Pharmacy Practice Lab

Pharm 411

Dr. Jackson

Exam 1

Name: Huyenvy Van

T-Number: 00417159

[1]
[2]
1. A 41 year old man is complaining of feeling thirsty, having to urinate more than usual, and
feeling very tired lately. These are symptoms of:

a. Diabetes type II – Both types of diabetes are generally associated with an increasing in urine
as well as feelings of thirst.

b. Coronary heart disease – The symptoms of coronary heart disease involves angina (angina
pectoris), chest pains,. There are also pain or discomfort in other areas of your upper body such
as the arms, left shoulder, back, neck, jaw, or stomach.

c. Hypertension – Hypertension does not really have any outward signs and thus it is also known
as the silent disorder.

d. Parkinson’s – Parkinson’s symptoms include involuntary trembling of the limbs, rigidity of the
muscles, akenesia, and postural instability.

e. All of the above

Choice A is correct because both type of diabetes include those symptoms

2. Which of the following factors impact patient interpretation of verbal and nonverbal messages?

a. Definition and perception of words – The definition of the sender’s words and the patient’s
perception of those words are also a major factor on how much the message is actually
understood.

b. Symbol – Symbols and pictures can also help in the interviewing process to improve the
patient overall understanding of their medications

c. Non-verbal element – The body language contains about 70% of the conversation during
counseling.

d. A and B only – C is correct for sure so the answer cannot be D.

e. A, B and C

Choice E is correct because all of the answers are important factors that may impact patient
interpretation in verbal and nonverbal messages

3. What percentage of all communication is done through body language?

a. 40% consists of body language

b. 50% consists of body language

[3]
 c. 70% consists of body language – A conversation between two people, especially a pharmacist
and patient’s during counseling, contains about 70% non-verbal element. This is in Dr.
McClayton’s notes and was also mentioned in Dr. Jackson’s lab.

c. 80% consists of body language

e. None of the above

The only choice that is correct is choice C which was mentioned in the lab by Dr. Jackson.

4. The final message is NOT what is said but how the patient perceives what was said?

a. True
b. False

The answer is choice A because at the end of the conversation, depending on the diverse
barriers, the messenger that the patient perceives can be quite different from what is meant.
The patient’s perception depends on how trustworthy the pharmacist or HCP.

5. What is analyzed during the Objective part of patient history?

a. Vital signs – Vital signs includes the patient’s blood pressure, pulse, etc.

b. Findings from physical examinations such as posture, bruising, and abnormalities

c. Results from laboratory tests –Clinical test data from laboratory.

d. Measurements – Measurements are a part of clinical data. These data consist of age, weight,
height, and etc.

e. All of the above

The Objective portion of SOAP consists of all data such as measurable clinical data and ROS so
the answer is E, all of the above.

6. When you are “feeling into”, you are showing empathy.

a. True
b. False

Choice A is correct because it is the definition of empathy from Dr. McClayton’s lecture. You are
putting yourself in the other person’s shoes.

[4]
7. When you are “feeling with”, you are not showing sympathy.

a. True
b. False

Choice B is correct because “feeling with” is the definition of sympathy from the Dr. McClayton’s
lecture. You are only showing sympathy but not really trying to put yourself in the other person’s
shoes.

8. One of the top 10 communication mistakes pharmacists make is not paying attention to both
verbal and nonverbal communication messages sent by their patients.

a. True
b. False

Choice A is correct. According to page 25 of “Patient Counseling”, pharmacist’s tends to either

forget or misinterpret the a part of communication (verbal part or non-verbal part).

9. What part of SOAP contains measurable data such as current medication, allergies, and test
results?

a. Subjective – Subjective is the part that the patient tells you.

b. Objective – Objective is the part that gained from your own observations and clinical data
from laboratory tests

c. Assessment – Assessment is when you interpret and combine all of the information together to
gain an overall understanding of the patient situation.

d. Plan – Planning is the last part of SOAP. It’s when you consider all the treatment methods and
adjusts it to the patient’s social and economic situation as well as how compliant they are.

e. All of the above

Choice B is correct since the Objective part of SOAP consists of measurable data from tests

10. Which of the following would NOT be classified as a pertinent component under the subjective
portion of S.O.A.P.?

a. Chief Complaint –The main chief complaint of the patient is under Subjective.

b. History of Present Illness – The history of present illness is acquired from was the patient says
so it’s Subjective.

[5]
 c. Allergies – Allergies are a part of Objective according to Dr. Jackson notes.

d. Past Medical History – under Subjective

e. Family History – under Subjective

Answer C is correct because it is under objective in her notes. (However, when I searched online,
“subjective is the problem from the patient’s point of view - how he feels. It may include the
chief complaint present illness, past history, current medications, diet and appetite, and
allergies.” Objective consists of the pharmacist’s observations, the physical examination,
laboratory results, and X-rays.)

