PHAR 340 Final Exam Prep

medication consumption (e.g. to screen for contradictions and drug-drug interactions)

to serve as the physician's resource for information about medical therapies

to provide patient education about medications

A only

A, B and C

cost more than secondary efforts

focuses on education and/or health policy

reverses genetic disease

target individuals rather than populations

none of the above

Primary prevention

Secondary prevention

Tertiary prevention

All of the above

Pharmaceutical Care

Systems Management

Public Health

All of the above

6

8

10

12

Repetitive nature of the work

Medication dispensing

Providing patient care

Dealing with insurance issues

patient counseling via toll free phone calls

personnel management

financial management

dealing with state regulatory affairs

Primary prevention

Secondary prevention

Tertiary prevention

All of the above

None of the above

Nurses

Physicians

Pharmacists

Pharmacy technicians

Primary prevention

Secondary prevention

Tertiary prevention

All of the above

None of the above

Primary, Secondary, and Tertiary Prevention

Disease, Diagnosis, Prognosis

Assessment, Monitor, Assurance

Access, Cost, Quality

Disaster preparedness

Chronic disease education

Exercise/Nutrition education

Medication adherence

Surgical removal of a cancerous tumor

the primary care physician

the patient

The internal medicine physician

the pharmacist

the care team (including physician(s), pharmacist(s), and the patient)

Chain

Supermarket

Independent

Mass merchandise

Allopathic physicians

Osteopathic physicians

Family members or self

Hospital wards

create/increase parent or family support

celebrate students' matriculation

increase professionalism

unify healthcare dress code

create alumni donation opportunities

miasma theory of disease

Galen's Humoralism

germ theory of disease

allopathic measures

helping students

religious roots

service to others

development of mind, body & spirit

none of the above

lower infant mortality

spends more on health care

has the best cost-to-benefit ratio

has the worst cost-to-benefit ratio

0% (the US has socialized medicine and everyone is covered)

1.63%

16.3%

100%

None of the above

repeatability of health care interventions

desired health outcomes

predictability of patient outcomes

patient satisfaction

care efficacy and reimbursement efficiency

Germ Theory

Miasma Theory

Humoralism

Interaction with patients

Technology

Dealing with insurance issues

Over the counter products

has lower infant mortality

spends more on health care

has longer life expectancy

the highest

average

the lowest

Effective communication among professionals

Increase planning/scheduling difficulty

Effective communication with the patient

Independent work for the good of the patient

Multiple professionals

RESULTED in the closure of all medical schools that did not meet established quality criteria

stimulated licensing legislation and established new requirements pertaining to training lengths and quality standards in laboratories and other training facilities

all of the above

medical school education and training has historically focused on curing illness, not preventing it

preventative medicine has historically been assigned low priority in medical school curricula

all of the above

pharmacy intern

pharmacy technician

pharmacy resident

Definition of pharmaceutical care

Definition of health by the World Health Organization

Definition of health by Healthy People 2010

Baylor University Hospital's school teachers plan

the American Hospital Association policies

the American Red Cross

1 and 2

1 and 3

2 and 3

Would strengthen the quality of hospital care

Were unsound and unethical

Would help boost physician income

Separate and often conflicting interests of governments, educational institutions, professional organizations, insurers, and providers

Declining need for health care professionals in several categories of practice

Interprofessionalism and interdisciplinary care

diagnosis related groups (DRGs)

prospective patient categories (PPCs)

epidemiology

immediate

non-urgent

emergent

Humoralism and Orthodox physicians

Osteopathy

Miasma and Sectarian physicians

Homeopathic physicians

Provided federal funding for hospitals

Created to separate categories of drugs (prescription & OTC)

Provided federal funding for polio vaccination programs

Amended the pure food & drug act to create the FDA

Physicians and Pharmacists

Registered Nurses and Physical Therapists

Physician Assistants and Nurse Practitioners

Occupational Therapists and Registered Nurses

Specialized skills training

Continuing education

Basic scientific theory

Credentialing

All of the above

Shouldn't receive War Dept. commissions

Was not a profession

Should share physicians education systems

Had achieved doctoral status

None of the above

Portability of insurance coverage

Patient privacy rules

Portability of patient records

The Hyde Amendment

The Flexner Amendment

Stabilizing hospital financing

Restricting hospital growth

Decreasing outpatient services

Non of the above are true

Veterans

Military personnel

Native Americans

A and B only

A, B, and C

the term to describe an affiliation between hospitals

the term used to describe an affiliation between inpatient surgery centers

the term used to describe a commensalistic relationship between local public health units

None of the above

Diagnosis-Reform Group

Diagnosis -Related Group

Disease-Related Group

None of the above

Separate and often conflicting interests of governments, educational institutions, professional organizations, insurers, and providers

Declining need for health care professionals in several categories of practice

Interprofessionalism and interdisciplinary care

Persons with co-occurring disorders often have more instances of premature death and higher rates of disability that hose who don’t have co-occurring disorder.

