Practice Examination (50 Questions) INSTRUCTIONS Candidates can use the practice exam to identify areas requiring further study in preparation for an official competency-based examination. The practice exam serves as an optional assessment tool, not a study guide for certification examinations. Adequate preparation for the certification examination is not limited to or reliant on taking the practice exam. It is crucial to understand that performance on a practice examination does not predict a candidate's success or failure on the competency-based NBMTM Certification Examination. Taking the practice exam is voluntary and offers no advantage over candidates who opt not to take it. Only one version of the BCMTMS practice exam is available. The exam content is derived from NBMTM's test specifications. The practice exam comprises 50 multiple-choice questions. NBMTM content experts have developed these questions. Unlike certification examination results, which use scaled scores, practice exam scores are reported as percentages. Upon completion of the practice exam, the results will be emailed to you. You may take as much time as needed for this practice exam. However, bear in mind that the actual BCMTMS exam consists of 200 questions with a four-hour time limit. After you finish the practice exam, NBMTM will email a summary of your performance, detailing correct and incorrect responses for each question. First Name*Last Name*Email* Which following statement is correct regarding irritable bowel syndrome (IBS)?* A. It is less common in those with Latin American descent. B. IBS-D is less prevalent than IBS-C. C. It is less common in women than men. D. It is usually diagnosed in patients under 50 years old. What is the mechanism of action of senna?* A. It decreases the cytosolic calcium concentrations thereby allowing for a greater force of contraction by the intestinal smooth muscle. B. It stimulates parasympathetic nerve endings that cause local peristalsis. C. It causes local irritation of the intestinal mucosa that stimulates the Auerbach’s plexus. D. It stimulates the sympathetic nervous system output on the smooth muscle of the intestine thereby increasing local peristalsis. A 69-year-old man with a history of heart failure describes his activity level as sedentary. Walking up a flight of stairs causes him shortness of breath. Which class of heart failure does he belong?* A. NYHA Class I B. NYHA Class II C. AHA Stage A D. AHA Stage B Which of the following is correct regarding Ranolazine therapy?* A. It does not increase QTc interval. B. It is allowed in patients taking strong CYP450 3A inhibitors and inducers. C. It is preferred for patients with long QT syndrome. D. It should not be used in heart failure patients with a reduced ejection fraction. Which of the following regarding MTM is true?* A. Only pharmacists are allowed to give comprehensive medication reviews. B. Only members with Medicare part D are eligible to have MTM services. C. Only board-certified pharmacists can practice MTM. D. Telephonic medication therapy management reviews cannot be reimbursed from Medicare. Which one of the following is the primary reason why CMS allows other professions other than pharmacists to conduct MTM reviews?* A. Pharmacists may not always be available in certain regions. B. Regulators wanted sponsors to have more flexibility to promote best practices. C. CMS believes that multidisciplinary approaches may provide a more comprehensive patient review. D. CMS aims to lower costs by using a diverse set of professionals. Which of the following service elements is a requirement of Part D Medication Therapy Management (MTM) programs?* A. A patient has to have 5 of the eligible conditions. B. Comprehensive Medication Reviews (CMRs) are performed face-to-face or by telephone. C. A minimum of 60 minutes discussion time for the provider and patient D. Written summaries without medication action plans and personal medication lists Which of the following should be included in a comprehensive medication review?* A. Patient's insurance information B. Prescription and over-the-counter drugs C. Patient's exercise routine D. Patient's employment status Which part of the CMR is specifically designed to outline the patient’s responsibility in helping to solve various identified problems?* A. Medication Action Plan (MAP) B. Patient Educational Inserts C. Manufacturer Package Inserts D. Comprehensive List Which of the following shows a positive aspect of using a telephonic model for MTM compared to a face-to-face model for MTM?* A. Patients may experience difficulty hearing from the phone. B. Patients are in a comfortable environment. C. Patients must have access to a phone line. D. Patients may face challenges in accessing information such as labs and other medical history. Which of the following can be added to the drug therapy guidelines for nursing facility residences to ensure avoidance of certain medications that are inappropriate?* A. Beer's list criteria B. Drug Interaction Lists C. Formulary List D. FDA Safety Recommendation Which star system is used by CMS to rate the quality of health and drug services in Medicare Advantage plans and Medicare Prescription Drug plans?