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Which of the following antibiotics do not require a dosage adjustment when administered to a patient

Answer
A Oxacillin and amoxicillin
B Nafcillin and dicloxacillin
C Ticarcillin and oxacillin
D Nafcillin and ticarcillin
E Piperacillin and dicloxacillin

Question:
During the hospitalization, MG's pain is well-controlled on morphine 3 mg IV Q4 hours. The team has
dose by 25%. Which Norco dosing regimen should the pharmacist recommend?
Answer
A Norco 5/325 mg every 12 hours
B Norco 5/325 mg every 4 hours
C Norco 7.5/325 mg every 6 hours
D Norco 10/325 mg every 6 hours
E Norco 10/325 mg every 4 hours

If 750 mL of a 25% (v/v) solution of methyl salicylate is diluted to a 3000 mL solution, what will be the
sign.

A patient is using Opana ER tablets. Which of the following statements concerning Opana ER is correc
Answer
A Opana ER should not be taken with food.
B If Opana ER is ingested with alcohol there will be reduced absorption of the drug, causing lack of an
C Opana ER can be used in patients with moderate-to-severe liver impairment.
D Opana ER is an antagonist at the mu opioid receptor.
E The chemical name is oxycodone.

Alexandra is a 46 year old female being seen at the methadone clinic. She is not enjoying her usual d
drug overdose. She is full of sadness, grief, and anxiety about the future. Alexandra takes the followi
Aleve. Which of her medications could be contributing to her depressive symptoms?
Answer
A Clonidine and Aleve
B Remeron and bisacodyl
C Clonidine and Peg-Intron
D Peg-Intron and Remeron
E Docusate and bisacodyl

A new drug for stroke prevention, CLOTBUST, was studied. The trial enrolled 2,062 patients. In the CLO
aspirin arm, p-value = 0.025. What was the absolute risk reduction of stroke in this trial? Round to ne
zero when the answer is less than one.

Select the correct application site and the maximum duration of a single application of the Transderm
Answer
A Upper torso; 2 days
B Abdomen; 2 days
C Behind the ear; 3 days
D Hip line; 3 days
E Buttock; 2 days

A patient with a deep vein thrombosis has been using warfarin for four months. The INR is stable arou
Answer
A If cimetidine is added, the INR would increase.
B If trimethoprim/sulfamethoxazole is added, the INR would decrease.
C If carbamazepine is added, the INR would increase.
D If phenobarbital is added, the INR would increase.
E If phenytoin is added, the INR would increase.

James is a 67 year old male who frequents the pharmacy. His past medical history includes a myocard
Today he brings in a prescription for Nexium. What action should the pharmacist take?
Answer
A Fill the prescription as written.
B Contact the prescriber about the interaction with Plavix. This combination could cause increased tox
C Contact the prescriber about the interaction with Plavix. This combination could cause the Plavix to
D Contact the prescriber about the interaction with Altace. This combination could cause an unsafe in
E Fill the prescription as written. Advise the patient to watch for signs of bleeding.

Question
Mesalamine is available in which of the following formulations? (Select ALL that apply.)
Answer
A Dipentum tablets
B Asacol-HD tablets
C Asacol suppositories
D Rowasa enema
E Rowasa suppositories

A study reports that of 52 patients who had a colonoscopy, the complication rate was 7.7% (95% Confi
Answer
A There is 95% confidence that the "true" complication rate is between 5.2% and 17.5%.
B The "true" complication rate is between 5.2% and 17.5%, 95% of the time.
C There is a 5% chance that the patient will have no complications.
D There is a 95% chance that the patient will have a complication.
E There is a 5% chance that the patient will have a complication.

An 83 year old female has just lost her husband. With the grief she is enduring and stress from family
benzodiazepine for short-term use. Which agent would be the safest recommendation for this patient?
Answer
A Serax (oxazepame)
B Halcion
C Valium
D Klonopin
E Librium

A female patient receiving chemotherapy to treat multiple myeloma has had her labs drawn. The com
oncologist has indicated that the patient should not get her next round of chemotherapy if the ANC is
number only. Do not enter units or commas. Include a leading zero when the answer is less than one
Labs:
Na (mEq/L) = 129 (135 145)
K (mEq/L) = 3.5 (3.5 5)
Cl (mEq/L) = 103 (95 103)
HCO3 (mEq/L) = 24 (24 30)
BUN (mg/dL) = 12 (7 20)
SCr (mg/dL) = 0.9 (0.6 1.3)
Glucose (mg/dL) = 118 (100 125)

WBC (cells/mm3) = 6.7 (4 11 x 10^3)


Hgb (g/dL) = 13.4 (13.5 18 male, 12 16 female)
Hct (%) = 40.1 (38 50 male, 36 46 female)
Plt (cells/mm3) = 202 (150 450 x 10^3)
PMNs (%) = 5 (45 73)
Bands (%) = 2 (3 5)
Eosinophils (%) = 3 (0 5)
Basophils (%) = 0 (0 1)
Lymphocytes (%) = 29 (20 40)
Monocytes (%) = 2 (2 8)

A 72 year old female had a stroke. The medical resident wants to give alteplase. Which of the followin
Answer
A A CT scan must confirm the absence of a hemorrhagic stroke before alteplase is given.
B Treatment should be initiated within 3 hours of symptom onset.
C Treatment should be initiated within 3 hours of patient arriving at the emergency department.
D Intracranial hemorrhage is a serious side effect of alteplase therapy.
E The maximum dose is 90 mg administered by intravenous infusion.

A 72 year old female had a stroke. The medical resident wants to give alteplase. Which of the followin
Answer
A A CT scan must confirm the absence of a hemorrhagic stroke before alteplase is given.
B Treatment should be initiated within 3 hours of symptom onset.
C Treatment should be initiated within 3 hours of patient arriving at the emergency department.
D Intracranial hemorrhage is a serious side effect of alteplase therapy.
E The maximum dose is 90 mg administered by intravenous infusion.

Paulette has received a prescription for Forteo. Which statement concerning Forteo is correct?
Answer
A This medicine should be used for a maximum of 3-5 years.
B The generic name of Forteo is denosumab.
C The same drug is available for treatment of hypercalcemia of malignancy as the branded product Xg
D Inject the medication using the subcutaneous injection pen each day, while sitting in a location whe
E The pen is good for 60 days; any medication remaining in the pen after this time must be discarded

Which of the following statements about pharmacogenomics are correct? (Select ALL that apply.)
Answer
A Pharmacogenomics is personalized medicine, where drugs are designed for individual patients base
B Pharmacogenomic testing can help predict what type of response a patient is likely to have to a dru
C Codeine is converted to morphine by CYP 2D6, therefore poor metabolizers will have an increased ri
D Patients with alleles 2C92 and 2C93 are more likely to bleed on warfarin therapy.
E Patients who are poor metabolizers of CYP 2C19 are not good candidates to receive Plavix.

Elaine has NYHA functional class III systolic heart failure. She needs to use an additional drug to lowe
be added for her blood pressure?
Answer
A Diltiazem
B Monopril
C Carvedilol
D Amlodipine
E Valsartan

What type of information can be found in The Red Book?


Answer
A Health information for international travelers
B Therapeutic equivalence
C Average wholesale price
D Drug interactions
E Pediatric doses

Counseling points on the use of Foradil should include the following: (Select ALL that apply.)
Answer
A Use for maintenance only. Do not use for acute attacks.
B Long-acting bronchodilators, such as Foradil, are associated with an increased risk of asthma-related
C This medication should be used once daily upon first awakening.
D Capsules may be kept at room temperature for up to 4 months.
E Leave the capsule in the sealed pack until just before use.

Which of the following statements concerning hypertensive urgency is accurate?


Answer
A Acute organ damage must be present for this classification.
B An appropriate treatment for hypertensive urgency is hydrochlorothiazide.
C An appropriate treatment for hypertensive urgency is oral clonidine.
D An appropriate treatment for hypertensive urgency is SL nifedipine.
E Intravenous administration of an antihypertensive is required.

Maya is a four-year old girl with a fever of 101.7 degrees Fahrenheit. She weighs 26.4 pounds. Maya h
recent incidents of conjunctivitis. The physician has recommended acetaminophen to be dosed at 10
Select the correct dose, in milligrams, to be given every 8 hours from the formulations in stock. Do no

A patient in the critical care unit is receiving Precedex for sedation. Which of the following statements
Answer
A It is reconstituted in dextrose solutions only.
B Precedex should only be given if a patient is also receiving a paralytic.
C Precedex is an alpha2-adrenergic antagonist.
D The maximum infusion duration is 48 hours.
E Patients are more easily arousable and alert when stimulated, compared to propofol.

Question
The PDE-5 inhibitors are contraindicated with which of the following drugs? (Select ALL that apply.)
Answer
A Minitran
B Imdur
C Nifedipine
D Isordil
E Nitrofurantoin

Which of the following statins should not be taken with grapefruit juice? (Select ALL that apply.)
Answer
A Mevacor
B Pravachol
C Lescol
D Crestor
E Zocor

Which of the following counseling statements concerning Concerta is correct?