Persons with co-occurring disorders do not have more instances of premature death and higher rates of disability that hose who don’t have co-occurring disorder.

Neither are true

From 2008 to 2014, there is a projected 6.6% annual decrease in spending for mental health and substance use services in the US.

From 2008 to 2014, there is a projected 6.6% annual increase in spending for mental health and substance use services in the US.

There will not be a % change in spending for mental health during this period in the US.

Cultural and linguistic minorities

Rural populations

Women and children in lower socio-economics

A and C only

All of the above

Is supported by research that is published in the clinical literature

The type of practice that is the basis of curriculum now offered by healthcare professions’ schools and colleges

Clinical literature that is reviewed and summarized by professionals with expertise in the specific area

All of the above

None of the above

Provide medication management services

Initiate and discontinue med use

Dose and refill authorizations

Laboratory monitoring

All of the above

Education (e.g., Training in pharmacotherapeutics; Preceptors’ prescribing habits)

Control and regulatory mechanisms

Demands by consumers and society

Promotional activities by drug manufacturers

All of the above

Raw Material Supply Manufacturing  Distribution  Dispensing  Patient

Raw Material Supply Patient  Manufacturing  Distribution  Dispensing

Raw Material Supply Dispensing  Patient  Manufacturing  Distribution

None of the above

Once a drug is approved for the market, the FDA has the ultimate power to determine how it is ultimately used.

Non-FDA-approved (“off-label”) indications are uses of a product that were not approved by the FDA, but have shown value after approval based on postmarketing research.

Non-FDA-approved indications cannot be promoted by the manufacturer.

Phase I

Phase II

Phase III

Phase IV

Oprah

Orphan

Albano

Vu

None of the above

All printed information accompanying a drug, label, wrapping & package insert

FDA Division of Marketing, Advertising & Communication seeks balanced, not misleading, scientifically accurate information for health care practitioners

Label claim (indication) is particularly important to sponsor because of its connection to reimbursement

A and B only

All of the above

Prices of related goods

Money income of the producer

Number of consumers in the market

Attitudes, tastes, and preferences of the consumer

Consumer expectations with respect to future prices and incomes

Techniques of production, including technology

Number of buyers in the market

Resource costs (material and wages)

Prices for related goods

Sellers’ expectations

Elastic

Inelastic

Unitary

None of the above

Homemaker

Wound care

Parenteral nutrition

Minor home surgery

Hospice care

Hospice services cannot legally be provided in a patient's home in most states.

Hospice services can legally be provided in a patient's home in most states.

the size and weight of infusion devices have decreased dramatically

Manufacturers have introduced disposable infusion devices

Pharmacists can only administer them

A and B only

All of the above

Initial patient database and assessment

Selection of products, devices, and ancillary supplies

Clinical monitoring

A and B only

All of the above

Offering Relief for 4 Million Seniors Who Hit the Medicare Prescription Drug Reimbursement Gap (donut hole): provides a one-time, tax-free $250 rebate check for uncovered prescription drug costs (2010).

Offering Prescription Drug Discounts: provides Medicare recipients who reach the prescription drug coverage gap with a 50% discount when buying Medicare Part D covered brand-name prescription drugs; for the next 10 years, seniors will receive additional savings on brand-name and generic drugs until the coverage gap is closed in 2020 (2011).

Providing Free Preventive Care for Seniors: provides certain free preventive services, such as annual wellness visits and personalized prevention plans for seniors on Medicare (2011).

Reducing Health Care Fraud and Abuse: invests new resources and requires new screening procedures for health care providers to boost federal antifraud and waste initiatives in Medicare ONLY.

Improving Health care Quality and Efficiency: establishes a new Center for Medicare & Medicaid Innovation (James Bresette) to test new ways of delivering care to patients to improve the quality of care, and reduce the rate of growth in costs for Medicare, Medicaid and CHIP (2011).

