WGU D116 Optimizing Medication Therapy:
Patient Scenarios & Best Practice
Correct
1/1 Points
2.A patient diagnosed with chronic pain calls to request an oxycodone (Oxycontin) refill.
Which action should the prescriber take initially?
a. Determine the patient’s current medication dosage and pain level.
b. Verify the patient’s adherence to the prescribed drug regimen.
c. Fax the renewal order to the pharmacy.
d. Arrange to schedule an appointment with the patient.
Feedback:Schedule II medications are not eligible for refills, and prescriptions must be
handwritten. It is important to verify the patient’s adherence to the drug regimen and
determine the current dosage of medication and pain level; however, this can be
accomplished by scheduling an appointment and evaluating the patient in person.
Correct
1/1 Points
3. A patient is prescribed metronidazole for bacterial vaginosis. Which patient history
finding would be most concerning to the provider?
a. The patient is unemployed.
b. The patient drinks two glasses of wine every night.
Feedback:Patients taking metronidazole should be educated not to drink alcohol to
prevent a disulfiram-like reaction. It would be concerning that the patient drinks wine
daily. History of a yeast infection may indicate increased risk for recurrence with
administration of an antimicrobial. A family history of cervical cancer is not related to
administration of metronidazole. Unemployment can indicate lack of insurance
coverage, which may limit the patient’s ability to purchase medications; however,
generic metronidazole is one of the less expensive medications.
c. There is a family history of cervical cancer.
d. The patient had a recent yeast infection.
Correct
1/1 Points
4. The provider prepares a patient with newly diagnosed type 1 diabetes for hospital
discharge. Which action by the provider will best support the patient’s ability to
effectively manage medication therapy?
a. Giving information about how diet and exercise affect insulin requirements
b. Teaching the patient about the long-term consequences of poor diabetes control
c. Asking the patient to demonstrate how to measure and administer insulin
Feedback:Because insulin must be given correctly to control symptoms and prevent an
overdose, it is most important for the patient to know how to measure and administer it.
Asking for a demonstration of technique is the best way to determine whether the
patient has understood the teaching. The other teaching points are important as well,
but they are not as critical.
d. Discussing methods of storing insulin and discarding syringes
,Correct
1/1 Points
, 5.A patient reports that a medication prescribed for recurrent migraine headaches is not
working. Which action is the prescriber’s priority when addressing the patient's
concern?
a. Assess the patient’s headache pain on a scale from 1 to 10.
b. Ask the patient about the number and frequency of tablets taken.
Feedback:When evaluating the effectiveness of a drug, it is important to determine
how often the patient is using the drug. Asking the patient to identify how many tablets
are taken and how often helps the provider determine effective dosages and adherence
to the medication regimen. The patient has already stated that the medication is not
working; the actual level of pain may determine the degree to which it is not working,
but it does not help the provider to determine why it is not working. The assessment
process should gather as much information about compliance, symptoms, and drug
effectiveness as possible before enacting a change in treatment. Biofeedback may be
an effective adjunct to treatment, but it should not be recommended without complete
information about drug effectiveness.
c. Prescribe a new medication for migraine management.
d. Suggest biofeedback as an adjunct to drug therapy.
Correct
1/1 Points
6. The drug manual states that older adult patients are at increased risk for
hepatotoxicity. Which action is most important when prescribing this medication to an
80-year-old patient?
a. Ensuring that the drug is taken in the correct dose at the correct time
b. Discontinuing the order; the drug is contraindicated for this patient
c. Giving the medication intravenously to avoid first pass metabolism
d. Obtaining baseline liver function studies
Feedback:The drug manual indicates that this drug increases risk of hepatotoxicity for
elderly patients. Getting information about liver function before giving the drug
establishes baseline data that can be compared with posttreatment data to determine
whether the drug is affecting the liver. Taking the correct dose at the correct interval
may minimize risk, but without baseline information, the effects cannot be determined.
Drugs are not routinely contraindicated for an increased risk of adverse effects
Correct
1/1 Points
7.A patient with bipolar disorder is prescribed daily lithium. Which action is most
important for the provider to take in order to determine if the therapeutic level is
maintained?
a. Prescribe the lithium to be taken at regular intervals
b. Assess the patient for signs and symptoms of lithium toxicity.
c. Evaluate preadministration blood work
d. Order periodic laboratory testing
Feedback:Therapeutic serum levels are determined through periodic laboratory
testing. Preadministration blood work may be necessary to obtain baseline status prior
to initiating treatment, but it will not determine therapeutic levels. Scheduling
Patient Scenarios & Best Practice
Correct
1/1 Points
2.A patient diagnosed with chronic pain calls to request an oxycodone (Oxycontin) refill.
