COC EXAM QUESTION

1. A patient diagnosed with iron deficiency anemia came

to an OPD pharmacy with a prescription containing
ferrous sulfate with appropriate dosage. Accordingly,
the pharmacist dispensed the requested medicine. On
his next visit, the patient explains that he fails to
adhere to his treatment due to a certain side effect.
Subsequently, the patient is still suffering from anemia.

What is the most likely side effect related to poor

adherence to treatment in this patient?

A. Orange urine
B. Black urine
C. Orange stool
D.Black stool
2. A pharmacist received a call from a wife of a 34-year-
old male patient with Type-1 diabetic mellitus after
she found him unconscious. She reported that the
patient was on insulin a missed his lunch.

What is the most appropriate advice the pharmacist

should give her?

A. provide him a 1 table spoonful or 3 cubes of sugar

B. Observe the patient until he becomes conscious
C. Take him to hospital and get emergency drugs
D.Buy glucose 40% from pharmacy and give orally

3. A 45-year-old man with a history of well controlled

hypertension and smoking came to community
pharmacy requesting for anti-acid after he experienced
Epigastric burn and blo vomiting of three days
duration. The pharmacist referred the patient to a
hospital for further evaluation and treatment.
 What is the most likely reason for referral of this
patient?

A. Smoking
B. Hematemesis
C. Hypertension
D.Hurt burn

4. A 42-year-old COVID-19 infected patient and who was

under a self-quarantine at home made a call to the
nearby pharmacy. He consulted a pharmacist on the
type of analgesic agent he should take to lower his
mild pain and headache. The pharmacist stressed on
on particular analgesic agent that he should avoid
using in particular.

What is the most probable analgesic agent that the

patient was consulted to avoid?
 A. Indomethacin
B. Paracetamol
C. Diclofenac
D.Ibuprofen

5. A patient who usually consumes raw meat comes to a

pharmacist and reports symptoms li abdominal cramp,
dizziness and passage of segments of a worm through
the anus. The pharmacist suspects a Taenia saginata
infection.

What is the most appropriate drug that the pharmacist

should dispense?

A. Thiabendazole
B. Albendazole
C. Praziquantel
D.Niclosamide
6. A patient treated with Methotrexate comes to a
pharmacist working in an oncology with a prescription
containing Ondansetron 8 mg PO BID for two months.

What is the most appropriate advice that the

pharmacist should provide to this patient?

A. Use it PRN
B. Use it regularly
C. Use it occasionally
D.Use it during vomiting

7. A 53-year-old woman has been taking Ibuprofen 400

mg PO TID for the last six menthe which relieved her
joint pain secondary to rheumatoid arthritis. But she
comes to outpatient clinic with complaints of loss of
appetite, epigastric pain, and nausea and vomiting
 after eating. The physician in consultation with the
clinical pharmacist associated the patient complaint to
the drug she has been taking.

What is the most likely intervention recommended for

this woman?

A. Continue with Ibuprofen and give Cimetidine

B. Discontinue with Ibuprofen and give Cimetidine
C. Continue with Ibuprofen and give Omeprazole
D.Discontinue with Ibuprofen and give Omeprazole

8. A 27-year-old male patient is diagnosed with

Helicobacter pylori associated peptic ulcer disease.
Evaluation of his medical record shows that he has a
history of penicillin allergy.

What is the most appropriate therapeutic regimen for

this patient?
 A. Tetracycline + Clarithromycin + Omeprazole
B. Amoxicillin + Clarithromycin + Omeprazole
C. Ciprofloxacin + Clarithromycin + Omeprazole
D.Metronidazole + Clarithromycin + Omeprazole

9. A 52-year-old woman developed a portal hypertension

secondary to cirrhosis for which she has been taking
appropriate doses of Furosemide and Spironolactone.
Today she comes to the outpatient department for her
regular follow up.

What is the most likely clinical chemistry parameter to

monitor this case?

A. Serum glucose
B. Serum potassium
C. Serum bicarbonate
D.Serum creatine kinase
10. A 44-year-old woman has been taking appropriate
dose of ferrous sulfate for iron deficiency anemia and
aluminum containing anti-acid for two weeks of
dyspepsia. Today she comes to an outpatient
department complaining unrelieved symptoms of
anemia and reports that she has been taking both
medications at the same time.

What is the most likely drug therapy need of this

patient?

A. Noncompliance
B. Indication
C. Safety
D.Effectiveness
11. A patient brought a prescription to prepare a cough
mixture of 125 ml Codeine solution cough mixture is
intended to contain 12 mg of Codeine in each
teaspoonful of the solution.

How many milligrams of Codeine are required to

prepare the solution?

A. 2500
B. 625
C. 300
D.60

12. A compounding pharmacist received a prescription

to prepare a certain dermatological ointment to be
applied twice daily for 2 weeks. The pharmacist in
charge has prepared the formulation and dispensed to
the patient with adequate counseling.
 What is the most appropriate cautionary label for this
preparation?

A. Take twice daily

B. For topical use only
C. Use for few days only
D.Store at room temperature

13. A patient brought a prescription containing ARV

drugs for his monthly follow up. While preparing and
packaging medicines, the patient urged the pharmacist
to issue quickly telling that she is familiar with the
medicines so that she can go for her business.

What is the most appropriate next step in managing

this patient?

A. Evaluating and Validating the prescription

 B. Labeling and providing information
C. Issuing medicines to the patient
D.Documenting the actions taken

14. A hospital pharmacist received a treatment order of

Triamcinolone 0.05%, Ointment Base ad 120 g. Sig.
Apply daily to the affected area. The pharmacist
prepared the medication accordingly and wrote a
label, which includes patient's name, Triamcinolone
ointment, apply topically daily for one month.