Linking Payment to Quality Outcomes: establishes a hospital Value Based Purchasing program in Traditional Medicare, offering financial incentives to hospitals to improve the quality of care; requires hospitals to publicly report performance for certain diagnoses and patients’ perceptions of care (2012).

Encouraging Integrated Health Systems: provides incentives for physicians hospitals to join together to form “Accountable Care Organizations” to better coordinate Medicare beneficiary patient care and improve quality, help prevent disease and illness and reduce unnecessary hospital admissions (2012).

Improving Preventive Health Coverage: provides new funding to state Medicaid programs that choose to cover preventive services for patients at a cost (equal to or similar to prescription gap/donut hole reimbursement) to expand the number of Americans receiving preventive care (2012).

Allowing States to Cover More People on Medicaid: provides federal matching funds for states covering some additional low-income individuals and families under Medicaid for whom federal funds were not previously available (2010).

Increasing Access to Services at Home and in the Community: allows states to offer home and community-based services to disabled individuals through Medicaid rather than institutional care in nursing homes through the Community First Choice Option (2011).

Increasing Medicaid Payments for only Sub-specialty Doctors and Surgeons: requires states to pay them no less than 100% of Medicare payment rates in 2013 and 2014 for primary care services.

All are false

Providing Additional Funding for the CHIP: provides states with two additional years of funding to continue coverage for children not eligible for Medicaid (2013).

Increasing Access to Medicaid: enables Americans who earn less than 133% of the federal poverty level eligible to enroll in Medicaid; provides states with 100% federal funding for the first 3 years to support this expanded coverage, phasing to 90% federal funding in subsequent years (2014).

Increasing Federal Match for CHIP: provide states with a 23% increase in CHIP matching rate up to 100%; CHIP eligible children excluded from the program because of enrollment caps are eligible for tax credits in the state health insurance exchanges (2015).

None are false; all are true

Providing New Consumer Protections

Improving Quality and Lowering Costs

Increasing Access to Affordable Care

Holding Insurance Companies Accountable

Providing New Consumer Protections

Improving Quality and Lowering Costs

Increasing Access to Affordable Care

Holding Insurance Companies Accountable

Providing New Consumer Protections

Improving Quality and Lowering Costs

Increasing Access to Affordable Care

Holding Insurance Companies Accountable

Providing New Consumer Protections

Improving Quality and Lowering Costs

Increasing Access to Affordable Care

Holding Insurance Companies Accountable

Providing New Consumer Protections

Improving Quality and Lowering Costs

Increasing Access to Affordable Care

Holding Insurance Companies Accountable

The pharmacist’s code of ethics at one time stated that a pharmacist should never discuss therapeutic effects with physician assistants.

The pharmacist’s code of ethics at one time stated that a pharmacist should never discuss therapeutic effects with patients.

The pharmacy technician code of ethics at one time stated that a pharmacist should never discuss therapeutic effects with patients.

None of the above are true

The HMO Act of 1973 mandated exclusion of a prepaid, fixed-fee option for some employers.

The HMO Act of 1973 mandated inclusion of a prepaid, fixed-fee option for some employers.

The HMO Act of 1973 mandated inclusion of a cost-plus option for some employers.

None of the above are true

The Hill-Burton Act provided federal funding for hospitals

The Hill-Burton Act provided federal funding for Veterans Administration hospitals only

The Hill-Burton Act provided federal funding for Critical Access hospitals

None are true

In 2006, the average number of prescription drug purchases is greater by the poor than for the middle income or high income.

In 2006, the average number of prescription drug purchases is lesser by the poor than for the middle income or high income.

In 2006, the average number of prescription drug purchases is equal by the poor, middle income, and high income.

None of the above

Millis Commission report (1975) indicated that pharmacists were adequately prepared in systems analysis, management, and communication skills.

Millis Commission report (1975) indicated that pharmacists were inadequately prepared in systems analysis, management, and communication skills.

Millis Commission report (1975) indicated that pharmacists were inadequately prepared in pharmaceutical, sociological, and psychological skills.

None of the about are true

The poor, minority, or immigrants (Non-citizens) are more likely to be uninsured compared to wealthier, white non-hispanic, or a US citizen

The poor, minority, or immigrants (Non-citizens) are more likely to be insured compared to wealthier, white non-hispanic, or a US citizen

All of the above are true

None of the above

Cost is the biggest factor or reason for not having health insurance.

