Pharmacy Practice Exam 2 April 10Th

Front 1

subjective...

Back 1

obtained through an interview or pt rep
always ID the info giver
must support the assessment and plan

Front 2

objective...

Back 2

info obtained by verifiable means
numbers, lab data
physical exam, rx records
all info must support the A&P

Front 3

S vs O

Back 3

who reported it?
who measured it?
keep it brief and focused

Front 4

Assessment

Back 4

assessment of medical / DRUG Therapy related problems
list numerically-prioritize problems
MUST include explanation of why problem exists
MUST contain therapeutic goals

Front 5

Plan

Back 5

numbered the same way as assessment
INDIVIDUALIZED instructions for drug therapy
ALWAYS include endpoints and followup
Use generic names - Sign your name

Front 6

format of a problem in assessment

Back 6

justify existence
describe therapeutic goals
outline reasonable therapeutic alternatives
DO NOT use "I recommend"
use bullet points within each number

Front 7

abbreviations in the note?

Back 7

avoid as much as possible
when in doubt, spell it out
NEVER abbreviate drug names

Front 8

5 most common mistakes of soap notes

Back 8

inclusion of extraneous info
exclusion of important info
info in the wrong place
vague or unclear reasoning
vague or unclear info
give EXACT numbers

Front 9

Resume tips

Back 9

keep it brief, good ones get read

Front 10

CV tips

Back 10

CV is always more detailed than Resume
Preferred by employers
exceeds 1-2 pages can even be 30-40
goes through every rotation
DOES not contain objective
grad prog, leadership, awards

Front 11

Resume organization

Back 11

chronological
functional
chronofunctional

Front 12

resume content

Back 12

list 2 addresses if possible
Objective! your #1 task area of interest within the profession
REVERSE chronological order of education - No high school REVCHRON of work too

Front 13

Achievements not related to pharmacy?

Back 13

nope!
Should include pharmacy and community service
References - available upon request

Front 14

Resume formatting

Back 14

white or off white bond paper
10-14 pt font, no more than 3 sizes
1 inch margins
preferably just one page, NMT 2

Front 15

3 components of interview

Back 15

opening formalities
information exchange
the close - say you look forward to hearing from them, WRITE a thank you

Front 16

should you bring up the salary?

Back 16

no, let the interviewer do it.
be prepared to discuss if they bring it up

Front 17

medication errors definition

Back 17

any preventable event that may cause or lead to inappropriate medication use or patient harm
May occur while the medication is in the control of Professional, Patient, or Consumer

Front 18

How many errors occur out of every 250 RXs? cost $ or lives?

Back 18

4 - 98.5% accuracy
$77 million in error money
7,000 people in the US die

Front 19

5 rights of every RX

Back 19

patient
strength
drug
ROA
time

Front 20

Lack of patient info

Back 20

demographic info
labs and vital signs
Safety strategies: document allergies, confirm pt ID, inquire about diagnosis, get lab values

Front 21

lack of drug info

Back 21

ex. incomplete med history *OTCs
knowledge deficit: refers to health pro
safe ideas: reconciliation processes, up to date info on drugs, pharmacist review

Front 22

communication/teamwork failures

Back 22

handwritten/spoken orders
intimidation: be confident
safe ideas: e-rx, fax, read back verbal orders, spell drugs!

Front 23

drug names, labels, packaging

Back 23

look alike/ sound alike, unlabeled meds
safe ideas: education, separate storage, indications!

Front 24

drug concentrations, storage, distribution

Back 24

multiple concentrations of drugs stocked, unsafe storage, untimely distribution resulting in missed/late doses
safe ideas: choose specific strengths, remove chem from drug areas, establish realistic delivery procedures

Front 25

medication delivery devices

Back 25

pump programming errors, orla meds given orally via leur devices
safe strategies: limit varieties, provide training, independent double checks, use specially designed oral syringes

Front 26

environmental factors and staffing issues

Back 26

clutter, noise distractions lights, inadequate staffing
Safe strategies: provide adequate/organized space and lighting, decrease distractions, schedule breaks and limit shifts

Front 27

staff competency and education

Back 27

interns increase risk of med errors, poor orientation, education and staff, new meds, poor error reporting
safe strategies: avoid overloading trainers, new med notices, encourage medication error reporting

Front 28

patient medication education

Back 28

pharmacists seen as too smart
literacy and language, unaware of causes and prevention available
safe strategies: encourage questions, 8th grade level instructions, pt's keep up to date drug list

Front 29

Quality assurance and risk management

Back 29

fear of disciplinary action, lack of double checks
safe strategies: promote reporting, use technology, independent double checks

Front 30

Decimals and zeros

Back 30

never follow a whole number with a decimal and a zero

Front 31

naked decimal point?