Answer
A The drug is available in a granule formulation if the child has difficulty swallowing the capsule.
B If your child has difficulty swallowing, the tablet may be crushed and mixed with applesauce.
C Your child's appetite may increase, therefore, give the dose in the morning after breakfast.
D The drug is available in an OROS formulation that provides an immediate release portion with longe
E Give the dose in the evening so that most of the side effects are experienced while the child is aslee

Lisa, a 30 year-old female, is getting her first job as a hospital pharmacist since completing school. Sh
conditions except for occasional acne and menstrual cramps. She will be working as a specialty pharm
during pharmacy school, with evidence of immunity). Her mother reports that Lisa received the childh
should Lisa receive now? (Select ALL that apply.)
Answer
A The influenza vaccine, seasonally, inactivated shot only
B The influenza vaccine, seasonally, live or inactivated
C Tdap vaccine, if no record of previous vaccination, and Td every 10 years thereafter.
D Menactra
E Hib vaccine

Lungs: Some wheezing bilaterally, some crackles on left.


Ext: No skin lesions, good peripheral pulses bilaterally
Labs on 2/11/15:
Na (mEq/L) = 136 (135 145)
K (mEq/L) = 3.7 (3.5 5)
Cl (mEq/L) = 101 (95 103)
HCO3 (mEq/L) = 25 (24 30)
BUN (mg/dL) = 22 (7 20)
SCr (mg/dL) = 1.6 (0.6 1.3)
Glucose (mg/dL) = 115 (100 125)
Ca (mg/dL) = 8.3 (8.5 10.5)
Mg (mEq/L) = 1.8 (1.3 2.1)
PO4 (mg/dL) = 4.5 (2.3 4.7)

WBC (cells/mm3) = 13.3 (4 11 x 10^3)


Hgb (g/dL) = 16.3 (13.5 18 male, 12 16 female)
Hct (%) = 44.9 (38 50 male, 36 46 female)
Plt (cells/mm3) = 426 (150 450 x 10^3)
AST (IU/L) = 54 (10 40)
ALT (IU/L) = 43 (10 40)
Albumin (g/dL) = 3.4 (3.5 5)
BNP (ng/L) = 137 (< 100 ng/L)

Tests on 2/11/15:
Chest X-ray: 4 small nodules noted in left lower lobe. No infiltrate. Recommend aspiration or biopsy t
EKG: Normal sinus rhythm, no ST or T wave changes.
Plan:
Admit to floor for management and further work-up of lung nodules.
Question:
What is the correct interpretation of SP's elevated BNP level?
Answer
A Increased BNP is specific for heart failure. This patient has heart failure.
B Increased BNP is specific for lung pathology. It correlates with the patient's lung nodules and COPD.
C BNP will be permanently increased in patients who have had a myocardial infarction or stent. It can
D Increased BNP indicates cardiac stress, but it is not specific to heart failure or heart disease.
E BNP is the most reliable marker for diagnosing a STEMI. This patient is having a STEMI.

A drug is categorized by the FDA as Pregnancy Category C. Select the correct meaning of this classific
Answer
A Studies in animals or humans show fetal abnormalities; use in pregnancy is contraindicated.
B Positive evidence of fetal risk is available, but the benefits may outweigh the risk in life-threatening
C Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequat
D Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate a
women despite potential risks.
E Controlled studies in animals and women have shown no risk in the 1st trimester, and possible fetal

Question
The specific gravity of a saline solution is 1.152 at room temperature. A prescription calls for 28 gram
the nearest tenth. Enter the number only. Do not enter units.

Question
A 45 year old patient is receiving the PN formula below. How many total calories are provided by this
Item/Quantities:
Dextrose 312 grams
Amino acids 62 grams
Sodium chloride 32 mEq
Sodium acetate 12 mEq
Potassium 20 mEq
Magnesium sulfate 10 mEq
Phosphate 21 mmol
Calcium 2.2 mEq
Multivitamins (MVI) 10 mL
Trace elements 1 mL
Famotidine 10 mg
Regular insulin 10 units
Sterile water qs ad 875 mL
Answer

Which of the following patients, if they have not received the vaccine previously, meet criteria to rece
Answer
A A 10 month old baby with renal insufficiency due to a congenital defect.
B A 26 month old child with asthma.
C A 79 year old male with COPD.
D A 50 year old female smoker.
E An otherwise healthy 75 year old male who has never received this vaccine.

A patient is diagnosed with a Non-ST Segment Elevation Myocardial Infarction (NSTEMI). Which of the
Answer
A Nitrates, meperidine, GP IIb/IIIa receptor antagonists
B Oxygen, nitrates, GP IIb/IIIa receptor agonists
C Anticoagulants, P2Y12 inhibitors, fibrinolytics
D Oxygen, lorazepam, morphine
E Anticoagulants, P2Y12 inhibitors, morphine

The pharmacist advises the nurse on safe intravenous administration of phenytoin. Which of the follow
Answer
A Phenytoin is rarely used in the emergency department due to the narrow spectrum of seizure covera
B Intravenous phenytoin can cause arrhythmias if it is infused too quickly.
C Elderly patients are more susceptible to the side effects of intravenous phenytoin compared to youn
D Intravenous phenytoin can cause dangerous elevations in blood pressure if infused too rapidly.
E The maximum infusion rate is 50 milligrams per minute.

Angelique is a 62 year-old African American female with hypertension. Her last BP reading was 163/9
represent this patient's blood pressure goal?
Answer
A < 120/80 mmHg
B < 130/80 mmHg
C < 130/90 mmHg
D < 140/80 mmHg
E < 150/90 mmHg

Ben is a 77 year old male with Parkinson disease. Ben is using carbidopa/levodopa 25/250 TID. He ha
brings the new prescription into the pharmacy. What recommendation should the pharmacist discuss
Answer
A The dose of ropinirole is too low.
B The dose of ropinirole is too high.
C Ropinirole is a replacement for Sinemet; the Sinemet should be discontinued.
D Ropinirole is reserved primarily for younger patients. Elderly patients should not receive it, because
E It would be preferable to prescribe pramipexole.

A concerned mother has arrived at the pharmacy with a prescription for Vyvanse for her nine-year-old
Answer
A Vyvanse is a pro-drug of dexmethylphenidate.
B Vyvanse capsules may be opened to dissolve the powder in yogurt, water or orange juice.
C Vyvanse is available as an extended-release capsule and as a transdermal patch.
D Vyvanse causes less tics than the active metabolite, methylphenidate.
E Vyvanse is DEA Category III and is preferable by some physicians.

A oral medication is dosed 675 mg BID. After a 675 mg oral dose, the resulting AUC is 42 mg/L x hr. B
nearest whole number. Enter the number only. Do not enter units or commas.

Sylvie has been prescribed Celebrex for osteoarthritis. She takes ramipril 10 mg daily for hypertension
bronchoconstriction) and penicillin (rash). Which of the following statements is correct?
Answer
A Celebrex contains meloxicam, which has the highest COX-2 selectivity.
B Sylvie should not take atorvastatin due to the stated sulfa allergy.
C The recommended dose of Celebrex for osteoarthritis is 20 mg BID or 40 mg daily.
D Celebrex has a decreased risk of cardiovascular complications compared to other NSAIDs and for th
E Celebrex is indicated for various conditions, including rheumatoid arthritis pain and acute pain.

A pharmacist received a prescription for azithromycin suspension 200 mg/5 mL, Sig: 10 mg/kg on Da
mL strength on hand and the antibiotic needed to be started immediately. The pharmacist gave the m
could be obtained. The mother calls the pharmacy to say she has just finished the temporary supply.
many more days of treatment remain? Enter the number only. Do not enter units or commas.

Craig has treatment-resistant depression. He has failed reasonable trials of doxepin, escitalopram, flu
(Select ALL that apply.)
Answer
A In some patients, a dosage increase is all that is required if the dose remains reasonable for the par
B Lithium is occasionally used for antidepressant augmentation.
C Abilify is an antipsychotic used as an add-on to the antidepressant for treatment-resistant depressio
D It is never appropriate to combine different antidepressants.
E Nefazodone is sometimes used as an augmentation agent, but has a risk of renal toxicity.

Which of the following statements concerning meningococcal vaccination is correct?


Answer
A Saudi Arabia requires proof of vaccination with Menveo or Menomune prior to travel at certain times
B Saudi Arabia requires vaccination with Twinrix prior to travel at certain times of the year.
C The meningitis belt of Australia requires vaccination with Menveo or Menomune prior to travel at ce
D The meningitis belt of Australia requires vaccination with Pneumovax prior to entry.
E The meningitis belt of Africa requires vaccination with Pneumovax 23 year-round.

Which of the following drugs are glycoprotein IIb/IIIa receptor antagonists?


Answer
A Abciximab, ticagrelor, clopidogrel
B Prasugrel, eptifibatide, abciximab
C Eptifibatide, tirofiban, abciximab
D Tirofibran, eptifibatide, ticagrelor
E Clopidogrel, alteplase, tirofiban

Jasmine is a thin, white female who has been taking prednisone 10 mg daily for several months. The p
profile to check for which of the following recommended agent/s?
Answer
A Dramamine
B Calcium and Vitamin D
C Ortho Evra
D Mirapex
E Vitamin B6

Question
Tom has end stage renal disease (ESRD) and uses many medications, including PhosLo. Which of the
Answer
A PhosLo is a second line therapy for hyperphosphatemia
B PhosLo should be taken 30 mins before meals
C PhosLo can cause an increase in serum calcium levels
D PhosLo is a synthetic polymer
E PhosLo can cause an increase in serum phosphate levels

A pharmacist receives a prescription for Vigamox. The pharmacist should scan the profile for the follow
Answer
A Elevated intraocular pressure
B Interstitial nephritis
C Urinary tract infection
D Bacterial conjunctivitis
E Cellulitis

Labs on 2/10/15:
Na (mEq/L) = 137 (135 145)
K (mEq/L) = 3.5 (3.5 5)
Cl (mEq/L) = 99 (95 103)
HCO3 (mEq/L) = 28 (24 30)
BUN (mg/dL) = 18 (7 20)
SCr (mg/dL) = 1.2 (0.6 1.3)
Glucose (mg/dL) = 254 (100 125)
Ca (mg/dL) = 7.8 (8.5 10.5)
Mg (mEq/L) = 1.1 (1.3 2.1)
PO4 (mg/dL) = 2.3 (2.3 4.7)

WBC (cells/mm3) = 14.2 (4 11 x 10^3)


Hgb (g/dL) = 13.6 (13.5 18 male, 12 16 female)
Hct (%) = 41.1 (38 50 male, 36 46 female)
Plt (cells/mm3) = 301 (150 450 x 10^3)
AST (IU/L) = 29 (10 40)
ALT (IU/L) = 25 (10 40)
Albumin (g/dL) = 3.1 (3.5 5)
A1C (%) = 10.2

Tests on 2/10/15:
Radiology of left foot: soft tissue swelling, but no evidence of bone involvement. Negative for osteom

Plan:
Admit to floor for incision and drainage of left foot wound, management of infection, and managemen
Question:
What is MG's corrected calcium level?
Answer
A 7.1 mg/dL
B 8.52 mg/dL
C 9.24 mg/dL
D 10.28 mg/dL
E 10.9 mg/dL

A pharmacist is preparing a piggyback infusion of the antibiotic Zosyn for a patient in the unit. Select
Answer
A This medication contains ticarcillin and the beta-lactamase inhibitor clavulanate.
B This is a beta-lactam antibiotic with beta lactamase inhibitor that covers Pseudomonas aeruginosa.
C This drug contains the cephalosporin ceftriaxone.
D This medication is one of the cephalosporins that does not require a reduced dosage for renal impai
E This is a cephalosporin that covers MRSA.

A female patient with advanced breast cancer will be receiving a highly emetogenic chemotherapy re
combinations would be reasonable?
Answer
A Aprepitant + Prednisone + Lorazepam
B Aprepitant + Methylprednisolone + Metoclopramide
C Aprepitant + Methylprednisolone + Compazine
D Aprepitant + Prednisone + Compazine
E Aprepitant + Dexamethasone + Ondansetron

Question:
SP has a biopsy of the lung nodules and is diagnosed with small cell lung cancer (SCLC). The cancer c
etoposide. Where in the cell cycle do cisplatin and etoposide work?
Answer
A Cisplatin, M-phase; Etoposide, S-phase
B Cisplatin, Non-cell cycle specific; Etoposide, M-phase
C Cisplatin, S-phase; Etoposide, G2 and S-phase
D Cisplatin, Non-cell cycle specific; Etoposide, G2 and S-phase
E Cisplatin, G2 and S-phase; Etoposide, Non-cell cycle specific

Carmen has had difficult sleeping since she changed the hours of her work shift. She asked her physic
concerning Ambien is correct?
Answer
A This class of medications act as agonists at the serotonin receptor.
B Ambien can cause somnolence and ataxia.
C Ambien is available over-the-counter in a lower dosage formulation.
D Ambien, compared to other hypnotics, has a lower risk of parasomnias.
E The dosing for the sublingual product Intermezzo is 3.5 mg QHS for females.

Ext: No skin lesions, good peripheral pulses bilaterally


Labs on 1/29/15:
Na (mEq/L) = 142 (135 145)
K (mEq/L) = 4.2 (3.5 5)
Cl (mEq/L) = 102 (95 103)
HCO3 (mEq/L) = 25 (24 30)
BUN (mg/dL) = 7 (7 20)
SCr (mg/dL) = 0.7 (0.6 1.3)
Glucose (mg/dL) = 176 (100 125)
Ca (mg/dL) = 9.2 (8.5 10.5)
Mg (mEq/L) = 2.2 (1.3 2.1)
PO4 (mg/dL) = 8.6 (2.3 4.7)

WBC (cells/mm3) = 11.7 (4 11 x 10^3)


Hgb (g/dL) = 14.3 (13.5 18 male, 12 16 female)
Hct (%) = 43.7 (38 50 male, 36 46 female)
Plt (cells/mm3) = 402 (150 450 x 10^3)
AST (IU/L) = 18 (10 40)
ALT (IU/L) = 22 (10 40)
Albumin (g/dL) = 4.7 (3.5 5)
A1C (%) = 8.7

Tests on 1/29/15:
Chest X-ray: no infiltrate
Plan:
Admit to floor for asthma exacerbation.

Question:
The pharmacist and diabetic educator meet with DD. Her insurance covers long-acting and rapid-acti
equivalent to her current daily dose of NPH? Round to the nearest unit of insulin.
Answer
A 8 units
B 11 units
C 14 units
D 20 units
E 28 units

Rudy, a 52 year-old male, approaches the pharmacy counter asking for bandages to cover a wound on
childhood vaccines he received. Which vaccine should the pharmacist recommend?
Answer
A DTaP
B DT
C Td
D Tdap
E None of the above

Helen has been taking warfarin 5 mg daily for the past 6 months for atrial fibrillation. All of her INR va
pharmacist recommend?
Answer
A Continue taking warfarin 5 mg daily. Re-check the INR within 1-2 weeks.
B Increase the warfarin dose by 25%.
C Hold warfarin until the INR is therapeutic. Re-start at 25% of the previous dose.
D Administer Vitamin K 5 mg orally. Re-start warfarin at 25% of the previous dose.
E Send the patient to the emergency department to assess for likely bleeding.

Question
A pharmacist has received a prescription for Gleevec. What indication should the pharmacist look for o
Answer
A Pulmonary fibrosis
B Cancer
C Osteoarthritis
D Hyponatremia
E Hypernatremia

An 80-year-old male has just had a major surgery and is at high risk for bleeding.
Allergies: NKDA
Past medical history: Hyperlipidemia, hypertension, mitral valve replacement

The patient was started on enoxaparin before the surgery and the physician wishes to restart it post-s
Answer
A Inform the prescriber that it would be preferable to use clopidogrel for this indication.
B Inform the prescriber that it would be preferable to use dofetilide for this indication.
C The enoxaparin should be restarted immediately after the surgery if patient is hemodynamically sta
D The enoxaparin should be restarted 24 hours after the surgery if the patient is hemodynamically sta
E The enoxaparin should be restarted 48 - 72 hours after the surgery if the patient is hemodynamicall

Which of the following chemotherapy drugs has the highest emetogenic risk?
Answer
A Bleomycin
B Etoposide
C Imatinib
D Vincristine
E Cisplatin

The pharmacist needs to add an additional 300 calories to a preparation of parenteral nutrition. If the
calories? Round to the nearest milliliter. Enter the number only. Do not enter units or commas.

Susie is a six year old girl with asthma. The physician calls the pharmacy to ask for the correct dose o
Answer
A A 4 mg dose of oral granules in the morning.
B A 4 mg dose of oral granules in the evening.
C A 5 mg chewable tablet once daily in the evening.
D A 5 mg chewable tablet taken BID.
E A 10 mg tablet once daily in the evening.

Esther has just entered a skilled nursing facility. She has a diagnosis of Parkinson disease, hypertensi
worsen her movement disorder?
Answer
A Hydrochlorothiazide 25 mg QAM
B Metoclopramide 10 mg QID
C Caribopa/Levidopa 25/100 TID
D Lorazepam 0.5 mg QHS PRN insomnia
E Docusate sodium 1-2 capsules QHS PRN constipation

An 89 kg female patient is being transferred from the cardiac catheterization suite to the cardiac ICU w
administered. The hospital has 100 mL vials of Integrilin 0.75 mg/mL. If the pharmacist sends a 100 m
enter units.

Paul is a 62 year-old male who will begin treatment with AndroGel 1.62%. Which of the following coun
Answer
A Apply to the upper arms and shoulders but not to the abdomen.
B Apply to the upper arms, shoulders or abdomen each morning before getting dressed.
C If a woman or child comes in contact with the gel wash hands quickly with alcohol gel.
D The pump does not need to be primed.
E The use of AndroGel can improve symptoms of prostate enlargement but it is not indicated for this p

An elderly female is asking about the risk of developing venous thromboembolism (VTE). Which of the
Answer
A Selective estrogen receptor modulating drugs
B Angina, chronic or variant
C Cancer
D Immobility
E Major trauma

Which of the following agents contains a long-acting beta agonist? (Select ALL that apply.)
Answer
A Spiriva HandiHaler
B Breo Ellipta
C Arcapta Neohaler
D Symbicort
E Tudorza Pressair

The mother of a 3 year-old girl brings you a prescription for an antibiotic suspension to treat acute oti
Answer
A Cephalexin 50 mg/kg/day, taken once daily
B Cephalexin 50 mg/kg/day, divided BID
C Azithromycin 30 mg/kg/day, taken once daily
D Amoxicillin 90 mg/kg/day, divided BID
E Amoxicillin 90 mg/kg, divided BID

A 44 year old male with an obstructive bowel disorder and impaired renal clearance has been NPO for
10 mL of multivitamin for infusion daily. Prior to calculating the electrolytes to be added, the pharmac
patient will be receiving from the parenteral nutrition. Round to the nearest whole number. Enter the

Lorcaserin is indicated for weight loss. Which of the following statements concerning lorcaserin is corr
Answer
A The brand name is Myrbetriq.
B Lorcaserin is Pregnancy Category D.
C Lorcaserin is a serotonin (5-HT2c) receptor agonist.
D The manufacturer is required to conduct Phase IV monitoring for cognitive effects in patients using l
E Lorcaserin is a stimulant agent.

Which of the following is a strong inducer of the CYP 3A4 enzyme?


Answer
A Erythromycin
B Nizoral
C Norvir
D Calan
E Dilantin

Olivia is a young girl weighing 44 pounds. She is to receive amoxicillin 90 mg/kg/day to be administer
in stock. The pharmacist will instruct the parents on how many mL of the suspension to draw up in an
units.

Nelson is a 57 year-old African American male with hypertension and type 2 diabetes. What is an app
Answer
A Angiotensin Receptor Blocker
B Calcium Channel Blocker
C ACE Inhibitor
D Beta-Blocker
E Nitrate

Choose the best definition of a cohort study.


Answer
A A study that follows a group of patients with some commonality over a given time period.
B A study used to estimate the relationship between an outcome of interest and population variables
C A study in which the participants receive each treatment in a sequential order.
D A pivotal clinical trial comparing a new drug to a placebo treatment group.
E A pivotal clinical trial comparing a new drug to a the standard treatment used for that condition.

Which of the following infectious disease matches (disease to vector) is correct?


Answer
A Malaria, transmitted by the Anopheles mosquito
B Dengue, transmitted by the Tsetse fly
C African sleeping sickness, transmitted by fecal-contaminated food or water
D Yellow fever, transmitted by infected dog or cat bite
E Japanese encephalitis, transmitted by fecal-contaminated food or water

A patient gave the pharmacist a prescription for Aranesp. The pharmacist should look for which of the
Answer
A Prolactin elevation
B Emphysema secondary to COPD
C End stage renal disease
D Human immunodeficiency virus
E Guilain-Barre syndrome

Question
Maria is a 65 year old post-menopausal sedentary female with a family history of breast cancer. She w
concerning raloxifene is correct?
Answer
A Raloxifene increases the risk of breast cancer; it is best avoided in patients with family history of thi
B Raloxifene can increase the bad cholesterol; the cholesterol panel should be checked prior to use.
C Raloxifene is often used in women at risk of breast cancer, but it can cause dangerous blood clots.
D The brand name is Prezista.
E Raloxifene, similar to estrogen, has the additional benefit of reducing hot flashes.

Which of the following antibiotic suspensions requires refrigeration?


Answer
A Cephalexin
B Azithromycin
C Clindamycin
D Sulfamethoxazole/Trimethoprim
E Clarithromycin

A clinical trial is published about a new drug, NOPAINZ, for pain reduction. There are 200 patients rand
in 85 patients taking NOPAINZ and in 45 patients taking placebo. Calculate the relative risk reduction
percentage. Enter the number only. Do not enter units or commas. Include a leading zero when the

A patient is prescribed Atripla. What are the components of Atripla?


Answer
A Efavirenz, etravirine, delavirdine
B Efavirenz, elvitegravir, rilpivirine
C Emtricitabine, rilpivirine, tenofovir
D Emtricitabine, efavirenz, tenofovir
E Emtricitabine, tenofovir

A patient has the following lab values. Calculate the patient's anion gap. Enter the number only. Do
Labs:
Na (mEq/L) = 131 (135 145)
K (mEq/L) = 3.1 (3.5 5)
Cl (mEq/L) = 99 (95 103)
HCO3 (mEq/L) = 20 (24 30)
BUN (mg/dL) = 12 (7 20)
SCr (mg/dL) = 0.9 (0.6 1.3)
Glucose (mg/dL) = 121 (100 125)

Drug Z was studied for the prevention of migraines in a pilot study. There were 243 patients in the stu
on placebo developed a migraine. How many patients need to be treated to prevent 1 migraine? Ente
Which of the following drugs can cause hypoglycemia?
Answer
A Fluoroquinolones
B Beta agonists
C Protease inhibitors
D Diazoxide
E Thiazide diuretics

Question:
In an attempt to optimize MG's medical management, his medical team calculates his estimated 10-y
the following recommendations is consistent with the 2013 ACC/AHA guidelines for treating dyslipidem
Answer
A No therapy recommended at this time.
B Initiate therapy with Crestor 10 mg
C Initiate therapy with Zocor 10 mg
D Initiate therapy with Zocor 40 mg
E Initiate therapy with Lipitor 40 mg

Lack of vitamin B1 is a common occurrence in patients with which of the following conditions?
Answer
A Hypothyroidism
B Ankylosing spondylitis
C Pernicious anemia
D Alcoholism
E Graves disease

A patient with psychosis and a long history of depression and alcohol abuse had a lack of noticeable b
upward, the patient had a seizure. The dose was decreased slightly. The patient had a second seizure
Answer
A The event should be reported to the state Board of Pharmacy which monitors severe drug reactions.
B The patient must have taken an overdose of the clozapine.
C The physician should be disciplined for prescribing this drug to a patient with these medical conditio
D The pharmacist should not have dispensed the second refill; this is a medication error.
E The patient experienced an adverse drug reaction to clozapine.

Multaq is a CYP 3A4 substrate. Which of the following statements concerning this drug is correct?
Answer
A A patient using this antiarrhythmic should limit the use of grapefruit to fewer than 1 or 2 servings w
B The concentration of Multaq will decrease when given concomitantly with systemic azole antifungal
C The generic name of Multaq is dronedarone.
D Multaq has a lower risk of liver damage than amiodarone and a higher risk of contributing to thyroid
E Multaq has a low risk of liver damage.

An investigational drug has the following pharmacokinetic parameters:


Bioavailability: 82%
Clearance: 9.35 L/hr
Volume of distribution: 87 L
What is the half-life of the investigational drug? Round to the nearest tenth. Enter the number only.

Which of the following antipsychotics are available in oral formulations suitable for patients with diffic
out? (Select ALL that apply.)
Answer
A Clozapine
B Olanzapine
C Risperidone
D Quetiapine
E Fluphenazine

A patient is taking 1 calcium carbonate tablet once daily. Each tablet weighs 1,500 milligrams (non-ele
She reports that her physician said that the "stomach absorption of the citrate form is better." The pat
citrate tablets (non-elemental total weight) will she need to provide a similar daily dose? Round to the
A medication has an elimination rate constant of 0.016 hr^-1 and a clearance of 2.56 ml/hr. What is

Of the drugs below used to treat rheumatoid arthritis, which drugs cannot be used for patients with ad
Answer
A Etanercept
B Methotrexate
C Hydroxychloroquine
D Sulfasalazine
E Leflunomide

Liraglutide once daily was compared with exenatide twice daily for type 2 diabetes in a 26-week rando
Answer
A The patients could select their own dose based on their blood glucose values.
B Neither the doctor nor the patients knew which patients received which treatment.
C Both the doctor and the patients knew which drug the patients received.
D The patients would start on one drug for 13 weeks, then switch to the other drug for 13 weeks.
E The trial was observational in nature.

Tom is picking up a prescription for pancreatic enzymes for his son. How should the pharmacist counse
Answer
A Give half of the dose before eating and the other half of the dose 1 hour after eating each meal.
B Give this medication twice daily: first thing in the morning and at bedtime with a full glass of water.
C Ideally the child should swallow the capsules whole, with meals and snacks, right before eating.
D If your child has difficulty swallowing the capsules, you can sprinkle them into his mouth and have h
E Give 1/2 his normal dose with snacks.