Losing a job is the biggest factor or reason for not having health insurance.

Being healthy is the biggest factor or reason for not having health insurance.

None of the above are true.

are projected not to exist within the next 10 years.

are only found in rural areas.

are the most prevalent of all community pharmacies.

usually specialize in the medication management of one or two disease states.

have the most direct patient contact of any of the areas of pharmacy practice.

require specialized training beyond the traditional pharmacy training.

only work in the evening.

glow in the dark.

only fill prescriptions

never have to deal with patient insurance issues

only work weekends

have evolved to manning phone banks to council and answer patient questions

Guernica

Formulary

Bar code

Computerized physician order entry (CPOE)

Time constraints

Health literacy

Interview skills

B and C only

All of the above

Fewer professional and technical resources needed

Less drug inventory and supply costs

Lack of face-to-face interaction with patients and providers

A and B only

All of the above

A hospital-based clinic

An independent clinic

A community pharmacy

A dependent hospital

Emergency Medical Treatment and Association Labor Act B. Emergency Medical Treatment and Active Law Act

Emergency Medical Treatment and Active Law Act

Emergency Medical Treatment and Active Legal Act

Emergency Medical Treatment and Active Labor Act

The patient centered medical home (PCMH) is not simply a place but a model of organization of primary care that delivers the core functions of primary health care. It does not encompass these five functions and attributes: Comprehensive care, Patient- centered, coordinated care, accessible services, quality and safety.

The patient centered medical home (PCMH) is not simply a place but a model of organization of primary care that delivers the core functions of primary health care. It encompasses five functions and attributes: Comprehensive care, Patient-centered, coordinated care, accessible services, quality and safety.

PCMH is a United States law

PCMH has not demonstrated quality

Healthcare services provided to a patient who is not an inpatient in a healthcare institution (e.g., nursing home or hospital) and can walk or move about to obtain those services.

The provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community.

Considered inpatient hospitals services

None of the above

medical school education and training has historically focused on curing illness, not preventing it

preventive medicine has historically been assigned low priority in medical school curricula

preventive medicine has always been a focus of the pharmacy profession

A and B only

All of the above

YMCA Gymnasiums

American Pharmacists Association

Corner drug stores

Hospitals

Prior approvals or prior authorization

Primary care as gatekeepers

Promotion of tertiary prevention

A and B only

All of the above

Finance of Scale

Scale of Economy

Scale of Justice

Economies of Scale

Hospital systems have increased outpatient (or ambulatory care) facilities and services as well as other healthcare interests

Hospital systems have decreased outpatient (or ambulatory care) facilities and services as well as other healthcare interests

Hospital systems have not changed

None of the above are true

10%

50%

100%

Taxing to decrease behavior has never been done

pre-existing conditions

lifetime limits

practicing preventive health

A and B only

All of the above

Yes, pharmacist provisions are increasing

No, pharmacist provisions are decreasing

Yes, pharmacist are encouraged to be like physicians

No, pharmacist are encouraged to be like nurses

Unlimited information access

Limited information access

lacking standardization

B and C only

None of the above

can be orders for labs, medications, etc.

eliminates verbal, telephone, faxed orders

ensures orders are legible

A and B only

All of the above

Bar Channel Medication Administration

Bar Channel Medicine Administration

Bar Code Medication Administration

Bar Code Medication Association

defaulting on a pharmacy claim

processing a pharmacy claim

Neither A or B is an example

Both A and B are examples

Anticipate technology outpacing policies, procedures, practices

Ramifications of large systems and automated processes

Health information exchange and data ownership

B and C only

All of the above

Too “sick” for self-care but healthy enough to avoid institutional setting

home care services available in the area

available of family members to assist

a and b only

a, b, and c

quality of nursing home care

appropriateness of Long-Term Care (LTC) setting selection

patient age

none of the above

all of the above

replacement products lower prices

utility is often elastic as prices increase

fewer buyers have ability or willingness to pay the higher price

complementary products become available as substitutes

the number of consumers in the market increases

increased risk of drug interaction issues

increased risk of medication adherence problems

enhanced patient communication

A and B only

all of the above

increase risk of drug interaction issues

increased risk of medication adherence problems

increased difficulty in communication

the same need for compassionate care

all of the above

staffed by health care professionals

provides both ambulatory and inpatient care

includes pharmacists as a part of the care team

concentration of healthcare facilities and equipment

all of the above

All patients of employer-based insurance plans suffering from a mental or substance abuse disor der avoid diagnosis or treatment.

