Section 1: Pharmacology

1. Which of the following is a prodrug that is converted to its active form in the liver?

 A) Lisinopril

 B) Enalapril

 C) Losartan

 D) Metoprolol

2. Which of the following antibiotics is classified as a macrolide?

 A) Ciprofloxacin

 B) Gentamicin

 C) Azithromycin

 D) Vancomycin

3. A patient with chronic kidney disease is prescribed a medication that is primarily excreted by the
kidneys. Which of the following factors is most important to consider in adjusting the dose?

 A) Hepatic function

 B) Serum creatinine levels

 C) Body surface area

 D) Age of the patient

Section 2: Pharmaceutical Calculations

4. A pharmacist needs to prepare 500 mL of a 10% w/v solution. How many grams of the solute are
required?

 A) 10 grams

 B) 50 grams

 C) 100 grams

 D) 500 grams

5. If a medication is available as a 250 mg tablet and the prescribed dose is 1.5 grams per day, how
many tablets should the patient take daily?

 A) 4 tablets

 B) 5 tablets

 C) 6 tablets

 D) 7 tablets
Section 3: Clinical Pharmacy

6. A 65-year-old male with a history of type 2 diabetes and hypertension presents with swelling in his
lower extremities. Which of the following medications is most likely causing this side effect?

 A) Metformin

 B) Lisinopril

 C) Amlodipine

 D) Hydrochlorothiazide

7. Which of the following statements is true regarding warfarin therapy?

 A) It is safe to use during pregnancy.

 B) It requires regular monitoring of INR levels.

 C) It has a rapid onset of action.

 D) Vitamin K enhances its anticoagulant effect.

Section 4: Ethics and Professional Practice

8. A patient requests an early refill of a controlled substance, stating they lost the previous
prescription. What should be the pharmacist's next step?

 A) Refill the prescription immediately.

 B) Contact the prescriber for verification.

 C) Refuse to refill the prescription.

 D) Report the patient to the authorities.

9. A pharmacist notices that a medication error has occurred but the patient has not yet been
harmed. What is the best course of action?

 A) Ignore the error since no harm was done.

 B) Inform the patient immediately.

 C) Report the error to the supervisor and document it.

 D) Adjust the medication without notifying anyone.

Section 5: Patient Management

10. A patient is prescribed a medication that must be taken with food to enhance absorption. The
patient asks what will happen if they take it on an empty stomach. The most appropriate response is:

 A) "The medication might not work as effectively."

 B) "It will cause severe stomach pain."

 C) "You will absorb it faster, so it might work better."

 D) "It doesn't matter; you can take it with or without food."

11. Which of the following is the most important counseling point for a patient taking a new
prescription for bisphosphonates?

 A) Take the medication at bedtime.

 B) Stay upright for at least 30 minutes after taking it.

 C) Take it with a full glass of milk.

 D) Avoid sunlight while taking the medication.

Answers:

1. B) Enalapril

2. C) Azithromycin

3. B) Serum creatinine levels

4. C) 50 grams

5. C) 6 tablets

6. C) Amlodipine

7. B) It requires regular monitoring of INR levels.

8. B) Contact the prescriber for verification.

9. C) Report the error to the supervisor and document it.

10. A) "The medication might not work as effectively."

11. B) Stay upright for at least 30 minutes after taking it.

This mock test provides a basic overview of the types of questions that might be asked during the
DOH/HAAD exam for pharmacists. You can use this as practice to gauge your readiness and identify
areas where you may need to focus more study.
Section 1: Pharmacology (30 Questions)

1. Which of the following is a beta-blocker commonly used to manage hypertension?

 A) Amlodipine

 B) Metoprolol

 C) Losartan

 D) Furosemide

2. Which antibiotic is the drug of choice for treating methicillin-resistant Staphylococcus aureus
(MRSA) infections?

 A) Vancomycin

 B) Amoxicillin

 C) Ceftriaxone

 D) Clindamycin

3. A patient on warfarin therapy should avoid which of the following over-the-counter medications
due to the risk of increased bleeding?

 A) Acetaminophen

 B) Ibuprofen

 C) Diphenhydramine

 D) Loratadine

4. Which of the following is a selective serotonin reuptake inhibitor (SSRI) used to treat depression?

 A) Amitriptyline

 B) Fluoxetine

 C) Diazepam

 D) Haloperidol

5. Which of the following drugs is classified as an angiotensin-converting enzyme (ACE) inhibitor?

 A) Losartan

 B) Lisinopril

 C) Amlodipine

 D) Atenolol

6. Which medication is indicated for the treatment of hyperlipidemia?

 A) Simvastatin

 B) Metformin

 C) Lisinopril
  D) Furosemide

7. Which of the following is a common side effect of opioid analgesics like morphine?

 A) Hypertension

 B) Constipation

 C) Diarrhea

 D) Tachycardia

8. Which antifungal medication is commonly used to treat systemic fungal infections?

 A) Fluconazole

 B) Nystatin

 C) Terbinafine

 D) Miconazole

9. A patient with asthma is prescribed a leukotriene receptor antagonist. Which of the following
medications fits this class?

