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QE 2006 Summer MOCK TEST 1 PartA Answers
1. MM’s daughter reports that her 85-year old, 49 kg. mother has been experiencing continuous nausea and her memory dementia has not improved in the 2 months that she has been on donepizil (Aricept) 5 mg. She asks you for advice on what to do. You would: A. Consult with the physician to add vitamin E to her therapy B. Consult with the physician to discontinue donezipil (Aricept) therapy C. Consult with the physician to increase the dose of donezipil (Aricept) to 10 mg daily D. Tell MM’s daughter to leave her mother on the same dose for another 2 months, then reassess E. Tell MM’s daughter to leave her mother on the same dose for another 2 months, then reassess and to take dimenhydrinate (Gravol) for the nausea Ans.: B 2. MD, a 17 year old, presents with a purpuric skin rash. She wonders if she is having another flare-up of her eczema, but this rash looks different. Her patient record is as follows: Allergies: penicillin History: eczema x 2.5 years epilepsy x 1 month
Current medications: betamethasone (Betnovate) Cr 0.05% bid prn x 2.5 years ethinyl estradiol/ levonorgestrel (Min-Ovral) x 10 months phenytoin (Dilantin) 200mg qhs x 1 month What is the most probable cause of her skin rash? A. An acute flare-up of her eczema B. A reaction to phenytoin C. A reaction to oral contraceptives D. An interaction between ethinyl estradiol/ levonorgestrel (Min-Ovral) and phenytoin (Dilantin) Ans.: B
3. Ms BB presents the following prescription for her 8 year-old daughter, who weights 30 kg and has an acute urinary tract infection: Ciproflaxin (Cipro) 500 mg Sig: i po bid until finished M: 14 You would: A. Call the doctor to clarify the dosage. B. Call the doctor and recommend sulfamethoxazole/ trimethoprim (Septra) suspension, 2.5 mL po bid C. Call the doctor regarding the appropriateness of the medication for this patient. D. Dispense the prescription as written, instructing the mother to give the drug with meals to reduce stomach upset. Ans.: C 4. JL approaches you confidentially stating that she had a “problem” every month for the last 5 months and has tried Miconazole (Monistat-3) and Clotrimazole (Canesten) ovules, 3 day therapy. Both were effective, but the problem recurs. This time her symptoms include frequent urination and thirst. She had her menstrual period ten days ago, but it is unpredictable. She has not been to her doctor for almost a year. Based on this information, you would be most concerned that she could be: A. Diabetic and the sugar spilling into her urine may be causing the recurrent yeast infections B. Diabetic, but the yeast infections could not be associated with the sugar in her urine C. Using the incorrect product. Recurrent infections respond better to 6-day therapy D. Undergoing pre-menopausal symptoms and the fluctuation in vaginal pH is contributing to her recurrent yeast infections E. Overusing non-prescription antifungals and the subsequent bacterial overgrowth is contributing to her recurrent bacterial infections Ans.: A 5. HB, a 76-year old, 40 kg patient wishes to purchase the following herbal products. Which would you NOT sell based on the following patient record information? Allergies: No known allergies Current medications: Warfarin (Coumadin) 2.5mg daily x 2 years Donepezil (Aricept) 5 mg daily x 2 months I-Ginkgo biloba II-Evening primrose oil III-Vitamin B complex A-I only B-III only
C-I and II D-II and III E-All of the above Ans: A
6. Which of the following medications may require dose adjustment if being taken by a patient just starting on thyroid hormone for hypothyroidism? I- Digoxin (Lanoxin) II-Insulin III-Phenobarbital A-I only B-III only C-I and II D-II and III E-All of the above Ans.: C 7. Case study for next two questions: EF 58 years old No known allergies Asthma Hypercholesterolemia Current medications: salbutamol (Ventolin) 100 mcg/puff HFA inhaler 2 puffs qid prn fluticasone (Flovent) 125 mcg/puff HFA inhaler 2 puffs bid atorvastatin (Lipitor) 20 mg once daily Alprazolam (Xanax) 0.25 mg bid and hs prn Lovastatin (Mevacor) counseling includes: I do not give during pregnancy II take with food III do not take with grape fruit juice a. I only b. III only c. I and II d. II and III e. I, II and III Patient Name: Age: Allergies: History:
Ans: E 8. EF’s doctor wants to prescribe an antibiotic for an upper respiratory tract infection. Based on his patient record, any of the following antibiotics could be recommended, EXCEPT: A. Amoxicillin 250mg tid x 10 days B. Ciprofloxacin (Cipro) 500mg bid x 10 days C. Doxycycline (Vibra-Tabs) 100mg 2 tablets on the first day then 1 tablet daily x 10 days D. Erythromycin (EryC) 333 mg tid x 10 days E. Sulfamethoxazole/ trimethoprim (Septra DS) bid x 10 days Ans.: D
9. Case study for next two questions: Patient Name: Age: Allergies: History: Lab reports: JB 60 years old Sulfonamides Deep Vein thrombosis (DVT) Urinary Tract Infection (UTI) CrCl 19 mL/min (normal CrCl = 100mL/min) Culture and Sensitivity Test: * Resistant to ampicillin * Sensitive to sulfa, ciprofloxacin, cephalosporins INR 2.5 (normal range 2-3)
Current Medications: warfarin (Coumadin) 1mg daily JB presents a new prescriptions for ciprofloxacin (Cipro) 500mg bid x 7 days for recurrent urinary tract infections. Based on the patient record above, you would: A. Dispense the ciprofloxacin as ordered with a note to monitor INRs B. Call the physician and recommend decreasing ciprofloxacin (Cipro) dose to 250 mg bid x 7 days with a note to monitor INRs C. Call the physician and recommend sulfamethoxazole/ trimethoprim (Septra) i bid x 7 days with a note to monitor INRs D. Call the doctor and recommend ampicillin 250 mg qid x 7 days with a note to monitor INRs
E. Do B, C, or D above Ans: B 10. Two weeks later, JB complains of heart burn especially at night. JB has already tried antacids and wonders if there is anything else that would help. Which of the following drugs would you NOT recommend? A. Alginic acid/ aluminum hydroxide (Gaviscon) B. Cimetidine (Tagamet) C. Famotidine (Pepcid AC) D. Ranitidine (Zantac) E. B, C, and D Ans.: B 11. A patient of yours, CE, asks what she could do to decrease her risk of osteoporosis. You would suggest all of the following options, EXCEPT: A. B. C. D. E. Elemental calcium 1000 – 1500 mg per day Vitamin D 400 IU daily Regular swimming Regular weight lifting Drinking milk
Ans.: C 12. Case study for next two questions: Patient Name: FJ Age: 40 years old Allergies: No known allergies History: Smoker Current medications: Zopiclone (Imovane) 7.5 mg qhs prn x 30 FJ presents the following new prescriptions: clarithromycin (Biaxin) 500mg bid x 7 days metronidazole (Flagyl) 500 mg bid x 7 days bismuth subsalicylate (Pepto Bismol) ii tabs qid x 7 days What is the most likely diagnosis according to this new prescription drug regimen? A. Escherichia coli intestinal infection B. Helicobacter pylori infection induced peptic ulcer C. Salmonella intestinal infection D. Intestinal amoebiasis E. Gardnerella vaginitis Ans.: B
he is wondering if it can cause a dry cough. Acetaminophen C. Hypoglycemia Ans. Within normal range – his diabetes appears well controlled . Lactic acidosis B. Bismuth subsalicylate (Pepto Bismol) must be taken 2 hours after clarithromycin and metronidazole D. in particular. Hyperglycemia C. The most appropriate advice for FG is that his blood glucose level is: A. Which of the following medications should NOT be recommended because they may adversely affect FG’s blood glucose levels? A. Cough D. Case study for next 4 questions: Patient Name: FG Age: 54-year old male Past medical history: non-insulin dependent (Type 2 diabetes x 5 years) Allergies: No known allergies Current medications: glyburide (Diabeta) 10mg daily FG comes into the pharmacy to pick up some over-the-counter medications for his medicine cabinet. Bismuth subsalicylate (Pepto Bismol) may take the tongue and stool black Ans. Avoid alcohol C. Dextromethorphan Ans. You advise him that the most common side effects of his glyburide (DiaBeta) is: A. FG tells you he has a current fasting blood glucose reading of 10 mmol/L. You would include the following recommendations in counseling FJ about the medication EXCEPT: A. Take with food or milk B. He is wondering if it is too low.: C 14.13.: D 16.: A 15. FG asks you what the most common side effects of his glyburide (DiaBeta) are. Pseudoephedrine B. Diphenhydramine D.
Add selegiline (Eldepryl) to Sinemet D. Alcohol may interact with certain oral hypoglycemic agents B.B. PK approaches you wondering why he isn’t on levodopa. Alcohol may cause weight loss D. High – refer patient to his physician C. Initiate a drug holiday Ans. Alcohol may aggravate peripheral neuropathy Ans. You go on to explain that carbidopa: .: A 19. Benign prostatic hypertrophy C. You advise him that he should not use diphenhydramine (Nytol) because of his: A. Restrict the protein in his diet C. You counsel FG that individuals with diabetes should limit alcohol consumption for a number of reasons. Rigidity Ans. sudden periods of “freezing” PK approaches you complaining about his “freezing” episodes. FG is concerned about his alcohol use because he has diabetes. Switch his levodopa/carbidopa (Sinemet) to the sustained-release formulation B. You explain that he is on a levodopa/ carbidopa (Sinemet 100/25) combination which is better than taking levodopa alone.: B 17. Low – recommend carrying glucose tablets to prevent hypoglycemia D. High – suggest switching to insulin Ans. EXCEPT: A.: C 18. Alcohol may impair the body’s ability to recover from hypoglycemia C. Case study for next 4 questions: Patient Name: PK Age: 69 years old Gender: Male Allergies: No known allergies Past medical history: Parkinson’s disease x 3 years Benign prostatic hypertrophy Non-insulin dependent (Type 2) diabetes – diet controlled Current medications: levodopa/ carbidopa (Sinemet 100/25) Presentation: Dyskinesia. All of the following are appropriate reasons.: B 20. He is wondering if there is something he can take to get rid of them. Calorie restricted diet B. You will recommend that his doctor: A. PK wants to purchase some diphenhydramine (Nytol) as he is having trouble sleeping at night. Diabetic nephropathy D.
: B 23. Take with high protein snacks Ans. and physiotherapist. Nifedepine . Acts as a gamma aminobutyric acid agonist Ans. Donepezil C. nurse. Inhibit the breakdown of serotonin in the brain B. Take with a light snack E. Decrease dopamine levels in the CNS D. Discontinue the drug for one week to avoid “on-off” phenomenon B. Crush the tablets and dissolve in soft food or fruit juice C.A. C. You reply that donepezil’s (Aricept’s) main pharmacological action is to: A. Increase acetylcholine levels in the brain C. ASA B. nursing home patient Past medical history: Alzheimers’ disease Raynauds disease Stroke at age 70.: D 21. What is the best advice you can give PK regarding how he should take his levodopa/ carbidopa (Sinemet 100/25)? A. Lorazepam D. partial disability on left side Hypercholesterolemia Allergies: Penicillin Current medications: donepezil (Aricept) 5 mg daily nifedipine (Adalat XL) 30 mg daily ASA 325 mg daily lorazepam (Ativan) 1 mg qhs prn Pravastatin (Pravachol) 20 mg qhs You participate in the bi-monthly review of TR’s medical progress and medication review with the physician. nutritionist. Prevents peripheral neuropathy Delays the progression of the disease Controls symptoms of hypertension Reduces the levodopa dose requirement Ans. Supplement with vitamin B6 100 mg po daily D. D. B. Case study for next 4 questions: Patient Name: TR Age: 75-year old.: D 22. The physiotherapist asks you how donepezil (Aricept) works. The nutritionist reports that grapefruit juice is a regular breakfast beverage for TR. You advise the nutritionist that grapefruit juice should be avoided because it interacts with TR’s: A.
: D 26. One month later. Space apart the grapefruit juice and the interacting medication by at least 2 hours B. E. You would recommend: A. Discontinue the interacting medication since risks outweigh the benefits C. C. you receive the following prescriptions for TR for communityacquired pneumonia. Congestion B.: D 24.: D 25. Sore throat . you decide she has allergic rhinitis. Discontinue the grapefruit juice Ans. After interviewing VJ. Monitor for increased levels and response of the interacting medication D. When calling the doctor. Which one of the following symptoms is more characteristic of seasonal allergic rhinitis? A. Which recommendation would you suggest to best manage the grapefruit juice? A. Case study for next 3 questions: Patient Name: VJ Age: 56 years old Gender: Female Past medical history: Gastroesophageal reflux disease Atrial fibrillation Allergies: No known allergies Current medications: rabeprazole (Pariet) 10 mg daily ramipril (Altace) 10 mg daily amiodarone (Cordarone) 200 mg daily Midsummer. clarithromycin (Biaxin) 500 mg bid x 10 days erythromycin (Eryc) 333 mg tid x 10 days cefuroxime (Ceftin) 500 mg bid x 10 days doxycycline (Vibra Tabs) 100 mg tid x 10 days sulfamethoxazole/ trimethorprim DS (Septra DS) i bid x 10 days Ans. D. he asks you to recommend the best alternative for this patient. Amoxicillin 500 mg tid x 10 days Upon review of the patient’s record you determine the prescription is inappropriate.Ans. not a cold. B. VJ appears at the dispensary counter to refill her rabeprazole (Pariet) prescription and is also looking for a cold preparation to relieve her cold symptoms. Nasal discharge C.
Decreased gastric acidity reduces erythromycin absorption C.D. fluticasone (Flonase) 50 mcg I puff each nostril bid Which of the following statements would you include when counseling VJ? A. What would you give NE regarding his nitroglycerin spray? A.: A 28. Apply in the morning. Beneficial effects require regular usage C. It is necessary to prime the spray prior to each use . Therapy should only be used for three months B. Remove at night Glyburide (Diabeta) 10 mg daily Nitroglycerin (Nitrolingual Pumpsray) prn NE’s angina has been poorly controlled. Shake the nitroglycerin pumpspray prior to use B. Erythromycin aggravates gastroesophageal reflux disease D. Erythromycin and rabeprazole interaction Ans. Erythromycin inhibits metabolism of ramipril E. Itchy eyes Ans: D 27.2 mg. VJ presents the following prescription: erythromycin base (Eryc) 333 mg tid x 10 days What are your concerns? A. Discontinue a few days after symptoms resolve D. Amiodarone and erythromycin interaction B. He is using the nitroglycerin spray 3 to 4 times a day.: B 29. Case study for next 2 questions: Patient Name: NE Age: Gender: 72 years old Male Past medical history: Non-insulin dependent (Type 2) diabetes x 20 years Allergies: No known allergies Current medications: enteric Coated ASA (Entrophen) 325 mg daily nitroglycerin patch (Nitro-Dur) 0. Therapy should be initiated at the maximum recommended dose E. See your doctor immediately to reevaluate your nitroglycerin therapy C. See your physician if no relief within 3 days Ans. VJ returns to the pharmacy two weeks later with a prescription for an intranasal corticosteroid.
6 hours B. JT approaches you and states that he is concerned about his triazolam (Halcion) usage. 8 hours C. shakes and chills B. fatigue and nausea D. muscle spasms and irritability C. You tell him that he can prevent or lessen the degree of nitrate tolerance from developing by having a daily nitrate free interval of at least: A. delirium.D. Case study for next 2 questions: Patient Name: Age: Gender: Allergies: JT 41 years old Male No known allergies Past medical history: Anxiety Difficulty sleeping (starting 3 years ago) Current medications: triazolam (Halcion) 0. You would recommend: . Increased headache. Diarrhea. He asks you what the most common withdrawal symptoms will be: A.: C 31. Doses may be repeated as many times as needed until complete relief is achieved Ans.5 mg qhs x 3 years acetaminophen/ caffeine/ codeine (Tylenol#1) – ii prn headache You notice that JT has been coming in early for refills for triazolam and has received extra prescriptions for this medication from many walk-in clinics. 24 hours Ans.: B 32. Seizures. 10 hours D. Insomnia. so he stopped using it 24 hours ago. and hallucinations Ans. On further questioning.: B 30. you discover that NE has been having angina at night. so he has been leaving the patch on for 24 hours. You offer to call JT’s doctor to suggest an effective triazolam withdrawal strategy.
Case study for next 2 questions: Patient Name: Age: Gender: MT 23 years old Male Past medical history: Hepatitis C with liver dysfunction Allergies: No known allergies Current medications: None MT was diagnosed with a fungal infection of the fingernail for which he was prescribed terbinafine (Lamisil) 250 mg daily orally.: C 35. Gradually tapering (25% per day) triazolam (Halcion) dose over one week D. Giving the equivalent dose of diazepam. Giving an equivalent dose of lorazepam (Ativan) Ans. D. Do not take with food as this reduces drug bioavailability Contact doctor to decrease the terbinafine prescribed dose Limit sun exposure as terbinafine causes photosensitivity Terbinafine is not effective against dermatophyte fungi Ans. B. MT should continue taking his terbinafine for: A. B.: B 34. then gradually decrease the dose over several months B. Which of the following statements would you include when counseling MT? A.: A 33. C. 2 weeks 4 weeks 3 months 12 months Ans.A. D. Another effective treatment for MT’s fingernail infection would be: . Go to the hospital emergency department for a flumazenil (Anexate) injection C. C.
B. C. C.: D 37. Dispense 24 Tylenol #3 and counsel the patient to be aware of drowsiness E. Patient Name: Age: Allergies: Current medications: HR 79 years old Allopurinol zopiclone (Imovane) 7. B. recommend discontinuing the ibuprofen (Motrin) C. Oral itraconazole (Sporanox) Topical clotrimaxole (Canesten) Topical terbinafine (Lamisil) Oral nystatin (Nilstat) Ans: A 36. Call the doctor to discuss the potential interaction between Tylenol #3 and ibuprofen (Motrin) D. Patient Name: Age: Allergies: Past medical history: Current medications: You receive the following prescriptions for MJ: Tylenol #3 Sig: I – ii q4h prn pain Mitte: 24 Upon review of the patient record. HIV infection Cancer chemotherapy Systemic cortiscosteroids Oral antibiotic therapy MJ 50 years old No known allergies Severe gastrointestinal cramps when on acetaminophen/ codeine (Emtec-30) ibuprofen (Motrin) 400 mg qid Ans. Which of the following is least likely to contribute to fungal fingernail infections? A. D. D. Call the doctor regarding duplicate therapy. Dispense 24 Tylenol #3 and counsel patient t discontinue ibuprofen while on Tylenol #3 Ans: A 38. Call the doctor and discuss the possible intolerance to codeine B. you would: A.A.5 mg hs prn hydrochlorothiazide 25 mg daily .
Patient Name: Age: Allergies: JB 62 years old Sulfonamides.: A 39. Call the doctor to recommend a 5-day course of therapy and dispense 10 norfloxacin (Noroxin) 400 mg tablets C. ciprofloxacin (rash) Current medications: naproxen 250 mg tid Medical conditions: Urinary tract infection Arthritis You receive the following prescription for JB: norfloxacin (Noroxin) 400 mg Sig: I bid x 10 days Upon review of the patient record. Dispense 20 norfloxacin (Noroxin) 400 mg tablets as prescribed Ans. Patient Name: Age: Allergies: History: Current medications: DF 51 years old Penicilllin Epilepsy carbamazepine CR (Tegretol CR) 400 mg bid . Call the doctor to decrease the dose of verapamil (Isoptin) Ans.: A 40.potassium chloride 600 mg (slow K) ii bid digoxin (Lanoxin) 0. Call the doctor regarding a potential verapamil (Isoptin) hypersensitivity C. you would: A. Call the doctor and recommend that the prescription be changed to sulfamethoxazole/ trimethorprim (Septra) ii bid D. Call the doctor regarding a possible hydrochlorothiazide interaction D.25 mg daily HR presents with a prescription for: verapamil SR ( Isoptin SR) 240 mg daily Upon reviewing the patient record. you would: A. warn the patient to notify you of any new gastrointestinal symptoms E. Call the doctor and recommend that the prescription be changed to Nitrofurantoin (MacroBID) 100 mg bid B. Call the doctor regarding a potential digoxin (Lanoxin) interaction B. Dispense as written.
Gout D. Call the doctor and recommend one application per day. Coronary insufficiency C.oxazepam (Serax) 15 mg qhs prn insomnia You receive a prescription for DF for: erythromycin 250 mg Sig: i q6h Mitte: 40 Upon review of the patient record.: A 41. Alcoholism Ans. JS’s doctor instructed him to start taking niacin tablets 500 mg tid. Ans. you would: A.: B 42. Call the doctor and recommend mupirocin (Bactroban) topical cream C. Call the doctor about a possible drug-drug interaction B. Call the doctor to recommend nystatin (Nyaderm) topical cream D. He asks you what this therapy is used to treat? You would tell him that it is used to treat: A. Hypercholesterolemia B. Anemia E. The patient record indicates the following: Patient Name: Age: Gender: Allergies: AJ 58 years old Male Sulfamethoxazole/ trimethoprim (Septra) Cephalosporins Current medications: salbutamol(Ventolin) HFA 100mcg/puff inhaler 1-2 puffs qid prn salmeterol/fluticasone (Advair-250) diskus 1 puff bid You receive the following prescription for AJ: silver sulfadiazine (Flamazine) Cream: Apply qid x 7 days to the burn Upon review of the patient record. B. Call the doctor about a possible intolerance to erythromycin D. Dispense 40 erythromycin base (EryC) 250 mg capsules and instruct the patient to take one capsule four times daily.: A . you would: A. Call the doctor about a possible drug-disease interaction C. Dispense silver sulfadiazine as ordered Ans.
JS approaches you to purchase a box of nicotine (Nicoderm) patches and asks.25 mg qam Maalox 15 mL qid pc & hs You receive the following prescription for JF: sucralfate (Sulcrate) 1 g Sig: 1 qid ac and hs Mitte: 30 days . then one after each loose bowel movement. Patient name: Age: Allergies: History: Current medications: JF 70 years old Sulfonamides Congestive heart failure digoxin (Lanoxin) 0. Upper arm B. Two caplets after each loose bowel movement. One caplet after each loose bowel movement to a maximum of 6 caplets daily C.: D 45. One caplet three times daily prophylactically starting on the day of arrival in Mexico B. All of the above Ans. Back C. Buttocks E. Two caplets at onset of diarrhea. One caplet every 4 hours after diarrhea starts and continue until stools are formed D. up to a maximum of 8 caplets a daily E.43. Lower rib cage D.: E 44. Two months later. to a maximum of 4 caplets daily Ans. You would recommend: A. “where is the best place on the body to apply the patch?” You would indicate: A. A young woman purchases loperamide (Imodium) 2 mg to take to Mexico and asks what dose she should take.
: A 46. 7. etc. Call the doctor to discuss a potential cross-sensitivity and recommend sucralfate (Sulcrate) be changed to ranitidine (Zantac) 150 mg bid E. In order to maintain similar blood levels. Ans. a 70-year old patient is currently taking phenytoin (Dilantin) 100 mg three capsules daily at bedtime. 6 mL in the morning and at bedtime C. Sell her potassium chloride in the brand of her choice and instruct her to see her doctor for a potassium blood level check D. you would give: A.Upon review of the patient prescription for JF. Dispense as written . bananas. A woman tells you that her friend told her she should be taking potassium chloride(Slow K) because she is on blood pressure medications. instructing the patient to take the digoxin (Lanoxin) with his noon meal C. Not sell her anything and instruct her to supplement her diet with potassium rich foods such as orange juice. Case study for next two questions: Patient name: AB Age: 50years old Gender: Female Past medical history: Borderline hypertension. Sell her 100 slow release potassium chloride tablets of a generic brand C. TL can no longer swallow these capsules so the doctor requests an equivalent dose of Dilantin suspension 125 mg/5 mL. 12 mL daily at bedtime Ans: A 48. instructing the patient to take the digoxin (Lanoxin) before one of his meals D. Not sell her anything and instruct her to consult her doctor first E. Dispense as written. You would: A. TL. you would: A.5 mL in the morning and at bedtime B. Call the doctor to discuss a potential cross-sensitivity and recommend sucralfate (Sulcrate) be changed to misoprostol (Cytotec) 200 mcg qid Ans. 5. Dispense as written. The medications she asks are spironolactone (Aldactone) 100 mg daily and captopril (Capoten) 25 mg bid. diet controlled x 4 years Lactose intolerant Allergies: Codeine . instructing the patient to take the digoxin (Lanoxin) two hours after the morning dose of sucralfate (Sulcrate) B. Sell her 100 potassium chloride (Slow-K) tablets B.: D 47. 11 mL daily at bedtime E.5 mL in the morning and at bedtime D.
Which regimen is most suitable for AB? A. after doing some research on her own. Increases calcium resorption from bone B.: B 49.Penicillin Peanuts Medications: Calcium 500 mg bid Vitamin D 1000 IU daily AB calls you for some information about menopause and hormone replacement therapy (HRT). She has decided to give HRT a try. Estradiol (Estrace) 1 mg daily and medroxyprogesterone (Provera) 5 mg days on days 14-25 of each month C. In response to her complaints of irritability. Conjugated estrogen (Premarin) 0. and difficulty sleeping. Decreases vasomotor flushing within two weeks C. Patient name: Age: Gender: Allergies: LT 43 years old male polymixin sulfate/ neomycin/ gramicidin (Neosporin) Past medical history: Ileostomy Medications: loperamide (Imodium) 2 mg bid Attapulgite (Kaopectate) 10 mL qid You receive the following prescription for LT: mupirocin (Bactroban) ointment sig: Apply to stomal area bid for fungal infection . her doctor has told her that she is in menopause and needs an estrogen supplement. Decreases risk of hypertension D. She does not wish to resume her menses. Estradiol (Estracel) 1 mg daily and micronized progesterone (Prometrium) 100mg daily Ans.625 mg daily and medroxyprogesterone (Provera) 2. you include that it: A. Conjugated estrogen (Premarin) 0.: A 50. Decreases frequency of migraine headache Ans. AB calls you several days later.625 mg daily and micronized progesterone (Prometrium) 100 mg daily D. When discussing the benefits of estrogen with AB. hot flushes.5 mg daily B.
2) 1-2 tid prn SK arrives at your pharmacy after being discharged from hospital with the diagnosis of Graves’ disease. It is used to control symptoms until spontaneous remission occurs D. Sweating. Call the doctor regarding a possible cross-sensitivity between Bactroban and Neosporin ointment Ans.: C 51. palpitations C. Call the doctor and recommend fusidic acid (Fucidin) ointment E. palpitations D. Which of the following is NOT a symptom of Graves Disease? A.Mitte: 15 g Upon review of the patient record. It is contraindicated in pregnancy C. Instruct the patient to apply the Bactroban more frequently if removed with washing C. Insomnia.Which of the following statements concerning propylthiouracil (Propyl-Tyracil)is true? A.: D 52. Constipation. you would: A. The most frequent adverse effect is osteoporosis . Dispense mupirocin (Bactroban) counseling the patient to apply thinly bid B. palpitations Ans. Diarrhea. palpitations B. Recommend clotrimazole (Canesten) topical cream D. It decreases the thyroid’s ability to synthesize thyroid hormone B. Case study for next 3 questions: Patient name: Age: Gender: SK 32 years old Female Past medical history: Hypethyroidism (Graves’ disease) Migraines Allergies: Medications: Sulfonamides propylthiouracil (Propyl-Thyracil) 100 mg tid propranolol (Inderal) 40 mg bid acetaminophen/ codeine/ caffeine (Tlenol No.
Synergistic with iodide Ans. Case study for next 4 questions: Patient name: RB Age: Gender: Weight: 81 years old Female 100 kg Past medical history: Osteoarthritis in fingers and legs x 10 years Mild leg edema Allergies: No known allergies Current medications: fluticasone (Flovent) 125 mcg/puff HFA inhaler 1 puff bid hydrochlorothiazide 25 mg daily for ankle swelling docusate sodium (Colace) 100 mg daily acetaminophen/ codeine/ caffeine (Tyleol No. Controls tremor C. D. B.: B 54. which one of the following is TRUE? A. Aggravates migraine B.: A 53. 2) 1 q4h prn RB was admitted to hospital with complaint of increased swelling in ankles and severe pain in her left leg. With regard to the use of a beta blocker in the management of hyperthyroidism. What factor most likely aggravated RB’s condition leading to her admission to the hospital? A. C. Causes neutropenia D.Ans.: A 55. She was diagnosed with deep vein thrombosis (DVT). Heparin . Obesity Laxative abuse Insufficient diuretic therapy Gender Ans. Which of the following drugs would most often be used as initial therapy for acute treatment of deep vein thrombosis in the hospital? A.
Refrain from telling your friend about RH’s condition. Based on the case above regarding RH. Measuring factor III and X D. you begin to worry that your friend isn’t aware of RH’s diagnosis. Which three (3) of the following actions would be most appropriate? A. Measuring international normalized ratio (INR) B.: A 58. who is dating your best friend. Refrain from telling your friend about RH’s condition. Streptokinase D. No monitoring required Ans. Case study for next 3 questions: While dispensing HIV/AIDS medications for RH. Disclose to your friend that RH is being treated for HIV/AIDS and urge her to see her doctor if they have had unprotected sex. You are also aware that it is a breach of confidentiality to inform your friend about RH’s condition and you are wondering how to handle this situation. ASA C. Disclose to our friend that RH is being treated for HIV/AIDS and urge her to see her doctor if they have had unprotected sex E. Counsel RH on preventive measures to prevent the spread of the virus and to inform all sexual partners about his condition C.: A. Call RH’s doctor to discuss your concerns and ask her/him to follow-up with RH B. but urge her to always use safe sex measures and to be checked for HIV/AIDS is she had unprotected sex Ans. E 59.B. which action (of the same responses) would you take first? A. Disclose to RH that you are a friend of the woman he is dating and urge him to inform her about his diagnosis D. but urge her to always use safe sex measures and to be checked for HIV/AIDS if she has had unprotected sex Ans: B . Warfarin Ans: A 56. B. Disclose to RH that you are a friend of the woman he is dating and urge him to inform her about his diagnosis D. Measuring prothrombin time (PT) C. Call RH’s doctor to discuss your concerns and ask her/him to follow-up with RH and your friend B. What would be the best prophylaxis for RB’s deep vein thrombosis when he is discharged from the hospital? A. E. Counsel RH on preventive measures to prevent the spread of the virus and to inform all sexual partners about his condition C.
Call Doctor to decrease dose of gentamicin (Garamycin) ear drops to 2 drops TID D. Continue the gentamicin ear drops along with the amoxicillin suspension B. Which of the following ratios is the best indicator of a pharmacy’s profitability? a) b) c) d) e) Ans: B Net profit to net sales Net profit to net worth Net profit to total assets Net profit to inventory Net profit to annual turnover 61.: B 62. JS’s mother presents a new prescription for JS for: Amoxicillin 250 mg TID x 5 days She states that his ear infection has worsened and he now has a perforated eardrum. Patient name: KG Age: 55 years old Gender: Female Allergies: No known allergies Medical conditions: Migraine headaches Medications: ASA/ butalbital/ caffeine/ codeine (Fiorinal C ½) 1 q3-4h prn – filled 1 week ago Ergotamine/ caffeine (Cafergot) 2 stat then 1 q30min up to 6 per day A family member presents the following prescription for KG who is at home with an acute migraine: Sumatriptan (Imitrex DF) 100 mg . Call Doctor to change ear drops to Ciprofloxacin/ Hydrocortisone (Cipro HC) Otic 2 drops TID Ans. How would you respond? A. Patient name: Age: Gender: Weight: Allergies: Medications: JS 6 years old male 27 kg No known allergies Gentamicin (Garamycin) ear drops 3 drops in affected ear TID – initated 3 days ago After 3 days of gentamicin ear drops. She asks if she should continue to give JS the gentamicin ear drops. Stop the gentamicin ear drops and start the amoxicillin prescription C.60.
Call the physician about a possible drug interaction between Sumatriptan (Imitex DF) and ergotamine/ caffeine (Cafergot) Ans. B. Fill the prescription and caution the patient not to start taking Sumatriptan (Imitrex DF) within 24 hours of taking Fiorinal C ½ C. 2 tablets every 30 minutes (max 8 doses per day) E. Fill the prescription and caution the patient not to start taking Sumatriptan (Imitrex DF) within 24 hours of taking ergotamine/ caffeine (Cafergot) B. 2 tablets at onset of diarrhea. Patient name: PS . Fill the prescription and counsel the patient about appropriate dosing of Sumatriptan (Imitrex DF) D.: D 64. You would recommend all of the following EXCEPT: A. Call the physician about a possible drug interaction between Sumatriptan (Imitrex DF) and Fiorinal C ½ E. C. D. Take loperamide (Imodium) 2 mg.Sig: 1 stat for migraine. then 1 tablet after each loose bowel movement (maximum 8 tablets per day) F. to take if severe diarrhea occurs Ans. Patient name: Age: Gender: Allergies: JC 30 years old male Penicillin ASA JC wants to know how to prevent or treat diarrhea while in Mexico. Drink only bottled water/ soft drinks without ice Eat food from reliable sources Eat only fruit cut and peeled by yourself Take bismuth subsalicylate (Pepto-Bismol). to maximum of 1 per attack or 2 per day Based on the patient record (above) you would: A.: A Comments: All triptans do not used with Ergotamine and MAO except Naratriptan Tc page 109 63. See your doctor for a prescription for ciprofloxacin.
Age: Gender: Allergies: Medical conditions: Medications: 55 years old male sulfonamides (no allergy to glyburide) Type 2 diabetes Glyburide (Diabeta) 10 mg daily x 3 years PS comes into your pharmacy with a prescription for atenolol (Tenormin) 50 mg daily You are most concerned that atenolol (Tenormin) may: A. Take dimenhydrinate (Gravol) 50 mg 1 hour before ECP to decrease nausea and vomiting B. increase blood sugar C. Which of the following counseling points is NOT appropriate when counseling genetic a patient on emergency contraceptive pills (ECP)? A. you should see your family doctor D. it provides protection against pregnancy for 6 – 7 days Ans. Taking ECP can result in transient side effects such as abdominal cramps.: D 66. headaches.: A 65. Patient name: Age: Gender: Allergies: EM 59 years old male Sulfonamides Molds Pollen Arthritis x 2 years Asthma x 1 year Medical conditions: . Once ECP is taken. If you do not experience withdrawal bleeding within 3 weeks after taking ECP. increase glyburide level D. decrease glyburide level Ans. mask signs of hypoglycemia B. and breast tenderness C.
Patient name: Age: Gender: Allergies: Medical conditions: Medications: Upon picking up his prescriptions. He has used tetrahydrozoline (Visine Original Formula) for 1 week and it is not working. He tells you his doctor wants to stop the naproxen because he has been taking his naproxen on an empty stomach and has developed an upset stomach.5 mg qam x 18 months Multivitamins (Centrum forte) one daily x 6 months Ans. D.Medications: Salbutamol (Ventolin) 100 mcg HFA inhaler 2 puffs QID prn – initiated 1 year ago Fluticasone (flovent0 125 mcg HFA inhaler 2 puffs BID – initiated 1 year ago Naproxen (Naprosyn) 500 mg BID – initiated 2 years ago EM presents a prescription for celecoxib (Celebrex) 100 mg BID x 60 capsules. Your recommendation would be: A. any of the above Ans. naphazoline/ antazoline (Vasocon A) 2 drops each eye QID C.: C 68. naphazoline (Albalon) 2 drops each eye QID B. B. DC asks you if you can recommend some other eyedrops for his extremely itchy/ watery eyes. tetrahydrozoline zinc sulphate (Visine allergy) 1-2 drops each eye TID – QID E. Patient name: Age: Gender: Allergies: JS 67 years old Female Diclofenac . adding misoprostol (Cytotec) to naproxen is cheaper DC 46 years old male Penicillin (anaphylaxis) Hypertension x 18 months Hydrochlorothiazide (Apo-Hydro) 12. sodium cromoglycate (opticrom) 2 drops each eye QID D. You would be concerned that celecoxib: A. C. has not been proven to be as effective as naproxen in arthritis is contraindicated in patients with asthma is contraindicated in patients with a sulfonamide allergy is expensive.: C 67.
Patient name: Age: Gender: Allergies: Medical conditions: SE 55 years old male Penicillin ASA Arrhythmia Hypertension . Discontinue amitriptyline and tryptophan and see her doctor within 48 hours E. Take JS to the closest emergency department as soon as possible Ans. What would you recommend? A. Start cyproterone/ ethinyl estradiol (Diane 35). Methocarbamol/ASA (Robaxisal) 2 QID with food and see her doctor if symptoms don’t improve in 48 hours B.: E 69. WB has been on minocycline (Minocin) and benzoyl peroxide/ erythpmycin (Benzamycin) for 2 weeks now. discontinue other medications Ans. Start norgestimate/ ethinyl estradiol (Tricyclen). She explains that her mother is extremely agitated and tremulous. Continue minocycline (Minocin) and benzoyl peroxide/ erythromycin (Benzamycin) for 2 months B. has a high fever and is really confused.Medical conditions: Medications: Insomnia Nerve pain Tryptophan (tryptan) 500 mg 2 qhs for sleep x 6 months Amitriptyline 50 mg 1-2 qhs nerve pain x 3 days JS’s daughter asks you to recommend something for her mother’s flu. is sweating a lot. What would you recommend? A. Start tazarotene (Tazorac) discontinue other medications C. discontinue other medications D. Apply qhs x 2 weeks Benzoyl peroxide (PanOxyl) 5% Gel Apply qhs x 6 months-now discontinued WB’s doctor calls you for advice. She’s in bed with muscle spasms. Start isotretinoin (Accutane). Patient name: Age: Gender: Allergies: Medical conditions: WB 28 years old Female No known allergies Acne Medications: Minocycline (Minocin) 100 mg daily x 2 weeks Benzoyl peroxide/ erythromycin (Benzamycin)Gel.: A 70. but has not seen any improvement in her acne. Discontinue amitriptyline and see her doctor within 48 hours D. Methocarbamol/ acetaminophen (Robaxacet) 2 tablets QID and see her doctor if symptoms don’t improve in 48 hours C. discontinue other medications E.
5 mL daily for UTI Prophylaxis x 2 months Salbutamol (ventolin) 1 mg/ml nebulas 2. would you recommend? A. The doctor calls you with a prescription for amoxicillin/ clavulanate (Clavulin 250 F) 250 mg TID x 10 days What would you do? A. Suggest changing to doxycycline (Vibra tabs) 100 mg daily x 10 days D.5 mL QID prn x 2 years Budesonide (Pulmicort) 250 mcg nebule BID x 2 years Medical conditions: Other: Medications: MN has been coughing up yellowish-green sputum.Hypercholesterolemia Medications: Digoxin (Lanoxin) 0. Patient name: MN Age: Weight: Gender: Allergies: 8 years old 50 kg male Captopril Codeine Mentoclopramide Penicillin Displastic multicystic kidneys. Suggest changing to erythromycin 125 mg QID x 10 days Ans. Suggest changing to erythromycin 250 mg QID x 10 days E.125 mg daily x 1 year Nitroglycerin (Nitro-dur) 0. Suggest reducing the dose to amoxicillin/ clavulanate (Clavulin 125 F) 125 mg TID x 10 days C.4 mg patch Apply at 8 am. unable to communicate CrCl 110 mL/min (Normal CrCl = 125 mL/min) Sulfamethoxazole/ trimethoprim (Septra) Susp. cefixime (Suprax) 400 mg daily C. Fill the prescription as written B. clarithromycin (Biaxin) 500 mg BID D.: D . amoxicillin/ clavulanate (clavulanate (Clavulin 500 F) 500 mg TID B. doxycycline (Vibra Tabs) 100 mg BID E. paraplegic.: D 71. Remove at 8 pm daily x 1 year Ramipril (Altace) 5 mg daily x 1 year Furosemide (Lasix) 40 mg daily x 1 year Simvastatin (Zocor) 20 mg daily x 1 year You receive the following prescription for SE for community-acquired pneumonia: Amoxicillin 500 mg TID x 10 days When calling the doctor to change the prescription which alternate antibiotic. norfloxacin (Noroxin) 400 mg BID Ans.
When counseling on the triamcinolone (Nasocort Aqueous). C.: D .72. you would include the following EXCEPT: A. You would be concerned about all of the following EXCEPT: A. Dispense as written and explain that the medication should be used regularly. Dispense as written and explain that the patient may not see results for at least 3 weeks D. Contact your doctor if you are experiencing yellow or green discharge D. Do not take OTC antihistamines while on triamcinolone (Nasocort Agueous) E. B.: B 74. Do not use decongestant nasal sprays while on triamcinolone (Nasocort Aqueous) Ans. not prn.Patient name: Age: Gender: Allergies: Medical conditions: DA 60 years old male No known allergies Type 2 Diabetes Hypercholesterolemia Occasional angina Half-marathon walker. Call the doctor to change the directions to 2 sprays in each nostril once daily C. Atorvastatin with grapefruit Metformin with attorvastatin Sildenafil with nitroglycerin Sildenafil with grapefruit Ans. D.4 mg Spray 1-2 sprays sl prn – initiated 3 weeks ago Other: Medications: DA requests a refill of his sildenafil (Viagra) prescription. eats grapefruit Atorvastatin (Lipitor) 20 mg qhs – initiated 2 years ago Metformin (Glucophage) 500 mg TID – initiated 2 years ago Sildenafil (Viagra) 100 mg hs prn – initiated 2 months ago Nitroglycerin (Nitrolingual) 0. Call the doctor to change the directions to 1 spray in each nostril three times daily B. Contact your doctor if you experience severe nose bleeds C. Blow your nose if necessary prior to use and avoid blowing your nose after use B.: B 73. Case study for next 2 questions DC brings in a prescription for triamcinolone (Nasacort Aqueous) 1 spray in each nostril TID PRN A. to receive the maximum benefit Ans.
B. Dispense the prescription as written and counsel the mother on its proper use. You would advise RK’s mother to take RK to see the doctor to get a prescription for: A. RK’s mother returns stating that RK is frequently waking up at night with shortness of breath. His mother brings in a new prescription for: ipratropium/ salbutamol (Combivent) inhaler 2 puffs before exercising and 2 puffs 3-4 times daily prn shortness of breath What would you do? A.75. asking that the son bring the inhaler in for a review of how to use it. cromoglycate (Intal) inhaler. ipratropium/ salbutamol (Combivent) inhaler . Case Study for next two questions: Patient name: RK Age: 9 years old Weight: 30 kg Gender: male Allergies: peanuts (anaphylaxis) Medical conditions: Medications: shortness of breath on exertion (asthma) Epipen (filled every year) RK has just been diagnosed with asthma. Recommend adding salbutamol (Ventolin) inhaler to the ipratropium therapy D.: D 76. Two weeks later. Recommend adding theophylline syrup to the ipratropium/ salbutamol (Combivent) therapy B. Ans. Recommend adding a corticosteroid to the ipratropium/ salbutamol (Combivent) therapy C. Recommend changing the prescription to salbutamol (Ventolin) inhaler E. She asks you if there is anything that can help.
Take with food to reduce eusophaegal ulcer Ans.: C 77. Either B or C E. Fluticasone (Flovent) inhaler D.C. What is the mechanism of action of etidronate (Didronel) in the treatment of osteoporosis? I. What is the range of normal fasting blood glucose values that he should try to achieve? A. 4-6 mmol/L C. A plus B or C Ans. Stimulates bone formation III. Inhibits bone resorption II. 12-18mmol/L Ans.: B 78. JZ has purchased a blood glucose-testing machine.: C . 1-3 mmol/L B. 8-12 mmol/L D.
JC has trouble paying for his medications and sometimes has not picked them up because of their high cost.3. The pharmacy intern tells JC it is the same medication as the doctor prescribed. Today. severe pain Low-income patient Hydromorphone (Dilaudid) 2 mg TID x 3 months Tylenol No. 2 QID prn pain x 5 months In the past. His condition is deteriorating and he is in intense pain. The pharmacy intern confirms that the vial contains hydromorphone 3 mg capsules. JC shows your pharmacy intern a vial of medication. labeled for a deceased patient. What are the three (3) most important factors to be considered in this case? I-Dosing information on the vials is inaccurate for JC .80. Patient name: Age: Gender: Allergies: Medical conditions: Other: Medications: JC 54 years old male no known allergies Bone Cancer. He wants to know if it is the same as what was prescribed for him. but to take 2 of the capsules twice daily to get the right dose. JC presents a new prescription for hydromorphone (HydromorphContin) 6 mg BID x 100 capsules. which he received from the doctor.
What is the least important information the pharmacist will consider? a. expiry. B. D.: B. A pharmacist is working as a reliever in another pharmacy. F.II-The integrity (storage. E-It is college of pharmacy decision. C. if he wants he can stop him from his vacation. It is frequently written by the physician d. He calls the pharmacy and say that that he is sick. tampering) of the medication is unknown JC needs pain medication The doctor is dispensing and not following appropriate dispensing procedures JC’s relationship with the doctor should be respected The pharmacy intern should respect the doctor’s professional judgment Ans. Minimum order for stock and shelf capacity b. E. The pharmacist remembered that the same patient came with another prescription of the same drug two days ago in another pharmacy where . E ETHICS 81. A pharmacist wants to leave on a weekend. A manufacturer of a new drug is trying to convince a pharmacist to buy a stock. expiry. The cost of the medicine Ans:B 83. what to do Ans: C 82. H. tampering) of the medication is unknown III-JC needs pain medication Ans-E A. The patient need for the drug c. JC’s PharmaNet record would be incomplete Dosing information on the vials is inaccurate for JC The other patient’s right to confidentiality has been breached The integrity (storage. A patient came with a prescription of Ativan 1mg. D. A-Pharmacy manager will ask when he will come back to work B-Give disciplinary notice and let college know about his absence C-It is the right of the pharmacist utilize his holidays D-It is manager choice. G. but the pharmacy manager does not grant leaves on a Sunday.
he will be ok b. call the doctor and tell him that the patient is addictive Ans:C 83. If a hospital Pharmacist contacts a community Pharmacist requesting a fax of an adult patient’s drug profile because the admitting physician is unable to obtain a complete medial history from the patient and the patient’s family cannot be contacted I-. What is the proper advice? a. A I only B III only C I and II D II and III I. it is a safe drug b. II and III . A woman phoned the pharmacist and told him that her husband has swallowed 30tabs of acetaminophen 325mg. refuse to fill the new prescription c. do not fill it c. It would be all right to transfer patient information from one pharmacist to another for the benefit of the patient. call the police b.he worked. II-Name of the pharmacist transferring the prescription should not be given III-Medication error occur in information transfer therefore should not transfer information. discuss the matter with the patient d. call the poison center to ask for advice d. refer to another pharmacy d. counsell her not to take too much of it Ans: D 85. take him to the emergency department Ans:D 84. How would you dispense a prescription for imipramine for two months for a woman who has attempted suicide? a. What should the pharmacist do? a. induce emesis-using ipecac c.
III. What action should he take? A-Tell the technician to counsel about Tylenol # 1. I-Due to confidentiality purposes these documented cannot be released to the father unless each family member is contacted and permission is taken by each member of the family to release this information to the father for tax purposes. A lady pharmacist returned from a maternity leave. hire one more pharmacist to cover up b. appoint a tech for a close watch Ans: B 87. leaving early in the evening (before the time). A pharmacist noticed that a technician is giving Tylenol #1 to a customer. When you ask the patient what size he needs he is not quite sure and shows you how long using his fingers. Ans-C 88-If a Father comes into the pharmacy requesting official receipts for his family’s prescription for an entire year. What should the manager do? a.Ans-A 86. warn her regarding disciplinary action c.She should be called on the phone in a confidential area and asked if it would be all right if her medical profile were given to her father for tax peruses. You then ask the patient what she is using for and the patient pauses and then says she needs it for her . A I only B III only C I and II D II and III E I. need pharmacist intervention D-Train technician on counselling tips for over the counter medications. Family members include a teenage daughter of 17 year age and a small son of 8 year old. A patient who looks a little bit confused and not too sure what to ask for comes in and asks you in a lower voice if you have syringes. II-Care of confidentiality should be taken in case of there daughter who is on birth control as the father may not be aware that the daughter is on birth control and she may not want her father to know this information.Technician cannot release exempted narcotics. She is not coming on time. II and III Ans-E 89-A person comes into the pharmacy and asks for some syringes the syringes are kept behind the counter to monitor the sales of the syringes to patients. making more mistakes in dispensing medicine. constipation side effect B-Tell the patient about hepatotoxicity if acetaminophen dose exceed 4g per day C.
You then offer to call his grandmother to see what exact size she needs.000 $115.0 8. II and III Ans-C 90.000 4.grandmother diabetes. ABC pharmacy has following figures appearing on its balance sheet.000 $75.000 Total fixed assets $40. Net worth of ABC pharmacy is a) b) c) d) e) Ans: C $195..3 2. Which of the following are appropriate actions: I. Cost of goods sold $500. counsel the patient on the side affects of illicit drug and that it would be a good idea to see his doctor regarding the use of such drugs.000 Total current assets $150.000 Inventory turnover rate for ABC pharmacy is a) b) c) d) e) Ans: B 91.000 Total liabilities $75.0 . and what could be done to help him get off them. because the pharmacist believes that this would benefit the patient and would be against the pharmacist own personal morals A I only B III only C I and II D II and III E I.000 Beginning inventory $200. III.38 3.5 6.000 Ending inventory $220.000 $225. The patient refuses and then finally says that he needs it for illicit drugs. The pharmacist at this point may chose to give the patient the syringes in order to avoid driving the patient to share syringes with other and get a transmitted disease.000 $110. II. The pharmacist may chose to not sell the patient the syringes.
budesonide (Pulmicort) 100 microgram 1 puff BID. Patient was using albuterol 2 puffs qid prn. do not exceed the dose of albuterol prescribed by the physician. III only c. What should the pharmacist do if the patient increased his frequency of using albuterol a. and is interested in its availability and cost. I only b. If difficulty of breathing persists. do not exceed the dose prescribed by the doctor. what should the pharmacist recommend? a.000+$40. advise doctor to increase dose of budesonide (pulmicort) c.000 93. see profile to check dose b.Comments: Total assets – total liabilities ($150. all of the above Ans :D (The maintenance dose of budesonide is 200-400 microgram twice daily and a higher dose may be necessary in some cases.000 = $150. Patient comes for refill of ibuprofen and salbutamol prn. All of the above Ans-E 96. if difficulty of breathing persists. I and II only d. contact your physician. Increasing frequency of use of salbutamol is noted. b. Which of the following information source is an appropriate I-Pharmacist Letter II-Canadian Pharmacist Journal III-Pharmacy Practice a. Also. II and III only e. to give mefenamic acid instead of ibuprofen c.$75. advise Dr. A doctor wants to give infusion of proton pump inhibitor and ask the pharmacist what is the source of information? . tell the patient to see the doctor for further assessment d. The pharmacist learns that the doctor read about the drug in a medical journal. He wants to treat a patient with allergic asthma. tell the patient to contact the doctor d. contact your physician) 94. The pharmacist asks you to gather information on omalizumab for her to review so she can respond to the doctor later.000) . all of the above Ans: D 95-A local family physician phones the pharmacy to inquire whether omalizumab is available in Canada.
