Planning and Intervention: Evidence-Based, Individualized, Documented
What the planning domain tests
Planning items ask you to convert a diagnosis into an actionable, guideline-concordant, patient-centered plan. Know first-line therapy for common primary care conditions (hypertension, type 2 diabetes, asthma, hyperlipidemia, depression, uncomplicated urinary tract infection) and the difference between disease-modifying treatment and symptom relief. Prescribing questions test starting dose, titration, monitoring labs, renal and hepatic adjustment, pregnancy and lactation safety, weight-based pediatric dosing, Beers criteria in older adults, and controlled-substance requirements. Nonpharmacologic intervention, immunization and health maintenance, patient education with teach-back, shared decision-making, motivational interviewing, referral, and care coordination all count as planning.
Traps that appear in items
- Choosing symptom relief when a first-line disease-modifying agent is indicated.
- Missing a contraindication: beta blocker in asthma, ACE inhibitor in pregnancy, NSAID in chronic kidney disease.
- Treating a number rather than a patient, or overtreating a stable asymptomatic finding.
- Omitting follow-up and safety-net instructions from an otherwise correct plan.
- Over-referring a stable outpatient to emergency care, or under-referring a true emergency.
- Forgetting health maintenance that should accompany the visit.
Rule of thumb
For every plan, name four things: the goal, the guideline-based first-line intervention, the monitoring parameter, and the follow-up interval.
Worked example
A 55-year-old Black adult with newly diagnosed uncomplicated hypertension and no comorbidity: start lifestyle counseling plus a thiazide-type diuretic or a dihydropyridine calcium channel blocker per guideline recommendations, obtain baseline metabolic panel and urinalysis, and reassess blood pressure in about one month. Each element - goal, agent, monitoring, follow-up - is present.