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

1.

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

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.
2.

EJ is a 22-year-old female who comes to the pharmacy complaining of moderate dry eye symptoms. Her ophthalmologist suggested she get an OTC eye lubricating agent. She works as a model and wears disposable contacts. With her occupation, she works varying hours of the day and sometimes overnight. Her symptoms last all day, sometimes worse at night. Which is the best first line option for EJ?

  • Prepare homemade saline solution and store at a cool temperature for use as needed

  • A gel based product, such as Refresh Liquigel® - carboxymethylcellulose 1%

  • An ointment based product, such as Refresh PM® - mineral oil 42.5%, white petrolatum 56.8%

  • A solution based product, such as Refresh Relieva for Contacts® - carboxymethylcellulose 0.5%

Explanation

Explanation
Correct Answer: D) A solution based product, such as Refresh Relieva for Contacts® - carboxymethylcellulose 0.5%
Since EJ wears disposable contact lenses, she requires a solution specifically formulated and safe for use with contacts. Gel and ointment-based products are not compatible with contact lens wear as they can coat the lens and blur vision. Homemade saline solutions are not sterile and pose a serious infection risk. Refresh Relieva for Contacts® is designed specifically for contact lens wearers, making it the safest and most appropriate choice for her dry eye symptoms throughout the day.
3.

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

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.
4.

A cold is a self-limiting viral infection most commonly caused by Rhinovirus.

  • True

  • False

Explanation

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.
5.

In comparison to cerumen impaction, patients experiencing acute otitis media typically present with which symptoms that aid in ruling the patient out for self-care treatment? SELECT ALL THAT APPLY.

  • Ear fullness

  • Ear itching

  • Abnormal drainage from ear

  • Ear pain

Explanation

Explanation
Correct Answer: C) Abnormal drainage from ear and D) Ear pain
Acute otitis media (middle ear infection) is characterized by ear pain and abnormal drainage, which are alarm symptoms that exclude a patient from self-care and require medical referral. Ear fullness and ear itching are commonly associated with cerumen impaction or swimmer's ear (otitis externa), which may be appropriate for self-care management. The presence of drainage and significant pain suggests a more serious infection, potentially involving tympanic membrane perforation, necessitating professional evaluation and antibiotic treatment.
6.

Which of the following is true about why alcohol, benzodiazepines, and opioids are discouraged in the treatment of obstructive sleep apnea?

  • These agents are all second line agents in the treatment of obstructive sleep apnea.

  • These agents depress the drive to breathe.

  • These agents lead to addiction.

  • These agents lead to nighttime awakenings.

Explanation

Explanation
Correct Answer: B) These agents depress the drive to breathe.
In obstructive sleep apnea (OSA), the upper airway already becomes partially or fully blocked during sleep, causing repeated episodes of apnea. Alcohol, benzodiazepines, and opioids are CNS depressants that suppress the respiratory drive and relax upper airway muscles, worsening airway obstruction and prolonging apneic episodes. This can lead to dangerous drops in oxygen saturation. While addiction potential is a concern with some of these agents, the primary reason they are specifically contraindicated in OSA is their respiratory depressant effect.
7.

Which of the following is an EXCLUSION for the self-care treatment of headaches?

  • Patient is 12 years old

  • Patient has had the headache for 1 day

  • Patient drinks occasionally, 1 alcoholic beverage every weekend

  • Patient also has a high fever (102.5°F)

Explanation

Explanation
Correct Answer: D) Patient also has a high fever (102.5°F)
A headache accompanied by a high fever is an exclusion for self-care because it may indicate a serious underlying condition such as meningitis, encephalitis, or a severe systemic infection requiring immediate medical evaluation. A 12-year-old can use appropriate OTC analgesics such as ibuprofen or acetaminophen, a headache lasting 1 day is within self-care parameters, and occasional light alcohol use is not a contraindication. Fever with headache together is the red flag that necessitates referral.
8.

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

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.
9.

Which of these are symptoms of the patient?

  • Trouble staying asleep

  • Trouble falling asleep

  • Early awakenings

  • None of the above

Explanation

Explanation
Correct Answer: B) Trouble falling asleep
The patient reports sleeplessness (difficulty falling asleep) and compensates by napping all day. She is worried about morning sedation from diphenhydramine, suggesting her primary complaint is sleep onset insomnia — trouble falling asleep at night. There is no mention of early awakenings or difficulty maintaining sleep once asleep. Daytime napping is a consequence of her nighttime sleeplessness, not a separate sleep maintenance symptom.
10.

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

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.

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