III only C. b and E e. American hospital journal c. I only B. He has just arrived from Hong Kong for a visit. She wants to know if he can get Dogmatil® here. All of the above Ans :D 97. American hospital journal c. Martindale. Canadian hospital journal b. what is the least important question he will ask about? A. A. communication skills Ans. New England medical journal Ans.: D 98-One of your regular patients comes to the pharmacy in search of Dogmatil® for her brother. When a manager wants to hire a pharmacist.: C . What are the primary sources of information? a. experience C. National formulary Ans-D 99. pharmacist qualifications B. Which of the following appropriate a. CPS d. The complete drug reference e. I and II only D. but his medication was lost with his luggage.I CPS II Medline III manufacturer leaflet A. II and III only E. Canadian hospital journal b. CPS d. She says her brother needs the medication for a mental condition and shouldn’t go without it. professional colleagues D.
A physician has prescribed 60 g of 0. c. no need to assess skills 104. A logical initial choice to use would be: A. but asks you to help her source information for a lecture. I only B. PubMed D.What advantage does the pharmacist have when using counseling aids with J. E-CPS C. used in conjunction with verbal counseling d. Methylphenidate (Ritalin) A. unbiased and accurate b. Dextroamphetamine sulfate (Dexidine) III.? a. no need to verbally counsel J.Which factor would reduce the effectiveness of print materials? a. no need to use a private counseling area d. CPS B. All of the above Ans: E 102. written at the grade 6-8 level c. Health Canada website E.J. Therapeutic choice Ans-C 101. III only C. saves time b. customized for patients Ans E 103.100-A diabetes teaching nurse knows that inhaled insulin will not be available in Canada in the immediate future. Darvon N II. Which one should be written down in the narcotic and controlled drug register I.J. no need to review or adjust materials e. You have available the commercially prepared cream containing 0. I and II D.2% fluocinolone acetonine . II and III E.01% fluocinolone acetonide cream. include numbered lists e.
23 mL are used to prepare a solution of concentration of 200.000 units/mL? A. to dilute the vial to produce a solution whose concentrations is 500.000 / 200.000.000 units/mL. Therefore the amount of sterile solvent requested is 10-2 = 8 mL Ans: A .01% fluocinolone acetonide (required in the Rx) contains 0. 25 Ans-A Working: i.2 g per 100 g = 0.000 = 25 mL.4 E.002 g fluocinolone per gramme of cream) Therefore. ii. 9.000 units/mL I need to be diluted to 5.000 units/mL. because 3 g Synalar and 60 g of Dermabase will give 63 g of total cream. 10 D. iii.2% fluocinolone acetonide (0.000 units).7 g Dermabase d) 3 g Synalar and 5 7 g Dermabase e) 12 g Synalar and 48 g Dermabase Ans-D Working: i.01/100 x 60 = 0. On the basis of this information. for the Rx you need 0.8 g Dermabase b) 3 g Synalar and 60 g Dermabase c) 0.2 C.0095% (0.(Synalar ® cream) and cream base (Dermabase ®) for dilution. 18. vial contains 5. Since no drug is removed from the vial (and it therefore still contains a total of 5.006 / 63 x 100) 105.000 units penicillin G potassium specifies that when 23mL of a sterile solvent are added to dry powder the resultant concentration is 200.000. iii. From (ii) we know that the powder occupies 2 mL of volume.000 units of penicillin G ii.006 g fluocinolone acetonide) You have 0.003 = 3 g Synalar cream Ans: D B is wrong.000 = 10 mL iv. This means that the volume of powder occupies 25-23 = 2 mL.2 g Synalar and 58.000. 60 g of 0.000. with a concentration of 0.006 / 0.3 g Synalar and 59.The package information enclosed with a vial containing 5. the total volume inside the vial is 5. To prepare the Rx you would require: a) 1.000/500. how many mL of sterile water injection should be used to prepare a solution containing penicillin G potassium 500. 8 B.000.
reactive A.Drug utilization review.Loan a 500 tablet full bottle and give back the unopened bottle within 48 hours III-Ask for 50 tabs and give back within 48 hours. I and II D. Drug utilization effectiveness is I. I only B. retrospective II. it is the process of quantitatively and systematically reviewing prescription claims data to evaluate the appropriateness of drug therapy. Which of the following procedure should you follow for the loan? I-Write percocet prescription for 50 tabs and record in your green narcotic book II. I only B. I. II and III E. You are receiving a prescription for 150 percocet tablets and when you checked. The patient needs it right now. All of the above Ans : A 107. III only C. you called the other pharmacy and they are ready to loan the tablets. III only C. you realized that there is only 100 tablets with you. II and III Ans: E .106. I and II D. prospective III. no recording is required A. II and III E.
Except: a. no effect of UV radiation in cloudy skies Ans: D 110. increase the dose twice Ans: A 112.108. What should you do to remedy the over dosage? a. In order to protect a baby from UV radiation. do stomach wash d. rush to emergency b. A baby swallowed a 15g tube of nystatin. avoid exposure to sunlight between 10am and 3 pm b.A baby had fever of viral origin. do not wake him up during the night to give him acetaminophen doses except if he had febrile seizures before Ans: B 109. give him acetaminophen five doses/day b. it was found that the Gentamycin is always below desired levels before infusion ends by half an hour. too low dose to get any serious side effects c. low therapeutic index c. increase the dose keep the same interval c. How can you manage the situation. use lotion SPF 15 d. A patient is treated with Gentamycin through IV infusion every 12h. all of the following should be done. What should the pharmacist consider in using interchangeable drugs? a. a. keep the dose the decrease the interval b. T max . use hat to protect his nose and ears from sunburns c. high therapeutic index b. increase the dose and decrease the interval d. give him acetaminophen not more than eight doses/day c.. avoid too much clothes d. give activated charcoal Ans: B TIPS: If more than 15g nystatin proper action should be refer to emergency 111. high AUC d. do all except: a.
for the eye A-0. How much water should be added to give a concentration of 100 mg/mL? a) 9.2. then the vial contains 1. the amount of water to be used to dilute is 10-0. Water 60 mL Make isosotonic solution Sig. When 3. you need to have 1. Since none was removed. we assume that the powder occpies (4-3.5 mL water was added to produce 4 mL of solution. the concentration of the resulting injectable is 250 mg/mL. Therefore.5 mL of volume. ii. chlorbutanol 0.5 mL of volume. Therefore.24.000/100 = 10 mL of final solution. But we know from above that the powder occupies 0. and the resulting concentration is 250 mg/mL. How many grams of boric acid should be used to compound the following Rx (NaCl equivalents: phenacetin 0.0 mL b) 9.5 mL Ans: B 114.66g C-0.33g D-348g E-0.54 .52) Phenacetin 1% Chlorbutanol ½% Boric acid q.5 mL of water is added to 1 g of penicillin powder. iii. Calculate number of NaCl equivalents required: (0.072g Ans-B Working: i.9 / 100) x 60 mL = 0.5 mL e) 12 mL Working: i. boric acid 0.000/250 = 4 mL (total penicillin is unchanged).Ans: A 113. Vial contains 1 g of penicillin powder.5) = 0. To dilute to 100 mg/mL.s.52g B-0.5 = 9.5 mL c) 10 mL d) 10. since only 3.
2 = 0. Vitamin D 10.12 Chlorbutanol: [(0. Tylenol c.24] = 0. Weight bearing exercise D. Calculate NaCl equivalents of each component as follows: Phenacetin: [(1/100) x 60] x 0.912 = 348 NaCl eg of boric acid are required Convert the above to grammes of boric acid: 348 NaCl Equivalents / 0.54 – (0.52 = 0. ibuprofen Ans: A .2 = 0.3 g x 0. indomethacin e. except: A. A father of a teenaged girl phones the pharmacy and asked him whether his daughter is taking birth control pills or not? What are the contradicting ethics pressing the pharmacist? a) Non-maleficence and confidentiality b) Beneficence and confidentiality c) Autonomy and confidentiality d) Veracity and confidentiality e) Justice and confidentiality Ans: D 116.24 = 0. Avoid smoking C.What will you recommend to a man with a swollen toe and has an allergy to NSAIDs? a. allopurinol d. Calcium diet E.5/100) x 60) x 0. Avoid alcohol B.072 Boric acid: Eq.669 g are required 115.000 IU Ans: E 117.All should be included in the lifestyle of an osteoporosis patient. Colchicin b.54 – 0.072) = 0.12 + 0.6 g x 0. iii. Required – [Eq phenacetin + Eq chlorbutanol] = 0.ii.
How do you apply methyl salicylates ointment for arthritis? I not to big areas II not to broken skin III use with wet compresses or hot pads a. III only c. I. A pharmacist needs to choose a brand of warfarin to give to a patient who has already started warfarin in the hospital. I and II d. Choose the brand used by hospital Choose the one with the quickest onset of action Choose the one with higher Cmax Product Price Profession Promotion Place a) I only b) III only c) I and II only d) II and III only e) All of the above Ans: A . II. Which of the following are correct? I. II and III Ans: C 119-All of the following are important fundamental principles of marketing EXCEPT: a) b) c) d) e) Ans: C 120. III. II and III e. I only b.118.