What is the most likely missed labeling information for

this extemporaneous prescription?

A. Brand name
B. Generic name
C. Batch number
D.Direction for use
15. 21-year-old male and 23-year-old female sibling
patients came with prescriptions for Amoxicillin and
Cloxacillin, respectively. The pharmacist in charge
received their prescriptions and dispensed with
adequate instructions. However, up on going to their
home, they mixed up their medicines and could not
identify which one to take properly.

What is the most likely dispensing procedure missed in

this case?

A. Interpreting and understanding

B. Documentation and counseling
C. Recording the transaction
D.Packaging and labeling
16. 25-year-old lady presented to a gynecology and
obstetrics clinic with complaints of lightheadedness
and easy fatigability. In addition, she reported that she
had unusual heavy menses since 10 days that demands
frequent changes of sanitary pads. Examination
showed a heart rate 76/min and her conjunctiva was
paper-white in color. The attending gynecologist set
the diagnosis as menorrhagia.

What physical finding best complies with her

diagnosis?

A. Heart rate level

B. Easy fatigability
C. Conjunctiva color
D.Lightheadedness

17. A 62-year-old male was presented with complaints

of increased urinary frequency, decreased force of
 stream and straining of one week duration. He is a
hypertensive patient and was on Nifedipine 20 mg PO
BID for the last 2 years. On examination, his prostate
was small in size, soft, symmetric, and mobile under
digital rectal examination. The diagnosis was set as
moderate benign prostatic hyperplasia and the
physician in charge requested a pharmacist for
possible therapeutic recommendations.

What would be the most appropriate Pharmaco-

therapeutic intervention for this patient?

A. Doxazosin
B. Prazosin
C. Alfuzosin
D.Tamsulosin

18. A 68-year-old male patient was diagnosed with urge

incontinence. He is taking Amitriptyline for four weeks
 as a major depression treatment. The patient
frequently faces difficulty in passing stool. The
pharmacist is concerned with the safety of the drug
prescribed.

Which adverse drug event is more associated with the

drug the patient took?

A. Diarrhea
B. Dry mouth
C. Constipation
D.Urinary retention

19. A patient brought a prescription that calls for 'Divido

75 mg capsule PO PRN'.

What component of this prescription could lead to

error while dispensing?
 A. Direction for use
B. Potency of the drug
C. Name of the medicine
D.Frequency of administration

20. A psychotic patient is taking Haloperidol 15 mg PO

QD. To decrease side effects of the trihexyphenidyl 5
mg PO QD was added.

What could be the possible side effect of the added

drug?

A. Diarrhea
B. Dryness of mouth
C. Exessecive swelling
D.Nausea And vomiting
21. A patient was prescribed Clozapine 300 mg tablet
PO BID for resistant change and Cotrimoxazole 960 mg
tablet PO BID for suspected of food poisoning

What is the potential adverse effect to be developed

from these medications’ interaction?

A. Drug fever
B. Renal damage
C. Drooling of safina
D.Bone marrow suppression

22. A father of nine-year-old child came to a pharmacy

and asked the senior pharmacist to give him Aspirin for
his child who has a moderate fever and headache. The
pharmacist decided to give him a relief medication
until he visits a physician.
 What should be the most appropriate decision made
by the pharmacist for this patient?

A. Give Aspirin 300 mg tablet PO PRN

B. Give Aspirin 81 mg tablet PO PRN
C. Replace request with Diclofenac 50 mg PO tablet PRN
D.Replace request with Paracetamol 500 mg tablet PO
PRN

23. A 55-year-old male was diagnosed with a peptic

ulcer disease secondary to Helicobacter pylori
infection.

What is the most appropriate initial therapy regimen

for this patient?

A. Amoxicillin I gm PO BID- Metronidazole 500 mg PO BID

+ Cimetidine 400 mg PO BID for 10 days
B. Amoxicillin I gm PO BID + Clarithromycin 500 mg PO
BID + Cimetidine 400 mg PO BID for 10 days
C. Amoxicillin I gm PO BID + Metronidazole 500 mg PO
BID-Omeprazole 20 mg PO BID for 14 days
D.Amoxicillin I gm PO BID + Clarithromycin 500 mg PO
BID+ Omeprazole 20 mg PO BID for 10 days

24. 34 year old women present in hospital with

complain of intense unilateral headache of two weeks
duration. The head ache is usually accompanied by
sever vomiting.

What is the initial drug of choice for the management

of this patient?

A. Acetaminophen
B. Tramadol
C. Aspirin
D.Sumatriptan
25. A 31-year old female known epileptic patient came
to neurology for regular follow- up She has been
maintained on one of the standard antiepileptic drugs.
Throughout her course of therapy, she was tested
positive for pregnancy. The neurologist warned her to
stop the current drug since the drug has high potential
to major birth ….

What drug is the most likely drug that has been taking?

A. Carbamazepine
B. Phenobarbital
C. Valproic acid
D.Phenytoin

26. A 12-year-old man was on standard dose of

Carbamazepine of three months for generalized
 partial seizure. The client presented to a neurology
clinic complaining minimal improvement in his seizure
control. The clinical team decided to initiate Sodium
Valproate

What is the most likely laboratory test that should be

done before starting the drug?

A. Liver function test

B. Renal function test
C. Thyroid function test
D.Serum electrolyte

27. A 60-year-old man was presented to an emergency

department with complaints of easy fatigability and
palpitation. With thorough history, physical
examination and laboratory investigations, the
physician in charge set the diagnosis as
tachyarrhythmia as the ECG sheet dictates Pi-segment
 of 0.15see, P wave 0.10sec, QRS rate 120/min and QTc
0,40sec.

Which ECG finding is most likely in line with diagnosis?

A. PR-segment duration
B. P wave duration
C. QTe duration
D.QRs rate

28. A 45-year-old man with history of acute coronary

syndrome came to an emergency department with
complaints of respiratory depression, confusion and
inability to arouse from bed. He was on Clopidogrel,
warfarin, low dose Aspirin and Morphine. The clinical
team associated the complaints with the drugs he has
taken.

What drug is the most likely cause for his complaints?

 A. Morphine
B. Warfarin
C. Aspirin
D.Clopidogrel

29. A pharmacist wanted to inaugurate a drug

information service in a certain hospital. Develops
many drug information materials and documented
them in the drug information.

What is the most appropriate next step in the drug

information processing?

A. Determine the purpose of the drug information

materials
B. Store the drug information materials in drug
information center
C. Decide what type of writing style to be used based on
audiences
D.Communicate the information with other health
professionals

30. A clinical pharmacist observed that most of A

hospitalized patients are receiving Cimetidine The
pharmacist reviews literatures and found that this
drug is strong enzyme inhibitor has drug interactions
with most drugs than Ranitidine. The pharmacist
requested the drug therapeutic committee for
addition of ranitidine and removal of Cimetidine from
the hosp formulary.

What is the most appropriate parameter considered

for replacing this drug formulary?

A. Efficacy
B. Safety
C. Cost
D.Formulation
31. A 70-year-old male hypertensive patient has been
taking Enalapril 5mg PO daily, but blood pressure was
poorly controlled. The physician consults an attending
pharmacist a the effectiveness of Amlodipine
compared to Enalapril to consider a regimen switch
"Population-Intervention-Comparison-Outcomes
(PICO)" model for framing his question.

What is the "Comparison" for framing the question in

this scenario?

A. Hypertension
B. Enalapril
C. Amlodipine
D.Blood pressure
32. A 32-year-old female patient presented to a hospital
with a compliant of menstruation for two consecutive
months. On examination, her blood pressure was
mmHg (repeated 155/4 mmHg), Temperature 36.7°C,
Respiratory rate 20/min and Pu 84/min. She was
positive for pregnancy test. It is expected from the
Pharmacist to--recommendations for antihypertensive
drugs considering the patient, disease and me-- related
factors.

What are the factors that should be considered to

provide appropriate recommendation?

A. Age, pregnancy, blood pressure

B. Sex. pregnancy, pulse rate
C. Pulse rate and pregnancy
D.Blood pressure and pregnancy
33. A 34-year old male who was diagnosed with knee
Psoriasis and put on cream BID six weeks back, visited
the outpatient department with complaints of clinical
remission despite he applied as per the direction given
before.

For which drug therapy should the pharmacist give a

priority for this patient?

A. Adherence
B. Effectiveness
C. Safety
D.Indication

34. A Five-year-old child was diagnosed with drug-

induced skin reaction secondary to Cephalexin
250mg/5ml BID use for community acquired
pneumonia since two days back. The patient was
febrile and the eruption was very painful and itchy. The
dermatologist on duty request a pharmacist for
 possible recommendations on the drug being taken by
the child.

What would be the most appropriate recommendation

for this patient?

A. Initiate analgesic agent

B. Avoid sunlight exposure
C. Discontinue with the medication
D.Use antihistaminergic agent

35. A 43-year-old female patient was diagnosed with

stage-II breast cancer. The general surgeon in charge
conducted a breast-conserving surgery as her breast
was big in size. Then, he sent her back home with an
appointment after three months. The oncology
pharmacist assessed for the possibility of adjuvant
therapy initiation for the residual cancerous tissue.
What drug therapy should the pharmacist give a priority
for this patient?

A. Adherence
B. Effectiveness
C. Safety
D.Indication

36. A 28-year-old female patient presented with a single

painless, palpable lump in her right breast. The fine-
needle aspiration cytology showed malignant changes
of the cells. Therefore she was diagnosed with early
stages breast cancer and put on Doxorubicin 60 mg/m²
IV and Cyclophosphamide 600 mg/m² IV to be
repeated every 21 days for four cycles after surgical
resection of the lump.

What would be the main purpose of initiating these

chemotherapeutic drugs?
 A. Cure the disease state
B. Conserve the breast tissue
C. Control the sign and symptoms
D.Decrease the disease progression

37. 45-year-old male patient comes to an OPD pharmacy

with a prescription calling for Enalapril 10 mg PO BID,
Furosemide 20 mg PO BID. Aspirin 81 mg PO daily and
Omeprazole 20 mg PO BID for one month. The stock
shows all of the drugs are available at the stated
strength except Enalapril that is available in 5 mg
strength.

What quantity of medications should be dispensed to

this patient?

A. Enalapril 60, Frusemide 60, Aspirin 30, and Omeprazole

30
B. Enalapril 60, Furosemide 60, Aspirin 30, and
Omeprazole 60
C. Enalapril 30, Furosemide 60, Aspirin 60, and
Omeprazole 120
D.Enalapril 120, Furosemide 60, Aspirin 30, and
Omeprazole 60

A prescription stating a 30 mg/5ml cough syrup, 3 mg

daily was brought to an OPD pharmacy for a two year old
child. After evaluating the prescription, the pharmacist
calibrated the medicine dropper to deliver 20 drops of
the cough syrup for I-ml.

What daily dose (in drops) of the cough syrup is going to

be administered to this child?

A. 15
B. 10
 C. 7.5
D.5

38. A senior pharmacist received a prescription from a

young man for Amoxicillin capsule 500 mg PO BID for 7
days and Ibuprofen tablet 400 mg PO TID for 5 days.
The man is begging the pharmacist to issue quickly as
he is familiar with the drugs so that he can go for his
business.

What is the most appropriate initial step in the

management of this patient?

A. Recording the actions taken

B. Issuing medicines to the patient
C. Preparing and labeling medicines for issue
D.Validating and understanding the prescription
39. A woman brought a prescription containing
Amoxicillin and Clavulanic acid combination oral
suspension 5 ml PO TID for 7 days. While selecting and
manipulating the medicines, a pharmacy assistant gets
a bit confused with the prescription and approaches
the pharmacist TO seek a consultation.

What is the most pertinent information missed in this

prescription?

A. Dosing frequency
B. Route of administration
C. Duration of the treatment
D.Strength of the medicine

40. A 30-year-old patient is diagnosed for non-

gonococal urethritis and came to a p working in
 dispensary with a prescription requesting for
Erythromycin 500 mg PO O seven days. The
pharmacist documents all the necessary information
with proper hand and recording.

For how long does this pharmacist need to keep

records of this patient?

A. Two years
B. Three years
C. Four years
D.Five years

41. A 25-year-old male patient diagnosed for Chancroid

comes to a pharmacist working in private pharmacy
with a prescription of Ciprofloxacin 500 mg PO BID for
3 days and certain another drug. The pharmacist
advises the patient not to take Ciprofloxacin with
other drug for at least three days.
What is the most likely drug that forced the decision of
the pharmacist?

A. Iron dextran
B. Iron sucrose
C. Ferrous sulfate
D.Ferric sorbitol

42. A physician requested a pharmacist working in drug

information center about Metformin in the treatment
of metabolic disorder occurred due to use of
Olanzapine for the treatment` schizophrenia.

What is the most appropriate order for search sources

to the information?

A. Primary → Secondary → Tertiary

B. Secondary→ Primary→ Tertiary
 C. Primary → Tertiary → Secondary
D.Tertiary → Secondary→ Primary

43. A pharmacist working in drug information center

wanted to prepare news letter on drug for health care
professionals working in a hospital.

What should be the appropriate steps for composing

the news letter?

A. summary → Body → Conclusion

B. Introduction → body Conclusion
C. Introduction → Methods → Result→ Discussion
D.Summary→ Result→ result → Conclusion
44. A chronic alcoholic patient was presented with
complaints of fatigue, malaise and tiredness. His
physician prescribes a drug that contains vitamin
B1+B2+B6+B-12

What is the correct order of vitamins prescribed for

the patient?

A. Adenosine Phosphate, Biotin, Riboflavin, Pyridoxine

B. Biotin, Riboflavin, Adenosine phosphate, Pyridoxine
C. Thiamine, Riboflavin, Pyridoxine, Cyanocobalamin
D.Ascorbic acid, Pyridoxine, Cyanocobalamin, Riboflavin

45. 28-year-old female patient is taking RHZE

medications for intensive phase of her TB treatment.
Until she gets cured from the illness, she decided to
avoid pregnancy by using oral contraceptives.
However, the pharmacist explained on the potential of
 Anti-TB medications in lowering the effect of oral
contraceptive.

What is the most likely drug that could lower

effectiveness of the oral contraceptive?

A. Ethambutol
B. Isoniazid
C. Pyrazinamide
D.Rifampin

46. A woman diagnosed with a urinary tract infection,

was on Norfloxacin 400 mg PO BID for 7 days. Besides,
she started to take Aluminum Hydroxide plus
Magnesium Trisilicate Antacid for a breakthrough GI
burning sensation.

What could be the possible interaction effect between

those drugs?
 A. Decreased absorption of the antacid
B. Decreased metabolism of Norfloxacin
C. Decreased metabolism of the Antacid
D.Decreased absorption of Norfloxacin

47. A woman presented with an acute migraine

headache, came to hospital. The physician on duty
prescribes Metoclopramide 10 mg tablet PO TID and
Paracetamol 1000 mg tablet PO QID.

What could be the importance of Metoclopramide in

addition to its antiemetic effect?

A. It decreases dopamine activity

B. It decreases migraine headache severity
C. It increases excretion rate of Paracetamol
D.It increases absorption rate of Paracetamol
48. 45-ycar-old man with a known hypertension and
diabetes was presented to a hospital routine follow up.
He was on Hydrochlorothiazide, Amlodipine, and
Metformin Spironolactone. The laboratory finding
revealed elevated fasting blood glucose and uric acid
the medical team decided that the patient's diabetes is
not well controlled and the possible rationale was
linked with the drugs he takes.

Which drug should be changed to control the patient's

diabetes?

A. Spironolactone
B. Metformin
C. Hydrochlorothiazide
D.Amlodipine
49. A 45-year-old man who is diagnosed with
hypertension, maintained on Hydrochlorothiazide 50
mg daily and Nifedipine 60 mg daily. On assessment,
he smokes cigarette occasionally, ingests 300 ml (4%)
alcohol daily and has limited salt intake. His BMI was
27 kg'm. On today's arrival, his diastolic blood pressure
is increased by 15 mmHg than the usual.

What is the most appropriate non-pharmacologic

counseling should be given to him?

A. Quit smoking cigarette

B. Stop salt consumption
C. Stop alcohol consumption
D.Do regular moderate exercise

50. A 60-year-old patient presented with midline

anterior chest discomfort, increasing pain that lasts
more than 20 minutes for the past six hours. On ECG
 evaluation, ST-segment was elevated and two value
increases in CK-MB biomarker set by hospital and
oxygen saturation was 95%. The clinician
presumptively diagnosed as ST-segment-elevation
acute coronary syndrome.

What diagnostic test would be recommended to

confirm the problem?

A. oxygen saturation test within 24 hour

B. Cardiac biomarker test within 48 hour
C. Serum fasting lipid panel test within 48 hour
D.Blood chemistry tests for sodium with 12 hour

51. A 40-year-old woman on Amlodipine and

Hydrochlorothiazide for hypertension management
came to the outpatient department tor regular follow-
up. She was taking combined oral contraceptives and
Acetaminophen additionally. On examination, her
 blood pressure was not controlled for the last two
weeks despite good adherence to the regimen. The
clinical team in charge associated the poor blood
pressure control with the drugs being taken.

What is most likely drug that could cause a poor

control in her blood pressure?

A. Combined oral contraceptive

B. Hydrochlorothiazide
C. Acetaminophen
D.Amlodipine

52. 28. An 18-year-old boy presented to a clinic with a

complaint of dyspnea and coughing limited his ability
to cope up with his basketball teammates. He states
that "it is worse w playing outdoors and worsens in
recent days than a month ago". He has a history of
experiencing several attack of bronchitis as a young
 child and the teammate's match usually lasts 90-95
minutes.

What is the most appropriate preventive therapy for

this patient?

A. Albuterol 10 minutes before exercise

B. Salmeterol 10 minutes before exercise
C. Formoterol 10 minutes before exercise
D.Terbutaline 10 minutes before exercise

53. A 67-year-old man was presented to an emergency

department with a complaint of excessive bleeding
from minor bruising and cuts while shaving his face.
The patient medication history shows that he has been
taking Warfarin for atrial fibrillation for three years,
Beclomethasone and Salbutamol for his asthma for six
months. In addition, he started an oral Theophylline
three weeks back because of increasing in frequency
 and severity of asthma symptoms. The laboratory
result indicates that international normalized ratio
(INR) of 3.5 (normal range: 2.5-3.5).

What is the most appropriate management for this

patient?

A. Monitor INR
B. Discontinue with Warfarin
C. Administer vitamin K
D.Discontinue with Theophylline

54. A 28-year-old known Type-l diabetes woman visited

an outpatient department complaining bilateral foot
pain, which she described as a burning and tingling
sensation. She is on Insulin therapy for the last six
years and currently has poor glycemic control. An
examination of her feet reveals that cool extremities
 with absent pulses, reduced vibration perception and
loss of 10-g monofilament pressure sensation.

What is the most likely assessment in favor of her

presentation?

A. Peripheral neuropathy
B. Deep vein thrombosis
C. Autonomic neuropathy
D.Peripheral arterial disease

55. A registered importer of pharmaceuticals in Ethiopia

decided to launch promotional activity on one of its
products with the aim of increasing its revenue and
conducted promotional activity that accounted for half
of the price of the drug.

What is the likely mistake committed by the company

while promoting the product?
A. The company conducted promotion as per promotion
and advertisement guideline.
B. The company violated promotional price threshold
set for the product.
C. The company conducted promotional activity below
the standard price.
D.The company did not violate the price restriction for
the promotion of pharmaceuticals.

56. A pharmaceutical company has been working to

develop a new vaccine for the prevention of HIV/AIDS
in America. A regulatory and marketing division of the
company has been jointly working to conduct
promotion for this unapproved product to secure
additional funding for further research without
mentioning the product name.

What is the appropriate promotion type for this

product?
 A.Coming soon advertisement
B. Institutional advertisement
C. Help-seeking advertisement
D.Prescription advertisement

57. A registered and licensed pharmacist applied to

Ethiopian Food and Drug Administration (EFDA) for a
license to open drug whole sale in Addis Ababa.

Which criteria should be fulfilled by the pharmacist to

obtain working license?

A. Conducting annual product review

B. Fulfilling physical premises requirements
C. Acquiring sufficient quantities of products
D.Implementing good dispensing practice
58. A pharmaceutical analyst working in a quality control
laboratory of national drug regulatory authority
obtains the following data for a spectrophotometric
analysis of an injection containing the local anesthetic
Bupivacaine: 0.245% w/v, 0.234% w/v, 0.263% w/v,
0.261% w/v, 0.233% w/v.

What type of test is the analyst most likely to conduct

for this particular product?

A. Identification test
B. Qualification test
C. Quantification test
D.Instrument performance test

59. A pharmaceutical industry has been preparing

coated tablet from for moisture sensitive dabigatranet
exilate.
 What unique packaging system should be used for this
drug?

A. Store in refrigerator
B. Pack in normal container
C. Store in cool temperature
D.Co package with desiccant

60. A pharmacist required an ophthalmic preparation

that does not cause irritation to the eye. It must also
permit the diffusion of the medicinal substance
throughout the secretions bathing the eye. The
pharmacist has selected ophthalmic ointments instead
of solutions.

What is the main reason for selecting ophthalmic

ointments in this case?

A. No irritating property
 B. Have elegant appearance
C. Extended residence time
D.Melt at body temperature

61. A pharmacist is preparing gel formulation for

diagnostic purpose. However, the gelling agent is
found to have stability problem and is also highly
oxidized during storage.

What is the most appropriate excipient to be added to

solve this problem?

A. Sodium Crystalline Methyl Cellulose

B. Ethylene Diamine Tetra-Acetic Acid
C. Aluminum Magnesium Silicate
D.Poly Ethylene Glycol
62. A pharmacist who is working in a research and
development unit has prepared acyclovir cream as a
drug of choice for herpes simplex keratitis. A sample
was taken to check the microbial quality of this
product. After some procedures, it was concluded that
the product contains bacterial endotoxins beyond the
permissible level.

What is the most likely test performed in this case?

A. Pyrogen test
B. Sterility test
C. Microbial limit test
D.Preservative efficacy test

63. A pharmacist who is working in a pharmacy

compounded Miconazole nitrate cream (2%) for fungal
skin infection treatment. The prescription ordered the
patient to apply twice a day for ten days.
 What is the most appropriate container that the
pharmacist should use in this case?

A. Glass tube
B. Hermetic canister
C. Prefilled syringe
D.Wide-mouthed jar

64. A researcher is writing a problem statement for his

research proposal on the magnitude and factors
associated with an antibiotics self medication practice
among health professionals in Ethiopia.

What is the main point that should be included under

this section?

A. Description of how the objectives will be achieved

B. Justification of why the study is needed.
 C. Description of what will be studied
D.Specifying the analysis procedures

65. A researched survey planned to conduct to find out

if there is a relationship between gender and health
related issues in a district.

What would be the first step to be done in this case?

A. Undertaking field work

B. Setting a general objective
C. Determining the sample size
D.Developing assessment tool

66. A researcher is interested in conducting research on

rational drug use among health professionals in
 selected public hospitals and health centers in a
region.

What is the most appropriate sampling technique for

this case?

A. Stratified sampling method

B. Simple random sampling
C. Systematic sampling
D.Sequential sampling

67. A researcher planned to conduct a study on

community drug use behavior using a cross sectional
study. The researcher initially calculated sample size;
however, felt that the response rate might be much
lower and the final result might not be representative
of the source population.

What is the most appropriate solution for this case?

A. To calculate the sample size and make adjustment
B. To continue the study with the calculated sample size
C. To change the study area to a more responsive
community
D.To double the sample size and proceed to the data
collection

68. A study was conducted in a hospital. The way in

which cases and controls, or exposed and non-exposed
individuals were recruited. The finding shows that
there is an apparent association even if, in reality, the
exposure and disease are not associated.

What is the most likely reason of the apparent

association in this study?

A. Recall bias
B. Selection bias
C. Interviewer bias
 D.Non response bias

69. Throughout the drug supply management cyclic

process, routine collection and analysis of
measurements are needed to determine the ongoing
progress toward objectives. This is one of the activities
that have to be performed by drug supply manager of
a hospital.

What is the most likely activity that is best explained in

the above case?

A. Evaluation
B. Analysis
C. Monitoring
D.Impact assessment
70. Bottled gas or kerosene powers refrigerators;
alcohol; and power Bunsen burners are among the
pharmaceuticals that need special storage conditions.

What is the most likely reason that necessitates the

special storage conditions?

A. Because they are Controlled Substances

B. Because they are Flammable
C. Because they are Cytotoxic
D.Because they are Bulky

71. A pharmacist, who works in a hospital, moves

products from the unloading dock, or receiving area,
after they are released for storage; and assigning them
to their designated storage area (rack, shelf, floor, etc.)

What is the most likely storage activity exercised by

the pharmacist in this case?
 A. Shipping
B. Put away
C. Receiving
D.Picking

72. Placing pharmaceuticals order is a routine activity in

logistics. In most logistics systems, an order is placed
for new supplies every month, or every quarter, from a
Service Delivery Point to a higher level. In some
logistics systems, the quantity to be resupplied is
calculated by the person (usually the pharmacy
professional) placing the order. And this is one of the
systems of ordering pharmaceuticals.

What is the most likely system of ordering

pharmaceuticals that the above case is referring?

A. Pull system
B. Push system
 C. Allocation system
D.Rationing system

73. A pharmacist is asked to assess the stock status of

Aspirin 81 mg in a clinic. There are 100 units of Aspirin
tablets in the store and 25 units of the medication are
dispensed every month.

For how long is most likely the available Aspirin will

last?

A. Four months
B. Two months
C. One month
D.Three months
74. A pharmacist working as a store keeper in a certain
hospital wants to set the safety stock level for
Amoxicillin 500mg capsules. Suppose the average
monthly consumption is 500 units and the average
lead time is three months.

What is the minimum safety stock quantity of

Amoxicillin?

A. 500 units
B. 1000 units
C. 1500 units
D.25000 units

75. A pharmacist applies the max-min inventory control

system for managing the stock of Metronidazole 250
mg capsules. The maximum and minimum stock
quantities of the drug were 4000 and 800 units
respectively. Moreover, the consumptions of the drug
 were 500 units, 500 units and 200 units in the past
three consecutive months.

What is the minimum stock level of Metronidazole 250

mg capsules?

A. 1½ months
B. 2 months
C. 4 months
D.10 months.

76. A hospital pharmacy store manager conducts stock

assessment of all products every two months. The
hospital policy is that the trigger for ordering is the end
of the review period for the commodities that are at
the minimum level.

Which type of inventory control system is most likely

used in the above case?
 A. Continuous ordering max-min system
B. Standard ordering max-min system
C. Forced ordering max-min system
D.Cyclic ordering max-min system

77. A senior pharmacist asked you to sort and

appropriately store alcohol, Phenobarbital, ether,
diazepam, Ceftriaxone, BCG vaccine, insulin and
Propranolol. These products are to be stored based on
their storage requirements.

What are the most likely products to be placed in a

separate store room?

A. Phenobarbital and diazepam

B. Ceftriaxone and Propranolol
C. Insulin and BCG vaccine
D.Alcohol and Ether
78. A.74 year old man com given pain His medical
history is significant for adeaneral type 2 diabetes
mellitus with retinopathy, peripheral vascular disease
and steanced coronary artery disease. He was sent to
the cardiac cathetersation laboratory for a
percutaneous coronary intervention Immediately
before the procedure Iohesol PO to enhance
visualization of cardiac arteries Laboratory
investigation on admission shows blood urea nitrogen
of 37 mudl (normal, 5-20) and serum creatinine of 11
mg/dl (normal, 0.5-12) Iwas says later, rose in baseline
renal function tests is seen with blood urea aropen of
60 mg/dl. and serum creatinine of and 2.0 mg/dl. A 24
hour urine collection shows a urine output of 700 ml...

What is the most likely cause for abnormality in renal

function test in this patient?

A. Diabetic nephropathy
B. Advanced age
 C. L---/???xol administration
D.Use of catheter

79. A 50-year-old man, who had a long-standing

hypertension and renal failure, was being treated with
Enalapril 5mg daily and Amlodipine 10 mg BID during
the last two months. His blood pressure was found to
be 158/108 mmHg and serum biochemistry revealed
serum creatinine levels of 110 mmol/L. (50-120
µmol/L, Na of 136mmol/L (135-145mmol/l) and K of
5.1 mmol/L (3.5-5.0 mmol/L).

Which electrolyte abnormality needs priority

management?"

A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D.Hyponatremia
80. A 60-year-old man with chronic renal failure,
hypertension and Dyslipidemia admitted to internal
medicine in patient floor with a chief compliant of
generalized body swelling. He started on Enalapril
10mg daily, Amlodipine 10 mg daily, Furosemide 40mg
IV BID and Simvastatin 10mg at night. His serum
creatinine of 110 mmol/L laboratory investigations
show a (50-120 µmol/L), serum sodium of 135mmol/l.
(135 115mmol/l) and serum potassium of 6.2mmol/L
(3.5-5.0 mmol/L).

What is the appropriate next step to resolve the drug

therapy problem in this patient?

A. Decrease the dose of Enalapril

B. Decrease the dose of Amlodipine
C. Decrease the dose of Simvastatin
D.Decrease the dose of Furosemide
81. A pharmacist member of a hospital drug and
therapeutics committee (UTC) recommended the
preparation of an essential medicines list and the use
of the list in the procurement process. Other members
of the DTC wanted to get justifications on the
advantages of using the essential medicines list during
procurement.

What is the reason of using essential medicines list in

the procurement processed?

A. Limiting the quantity of each medicine to be procured

B. Ensuring availability of medicines at the hospital
C. Helping the DTC to efficiently hire health professionals
D.Limiting procurement to products from local suppliers
82. A hospital drug and therapeutics committee (ITC)
assigns a pharmacist to help with the selection of
medicines for inclusion in the procurement list. For
each medicine, the pharmacist wanted to get
information on indications for use, dosage schedule,
contraindications, side effects and information that
should be given to the patient.

What is the most appropriate source of information

that should be used?

A. Hospital formulary manual

B. Hospital essential medicine list
C. Standard treatment guideline
D.National essential medicine list

83. A primary hospital utilized 300, 250, 200 and 450

Packs of Ceftriaxone injection in September, October,
November and December, respectively. The lead time
 for the product is two months with safety stock of 600
packs. The procurement period is also six months.

What would be the maximum stock level of

Ceftriaxone injection?

A. 1800 pack
B. 2400 pack
C. 3000 pack
D.4200 pack

84. Assume, you are a hospital pharmacist engaged in

managing the hospital inventory. The lead time for a
product is less than three hours.

How is the safety stock and average monthly

consumption related with the lead time?
A. Safety stock is not required since the lead time of the
products is zero
B. The safety stock is equal to the average monthly
consumption
C. The safety stock is twice the average monthly
consumption
D.The lead time doesn't affect the maximum stock level

85. A 55-year-old woman with complaints of palpable

lump, nipple discharge and edema, redness and
warmth on her breast came to a hospital. Her history
shows that she gave no birth until now and she saw
her menses at age of 10). She also smokes cigarette
and drinks alcohol. The biopsy was taken and test was
done which revealed a breast cancer.

What are the conditions that show this patient has

breast cancer?

A. Nulliparity, smoking cigarette and being age 55 years

B. Seeing menses at age of 10 years and nulliparity
C. Smoking cigarette, drinking alcohol and nulliparity
D.Smoking cigarette and seeing menses at age of 10
years

86. A 50-year-old woman with a diagnosis of colorectal

cancer was admitted to a hospital. The medications
ordered for her colorectal cancer includes FOLFOX
(Fluorouracil, Leucovorin, and Oxaliplatin).

What is the predicted importance of Leucovorin in this

patient?

A. Because of its chemotherapeutic effect

B. To counter act the adverse effect of Fluorouracil
C. To increase the absorption time of fluorouracil
D.To decrease the adverse effect of Oxaliplatin
87. A hospital drug and therapeutics committee wants
to prepare an essential medicines list.

What is the most relevant factor in the selection of

medicines to be included in the list?

A. Availability in the international market

B. Unit prices of the medicines
C. The local disease pattern
D.The national disease pattern

88. A pharmacist working in a hospital's inventory

management team wants to select pharmaceuticals for
procurement in the next budget year. The pharmacist
wants to purchase all pharmaceuticals in the essential
medicine list. In the process, the pharmacist has listed
all vital pharmaceuticals to be purchased. However,
the allocated budget is inadequate.
 What is the most appropriate next step?

A. Select low cost essential medicines

B. Select low cost desirable medicines
C. Select slow moving medicines
D.Select fast moving medicines

89. A pharmacist was asked to arrange the medicines in

the hospital pharmacy store, which is small in size.
Thus, the pharmacist has to decide the type of stock
classification method that enables efficient utilization
of the storage space.

What is the most appropriate stock classification

method the pharmacist should use?

A. Alphabetical order
B. Dosage form type
C. commodity code
 D.Therapeutic category

90. In preparation for a national vaccination campaign,

the Pharmaceutical Fund and Supply Agency (PFSA)
procured the required vaccine eight months before the
campaign. The vaccine was then kept frozen in the
warehouses of PFSA till the time of the campaign.

What is the most likely vaccine to be used in the

campaign?

A. DT
B. DPT
C. Measles
D.Oral polio
91. A pharmacist working in medicines disposal
committee encountered expired syringes to dispose.
The pharmacist wants to choose an appropriate
disposal method for the syringes.

What is the most appropriate method to dispose the

expired syringes?

A. Burial on-site
B. Encapsulation
C. Autoclaving
D.Incineration

92. A pharmacist wants to manufacture dry powder

inhalers (DPI) with good aerosolization characteristics.
He selected appropriate ingredients (API and carrier)
and filled using the filling machine.
 Which formulation optimization will improve the
aerosolization?

A. Using B-lactose monohydrate as a carrier

B. Using salt form of API with high sorption
C. Using crystalline API and lactose
D.Using of API with low Melting point (<80 °C)

93. You were involved in a study conducted in a drug

firm's R & D unit. The firm produced one batch of
tablets and wants to evaluate their quality. Tablets
were formulated from an insoluble active
pharmaceutical ingredient and you were interested in
those parameters that are important for bioavailability
predictions.

What is the mo critical parameter that must be tested?

A. Disintegration
 B. Dissolution
C. Friability
D.Absorption

94. A physician wants to prescribe drug 'Y' for both local

and systemic effect. Because of its gastric irritating
effect, the physician requested the drug to be
formulated in the form of an ointment for topical
administration.

Which base type a pharmacist uses to increase the

drug's percutaneous absorption?

A. lanolin
B. Hard paraffin
C. Oil in water emulsion
D.Polyethylene Glycol mixture
95. A pharmacist was preparing and dispensing
medicated creams for his patients. Few days later, a
patient who didn't like the cooling effect of the cream
visited the pharmacy and complained the cooling
sensation after rubbing the cream to the application
area. Thus, the pharmacist planned to change the base
to minimize the cooling effect of the cream.

Which type of base needs to be changed?

A. From hard Paraffin to Lanolin

B. From soft Paraffin to hard Paraffin
C. From Lanolin to Polyethylene Glycol
D.From W/O emulsion to O/W emulsion

96. You are working in a small scale granulation unit in a

drug firm. If you want to scale up the granule
preparation using the fluid bed granulator, variables
such as air temperature, spray nozzle location, bed
 humidity, spray rate, and atomization pressure can all
affect the granule characteristics. Control of such
parameters to yield a consistent product at a large
scale constitutes a successful scale-up strategy. You
are planning to limit the number of process
parameters to control for scale-up purposes.

What is the most appropriate critical process of

parameter you prefer?

A. Bed humidity and atomizing air pressure

B. Spray rate and nozzle location
C. Air temperature and spray rate
D.Bed humidity and nozzle location

97. A pharmacist is requested to prepare aspirin tablets.

Initially, he formulated granules using roller
compactor. When the prepared granules were
characterized, they form soft compact or friable
 granules. Before proceeding to the main compression
process, the pharmacist has to reformulate the granule
by controlling process and formulation parameters.

What is the most likely importance of using remedy in

the process?

A. To decrease compaction force

B. To decrease roller speed
C. To decrease compressible binder
D.To increase blend time of powder and lubricant

98. A pharmacist extracting a substance from a plant

was using suction filtration technique but during
filtration the intended amount of extract (filtrate) was
not obtained.
What should the pharmacist do to solve this problem?
 A. Decreasing the surface area of the filter media
B. Reducing the suction pressure
C. Incorporation of tale into the slurry
D. Increasing resistance using filter beds

99. A pharmacist working in a hospital's inventory

management team wants to select pharmaceuticals for
procurement in the next budget year. The pharmacist
wanted to purchase all pharmaceuticals in the
essential medicines list. However, there was shortage
of budget and the pharmacist conducted an ABC-VEN
matrix analysis.

What is the most appropriate next step for the

pharmacist?

A. Prioritizing essential and class A items

B. Prioritizing essential and class B items
C. Prioritizing fast moving items
 D.Prioritizing vital and class C items

100. Suppose you work in the drug supply management

unit of a hospital, which was established ten years
back. The hospital mostly purchases its health
commodities from local suppliers, unless there is
emergency stock-out. The hospital has a complete
record of the purchase and utilization of
pharmaceuticals. There was also a relatively
uninterrupted supply trend of pharmaceuticals. Thus,
you decided to quantify an amount of pharmaceuticals
for the next budget year.

What is the most appropriate quantification method to

use for the above scenario?

A. Proxy-consumption
B. Consumption
C. Morbidity
D.Service level projection