General Directions:
For each of the scenarios below, answer A, B, C, D & E using clinical
practice guidelines where applicable. If any parts of the rubric (A, B, C, D & E) do not have an answer, as an example, no prescriptions can be written, please leave the answer blank.
List the drugs (not just the drug class) in discussion (B)
Explain the problem and explain how you would address the problem (Rationale, C).
If prescribing a new drug, write out a complete medication order (D).
List the references (E)
Written Expression and Formatting, Proper English writing standards, Correct grammar, mechanics, and proper punctuation are required.
Any Qs asked that you think do not directly fall under A, B, C, D & E, answer them under C, the Rationale.
1. Jamie is a 38-year-old homeless bipolar patient who is diagnosed with an acute psychotic episode. He tells you that he has been on lithium for years and was recently started on imipramine 75 mg daily by someone at a free clinic. What treatment plan would you develop for Jamie? Would you discontinue any medications? What medications would you add?
A. Patient history considered in making the medication selection:
YOUR ANSWER
B. Medication prescribed or changed (Spell out the names of drugs):
YOUR ANSWER
C. Rationale provided to include ‘WHY’ the decision using Clinical Guidelines:
YOUR ANSWER
D. Written medication orders with all 5 aspects required for a valid order (your prescription order):
YOUR ANSWER
E. At least 3 References for the scenario scholarly, peer-reviewed, the past 5 years to include the appropriate clinical practice guidelines if applicable:
YOUR ANSWER
2. A 68-year-old woman has a history of rheumatoid arthritis and has been taking nabumetone (Relafen) 1000 mg po qd for 2 years. Other pertinent past medical history includes occasional incontinence, Crohn’s disease with frequent exacerbations, and well-controlled diabetes type 2. Recently, her arthritis pain has been much worse, and she is requesting additional medication for her rheumatoid arthritis. What would be appropriate additional therapy for this patient? What monitoring would be appropriate to monitor this medication? What monitoring would be appropriate for this medication?
A. Patient history considered in making the medication selection:
YOUR ANSWER
B. Medication prescribed or changed:
YOUR ANSWER
C. Rationale provided to include Current literature to support the rationale with Clinical Guidelines:
YOUR ANSWER
D. Written medication orders with all 5 aspects required for a valid order.
YOUR ANSWER
E. References for the scenario scholarly, peer-reviewed, the past 5 years to include the appropriate clinical practice guidelines if applicable. Use at least 3 sources for each scenario and cite sources using APA format:
YOUR ANSWER
3. Sheila is a 26-year-old with a history of head injury and tonic-clonic seizures. She is seen today with complaints of “funny” eye movements, feeling uncoordinated, blurred vision and feeling lethargic. Her current medications include Ritalin 10 mg po BID, Dilantin 300 mg po BID, Paxil 20 mg po daily, Lasix 20 po daily. Lab Values from today Dilantin level of 11microG/mL, Albumin 2g/dL, WBC 9.9×109/L, Plt 177×109/L, Na+ 141mEq/L, K+ 4.2mEq/L, Hgb 13.2g/dL. What do you think is causing the patient’s symptoms? What lab values and calculated corrected medication level support your diagnosis? What is your treatment plan for this patient?
A. Patient history considered in making the medication selection:
YOUR ANSWER
B. Medication prescribed or changed:
YOUR ANSWER
C. Rationale provided to include Current literature to support the rationale with Clinical Guidelines:
YOUR ANSWER
D. Written medication orders with all 5 aspects required for a valid order.
YOUR ANSWER
E. References for the scenario scholarly, peer-reviewed, the past 5 years to include the appropriate clinical practice guidelines if applicable. Use at least 3 sources for each scenario and cite sources using APA format:
YOUR ANSWER
4. Xavi is a 44-year-old man with complaints of low back pain following a motor vehicle accident. The accident occurred 7 days ago. He rates his pain 8 out of 10. He was prescribed Lortab (hydrocodone acetaminophen) 5 / 325 in the ER last week. He is requesting a refill of the Lortab today and indicates it just barely makes him comfortable. What treatment plan would you implement for Xavi? What medications would you prescribe, and how would you monitor them? What education would you provide regarding his treatment plan?
A. Patient history considered in making the medication selection:
YOUR ANSWER
B. Medication prescribed or changed:
YOUR ANSWER
C. Rationale provided to include Current literature to support the rationale with Clinical Guidelines:
YOUR ANSWER
D. Written medication orders with all 5 aspects required for a valid order.
YOUR ANSWER
E. References for the scenario scholarly, peer-reviewed, the past 5 years to include the appropriate clinical practice guidelines if applicable. Use at least 3 sources for each scenario and cite sources using APA format:
YOUR ANSWER
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