11. Which of the following is one of the reason(s) why a patient would need counseling?

a. Increases compliance – This is true because you want to increase the patient compliance to
stay with the treatment plan that was devised for them.

b. To note the history of patient illness – This is true because you want to avoid any adverse
conditions due to the new medication because of a lack of the patient’s history.

c. Patient background is needed for proper therapeutic assessment – This is true because
without the patient background, we might come up with a treatment plan that consists of
useless or adverse drugs.

d. All of the above

e. None of the above

All of the above are true based on the “Patient counseling” packet as well as some common
sense so the correct answer is choice D.

12. De-personalizing is when a pharmacist:

a. Interact directly with the patient –You are interacting with patient so you are personalizing.

b. Is showing sympathy – You are interacting with patient so you are personalizing.

[6]
 c. Is showing controlling behaviors – This belongs to authoritarian style of communication no
de-personalizing.

d. Responds emphatically to the patients situation – You are interacting with patient so you are
personalizing.

e. Talks to the patient’s son rather than the patient because he is too old and senile – This is
obviously a model example of de-personaling from the patient. The pharmacist is not talking
directly to the patient.

De-personalizing is when the pharmacists talks to person other than the actual patient due to
certain reasons and depriving the individual of your attention. Choice E is the only one with a
situation where the pharmacist talks to a different person other than the actual patient.

13. Reason pharmacists may want to work to improve communication?

a. Medication related errors – This is not the best answer.

b. Use medications appropriately – This is not the best answer.

c. Ultimately meet their therapeutic goals – This is the ultimate goal that you as a
pharmacist wish for the patient to achieve.

d. Help patients make informed decisions – This is not the best answer.

e. Improve patient outcomes. – This is not the best answer.

All of the answers are correct, however, the BEST answer is C.

14. What information is not to be discussed with the patients?

a. How to self monitor drug therapy - This is part of counseling based on patient-centered
and increase compliance.

b. What to do if a patient misses a dose. – This must also be dealt with since some patient
might overdose themselves.

c. Don’t drink and smoke marijuana because it’s not good for the health. – This is not part of
a pharmacist’s responsibility in counseling a patient.

d. How to take the medications. – This is an obvious part of counseling and also a major
part.

[7]
 e. How to store the medications. - Another part when we are dealing with easily degradable
or contaminable drugs for example insulin.

All of the above are obvious answers logically, the only one that didn’t fit is telling the patient
not to drink or take marijuana. Even if we said something like that, the reason needs be because
of some kind of interaction with the medication not just because it’s good for the patient. Thus,
the answer is C which is not true.

15. One of the followings is the law enacted by the Federal Government that mandated pharmacists
to perform Drug Use Reviews for Medicaid patients

a. American Council on Pharmacy Education – ACPE provides accreditations for pharmacy

programs and also defines what patient-centered care would consist of.

b. The Omnibus Budget Reconciliation Act 1990 (OBRA ’90) – OBRA’90 requires that
pharmacists responsible for Prospective Drug Review (ProDUR), patient counseling, and
maintaining proper patient records.

c. The Health Insurance Portability and Accountability Act of 1996 – This law helps protect the
insurance coverage for workers and their families when they change or lose their jobs. It also
deals with the security and privacy of health data.

d. A and B only

e. A, B and C

Choice B is the only one correct according the packet “Patient-Centered Communication in
Pharmacy Practice”. OBRA ’90 mandated that pharmacists offer to counsel Medicaid outpatients
about prescription medications as well as ProDUR.

16. Which of the following(s) discusses the pharmacy care process?

a. Collecting and using patient information – This is needed as the subjective part of SOAP.
b. Identifying patient's drug related problems – It basically means what is the patient
problem.
c. Developing solutions to these problems – This is the Assessment part of SOAP.
d. Selecting and recommending therapies – This is the Planning part of SOAP.
e. All of the above

Choice E is correct because all of the answers can be found on pg. 10 of the “Patient Handling”
packet and all of them are part of SOAP.

[8]
17. Who should a pharmacist counsel?

a. Patient with poor literacy – The pharmacist can use lower grade level words to counsel.

b. Patient whose profile shows a change in the medication or dosing – This is obviously a job for
the pharmacist.

c. Patient receiving medication with special storage requirement. – As was established earlier,
this is also part of what a pharmacist must counsel about in cases such as insulin.

d. None of the above.

e. All of the above.

