CPC Medication Management and Reconciliation 1 — Questions and Answers
Question 1: A community paramedic conducts a home visit and finds a patient taking 11 different medications. This situation is BEST described as:
- Multimorbidity
- Polypharmacy (Correct answer)
- Pharmacokinetic interaction
- Medication non-adherence
Correct answer: Polypharmacy
Polypharmacy is defined as the concurrent use of multiple medications (commonly 5 or more) and is a major risk factor for adverse drug events, particularly in older adults.
Question 2: During medication reconciliation, a community paramedic notices the patient is taking both warfarin and aspirin without any documented indication for dual therapy. The BEST action is to:
- Discontinue one of the medications during the visit
- Document the finding and report it to the supervising physician for review (Correct answer)
- Advise the patient the combination is safe as long as doses are taken as prescribed
- Instruct the patient to stop aspirin immediately
Correct answer: Document the finding and report it to the supervising physician for review
Identifying and reporting potential drug interactions or duplications to the supervising physician is the appropriate community paramedic response — medication changes require physician authorization.
Question 3: Which of the following BEST describes the purpose of medication reconciliation in the MIH setting?
- To identify and resolve discrepancies between what a patient is prescribed and what they are actually taking (Correct answer)
- To replace the pharmacist's duty counseling during dispensing
- To authorize refills for patients who have run out of medications
- To document only the medications the patient purchased over the counter
Correct answer: To identify and resolve discrepancies between what a patient is prescribed and what they are actually taking
Medication reconciliation compares the patient's actual medication use against the prescribed regimen to identify and resolve discrepancies, errors, or safety concerns.
Question 4: A community paramedic observes that a patient is crushing an extended-release (ER) tablet to make it easier to swallow. The MOST important reason to correct this practice is that:
- Crushing the tablet makes it taste bitter
- Crushing destroys the extended-release mechanism, risking dose dumping and toxicity (Correct answer)
- The patient should switch to a liquid formulation instead
- Extended-release tablets are more expensive and should not be wasted
Correct answer: Crushing destroys the extended-release mechanism, risking dose dumping and toxicity
Crushing extended-release tablets destroys the controlled-release coating, causing the entire dose to be absorbed at once — a dangerous phenomenon known as dose dumping.
Question 5: When performing a home medication review, which of the following is MOST important to assess in an elderly patient taking multiple medications?
- The color and shape of each tablet for identification purposes
- Fall risk related to medications such as sedatives, antihypertensives, and diuretics (Correct answer)
- Whether the patient prefers brand-name or generic drugs
- The country of origin of each medication
Correct answer: Fall risk related to medications such as sedatives, antihypertensives, and diuretics
Medications such as sedatives, antihypertensives, and diuretics are among the most common contributors to fall risk in elderly patients, making fall risk assessment a top priority.
Question 6: A patient tells a community paramedic they stopped taking their antihypertensive because 'it makes me dizzy.' The community paramedic should FIRST:
- Tell the patient to restart the medication immediately
- Acknowledge the concern, assess for orthostatic hypotension, and notify the supervising physician (Correct answer)
- Advise the patient to take the medication only every other day
- Document the refusal and close the case
Correct answer: Acknowledge the concern, assess for orthostatic hypotension, and notify the supervising physician
Validating the patient's concern, clinically assessing for orthostatic hypotension, and reporting to the physician ensures the side effect is properly evaluated before any change to the regimen.
CPC Medication Management and Reconciliation 1
A community paramedic conducts a home visit and finds a patient taking 11 different medications.
This situation is BEST described as: