Pharmacy PEBC Practice Exam

A community pharmacy provides prescriptions for elderly patients in a nearby long-term care facility where the nursing staff administer medications. When processing the monthly refills for NR, an 83 year old female resident, the pharmacist notices that NR’s lorazepam refills have been ordered several days early on the last 2 occasions. Which of the following is the most appropriate action for the pharmacist to take?

1. Ask NR if there has been a dosage change with her lorazepam.

2. Ask the nurse at the residence to check NR’s medication administration records.

3. Alert the prescribing physician that NR is taking more lorazepam than prescribed.

4. Report the nursing staff at the residence for a fraudulent diversion of medication.

The correct answer is: Ask the nurse at the residence to check NR’s medication administration records.

The most appropriate action for the pharmacist to take is to ask the nurse at the residence to check NR's medication administration records. This is because it is important to gather more information before jumping to any conclusions or reporting anyone for potentially fraudulent activity. Asking NR directly about a dosage change may be inappropriate or uncomfortable for her, and alerting the prescribing physician may not provide enough context or evidence. Reporting the nursing staff without any concrete evidence could also cause unnecessary conflict and harm relationships. Therefore, asking the nurse to check medication administration records would provide more insight into the situation and allow for a more appropriate response.