 A) Salbutamol

 B) Montelukast

 C) Fluticasone

 D) Ipratropium

10. What is the mechanism of action of metformin in the management of type 2 diabetes? - A)
Increases insulin secretion - B) Decreases hepatic glucose production - C) Stimulates insulin receptor
activity - D) Delays carbohydrate absorption

11. Which of the following medications is a proton pump inhibitor (PPI)? - A) Ranitidine - B)
Omeprazole - C) Metoclopramide - D) Famotidine

12. Which of the following medications is an HMG-CoA reductase inhibitor? - A) Ezetimibe - B)

Atorvastatin - C) Fenofibrate - D) Niacin

13. A 60-year-old female is on bisphosphonate therapy for osteoporosis. Which of the following is a
key counseling point? - A) Take the medication at night - B) Avoid lying down for 30 minutes after
taking the medication - C) Take it with a full glass of milk - D) Avoid sunlight exposure

14. Which of the following drugs is a short-acting insulin? - A) Insulin glargine - B) Insulin lispro - C)
Insulin detemir - D) Insulin NPH

15. Which of the following is a loop diuretic? - A) Hydrochlorothiazide - B) Spironolactone - C)

Furosemide - D) Acetazolamide

16. Which medication is used as a first-line treatment for generalized anxiety disorder (GAD)? - A)
Diazepam - B) Escitalopram - C) Amitriptyline - D) Lithium

17. Which of the following medications is used to treat Parkinson’s disease by increasing dopamine
levels in the brain? - A) Levodopa/Carbidopa - B) Selegiline - C) Amantadine - D) All of the above
18. Which antibiotic class is known for its potential to cause tendon rupture? - A) Cephalosporins - B)
Fluoroquinolones - C) Macrolides - D) Tetracyclines

19. Which of the following medications is most appropriate for the treatment of chronic heart failure
with reduced ejection fraction (HFrEF)? - A) Metoprolol - B) Digoxin - C) Furosemide - D) All of the
above

20. Which of the following is a long-acting muscarinic antagonist (LAMA) used in the management of
chronic obstructive pulmonary disease (COPD)? - A) Tiotropium - B) Salmeterol - C) Albuterol - D)
Beclomethasone

21. Which of the following drugs is an antipsychotic used primarily to treat schizophrenia? - A)
Haloperidol - B) Sertraline - C) Lorazepam - D) Carbamazepine

22. Which of the following is a contraindication for the use of oral contraceptives? - A) Hypertension -
B) Thromboembolic disorders - C) Diabetes - D) Asthma

23. Which of the following is used as an antidote for acetaminophen overdose? - A) Naloxone - B)
Flumazenil - C) N-acetylcysteine - D) Atropine

24. Which of the following is a potential side effect of long-term corticosteroid therapy? - A)
Hypoglycemia - B) Osteoporosis - C) Weight loss - D) Hypotension

25. Which of the following is a common side effect of anticholinergic medications? - A) Diarrhea - B)
Dry mouth - C) Increased salivation - D) Bradycardia

26. Which of the following medications is used to treat benign prostatic hyperplasia (BPH)? - A)
Tamsulosin - B) Finasteride - C) Dutasteride - D) All of the above

27. Which of the following is a contraindication for the use of beta-blockers? - A) Asthma - B)
Hypertension - C) Angina - D) Glaucoma

28. Which of the following medications is most appropriate for the management of acute gout? - A)
Allopurinol - B) Colchicine - C) Probenecid - D) Indomethacin

29. Which of the following is a common side effect of statin therapy? - A) Muscle pain - B)
Hypertension - C) Tachycardia - D) Weight gain

30. Which of the following medications is used to prevent migraines? - A) Sumatriptan - B)

Propranolol - C) Ibuprofen - D) Acetaminophen

Section 2: Pharmaceutical Calculations (20 Questions)

31. A patient is prescribed 250 mg of a medication every 8 hours. The medication is available as 125
mg/5 mL suspension. How many milliliters should the patient take per dose? - A) 10 mL - B) 15 mL -
C) 20 mL - D) 25 mL