Choice E is correct because all of the answers can be found on pg. 7 of the “Patient Handling”
packet and the answer is pretty obvious since a pharmacist should be able to counsel almost
anyone.

18. Barriers in communication are?

a. Excessive work load – When a pharmacist is busy, he is obviously distracted by the work
load to properly interact with the patient.

b. Lack of time and /or staff – This reduces the efficiency and amount of available time to
properly counsel the patient
.
c. Color of the pharmacy – Colors is not really a barrier to communication unless it’s some
weird designs.

d. A and B only

e. A, B and C

Choice D is correct because only answer choices A and B can be found on pg. 21 of the “Patient
Handling” packet.

19. A patient comes in to the pharmacy for some anti-diabetic drugs for the first time. Which term(s)
you would you use during counseling?

a. Polyuria
b. Polyphagia
c. Polydipsia
d. All of the above
e. None of the above

Choice E is the correct answer because all three answers are professional jargon that you should
avoid using on a patient.

20. PMH stands for

[9]
 a. Past Medication History – This could also be possible if you don’t know about SOAP.
b. Present Medication History – There is no such thing as Present …. History.
c. Present Medical History – There is no such thing as Present …. History.
d. Past Medical History – This is in the Subjective part of SOAP.
e. Patient’s Medical History –This could be a possible logical answer.

Choice D is correct according to pg. 28 of the “Patient Handling” packet and it is in the Subjective
part of SOAP.

21. Which of the following statements elicit appropriate feedback from the patient during
counseling?

a. It is important that I understand how you are going to take this medication – (pg. 4)
b. Please summarize the most important things about this medication – (pg. 4)
c. When are you going to see your friend – there is no reason to ask this from you patient
d. A and B only
e. A, B and C

Choice D is correct according to the packet, “Principles & Elements of Interpersonal

Communications”, while choice C is just pure nonsense. There is a list of things to check if the
patient understood keys point of the counseling on page 4.

22. To prevent misperceptions and misunderstandings, pharmacists should NOT do which of the
following?

a. Avoid the use of equivocal terms – For example, you need to take this with a glass of water
(exactly how much?)

b. Use professional jargon to appear qualified – You should not use this because the patient
won’t understand it.

c. Use low-level abstractions to build clarity – This can obviously increase understanding.

d. Recognize the differences in cross-cultural styles of speaking – If you understand this, it will
help reduce this barrier.

e. Use visual aids to help patient’s comprehension – This can help increase the patient’s
understandings if they are visual learner, non-english speakers, or hearing-impaired.

Choice B is the only thing that a pharmacist would NOT do. The use of professional jargon is
inappropriate for a patient. The pharmacist should use layman terminologies to instruct the
patient and thus increase the patient understandings.

23. What are the primary function(s) of communication between pharmacists and patient?

a. It establishes the ongoing relationship between you and your patients – This helps the
pharmacist to build rapport with the patient.

b. It provides the exchange of information necessary to assess your patient’s health conditions –
This is pretty much the Subjective and possibly the Objective portion of SOAP.

c. It provides the exchange of information necessary to reach decisions on treatment plans –

This is pretty much the Subjective and possibly the Objective portion of SOAP.

[10]
 d. A and b

e. A, b and c

Choice E is correct because all of the choices above are the main reasons. Choice A is the same
as building rapport. Choice B and C are the main function of counseling and as well as part of
SOAP.

24. Strategies to improve the communication include all of the following except

a. Explain things clearly in plain language – Clarity of a spoken language can increases patient’s
understandings.

b. Speak very loudly as possible, so that patient can understand – This is not necessary and can
be considered rude. Even with the hearing-impaired, you can just use a note pad to
communicate effectively.

c. Focus key message and repeat – This helps the patient retains the information by
emphasizing on the important points.

d. Use a “teach back” or “Show me” technique to check understanding – This method can reveal
to the pharmacist how much of the information the patient had understood.

e. Effective solicit question. – This can help patient to understand if used correctly. (Not sure)

Choice B is the correct answer. Choice A, C, and D are obviously correct while E might still be a bit
vague. However, comparing B and E, choice B is something that you should NOT do.

25. Which of the following best describes medicine use process from patient prospective?

a. Illness  prescription order  presents to pharmacy  dispensing – This is the only one in
correct order.

b. prescription order  presents to pharmacy  dispensing  Illness – This is not in order.

c. Illness  dispensing prescription order  presents to pharmacy – This is not in order.

d. dispensing  Illness  prescription order  presents to pharmacy – This is not in order.

e. None of the above

Choice A is the only possible answer according to Dr. McClayton’s first packet, “Patient-Centered
Communication in Pharmacy Practice”.

[11]