Administrative Medical Assisting 8th Edition French

Solutions Manual

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inistrative Medical Assisting 8th Edition French Solutions Manual

CHAPTER 10

Drug and Prescription Records

COMPETENCIES
Following are the Commission on Accreditation of Allied Health Education Programs (CAAHEP) and
the Accrediting Bureau of Health Education Schools (ABHES) competency standards for medical assisting
­educational programs that apply to this chapter. A full list of competencies may be found in Section III of this
Instructor Manual as well as Appendix B of the textbook.

CAAHEP Areas of Competence

I.C Anatomy and Physiology—Cognitive
11. Identify classifications of medications
II.C Applied Mathematics—Cognitive
5. Identify both abbreviations and symbols used in calculating medication dosages
X.P Legal Implications—Psychomotor
3. Document patient care accurately in the medical record
X.A Legal Implications—Affective
2. Protect the integrity of the medical record
XII.C Protective Practices—Cognitive
6. Discuss protocols for disposal of biological chemical materials

ABHES Areas of Competence

3. Medical Terminology
d. Define and use medical abbreviations when appropriate and acceptable
4. Medical Law and Ethics
a. Follow documentation guidelines
b. Institute federal and state guidelines when releasing medical records or information
f. Comply with federal, state, and local health laws and regulations
6. Pharmacology
a. Identify drug classifications, usual dose, side effects, and contraindications of the most commonly used
medications
c. Prescriptions:
1. Identify parts of prescriptions
2. Identify appropriate abbreviations that are accepted in prescription writing
3. Comply with legal aspects of creating prescriptions including federal and state laws
d. Properly use Physician’s Desk Reference (PDR), drug handbook, and other drug references to identify a
drug’s classification, usual dosage, usual side effects, and contraindications
9. Medical Laboratory Procedures
c. Dispose of hazardous materials

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 Chapter 10   Drug and Prescription Records

LESSON PLAN SUGGESTIONS

1. Emphasize legal restrictions that apply to the medical assistant’s role when prescription drugs are
­prescribed and refilled.
2. Review drug terms, abbreviations, and symbols.
3. Discuss the answers to the review questions and exercises completed for the previous chapter.
4. Assign and discuss the abbreviations and spelling review lesson in the Workbook.
5. Assign the review questions and critical thinking exercises in the Workbook for homework.
6. Workbook Job Skills 10-1 through 10-8 may be assigned for homework.

ADDITIONAL ACTIVITIES
1. Invite a pharmacist or a pharmacy technologist to speak to the class about his or her job and about drugs,
drug databases, drug laws, prescriptions, and refills.
2. Assign each student one of the top 200 drugs to report on, giving its source, generic and brand names, how
it is supplied, uses, dosage, how it is administered, side effects, interactions, and contraindications.
3. Make drug abbreviation flash cards for oral drills during class time.
4. Invite a representative from a law enforcement agency to speak on prescription drug abuse.
5. Have students look up websites listed in the Resources section at the end of the chapter and report on
­information that is available via the Internet.

STOP AND THINK CASE SCENARIOS AND ANSWERS

Determine Correct Medication

Scenario: An established patient, Charlie Gutierrez, is seen for an evaluation of a red rash-like dermatitis on
both feet. Dr. Practon hands the patient a written prescription. As the patient is leaving the office, Mr. Gutierrez
hands you the prescription and asks you what it says. In reading it, the handwritten name of the medication
looks like either Lamictal or Lamisil.
Critical Thinking:
1. What would you do to determine the correct medication? Ask the physician. If the physician is not available,
with the diagnosis in mind, look up the medication in a PDR or drug book.
Rationale: Lamictal (lamotrigine) is used to treat seizures and manic depression, and Lamisil (terbinafine) is used
to treat fungal infections, so the diagnosis would give you the needed information to verify the correct drug name in a
reference book.
2. What are some preventive measures to help avoid cases of mistaken drug identity? Have the physician print
the name of the medication if it is illegible or use e-prescriptions.

Determine Food and Drug Allergies

Scenario: An established patient, Sonja Tucker, is seen for an evaluation of severe back and side pain. It is
s­uspected she may be passing a kidney stone, so Dr. Practon orders an intravenous pyelogram, which will
require radiographic contrast material. You notice an alert tag on her medical record that states she is allergic to
­shellfish.

