1 QE Competency 1 Therapeutic MOCK Test 1 QA May 2013

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Therapeutic MOCK TEST 1 - May 2013
1) MP is a 50 year old man. His medical history started

hydrochlorothiazide (HCTZ) 25 mg po qd 2 months ago.
After 4 months HCTZ increased 25 mg po because his BP
was uncontrolled. He is diabetic, has
hypercholesterolemia. MP had anaphylactic reaction
with amoxicillin in childhood. He smokes half pack a day.
Which section of SOAP we have to write this allergy?
A) Subjective
B) Objective
C) Assessment
D) Plan
E) Follow up
Ans: A
2) Which of the following is the next most appropriate

step in treating MP ?
a. Discontinue HCTZ and re-evaluate blood pressure.
b. Adding lisinopril 10 mg po qd to HCTZ 25 mg po qd
c. Adding Atenolol 100 mg po qd to HCTZ 25 mg po qd
d. Increase HCTZ to 50 mg po qd
e. Lifestyle changes require and discontinue HCTZ
Ans: B
Tips: Atenolol masks hypoglycemia and
hydrochlorothiazide is diabetogenic
Tips Inc Copyright 2000-2013 Prevent Piracy & Report Piracy 1

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3) Counseling on hydrochlorothiazide 25 mg po qd
includes:
A. Do not wear contact lenses
B. Take it in the morning
C. Take with a glass of orange juice or banana (K+
supplement)
D. All of the above
E. B and C
Ans: D
4) NKP is a 47 year old patient has just started raw diet

only few days, taken citrus juice daily. Maintain healthy
life style such diet and exercise. Patient using
atorvastatin 20 mg to treat high cholesterol and recent
visit doctor, he increases atorvastatin dose to 40 mg.
Patient complains severe dyspepsia and diarrhea. It’ may
be due to:
a. Because he is on raw food diet
b. Changed atorvastatin 20 mg to 40 mg
c. Takes citrus juice
d. Exercise
e. Multivitamins
Ans. B
Tips: What does statins have GI SEs. However statins
common GI SEs. Raw food is high fibre content (insoluble
fibre).

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5) NPK is diagnosed high LDL and TG, what is the best

therapy to initiate?
A)Rosuvastatin
B)Cholestyramine
C)Niacin
D)Fenofibrate
E)Ezetamibe
Ans: A
TC page 438, 6th ed. Rosuvastatin and atorvastatin have
high lowering effect on LDL and TG
6) KP is 53 year old patient who had hypertension came

to pharmacy and had prescription of rosuvastatin 10 mg
daily as doctor diagnosed him to use hyperlipidemia. Hel
told to pharmacist do not want to start medication.
Wants to try lifestyle changes. Pharmacist start talking to
him about his condition and explained to him benefit of
using of medication but also after patient wanted to go
lifestyle modification first. What should a good
pharmacist do in this situation?
A) respect patient autonomy and give him right to decide
B) ask patient to see different doctor for second opinion
C) ask patient to start after trying lifestyle modifications
D) provide patient more evidence base document to
show benefit of medication and dangers of
hyperlipidemia
E) Ask patient what did your doctor tell you.
Ans: D

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7) KM a 60 yo MI patient had bypass surgery past 4

months ago using ASA 325 mg daily, clopidogrel 75 mg
daily, rosuvastatin 10 mg daily, nodolol 80 mg daily and
salbutamol prn, budesonide daily. Now hospitalized with
severe asthma.
What is the pharmacist concern in KM?
I) drug and drug interactions
II) drug and disease interactions
III) drug and food interactions
a) I only b) III only c) I and II d) II and III e) I, II and III
Ans: C
8) A 60 yo patient came to emergency and doctor

diagnosed STEMI and ordered Alteplase injection.
Currently patient blood pressure is 190/110. What is the
drug related problem?
A) patient is receiving medication which is NOT indicated
for this therapy
B) Patient is receiving medication have adverse drug
reaction
C) Patient is receiving medication that is under dose
D) Patient is receiving medication that is overdose
E) Patient is Not receiving indicated therapy for
indication
Ans: A

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9) A 66 yo male in warfarin treatment for deep vein
thrombosis. A doctor calls and tells you that one of your
mutual patients has taken too many warfarin tablets in error
and has an INR value of 5.2 without any symptoms of
problems. She would like to treat with vitamin K to lower the
INR promptly. Do you have any recommendations?
A) Low dose oral vitamin K therapy promptly reduces elevated
INR
B) Skip dose of warfarin for a day and monitor INR
C) Continue warfarin therapy increase frequency of
monitoring INR
D) Low dose of vitamin K injections promptly reduces elevated
INR
E) It is not a concern, so continue therapy without interruption
Ans: A
Tips; as per CMAJ Feb 2003. It is recommended to low
dose of vitamin K 1 mg or 4 to 5 mg for patient with
INR more than 5 in bleeding or no bleeding symptoms.
10) A 64 yo man weighing 115 kg, and tall 60 inches,

presents to his physician after long international flight
complaining of pain, swelling of his right lower leg. The
patient had knee surgery a month before he travelled.
His medication profile include, CHF (ejection fraction <
15%), remission from lymphoma, MI. His father,
mother, and sister are all diseased from stroke,
pulmonary embolism. Given his profile. Patient most
likely suffering from?
Which of the following is NOT risk factors of DVT?

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A) Knee surgery B) over weight C) long flight D)

family history E) gender
Ans: E
Tips: RF for above patient, except gender. other RFs
include age > 40 yr, cancer, CHF, MI, and obesity.
11) What is the most important recommendation should

provided to decrease risk of deep vein thrombosis?
A) Avoid taking flights
B) Increase mobility of legs
C) Avoid physical activity
D) Avoid vitamin K intake
E) Avoid dark green vegetables
Ans: B
12) Patient is hospitalized. Drs initiated heparin

infusion. What is incorrect about heparin
A) Heparin dose is based on body weight
B) Loading dose is 80 units/kg and maintenance dose is
15 to 25 units/kg/hr.
C) Heparin is slower onset than LMWH
D) LMWH have longer half life
E) LMWH have predictable response thus not
monitored
Ans: C
13) If doctor initiated dalteparin, which of the following

is NOT required to monitor?
A) Bleeding B) aPTT C) Rash D) INR E) Bruise

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Ans: B and D
Tips: LMWH act selectively binding with factor Xa,
which is affects on aPTT. However this has NO effect on
prothrombin time, therefore INR is not beneficial.
Dabigatran can be monitored for aPTT. Ref: eCPS
14) A 60 years old patient having systolic CHF. His LVEF

is ≤ 40%. He is intolerant to ß-blocker. His doctor should
Rx for him:
I) CCB II) Only ACEI III) ACEI + ARBs
A-I only
B-III only
C-I and II only
D) II and III only
E-I, II, III
Ans: (B)
Reference: Therapeutic Choices 5th edition Page 488
15) In the above scenario if persistent symptoms i.e. if

there is no improvement in LVEF, then:
I) Discontinue ACEI and ARBs and give Spironolactone
II) Discontinue ACEI and ARBs and give
Hydralazine/Isosorbide dinitrate
III) Add Digoxin to the above regimen
A-I only
B-III only
C-I and II only

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D-II and III only

E-I, II, III
Ans: (B)
TIPS: Since in case of persistent signs and symptoms,
there is a possibility of cardiac lesion, and the patient
may develop SVA.
16) Which of the following is NOT used in CHF?

A) Spironolactone
B) Verapamil
C) amlodipine
D) Ethacrinic acid
E) carvedilol
Ans: B
Josh Holiday is a 26 year old unemployed university

graduate is treatment of major depression. Recently he
purchased several packs of pseudoephedrine from 2 to 3
pharmacies. He has been sent to the hospital by
recommendation of pharmacist after he checked his
blood pressure in pharmacy it was 195/95.
17) What antidepressant he was using?
A) sertraline
B) Amitriptyline
C) Tranylcypromine
D) Selegiline
E) Bupropion
Ans: C
Tips: Desloratidine is recommended as decongestant in
patient using MAO Inh.

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18) A 66 yo patient arrived to emergency after 6 hours

of symptoms of severe headache, confused and blurred
vision. He had history of transient ischemic attack,
hypertension < 160/85, high cholesterol and diabetes.
Doctors in ER have diagnosed is condition as acute
stroke?
What is the reason doctors have decided not to give
Alteplase
A) he is 66 yr old
B) he has history of high blood pressure
C) He arrived to ER after 6 hours
D) He has history of cholesterol
E) he has history of diabetes
Ans: C
Tips: inclusion criteria are < 3 - 4.5 hr, BP <180/110,
age <75 yr, NO previous surgeries.
19) The above patient having atrial fibrillation. What is

will be given secondary prevention of atrial fibrillation of
stroke?
A) ASA
B) Warfarin
C) ASA + clopidogrel
D) ASA + dypiridamole
E) Metoprolol
Ans: B

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20) A 64 year old patient with CHF, has problem with one
flight upstairs and from walking 200 yard from car to
home. This is characterized, what NYHA levels is?
A) NYHA Class 1
b) NYHA Class II
C) NYHA Class III
D) NYHA Class IV
Ans: C
21) Which of the following drugs are not considered in a

patient with hypertension and heart failure?
A) Ramipril
B) Nifedipine
C) Metoprolol
D) verapamil
E) Amlodipine
Ans: D
Tips: Verapamil is not used in CHF.
22) MK is a 62 year old man. He is on warfarin 2.5 mg

daily for the for the prevention of atrial fibrillation.
Past 3 days ago MK developed sore throat and his
doctor considering to prescribe ampicillin 500 mg QID
A-Effects of warfarin may be increased resulting in
increased risk of bleeding.
B-Effects of warfarin may be decrease resulting in
increased risk of bleeding.
C- Effects of warfarin may be increased resulting in
decreased risk of bleeding.

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D- Effects of warfarin may be decrease resulting in

decreased risk of bleeding.
E- Effects of warfarin may be decrease resulting do not
effects on bleeding
Ans: A
Tips: INR should be monitored upon addition of
ampicillin and withdrawal of ampicillin. INR should be
periodically reassessed for at least 3 weeks after
ampicillin discontinue, since adjustment in the warfarin
dose may be necessary to maintain an effective level of
anticoagulation.
Cotrimoxazole increase INR. Macrolide (erythromycin,
clarithromycin) increase INR. Fluroquinolone increase
INR.
23) MK is currently stabilized on warfarin 2.5 mg QD

treatment. Which of the following drugs may decrease
warfarin levels
A-Carbamazepine
B-Clarithromycin
C-Cotrimoxazole
D-Ciprofloxacin
E-Digoxin
Ans: A
Tips: Carbamazepine is enzyme CYP 2D6 inducers. It
will decrease warfarin blood levels. Clarithromycin
(and, to a lesser extent, azithromycin) and
cotrimoxazole may increase warfarin blood levels.
Clarithromycin may also increase levels of
carbamazepine, digoxin, statins and theophylline. Other

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antibiotics that may increase warfarin and digoxin

levels include fluroquinolones
24) A 65 years old patient was admitted to ICU

experiencing acute ischemic stroke. His stroke symptoms
started 8 hours ago. His was recently discharged from
hospital after treatment of mild hemorrhagic stroke
symptoms. Why did the doctor decided not to give
Alteplase?
I) Age
II) more than 6 hours
III) Hemorrhagic symptoms
A) I only B-III only
C) I and II only
D) II and III only
E)I, II, III
Ans: D
Tips: Age 75 and above, more than 6 hr and bp 185/110
and hemorrhage are the absolute CIs of alteplase.
25) A 41 years old a chronic alcoholic male, no known

allergies, past medical history: Anxiety, difficulty
sleeping. Current medications: triazolam 0.5 mg qhs x 3
years and acetaminophen/caffeine/codeine (Tylenol #1)
ii prn headache. You notice that this patient has been
coming in early for refills for triazolam and has
received extra prescriptions for this medication from
many walk-in clinics. Patient approaches you and states
that he is concerned about his triazolam usage, so he

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stopped using it 24 hours ago. He asks you what the

most common withdrawal symptoms will be:
A. Diarrhea, shakes and chills
B. Insomnia, muscle spasms and irritability
C. Increased headache, fatigue and nausea
D. Seizures, delirium, and hallucinations
Ans: B
Tips: Autonomic hyperactivity, insomnia, anxiety,
muscle spasm.
26) Which of the following patient assessment is LEAST

important for insomnia?
A) Total sleep time
B) Sleep latency
C) Early and/or frequent awakening
D) Alcohol consumption
E- Daytime impact of sleeping problem
Ans: D
Tips: Sleep diary: TC page 126
27) A physician prescribed alprazolam 0.5 mg SL 3 tab.

Repeat 5 times. What is correct?
A) Prescription is NOT valid
B) Prescriptions is forged
C) Prescription should not contain repeats
D) prescription is valid
E) the prescription is NOT allowed
Ans: D

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Tips: Benzodiazepine can be refilled. Benzodiazepine

refills do not require intervals to be specified. Control
substance part 1 doctor has to specify intervals of repeats
and repeats allowed only for written prescriptions.
28) The pharmacist fills a prescription for sumatriptan

100 mg tablets for a patient with migraine. Appropriate
information to provide to the patient includes which of
the following?
a. If the sumatriptan does not relieve the headache
within four hours, ergotamine may be used.
b. If no relief is achieved in two hours, sumatriptan may
be repeated.
c. If the headache is relieved but another headache
occurs eight hours later, sumatriptan may be used for the
second headache.
d. The maximum dosage in any 24 hour period is six
tablets.
e. If relief is not achieved, no other medication can be
used for 24 hours.
Ans: C
29) A 30-year-old patient, is currently on antidepressant

treatment, wants to stop taking fluoxetine because she
continues to have trouble sleeping and does not wish to

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use a sedative. Which is the best option to improve

sleep?
a) Add lorazepam at bedtime
b) Switch to bupropion
c) Switch to moclobemide
d) Switch to mirtazapine
Ans: D
30) MD is a 40-year-old woman who has recently been

diagnosed with panic disorder. She describes to you the
very frightening episodes she has experienced over the
last six months. She was convinced she had a serious
heart problem, but has been assured by her doctor that
she is physically healthy. She is obviously very anxious,
fidgeting with her purse, looking around to see who
may also be in the pharmacy. Upon questioning, you
found out that she has been having trouble
concentrating and sleeping and that she is very worried
about having another attack.
Which of the following medications would be the best
choice, as a single agent, for immediate relief of MD’s
symptoms?
a. Buspirone
b. Desipramine
c. Alprazolam
d. Fluoxetine
Ans: C

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TIPS: As alprazolam is related to BDZs it’s the best

choice.
FG is a 65-year-old war veteran with a 40-year history

of paranoid schizophrenia. His symptoms include poor
personal hygiene, blunted affect, and delusions,
accompanied by auditory and visual hallucinations. His
delusional symptoms relate to his wartime experiences.
His visual hallucinations involve enemy soldiers from
the war who he believes are stalking him. FG's auditory
hallucinations include the sounds of war, accompanied
by enemy soldiers threatening to end his life if he does
not keep his guard up. FG has been unable to maintain
a job or adequate housing for many years. He currently
lives under a bridge "in case he needs to make a
getaway down the river."
When workers from the free clinic are able to locate
him, they attempt to provide medical care and evaluate
his schizophrenia. If sample medications are available,
they provide him with them. According to their records,
FG was given haloperidol 15 mg 3 times daily and
benztropine 1 mg 3 times daily when they last evaluated
him. He was given enough medication for a few weeks
so that they could evaluate the effectiveness and any
adverse effects. During previous trials with other
neuroleptic agents, extrapyramidal side effects have
limited the dose FG could tolerate.
The physician on the team would like to discontinue the
haloperidol and initiate an agent with fewer
extrapyramidal side effects. He searches the medication

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supply and finds that he has samples of fluphenazine,

chlorpromazine, thiothixine, and risperidone.
31-Which agent is least likely to cause extrapyramidal

side effects?
A-Fluphenazine
B-Chlorpromazine
C)Thiothixine
D-Risperidone
E-Clozapine
Ans-D
Tips: Risperidone is the agent least likely to cause
extrapyramidal side effects. At doses ≤6 mg per day, the
side effect rate with risperidone is similar to that with
placebo. With increased doses, the risk of
extrapyramidal side effects increases. The most
common side effects with low-dose risperidone are
asthenia and sedation.
32) MJ is a 29 year old has been diagnosed for Crohn's
disease. If MJs doctor is considering CDs for remission.
What the treatment?
A) 5-ASA 4 to 5 wk
B) Sulfasalazine 4 to 5 wk
C) Prednisone PO 40-60 mg, 12 to16 wks
D) Methotrexate
E) Infliximab
Ans: C
TC page 840, 6th.ed.

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ST, is a 57-year-old male nurse who works for the local

pulmonologist, arrives at work one day complaining of
weakness and fatigue. He explains that these symptoms
have worsened over several days. He reports feeling out
of breath when walking around the office but denies
having had these difficulties in the past.
ST's medical history is significant for hypertension and
benign prostatic hypertrophy. Three months ago he was
hospitalized with a ventricular arrhythmia. His current
medication regimen includes:
 Felodipine 5 mg daily
 Tamsulosin 0.4 mg daily
 Amiodarone 400 mg daily
ST denies the use of herbal products or OTC
medications. He denies tobacco use but admits to social
drinking. His family history is significant for
hypertension.
The pulmonologist for whom ST works is concerned
about ST's symptoms and performs a physical
examination, along with laboratory work. ST's vital
signs are reported as follows: blood pressure, 150/95
mm Hg; heart rate, 90 beats/min, temp 98.6°F, and
respiratory rate, 20 breaths/min. The exam is
unremarkable, with no signs of pulmonary congestion,
lower extremity edema, or signs of infection. The basic
metabolic panel and complete blood count are within
normal limits. The only lab result found to be outside of
normal limits is an elevated erythrocyte sedimentation
rate (ESR).
The pulmonologist is concerned that ST's medications
may be causing pulmonary problems. He performs a

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bronchoscope to obtain a lung biopsy, which

demonstrates diffuse alveolar damage and fibrosis.
33) What could be pulmonologist concern?

A) Felodipine 5 mg daily
B-Tamsulosin 0.4 mg daily
C) Amiodarone 400 mg daily
D-Blood pressure
E-Heart rate
Ans-C
34) All of the following are side effects of amiodarone

EXCEPT:
A) Conjunctivitis
B) Pulmonary fibrosis
C) Aplastic anemia
D) Liver dysfunction
E) Photophobia
Ans: C
Tips: The pulmonologist concerns that ST's medications
are causing his symptoms are valid. ST is exhibiting
signs and symptoms of Amiodarone- induced
pulmonary fibrosis. These patients typically present
with an elevated ESR and dyspnea during the first year
of therapy. Treatment involves dosage reduction or
discontinuation of amiodarone or initiation of
corticosteroid therapy. Symptoms resolve quickly once
therapy is altered.

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35) Which of the following is NOT required to monitor for

amiodarone?
A) eye exam
B) occult blood in stools
C) Persistent cough
D) Chest x-ray
E) Peripheral skin pigmentation
Ans: B
Tips: Occult blood in stool is traces blood which is NOT
detectable
36) A 22-year-old woman, otherwise healthy, presents

with a 6-month history of episodes of unresponsiveness
accompanied by lip smacking lasting 1 to 2 minutes and
occurring 2 to 3 times per month. She takes no
medications She is in a monogamous relationship with a
male sexual partner and only occasionally
uses contraception. A routine EEG shows left temporal
epileptiform activity and MRI of the brain shows left
mesial temporal sclerosis. Which of the following drugs
have decrease the effectiveness of oral contraceptive
pills?
i. Gabapentin
ii. Lamotrigine
iii. Topiramate
a) I only
b) III only
c) I and II

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d) II and III
e) I, II III
Ans-D
37) Which of the following side effects of phenytoin

therapy is not related to increased serum
concentrations?
I) Ataxia
II) Sedation
III) Hirsutism
a) I only b) III only
c) I and II only
d) II and III only
e) I, II and III
Answer: B: Hirsutism is a common side effect of
phenytoin and is not correlated with serum phenytoin
concentration. Ataxia and sedation are concentration-
dependent side effects.
Drugs that cause hirsutism include: phenytoin,
androgen, finasteride, OCP, prednisone
38) After her phenytoin therapy has been
optimized, ZM returns to the clinic just before her
wedding and requests an oral contraceptive.
Which of the following statements regarding oral
contraceptives and phenytoin is most correct?
A. There is no potential drug-drug interaction
B. Phenytoin inhibits the metabolism of phenytoin
and may increase their side effects.
C. Oral contraceptives inhibit the metabolism of
phenytoin and may increase its side effects.

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D. Phenytoin induces the metabolism of oral

contraceptives and may decrease their efficacy.
E. Oral contraceptives induce the metabolism of
phenytoin and may decrease its efficacy.
Answer: D: Phenytoin is an enzyme inducer. It may
increase the metabolism of oral contraceptives and
reduce their efficacy. Patients should be advised to
consider alternative methods of contraception to
avoid unplanned pregnancy.
39) Doctor doubled dose of phenytoin, when to

measure steady state concentration?
A) After 1 day
B) After 1 week
C) After 1 month
D) After 2 week
E) After 3 week
Ans:
Tips: On average at phenytoin dose of:
300 mg/day takes approx. 5 to 7 days to Css
Example. Patient receiving phenytoin 300 mg capsule

daily. The Css is 9.2 mcg/ml. If doctor increased dose
to 400 mg daily. What will be Css.

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Cnew = (Dnew/Dold) x Cold then increase 15 to 33%
Cnew = (400 mg/300 mg) x 9.2 mcg

= 12.3 mcg/ml
For 15% is 1.15 x 12.5 = 14.1 mcg/ml
For 33% = 16.4 mcg/ml
Then range is 14.1 mcg/mL to 16.4 mcg/mL
40) KM is a 75 yo women, frequently forgets daily

activities such housekeeping, names of relative and
friends... Doctor diagnosed Alzheimer's. What is goal of
therapy?
A) Delay the time to transfer nursing home facility
B) Decrease mortality
C) Decrease cognitive functions damage
D) Decrease the time for pharmacotherapy
E) Increase medication compliance
Ans: C
Tips: Decrease cognitive functions damage this delays
progression of disease and prevent getting into severe
form of dementia. Lab test to confirm cognitive MME,
MoCA.
A 55 year-old male, new patient to your pharmacy,

overweight suffered a non-ST elevation myocardial

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infarction 6 days ago had PCI in hospital, bare metal stent

to
proximal LAD. Currently his medical conditions
hypertension, LDL 2.5mmol/L, Tchol/HDL 5. Social
history: has smoked 1 ppd x 30 years, family history:
brother died of MI 6 years ago. Currently have new
prescriptions: EC ASA 325 mg once daily, clopidogrel 75
mg once daily, metoprolol 50 mg bid and ramipril 2.5 mg
once daily. Patient using currently vitamin E 800 IU uses
for the last one year, hoping that prevent any
cardiovascular problems.
41) What is the recommended blood pressure goals for

secondary prevention of Acute coronary syndrome
patients.
A-135/85
B-140/90
C-145/95
D-160/85
E-150/90
Ans: B
Tips: TC page 460, 6th ed. shows 140/90
42) Overwhelming data in patients with established CAD

supporting the benefits of anticholenesterase drugs in
mortality, cardiovascular mortality and stroke. What is

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the drug of choice recommended above patient to

achieve target LDL ?
A) Rosuvastatin
B-Ramipril
C) Niacin
D) Fenofibrate
E-Beta blockers
Ans: A
43) After PCI, and stent doctor has prescribed EC ASA 325
mg once daily, clopidogrel 75 mg once daily Which of the
following is NOT the common side effect of clopidogrel?
A)Joint pain B)headache C) constipation D)Rash
E)Diarrhea
Ans: C
Tips: Comparison of ASA, clopidogrel and ticlopidine
44) A 53-year-old lady came to the pharmacy with a

prescription for Wellbutrin 150 mg SR. Her profile
shows that she was on Wellbutrin 150mg XL. The
pharmacist asked the patient whether she is aware of
any changes that her doctor made for her therapy, and
she replied that nothing her doctor told her about that.
The best action the pharmacist should do is:
A.Dispense Wellbutrin 150mg SR since there is no
difference between the two
B. Dispense Wellbutrin XL as in her profile

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C.Call the doctor to see if he has intended to change XL

to SR
D.Give the generic bupropion SR
E. None of the above
Ans: (C)
Tips: Wellbutrin XL is once a day and Wellbutrin SR is
twice a day but could be given once a day, so the best
option is to call the doctor that the
45)A patient was taking fluoxetine for about 4 months.

She is bringing a new RX for moclobomide. What should
you do about this new RX?
a) Call the Dr. and say this new RX will not work because
it has the same effect as fluoxetine
b) Fluoxetine should be stopped 2 weeks before starting
moclobomide
c) Ask Dr. to prescribe a MAO inh instead of
moclobomide
d) Fill the RX and tell pt. to stop fluoxetine
Ans: B
46) A patient’s profile 75 year-old female: Weight: 52 kg,

has acute ischemic stroke, atrial fibrillation,
hypothyroidism, osteoarthritis, and osteoporosis.
Medication profile. Digoxin 0.125 mg po qd; Naproxen
375 mg po bid Levothyroxine 0.1 mg po qd; Calcium
gluconate 125 mg po qd
The physician should:
a. Increase the dose of digoxin

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b. Decrease the dose of digoxin

c. Decrease the dose of levothyroxin and monitor digoxin
d. Increase dose of levothyroxine to 0.150 mg po qd
Ans: C
Tips: Levothyroxine might cause arrhythmias.
47). A patient wants to stop taking fluoxetine because

she continues to have trouble sleeping and does not wish
to use a sedative. Which is the best option to improve
sleep?
a) Add lorazepam at bedtime
b) Switch to bupropion
c) Switch to moclobemide
d) Switch to mirtazapine
Ans: D
Tips: What is the least nauseating SSRI? sertraline?
48) You were told by the same patient that she once was
on antidepressant that caused her limbs to jerk at night.
Which antidepressant is most likely to cause this
problem?
a) Mirtazapine
b) venlafaxine
c) bupropion
d) moclobemide
Ans: D

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49) A 36-yo female who presents to your outpatient clinic

with a chief complaint of persistent dry cough x3 days. JJ
is now on the following medications: Celebrex 100 mg po
bid, docusate 100 mg po bid, fluoxetine 20 mg po qd, and
captopril 12.5 mg po tid. She comes back to the clinic 6
months later and is complaining of a dry cough persistent
for greater than 2 weeks. The cough she presented with
at her last visit resolved within days of taking
dextromethorphan. What would your assessment of this
patient?
a) She may have chronic cough that will be unresponsive
to any medication.
b) Fluoxetine causes cough unresponsive to antitussive.
Therefore, you would recommend switching to another
antihypertensive.
c) Captopril causes cough unresponsive to antitussive.
Therefore, you would recommend switching to another
antihypertensive.
d) You would recommend referring her to an allergist.
e) Captopril causes cough unresponsive to antitussives;
therefore, you would recommend the patient’s doctor to
change to same class of antihypertensive.
Ans: C
Tips: ACE inhibitors, especially captopril, can induce
cough resistant to usual antitussive therapy. The only
therapeutic intervention would be to change to a
different class agent and see if cough resolves.
Depending on when JJ was started on captopril and when

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she developed the cough, it would be the intervention of

choice. Cough for ACEI can occur any time.
50) A patient was scheduled for an endovascular coiling

procedure to treat a brain aneurysm. Several days
before the procedure, the neurosurgeon wrote a
prescription for Plavix 150 mg po daily with
acetylsalicylic acid (ASA) 325 mg po daily. The patient
was to take these medications to prevent platelet
aggregation and clot formation during, and as a result
of, insertion of a foreign substance (the coils) into the
vascular system. The day before the scheduled
procedure, the patient was admitted to the hospital as
planned. Fortunately, the patient had remembered to
bring all current medications to the hospital. During
medication reconciliation, the pharmacist noticed that
the patient was taking Pradax 150 mg daily instead of
the intended Plavix 150 mg daily. The hospital
pharmacist called the community pharmacy to discuss
the situation. It was determined that the order for
Plavix had been misinterpreted and that Pradax had
been dispensed in error.
The hospital pharmacist should inform this incident to?
I) The neurosurgeon should be notified before surgical
procedure
II) Institute of Safe Medication Practices Canada
III) Pharmacy and Therapeutic Committee
A-I only
B-III only
C-I and II only

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D-II and III only

E-I,II, III
ANS:C
51) Which of the following measures can prevent these

type mix ups!
A. Include the generic name throughout the prescription
process like clopidogrel for Plavix and dabigatran
etexilate for Pradaxa
B. Read label with patient at counselling point
C. Read label at the time taking drug from shelf and read
label at the time of counting and placing bottle back into
shelf
D. Consider automated alert system in computers
E. Academic detailing to enhance prescription practices
ANS: A
52) A physician asked for heparin 2,000 units during a

procedure. The nurse retrieved two vials of heparin
from an automated dispensing cabinet that was
supposed to be stocked with 1,000 units/1 mL vials. But a
pharmacy technician had accidentally stocked the cabinet
with look-alike vials of 10,000 units/1 mL heparin vials.
Both concentrations... are in the same size vials with
similar orange-brown labels and vial caps... causing the
nurse to overlook the stocking error. The patient received
heparin 20,000 units, but the nurse quickly noticed the
mistake!

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Which of the following is the management of heparin

overdose?
I) Stop using heparin and test aPTT and INR
II) Protamine sulphate antidote administration
III)Treatment included administration of intravenous
fluids, plasma volume expander, fresh frozen plasma,
packed red blood cells, and platelets.
A) I only B-III only C-I and II only D-II and III only E-I,II, III
ANS:E
53) Multiple issues often underlie the inadvertent

administration of high-concentration heparin. What are
the examples of contributing factors to such incidents
include:
A. The storage of high-concentration heparin vials close
to low-concentration heparin flush products.
B. Confirmation bias that can cause a health care
professional to read a label or select a drug product and
“see” what they expect to see, rather than what is
actually selected.
C. Often, more concentrations than necessary are present
in both the pharmacy and patient care area stock.
D. Incomplete communication between physicians and
nurses at the time of gathering drugs and supplies for
central vascular line (CVL) insertion and during procedure
E. All of the above
ANS:E

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54) GS is a 49 year women. Her physician had prescribed

morphine ‘.5 mg’ IV for the management of post-
operative pain. However, a unit secretary did not see the
decimal point and transcribed the order by hand onto a
medication administration record (MAR) as ‘5 mg.’ An
experienced nurse followed the directions on the MAR
without question and gave the baby 5 mg of IV.
Morphine initially and another 5 mg dose two hours
later.
Which of the following serious symptoms could be
associated with fatal error?
A) Mydriasis B)Severe constipation C) Respiratory
depression D) Bleeding E)All of the above
Ans: C
55) Venlafaxine was omitted for 10 days for a 78 year old

patient. The order was inadvertently crossed off from
medication administration records and subsequently not
transcribed on transfer to chronic care. Patient
experienced all of the following, except?
A) nausea and vomiting B)Delirium C) Flu like symptoms
D)Insomnia E)Tremors
Ans: E
Tips: SSRI or SNRI withdrawal or discontinued symptoms:
flu like symptoms. However no tremors and cognitive
symptoms.

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56) A nurse had an order to administer a 200 mg depot

injection of zuclopenthixol decanoate. She had no
previous experience with the drug and misunderstood
the vial’s label. Instead of giving the patient his usual
dose of 1ml of a 200mg/ml solution, she interpreted
the entire vial to contain 200mg. Five times the normal
dose was given (the vial was only half full). The patient
may experienced the following?
A) unpleasant extra pyramidal symptoms
B) suicidal symptoms
C) disorientation
D) Insomnia
E)none of the above
ANS: A
57) Which of the following can be crushed and chewed?

A) Dutasteride
B) Ibandronate
C)Duloxetine
D) Divalproex
E) ASA 80 mg
ANS:E
58. BN is a 91kg, 52-year old female who was recently

diagnosed with type 2 diabetes. On physical exam her BP
was 190/94, serum creatinine was 150umol/L, K is
4.5mmol/L.
11) The recommended BP target for BN is?
A) <130/80
B)>130/80

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C) 140/90
D)<140/90
E)>140/90
Ans: A
59) What is the target waist line circumference?

A)<99 cm B)<102 C)<88 cm d)>88 cm e)>102 cm
Ans:C
60. What is the initial therapy?

A) Ramipril 5 mg
B) verapamil/losartan
C) Atenolol
D) metoprolol
E) Hydrochlorothiazide 50 mg
Ans: B
61) After 6 months, she has still high blood pressure

155/90, what to do?
A. Increase dose to Ramipril 5 mg
B. Check the compliance of medication
C. Change Ramipril 2.5 mg to Losaartan
D. Change Ramipril 2.5 mg to Hydrochlorothiazide 25 mg
E. Change Ramipril 2.5 mg to Metoprolol 50 mg
ANS: B

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62. JM is 75 year old diagnosed with Alzheimer’s disease

and diastolic dysfunction, his current medication include
donepezil 10mg QD, furosemide 40mg QD, verapamil SR
180mg QD. Jims father and mother both have had
suffered Alzheimer in their old age.
Symptoms of Alzheimer’s disease, all EXCEPT:
a) Slurred speech
B)Delay cognitive functions detritions
C)Fatigue
D)Dementia
E) Loss of memory
Ans: C
Tips: Fatigue and reversing cognitive functions are NOT a
goal of therapy for dementia.
63) All of the following are the risk factor of Alzheimer’s

disease, EXCEPT
a) Female gender
B)Family history
C)Age
D)Emotional stress
E)None of the above
Ans: D
64. A 10 years old patient experiencing Otitis media. His

doctor prescribed for him Suprax 100 mg/5ml, 10 ml TID.
Parents have a concern that their child is old enough

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now, and they would prefer tablet. The pharmacist

should do the following:
(A) Call the doctor to switch change dosage form
(B) Tell the parents that there is no difference between
the tablet and the susp. in treating the ear infection
(C) Tell the parents that the tablet is given for patients
that have an age of 18 and more
(D) Otitis media should be treated with suspension and
not tablet in order to have a better effect
(E) Tell the parents that the taste of tablet is bitter
Ans: D
65) Mr BB is a 55year old obese man who has been a
patient at your pharmacy for many years. He is receiving
atenolol 50 mg OD for hypertension, atorvastatin 20 mg
OD and glyburide 5 mg BID for blood glucose control. He
smoked a pack of cigarettes a day for the last 38 years.
His lipid profile is under controlled. By some reason he
started to take herbal product containing niacin and find
problem of muscular pain. This pain was not continuous.
What should patient do?
A. Take Tylenol on prn base
B. Refer to his physician
C. Ask for creatinin kinase test
D. Patient need not to worry as this pain subsides after
discontinuation of herbal products.
E. Use antidote of niacin
Ans-B

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66) A 65-year-old man with a history of hypertension,

atrial fibrillation, hypercholesterolemia, and a right
middle cerebral artery stroke 6 months previous
reports 3 separate episodes of head deviation to the left
with rhythmic jerking of the left arm and left side of his
face lasting approximately 1 minute. He is taking
warfarin, atenolol, and atorvastatin. What is drug of
choice for epilepsy.
A-Lamotrigine (monotherapy)
B-Gabapentin,
C-Valproic acid
D-Phenytoin
E-Carbamazepine
Ans: A
67)If patient peptic ulcer symptoms do not respond to

the initial trial of esomeprazole 20 mg daily for 4 wks,
which would be the most appropriate recommendation?
A-decrease alcohol intake
B-Take small meals
C-Add domperidone
D-Switch treatment to H2RA
E- Double dose of esmoprazole
Ans: E
TC page 727, Management
68) A pharmacist is working as a relief in another

pharmacy. A patient came with a prescription of Ativan
1 mg. The pharmacist remembered that the same
patient came with another prescription of same drug

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two days ago in the other pharmacy where he worked.

What should the pharmacy do?
A.Call the police
B. Refuse to fill the new prescription
C.Discuss the matter with the patient
D.Call the doctor and tell him that the patient is
addictive
Ans: C
Tips: tell patient that, want to discuss with your new
doctor.
69) A 58-year-old female patient with weight of 52 kg.

Her creatinine clearance 40mL/min has M.I., Angina,
atrial fibrillation, CHF and hypercholesterolemia.
KCl = 4 meq/L (normal value 3.5 to 5 meq/L)
Current medication: Digoxin 0.125 mg po QD,
Furosemide 40 mg po QD, Warfarin 5 mg po QD,
Lovastatin 20mg po initiated 1 month ago, Captopril
12.5 mg po tid, Kcl, 20 meq po BID, Nitroglycerin
0.4mg SL prn, Nitroglycerin patch 0.4mg/hr q 24h
Which of the following is appropriate recommendation
with Janna’s physician:
I. Fill the prescription the way it is
II. Decrease digoxin dose
III. Increase furosemide dose
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans: B (III only)

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Tips: Digoxin dose is suitable for this creatinin

clearance because it is a low level. Furosemide should be
increased due to renal creatinin clearance is low. TC 4th
ed. page 1202.
70) MJ is 70 year old man. Has been on anti-parkinson's

medications levodopa/carbidopa tid. and Furosemide for
the treatment of hypertension. He also uses arthritis
medications Acetaminophen 650 mg q6h and vitamin B12
injections. Recently he has been diagnosed for urinary
incontinence. What is the cause of urinary incontinence?
A) Levodopa/carbidopa
B) Furosemide
C) Acetaminophen
D) Vitamin B12 injection
Ans: A
TC page 879 6th ed. Drugs that may cause or aggravate
urinary retention should be avoided in urinary
incontinence.
71) The doctor prescribes a combination treatment of

SSRI + benzodiazepines for which there is a risk for a
pharmacokinetic interaction. Which of the following is
the best course of action?
A) Recommend avoiding the combination due to the
narrow safety margin of SSRI

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B) Recommend avoiding the combination due to narrow

safety of margin of benzodiazepines
C) Dispense the combination and monitor for increased
side effects of SSRI
D) Dispense the combination and monitor for increased
side effects of benzodiazepines
Ans: D
72) A 30 yo maniac patient on lithium 600 mg q8h

admitted to hospital with hallucination and
disorientation. What is the better explanation or drug
related problem?
A) non adherence
B) taking too much medication
C) Taking too little dose
D) toxicity of lithium
E) Need additional drug therapy
Ans: E
Tips: Lithium min dose 900 mg to 2100 mg daily. Over
dose symptoms can occur if lithium serum levels are over
2 mEq/L. Hallucination, and disorientation need
additional therapies like mood stabilizers.
73) A 25 year old student is taking paroxetine daily for

the treatment of depression for the past 3 months.
Currently doctor diagnosed patient as maniac. What is
appropriate to do?
A) Continue paroxetine and start lithium
B) Discontinue paroxetine and start lithium

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C) Continue paroxetine and add haloperidol and lithium

D) Discontinue paroxetine and add haloperidol
E) Increase dose of lithium
Ans: B
74) A patient with neuropathic pain was prescribed

carbamazepine by his doctor, with some relief of his signs
and symptoms but with more side effects that are
bothering the patient. Which of the following symptoms
are not dose dependent?
A-Rash B-Dizziness C-visual disturbances
D-GI upset
Ans-A
Tips: Carbamazepine idiosyncratic ADR is rash, require to
discontinue and talk to doctor. A patient with allergic
amitriptyline should not take carbamazepine because
these two drugs are structurally same class.
75) A patient was on lovastatin since last six months. His

lipid profile is under controlled. By some reason he
started to take herbal product containing niacin and find
problem of muscular pain. This pain was not continuous.
What should patient do?
A. Take Tylenol on PRN base
B. Contact to doctor
C. Contact to doctor and ask for CK-MM tests
D. Patient need not to worry

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ANS: C
Tips: TC 6th ed. page 440
76) What laboratory test monitored regularly, patient

using statins?
A-LFT (AST +ALT) B) CK-MB C) BP D) RFT E) CK-
MM
ANS: A
77)What statin should take with food?

A) Atorvastatin
B) Lovastatin
C-Fluvastatin
D-Simvastatin
E-Rosuvastatin
ANS: B
Tips: FL are taken with food. Lovastatin have very high
effect on bioavailable.
78) A 10 years child with ADHD. His doctor diagnosed

his condition and prescribed methylphenidate CR
capsule 10 mg twice daily. Best thing the pharmacist
should do is
A-Call the doctor to switch the patient to
methylphenidate CR tab 20 mg/dose since the later is
given in divided doses.

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B-Call the doctor to ensure him that methylphenidate

CR is given once daily and not twice daily
C-Dispense the prescription as it is
D-Call the doctor to prescribe him methylphenidate
since the capsule can be opened and sprinkled on soft
foods
E-None of the above
Ans:B: methylphenidate CR is given as 20 mg/dose 8
hours apart and controlled release as a single dose
79) What is monitored in 10-year-old using

methylphenidate, except?
A-Weight loss
B-Insomnia
C-Constipation
D-Reduce hyperactivity
E-Attention in his studies
F-Suicidal plans
Ans-C
80)The child mother is concerned about addiction of

ADHD medications, What to tell her? except
A) Giving ADHD therapy now will reduce the abuse
further in life
B) Drug has addiction. However it is safe to use as
prescribed by doctor.
C) Improve in social interactions
D) Improve in athletic performance
E-Improve academic performance
Ans: D

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81) Which of the following antidepressants is most

effective in the treatment of post herpetic neuralgia, and
diabetic neuropathic pain?
a. Amitriptyline
b. Fluoxetine
c. Paroxetine
d. Citalopram
Ans: A
TC page 143
Tips: Amitriptyline is used in post herpetic, diabetic
neuropathic pains, however it not used in trigeminal
neuralgia pain Amitriptyline dose 10 to 25 mg QHS daily
at weekly intervals until pain relief or side effects.
82)Which of the following DOES NOT have any value in

the treatment of symptoms of trigeminal neuralgia
I) Carbamazepine
II) Baclofen
III) Meloxicam
A-I only
B-III only
C-I and II only
D-II and III only
E-I, II, III
Ans: B
TC page 139
NSAIDs, and acetaminophen are NOT effective for the
treatment of neuralgia.

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83) KP is a 27 year old man using salbutamol and

fluticasone inhalers for asthma. Having dry cough. He
asks pharmacist, why all OTC cough suppressants like
dextromethorphan (DM) should be avoided?
A) DM may hide early symptoms of asthma attack
B) DM interact with corticosteroids making both
ineffective
C)all people asthma should consult with physician as
soon as respiratory symptoms develops
D) codeine is more safe and effective for people with
asthma
Ans: A
84. What is the target of total cholesterol in the patient

have coronary artery disease (MI, post MI, STEMI,
NSTEMI, Unstable angina)
A) < 2.2 mmol/L
B) <4.0 mmol/L
C) <1.8 mmol/L
D) 4.5 mmol/L
ANS: B
TC page 436, 6th ed.
85) What is the target of LDL in the patient have diabetes

mellitus

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A) < 2.2 mmol/L

B) <2.0 mmol/L
C) <1.8 mmol/L
D) 2.5 mmol/L
ANS: B
86) Which of the following patient have high risk of Acute

Coronary syndrome.
A) + ve cardiac enzyme like Troponin I
B) ST segment changes
C) TIMI risk score > 3
D) Heart failure
E) All of the above
ANS: E
87) A pharmacist during in putting a prescription into the

computer forgot to enter the number of refills that were
indicated in the prescriptions, and the patient pick up his
medication from the pharmacy and went home. The best
action the pharmacist should do:
A-Call the patient to tell him that you forgot to put the
number of refills
B-No problem, next time when he comes you can tell him
to go to his doctor to write other refills
C-Don’t tell the patient that you forgot to put the refills

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D-Call the patient inform him that you forgot to put the
refills and tell him that you are going to enter the refills
into the computer
E-None of the above
Ans-D
Tips: We have to call the patient inform him about the
error, and input the number of refills into the computer,
and issue a drug incident error for that and inform the
manager or district manager about that, and take the
steps of not repeating this error again
88) KK, is a 43-year-old male, presents to your pharmacy

requesting something for his “ulcer.” On questioning him,
you learn that: 1) he has had “stomach pains: that have
been getting progressively worse over the month; 2) he
does not take any NSAIDs/ASA; 3) his pain does not rise
towards the neck (heartburn); 4) he has not alarm
features; and 5) he never has been diagnosed with an
ulcer. He smokes 3 to 4 cigarettes a day and usually has 2
glasses of wine with dinner. Based on the evidence, what
would be an appropriate next step to manage KK?
a) Stop the cigarettes and the wine
b) Try an alginate-containing product
c) Suggest he see his family doctor for possible H. pylori
testing.
d) Go to the Emergency room to be assessed for a
possible peptic ulcer
Ans: C

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A 80 yo male with NYHA II CHF (EF 33%), purchasing

Gravol for nausea, dizziness, ↓appetite x 2wks. He
thinks it is related to recent ramipril dose increased.
Patient medical history include MI (past 3 yr ago),
HTN(past 20 yrs), ↑lipids(x 2yrs), CHF(x 1yr), atrial
fibrillation ( for 10 wks). His current meds include:
Pravastatin 40mg QD (x2yrs), amiodarone 200mg QD
(x6wks), digoxin 0.25mg QD (x1yr), warfarin 5mg QD
(for a 6wks), carvedilol 25mg BID (x 1yr), HCTZ 25mg
QD (x 25yrs), Ramipril 10mg QD (↑from 5mg 2wks
ago).
89) A patient has symptoms of heart failure at less than

ordinary activity, which is defined as?
A-symptoms may appear at climbing one flight upstairs.
Or walking 200 yards
b-symptoms may appear 30 minutes jogging
C-symptoms may appear after 3 to 5 times of exercise for
30 min in a week
D-None of the above
Ans-A
90) What is initial therapy for patient has heart failure

symptoms from NYHA classification 1 to IV.
A) ACE I and beta blockers
B-ARBs and beta blockers
C-Digoxin and beta blockers
D-Diuretics and beta blockers
E-Spironolactone and beta blockers

PharmacyPREP.com
Ans: A
91) If hypothetically doctor choose to use metoprolol and

enalapril to assess the tolerability. Which of the following
need to be watched?
A) Shortness of breath
B)Ankle edema
C) Weakness
D) Dry or productive cough
E)Fatigue
Ans: D
92) A regular customer of your pharmacy, complaining

about having to get up in the nights, as he woke up two
times due to asthma symptoms. Currently he is on
salbutamol and ICS puffers. What is the first step a
pharmacist should do?
A) refer to doctor
B) recommend sleep hygiene
C) increase dose of ICS
D) Add to LABA or LTRA
E) Check use of salbutamol and ICS puffers devices
Ans: E

