Module 3: Practice of Pharmacy

Situation:

The clinical pharmacist performed medication history taking for a patient. The following are the medications that the patient is
currently taking: Aluminum Magnesium Hydroxide, Dextromethorphan, Ferrous Sulfate, Ipratropium Bromide, Montelukast,
Nitroglycerin, Simvastatin, Vitamin C and Warfarin.

2. Which of the medications was prescribed for prevention of the attacks of her difficulty of breathing?

a. Dextromethorphan

b. Nitroglycerin

c. Ipratropium Bromide

d. Montelukast

3. Upon admission, the doctor prescribed Doxycycline. Which of the medications will affect its absorption?

I. Warfarin

II. Aluminum Magnesium Hydroxide

III. Ferrous Sulfate

IV. Vitamin C

a. I, II, III, IV

b. I, IV

c. II, III

d. II, III, IV

4. Upon discharge, the attending physician (AP) ordered that his medications during his hospitalization will be continued and added
“Lipitor”. What information can the pharmacist provide for this medication order in relation to the Simvastatin that the patient is
currently taking?

a. Refer to the AP for possible changes in the discharged medications since there is therapeutic duplication for the two
drugs.

b. Medication counselling should be made since the patient should be informed that Simvastatin and “Lipitor” need to be
taken in the morning for best results.

c. Refer to the AP for possible dose adjustments for the “Lipitor” due to the Simvastatin. Dose maybe changed in either of
the drugs.

d. Dose spacing should be done for the two drugs. Inform the patient to take “Lipitor” 1 hour before Simvastatin

5. Varenicline is a drug used for:

a. Erectile Dysfunction

b. Smoking Cessation

c. HIV Infection

d. Seizure Disorders
6. Which of the following the correct Tall Man lettering for Dopamine and Dobutamine?

a. DOPamine, DOBUTamine

b. dopAMINE, dobutAMINE

c. DOPAMINE, DOBUTAMINE

d. dopamine, dobutamine

7. A physician prescribed a medication for the patient, transcribe the instructions for the patient:

Instill 2 gtts a.d. qid 4 wks

a. Instill two drops on the left eye, 4 times a day, for 4 weeks

b. Instill two drops on the right eye, 4 times a day, for 4 weeks

c. Instill two drops in the left ear, 4 times a day, for 4 weeks

d. Instill two drops on the right ear, 4 times a day, for 4 weeks

8. Senolytic drugs are intended to:

a. Alter the aging process

b. Improve fertility

c. Treat auto-immune disorders

d. Prevent cancer

9. Which of the following needles has the smallest diameter?

a. 30G x 1/2in

b. 21G x 2in

c. 23G x 1in

d. 27G x 1 1/4in

10. Cystatin C is a biomarker for:

a. Cardiac disease

b. Liver disease

c. Kidney disease

d. Pulmonary disease

11. A patient has been diagnosed with UTI and was treated with Ciprofloxacin. After 7 days of treatment, no significant improvement
has been achieved. What could she have been taking together with the anti-bacterial?

a. Vitamin B complex

b. Ascorbic acid

c. Ferrous sulfate

d. Omega-3 fatty acids

12. Which of the following agents is used for neutropenia?

a. Romiplostim

b. Erythropoeitin

c. Filgrastim

d. Avatrombopag

13. Which of the following statements are true regarding drug interactions?
 I. Drug interactions maybe intentional.

II. Drug interactions are always associated with harmful effects.

III. Drug interactions may result to responses other than the intended effects of a drug.

a. I, II

b. I, III

c. II, III

d. I, II, III

14. Which of the following statement/s is/are true regarding drugs used for blood disorders?

I. Thrombolytics lyse clots, an example is Aspirin, while anti-thrombotics inhibit clot formation and an example is
Reteplase.

II. Thrombolytics lyse clots, an example is Reteplase, while anti-thrombotics inhibit clot formation and an example is
Aspirin.