A bottle is labeled 0.89 PPM of Drug X. How many liters of this solution will contain 5 mg of Drug X? R

Question
Which of the following statements is true about the progestin-only daily contraceptive pill?
Answer
A One of the brand names is Microgestin.
B The progestin-only pill should be avoided during lactation.
C If more than 3 hours have elapsed from regular dosing schedule, a back-up method is needed for 48
D The first pack must be started on the Sunday after menstruation begins.
E The progestin-only pill is more effective than estrogen/progesterone combinations.

A patient has been prescribed cyclobenzaprine. Which of the following statements is correct?
Answer
A Cyclobenzaprine acts as a central alpha-1 agonist.
B Abrupt withdrawal of agents in this class may result in severe rebound spasticity.
C The brand name of cyclobenzaprine is Soma.
D The brand name of cyclobenzaprine is Flexeril.
E The usual dose of cyclobenzaprine is 20 mg PO TID.

Joan has diabetes with microalbuminuria. The blood pressure today is 162/91 mmHg. She has no oth
Answer
A Valsartan
B Metoprolol
C Hydrochlorothiazide
D Labetolol
E Diltiazem

Which of the following statements concerning Zyvox is true?


Answer
A Zyvox is part of the streptogramin class of antibiotics.
B Zyvox provides coverage against most gram-negative bacteria.
C The Zyvox oral suspension should be refrigerated.
D Zyvox should not be used within 2 weeks of MAO inhibitors.
E The Zyvox dose should be adjusted with moderate renal impairment, defined as a CrCl < 60 mL/min

1/12/15
Thalitone 12.5 mg daily
Norvasc 10 mg daily
Prinivil 10 mg daily (dispense 30 with no refills)
Celexa 20 mg daily - discontinue
Cymbalta 40 mg daily (dispense 30 with no refills)
MacroBID 100 mg BID x 7 days
OTC aspirin 81 mg daily
OTC calcium and vitamin D encouraged
2/3/15
Obtain discharge medication summary from hospital
Height, Weight and Vital Signs:
Height: 5'10" Weight: 167 lbs
Vitals: BP: 152/83 HR: 85 RR: 15 Temp: 98.9 F O2 Sat: 98% Pain: 0/10

Question:
During TZ's hospitalization, she was started on an oral anticoagulant for stroke prevention. What drug
visit on 1/12/15.
Answer
A Thalitone reduces the efficacy of anticoagulation therapy.
B Celexa inceases bleeding risk when used concurrently with anticoagulants.
C Prinivil inceases bleeding risk when used concurrently with anticoagulants.
D Norvasc reduces the efficacy of anticoagulation therapy.
E Thalitone inceases bleeding risk when used concurrently with anticoagulants.

Which of the following drugs will lower the seizure threshold and increase the risk of seizures in susce
Answer
A Demerol
B Methyldopa
C Clozaril
D Lariam
E Wellbutrin

A recipe for an oral product reads as follows: Dissolve five 25 mg tablets in 50 mL of solution." What
second number (x) of the ratio strength (1:x). Do not enter units.

Which of the following statements are true about HIV pre-exposure prophylaxis? (Select ALL that apply
Answer
A An individual who does not have HIV can take one Truvada tablet daily to reduce his risk of becomin
B An individual who has HIV can take one Atripla tablet daily to reduce his risk of transmitting the viru
C The individual must be at a very high risk for acquiring HIV in order to be a candidate for pre-exposu
D The HIV test must be taken weekly when using pre-exposure prophylaxis therapy.
E Once treatment is initiated, the individual no longer needs to follow safe sex practices.

A 43 year-old female patient with type 2 diabetes and normal renal function started taking Januvia 10
Answer
A The chemical name is saxagliptin.
B It is an incretin enhancer.
C It is an alpha-glucosidase inhibitor.
D It is weight neutral.
E It can cause a rash.

Joanna is 76 year old woman who will be starting Enablex for overactive bladder. Dry mouth is a comm
dry mouth and this class of medications?
Answer
A Using long-acting formulations, topical gels or patches (versus immediate release oral formulations)
B Dry mouth is a cholinergic side effect of drugs used for overactive bladder.
C Counsel patients to suck on lollipops or sugar candy to keep mouth moist.
D Dry mouth lowers the incidence of dental caries, which is beneficial, but is uncomfortable.
E Over-the-counter diphenhydramine can lessen this side effect but cannot be recommended in patien

A young adult female patient has been prescribed Tylenol #3 in the emergency department. Choose t
Answer
A This medication contains acetaminophen and hydrocodone.
B Tylenol #3 is a DEA Schedule II drug.
C She will produce higher amounts of morphine if she is a 2D6 rapid metabolizer, which could be harm
D Tylenol #3 has a low degree of GI side effects compared to drugs such as Vicodin or Norco.
E Codeine is the drug of choice in children post-tonsillectomy.

Which of the following agents is associated with modest weight loss?


Answer
A Topamax
B Lyrica
C Trileptal
D Keppra
E Neurontin

A pharmacist receives a prescription for Ciloxan. Which of the following conditions is Ciloxan used to t
Answer
A Gray syndrome
B Cytomegalovirus
C Cellulitis
D Bacterial conjunctivitis
E Septic arthritis

Question:
DD is started on Solu-Medrol 20 mg IV Q8H for the first 48 hours of her hospitalization. Her oxygen sa
equivalent dose of oral prednisone. What is the equivalent daily dose of oral prednisone?
Answer
A 15 mg
B 25 mg
C 48 mg
D 75 mg
E 100 mg

James is a 56 year old male who has brings a prescription for tapentadol ER to the pharmacy. Choose
Answer
A The brand name is Nucynta ER.
B The brand name is Oxecta ER.
C Males may consume a maximum of 3 alcoholic drinks and females a maximum of 2 alcoholic drink p
D Tapentadol is a DEA schedule III drug.
E Tapentadol should be avoid in patients with aspirin sensitivity or allergy.

Doris is a 67 year-old female who has been prescribed weekly alendronate for osteoporosis preventio
Answer
A 5 mg PO weekly
B 10 mg PO weekly
C 35 mg PO weekly
D 70 mg PO weekly
E 140 mg PO weekly

The pharmacy receives the following parenteral nutrition order. What percentage of the total calories
Do not enter the percentage sign.
Item/Quantities:
Dextrose 280 grams
Amino acids 75 grams
Sodium chloride 38 mEq
Sodium acetate 16 mEq
Potassium 40 mEq
Magnesium sulfate 10 mEq
Phosphate 21 mmol
Calcium 4.45 mEq
Multivitamins (MVI) 10 mL
Trace elements 1 mL
Famotidine 10 mg
Regular insulin 40 units
Sterile water qs ad 980 mL

Mandy is a 22 year old graduate student. She has suffered from bouts of depression for as long as she
prescription for bupropion. Which of the following are side effects or potential adverse effects of bupro
Answer
A Seizures, impotence, and hyponatremia
B Dry mouth, seizures, hepatic failure (especially during the first 6 months of therapy)
C Hyponatremia, insomnia, impotence
D Dry mouth, insomnia, and seizures
E Impotence, insomnia, hepatic failure (especially during the first 6 months of therapy)

Mark is a 28 year old male who was in a motor vehicle accident, resulting in moderate to severe pain.
extra-strength acetaminophen 500 mg. He has been using 5-6 Vicodin tablets and 5-6 acetaminophen
regimen.
Answer
A The recommendation to alternate Vicodin with acetaminophen is unsafe and should not be continue
B The primary risk to the patient is drowsiness.
C The primary risk to the patient is addiction potential.
D The primary risk to the patient is kidney damage.
E The primary risk to the patient is liver damage.

Jack is beginning amiodarone therapy for ventricular fibrillation. His other medical conditions include h
hypertrophy. Jack's daily medications include digoxin 0.25 mg daily. What suggestion should the pharm
Answer
A The dose of digoxin should be decreased by up to 50% due to the inhibition effect of amiodarone.
B Amiodarone will increase the metabolism of digoxin.
C The dose of digoxin should be increased by 30-50% in most patients beginning concurrent amiodaro
D The amiodarone should be switched to dronedarone, which is considered the preferable agent when
E Amiodarone is contraindicated in patients receiving digoxin.

Which of the following injection sites and type is correct for administration of Lovenox?
Answer
A Thigh, subcutaneous
B Triceps (fatty tissue), subcutaneous
C Abdomen, subcutaneous
D Abdomen, intramuscular
E Deltoid, intramuscular

Which of the following is considered a high-intensity statin?


Answer
A Crestor 20 mg
B Pravachol 40 mg
C Mevacor 40 mg
D Lescol 40 mg
E Livalo 1 mg

Which of the following statements concerning the influenza vaccine is correct?


Answer
A ACIP recommends that everyone receive an annual influenza vaccine from the ages of 2 years and o
B Healthcare personnel, even if healthy, should receive the flu shot and not the live flu intranasal form
C The completely egg-free flu vaccine product is called Flucelvex.
D The completely egg-free flu vaccine product is called Flublok.
E Healthy patients ages 12 months to 55 years can receive the live flu vaccine.

A female patient is in the critical care step-down unit. She has been diagnosed with a pulmonary emb
valve replacement surgery. She will receive 7,500 units of heparin in 250 mL 0.9% NaCl to be infused
patient receive per minute? Enter the number only. Do not enter units or commas.

Mary was feeling poorly and went to the physician, who ordered a thyroid panel. The lab results come
statement.
Answer
A Mary has hyperthyroidism, as evidenced by the high TSH.
B Mary has hypothyroidism, as evidenced by the low T4.
C Mary should be treated with potassium iodide.
D Mary's thyroid status cannot be determined without the T3 value.
E Mary has Grave's disease.

What are possible complications with long-term phenytoin therapy? (Select ALL that apply.)
Answer
A Hirsutism
B Skin thickening (children)
C Shrinkage/atrophy of dental gum tissue
D Osteoporosis
E Hypertension

Nancy is a business executive being seen in the Family Medicine Clinic for "really bad sadness and fee
She has an important presentation coming up next month with the senior vice president of her compa
avoid becoming depressed every month. Which statement is true regarding the treatment of Pre-Mens
Answer
A PMDD can be treated, in most cases, with Abilify.
B Sarafem is indicated for PMDD and contains the SSRI sertraline.
C PMDD can be treated effectively with the mini-pill in women who are not candidates for estrogen the
D PMDD can be treated, in most cases, with light therapy.
E She can be treated with Sarafem 20 mg PO Q AM, starting 14 days before the expected date of her

John is a 50 year old male who comes into the pharmacy with a prescription for Advair Diskus 250/50,
Answer
A Advair 250/50 contains 250 mcg fluticasone and 50 mcg salmeterol.
B Advair 250/50 contains 250 mcg salmeterol and 250 mcg fluticasone.
C An equivalent HFA dose is Advair HFA 230/21, taken two puffs BID.
D An equivalent HFA dose is Advair HFA 250/50, taken one puff BID.
E If also using a rescue inhaler at the same time, the patient should be instructed to use the rescue in

Omeprazole can increase the risk of which of the following events? (Select ALL that apply.)
Answer
A Pneumonia in hospitalized patients
B Urinary tract infections
C Heart attacks
D Fractures
E C. difficile infections

What is an appropriate starting dose for a patient beginning metformin for type 2 diabetes?
Answer
A 250 mg twice daily
B 500 mg twice daily
C 1000 mg twice daily
D 2.5 mg once daily
E 5 mg once daily

An 84 year old female patient is admitted to the hospital. She weighs 145 pounds and is 5 foot 6 inch
body weight? Round to the nearest whole number. Enter the number only. Do not enter units.
Labs:
Na (mEq/L) = 142 (135 145)
K (mEq/L) = 4.4 (3.5 5)
Cl (mEq/L) = 102 (95 103)
HCO3 (mEq/L) = 26 (24 30)
BUN (mg/dL) = 18 (7 20)
SCr (mg/dL) = 1.1 (0.6 1.3)
Glucose (mg/dL) = 98 (100 125)
Which vaccine contains Hepatitis A and Hepatitis B in a combination shot?
Answer
A Combivax
B Comvax
C Twinrix
D Varivax
E Afluria

Question
Which of the following statements concerning insulins are correct? (Select ALL that apply.)
Answer
A Glulisine is a long-acting insulin.
B Novolog 70/30 contains 70% longer-acting insulin and 30% shorter-acting insulin.
C Lispro and Apidra are rapid-acting insulins.
D The common insulin concentration is 200 units in each mL.
E Aspart is a rapid-acting insulin called Humalog.

Jordan has anemia caused by end stage renal disease (ESRD). Which of the following statements is tru
Answer
A Patients receiving Procrit should be warned of the risk of hypotension.
B Treatment with erythropoietin stimulating agents (ESAs) should continue until the hemoglobin level
C ESAs should only be used to treat anemia in ESRD when the hemoglobin level is < 10 g/dL.
D Aranesp carries a boxed warning for angina.
E Aranesp can improve certain types of blood cancer, but is not useful for other types of cancer.

A patient receiving ramipril and a potassium-sparing diuretic is hospitalized with heart rhythm problem
effects of potassium on the heart?
Answer
A Digoxin, Injection
B DigiFab, Injection
C Kayexalate, Rectal
D Calcium, Injection
E Glucagon, Injection

The pharmacist has an order for heparin 20,000 units in 500 mL D5W to infuse at 2,000 units/hour. Wh

A patient is receiving 500 mL of sodium chloride irrigation solution labeled 327 mOsm/L. The pharma
How much sterile water should be added to the bag? Round to the nearest milliliter. Enter the numbe

What is the mechanism of action of ranitidine?


Answer
A Neutralizes pepsin via hydroxylation.
B Neutralizes acid in a buffering reaction (producing salt and water).
C Reversibly inhibits the histamine-2 receptors on the parietal cells.
D Irreversibly binds to parietal cells which blocks the final step in acid production.
E Irreversibly inhibits the histamine-2 receptors on the parietal cells.

George is a 225 pound male who has been taking ramipril 5 mg daily and chlorthalidone 25 mg daily
morphine to a fentanyl patch. Which statement is correct?
Answer
A The patient is not a candidate for fentanyl patches.
B Fentanyl patches can only be used in patients taking 100 mg of morphine equivalent daily; the patie
C The fentanyl patch dosing schedule should begin at one patch every 3 days.
D When the fentanyl patch is removed it should be folded in half (sticky sides together) and discarded
E The morphine should be discontinued the same morning as the patch is started to avoid risk of over

When TZ went to the hospital for chest pain on 1/15/15, she was very anemic (Hgb 10.4 g/dL). A Coom
the drug-induced differential diagnosis her providers were considering based on the test they ordered
Answer
A Prinivil
B Thalitone
C Macrobid
D Cymbalta
E Norvasc

Mae is an 82 year old woman in a skilled nursing facility taking chlorpromazine for dementia-related p
with her eyes. Which of the following statements is correct?
Answer
A Because of her age, she is at an increased risk of the drug causing death due to renal failure.
B She is experiencing a form of akathesia, which can be corrected by a reduction in dose.
C She is experiencing a form of tardive dyskinesia. This side effect is more likely because of her age a
D She is experiencing a form of tardive dyskinesia. This side effect is more likely in young males.
E She is experiencing a form of dystonia. This side effect is more likely in young males.

A patient comes to the pharmacy with a prescription for Harvoni. What are the components of Harvon
Answer
A Ledipasvir and simeprevir; Hepatitis B
B Ledipasvir and sofosbuvir; Hepatitis C
C Simeprevir and sofosbuvir; Hepatitis C
D Ribavirin and simeprevir; Hepatitis B
E Lamivudine and ledipasvir; Hepatitis C

Which antipsychotic is most likely to present a problem in a patient already taking a drug that prolong
Answer
A Risperdal
B Geodon
C Invega
D Latuda
E Saphris

parenteral nutrition order is received for 725 mL of D50%, 890 mL of Aminosyn 8.5%, 500 mL of 10%
Round to the nearest whole number. Enter the number only. Do not enter units or commas.

A medical resident calls the pharmacy to ask how a patient should be converted from warfarin to Prad
Answer
A Discontinue warfarin. Start Pradaxa 2 hours before the next scheduled dose of warfarin.
B Discontinue warfarin. Start Pradaxa when the INR is less than 1.5.
C Discontinue warfarin. Start Pradaxa when the INR is less than 1.
D Decrease the dose of warfarin by 50%, then discontinue warfarin and start Pradaxa when the INR is
E Discontinue warfarin. Start Pradaxa when the INR is less than 2.

What is the safest and most practical use of prescription stimulant agents for weight loss?
Answer
A Use only short-term, in addition to changes in diet and increased physical activity and only for patie
B Useful in patients who will not engage in a regular diet and physical activity program.
C Useful in patients with cardiovascular disease who require fast weight loss.
D Useful long-term to help maintain weight loss in patients who cannot decrease caloric intake by oth
E Useful in patients who experience lethargy or are frequently tired.

A pharmacist is preparing an injection of the Zostavax vaccine. Which of the following statements con
Answer
A Use a needle at least 1.5" long in overweight patients.
B The vaccine must be reconstituted prior to use with normal saline.
C Do not administer if the patient has an allergy to neomycin or gelatin.
D Zostavax is a live vaccine and must not be used in patients with severe immunosuppression.
E This vaccine is administered subcutaneously in the fatty tissue over the triceps.

A pharmacist adds 600 mg of a drug to 250 mL of 0.9% sodium chloride. If the solution is administere
the answer. Enter the number only. Do not enter units or commas.