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93) The above patient comes to pharmacy. Asking why he

got oral fungal infections. He is currently using inhaled
corticosteroid like fluticasone 500 mcg bid. What is the
cause of his oral fungal infection?
A) Due to high dose if ICS
B) Due to incorrect technique of ICS
C) Due to NOT using spacer
D) It is usual side effect of ICS
Ans: D
94) A patient has COPD and renal failure, developed

pneumonia, which of the following fluroquinolones can
be used?
A) Ciprofloxacin
B) Moxifloxacin
C) Levofloxacin
D)Norfloxacin
E) Gemifloxacin
Ans-B
Tips: Hepatic elimination antibiotics: doxycycline,
azithromycin, and clarithromycin (major), moxifloxacin,
clindamycin, Pen V, ceftriaxone, spectinomycin.
95) Ted is a 55 year-old male, and a new patient to your

pharmacy. 163 cm, 86 kg

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He suffered a non-ST elevation myocardial infarction 1

week ago. He tells you that he had PCI in hospital, with a
bare metal stent to his proximal LAD. What are the
clinical features used to calculate TIMI risk score?
A)Age >65 y
B)hypertension
C)high cholesterol
D)any ASA use within 7 d
E) all of the above
Ans: E
96. Ms AB is 72 kg. 50 y/o woman who was recently

diagnosed with type 2 diabetes. On physical exam her BP
is 120/80. Her family doctor told her the results of her
24hour urine collection showed a normal amount of
protein in the urine. Which of the following interventions
should be implemented to decrease Ms AB’s chance of
developing renal disease?
A)Initiation of an ACE inhibitor
B)Initiation of an ARB
C)Optimal blood glucose control
D)Reduction of protein intake to 0.6 g/kg/day
ANS: C
97) A patient was taking Dimicron 180 mg (glicalizide)

dose recently decreased to 80 mg BID. also the patient.
The patient suppose to be given 1 box of Diovan
(valsartan) 80 mg and boxes of Dimicron the label of
Diovan was wrongly placed on Dimicron and the vice

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versa. The patient is advised to take 1 pill of Diovan and

2 pill of Dimicron. Because of wrong labeling, which
symptoms patient experience initially?
A) Increased pulse rate
B) decrease pulse rate
C) Decrease systolic pressure
D) decrease diastolic pressure
E) Hypoglycemia
ANS: C
98) A 65 years old patient presents with psychomotor

agitation. Patient is on Fluoxetine for 6 weeks for the
treatment of depression. There was an improvement in
his appetite and in his sleep disturbance. Doctor should
now:
(A) Taper and discontinue the medication
(B) Continue the medication for 6 months
(C) Add Lithium
(D) Add Olanzapine
(E) “C” or “D”
Ans: (D)
Reference: Therapeutic Choices 6th
edition...Antidepressant management If partial response
augmentation with lithium or SGA. or CBT/IPT
99) A parent of ADHD child call your pharmacy to ask her

concern on her child medication. After initiated
methylphenidate bid 10 mg takes 7 am SR tabs and 3 pm

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IR tabs. She is concerned about her child loosed his

appetite and going to bed late in nights wakes up late in
the morning. What is the appropriate to do?
A) ask her to contact doctor
B) ask her to check weight
C) ask her to give medication 7 am SR tab and 12 noon IR
tabs
D) ask her increase diet
E) ask her to check his school performance
Ans: C
Tips: Give medication with meals, high calories meals,

when stimulants effects are low specially breakfast and
bedtime and supplemental boost ensure and also engage
child in meal prep and shopping for favourite food.Ref:
Rx files. To increase appetite cyproheptadine can be
used.
100. A 41 years old a chronic alcoholic male, no known

allergies, past medical history: Anxiety, difficulty
sleeping. Current medications: triazolam 0.5 mg qhs x 3
years and acetaminophen/caffeine/codeine (Tylenol #1)
ii prn headache
You notice that this patient has been coming in early for
refills for triazolam and has received extra
prescriptions for this medication from many walk-in
clinics.
Patient approaches you and states that he is concerned
about his triazolam usage, so he stopped using it 24

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hours ago. He asks you what the most common

withdrawal symptoms will be:
A. Diarrhea, shakes and chills
B. Insomnia, muscle spasms and irritability
C. Increased headache, fatigue and nausea
D. Seizures, delirium, and hallucinations
Ans: B

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PharmacyPREP.

Therapeutic MOCK TEST 1 - May 2013

1) MP is a 50 year old man. His medical history started

2) Which of the following is the next most appropriate

Tips Inc Copyright 2000-2013 Prevent Piracy & Report Piracy 1

4) NKP is a 47 year old patient has just started raw diet

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5) NPK is diagnosed high LDL and TG, what is the best

6) KP is 53 year old patient who had hypertension came

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7) KM a 60 yo MI patient had bypass surgery past 4

8) A 60 yo patient came to emergency and doctor

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10) A 64 yo man weighing 115 kg, and tall 60 inches,

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A) Knee surgery B) over weight C) long flight D)

11) What is the most important recommendation should

12) Patient is hospitalized. Drs initiated heparin

13) If doctor initiated dalteparin, which of the following

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14) A 60 years old patient having systolic CHF. His LVEF

15) In the above scenario if persistent symptoms i.e. if

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D-II and III only

16) Which of the following is NOT used in CHF?

Josh Holiday is a 26 year old unemployed university

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18) A 66 yo patient arrived to emergency after 6 hours

19) The above patient having atrial fibrillation. What is

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21) Which of the following drugs are not considered in a

22) MK is a 62 year old man. He is on warfarin 2.5 mg

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D- Effects of warfarin may be decrease resulting in

23) MK is currently stabilized on warfarin 2.5 mg QD

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antibiotics that may increase warfarin and digoxin

24) A 65 years old patient was admitted to ICU

25) A 41 years old a chronic alcoholic male, no known

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stopped using it 24 hours ago. He asks you what the

26) Which of the following patient assessment is LEAST

27) A physician prescribed alprazolam 0.5 mg SL 3 tab.

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Tips: Benzodiazepine can be refilled. Benzodiazepine

28) The pharmacist fills a prescription for sumatriptan

29) A 30-year-old patient, is currently on antidepressant

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use a sedative. Which is the best option to improve

30) MD is a 40-year-old woman who has recently been

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TIPS: As alprazolam is related to BDZs it’s the best

FG is a 65-year-old war veteran with a 40-year history

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supply and finds that he has samples of fluphenazine,

31-Which agent is least likely to cause extrapyramidal

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ST, is a 57-year-old male nurse who works for the local

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