III. Anti-thrombotics lyse clots, an example is Reteplase, while thrombolytics inhibit clot formation and an example is
Aspirin.

a. I, II

b. II

c. I, II, III

d. I

15. The hospital pharmacist reviewed several clinical papers concerning the benefits of a new formulary drug and is preparing a
summary comparing the findings for publication. Which term is used to describe this type of review?

a. Dimensional analysis

b. Double blind study

c. Meta-analysis

d. Peer review

16. The health care provider administered Naloxone for a patient in the ER. Which of the following physical assessment data
would be important to indicate that the drug has been effective?

a. Absence of fever

b. Seizure activity has stopped.

c. Respiratory rate has normalized.

d. Chest pain has become better.

17. The IV fluid “D5W” means

a. 0.5% Dextrose in water

b. 0.05% Dextrose in water

c. 50% Dextrose in water

d. 5% Dextrose in water

18. Drug A induces the metabolism of Drug B, what will be the result?

a. Increased blood concentration of A

b. Increased blood concentration of B

c. Decreased blood concentration of A

d. Decreased blood concentration of B

19. Which of the following drugs can increase the clearance of another drug?

I. Cimetidine

II. St. John’s Wort

III. Carbamazepine

IV. Smoking

a. I, II, III

b. II, III, IV

c. III, IV

d. I, II, III, IV

20. A STAT order means the drug is administered:

a. As single dose

b. Repeatedly

c. Immediately

d. As needed

21. Laboratory result to determine the capacity of lung function:

a. 2D Echo

b. Peak Flow

c. X-ray

d. ECG

22. Which of the following transactions will decrease the stock-on-hand of a certain drug?

I. Stocking the inventories delivered by the supplier

II. Dispensing the prescribed drug to the patient

III. Returning the drug to the supplier after a recall order

a. I, II, III

b. I, III

c. I, II

d. II, III

23. Which of the following refers to the science that evaluates the value of a pharmaceutical product or drug therapy compared to
its effect?

a. Pharmacogenetics

b. Pharmacoeconomics

c. Pharmapreneurship

d. Pharmacogenomics

24. Which of the following refers to a systematically developed statement designed to assist practitioners and patients in making
decisions about appropriate health care for a specific clinical circumstance?

a. Medication reconciliation

b. Implementing rules and regulations on hospital accreditation

c. Standard treatment guideline

 d. Sentinel events policy

25. Which of the following drugs can be used in the treatment of Taenia saginata?

a. Niclosamide

b. Ceftriaxone

c. Mebendazole

d. Primaquine

26. In the classification of drugs in the formulary, which of the following will NOT be included in the list under “anti-cancer drugs”?

a. Goserelin

b. Bevacizumab

c. Sirolimus

d. Asparaginase

27. Which of the following are TRUE regarding Streptomycin?

I. Mechanism of action is similar to Erythromycin.

II. Belongs to the aminoglycoside group

III. Has activity against Mycobacterium tuberculosis

a. I, II

b. I, III

c. I, II, III

d. II, III

28. Which of the following is/are TRUE regarding Co-trimoxazole?

I. It is a combination of Trimethoprim and Sulfisoxazole.

II. The individual agents both exert anti-bacterial effect.

III. Topical preparations are commercially available locally.

a. I, II

b. II

c. I

d. I, II, III

29. Laboratory test result for which of the following should be monitored in a patient on a daily regimen of IV

methylprednisolone?

a. Serum Calcium

b. Serume Glucose

c. Serum Creatinine

d. Lactate Dehydrogenase

30. Which of the following is/are considered as “error-prone abbreviations” by the Institute of Safe Medication Practices?

I. mcg

II. IU
 III. cc

IV. mL

a. I, II, III, IV

b. I, III, IV

c. II, III

d. II

31. A reversible cholestatic jaundice is an adverse effect of erythromycin in which specific form of the drug?

a. Stearate

b. Estolate

c. Palmitate

d. Ethylsuccinate

32. Which of the following macronutrients are found in Total Parenteral Nutrition?

a. Fats, Vitamins, Carbohydrates, Trace Elements

b. Carbohydrates, Proteins, Fats

c. Carbohydrates, Proteins, Vitamins

d. Proteins, Fats, Electrolytes

33. A patient weighing 120 lbs. was administered 2.1 grams of a drug that was intended to be dosed at 30mg/kg. What can you
say about the dose administered?

a. Underdose

b. Correct

c. Cannot say, need more information

d. Overdose

34. If serotonin syndrome occurs as an event associated with one serotoninergic drug, such as an SSRI, the type of ADR that
has occurred is:

a. A

b. B

c. C

d. D

35. Which of the following BEST describes the age group of neonates?

a. Those between 1 month to 1 year

b. Those between 0 to 28 days

c. Those between 0 day to 6 months

d. Those between 0 day to 3 months

36. A formula for an antifungal shampoo contains 2%w/v of Ketoconazole. How many grams of Ketoconazole would be needed
to prepare 24 liters of the shampoo?

a. 50

b. 5,000

c. 500

d. 5
37. Which of the following is NOT an advisable mode of administration for potassium supplements?

a. Modified-release tablet

b. Oral solution

c. IV bolus

d. IV infusion

38. When choosing medicines for inclusion into the formulary, evaluation would involve looking at the complete cost of using the
drug. What type of cost would quality of life belong?

a. Indirect Cost

b. Intangible Cost

c. Direct Cost

d. Direct, Indirect and Intangible Costs

39. A patient was prescribed the drug Febuxostat and asked you, the pharmacist regarding its use. She showed you her
laboratory results. Which of the following results in her lab examination is the reason for prescribing the drug?

a. High uric acid

b. Low haemoglobin

c. High low-density-lipoprotein

d. High triglyceride

40. Which of the following components of parenteral nutrition is/are micronutrients?

I. Electrolytes

II. Dextrose

III. Triglycerides

a. III

b. I, II, III

c. II, III

d. I

41. The pharmacist was reviewing a new order of Aldactone for a patient receiving an ACE inhibitor. Which of the following
significant interaction should be noted by the pharmacist?

a. Both drugs may interact to cause an elevation in uric acid levels.

b. Both drugs may interact to cause a decrease in blood sugar levels.

c. Aldactone may antagonize the effect of the ACE inhibitor.

d. Both drugs may interact to cause an elevation in potassium levels.

42. Quinidine Sulfate 200mg capsule and Quinidine 200 mg tablet are considered as:

a. Therapeutic alternatives

b. Therapeutically equivalent

c. Pharmaceutically equivalent

d. Pharmaceutical alternatives

43. Which of the following refers to the drug distribution system in which each peripheral facility determines the drug quantities to
be requisitioned from procurement unit or warehouse?

a. Unit dose distribution system

 b. Pull system

c. Direct purchase from suppliers

d. Push system

44. Which of the following has been found to reduce sleep onset latency in many sleep related disorders in both adults and
children?

a. Melatonin

b. Glucosamine

c. Ginkgo biloba

d. St. John’s Wort

45. Preferred route of NTG for the treatment of angina attacks:

a. Oral

b. Transdermal

c. Sublingual

d. Intravenous

46. The recommended route of administration for Sodium Nitroprusside is:

a. Intramuscular

b. IV Bolus

c. IV Infusion

d. B and C

47. Botulinum toxin A is intended for:

a. Treatment of glaucoma

b. Neuromuscular blockade

c. Myasthenia gravis

d. Cosmetic purposes

48. Which of the following is an ultra-short acting insulin preparation?

a. Insulin Detemir

b. Isophane Insulin

c. Semilente Insulin

d. Insulin Glulisine

49. Which of the following branded medicines is not a modified release preparation?

a. Diamicron MR

b. Depakote XR

c. Ponstan SF

d. Aspilets-EC

50. A new test for SARS-COV-2 does not detect the presence of the virus in someone who is infected. This is known as:

a. False-negative result

b. True-negative result

c. False-positive result
 d. True-positive result

51. Which of the following is an ultra-long-acting insulin preparation?

a. Insulin Glargine

b. Regular Human Insulin

c. Insulin Lispro

d. Lente Insulin

52. Physicochemical incompatibilities can be detected by:

I. Change in color

II. Formation of precipitate

III. Evolution of gas

a. II, III

b. I, III

c. I, II, III

d. I, II

53. Which of the following BEST describes endorphins?

a. Endogenous opioid peptides

b. Class of anti-diabetics

c. Biogenic amines believed to cause schizophrenia

d. Adrenergic neurotransmitters

54. Which of the following are microvascular complications related to diabetes mellitus resulting from poor glycemic control due
to non-compliance with the treatment plan?

I. Retinopathy

II. Nephropathy

III. Cardiomegaly

a. I, II, III

b. I, II

c. II, III

d. I, II

55. Which of the following medications is most likely to cause drug interactions and endocrine side effects?

a. Ranitidine

b. Omeprazole

c. Cimetidine

d. Lansoprazole

56. Which of the following medications can INCREASE the likelihood of patient falls?

I. Zolpidem

II. Loratadine

III. Olanzapine

a. I, II, III
 b. I, III

c. II, III

d. I, II

57. The physician order an infusion of NSS 500 mL in 3 hours using a 15drops/mL set. With 1.5 hours remaining, you discover
that only 150mL is left in the bag. At what rate, in drops per minute, will the infusion be reset?

a. 10 drops/minute

b. 5 drops/minute

c. 25 drops/minute

d. 20 drops/minute

58. Which of the following statements are TRUE regarding creatinine?

I. It is produced during skeletal muscle contraction.

II. It is excreted by the kidneys.

III. Its level in the blood decreases if renal function diminishes.

a. I, III

b. I, II

c. I, II, III

d. II, III

59. Which of the following statements are TRUE regarding palliative care for cancer patients?

I. Provides relief from pain and other distressing symptoms

II. Integrates psychological and spiritual aspects of patient care

III. Addresses cure for the disease such as surgical removal of the tumor

a. I, II

b. I, II, III

c. II, III

d. I, III

TOP ANTIBIOTIC CHOICES FOR SURGICAL PROPHYLAXIS IN ADULTS AND CHILDREN

Antibiotic Total (in %)

1 Cefuroxime 31.1

2 Cefazolin 10.4

3 Cefoxitin 8.3

4 Amoxicillin + Enzyme Inhibitor 7.3

5 Metronidazole 5.4

6 Ceftriaxone 5

7 Gentamicin 4.2
 8 Clindamycin 3.8

9 Ciprofloxacin 3.3

10 Ampicillin + Enzyme Inhibitor 3.1

60. What is being referred to as “Enzyme Inhibitor” in the entry “Ampicillin + Enzyme Inhibitor”?

a. Sulbactam

b. Tazobactam

c. Beta-lactamase

d. Clavulanic Acid

61. How many percent belongs to the category of Cephalosporins?

a. 54.8
b. 46.5
c. 10.4
d. 65.2
62. How many percent belongs to the category of Aminoglycosides?

a. 8

b. 4.2

c. 3.3

d. 7.1

63. Which of the following is a short-acting insulin preparation?

a. Insulin Aspart

b. Regular Human Insulin

c. Insulin Degludec

d. Neutral Protamine Hagedorn Insulin

64. What license should be current to legally dispense dangerous drugs for the requirements of patients?

a. P1

b. S3

c. S4

d. S2

65. Adverse effect of Quinolones:

a. Disulfiram-like effects

b. Red-man syndrome

c. Tendonitis

d. Aplastic anemia

66. PhilPSP stands for:

a. Philippine Professional Standards for Pharmacists

b. Philippine Pharmacy Standards of Practice

 c. Philippine Practice Standards for Pharmacists

d. Philippine Pharmaceutical Sciences Program

*A patient at the ICU was prescribed with Levodopa/Carbidopa 250mg/25mg tablet (Approximate weight of each tablet is 300mg.),
to be administered via NGT with the following dosing regimen: ½ tablet (at 6am), ¼ + ½ tablet (at 10am), ¼ + 1/8 tablet (at 2pm),
½ tablet (at 6pm), ¼ + 1/8 tablet (at 10pm)

67. What is the total dose needed by the patient per day?

a. 312.5mg/31.25mg

b. 750mg/75mg

c. 625mg/62.5mg

d. 531.2mg/53.12mg

68. If the pharmacy will prepare paper tablets for the said medication PER DAY, how many tablets will be used in compounding
of the medication order?

a. 4

b. 2

c. 3

d. 5

69. Which of the following statements are TRUE?

I. Levodopa inhibits the peripheral metabolism of Carbidopa.

II. Carbidopa inhibits the peripheral metabolism of Levodopa.

III. Immediate release tablets can be crushed for NGT administration.

IV. Immediate release tablets CAN NOT be crushed for NGT administration.

a. I, IV

b. II, III

c. II, IV

d. I, III

A prescription presented to the pharmacist contains four (4) medications for a hypertensive patient from different
pharmacological classes which include:

Drug A: Protease Inhibitor

Drug B: Non-selective Beta-blocker

Drug C: Calcium Channel Blocker

Drug D: ACE-Inhibitor

70. Which of the medications is/are indicated for his hypertension?

a. Drug A
b. Drug B
c. Drugs C and D
d. Drugs B, C and D
71. If the patient has asthma, which of the drugs may potentially aggravate his condition?

a. Drug D
b. Drug B
 c. Drug C
d. Drug A
72. Aside from hypertension, given the drugs prescribed, what co-morbidity maybe present in this patient?

a. Allergy
b. Diabetes
c. Malaria
d. Viral infection
The pharmacist received a prescription of Clarithromycin for a patient at the ER.

73. What antibiotic belongs to the same classification of Clarithromycin?

a. Azithromycin

b. Clindamycin

c. Gentamicin

d. Vancomycin

74. If the dose prescribed is 20mg/kg/day, what will be the daily dose if the patient weighs 40kg?

a. 400 mg
b. 600 mg
c. 800 mg
d. 200 mg
75. The dose of the patient was changed to 125mg/5mL one tablespoon, twice a day for 7 days and was advised to go home. If
only 35-mL bottle preparation is available, how many bottles are needed to complete the regimen?

a. 2
b. 6
c. 3
d. 4

MD: JD

Pt.: SG; Age: 8; Sex: F

Rx

Metronidazole 25mg/5mL

Sig: Give 10 mL tid for 7d

76. What is written in the superscription?

a. Rx

b. Information about the patient

c. Give 10 mL three times a day for 7 days

d. Metronidazole 25mg/5mL

77. How many bottles of Metronidazole is needed to complete the dosing regimen for 7 days, if the available preparation is at 60-
mL packaging?
a. 5
b. 4
c. 3
 d. 6
78. What would most likely be the patient’s illness for her to be prescribed this medication?

a. Ascariasis

b. Viral gastroenteritis

c. Amoebiasis

d. Bronchial asthma

79. If a hospital is to create a stroke emergency team, the team will include which of the following agents in their formulary as an
immediate treatment for cerebrovascular ischemia?

a. Actilyse

b. Arixtra

c. Plavix

d. Lanoxin

80. Which of the following is NOT a diuretic?

a. Acetazolamide

b. Mannitol

c. Spirinolactone

d. Desmopressin

81. What is the use of Mannitol when administered orally?

a. Reduction of edema

b. Cathartic

c. Osmotic diuretic

d. Hypertension

82. Which of the following is/are TRUE regarding Sildenafil?

I. An adverse effect observed is priapism.

II. It is used for erectile dysfunction.

III. It is classified as a phosphodiesterase-5-enzyme inhibitor.

a. I, II

b. III

c. I, II, III

d. II

83. In drug interaction references, the drug affected by the interaction is referred to as the:

a. Inactive drug

b. Precipitant drug

c. Active drug

d. Object drug

84. The dose of Paracetamol for infants less than 3 months of age is 10mg/kg to be taken 3 to 4 times daily. What is the volume
per dose of Paracetamol oral drops (100mg/mL) should be given to a child weighing 11 lbs.?