A patient brings in a new prescription for clarithromycin to your pharmacy. He says he is allergic to ery
filled as written? (Select ALL that apply.)
Answer
A Did you receive any treatment as a result of your reaction to erythromycin?
B Is anyone else in your family allergic to erythromycin?
C Have you ever taken Biaxin in the past?
D What happened when you took erythromycin? Did you have nausea, or stomach upset, or swelling i
E Have you ever taken Azactam in the past?

A patient is receiving ribavirin as part of her hepatitis C regimen. Which of the following are boxed wa
Answer
A Significant teratogenic effects and lactic acidosis
B Lactic acidosis and hemolytic anemia
C Hemolytic anemia and vesicant potential
D Significant teratogenic effects and hemolytic anemia
E Vesicant potential and significant teratogenic effects

Which of the following medications represents a common over-the-counter agent used to treat opioidAnswer
A Psyllium or methylcellulose
B Sennosides
C Lubiprostone
D OsmoPrep
E Picosulfate

A 4 mL vial is labeled potassium chloride (4 mEq/mL). How many grams of potassium chloride are pre
units or commas.

GI: Normal bowel sounds


Extremities: Large area (7 cm x 9 cm) oozing pus and blood on sole of left foot. Some surrounding cel
Labs on 2/10/15:
Na (mEq/L) = 137 (135 145)
K (mEq/L) = 3.5 (3.5 5)
Cl (mEq/L) = 99 (95 103)
HCO3 (mEq/L) = 28 (24 30)
BUN (mg/dL) = 18 (7 20)
SCr (mg/dL) = 1.2 (0.6 1.3)
Glucose (mg/dL) = 254 (100 125)
Ca (mg/dL) = 7.2 (8.5 10.5)
Mg (mEq/L) = 1.1 (1.3 2.1)
PO4 (mg/dL) = 2.3 (2.3 4.7)

WBC (cells/mm3) = 14.2 (4 11 x 10^3)


Hgb (g/dL) = 13.6 (13.5 18 male, 12 16 female)
Hct (%) = 41.1 (38 50 male, 36 46 female)
Plt (cells/mm3) = 301 (150 450 x 10^3)
AST (IU/L) = 29 (10 40)
ALT (IU/L) = 25 (10 40)
Albumin (g/dL) = 3.1 (3.5 5)
A1C (%) = 10.2

Tests on 2/10/15:
Radiology of left foot: soft tissue swelling, but no evidence of bone involvement. Negative for osteom

Plan:
Admit to floor for incision and drainage of left foot wound, management of infection, and managemen
Question:
While awaiting the incision and drainage, the infectious disease specialist would like to treat MG with
anaerobes. Which of the following IV regimens should the pharmacist recommend for MG?
Answer
A Unasyn monotherapy
B Clindamycin + Cipro
C Rocephin + Flagyl
D Zosyn monotherapy
E INVanz monotherapy

Which of the following are appropriate patient counseling points for the Combivent Respimat? (Select
Answer
A Common side effects include cough and dry mouth.
B To take an inhalation, turn the base, open the cap, and press the dose-release button.
C Shake the inhaler prior to taking an inhalation.
D The Combivent Respimat needs to be primed prior to use.
E Take 1 inhalation four times daily.

A pharmacist has calculated that a patient requires 27 mmol of phosphate and 75 mEq of potassium f
chloride will be required? [K-Phos contains 3 mmol Phosphate with 4.4 mEq K+ per mL, and KCl contai
Answer
A 9 mL KPO4 and 17.7 mL KCl
B 17.7 mL KPO4 and 9 mL KCl
C 28.5 mL KPO4 and 9 mL KCl
D 6.1 mL KPO4 and 37.5 mL KCl
E 37.5 mL KPO4 and 6.1 mL KCl

A patient picks up a new prescription for tacrolimus capsules from the pharmacy. Which of the followi
Answer
A This is the preferred transplant drug because it does not require regular lab (blood) monitoring tests
B You may experience headaches, nausea, diarrhea and/or tremor.
C Your weight, temperature and blood pressure (and blood sugar if you have diabetes) should be mon
D You are at risk for infection; report at once if you develop fever or feel weak and tired. This drug incr
E Tacrolimus is also called Prograf. There is a different formulation of this drug called Astagraf XL.

Etanercept carries a boxed warning for which of the following conditions? (Select ALL that apply.)
Answer
A Teratogenicity
B Increased risk of serious infections
C High risk of severe SJS/TEN rash
D Increased risk of lymphomas
E Reactivation of latent tuberculosis

Ted has Parkinson Disease and uses Requip and Parcopa to control his symptoms. Ted has been exhib
Answer
A Haldol
B Risperdal
C Fanapt
D Seroquel
E Fluphenazine

A 58 year-old male patient complains of impotence. He has severe liver impairment but states he is he
activity. Is this starting dose appropriate?
Answer
A Yes, the dose is correct.
B No, he should begin sildenafil at 25 mg, 1 hour prior to sexual activity.
C No, he should begin sildenafil at 100 mg, 1 hour prior to sexual activity.
D It would be preferable for him to use the alprostadil injection.
E It would be preferable for him to use vardenafil.

Which of the following drugs is not available in a suppository formulation?


Answer
A Clotrimazole
B Alprostadil
C Acetaminophen
D Mesalamine
E Phenazopyridine

A patient with sickle cell disease has been using Desferal, but is tired of the infusions. What can the p
Answer
A Exjade has less interactions in the gut than Desferal.
B Exjade can be used with severe renal impairment while Desferal cannot.
C Exjade is taken 30 mins before eating on an empty stomach. It can cause gastrointestinal hemorrha
D Exjade is taken with meals to reduce risk of gastrointestinal hemorrhage.
E Exjade is an oral medication, but Desferal is better tolerated even though it is given by injection.

Question:
DD is discharged on a new insulin regimen consisting of Levemir and Apidra pens. How long are these
Answer
A Levemir 14 days, Apidra 28 days
B Levemir 28 days, Apidra 28 days
C Levemir 42 days, Apidra 42 days
D Levemir 42 days, Apidra 28 days
E Levemir 30 days, Apidra 10 days

Susan has unsuccessfully tried various nicotine replacement products to quit smoking. She is intereste
Answer
A The generic name is varenicline.
B The generic name is bupropion.
C It is a dopamine antagonist.
D It can also be used for patients with depression.
E Chantix does not cause much somnolence, so is a good choice for people who need to be alert at wo

Question
Riva has cystic fibrosis and is currently taking pancreatic enzyme products. Which of the following are
Answer
A Betapace
B Zohydro
C Zenpep
D Viokace
E Creon

A patient weighing 115 kg is to receive 0.4 mg/kg per day amphotericin B by IV infusion. The product
dose? Enter the number only. Do not enter units or commas.

In a pivotal clinical trial in 1,000 patients for the new antibiotic Super X, there were four cases of Stev
treatment arm. What is the relative risk of Stevens Johnson syndrome? Enter the number only. Do no

Counseling points for Aranesp should include which of the following?


Answer
A Seek immediate medical attention if you have pale stools.
B Shake the vial well before drawing up your dose.
C You can pre-fill several syringes provided you store them in the refrigerator.
D Inject into the deltoid or buttock muscle.
E Make sure you monitor your blood pressure regularly; this medication can increase blood pressure.

Which of the following bacterial organisms is not covered by ertapenem?


Answer
A Staphylococci
B Streptococci
C Acinetobacter
D E. coli
E H. influenzae

A 52-year-old patient is receiving a PN containing 26 mmol of phosphate and 12 mEq of calcium in a t


should not exceed 45 mEq/L. What is the combined calcium and phosphorus in this PN order and is it c
Answer
A 64 mEq/L, no
B 30.5 mEq/L, yes
C 32 mEq/L, yes
D 72 mEq/L, no
E 27.4 mEq/L, yes

A pharmacist needs to prepare 180 grams of a 15% lidocaine ointment. The pharmacist has 2% and 2
this prescription?
Answer
A 50 g of 2% and 130 g of 20%
B 50 g of 20% and 130 g of 2%
C 20 g of 2% and 200 g of 20%
D 110 g of 2% and 80 g of 20%
E 80 g of 2% and 110 g of 2%

What is the mechanism of action of Arixtra?


Answer
A Direct thrombin inhibitor
B Vitamin K antagonist
C Blocks fibrinogen binding to GPIIb/IIIa receptors on platelets
D Synthetic pentasaccharide that binds to antithrombin to selectively inhibit Factor Xa
E Inhibits P2Y12 receptor on platelets

Which statements concerning the prostaglandin analogs used for glaucoma are correct? (Select ALL th
Answer
A The patient should keep all in-use bottles of any of the prostaglandin analogs in the refrigerator.
B The patient can keep the bottle of the prostaglandin analog in use at room temperature.
C The unused bottles of prostaglandin analogs should be kept frozen.
D In the pharmacy, the intact bottles of Lumigan are stored in the refrigerator.
E In the pharmacy, the intact bottles of Xalatan are stored in the refrigerator.