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 Chapter 10   Drug and Prescription Records

Critical Thinking:
1. What else might the patient be allergic to? iodine
Rationale: Shellfish contain iodine, so it is not advisable for anyone who has had an allergic reaction to shellfish to
have a medical test in which the radiographic material contains iodine, such as an IVP.
2. What should you say to Dr. Practon in this situation? In private, call Dr. Practon’s attention to the allergy
alert tag saying, “Dr. Practon, I just noticed that Sonja Tucker is allergic to shellfish.”
Rationale: It is best to be up front in situations like this; this could be a life-threatening situation for the patient.
Keep the conversation private so as not to undermine the patient’s confidence in the physician.
3. Are there additional questions you might ask the patient? What kind of reaction did you have to shellfish?
Have you ever had an IVP before? Have you ever had any other nuclear medicine tests that used iodine
(e.g., thyroid uptake)?

EXAM-STYLE QUESTIONS AND ANSWERS

1. The drug law that called for registration of all doctors, pharmacists, and vendors to submit paperwork for
all drug transactions is the:
a. Harrison Narcotic Act
b. Volstead Act
c. Food, Drug, and Cosmetic Act
d. Controlled Substances Act
e. Compassionate Use Act
2. The first federal commissioner of narcotics was:
a. Reverend Charles Brent
b. Hamilton Wright
c. Francis Burton Harrison
d. Andrew Volstead
e. Harry J. Anslinger
3. The drug law that mandates drugs be put into five different schedules according to their potential for abuse
is the:
a. Harrison Narcotic Act
b. Volstead Act
c. Food, Drug, and Cosmetic Act
d. Controlled Substances Act
e. Compassionate Use Act
4. The following procedure(s) is/are typically followed when prescribing Schedule II narcotics:
a. The physician writes an order for the narcotic on a triplicate prescription form.
b. The physician writes an order for the narcotic on a regular prescription form.
c. The physician telephones in the order for the narcotic prescription.
d. The physician writes the prescription on a “narcotics only” prescription form.
e. All of the above are correct.

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 Chapter 10   Drug and Prescription Records

5. Less expensive drugs manufactured with the same chemical formula as the original drug whose patent has
expired are called:
a. brand name drugs
b. generic drugs
c. chemical duplicates
d. pharmaceutical substitutes
e. Class B drugs
6. A useful prescription drug reference book that most physicians have in their libraries is the:
a. United States Pharmacopeia
b. National Formulary
c. Physicians’ Desk Reference
d. Physicians’ Desk Reference for Nonprescription Drugs
e. word book
7. The administration route for medication placed under the tongue would be called:
a. sublingual
b. otic
c. buccal
d. transdermal
e. oral
8. The component of a prescription labeled “signature” is:
a. the recipe
b. where the name of the drug or medication goes
c. where the instructions to the patient are written
d. where the physician signs his or her name
e. the directions to the pharmacist
9. When “e-prescribing,” a drug:
a. colored prescription pads are used
b. tamper-proof prescription pads are used
c. resistant paper is used
d. thermocratic ink is used
e. prescriptions are entered into software applications and transmitted electronically
10. The abbreviation “q.i.d.” means:
a. four times a day
b. three times a day
c. two times a day
d. morning, noon, and nighttime
e. every afternoon
11. A pharmaceutical representative is also called a:
a. salesperson
b. sales representative
c. pharmacist
d. detail rep or person
e. medical representative

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 Chapter 10   Drug and Prescription Records

