PTCE Patient Counseling 3 — Questions and Answers
Question 1: A patient picking up metformin asks if they can crush the extended-release tablets to make them easier to swallow. The technician should:
- Refer the patient to the pharmacist because crushing extended-release tablets can be dangerous (Correct answer)
- Tell the patient it is fine to crush any tablet
- Advise the patient to split the tablet in half instead
- Tell the patient to dissolve it in water before taking
Correct answer: Refer the patient to the pharmacist because crushing extended-release tablets can be dangerous
Crushing extended-release formulations destroys the controlled-release mechanism and can cause dose-dumping; pharmacist guidance is required.
Question 2: Which auxiliary label is most appropriate for a prescription of tetracycline?
- Avoid prolonged exposure to sunlight (Correct answer)
- Take with a full glass of milk
- May cause drowsiness—do not drive
- Refrigerate after opening
Correct answer: Avoid prolonged exposure to sunlight
Tetracyclines cause photosensitivity, so patients should be warned to avoid prolonged sun exposure.
Question 3: When a patient's address changes, updating it in the pharmacy system is important primarily because:
- Correct address ensures medication deliveries reach the patient and emergency contacts can be verified (Correct answer)
- Insurance companies require address changes monthly
- State law requires addresses be updated every 90 days
- The prescriber needs the new address on file
Correct answer: Correct address ensures medication deliveries reach the patient and emergency contacts can be verified
Accurate demographic data ensures deliveries succeed, enables emergency contact, and supports accurate billing.
Question 4: A patient asks the technician about the difference between brand-name Synthroid and generic levothyroxine. The technician should:
- Refer the patient to the pharmacist and note that substitution questions may involve clinical considerations for thyroid medications (Correct answer)
- Tell the patient generics are always identical to brand and switch them automatically
- Tell the patient brand is always better and not to accept generics
- Advise the patient to stop taking levothyroxine until they speak with their doctor
Correct answer: Refer the patient to the pharmacist and note that substitution questions may involve clinical considerations for thyroid medications
Narrow therapeutic index drugs like levothyroxine have brand/generic nuances that require pharmacist counseling.
Question 5: What information should always be verified when a patient picks up a prescription to ensure the right patient receives the right medication?
- Full name and date of birth (Correct answer)
- Health insurance card number only
- Phone number only
- Prescriber name only
Correct answer: Full name and date of birth
Using two patient identifiers—typically name and date of birth—is standard practice to prevent dispensing errors.
Question 6: A patient asks why their nitroglycerin tablets must be kept in the original amber glass bottle. The best technician response is:
- Nitroglycerin is sensitive to light, heat, and moisture, so the original container protects potency—the pharmacist can explain more (Correct answer)
- Tell the patient the bottle is only for decoration
- Advise the patient any dark bottle will work
- Tell the patient the instruction is outdated and they can use a plastic bottle
Correct answer: Nitroglycerin is sensitive to light, heat, and moisture, so the original container protects potency—the pharmacist can explain more
Nitroglycerin degrades when exposed to light, heat, and moisture, making the original amber glass container essential for potency.
Question 7: A patient mentions they have been self-medicating with St. John's Wort for depression. Why is this important information for the pharmacist to know?
- St. John's Wort has significant drug interactions, including reducing the effectiveness of many prescription medications (Correct answer)
- St. John's Wort is FDA-approved and has no interactions
- Herbal supplements never interact with prescription drugs
- The pharmacist only needs to know about prescription medications
Correct answer: St. John's Wort has significant drug interactions, including reducing the effectiveness of many prescription medications
St. John's Wort is a potent CYP450 inducer that can reduce plasma levels of many drugs, including oral contraceptives and antiretrovirals.
PTCE Patient Counseling 3
A patient picking up metformin asks if they can crush the extended-release tablets to make them easier to swallow.
The technician should: