Sample Q

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SampleQuestions
PharmacistEvaluatingExaminationSampleQuestions
ThefollowingsamplequestionsareNOTintendedordesignedtobeasampleexamination,anddoNOTrepresentanexactmodelofthe
PharmacistEvaluatingExaminationintermsofdifficultyandproportionoftopics.However,individually,thesequestionsareintendedtobe
representative,informatandphrasingstyle,ofthetypesofquestionsfoundonthePharmacistEvaluatingExamination.Theyalsoillustratea
varietyofthesubjectareascontainedintheexaminationblueprint.Pleasenotethatthesequestionsarereviewedandupdatedperiodically.
Pleaseseebelowfortheanswerstothesesamplequestions.
BIOMEDICALSCIENCES
1Folicacidhastetrahydrofolatecoenzymeactivitywhichisbasedonthe:
a.pyrimidinering.
b.purinering.
c.pyrazinering.
d.pteridinering.
e.pyridinering.
2Enkephalinsarepeptidesthat:
a.havenarcoticantagonistactivity.
b.exertactionsresemblingthoseofopioids.
c.arefoundonlyinthecentralnervoussystem.
d.causebloodvesselwallrelaxation.
e.transmitpainimpulses.
3Caroteneistheprecursorof:
a.retinol.
b.thiamine.
c.calciferol.
http://www.pebc.ca/index.php/ci_id/3074/la_id/1/print/true/art_id/3126.htm
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d.riboflavin.
e.retinoicacid.
4Truestatementsregardingtranscriptionincludewhichofthefollowing?
a.TheenzymeresponsibleforinitiatingtranscriptionisRNApolymerase.
b.TheenzymeresponsibleforinitiatingtranscriptionisDNApolymerase.
c.Duringtranscription,thegeneticinformationcontainedinthenucleotidesequence
oftRNAistranslatedintoaproteinstructure.
d.Theprocessoftranscriptionincludesthesplicingofexons.
e.Followinginitiation,thenextstageoftranscriptionistermination.
5Diphtheriaiscausedby:
a.Plasmodium.
b.Vibrio.
c.Shigella.
d.Neisseria.
e.Corynebacterium.
6Whichofthefollowingbloodvesselstransportsnutrientrichbloodfromtheintestinestotheliver?
a.Hepaticartery
b.Hepaticportalvein
c.Greatsaphenousvein
d.Inferiorvenacava
e.Superiorvenacava
7Thebloodvolumeoftheaverageadultisapproximately:
a.5L.
b.10L.
c.15L.
d.20L.
e.25L.
8Inadults,communityacquiredpneumoniacausedbywhichofthefollowingorganismsisassociatedwiththehighestmortalityrate?
a.Chlamydiapneumoniae
b.Mycoplasmapneumoniae
c.Haemophilusinfluenzae
d.Streptococcuspneumoniae
e.Pneumocystisjirovecii
9Whichofthefollowingisthemajorinhibitoryneurotransmitterinthebrain?
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a.Gammaaminobutyricacid
b.Dopamine
c.Glutamate
d.Acetylcholine
e.Glycine
10WhichofthefollowingenzymescatalyzesthesynthesisofDNAfromviralRNA?
a.Reversetranscriptase
b.DNApolymerase
c.RNApolymerase
d.Endonuclease
e.AminoacyltRNAsynthetase
11Oftheessentialtransitionmetalionsfoundinthehumanbody,theonepresentathighestoverallconcentrationis:
a.copper.
b.cobalt.
c.iron.
d.manganese.
e.zinc.
12Theopticdiscisalsocalledthe:
a.blindspot.
b.cornea.
c.iris.
d.pupil.
e.maculalutea.
13Ifsystemicbloodpressuredecreases,whichofthefollowingwouldoccurtohelpreturnbloodpressuretonormal?
a.Increasedurineproduction
b.Increasedacetylcholinerelease
c.Increasedaldosteronesecretion
d.Increaseddiameterofsystemicarterioles
e.Increasederythropoietinproduction
PHARMACEUTICALSCIENCES
14Correctstatementsregardingreversedphasehighperformanceliquidchromatographyincludewhichofthefollowing?
IThestationaryphaseishydrophobic.
IIThemobilephaseispolar.
IIIThecompoundtobeseparatedisverypolar.
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a.Ionly
b.IIIonly
c.IandIIonly
d.IIandIIIonly
e.I,IIandIII
15IfthepKaofphenobarbitalis7.4,whatapproximatefractionofthedrugwouldbe
ionizedatpH8.4?
a.10%
b.30%
c.50%
d.90%
e.100%
16Allofthefollowingstatementsconcerningthelyophilizationofaparenteralproduct
arecorrect,EXCEPT:
a.thereisminimallossofactivityinheatlabilematerials.
b.theliquidmustbefrozentobelowtheeutectictemperature.
c.thesoluteusuallyformsanamorphousglass.
d.theeutectictemperatureisthefreezingpointofthedrugsolution.
e.waterisremovedfromthefrozenmixturebysublimation.
17Dopamineisusefulinthetreatmentofcardiogenicshockbecauseit:
a.selectivelydilatesrenalandmesentericvascularbeds.
b.doesnotinduceperipheralvasoconstriction.
c.decreasestheforceofmyocardialcontraction.
d.delaystheatrioventricular(AV)conductiontime.
e.prolongstheQTintervalontheECG.
18Concentrationofadruginbreastmilkexceedsthatinplasma,ifthedrug:
a.isbasic.
b.isproteinbound.
c.isacidicbutnotproteinbound.
d.hasasmallvolumeofdistribution.
e.hasalargevolumeofdistribution.
19MercapturicacidderivativesinphaseIImetabolismcanresultfromreactionsof:
a.glutathioneconjugates.
b.glucuronideconjugates.
c.glycineconjugates.
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d.glutamateconjugates.
e.sulfateconjugates.
20Tetrodotoxinisaselectiveinhibitorofthe:
a.calciumionchannel.
b.sodiumionchannel.
c.potassiumionchannel.
d.chlorideionchannel.
e.nicotinicionchannel.
21
Valproicacidismetabolizedbyaliphatichydroxylationtotheabovetwostructures.
Therelationshipbetweenthetwometabolitesillustratestheconceptof:
a.conformationalisomerism.
b.structuralisomerism.
c.geometricisomerism.
d.opticalisomerism.
e.diastereoisomerism.
22Carbonmonoxidebindsto:
Ihemoglobin.
IImyoglobin.
IIIcytochromeoxidase.
a.Ionly
b.IIIonly
c.IandIIonly
d.IIandIIIonly
e.I,IIandIII
23Truestatementsregardingipratropiumbromideincludeallofthefollowing,EXCEPTthatipratropiumbromide:
a.isacompetitivemuscarinicantagonist.
b.existsasaquaternaryammoniumcompound
c.ispoorlyabsorbedthroughairwayepithelium.
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d.requiresnebulizationforinhaledtherapy.
e.enhancesthebronchodilatoryeffectsoftheopyhlline.
24DiazepamInjectionU.S.P
Diazepam5mg/ml
Ethanol10%
Propyleneglycol40%
Benzylalcohol1.5%
WaterforInjectionqs100%
Intheformulationgivenabove,whichofthefollowingingredientsfunctionascosolvents?
IEthanol
IIPropyleneglycol
IIIBenzylalcohol
a.Ionly
b.IIIonly
c.IandIIonly
d.IIandIIIonly
e.I,IIandIII
25Bothisoxazoleandoxazoleringsarefoundassubstituentsinsomebacteriostaticsulfanilamides.Theyarepresentinthesestructures
specificallybecauseoftheir:
a.sizesandshapes.
b.tautomericactivities.
c.enzymaticactivities.
d.electrondonatingeffects.
e.electronwithdrawingeffects.
26TheMichaelisMentenequationwillappearfirstorder:
a.whenthesubstrateconcentrationismuchsmallerthanKm.
b.whenKmismuchsmallerthanthesubstrateconcentration.
c.whenVmax ismuchsmallerthanKm.
d.whenVmax ismuchlargerthanKm.
e.whenKmapproachesVmax .
27Withrespecttobioequivalence,theparameterCmax is:
a.affectedbytheextentofabsorptiononly.
b.affectedbytherateofabsorptiononly.
c.affectedbyneitherratenorextentofabsorption.
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d.affectedbybothrateandextentofabsorption.
e.theonlysignificantparameter.
28
Whichofthehydroxylsinthecompoundaboveisatertiaryalcohol?
a.Hydroxyl1
b.Hydroxyl2
c.Hydroxyl3
d.Hydroxyl4
e.Hydroxyls1and2
29
Theabovestructuresarerelatedtooneanotheras:
a.bioisosteres.
b.enantiomers.
c.homologs.
d.rotamers.
e.positional(structural)isomers.
30Fivesubjectsgivenasingleintravenousdoseofadrughavethefollowingeliminationhalflives:3,9,6,5and4h(hours).Themeanhalflife
is:
a.4h.
b.5h.
c.5.4h.
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d.5.8h.
e.6h.
31Reasonsforusingcoatingsontabletsincludeallofthefollowing,EXCEPT:
a.tomaskthetasteofthedrug.
b.tomasktheodorofthedrug.
c.toimprovetheappearanceofthetablet.
d.toincreasethedrugsreleaserate.
e.toprotectthedrugfromstomachacid.
32Whichofthefollowingfactorswouldbeimportantindeterminingtheconcentrationofdrugthatwouldbereachedinthecerebrospinalfluidfor
treatmentofmeningitis?
IOil/waterpartitioncoefficient
IIBindingtoplasmaprotein
IIIpKaofthedrug
a.Ionly
b.IIIonly
c.IandIIonly
d.IIandIIIonly
e.I,IIandIII
33Whichofthefollowingtermsindicatesalossofmoisture?
a.Deliquescence
b.Efflorescence
c.Hygroscopicity
d.Polymorphism
e.Condensation
34WhichofthefollowingstatementsisFALSEregardingtabletformulation?
a.Diluentsarefillerstoaddbulktothetablet.
b.Lubricantshelpthepatienttoswallowthetabletmoreeasily.
c.Bindingagentsmaybeaddeddryorinsolution.
d.Disintegrantsdrawwaterintothetabletcausingittoburst.
e.Glidantspromotetheflowofmaterialsduringcompression.
35Factorsthatdeterminebioequivalenceoftwobrandsofadruginclude:
Ithetasteofthepreparations.
IIthephysicalappearanceofthepreparations.
IIIpharmacokineticparametersofthepreparations.
a.Ionly
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b.IIIonly
c.IandIIonly
d.IIandIIIonly
e.I,IIandIII
36Ifthetotalbodyclearanceofadrugis200mL/mininanormalhealthyadultandtherenalclearanceis10mL/minthenonemayassumethat:
a.thedrugisextensivelymetabolized.
b.greaterthannormaldrugaccumulationwouldoccurinpatientswithmoderaterenalfailure
c.enterohepaticrecyclingissignificant.
d.thedrugisnotboundtoplasmaproteins.
e.thedrugisconcentratedinadiposetissue.
37Themajorpathwayforthebiotransformationofthefollowingcompoundisbyhydrolysis.Identifythesitewhichwouldbemostsusceptibleto
hydrolysis.
a.A
b.B
c.C
d.D
e.E
38Mechanismsofdruginteractionswithacetylsalicylicacid(ASA)include:
a.inductionofmicrosomalenzymes.
b.inhibitionofmicrosomalenzymes.
c.inhibitionofliposomalenzymes.
d.displacementofotherdrugsboundtoserumalbumin.
e.enhancedplateletaggregation.
39WhichofthefollowingdiureticsisusedtoblocktheNa+H+exchangesystemoftherenaltubule?
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a.Furosemide
b.Hydrochlorothiazide
c.Spironolactone
d.Acetazolamide
e.Amiloride
40Atropinepoisoningcanberecognizedbyallofthefollowingsignsorsymptoms,EXCEPT:
a.dryskin.
b.flushedappearance.
c.deliriumandrestlessness.
d.mydriasis.
e.diarrhea.
41Theorganophosphatescommonlyfoundininsecticidesarethoughttoactbywhichofthefollowingmechanisms?
a.Combiningwithacetylcholine
b.Potentiatingtheactionofacetylcholinesterase
c.Formingaverystablecomplexwithacetylcholinesterase
d.Reactingatthecholinergicreceptor
e.Preventingthereleaseofacetylcholinefromthenerveending
42Acarbosesmoothsandlowers:
a.postprandialbloodglucoselevelsbyblockingabsorptionofcarbohydrates.
b.postprandialbloodglucoselevelsbydelayingabsorptionofcarbohydrates.
c.preprandialbloodglucoselevelsbyblockingabsorptionofcarbohydrates.
d.preprandialbloodglucoselevelsbydelayingabsorptionofcarbohydrates.
e.preprandialandpostprandialbloodglucoselevelsbyblockingabsorptionofcarbohydrates.
43Whichofthefollowingstatementsistrueregardingtheuseofmonoclonalantibodydrugtherapies?
a.Flulikesymptomscommonlyoccuratthestartoftherapy.
b.Tcellsarestimulatedandwillinitiateahostrejectionprocess.
c.Adalimumabisamurinederivedimmunoglobulinmonoclonalantibodyproduct.
d.Useofchimericmonoclonalantibodiesisassociatedwithincreasedimmunogenicity.
e.UseofFcfragmentsavoidsraisinganimmuneresponseagainsttheFABpart.
QUESTIONS44TO46INCLUSIVEREFERTOTHEFOLLOWING:
A3yearoldchildwasadmittedtothehospitalfollowingingestionofanoverdoseofacetylsalicylicacid.Thechildwassemicomatose,
flushedandflaccid.Herpupilswerefixedanddilated.Respirationsweredeepandrapid.Laboratoryinvestigationindicatedserum
salicylatelevelof5.8mmol/LandaurinarypHof6.
44Thesyndromeofdeepandrapidrespirationswouldinitiallyleadto:
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a.respiratoryacidosis.
b.respiratoryalkalosis.
c.renalexcretionofacid.
d.markedreductioninbodytemperature.
e.increasedchlorideeliminationinurine.
45Asaresultofothermechanismsthechildwouldlikelyprogressto:
a.hyperglycemia.
b.hypoglycemia.
c.metabolicalkalosis.
d.systemicacidosis.
e.renalfailure.
46Oneformoftherapytohastentheexcretionofsalicylateinvolvestheadministrationof:
a.vasopressin(ADH).
b.probenecid.
c.ammoniumchloride.
d.sodiumbicarbonate.
e.aluminumhydroxide.
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47Thefractionofboundreceptorsinawelldefineddrugreceptorbindingsystemisdeterminedby:
Itheequilibriumdrugreceptordissociationconstant.
IIthefreedrugconcentration.
IIIthetotalreceptorconcentration.
a.Ionly
b.IIIonly
c.IandIIonly
d.IIandIIIonly
e.I,IIandIII
48Insomeparenteralformulations,sodiummetabisulphiteisincludedas:
a.anantioxidant.
b.achelator.
c.asolubilizer.
d.acosolvent.
e.anemulsifier.
49Thecarbonicanhydraseinhibitordorzolamideisstructurallyclassifiedasa:
a.biguanide.
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b.butyrophenone.
c.sulfonamide.
d.sulfonylurea.
e.thiazolidinedione.
50WhichofthefollowingstatementsisFALSEregardingvirusvectorsusedintheproductionofbiotechnologydrugs?
a.Virusescanbeintroducedbynutrients.
b.Virusescanbegeneratedbyaninfectedproductioncellline.
c.Themostfrequentsourceofvirusintroductionisthegrowthmedia.
d.Virusescanbeinactivatedbyphysicalorchemicaltreatmentoftheproduct.
e.Thereisatrendtowardusingbetterdefinedgrowthmediainwhichserumlevelsaresignificantlyreduced.
51WhichofthefollowingexcipientsisNOTcommonlyfoundinbiotechnologyformulations?
a.Albumin
b.Lysine
c.Tween20
d.Saline
e.Phosphate
52Anangiotensinconvertingenzyme(ACE)inhibitorforwhichbothrenaleliminationandmetabolismareimportantintheeliminationofthedrug
anditsactivemetabolitesis:
a.enalapril.
b.fosinopril.
c.lisinopril.
d.quinapril.
e.ramipril.
53Oncedailydosingofaminoglycosidesiseffectivedueto:
a.prolongedresidenceoftheantibioticinthebody.
b.postantimicrobialeffect.
c.enhancedtissueaccumulation.
d.reducedrenalclearance.
e.higherpeaktroughdifferences.
54Themethodofionizationofmassspectrometrywhichresultsinwellestablisheddiagnosticfragmentationpatternsthatareusefulinthe
identificationofcompoundsofunknownstructureiscalled:
a.atmosphericpressurechemicalionization(APCI).
b.chemicalionization(CI).
c.electronimpact(EI)ionization.
d.electrosprayionization(ESI).
e.fastatombombardment(FAB)ionization.
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55Anophthalmicsolutioncontainszincsulfate0.25%,phenylephrineHCl0.12%andboricacid1.1%(NaClequivalents:zincsulfate0.15,
phenylephrineHCl0.32,boricacid0.5).Relativetolacrimalfluid,thesolutionis:
a.isotonic.
b.hypotonic.
c.hypertonic.
d.hyperosmotic.
e.isoosmotic.
PHARMACYPRACTICEClinicalSciences
56Whichofthefollowingstatementsistrueregardingnitratetolerance?
a.Tolerancedoesnotoccurwithoralisosorbidedinitrate.
b.Tolerancedoesnotoccurinpatientswhoareconcurrentlyonmetoprolol.
c.Toleranceisdependentupontheadministrationscheduleofnitratemedication.
d.Tolerancedoesnotoccurwithtopicalnitroglycerinointment.
e.Tolerancedoesnotoccurwithtransdermalnitroglycerin.
57Theshockandairwayedemaofanaphylaxisarebesttreatedwith:
a.salbutamol.
b.diphenhydramine.
c.epinephrine.
d.acetazolamide.
e.aminophylline.
58Whichofthefollowingstatementsistrueregardingpioglitazonetherapy?
a.Itrequiresongoingmonitoringofrenalfunction.
b.Itdoesnotdependonthepresenceofinsulinforitsaction.
c.Multipledailydosingisrequiredduetoitsshorthalflife.
d.Pulmonaryfibrosisisararebutseriousadverseeffect.
e.Ithasshownbenefitsinreducingglycosylatedhemoglobinlevels.
59Prednisonemayproduceallofthefollowingeffects,EXCEPT:
a.skeletalmuscleweakness.
b.hypoglycemia.
c.sodiumretention.
d.pepticulceration.
e.loweredresistancetoinfection.
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SMisa34yearoldfemalewho,whilevacationinginMexico,beganprophylactictreatmentfortravellers'diarrhea.Shortlythereafter
shecomplainedofafeelingoffullnessinherears,blackstoolsandablacktongue.SMsprevioushistoryincludesanallergyto
sulfonamides.
60WhichofthefollowingdrugscouldbethecauseofSM'scomplaints?
a.Bismuthsubsalicylate
b.Cotrimoxazole
c.Doxycycline
d.Amoxicillin
e.Loperamide
61Organismscommonlyimplicatedinthecauseoftravellers'diarrheainclude:
IBacteroidesfragilis.
IIEscherichiacoli.
IIIShigellasp.
a.Ionly
b.IIIonly
c.IandIIonly
d.IIandIIIonly
e.I,IIandIII
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62Whichofthefollowingmedicationsrequiresmonitoringfortheadverseeffectofdyslipidemia?
a.Ciprofloxacin
b.Allopurinol
c.Isotretinoin
d.Ramipril
e.Raloxifene
63IntheInternationalSystemofUnits(SI),mostdruglevelsaretobereportedintheunitsofmicromoles/litre(mol/L).Thetherapeutic
concentrationrangefortheophylline(molecularweight180)is1020mcg/mL.TheSIequivalentwouldbe:
a.0.0550.11mol/L.
b.2755mol/L.
c.55110mol/L.
d.110220mol/L.
e.180360mol/L.
64Themotherofa6yearoldchildpresentstothepharmacistwithawrittenprescriptionforamoxicillinthatwasorderedbythephysician3days
earlier.Shestatesthatherchildwasdiagnosedwithotitismediaandthesymptomshaveremainedthesameoverthepast3days.Whichofthe
followingisthemostappropriatepharmacistresponse?
a.Filltheprescriptionaswritten.
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b.Refusetofilltheprescriptionastheantibioticorderisnolongercurrent.
c.Indicateaneedtocontacttheprescriberbeforefillingtheprescriptionatthistime.
d.Filltheprescriptionforaquantitythatistheorderedamountlessthreedayssupply.
e.Explainthat,atthislatedate,antibiotictherapywilllikelybeineffectiveforthechild.
65RFisan80yearoldfemalewhodevelopedCDAD(Clostridiumdifficileassociateddiarrhea)afterrecenttreatmentofaurinarytractinfection
withciprofloxacin.Sheisadmittedtohospitalwithprofounddiarrhea(8waterybowelmovementsperday)andfever.Basedonhersymptoms,
whichofthefollowingisthemostappropriatetherapychoiceforher?
a.Oralmetronidazole
b.Intravenousmetronidazole
c.Oralcholestyramine
d.Oralvancomycin
e.Intravenousvancomycin
66CC,a72yearoldfemale,complainstothepharmacistthatherstomachhasbeenbotheringherrecently.Currentmedicationsinclude:
levothyroxine0.1mgpodaily(x30years),acetaminophen500mgpoqid(x5months),atorvastatin40mgpohs(x4years),ibuprofen400mg
potidprnjointpain(x2months)andzopiclone3.75mgpohsprn(x3months).BasedonCC'scurrentsymptoms,whichofthefollowingdrug
therapyproblemsbestdescribesCCscurrentsituation?
a.Toohighadosageofatorvastatin
b.Toohighadosageofzopiclone
c.Needforcytoprotectionwithibuprofen
d.Druginteractionbetweenatorvastatinandzopiclone
e.Toolowadosageoflevothyroxine
67A27yearoldpatientpresentstoacommunitypharmacyforthefirsttimeandtellsthepharmacistthatheexperiencedanallergytoapenicillin
productasachild.Hissymptomsincludedhives,wheezingandfacialswelling,whichresultedinhospitalizedcare.Whichofthefollowingisthe
mostimportantreasonforacommunitypharmacisttodocumentthistypeofinformationinapatientsmedicationprofilerecord?
a.Toprovidedrugallergyinformationtothepatientsinsuranceprovider
b.Toencouragethepatienttofillfutureprescriptionsatthispharmacy
c.Toadvertiserelevantpharmacyproductsorservicestoappropriatepatients
d.Toenhancecontinuityofpatientcareregardlessoftheprescriber
e.Toprovidearecordofcognitiveservicesforinsurancereimbursement
TKisa63yearoldmalewithchronickidneydisease(CrCl=29mL/min/1.73m2)andgout.Heexperiencedhislastgoutattackabout2
monthsago.Todayhistoeisextremelypainful,hot,redandswollen.Atawalkinclinic,hereceivesaprescriptionfornaproxen500
mgpobidfor5days.TKsothercurrentmedicationispravastatin20mgpohs.
68WhatdrugtherapyproblemshouldthepharmacistidentifyforTK?
a.Naproxenisinferiortoindomethacinforthetreatmentofacutegout.
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b.Thedurationofnaproxentreatmentistooshort.
c.Naproxenshouldbeavoidedinpatientstakingpravastatin.
d.Naproxenshouldbeavoidedinpatientswithrenaldysfunction.
e.Thefrequencyofnaproxendosingistoolow.
69Followingsuccessfulresolutionoftheacuteepisode,TKsphysiciandecidesthatheshouldinitiateallopurinol.TKshouldbeadvisedto:
a.limitfluidintake.
b.takemedicationonanemptystomach.
c.useprecautionstoavoidphotosensitivity.
d.reportanyskinrashoritchingtothephysician.
e.avoiddairyproductsormultivitaminswithin2hoursofdose.
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70Allofthefollowinghavebeenimplicatedincausingtoxicnephropathy,EXCEPT:
a.cyclosporine.
b.sulfonamides.
c.cisplatin.
d.penicillamine.
e.erythromycin.
71Inthetreatmentofapatientwhohasasolidtumour,whichofthefollowingsideeffectstypicallyoccurs1to2weeksafterchemotherapy?
a.Neuropathy.
b.Cardiotoxicity.
c.Neutropenia.
d.Emesis.
e.Nephrotoxicity.
72Lactoseintoleranceisclassifiedasa(n):
a.allergy.
b.enzymedeficiency.
c.mineraldeficiency.
d.transporterabnormality.
e.vitamindeficiency.
73Parkinson'sdiseaseischaracterizedbyadeficiencyof:
a.acetylcholineinthemotorcortex.
b.noradrenalineinthespinalmotorneurons.
c.gammaaminobutyricacid(GABA)ininhibitorypathways.
d.dopamineinthenigrostriatalpathway.
e.serotonininthebrainstem.
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74Allofthefollowingstatementsaretrueregardingchronicinflammation,EXCEPT:
a.itmaydevelopasagranulomatousinflammation.
b.itmaybecausedbypersistentinfectionssuchastuberculosis.
c.itmayoccurwithautoimmunediseasessuchasrheumatoidarthritis.
d.largenumbersofmacrophagesarefoundintheinfiltrate.
e.lymphocytesandeosinophilsarerarelyinvolvedinitsdevelopment.
75Whichofthefollowingischaracterizedasanautoimmunedisorder?
a.Alzheimersdisease
b.SystemicLupusErythematosus
c.Osteoarthritis
d.Parkinsonsdisease
e.Pagetsdisease
76Apregnantfemalepresentswithaprescriptionforanantibioticfortreatmentofaurinarytractinfection.Shetellsthepharmacistthatshe
doesntknowwhythedoctorgaveherthemedication,becausesheisntexperiencinganysymptoms.Herpresentationisconsistentwithwhich
ofthefollowingdiagnoses?
a.Cystitis
b.Septicemia
c.Urinaryretention
d.Pyelonephritis
e.Asymptomaticbacteriuria
77Acommunitypharmacistwouldliketobeginadiabeticeducationprogramforlocalpatientsnewlydiagnosedwithtype2diabetesmellitus.
BeneficialinformationforthisgroupincludesallofthefollowingEXCEPT:
a.strategiestominimizecardiacriskfactors.
b.factsondiabetesanditscomplications.
c.useofthevariousglucometers.
d.appropriatedietaryrecommendations.
e.techniqueforthemixingofinsulins.
PHARMACYPRACTICEProfessionalPracticeSkills
78WhichofthefollowingisNOTabenefitofperformingmedicationreconciliationactivitiesinahospitalsetting?
a.Reductionofmedicationerrors
b.Reductionofinventorypilferage
c.Reductionofpreventableadverseeffects
d.Assessmentofpatientadherencetotherapy
e.Enhancedaccuracyofpatientallergyinformation
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79TheCompendiumofPharmaceuticalsandSpecialties(CPS)isausefulresourceforlocatingwhichofthefollowing?
a.Clinicalrecommendationsfordentalprophylaxisofbacterialendocarditis
b.DetailedmonographsforallprescriptionpharmaceuticalsavailableinCanada
c.ApprovedindicationsforallprescriptionandnonprescriptionpharmaceuticalsinCanada
d.Canadianconsensusguidelinesondrugtherapiesusedtotreathypertension
e.Bioequivalencedatacomparinginterchangeablepharmaceuticalproducts
80Indispensing,theLatinabbreviationfor"beforemeals"is:
a.ac.
b.aa.
c.pc.
d.ic.
e.cc.
81Indispensing,theEnglishmeaningfortheLatinphraseexaquais:
a.withorinwater.
b.extracellularfluids.
c.exactamount.
d.solubleinwater.
e.outofwater.
82AerosolOT(AOT)isusedinveterinarymedicineasalaxative.If250gofAOTisdissolvedin1000mLofglycerin(densityofglycerinis1.25
g/mL),theconcentrationofAOTinthesolutionis:
a.12.5%w/w.
b.16.7%w/w.
c.20.0%w/w.
d.23.8%w/w.
e.25.0%w/w.
83AppropriatequalitycontrolprocedurestoensureproductandpatientsafetyinthepharmacydoNOTincludewhichofthefollowing?
a.Adheringtoguidelinesforcoldchainmanagement.
b.Maintainingaregularcleaningschedulefordispensarysurfaces.
c.Cleaningcountingtraysandautomatedcountingmachinesregularly.
d.UsingTALLmanletteringonallprescriptionlabels.
e.Regulatingthepharmacysindoorclimatewheremedicationsarestored.
84Thehospitalpharmacistisaskedforadvicefromaphysicianafteranewlyadmittedpatientisdiagnosedwithischemicstroke.Intheselection
ofdrugtherapyfortheinitialmanagementofthispatient,thepharmacistwouldfindallofthefollowingresourcesuseful,EXCEPT:
a.publishedclinicalguidelines.
b.HarrisonsPrinciplesofInternalMedicine.
c.primaryjournalarticles.
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d.CompendiumofTherapeuticChoices.
e.CompendiumofSelfCareProducts.
85Thepharmacistfillsaprescriptionforsumatriptan100mgtabletsforamigrainepatient.Appropriateinformationtoprovidetothepatient
includeswhichofthefollowing?
a.Ifthesumatriptandoesnotrelievetheheadachewithinfourhours,ergotaminemaybeused.
b.Ifnoreliefisachievedintwohours,sumatriptanmayberepeated.
c.Iftheheadacheisrelievedbutanotherheadacheoccurseighthourslater,sumatriptanmaybeusedforthesecondheadache.
d.Themaximumdosageinany24hourperiodissixtablets.
e.Ifreliefisnotachieved,noothermedicationcanbeusedfor24hours.
86Whichofthefollowingisappropriateauxiliarylabellingforallopurinol?
a.Takewithplentyoffluids.
b.Takeonanemptystomach.
c.Avoidconcurrentintakeofdairyproducts.
d.Avoidconcurrentintakeofgrapefruitjuice.
e.Exposuretosunlightmaycauseadversereactions.
87Therecommendedpediatricdosageforazithromycintherapyis12mg/kgpooncedailyonDays1through5.Forachildweighing8.3kg,
calculatethetotalvolumeneededforthetotalcourseoftreatment,ifaproductsupplying200mg/5mLissuppliedforthisorder.
a.12.5mL
b.15mL
c.25mL
d.37.5mL
e.50mL
88Apharmacistismakingapresentationonmedicationadherencetoagroupofclients.Whichofthefollowingwouldbethemostappropriate
indicatoroftheeffectivenessofthepresentationfortheseclients?
a.Increaseinfillquantityforeachprescriptionrefill
b.Reducednumberofprescriptionsfilledpermonth
c.Increaseinnumberofnonprescriptionmedicationsused
d.Reducednumberofprescriptionrefilldatespermonth
e.Prescriptionrefilldatesclosertoexpectedfillintervals
89Rx Timolol0.25%drops
Mitte:15mL
Sig:gtt.io.d.bid
Ontheprescriptionlabeltheinstructionstothepatientshouldread:
a.applyonedropintobotheyestwicedaily.
b.instilonedropintothelefteyetwicedaily.
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c.instilonedropintotherighteyetwicedaily.
d.shakewellandinstilonedropintothelefteyetwicedaily.
e.shakewellandinstilonedropintotherighteartwicedaily.
90Thefollowingprescriptionisreceivedinacommunitypharmacy:
Losec 20mg
S:ipobid
M:2weeks
Whichofthefollowingiscorrectlabellingforthisprescription?
a.Takeonetablettwiceweekly(28tablets).
b.Takeonetablettwiceweekly(4tablets).
c.Taketwotabletstwicedaily(56tablets).
d.Takeonetablettwicedaily(28tablets).
e.Takeonetablettwicedaily(14tablets)
91WhichofthefollowingstatementsistrueregardingTylenolElixirWithCodeine(each5mlcontainsacetaminophen160mgandcodeine8
mg)?
a.Itrequiresawrittenorderfromanauthorizedprescriber.
b.Itisanexampleofalegallyexemptedcodeineproduct.
c.Saleforselfmedicationusemustinvolveapharmacist.
d.ItisregulatedundertheBenzodiazepinesandOtherTargetedSubstancesAct.
e.Authorizedprescribersincludechiropractors.
92Aphysicianwantstoswitchaterminallyillpatientfromslowreleasemorphinesulfatetablets,15mgtwicedaily,toaliquidmorphinesulfate
dosageformbecausethepatienthasdifficultyinswallowingtablets.Ifamorphinesulfatesolutioncontaining5mgpermLisprescribedq4h,what
volumeshouldbedispensedfora20daysupplytoprovidethesamepainreliefasthetabletregimen?
a.20mL
b.60mL
c.80mL
d.100mL
e.120mL
93Averticallaminarflowhood(LFH)ispreferredtoahorizontalLFHwhenpreparingaparenteralformulationof:
a.aminophylline.
b.doxorubicin.
c.magnesiumsulfate.
d.nitroglycerin.
e.penicillin.
94Whichofthefollowingdrugordersisincompleteandrequiresfollowupwiththeprescriber?
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a.ZithromaxZPak (azithromycin250mg),2tabspoonday1and1tabpoondays25.
b.Flonase(fluticasone)100mcgspray,1or2spraysineachnostrilbidx1bottle
c.Actonel(risedronate),35mgpoonceweeklyx12tabs
d.Cozaar(losartan),50mgpobidx1month
e.Zocor(simvastatin),1tabpohsfor3months
95Inestablishingaprofessionalrelationshipwithapatient,whichofthefollowingprinciplesistheLEASTcompatiblewiththephilosophyof
pharmaceuticalcare?
a.Autonomy.
b.Nonmaleficence.
c.Confidentiality.
d.Paternalism.
e.Veracity.
96JN,a17yearoldmalewithahighlyresistantformoftesticularcancer,isinhospitalfortreatment.Heisanintelligent,articulateyoungman.
Hisparentsareinsistingthatthephysiciantreathimwiththelatestexperimentaltherapy,butJNdoesnotwanttoundergothetreatment.Ifthe
physiciangoesaheadandgivestheexperimentaltherapywhatethicalprinciplewillhavebeenviolatedthemost?
a.Confidentiality
b.Nonmaleficence
c.Justice
d.Veracity
e.Autonomy
97Whichofthefollowingstatementsiscorrectregardinghypothesistesting?
a.AtypeIerrorfrequentlyoccurswhensamplesizesaresmall.
b.AtypeIIerrorismoreseriousthanatypeIerror.
c.Smallpvaluessuggestthatthenullhypothesisislikelytobetrue.
d.Thelargerthepvalue,themorelikelythenullhypothesisisfalse.
e.Pvalueistheprobabilityofwronglyrejectingthenullhypothesisifitisinfacttrue.
98Anadequatelypowered,randomizedcontrolledtrialconductedover2yearsdemonstratedthattheprimaryoutcome(aseriouscardiovascular
event)occurredin15%ofthepatientswhoreceivedthenewdrug,whereastheprimaryoutcomeoccurredin25%ofthepatientswhoreceiveda
placebo.Therelativeriskreductionachievedwiththenewdrugis:
a.10%.
b.15%.
c.25%.
d.40%.
e.50%.
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99Inanadequatelypowered,randomizedcontrolledtrialconductedover3years,aspecificserioussideeffect(i.e.,reductioninleukocytes)with
conventionaltherapyisseenin0.5%ofthestudysample.Inpatientswhoreceiveanewlydiscovereddrug,only0.45%experiencethesame
sideeffect.Basedontheseresults,theminimumnumberofpatientsthatwouldhavetoreceivethenewdrugfor3yearstostatistically
demonstratethepreventionofoneepisodeofthissideeffectinatleastonepatientis:
a.15.
b.20.
c.150.
d.200.
e.2000.
100Inastudycomparing2drugtreatmentregimens,atypeIIerroroccurswhen:
a.thestatisticalconclusionisthatthereisadifferencebetweenthe2treatmentregimenswhenadifferencedoesnotactuallyexist.
b.thestatisticalconclusionisthatthereisnodifferencebetweenthe2treatmentregimenswhenadifferenceactuallydoesexist.
c.theplevelis>0.05.
d.thedrugtreatmentsstudiedarenotappropriatecomparatorsforthedisease.
e.theexclusioncriteriaaretoorestrictive.
101Apharmacisthasreceivedinformationregardinganewdrugtotreathypertension.Theinformationisbasedona2month,placebo
controlled,randomizedstudyof1000adultsthatshowedastatisticallysignificantaveragedecreaseinsystolicpressurefrom160mmHgto141
mmHgandindiastolicpressurefrom98mmHgto86mmHg.Themostcommonadversereactionswerestomachupsetanddizziness.Which
ofthefollowingisthemostsignificantlimitationofthisstudy?
a.Thestudysizewastoosmalltoassessefficacy.
b.Thepatientsdidnotachieveguidelinetargetsforhypertension.
c.Bloodpressureisasurrogateoutcome.
d.Longtermsafetyandefficacywerenotassessed.
e.Placeboisnotanappropriatecomparator.
BEHAVIOURAL,SOCIALANDADMINISTRATIVEPHARMACYSCIENCES
102Indecidingwhatdrugsareappropriateforitsformulary,thehospitalmustconsideradrugsefficacy,associatedworkload,andacquisition
cost.SeveralnewantifungalIVdrugs(drugA,drugB,drugC,anddrugD),allwithequalefficacy,haverecentlybecomeavailable.Currentlythe
hospitalstocksdrugE,whichhasbeenavailableforseveralyears.Dataforthemedicationsisasfollows:
Drug
Cost/Day
Dosing
Frequency
Treatment
Duration(days)
$2.50
qid
14
$2.25
oncedaily
14
$5.00
bid
$2.25
bid
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$2.25
qid
Themostappropriatechoiceforthehospitalis:
a.DrugA.
b.DrugB.
c.DrugC.
d.DrugD.
e.DrugE.
103Whichfinancialstatementcouldbeusedtodeterminethetotalvalueofprescriptiondrugsalesforapharmacyduringthecourseofayear?
a.Balancesheet
b.Statementofinvestments
c.Statementofchangesinfinancialposition
d.Incomestatement
e.Statementofequity
104ThestandardofuniversalaccesstogovernmentinsuredhealthcareinCanadaismandatedby:
a.theCanadaHealthAct.
b.individualprovincesandterritories.
c.HealthCanadasHealthEnvironmentandConsumerSafetydirectorate.
d.CanadianAgencyforDrugsandTechnologiesinHealth
e.PublicHealthAgencyofCanada.
105TheCanadaHealthAct(1984)embodiesallofthefollowingprinciples,EXCEPT:
a.affordability.
b.accessibility.
c.comprehensiveness.
d.portability.
e.universality.
106Whichofthefollowingresponsibilitiescanbeappropriatelydelegatedtoanonpharmacistmanagerofacommunitypharmacy?
a.Purchasingnarcoticdrugs
b.Selectingclinicaldecisionsoftwareforthedispensarycomputer
c.Coordinatingstaffscheduling
d.Supervisingpharmacytechnicians
e.Determiningworkflowforthepharmacysprofessionalservices
107Academicdetailingbypharmacistsprovidesaservicetophysiciansby:
a.educatingonimprovedprescriptionlegibility.
b.advisingonoptimalpatientinterviewingtechniques.
c.recommendingstrategiestoavoidmedicationwastage.
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d.providingcurrentinformationonbestprescribingpractices.
e.promotingtheuseofphysiciansamplesgiventopatients.
108AroleofTheNationalAssociationofPharmacyRegulatoryAuthoritiesisto:
a.auditthefinancialperformanceofprovincialpharmacylicensingbodies.
b.promoteharmonizationofpharmacypracticestandardsacrossCanada.
c.establishaunifiedlobbyvoiceforpharmacistsfromalltypesofpracticesettings.
d.providemechanismsforthepublictofilecomplaintsaboutpharmacycareproviders.
e.accreditthepharmacyprogramsatCanadianuniversities
AnswerstoSampleQuestions
1.(d)
26.(a)
51.(c)
76.(e)
101.(d)
2.(b)
27.(d)
52.(b)
77.(e)
102.(d)
3.(a)
28.(b)
53.(b)
78.(b)
103.(d)
4.(a)
29.(c)
54.(c)
79.(a)
104.(a)
5.(e)
30.(c)
55.(b)
80.(a)
105.(a)
6.(b)
31.(d)
56.(c)
81.(a)
106.(c)
7.(a)
32.(e)
57.(c)
82.(b)
107.(d)
8.(d)
33.(b)
58.(e)
83.(d)
108.(b)
9.(a)
34.(b)
59.(b)
84.(e)
10.(a)
35.(b)
60.(a)
85.(c)
11.(c)
36.(a)
61.(d)
86.(a)
12.(a)
37.(c)
62.(c)
87.(a)
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13.(c)
38.(d)
63.(c)
88.(e)
14.(c)
39.(d)
64.(a)
89.(c)
15.(d)
40.(e)
65.(d)
90.(d)
16.(d)
41.(c)
66.(c)
91.(a)
17.(a)
42.(b)
67.(d)
92.(e)
18.(a)
43.(a)
68.(d)
93.(b)
19.(a)
44.(b)
69.(d)
94.(e)
20.(b)
45.(d)
70.(e)
95.(d)
21.(b)
46.(d)
71.(c)
96.(e)
22.(e)
47.(c)
72.(b)
97.(e)
23.(d)
48.(a)
73.(d)
98.(d)
24.(c)
49.(c)
74.(e)
99.(e)
25.(e)
50.(c)
75.(b)
100.(b)
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