12. What device can be used when a patient has difficulty remembering when to take medications?
a. medication schedule card
b. drug dispensing container
c. medication alert bracelet
d. drug flow sheet
e. both a and b
13. To educate a patient about possible drug side effects, advise the patient to:
a. stop taking the medication if a side effect is suspected
b. throw away the medication if a side effect occurs
c. call the office if one of the typical symptoms occurs (e.g., dizziness, nausea, headache)
d. go directly to the emergency room
e. wait until the next office visit and advise the physician
14. Which of the following statements is correct?
a. All Schedule I drugs should be kept under lock and key.
b. All Schedule I and II drugs should be kept under lock and key.
c. All Schedule I, II, and III drugs should be kept under lock and key.
d. All Schedule I, II, III, and IV drugs should be kept under lock and key.
e. All Schedule I, II, III, IV, and V drugs should be kept under lock and key.
15. Uncontrolled substances may be discarded by:
a. throwing them in a waste receptacle
b. flushing them down the toilet
c. discarding them with hazardous medical waste
d. contacting a reverse distributor for pick up
e. shipping them to the DEA

ABBREVIATION AND SPELLING REVIEW

Definitions for abbreviations are found in textbook Tables 7-1 and 10-3 as well as in the list of abbreviations in
Appendix B of the Workbook. Students should use their medical dictionaries for spelling.
Chart note for Lillian M. Chan.
OB obstetric
LMP last menstrual period
Pt patient
D&C dilatation and curettage
C-section cesarean section
CBC complete blood count
UA urinalysis
WR Wassermann reaction (syphilis test)
ret return
mo month

REVIEW QUESTIONS AND ANSWERS

1. Fill in the following blanks:
a. Most Americans have taken at least one prescription medication in the last decade.
b. In the years 2007–2008, 76% of adults 60 years of age or older used two or more prescription drugs.
c. In the years 2007–2008, 37% of adults 60 years of age or older used five or more prescription drugs.

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 Chapter 10   Drug and Prescription Records

2. Match the law or agency in the right column with the description in the left column by writing the correct
letters in the blanks.
c Law requiring transfer tax for those who a. Harrison Narcotic Act
sold marijuana. b. Volstead Act
e Federal law that requires the pharmaceutical c. Marijuana Tax Act
industry to maintain physical security and d. Food, Drug, and Cosmetic Act
strict recordkeeping for scheduled drugs. e. Controlled Substances Act
a First law to control the prescription, sale, and f. Food and Drug Administration
possession of narcotic drugs. g. Drug Enforcement Administration
g Organization that regulates the manufacturing
and dispensing of dangerous and potentially
abused drugs.
b Law that prohibited the manufacture, transportation,
and sale of beverages containing more than 0.5%
alcohol.
f Agency that determines the safety of drugs
before it permits them to be marketed.
d  First law that required the labeling of drugs with
directions for safe use.
3. True or False. Recreational marijuana is now legal in several states.
4. Where must the physician register for a narcotic license and when must the license be renewed? Register
and renew through Drug Enforcement Administration (national, district, or regional office); every 3 years if
­prescribing only and every year when dispensing.
5. Refer to textbook Table 10-1, Five Schedules of Controlled Substances, and answer the following
­questions.
a. On which schedule(s) may prescriptions be written by the health care worker? Schedules IV and V
b. On which schedule(s) will the medical assistant most likely be handling triplicate forms for the doctor?
Schedule II
c. On which schedule(s) do drugs have the most potential for abuse? Schedule I
6. If a medical practice dispenses controlled substances, how long must an inventory be kept for Schedule
I and II drugs? 2 years
7. Name and define the three types of drug names.
a. generic or official name: established, official, nonproprietary name of a drug
b. chemical name: long, complicated name of a drug describing chemical content
c. brand name: proprietary or trade (copyrighted) name of a drug
8. Define generic drug: When the patent expires for an originally manufactured drug, a generic drug,
­manufactured according to the same chemical formula, may be produced by other manufacturers; it is
­essentially identical to the brand name drug, but the cost is greatly reduced.
9. In the Physician’s Desk Reference, which section is used most frequently by the medical assistant?
­alphabetical brand/generic name index
10. Name and define the four components of a prescription.
a. superscription: the symbol Rx, meaning “recipe”
b. inscription: name of the drug, quantity of ingredients, and strength of dose
c. subscription: directions to the pharmacist on size of dose, quantity of drug given for the prescription, and
form of medication (capsules or tablets)
d. signature: instructions to the patient from the physician telling the patient how to take or apply the
medication

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 Chapter 10   Drug and Prescription Records

