CTCS Practice Test

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CTCS Practice Test (V1)

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Question 1

A pharmacist is performing discharge medication reconciliation for a patient admitted for a COPD exacerbation. The pre-admission medication list includes albuterol HFA. The inpatient MAR shows the patient received ipratropium/albuterol nebulizers. The new discharge prescription is for a tiotropium inhaler. What is the most significant medication discrepancy that the pharmacist must clarify with the provider?

  1. Whether the patient should continue their home albuterol HFA for rescue therapy in addition to the new tiotropium.
  2. Why the patient received a nebulizer in the hospital instead of their home inhaler.
  3. If the new tiotropium inhaler requires a prior authorization from the patient's insurance.
  4. The brand name of the tiotropium inhaler that should be dispensed.

Question 2

A CTCS calls a patient 48 hours after discharge from the hospital for heart failure. The patient states, "I'm not taking that new furosemide because my ankles aren't swollen right now." What is the pharmacist's most appropriate response?

  1. "You must take it, or you will be readmitted to the hospital. I am noting your non-compliance."
  2. "That's understandable. Can you tell me what your understanding is for why the doctor prescribed that new water pill for you?"
  3. "You should only take it when your ankles are swollen. It sounds like you are using it correctly."
  4. "I will contact your cardiologist and have them explain the importance of the medication to you again."

Question 3

The primary goal of a "Meds to Beds" program, where discharge prescriptions are delivered to the patient's bedside before they leave the hospital, is to:

  1. Increase pharmacy revenue from capturing discharge prescriptions.
  2. Reduce the number of medications prescribed at discharge.
  3. Overcome the barrier of primary non-adherence by ensuring the patient has their medications in hand before discharge.
  4. Allow the hospital pharmacy to clear out nearly expired medications.

Question 4

During a discharge counseling session, the pharmacist notices the patient's new prescriptions include both enoxaparin injections and apixaban tablets. What is the pharmacist's immediate responsibility?

  1. Counsel the patient on the proper injection technique for enoxaparin.
  2. Contact the prescribing provider immediately to clarify this potential therapeutic duplication of anticoagulants.
  3. Check the patient's insurance to see if both medications are covered on their formulary.
  4. Ask the patient which of the two medications they would prefer to take.

Answer Key

  • Question 1: A. Whether the patient should continue their home albuterol HFA for rescue therapy in addition to the new tiotropium. (This is a critical ambiguity; tiotropium is a maintenance inhaler, and the need for a rescue inhaler must be explicitly clarified.)
  • Question 2: B. "That's understandable. Can you tell me what your understanding is for why the doctor prescribed that new water pill for you?" (This uses a non-judgmental, open-ended question to assess the patient's health literacy and identify the knowledge gap.)
  • Question 3: C. Overcome the barrier of primary non-adherence by ensuring the patient has their medications in hand before discharge. (The core purpose is to prevent patients from failing to pick up their crucial new medications after leaving the hospital.)
  • Question 4: B. Contact the prescribing provider immediately to clarify this potential therapeutic duplication of anticoagulants. (Using two anticoagulants simultaneously is extremely dangerous and is almost always an error, unless it is for a specific, short-term bridging protocol that must be confirmed.)