Chicago State University School of Pharmacy PHAR 6128 Pharmacy Patient Skills II
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Free Chicago State University School of Pharmacy PHAR 6128 Pharmacy Patient Skills II Questions
VS is a 56-year-old male complaining of mild left leg pain following a cycling accident that occurred yesterday. VS reports no inflammation, but he does have broken skin in the area secondary to cuts and scrapes from the accident. VS reports no drug allergies and has a medical history significant for impaired renal function. Which of the following would be the BEST treatment option for VS's pain?
- Heat Treatment
- Ibuprofen
- Naproxen
- Acetaminophen
Explanation
Correct Answer: D) Acetaminophen
This patient has impaired renal function, which is a contraindication for NSAIDs such as ibuprofen and naproxen, as these agents reduce renal prostaglandin synthesis, causing further vasoconstriction of renal vasculature and potentially worsening kidney function. Heat treatment is contraindicated given the presence of broken skin, cuts, and scrapes, as it could worsen inflammation and increase infection risk. Acetaminophen is renally safe at appropriate doses and has no contraindications in this patient, making it the best pharmacologic choice.
What is the most appropriate recommendation for a person presenting with an ineffective "wet" cough and nasal congestion?
- Guaifenesin and pseudoephedrine
- Diphenhydramine
- Loratadine and pseudoephedrine
- Dextromethorphan and phenylepherine
Explanation
Correct Answer: A) Guaifenesin and pseudoephedrine
A wet (productive) cough indicates mucus that needs to be expectorated. Guaifenesin is an expectorant that thins and loosens mucus, making the cough more productive and effective. Pseudoephedrine is a decongestant that relieves nasal congestion by constricting blood vessels. Together, they address both symptoms directly. Dextromethorphan suppresses cough and would be counterproductive for a wet cough that needs to clear secretions. Diphenhydramine and loratadine are antihistamines more appropriate for allergic symptoms.
Which of the following medications should be avoided in children < 16 years old with symptoms of viral infection due to the risk of developing Reye's Syndrome?
- Acetaminophen (APAP)
- Aspirin (ASA)
- Naproxen (NSAID)
- Ibuprofen (NSAID)
Explanation
Correct Answer: B) Aspirin (ASA)
Reye's Syndrome is a rare but potentially fatal condition characterized by acute encephalopathy and liver failure, strongly associated with aspirin use in children and teenagers recovering from viral illnesses such as influenza or chickenpox. For this reason, aspirin is strictly contraindicated in patients under 16 years old with viral infections. Acetaminophen and NSAIDs such as ibuprofen and naproxen are safe and appropriate alternatives for fever and pain management in this population.
Which of the following medications should be avoided in children < 16 years old with symptoms of viral infection due to the risk of developing Reye's Syndrome?
- Acetaminophen (APAP)
- Aspirin (ASA)
- Naproxen (NSAID)
- Ibuprofen (NSAID)
Explanation
Correct Answer: B) Aspirin (ASA)
Reye's Syndrome is a rare but potentially fatal condition characterized by acute encephalopathy and liver failure, strongly associated with aspirin use in children and teenagers recovering from viral illnesses such as influenza or chickenpox. For this reason, aspirin is strictly contraindicated in patients under 16 years old with viral infections. Acetaminophen and NSAIDs such as ibuprofen and naproxen are safe and appropriate alternatives for fever and pain management in this population.
There are two questions associated with this case." "Insomnia-Fatigue Case 2."
A regular patron of the grocery store pharmacy comes to pick up his monthly refill for temazepam (Restoril), which is a long-acting benzodiazepine. He also wants to ring out a 4-pack of Corona Light and 4 sugar-free Red Bulls. He seems out of it — you ask him for his birthday multiple times and each time he gives you his address.
Which of the following questions may be used to assess aggravating factors in SCHOLAR-MAC?
- What makes the symptoms worse?
- Has this happened in the past?
- When did the symptoms start?
- What makes the symptoms better?