Which action should the prescriber take initially?
a. Determine the patient’s current medication dosage and pain level.
b. Verify the patient’s adherence to the prescribed drug regimen.
c. Fax the renewal order to the pharmacy.
d. Arrange to schedule an appointment with the patient.
Feedback:Schedule II medications are not eligible for refills, and prescriptions must be
handwritten. It is important to verify the patient’s adherence to the drug regimen and
determine the current dosage of medication and pain level; however, this can be
accomplished by scheduling an appointment and evaluating the patient in person.
Correct
1/1 Points
3. A patient is prescribed metronidazole for bacterial vaginosis. Which patient history
finding would be most concerning to the provider?
a. The patient is unemployed.
b. The patient drinks two glasses of wine every night.
Feedback:Patients taking metronidazole should be educated not to drink alcohol to
prevent a disulfiram-like reaction. It would be concerning that the patient drinks wine
daily. History of a yeast infection may indicate increased risk for recurrence with
administration of an antimicrobial. A family history of cervical cancer is not related to
administration of metronidazole. Unemployment can indicate lack of insurance
coverage, which may limit the patient’s ability to purchase medications; however,
generic metronidazole is one of the less expensive medications.
c. There is a family history of cervical cancer.
d. The patient had a recent yeast infection.
Correct
1/1 Points
4. The provider prepares a patient with newly diagnosed type 1 diabetes for hospital
discharge. Which action by the provider will best support the patient’s ability to
effectively manage medication therapy?
a. Giving information about how diet and exercise affect insulin requirements
b. Teaching the patient about the long-term consequences of poor diabetes control
c. Asking the patient to demonstrate how to measure and administer insulin
Feedback:Because insulin must be given correctly to control symptoms and prevent an
overdose, it is most important for the patient to know how to measure and administer it.
Asking for a demonstration of technique is the best way to determine whether the
patient has understood the teaching. The other teaching points are important as well,
but they are not as critical.
d. Discussing methods of storing insulin and discarding syringes
,Correct
1/1 Points
, 5.A patient reports that a medication prescribed for recurrent migraine headaches is not
working. Which action is the prescriber’s priority when addressing the patient's
concern?
a. Assess the patient’s headache pain on a scale from 1 to 10.
b. Ask the patient about the number and frequency of tablets taken.
Feedback:When evaluating the effectiveness of a drug, it is important to determine
how often the patient is using the drug. Asking the patient to identify how many tablets
are taken and how often helps the provider determine effective dosages and adherence
to the medication regimen. The patient has already stated that the medication is not
working; the actual level of pain may determine the degree to which it is not working,
but it does not help the provider to determine why it is not working. The assessment
process should gather as much information about compliance, symptoms, and drug
effectiveness as possible before enacting a change in treatment. Biofeedback may be
an effective adjunct to treatment, but it should not be recommended without complete
information about drug effectiveness.
c. Prescribe a new medication for migraine management.
d. Suggest biofeedback as an adjunct to drug therapy.
Correct
1/1 Points
6. The drug manual states that older adult patients are at increased risk for
hepatotoxicity. Which action is most important when prescribing this medication to an
80-year-old patient?
a. Ensuring that the drug is taken in the correct dose at the correct time
b. Discontinuing the order; the drug is contraindicated for this patient
c. Giving the medication intravenously to avoid first pass metabolism
d. Obtaining baseline liver function studies
Feedback:The drug manual indicates that this drug increases risk of hepatotoxicity for
elderly patients. Getting information about liver function before giving the drug
establishes baseline data that can be compared with posttreatment data to determine
whether the drug is affecting the liver. Taking the correct dose at the correct interval
may minimize risk, but without baseline information, the effects cannot be determined.
Drugs are not routinely contraindicated for an increased risk of adverse effects
Correct
1/1 Points
7.A patient with bipolar disorder is prescribed daily lithium. Which action is most
important for the provider to take in order to determine if the therapeutic level is
maintained?
a. Prescribe the lithium to be taken at regular intervals
b. Assess the patient for signs and symptoms of lithium toxicity.
c. Evaluate preadministration blood work
d. Order periodic laboratory testing
Feedback:Therapeutic serum levels are determined through periodic laboratory
testing. Preadministration blood work may be necessary to obtain baseline status prior
to initiating treatment, but it will not determine therapeutic levels. Scheduling