Jack developed trouble breathing and hypotension when receiving morphine by injection in the hospit
Answer
A Oxycodone
B Fentanyl
C Hydromorphone
D Hydrocodone
E Oxymorphone

At 2000 hours, the concentration of Drug A was measured at 52.6 mcg/mL. The next morning, at 080
Enter the number only. Do not enter units or commas. Include a leading zero when the answer is less

A pharmacist will counsel a patient who is beginning lamotrigine therapy for bipolar disorder. Which o
Answer
A This medication can cause serious skin reactions, including a very severe rash, especially if the dose
B One of the brand names for this medicine is Keppra.
C One of the brand names for this medicine is Stavzor.
D Do not stop taking this medicine abruptly. The dose will need to be slowly decreased by your physic
E This medication has few drug interactions and is safely used with most other seizure drugs.

A patient with atrial fibrillation was confused about his digoxin dose and took too many tablets, severa
experiencing signs or symptoms of toxicity, so his providers will wait until the patient's digoxin level d
estimated by the pharmacist to be 42 hours. How many hours will it take for the patient's digoxin leve
the number only. Do not enter units.

Which of the following dosing regimens would be appropriate for a patient using niacin extended-relea
Answer
A Start with of a 500 mg tablet with dinner, can increase weekly up to 6 grams daily (divide the dos
B Start at 500 mg QHS x 4 weeks (after a light snack), followed by 1,000 mg QHS x 4 weeks, can incre
C Start with 1,000 mg tablet with dinner, can increase weekly up to 6 grams daily (divide the doses an
D Start with 2,000 mg tablet with dinner, can increase weekly up to 5 grams daily (divide the doses an
E Start at 1,500 mg QHS x 4 weeks (after a light snack), followed by 2,000 mg QHS x 4 weeks, can inc

Heart: Regular rate and rhythm


Lungs: Wheezing heard bilaterally
Ext: No skin lesions, good peripheral pulses bilaterally
Labs on 1/29/15:
Na (mEq/L) = 142 (135 145)
K (mEq/L) = 4.2 (3.5 5)
Cl (mEq/L) = 102 (95 103)
HCO3 (mEq/L) = 25 (24 30)
BUN (mg/dL) = 7 (7 20)
SCr (mg/dL) = 0.7 (0.6 1.3)
Glucose (mg/dL) = 176 (100 125)
Ca (mg/dL) = 9.2 (8.5 10.5)
Mg (mEq/L) = 2.2 (1.3 2.1)
PO4 (mg/dL) = 8.6 (2.3 4.7)

WBC (cells/mm3) = 11.7 (4 11 x 10^3)


Hgb (g/dL) = 14.3 (13.5 18 male, 12 16 female)
Hct (%) = 43.7 (38 50 male, 36 46 female)
Plt (cells/mm3) = 402 (150 450 x 10^3)
AST (IU/L) = 18 (10 40)
ALT (IU/L) = 22 (10 40)
Albumin (g/dL) = 4.7 (3.5 5)
A1C (%) = 8.7

Tests on 1/29/15:
Chest X-ray: no infiltrate
Plan:
Admit to floor for asthma exacerbation.
Question:
What is the best action to take regarding DD's serum phosphorus?
Answer
A Initiate PhosLo 667 mg TID with meals
B Initiate Fosrenol 500 mg TID with meals
C Initiate Renagel 800 mg TID with meals
D Obtain an ultrasound of the kidneys. DD likely has undiagnosed chronic kidney disease.
E Repeat the laboratory test. This finding is not consistent with DD's medical history or medications.

A cancer patient has developed anemia. Which of the following statements concerning the use of eryt
Answer
A The only acceptable time to use these agents in a patient with cancer is if the treatment goal is cura
B The only acceptable time to use these agents in a patient with cancer is if the hemoglobin level is <
C The only acceptable time to use these agents in a patient with cancer is if the hemoglobin level is <
D The blood pressure can fall very low and must be monitored in a patient using these agents.
E These agents contribute to tumor growth and are no longer used commonly to treat anemia in patie

Which of the following are long-acting anticholinergics? (Select ALL that apply.)
Answer
A Tudorza Pressair
B Atrovent HFA
C Spiriva HandiHaler
D Arcapta Neohaler
E Breo Ellipta

Bob was recently diagnosed with angina. His physician plans to prescribe nitroglycerin. Which of the
Answer
A Sublingual spray
B Sublingual tablets
C Topical ointment
D Transdermal patches
E Rectal suppository

Question:
During TZ's hospitalization, she was started on an oral anticoagulant for stroke prevention that require
Answer
A Eliquis, Xarelto, Pradaxa
B Eliquis, Arixtra, warfarin
C Lovenox, Xarelto, Pradaxa
D Fragmin, Pradaxa, argatroban
E Pradaxa, Xarelto, warfarin

Question
An order is received for a parenteral nutrition solution containing 1,340 mL of D20W, 630 mL of 15% a
backorder, but the pharmacy has 8.5% amino acid solution on hand. How many milliliters of 8.5% am
number only. Do not enter units or commas.

Which of the following statements concerning sumatriptan is correct?


Answer
A Sumatriptan is contraindicated in patients with uncontrolled hypertension.
B Sumatriptan is available as a needleless injection, intramuscular injection, and nasal spray.
C If the migraine goes away and then returns, a second dose can be taken if 3 hours have elapsed sin
D The most common side effects of sumatriptan are throat/neck pressure and insomnia/trouble sleepi
E Imitrex nasal spray is suitable for patients with cerebrovascular disease due to lower risk of systemi

The pharmacy receives a prescription for 100 grams of 5% salicylic acid ointment. The pharmacy has
petrolatum should be used to compound the prescription? Express the answer in grams, rounded to t

Parenteral nutrition is ordered for a patient in the cardiac care unit. The prescription is written for 750
many mL of D70% are required? Round to the nearest whole number. Enter the number only. Do not

Charles is a 74 year-old male who has COPD with chronic bronchitis and emphysema. The physician h
Which of the following is a correct statement regarding Spiriva?
Answer
A Spiriva is formulated as a capsule that is placed into the HandiHaler device.
B Spiriva contains ipratropium, which is an anticholinergic medication.
C Spiriva is a long-acting beta-2 agonist.
D Spiriva comes in a metered dose inhaler.
E Spiriva is dosed 1 puff twice per day after breakfast and after dinner.

Which of the following drugs are glycoprotein IIb/IIIa receptor antagonists? Answer
A Abciximab, ticagrelor, clopidogrel
B Prasugrel, eptifibatide, abciximab
C Eptifibatide, tirofiban, abciximab
D Tirofibran, eptifibatide, ticagrelor
E Clopidogrel, alteplase, tirofiban

Which of the following agents contains a long-acting beta agonist? (Select ALL that apply.)
Answer
A Spiriva
B Breo Ellipta
C Arcapta
D Symbicort
E Tudorza

Tom is picking up a prescription for pancreatic enzymes for his son. How should the pharmacist counse
A Give half of the dose before eating and the other half of the dose 1 hour after eating each meal.
B Give this medication twice daily: first thing in the morning and at bedtime with a full glass of water.
C Ideally the child should swallow the capsules whole, with meals and snacks, right before eating.
D If your child has difficulty swallowing the capsules, you can sprinkle them into his mouth and have h
E Give 1/2 his normal dose with snacks.

Jack is beginning amiodarone therapy for ventricular fibrillation. His other medical conditions include h
hypertrophy. Jack's daily medications include digoxin 0.25 mg daily. The pharmacist should call the pre
A The dose of digoxin should be decreased by up to 50% due to the inhibition effect of amiodarone.
B Amiodarone will increase the metabolism of digoxin.
C The dose of digoxin should be increased by 30-50% in most patients beginning concurrent amiodaro
D The amiodarone should be switched to dronedarone, which is considered the preferable agent when
E Amiodarone is contraindicated in patients receiving digoxin.

Choose the best definition of a cohort study:Choose the best definition of a cohort study: Answer
A A study that follows a group of patients with some commonality over a given time period.
B A study used to estimate the relationship between an outcome of interest and population variables
C A study in which the participants receive each treatment in a sequential order.
D A pivotal clinical trial comparing a new drug to a placebo treatment group.
E A pivotal clinical trial comparing a new drug to a the standard treatment used for that condition.

Mary was feeling poorly and went to the physician, who ordered a thyroid panel. The lab results come
statement: Answer
A Mary has hyperthyroidism, as evidenced by the high TSH.
B Mary has hypothyroidism, as evidenced by the low T4.
C Mary should be treated with potassium iodide.
D Marys thyroid status cannot be determined without the T3 value.
E Mary has Graves disease.

d
6.25

2.5

BD

469

bde

abde

120

abd

ae

bcd

24.3

1309

bcde

bce

b
8

abc

e
273

bcd

14

12

0.73

12
7

6.4

abc

43

ce
5.6

acde
400

ac

bde

24

20

abd

ae

ade

36

bc

d
50

227

b
1233

cde
115.2

acd

1.2

abde

bde

cde
460
4

be

12

70

ac

1112

83.3
536

bcd

ce

193