Explanation
Correct Answer: A) What makes the symptoms worse?
In the SCHOLAR-MAC framework, "A" stands for Aggravating and Alleviating factors. Aggravating factors refer to what makes the symptoms worse, while alleviating factors refer to what makes them better. "Has this happened in the past?" relates to History, "When did the symptoms start?" relates to Onset, and "What makes the symptoms better?" relates to the alleviating component — not the aggravating factor being asked about here.
DF is a 33-year-old male complaining of mild (pain score = 3) right ankle pain following an injury that occurred yesterday during his kickball game. DF reports mild inflammation and has some minor cuts and bruises in the affected area. DF reports an allergy to salicylates and has a medical history significant for chronic alcohol abuse (> 4 alcoholic beverages/day). Which of the following would be the BEST treatment option for DF's pain?
- Ibuprofen
- Acetaminophen
- Heat treatment
- Aspirin
Explanation
Correct Answer: C) Heat treatment
This patient has two critical contraindications that eliminate most pharmacologic options. Aspirin is contraindicated due to his salicylate allergy. Ibuprofen (an NSAID) is contraindicated because NSAIDs can worsen bleeding risk with open cuts and should be avoided with alcohol use. Acetaminophen is contraindicated with chronic heavy alcohol use (>3 drinks/day) due to the risk of severe hepatotoxicity. Heat treatment, while typically not preferred for acute injuries with inflammation, is the safest option given all pharmacologic choices are contraindicated in this patient.
DF is a 33-year-old male complaining of mild (pain score = 3) right ankle pain following an injury that occurred yesterday during his kickball game. DF reports mild inflammation and has some minor cuts and bruises in the affected area. DF reports an allergy to salicylates and has a medical history significant for chronic alcohol abuse (> 4 alcoholic beverages/day). Which of the following would be the BEST treatment option for DF's pain?
- Ibuprofen
- Acetaminophen
- Heat treatment
- Aspirin
Explanation
Correct Answer: C) Heat treatment
This patient has two critical contraindications that eliminate most pharmacologic options. Aspirin is contraindicated due to his salicylate allergy. Ibuprofen (an NSAID) is contraindicated because NSAIDs can worsen bleeding risk with open cuts and should be avoided with alcohol use. Acetaminophen is contraindicated with chronic heavy alcohol use (>3 drinks/day) due to the risk of severe hepatotoxicity. Heat treatment, while typically not preferred for acute injuries with inflammation, is the safest option given all pharmacologic choices are contraindicated in this patient.
All of the following are non-pharmacologic options for self-treatment for water-clogged ears, EXCEPT:
- Using a blow dryer on a low setting (cool or warm) around the ear to air dry, avoiding blowing directly into the ear
- Tilting the ear downward and gently manipulate the auricle to allow the water to flow from the ear
- Using water absorbent ear plugs, after exposure to water, to dry the fluid accumulation in the ears for ages 17 and up
- Using a cotton-tipped applicator to clean and soak up the moisture and cerumen from the ear
Explanation
Correct Answer: D) Using a cotton-tipped applicator to clean and soak up the moisture and cerumen from the ear
Cotton-tipped applicators (Q-tips) should never be inserted into the ear canal as they can push cerumen deeper, damage the delicate ear canal skin, or perforate the tympanic membrane, increasing the risk of infection. All other options are appropriate nonpharmacologic measures — a blow dryer on low setting, gravity-assisted drainage by tilting the head, and absorbent ear plugs are all safe methods for managing water-clogged ears.
A cold is a self-limiting viral infection most commonly caused by Rhinovirus.
- True
- False
Explanation
Correct Answer: A) True
The common cold is indeed a self-limiting upper respiratory tract infection, meaning it resolves on its own without specific medical treatment, typically within 7–10 days. Rhinovirus is the most common causative pathogen, responsible for approximately 30–50% of all cold cases. Other viruses such as coronaviruses, adenoviruses, and respiratory syncytial virus can also cause cold symptoms, but rhinovirus remains the predominant cause.
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