11. Match the drug route in the right column with the correct definition in the left column by writing the cor-
rect letters in the blanks.
d medication administered into a joint a. ophthalmic
b medication administered through the ear b. otic
g medication absorbed through the skin using a patch c. endotracheal
e medication placed between the cheek and gum d. intra-articular
a medication administered to the eye e. buccal
f medication placed under the tongue f. sublingual
c medication administered through the trachea g. transdermal
12. Write the abbreviation or symbol for the following pharmaceutical terms.
a. after meals p.c.
b. drops gtt.
c. every morning q.a.m. or every a.m.
d. every two hours q.2 h. or every 2 h
e. intramuscular IM
f. when necessary p.r.n. or PRN
13. True or False. All medical assistants can enter medication orders into a computerized system for CMS pre-
scription incentive programs. no, only medical assistants with the CMA (AAMA) certification or those who
have passed the Assessment-Based Recognition program offered by the AAMA
14. When charting medication refills, list the items needed to record:
a. date of refill approval
b. name of the medication
c. dosage strength
d. number of tablets or capsules
e. pharmacy name
f. medical assistant’s name and credentials
15. Name several ways the medical assistant can instruct the patient about drug dosages to be sure the patient
understands the directions.
a. Speak directly to the patient, asking for the directions to be repeated.
b. Ask the patient to verify the drug by bringing it in, taking it to the pharmacy, or using the PDR.
c. Clearly write out the name of the medication.
d. Use a medication schedule card and write down the patient’s medications.
e. Include friends and family members when instructions are given.
16. Name three important items to include when instructions are given to patients taking antibiotics.
a. Always finish the complete prescription, even if symptoms subside.
b. Call to inform the physician’s office if the patient stops taking the medication.
c. Call to report any adverse reactions that might occur.
17. Name three ways a medical assistant can track a patient’s drug use habits.
a. documentation in the medical record
b. drug flow sheet or medication log
c. electronic records
18. Name five ways to protect prescription pads from being misused. Students may have any five of the
following:
Store pads under lock and key.
Minimize number of pads in use.
Do not leave pads unattended.
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 Chapter 10   Drug and Prescription Records

Number prescription blanks.

Do not sign prescription blanks in advance.
Write in indelible ink.
Write out amounts or list using roman numerals.
Do not use prescription pads as memo pads.
Obtain tamper-proof prescription pads.
19. Name some common side effects associated with medications. Note: students may come up with additional
side effects.
a. dizziness
b. drowsiness
c. nausea
d. vomiting
e. rash
f. respiratory trouble
g. sleeplessness
h. headache
i. blurred vision
j. hemorrhaging
k. constipation
l. appetite or weight loss
20. If the patient does not have any known allergies, what is the abbreviation listed on the “alert tag” on the
front of the patient’s chart? NKA (no known allergies)

CRITICAL THINKING EXERCISE ANSWERS

1. If a pharmacist calls the office and the physician approves a refill on Mr. Hamilton’s prescription, what
administrative task should the medical assistant then perform (list details)? Pull the patient’s chart or access
the medical record and record the refill approval with the date, drug name, dosage, amount given, pharmacy,
and your initials
2. Mrs. Schwartz telephones and says that the doctor prescribed Hytrin, but she cannot remember why. With
the physician’s permission, you would tell her that the medication is being prescribed for her hypertension.
3. Rewrite the following statements as they would appear on a prescription, using Latin abbreviations.
a. Proventil (albuterol) inhaler 100 mg/5 ml, Sig: 1 or 2 inhalations, q.4 h. p.r.n.
b. Cardizem CD (diltiazem HCl) caps, 180 mg, #100, Sig: i a.c. and i q.h.s. or i h.s.
c. Lanoxin (digoxin) tabs, 0.125 mg, #60, Sig: i q.d.
d. Vantin (cefpodoxime proxetil) tabs, 200 mg, #28, Sig: i p.o. q.12 h. × 14d

JOB SKILL 10-1 SPELL DRUG NAMES

Dictated drug names:

Phonetics Spelling
1. CAR-de-zem Cardizem
2. di-ah-BEN-eze Diabinese
3. FEE-a-sol Feosol
4. NAP-ro-sin Naprosyn
5. LIP-ah-tour Lipitor

