REGISTRATION EXAMINATION

SAMPLE PAPER

AUTUMN 2003 (for examination sittings in 2004)

PART II (OPEN BOOK and CALCULATIONS)

Instructions to candidates:

1. For each question there are five options, A, B, C, D and E. Choose

only one of the options as your answer for each question.

2. You should answer the questions as though you were a registered

pharmacist, not a preregistration trainee.

3. There are 30 open book questions in this paper and 10 calculation questions i.e. the paper is half the size
of the actual registration examination open book/calculations paper.

4. You should score one mark for each correct answer: no marks to be deducted for incorrect answers or
omissions.

5. The time allowance for this paper is 75 minutes.

6. The reference sources that may be used in this test are the British
National Formulary Number 45 (March 2003 edition), the Drug
Tariff/Scottish Drug Tariff (March 2003 edition) and the Medicines,
Ethics and Practice guide Number 27 (July 2003 edition).

7. The use of calculators is not permitted.

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 SECTION I
(10 questions)

Directions for questions 1 to 10. Each of the questions or incomplete statements in this section is
followed by five suggested answers. Select the best answer in each case.

1. Sally is 3 years old and suffers from recurrent urinary-tract infections. Her doctor decides to
start her on prophylactic trimethoprim. A suitable daily dose is:

A 2 mg

B 30 mg

C 45 mg

D 60 mg

E 100 mg

2. Mr B has type 2 (non-insulin-dependent) diabetes mellitus and regularly takes gliclazide

tablets. He has been admitted to hospital to investigate the cause of his poor blood glucose
control. As part of the review you are asked to look at his current medication. Which one of the
following medicines is most likely to have adversely affected Mr B’s blood glucose levels?

A bendroflumethiazide (bendrofluazide) tablets 5 mg om

B prazosin tablets 1 mg tds

C tramadol 100 mg qds

D aspirin 75 mg om

E simvastatin 20 mg on

3. Mrs Q is 55 years old and is not exempt from paying prescription charges. She presents a
National Health Service prescription for the following items:

Tridestra tablets, 2 x OP
Adalat LA tablets 30 mg, 1 x 28
Scholl Class II thigh stockings, 1 pair

How many prescription charges is she required to pay?

A 1

B 2

C 3

D 5

E 6

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4. A woman asks for your advice. She is concerned after reading a magazine article which stated
that it is dangerous to drink grapefruit juice when taking some medicines for high blood
pressure. She currently takes Adizem-XL capsules 240mg om, and wishes to continue to have
a glass of grapefruit juice with her breakfast. Which one of the following responses should you
give?

A advise her to stop taking the Adizem-XL and have her blood pressure checked after
one week

B advise her to drink long-life, as opposed to fresh, grapefruit juice

C reassure her that there is no problem with grapefruit juice and her current medication

D advise her to take the Adizem-XL and grapefruit juice at least 2 hours apart

E suggest she makes an appointment with her medical practitioner about changing from
Adizem-XL to an alternative antihypertensive

5. You are asked to comment on the suitability of the following antibiotics for Mr N, who has a chest
infection and a glomerular filtration rate (GFR) of 35 mL/minute. Which one of the following
antibiotics is contraindicated?

A erythromycin

B cefalexin (cephalexin)

C ciprofloxacin

D amoxicillin (amoxycillin)

E oxytetracycline

6. XP Maxamaid has been approved by the Advisory Committee on Borderline Substances for
use in which one of the following groups of patients?

A patients with maple syrup urine disease

B patients with isovaleric acidaemia

C patients with hypermethioninaemia

D patients with phenylketonuria

E patients with tyrosinaemia

7. A young woman asks you to recommend something for her indigestion. After discussing the
non-prescription medicines available she decides to buy a pack of Zantac 75 tablets (ranitidine
75 mg tablets). Under the Marketing Authorisation, the treatment duration limit for continuous
self-medication with ranitidine when sold as a Pharmacy (P) medicine is:

A 3 days

B 7 days

C 10 days

D 14 days

E 28 days

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8. The following patients ask to buy a bottle of Pavacol D for their own use. You should not make
the sale to which one of them?

A a woman who takes Colpermin capsules

B a man who uses a salbutamol and beclometasone (beclomethasone) inhaler

C a woman who takes Microgynon 30 tablets

D a man who takes metformin tablets

E a woman who is breast-feeding her child

9. You receive the following prescription:

Hydrogen peroxide solution x 100 mL

Dilute 1 part with 3 parts tepid water before using as a dental cavity wash

What strength of hydrogen peroxide solution would be appropriate for you to supply?

A 10 volume

B 20 volume

C 40 volume

D 0.1%

E 1.5%

10. You are asked to advise on the choice of antibiotic(s) for Mrs V. She has a prosthetic heart
valve and is due to undergo gynaecological surgery under general anaesthesia so requires
prophylactic treatment to prevent endocarditis. Mrs V is not known to have any infection
currently, but is allergic to penicillin. Which one of the following should you recommend?

A amoxicillin

B vancomycin

C amoxicillin plus gentamicin

D vancomycin plus gentamicin

E clindamycin

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 SECTION II
(7 questions)

Directions for questions 11 to 17. For each numbered question select the one lettered option above it
which is most closely related to it. Within each group of questions each lettered option may be used
once, more than once, or not at all.

Questions 11 and 12 concern the following medicines:

A fluconazole capsules 50 mg

B metronidazole tablets 400 mg

C minocycline tablets 50 mg

D cefradine (cephradine) capsules 250 mg

E doxycycline capsules 100 mg

Select, from A to E, which one of the above:

11. will not be reimbursed if prescribed on a prescription form FP10D / GP14 (Scotland)

12. is used to treat giardiasis

Questions 13 and 14 concern the following medicines:

A temazepam 10 mg tablets

B phenobarbital (phenobarbitone) 30 mg tablets

C morphine sulphate 10 mg/5 mL oral solution

D diazepam 10 mg tablets

E morphine sulphate 100 mg/5 mL oral solution

Select, from A to E, which one of the above:

13. has to meet Controlled Drug handwriting requirements

14. does not require a licence for import and export

Questions 15 to 17 concern the following preparations:

A Synalar N cream

B Betnovate-C ointment

C Betnovate RD cream

D Alphaderm cream

E Halciderm Topical cream

Select, from A to E, which one of the above:

15. is classified as a 'very potent' corticosteroid preparation

16. contains parabens

17. can stain clothing

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 SECTION III
(7 questions)

Directions for questions 18 to 24. Each of the questions or incomplete statements in this section is
followed by three responses. For each question ONE or MORE of the responses is (are) correct. Decide
which of the responses is (are) correct. Then choose:

A if 1, 2 and 3 are correct

B if 1 and 2 only are correct

C if 2 and 3 only are correct

D if 1 only is correct

E if 3 only is correct

Directions Summarised
A B C D E
1, 2, 3 1, 2 2, 3 1 3
only only only only

18. Regarding the Royal Pharmaceutical Society’s guidance on developing and implementing
standard operating procedures (SOPs) for dispensing, which of the following statements is/are
true?

1 the requirement to put in place and implement SOPs does not apply to pharmacies
where no support staff are employed

2 the development of SOPs should normally be overseen by the pharmacist who is in

day to day charge of the pharmacy

3 SOPs should be reviewed at least once every 2 years

19. Yellow cards are available for reporting adverse drug reactions to the Medicines & Healthcare
products Regulatory Agency (formerly MCA). Adverse reactions to which of the following
should be reported using this system?

1 intra-uterine devices

2 contact lens fluids

3 X-ray contrast media

20. Regarding medicines for veterinary use, which of the following statements is/are true?

1 labels for dispensed veterinary medicines must state the type of animal for which the
medicine has been prescribed

2 sales of pharmacy and merchant list (PML) veterinary medicines from a registered
pharmacy must be supervised by a pharmacist

3 prescriptions written for prescription-only veterinary medicines must include a

declaration that the medicine is for an animal or herd under the veterinary surgeon’s
care

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 Directions Summarised
A B C D E
1, 2, 3 1, 2 2, 3 1 3
only only only only

21. Mrs K has Parkinson’s disease and has recently been prescribed cabergoline tablets. Which of
the following is/are dispensing requirement(s) for cabergoline tablets?

1 tablets should be dispensed in their original container

2 unused tablets should be discarded 4 weeks after first opening the container

3 women of child-bearing potential should avoid handling crushed or broken tablets

22. Which of the following is/are true when considering the provision of services to drug misusers?

1 a sugar free formulation of methadone liquid may be dispensed when the prescription
specifies a syrup, if requested by the patient

2 pharmacists providing services to drug misusers may decline to provide a service to a

patient whose conduct is unacceptable

3 a pharmacy that provides services to drug misusers must operate a patient

medication record system, notified to the Information Commissioner

23. Miss D has severe acne and her doctor has prescribed Roaccutane capsules for her. She
should be advised to:

1 avoid wax epilation

2 practise effective contraception

3 take the capsules with or after food

24. A person who holds a certificate of proficiency in ambulance paramedic skills issued by the
Secretary of State may administer which of the following parenteral prescription-only
medicines?

1 chlorphenamine (chlopheniramine) maleate

2 hydrocortisone sodium succinate

3 naloxone hydrochloride

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 SECTION IV
(6 questions)

Directions for questions 25 to 30. The following questions consist of a statement in the left-hand
column followed by a second statement in the right-hand column.

Decide whether the first statement is true or false.

Decide whether the second statement is true or false.

Then choose:

A if both statements are true and the second statement is a correct explanation of the
first statement

B if both statements are true but the second statement is NOT a correct explanation of
the first statement

C if the first statement is true but the second statement is false

D if the first statement is false but the second statement is true

E if both statements are false

Directions Summarised
First Second
Statement Statement
A True True 2nd statement is a correct explanation of the first
B True True 2nd statement is NOT a correct explanation of the first
C True False
D False True
E False False

Question 25 concerns a client who tells you that she currently obtains her vaginal contraceptive cap
(Dumas Vault Cap) and Duragel spermicidal gel free of charge from the local family planning clinic, but
wonders if she can obtain them from her GP on an NHS prescription.

25.
FIRST STATEMENT SECOND STATEMENT

The client can obtain these items via her GP on Contraceptive devices listed in the Drug Tariff
an NHS prescription and spermicidal preparations may be
prescribed on a prescription form FP10 / GP10
(Scotland)

26.
FIRST STATEMENT SECOND STATEMENT

Glyceryl trinitrate infusion must be administered Glyceryl trinitrate is incompatible with polyvinyl
using Viaflex or Steriflex containers chloride infusion containers

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 Directions Summarised
First Second
Statement Statement
A True True 2nd statement is a correct explanation of the first
B True True 2nd statement is NOT a correct explanation of the first
C True False
D False True
E False False

Question 27 concerns the information on the following standard NHS prescription, which has been
issued by a GP. You receive the prescription on 2.4.03:

27.
FIRST STATEMENT SECOND STATEMENT

The above prescription is legally valid Liquid preparations of morphine salts

containing no more than 0.2% morphine
(calculated as anhydrous morphine base), in
preparations from which the morphine cannot
be readily recovered in amounts which
constitute a risk to health, are classified as CD
Inv POM

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 Directions Summarised
First Second
Statement Statement
A True True 2nd statement is a correct explanation of the first
B True True 2nd statement is NOT a correct explanation of the first
C True False
D False True
E False False

28.
FIRST STATEMENT SECOND STATEMENT

Dispensed erythromycin stearate tablets should Antacids can damage enteric coatings designed
be labelled with “Do not take indigestion to prevent dissolution in the stomach
remedies at the same time of day as this
medicine”

Question 29 concerns the following extract from a National Health Service prescription form FP10 /
GP10 (Scotland) which has been endorsed 'Aldomet':

methyldopa 250 mg tabs

1 tds Mitte 90

29.
FIRST STATEMENT SECOND STATEMENT

The prescription will be returned from the Methyldopa is included in Part VIII Drug Tariff
pricing authority with no payment (England & Wales) / Part 7 (Scottish Drug Tariff)

30.
FIRST STATEMENT SECOND STATEMENT

Furosemide (frusemide) is contra-indicated in Hypokalaemia increases the risk of digoxin

patients with congestive cardiac failure who are toxicity
taking digoxin

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DESIGNATED CALCULATION QUESTIONS START HERE

Some of these questions will require use of the BNF, others will not.

Directions for questions 31(Calc) to 36(Calc). Each of the questions or incomplete statements in this
section is followed by five suggested answers. Select the best answer in each case.

Question 31(Calc) concerns the following extract from a prescription:

prednisolone 5 mg tablets

take 30 mg daily for 3 days then

reduce by 5 mg every 3 days
until the course is finished
(total course 18 days supply)

31(Calc). Which one of the following is the exact number of prednisolone 5 mg tablets that you should
supply?

A 126

B 84

C 63

D 56

E 18

32(Calc). Salbutamol Tablets BP are available as tablets containing salbutamol sulphate equivalent to 2
mg and 4 mg of salbutamol. To prepare salbutamol 2 mg tablets, what weight of salbutamol
sulphate is needed in each tablet?

molecular weights: salbutamol: C13 H21 NO3 = 239.3

salbutamol sulphate: (C13 H21 NO3)2 H2SO4 = 576.7

A 0.83 mg

B 1.66 mg

C 2.00 mg

D 2.41 mg

E 4.82 mg

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33(Calc). You receive a prescription for captopril 3.125 mg qds for 30 days. The lowest strength preparation
of captopril available to you is 12.5 mg tablets, each weighing 75 mg, so after discussion with the
prescriber you decide to supply 200 mg powders each containing 3.125 mg of captopril using
lactose as a diluent. What weight of lactose needs to be added to the tablets to supply the exact
amount required on the prescription?

A 15.125 g

B 21.75 g

C 22.8 g

D 23.625 g

E 24.75 g

34(Calc). A tablet contains 5% w/w of binder, which is added to the other ingredients during granulation
as a 25% w/v solution. What volume of this solution is required for the manufacture of 500,000
× 100 mg tablets?

A 50 litres

B 25 litres

C 12.5 litres

D 10 litres

E 5 litres

35(Calc). A boy weighing 15 kg has been admitted to hospital for a tonsillectomy. During the operation
he is given an intravenous dose of 4 micrograms/kg fentanyl injection. The fentanyl injection
contains 100 micrograms/2 mL. What volume of fentanyl injection should he have been given?

A 0.6 mL

B 1.2 mL

C 3.0 mL

D 6.0 mL

E 12 mL

36(Calc). Mr P has cardiovascular disease and is taking Gaviscon Advance suspension, 10 mL qds. You
are asked to calculate how many mmol of sodium ions Mr P receives each day from the
Gaviscon Advance suspension. Which one of the following is correct?

A 4.6 mmol

B 18.4 mmol

C 23 mmol

D 92 mmol

E 120 mmol

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Directions for questions 37(Calc) and 38(Calc). For each numbered question select the one lettered
option above it which is most closely related to it. Within the group of questions each lettered option may
be used once, more than once, or not at all.

Questions 37(Calc) and 38(Calc) concern the following quantities:

A 0.02 mg

B 0.2 mg

C 2 mg

D 20 mg

E 200 mg

Select, from A to E, which one of the above:

37(Calc). is the weight of thiamine hydrochloride contained in 20 mL of Metatone Tonic. Metatone Tonic
contains 500 micrograms of thiamine hydrochloride in 5mL.

38(Calc). is the weight of potassium chloride contained in 50 mL of a 0.4% solution

13
Directions for question 39(Calc). The question in this section is followed by three responses. For the
question below ONE or MORE of the responses is (are) correct. Decide which of the responses is (are)
correct. Then choose:

A if 1, 2 and 3 are correct

B if 1 and 2 only are correct

C if 2 and 3 only are correct

D if 1 only is correct

E if 3 only is correct

Directions Summarised
A B C D E
1, 2, 3 1, 2 2, 3 1 3
only only only only

39(Calc). Which of the following will provide a 0.3 mg dose of adrenaline / epinephrine?

1 3 mL of a 100 microgram/mL solution

2 0.3 mL of a 1 in 1000 solution

3 0.03 mL of a 1 in 10,000 solution

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Directions for question 40(Calc). The following question consists of a statement in the left-hand
column followed by a second statement in the right-hand column.

Decide whether the first statement is true or false.

Decide whether the second statement is true or false.

Then choose:

A if both statements are true and the second statement is a correct explanation of the
first statement

B if both statements are true but the second statement is NOT a correct explanation of
the first statement

C if the first statement is true but the second statement is false

D if the first statement is false but the second statement is true

E if both statements are false

Directions Summarised
First Second
Statement Statement
A True True 2nd statement is a correct explanation of the first
B True True 2nd statement is NOT a correct explanation of the first
C True False
D False True
E False False

Question 40(Calc) concerns the following scenario:

You receive a telephone call from a junior doctor working in the hospital’s Accident and Emergency
department. He is treating a patient with ventricular arrhythmias following myocardial infarction, and has
already given him 100 mg lidocaine (lignocaine) as a bolus dose. He now wants to start an infusion of
lidocaine using a standard bag of lidocaine 0.2%, and asks you to advise on the infusion rate.

40(Calc).
FIRST STATEMENT SECOND STATEMENT

The infusion rate should be set at 120 mL/hour The initial infusion rate of lidocaine for the
for the first 30 minutes treatment of ventricular arrhythmias is 4
mg/minute for the first 30 minutes

END OF QUESTIONS

Now go back and check your work

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