* A. 4 Star System B. 5 Star System C. 8 Star System D. 10 Star System Which of the following is an appropriate entity to outsource MTM (Medication Therapy Management) services?* A. Offshore Business Processing offices B. Local Pharmacies C. Plan sponsored PBMs (Pharmacy Benefit Managers) D. A non-pharmacy medical clinic Which of the following is one of the 5 core elements defined by the American Pharmacist Association, the National Association of Chain Drug Stores, and the Center of Medicare and Medicaid Services for MTM services?* A. Interaction with other health care professionals B. Providing financial assistance to the needy C. Offering free medication samples D. Comprehensive Medication Review What is a primary difference between medication reconciliation done at the hospital versus a comprehensive medication review (CMR)?* A. CMRs primarily focuses on medications patients will take during their hospital stay. B. CMRs are mostly carried out during hospital admissions. C. Medication Reconciliation involves thorough patient education about all their medications. D. CMRs only concern themselves with the possible drug interactions during the hospital stay. Which of the following is considered nonverbal communication?* A. Texting B. Rate of Speech C. Tone of Voice D. Facial Expressions Which of the following is a characteristic of an open-ended question?* A. It can generally lead patients in one direction. B. It typically require a "yes" or "no" response. C. It can restrict the amount of unexpected information from the patient. D. It can determine how well the patient understands you and the language you are speaking. Which of the following might indicate that a patient may have low health literacy?* A. The patient is able to demonstrate teachback instructions. B. The patient repeatedly mentions that they have forgotten their glasses. C. The patient keeps all medical documents organized and readily available. D. The patient engages in discussions with the healthcare provider about treatment options. An 18-year-old male with allergic rhinitis has recently been diagnosed with uncontrolled asthma. He only has a rescue inhaler. Which maintenance inhaler should be recommended for long-term therapy?* A. Flovent B. Tudorza C. Combivent D. Performomist During a medication review, a patient mentions they have been prescribed Singulair (Montelukast) and inquires about the administration. Which of the following is the most appropriate response from a pharmacist?* A. It is best for the patient to take it in the morning. B. The patient should take it as needed when her asthma symptoms seem to get worse. C. The patient should take this in the evening since she has asthma. D. It is best for the patient to take it twice daily. A 30-year-old patient with asthma is on fluticasone propionate 110mcg inhaler twice daily and albuterol as needed. He wakes up coughing on occasion, experiences daily shortness of breath and wheezing, and uses his albuterol inhaler 4 to 5 times weekly. Based on these symptoms, how should his medication be adjusted?* A. Increase fluticasone to 2 puffs twice daily and reassess in 2 weeks. B. The patient's asthma is well-controlled; no changes are necessary. C. Increase the frequency of albuterol to every 4 hours as needed. D. Initiate Medrol dose pack immediately. Which of the following beta-blocker is suggested for patients with persistent asthma who also have heart failure?* A. Propranolol B. Atenolol C. Metoprolol Succinate D. Carvedilol Which of the following is considered a common risk factor for atrial fibrillation?* A. Fatty Liver Disease B. Hyperthyroidism C. Excessive Consumption of Water D. Lack of Sun Exposure During the MAP (Medication Action Plan), which of the following is most recommended for a patient taking Dronedarone (Multaq)?* A. Take Dronedarone on an empty stomach. B. Avoid grapefruit juice while taking Dronedarone. C. Take Dronedarone with antacids to reduce potential stomach upset. D. Take Dronedarone twice a day with a diuretic to prevent fluid retention. Which beta-blocker would you recommend for ventricular rate control in patients who have atrial fibrillation secondary to hyperthyroidism?* A. Atenolol B. Metoprolol C. Sotalol D. Propranolol Which of the following terms could be described as a mild degree of mania?* A. Psychotic Depression B. Hypomania C. Euthymia D. Melancholic Depression A patient with bipolar I disorder, recovering from a major depressive episode 4 months ago, is on paroxetine and valproic acid. How should the patient be classified regarding the use of paroxetine in terms of medicantion-related problems?* A. There is a need for additional monitoring. B. There is a need for adherence. C. The use of paroxetine may be considered potentially inappropriate. D. Consider the possibility of Serotonin Syndrome. Which of the following is not a common adverse effect of lithium?* A. Weight Loss B. Polyurea C. Tremor D. GI upset Which of the following is the most common cause of chronic kidney disease?* A. Hypertension B. Diabetes Mellitus C. Drug overuse D. High Sodium Diet Which of the following is an appropriate counseling recommendation for a patient with chronic kidney disease?