Back 31

NO! always place a zero before the decimal if the dose is smaller than 1

Front 32

Abbreviations to avoid

Back 32

use daily instead of QD
use unit instead of U
every other day not QOD
morphine sulfate and magnesium sulfate should be written out

Front 33

symbols to avoid

Back 33

><, write them out!
write drugs in full
do not use apothecary units
do not use CC, write mL
use mcg not ug
don't use @, write at

Front 34

other ways to avoid errors

Back 34

give adequate space b/w drug dose unit
repeat verbal orders
watch units
counsel counsel counsel!

Front 35

In those older than 50, which is a more important indication of cardiovascular disease? sys or dia?

Back 35

systolic BP greater than 140mmHg is more important as a risk factor

Front 36

at what measure does CVD begin to double for each increment of 20/10?

Back 36

beginning at 115/75 mmHg, CVD risk doubles for each increment of 20/10mmHg

Front 37

What's the deal with being normotensive at 55 years old?

Back 37

Those who are normotensive at 55 years of age will have a 90 percent lifetime risk of developing hypertension

Front 38

Prehypertensive individuals (SBP 120—139 mmHg or DBP 80—89 mmHg)

Back 38

require health- promoting lifestyle modifications to prevent the progressive rise in blood pressure and CVD;

Front 39

How many meds required for BP target goal of 130/80 in diabetics and those with chronic kidney disease?

Back 39

2 meds; thiazide diuretic + ACE, ARB, or Ca channel blocker

Front 40

how is orthostatic hypertension defined?

Back 40

supine to standing decrease greater than 20mmHg or greater than 10mmHg diastolic; more OH in diabetics

Front 41

causes of resistent hypertension

Back 41

improper measurement
volume overload: too much salt, volume retention, inad. diuretic therapy
drug induced: nonadherence, NSAIDS, illicit drugs, OTCs
other conditions: alcohol and obesity

Front 42

blood pressure readings for normal, prehyper, stage 1 and 2

Back 42

Normal-less than 120/80 mm HG
Pre-HTN-120-139/80-89 mm Hg
Stage I-140-159/90-99 mm HG
Stage II-Greater than or equal to 160/100 mm HG

Front 43

reading if cuff is too large or too small?

Back 43

too large? falsely low reading
too small? falsely high reading

Front 44

normal heart rate and respiration rate for adults

Back 44

heart 60-100
RR 12-20

Front 45

how should the earlobe be moved for proper admin of otic drops?

Back 45

Adults- hold the earlobe up and back
Children-hold the earlobe down and back
Keep head tilted for 2-5min

Front 46

how to instill an eye drop?

Back 46

pull back lower eyelid and look up
instill drop, close eye and look down
place pressure near nose to slow drainage
WAIT at least 5 min between drops

Front 47

how to instill an eye ointment?

Back 47

look up and make a pouch from eyelid
instill .25 to .5 inches of ointment
close eye and look in all directions for even distribution 1-2 minutes
may blur vision - wait 10 minutes before applying another drug

Front 48

Metabolic syndrome (X) is characterized by 3 of the following signs

Back 48

insulin resistance
abdominal fat
high blood sugar
high triglycerides
low HDL
Pro-thrombotic state
elevated BP

Front 49

Indications of diabetes

Back 49

FPG of greater than or equal to 126
casual blood glucose of greater than or equal to 200
2 hour plasma glucose greater than or equal to 200 during an oral glucose tolerance test

Front 50

can a meter diagnose diabetes?

Back 50

no
2 tests on 2 different days
need to see a doctor

Front 51

normal FSBS measurements

Back 51

fasting 70-100
preprandial <110
postprandial <140
A1C 4-6%

Front 52

Diabetic FSBS measurements

Back 52

fasting 80-130
preprandial <140
postprandial <180
A1C <7% now <6.5%