II and III e. II and III Ans : A 124. I only b. III only c. I and II d. I only b. II and III e. doxorubicine d. II and III Ans: D 122. aminophylline b. III only c. What is the treatment goal of psoriatic therapy? I reduce underlying inflammation II increase epidermal proliferation III eradicate the condition completely a. II and III e. magnesium sulfate e. I. I and II d. which one is correct? I pills should be used 10-15 minutes before travel II pills should be used at least 30 minutes before travel III dimenhydrinate Gravol can cause drowsiness a. I and II d.In motion sickness. nitroglycerin c. II and III Ans: E . III only c. I. penicillin Ans : C 123. I only b.Which one is true regarding minocycline 100mg BID and Minocycline 50 QID? I Css average is the same II Cmax is lower in 560mg QID III Tmax in 50mg QID is less than 100mg BID a.A vertical laminar flow hood should be the best choice to used for which of these medications? a. I.121.
What is appropriate/ a. III only c. Which one should be written down in the narcotic and controlled drug register I Darvon N II Dextroamphetamine sulfate (Dexidine) III methylphenidate (Ritalin) A I only B III only C I and II D II and III E I. Canadian doctor has to countersign Rx c. He needs a refill. Refer him to the emergency department E. II and III e. A patient got treatment from USA for cancer. Get from States under special access program if need same drug b. II and III Ans: E 127. I only b. Call drug information center for help Ans: D . Canadian Dr should write substitutes ans :B 128. Induce emesis-using ipecac C. II and III Ans: A 126. I and II d. I. A woman phoned the pharmacist and told him that her husband has swallowed 30tabs of acetaminophen 325mg. He will be all right. he should not worry and this not a serious concern B. What is the proper advice? A. How do we decide which one has faster onset of action? I by comparing the two Tmax I by comparing the rate of absorption III by comparing two AUC a. Call the poison center to ask for advice D. He got medicine from the States.A woman needs a sleeping pill and we have two brands of diazepam.125.
129. to ensure that therapy is as effective as possible in arresting or delaying joint damage and destruction c. I only b. volume of distribution (Vd) of lipid-soluble drug is increased Ans-E Ans: all of the above . ibuprofen c. II and III Ans. NSAIDs. Tylenol b. chloroquine.Counselling on PABA products includes: I stains cloths II it absorbs the UV III it blocks the UV rays a. three types of drugs are used to achieve the above target. I. III only c.A pianist woman comes to the doctor and complains of pain and she says she can’t do her regular job. I and II d. What is the goal in arthritis therapy? a. mersendol Ans: B 132. gold) and corticosteroids (prednisolone.: C 131. the protein binding of acidic drug is decreased III.Which one is true in the elderly? I-the hepatic metabolism (first pass effect) is decreased II. II and III e. intraarticular cortisone injection) D-All of the above Ans : all of the above 130. robaxacet e. Alcohol abuse patient with liver failure has headache what to give a. to allow the patient to function as normally as possible in the short term b. coated ASA d. DMARDs (methotrexate.
B and C Ans: D 133.Which one is true in treating a person who has been overdosed by meperidine? I.A woman started birth control 2 days ago. take it in the morning c. Which one is not related to her problem? a.Counselling on Hydrochlorthiazide (HCTZ) includes: a. having sex often d.132. all of the above e. candidiasis c. meperidine c. A and B Ans: B 135. all of the above e. do not wear contact lenses b. if naloxone does not work in the first shot it can be repeated III-. take with a glass of orange juice or banana (K-supplement) d. Trichomonas infection b. none of the above Ans: C .Which one should be recorded in the narcotic sales book a. She is sexually active and has vaginitis with discharge. Phenobarbital b.use naloxone as antidote II. Tylenol #3 d. naloxone will prevent the respiratory depression caused by meperidine Ans-E Ans: all of the above 134.
The following parameters would provide the best estimate of relative bioavailability for a drug ingested orally a) b) c) d) e) onset of drug action duration of drug action maximum plasma concentration area under the AUC serum half life Gastric lavage Syrup of ipecac Control of vital functions Electrolytes Blood analysis Ans: D 139. Ans: C .You get a phone call from a life insurance company asking about a patient’s current medication. A pharmacist needs to choose a brand of warfarin to give to a patient who has already started warfarin in the hospital. Choose the one with the quickest onset of action VI. What basic principle in the treatment of poisoning are the overlooking a) b) c) d) e) Ans-c 138. A doctor and nurse start frantically looking for naloxone for a female patient is suspected of overdosing of IV narcotics. Choose the one with higher Cmax a) I only b) III only c) I and II only d) II and III only e) All of the above Ans: A 137. Choose the brand used by hospital V. What should you do? A-Give the information without telling the patient B-Give the information and tell the patient later C-Do not give the information unless you have patient’s consent in writing D-Pharmacist have right to share information with physician and insurance companies E-Insurance company have right to get information from pharmacist.136. Which of the following are correct? IV.
Which action should be taken? I infusion of multivitamin thiamine (pyridoxine 100mg IV q day) for neurological symptoms II diazepam for withdrawal symptoms III phenytoin for convulsions a.0 mg/hr . II and III e. II and III Ans: E 141-A patient weighs 70 kg with normal renal function is injected with an IV drug for 10 hours.55mg/hr k = .693 936. T half of drugs is 1 hr and an apparent volume of distribution is 9Litres. I and II d.An alcoholic patient is being attended to in the emergency ward. I. I only b. III only c.693/ t1/2 = .693/ 1 = .0 mg/hr 1350. The desired plasma concentration is 15 mg/dl. What is the rate of infusion for this patient? a) b) c) d) e) Ans: A Comment: Vd = 9 L → 90 dL T ½ = 1 hr Css = 15 mg/dL R = Css x Vd x Kel = 15mg/dl x 90 dl x kel = 935.0 mg/hr 468.6 mg/hr 135.0 mg/hr 93.140.
I only B.20 g benzocaine and 8. she becomes concerned that she is not receiving the correct medication. Patient is being treated with ampicillin and gentamycin. temperature serum creatinine partial thromboplastin time 1 g of benzocaine and 9 g of ointment base 1. but went to her doctor because she still has no interest in doing things she used to enjoy. and continuous to lose weight. Venlafaxine. III only C. II.35 of benzocaine and 8. II and III E. I.75 g of ointment base 1. each with little or no effect. She has been somewhat controlled for the past six months with escitalopram (Lexapro) 10 mg daily. I and II D. IIIOlanzapine may cause extrapyramidal symptoms A. Which of the following appropriate counselling olanzapine: IExplain that increased appetite and weight gain may be beneficial side effects. The physician called your pharmacy and asked you to prepare him 10 g of 2.6 g of ointment base 1. II and III Ans-E . has trouble sleeping. and tells you her doctor is giving her another antidepressant. How much benzocaine and ointment base will you need for this prescription? a) b) c) d) e) Ans: C 143. In the past.25 g of benzocaine and 8. her depression was treated with clomipramine.5% of benzocaine ointment.142. In stock you have 20% benzocaine ointment. She presents with a prescription for olanzapine 5 mg daily. IISuggest that she let her doctor know if she is gaining too much weight.6 g of ointment base a) I only b) III only c) I and II only d) II and III only e) All of the above Ans-C 144-AZ is a 42-year old female who has a five-year history of major depressive disorder (MDD) without psychotic features.7 g of ointment base 1. When she reads in the patient information leaflet that the medication is used for schizophrenia. III. and the combination of paroxetine and lithium. Useful monitoring parameter/s is/are I.30 of benzocaine and 8.
II.145. give antacids to reduce GI upset take until finished take with food to decrease GI upsest a) I only b) III only c) I and II only d) II and III only e) All of the above Ans-D 146. I and II d. I only b. III only c. II and III Ans: B . The information that you can give to the patient when dispensing ketoconazole may include which of the following I.Which one does not need the label “shake well” I AEROSOLS II flonase III nitroglycerin pump (nitro lingual pump) a. I.Primary sources of information include which of the following? I-Canadian hospital journal II-American hospital journal III-Pharmacoeconomics Ans-E 147. II and III e. III.
I only B.149.A patient with shortness of breath. fosamax alendronate c. hormone replacement therapy d. What will be your conversation with the doctor? I fill the prescription the way it is II changing HCTZ to furosemide III decrease the dosage of digoxin A. Which one is the better therapy for this woman? a. All of the above Ans: D 150. verapamil and nitro lingual spray prn.A 74 year old female in a nursing home with osteoporosis is taking ibuprofen 300mg BID and ranitidine 150 mg BID. III only C. I and II D. swollen ankle. He is already taking HCTZ. didrocall etidronate b. Calcitonin Ans :D . II and III E. high blood pressure and exerciseinduced angina comes to the pharmacy with a Rx for digoxin 0.20mg/day.
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