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 Chapter 10   Drug and Prescription Records

6. LAY-six Lasix
7. eye-bu-PRO-fen Ibuprofen
8. die-AS-a-pam Diazepam
9. TEN-or-min Tenormin
10. aug-MEN-tin Augmentin

JOB SKILL 10-2 DETERMINE THE CORRECT SPELLING OF DRUG NAMES

1. Dr. Practon’s last chart note on Mr. Hoy Cho states “advised the patient to take (b) aspirin 1 tab. b.i.d.”
2. After Ray Nunez suffered a mild heart attack, the physician prescribed a (a) nitroglycerin patch daily.
3. Maria Sanchez telephones stating she has a cold and wants to know if it is all right to take (a) Contac, an
over-the-counter drug.
4. Mrs. Hatakeyama’s allergy is easily treated with (b) Actifed.
5. Rosaria LaMaccia suffered a mild respiratory infection, and Dr. Practon gave her a prescription for
(a) Ceclor.
6. The patient is complaining of muscle spasms in the lumbar region, so a prescription for (a) Flexeril is given.
7. Fayetta Brown’s diagnosis is duodenal ulcer, so she is given a prescription for (b) Bentyl.
8. A year ago, Mae James had a urinary tract infection and was prescribed (b) Septra.
9. Ventricular arrhythmias are diagnosed in Cameron Lesser’s case, so (b) Quinaglute is given.
10. After the death of her spouse, Danielle La Fleur became depressed and Dr. Practon prescribed
(b) amitriptyline.

JOB SKILL 10-3 USE a drug reference book to locate information

1. What is the dosage she is taking? 4 mg
2. Where did you find the information? answers will vary but should include the name of the reference book or
website and a product or pill identification section
3. In what section of the PDR did you find the information? (optional) Product Identification Guide (gray)
4. What is the generic name for Coumadin? Warfarin
5. What type of medication is Coumadin? The drug classification is “anticoagulant.”
6. Name the most common G.I. side effects: the most common adverse reactions include nausea, vomiting, and
mouth sores

JOB SKILL 10-4 TRANSLATE PRESCRIPTIONS

1. Tagamet, four hundred milligrams, number thirty, one by mouth before bedtime.
2. Darvocet N-one hundred, dispense number sixty tablets, two every four hours whenever necessary for pain.
3. Diovan HCT, one hundred sixty milligrams and twelve one half milligrams, number one hundred, one by mouth
every day.
4. Tenormin, fifty milligrams, number one hundred, one every day.
5. Robitussin-DAC, one four ounce bottle, two teaspoons every four hours when necessary for cough.
6. Isordil (isosorbide dinitrate), twenty milligrams, number thirty, one by mouth every twelve hours.
7. Compazine, twenty-five milligram suppositories, number fourteen, one rectally two times a day, whenever
­necessary, for vomiting.
8. Vanceril inhalation aerosol, forty-two micrograms, number one bottle, two inhalations four times a day,
­whenever necessary, for asthma.
9. Timoptic Solution, zero-point-twenty-five percent, one bottle, one drop in each eye two times a day.

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 Chapter 10   Drug and Prescription Records

JOB SKILL 10-5 RECORD PRESCRIPTION REFILLS IN MEDICAL RECORDS

The four file folder labels should appear as follows:

JOB SKILL 10-6 WRITE A PRESCRIPTION

The prescription should appear as follows:

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inistrative Medical Assisting 8th Edition French Solutions Manual

Chapter 10   Drug and Prescription Records

JOB SKILL 10-7 INTERPRET A MEDICATION LOG

Directions: Refer to the medication log (Figure 10-2 in the Workbook). It is November 17, and Mary Beth Foley
calls to request a refill on her Glucotrol. Look at the medication log in the text and determine: (1) Has she been
prescribed the medication? YES. (2) How many days has it been since she got her last refill? 41 days. (3) Is it time
to refill the medication? NO. (4) When may she call for her next refill? She should have medication to last until
January 5, so she can call around December 23 to allow time for processing (14 days if it is a mail order).

JOB SKILL 10-8 RECORD ON A MEDICATION SCHEDULE

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