All physicians of employer-based insurance plans suffering from a mental or substance abuse dis order avoid diagnosis or treatment.

Many physicians of employer-based insurance plans suffering from a mental or substance abuse disorder avoid diagnosis or treatment.

Many patients of employer-based insurance plans suffering from a mental or substance abuse dis order avoid diagnosis or treatment.

The VA system includes medical centers, outpatient clinics and community clinics

VA pharmacists provide a large variety of clinical services

Ambulatory services available through the VA are restricted to combat related illnesses

a and b

All of the above

American Society of Health-System Pharmacists

American Association of Colleges of Pharmacy

American Colleges of Pharmaceutical Education

All of the above

Making patients more sensitive costs and quality (e.g., transparency of information; tiered cost- sharing, defined contributions for health insurance)

Report costs, quality, and quantity of services of providers to promote competition among providers.

Design physician and hospital reimbursement schemes with incentives to reduce costs.

B and C only

All of the above

oligopoly

monopsony

elastic demand

monopoly

open information

available substitute goods

lower barriers to entry

many market participants

a strong patent and copyright system

number of consumers

availability of substitutes

price

supply

none of the above

significantly higher than skilled nursing care

approximately $3300/month (2010 data)

approximately $200/bed/day (2010 data)

100% covered by Medicare and Medicaid

none of the above

increasing use of PAs and NPs

performing more services on an inpatient basis

increasing outpatient services offered

requiring minimum patient stay lengths

requiring prior approvals

physical therapy

broken leg rehab

Alzheimer's

surgery

IV drug therapy

Access

Quality

Cost

None of the above

recommends drug recalls to the Consumer Products Safety Commission

has little control of how a drug is used after approval

has no regulatory authority for non-print advertising (FCC regulates) of drugs

provides DEA agents to Homeland Security to enforce reimportation regulations


all of the above

to request approval for marketing a new drug

prior to phase IV clinicals

to request approval to begin phase I clinicals

A & B only

all of the above

Omissions

Duplications

Dosing errors

a and b only

a, b, and c

their homes

the hospital

skilled nursing facilities

hospice

none of the above

cause an increase in demand

cause a decrease in demand

cause increased utility

cause decreased utility

none of the above

is quite similar to the market for Medicare services

has strong regulation to ensure qualified, competent sellers

might have market analysts who sell exclusive, valuable market information

has financing to support substantial capital expenditures for market entry

has no collusion

increased standards for medical education

creation of HMO's

elimination of osteopathic medical schools

rejection of the germ theory of disease

in 10-15 years

in 15-30 years

in over 100 years

not projected - depends on rate of new drug approval

none of the above

Personnel management

Medication preparation

Medication Dispensing

Business related activities-financial management

hospital funding

the FDA

the category of Legend drugs

pharmacists' license requirements

pharmacovigilance

pandemic preparedness

healthcare workforce development

cosmetic surgery

None of the above

Part A

Part B

Part C

Part D

none of the above

premarketing clearance

regulation of labeling

manufacturing regulation

development of bioequivalent compounds

conducting postmarketing surveillance

Clinical training

Research

Cadavers and sleeplessness

Basic science

Internships followed by Residency

systems integration

transactional integrity

barcode specificity

A & B above

A, B, & C above

typically result in increased demand

have no effect on demand

typically result in decreased demand

Nurses -> Physicians -> Pharmacists

Physicians -> Pharmacists -> Nurses

Pharmacists -> Nurses -> Physicians

Pharmacists -> Physicians -> Nurses

Physicians -> Nurses -> Pharmacists

provider/physician induced demand

selectivity in when patients purchase health insurance

increase risk of heart disease between genders

epidemic diseases

none of the above

Communicable diseases are more prevalent than chronic diseases in developing countries.

Chronic diseases are more prevalent than communicable diseases in developing countries.

Developing countries all have portability of benefits.

Developing countries all have a socialized medicine system of health care.

Socialized health insurance

Social security

Social solidarity

None of the above

Market failure prevents healthcare access

Safety of a product must be assured

practitioners must be licensed

A & B above

A, B, & C above

independent living

skilled nursing

activities

dining

all of the above