* A. If the patient forgets a dose of phosphate binder at lunch, then take it with a high-phosphate meal later. B. Orange juice should be consumed regularly to increase potassium content. C. Ibuprofen should be used in preference instead of acetaminophen. D. The patient should only check your blood pressure at your physician's office and not at home. Which of the following phosphate binders can you give to a patient without increasing the patient's calcium levels?* A. PhosLo B. Titralac C. Calphron D. Renvela Which of the following parameters indicate that a patient is "high risk for future COPD exacerbations?* A. Daily use of both an LA beta-2 agonist and anticholinergic bronchodilator B. History of 1 COPD exacerbation in the previous 12 months C. FEV-1 (Forced expiratory volume in one second) is less than 80% but more than 50% D. Grade 2 airflow limitation When should you refer a COPD patient IMMEDIATELY to a physician?* A. When patients experience unrelieved shortness of breath after climbing several flights of stairs B. Increase symptoms of coughing and shortness of breath but relieved with a short-acting inhaler C. Shortness of breath not relieved by a rescue inhaler D. Patient experiencing severe nighttime cough In an MTM review, a patient with COPD from long-term smoking expresses a desire to reduce the number of medications. Which agent is best to recommend for potential discontinuation by their physician?* A. LAMA B. Leukotriene modifiers C. Short-acting beta-2 agonists D. Long-acting beta-2 agonists A 67-year-old male with allergic rhinitis, hypertension, diabetes, and a 15 pack-year smoking history is reviewing his medications: benazepril 20 mg daily, levocetirizine 5mg daily, and metformin 500 mg twice daily. He reports occasional shortness of breath when hurrying but manages daily activities comfortably. What should a pharmacist recommend?* A. Initiating furosemide due to possible heart failure symptoms B. Discontinuing metformin due to possible symptoms of lactic acidosis C. Initiating fluticasone nasal spray for allergy rhinitis D. Initiating smoking cessation What counseling points would should a pharmacist provide for a patient using a Symbicort (budesonide-formoterol) inhaler?* A. Use it immediately when feeling shortness of breath. B. Rinse mouth due to small risk in developing thrush from Candida albicans. C. Monitor blood pressure due to possibility of decreased blood pressure with corticosteroid inhalers. D. Rinsing the mouth afterward may help prevent dry mouth side effects. When using a peak flow meter, which of the following is recommended for patients to do?* A. Place the mouthpiece into the mouth under the tongue. B. Breath in normally and breath out slowly. C. Patient should record the average of three attempts. D. Patient should be instructed to breathe out as hard and fast as they can in a single blow. Which activity is most likely to induce an angina attack?* A. Walking up several flights of stairs quickly B. Drinking a cold beverage rapidly C. Being exposed to cold weather D. Doing a stretching exercise What would be the appropriate action to take for a patient experiencing angina who is using Nitroglycerin?* A. If the pain does not improve in 15 minutes after the three doses, call 911. B. Advise the patient to chew nitroglycerin for faster onset. C. Wait 15 minutes to repeat a second dose. D. Recommend storing nitroglycerin in a pillbox for easier access during an attack. Among the following comorbid conditions, which one is most commonly associated with Alzheimer's disease?* A. Depression B. Euphoria C. Insomnia D. Gout Which of the following best describes the mechanism of action of memantine (Namenda)?* A. D2 receptor agonists B. Antagonizes NMDA receptor C. Inhibits acetylcholinesterase D. Inhibits Monoamine Oxidase Enzymes When should duloxetine (Cymbalta) be avoided in an older adult patient?* A. History of hypertension B. History of seizure C. Poor renal function D. Concurrent use of amlodipine Which enzyme is commonly affected by genetic polymorphisms that categorize individuals as ultra-rapid, intermediate, or poor metabolizers?* A. MAO-A B. ACE C. COMT D. CYP2D6 What legislation aims to protect people from being discriminated against based on their genetic information in the context of employment and health insurance?* A. CLIA B. HIPAA C. GINA D. ELGI Which technique is often used for the amplification of DNA segments in pharmacogenomics testing?* C. Chromatography D. Spectrophotometry B. Electrophoresis A. Polymerase Chain Reaction Which documentation system is commonly used for structuring medication therapy management (MTM) documentation?* A. ICD-10 B. PSBAR C. HL7 D. SOAP Which set of standards should be integrated for transmitting electronic healthcare information between systems for MTM?* A. SOAP B. HL7 C. ICD-10 D. PSBAR What should be reviewed to improve the quality of medication therapy management services after a therapeutic failure?* A. Outreach tracking B. CPT codes C. Root cause analysis D. PSBAR Which of the following codes is commonly used for billing medication therapy management services?* B. ICD-10 D. E/M A. CPT C. HCPCS For best practices in billing within the domain of medication therapy management, what is essential to focus on?* A. Proficiency in SOAP documentation B. Understanding compliance procedures C. Mastery of time management for MTM D. Proficiency in using specific CPT codes