a. 2mL
b. 1.5mL
 c. 0.5mL
d. 2.5mL
85. Which of the following is classified as a urinary tract antiseptic?

a. Povidone-iodine
b. Sodium bicarbonate
c. Nitrofurantoin
d. Hexetidine
86. You are directed to weigh 10 grams of a substance so as to limit the error to 0.1%. Calculate the maximum potential error, in
terms of grams, that you would not be permitted to exceed.

a. 1g
b. 0.02 g
c. 0.01 g
d. 0.1 g
87. Which of the following is/are TRUE regarding Celecoxib?

I. It is a sulfonamide.
II. It is a COX-1 selective inhibitor.
III. It is associated with a higher incidence of thrombotic events.
a. III
b. I, II, III
c. II
d. I, III
88. What is the advantage of Tiotropium over Ipratropium?

a. It does not cause xerostomia.

b. It is available as an oral preparation.
c. It is suitable for acute attacks of wheezing.
d. It has a longer duration of action.
89. The serum creatinine of a 65-year old female weighing 150 lbs. was 1.5mg/dL. What is her creatinine clearance?

a. 94.6mL/min.
b. 104.3mL/min.
c. 40.2mL/min.
d. 27.3mL/min.
90. Which of the following is important in monitoring of the effects of Warfarin?

a. INR
b. HbA1C
c. Platelet Count
d. AST:ALT Ratio
91. Which of the following parameters should be considered when storing medications?

I. Temperature
II. Air velocity
III. Particle count
IV. Relative humidity
 a. II, III
b. I, IV
c. I
d. I, II, IV
92. Code carts located at nursing units and clinics are used primarily for what purpose?

a. Availability of critical medications and supplies to respond to emergencies.

b. Securing all controlled substances available at the units.

c. Securing prn medications for individual patients.

d. Availability of unit doses for 24 hour medications for individual patients

93. What adverse effect may result in the intake of HMG-CoA Reductase inhibitors?

a. Bleeding

b. Hypoglycemia

c. Rhabdomyolysis

d. Hypertensive Crisis

94. When 2 interacting drugs result to the alteration of the absorption of one of the drugs, this interaction is classified as a:

a. Pharmacokinetic interaction

b. Physicochemical interaction

c. Pharmacodynamic interaction

d. Pharmaceutical interaction

95. A diabetic patient suffering from hypertension is having Enalapril. However, he complained of severe dry cough which has
been associated with the drug. Which would be the best alternative for Enalapril in this patient?

a. Losartan

b. Indapamide

c. Amlodipine

d. Captopril

96. Increased levels of which of the following maybe associated with a decreased risk of atherosclerosis?

a. Very-low-density lipoprotein

b. Low-density lipoprotein

c. High and low-density lipoprotein

d. High-density lipoprotein

97. Which of the following are cardiac biomarkers released when muscle cells are damaged specifically during AMI?

a. Creatinine Kinase-MB

b. Lactate Dehydrogenase

c. Creatinine

d. Neutrophil

98. What is the interaction between Vitamin K and Warfarin?

a. Additive

b. Antagonistic
 c. Potentiation

d. Synergistic

99. Which of the following is NOT a use of Epsom salt?

a. Anti-convulsant

b. Anti-arrhythmic

c. Anti-asthma

d. Anti-diarrheal

100. Which of the following is/are TRUE regarding crystalloids and colloids in IV therapy?

I. Colloids are more expensive than crystalloids.

II. 0.9% NaCl is an example of a crystalloid solution while Dextran is an example of a colloid solution.

III. Colloid solutions are more preferred than crystalloid solutions in cases of septic shock and hypovolemic shock.

a. I, II, III
b. I, II

c. II, III

d. III

*101. Sulfonamides when given to babies will result to kernicterus via what mechanism?

a. Deposition of conjugated bilirubin in the brain

b. Inhibition of direct bilirubin

c. Displacement of unconjugated bilirubin from plasma albumin

d. Conversion of unconjugated bilirubin to conjugated bilirubin