dextromethorphan can have a drug interaction with which class of medications, potentially leading to serotonin syndrome?
- a. Statins
- b. ACE Inhibitors
- c. MAOIs and SSRIs
- d. Beta-blockers
Answer: c. MAOIs and SSRIs
38. The role of the pharmacist in self-care is to ensure the patient receives a therapy that is:
- a. The newest product on the market.
- b. Safe and effective for their specific symptoms and health conditions.
- c. The most expensive product available.
- d. Recommended by a celebrity.
Answer: b. Safe and effective for their specific symptoms and health conditions.
39. A patient wants a decongestant but has BPH (Benign Prostatic Hyperplasia). The pharmacist should counsel the patient that:
- a. Decongestants are the preferred treatment for BPH.
- b. Decongestants can worsen the symptoms of BPH, such as urinary retention.
- c. Topical decongestants are safer than oral ones in this case.
- d. Both b and c are correct.
Answer: d. Both b and c are correct.
40. The self-care management of allergies and colds is covered in the Patient Care I course.
- a. True
- b. False
Answer: a. True
41. What is the main benefit of using a second-generation antihistamine over a first-generation one for allergies?
- a. It is more effective.
- b. It is less expensive.
- c. It is non-sedating or less-sedating.
- d. It has a faster onset of action.
Answer: c. It is non-sedating or less-sedating.
42. A patient with a sore throat, fever, and swollen lymph nodes should be:
- a. Recommended an OTC cough drop.
- b. Referred to a physician to rule out a bacterial infection like strep throat.
- c. Given a topical decongestant.
- d. Told to take dextromethorphan.
Answer: b. Referred to a physician to rule out a bacterial infection like strep throat.
43. The “Symptoms” part of the SCHOLAR assessment is for:
- a. Determining the patient’s chief complaint.
- b. Listing all of the patient’s other medical conditions.
- c. Understanding what the patient has tried already.
- d. Identifying aggravating factors.
Answer: a. Determining the patient’s chief complaint.
44. Combination cough and cold products are always a better choice than single-ingredient products.
- a. True
- b. False
Answer: b. False
45. Using the SCHOLAR-MAC acronym helps the pharmacist to:
- a. Systematically gather all necessary information for a self-care recommendation.
- b. Speed up the consultation process.
- c. Make a definitive diagnosis.
- d. Avoid talking to the patient directly.
Answer: a. Systematically gather all necessary information for a self-care recommendation.
46. Which of the following is a non-pharmacologic recommendation for a stuffy nose?
- a. Using a cool-mist humidifier or vaporizer.
- b. Drinking less water.
- c. Lying flat on your back.
- d. Taking a stimulant.
Answer: a. Using a cool-mist humidifier or vaporizer.
47. A patient wants an OTC product for their child’s fever. The pharmacist should ask for what crucial piece of information first?
- a. The child’s favorite color.
- b. The child’s weight and age.
- c. The time the child went to bed.
- d. The child’s last report card.
Answer: b. The child’s weight and age.
48. Why is treating a productive cough with a potent antitussive sometimes not recommended?
- a. It can cause rebound congestion.
- b. It can lead to the retention of mucus and secretions in the lungs.
- c. It is not effective for productive coughs.
- d. It has too many drug interactions.
Answer: b. It can lead to the retention of mucus and secretions in the lungs.
49. The overall goal when a patient seeks self-care is to:
- a. Make a sale.
- b. Help the patient achieve a positive health outcome safely and effectively.
- c. Practice your counseling skills.
- d. Refer every patient to a physician.
Answer: b. Help the patient achieve a positive health outcome safely and effectively.
50. An important part of counseling a patient on a new OTC product is to tell them:
- a. The proper dose and frequency.
- b. Potential side effects.
- c. When they should follow up with a doctor if symptoms don’t improve.
- d. All of the above.
Answer: d. All of the above.