Patient Counseling>Counseling Priority Practice Test

A 28-year-old man with treatment-resistant schizophrenia is starting clozapine after inadequate response to risperidone and olanzapine. Baseline ANC is 3,500 cells/mm3 and he is enrolled in the REMS program with weekly lab monitoring arranged. He smokes one pack per day and lives with his parents, who will help supervise medications. He denies a seizure history. Current meds include metformin for antipsychotic-induced weight gain and a bowel regimen for constipation risk. He asks what side effects to watch for and how serious they might be. Vitals are stable. He has transportation for lab visits but worries about missing work if he feels unwell.

A 68-year-old man with nonvalvular atrial fibrillation is starting warfarin 5 mg nightly. Baseline INR is 1.1. His medications include lisinopril and hydrochlorothiazide. He reports using over-the-counter ibuprofen several days each week for knee pain and occasionally drinks green smoothies that include kale and spinach. He lives alone and has never taken an anticoagulant before. The prescriber plans frequent INR checks for dose titration. The patient asks the pharmacist what he should focus on while getting started and whether he can keep using his usual pain reliever. He denies a history of peptic ulcer disease or major bleeding. Blood pressure today is 132/78 mm Hg. He does not drink alcohol regularly and has no known drug allergies.