32. A 1 L IV bag contains 0.9% sodium chloride. How many grams of sodium chloride are in the bag? -
A) 0.9 grams - B) 9 grams - C) 90 grams - D) 900 grams

33. A medication is dosed at 5 mg/kg/day for a child weighing 20 kg. The total daily dose should be: -
A) 50 mg - B) 100 mg - C) 150 mg - D) 200 mg
34. A pharmacy receives a prescription for 30 mL of a 1:500 w/v solution. How many grams of the
solute are needed to prepare this solution? - A) 0.06 grams - B) 0.3 grams - C) 0.6 grams - D) 1.5
grams

35. If a medication has a half-life of 6 hours, how much of the drug will remain after 24 hours if the
initial dose was 200 mg? - A) 100 mg - B) 50 mg - C) 25 mg - D) 12.5 mg

36. How many grams of glucose are required to prepare 500 mL of a 5% (w/v) glucose solution? - A)
2.5 grams - B) 5 grams - C) 25 grams - D) 50 grams

37. A prescription calls for 60 mL of a 20% solution. The stock solution available is 80%. How many
milliliters of the stock solution are needed to prepare the prescription? - A) 10 mL - B) 15 mL - C) 20
mL - D) 25 mL

38. A patient requires 1,000 mg of a drug that is available in 250 mg tablets. How many tablets
should the patient take? - A) 2 tablets - B) 3 tablets - C) 4 tablets - D) 5 tablets

39. A physician orders 0.5 mg/kg of a medication for a patient weighing 70 kg. The medication is
available in a concentration of 10 mg/mL. How many milliliters of the medication should be
administered? - A) 0.35 mL - B) 1.75 mL - C) 3.5 mL - D) 7 mL

40. How many grams of sodium chloride are needed to make 250 mL of a 0.9% w/v sodium chloride
solution? - A) 0.9 grams - B) 1.8 grams - C) 2.25 grams - D) 2.5 grams

41. A 250 mL IV bag contains 500 mg of a drug. What is the concentration of the drug in mg/mL? - A)
0.5 mg/mL - B) 1 mg/mL - C) 2 mg/mL - D) 5 mg/mL

42. A 5% dextrose solution contains how many grams of dextrose in 1 liter? - A) 0.5 grams - B) 5
grams - C) 50 grams - D) 500 grams

43. A patient is to receive a 2 mg/kg dose of a medication. If the patient weighs 75 kg, how many
milligrams of the drug should be administered? - A) 100 mg - B) 150 mg - C) 200 mg - D) 300 mg

44. A medication order is written for 1 liter of a 1% w/v solution. How many grams of the drug should
be used to prepare this solution? - A) 1 gram - B) 10 grams - C) 100 grams - D) 1,000 grams

45. A patient needs to take 150 mg of a drug that is available as 50 mg tablets. How many tablets
should the patient take per dose? - A) 1 tablet - B) 2 tablets - C) 3 tablets - D) 4 tablets

46. If a prescription calls for 100 mL of a 1:250 solution, how many grams of solute are needed? - A)
0.4 grams - B) 0.2 grams - C) 0.1 grams - D) 0.5 grams

47. A pharmacist needs to prepare 50 mL of a 2% solution from a stock solution of 10%. How much
of the stock solution should be used? - A) 5 mL - B) 10 mL - C) 15 mL - D) 20 mL

48. A 100 mL IV bag contains 2 grams of a drug. What is the concentration of the drug in mg/mL? - A)
10 mg/mL - B) 20 mg/mL - C) 30 mg/mL - D) 40 mg/mL

49. A solution contains 0.25 grams of a drug in 500 mL. What is the concentration in mg/mL? - A) 0.5
mg/mL - B) 1 mg/mL - C) 2 mg/mL - D) 5 mg/mL

50. How many milliliters of a 70% w/v solution are needed to prepare 500 mL of a 10% w/v solution?
- A) 50 mL - B) 75 mL - C) 100 mL - D) 150 mL
Section 3: Clinical Pharmacy (20 Questions)

51. A patient with diabetes is prescribed an ACE inhibitor for hypertension. Which of the following is
the main reason for choosing this class of drug? - A) To reduce insulin resistance - B) To prevent
nephropathy - C) To control blood glucose levels - D) To reduce cholesterol levels

52. A patient on digoxin therapy is experiencing nausea, vomiting, and visual disturbances. What
should be the first course of action? - A) Increase the dose - B) Discontinue the drug - C) Monitor
serum digoxin levels - D) Prescribe an antiemetic

53. Which of the following is a key consideration when prescribing metformin to a patient with renal
impairment? - A) Risk of hypoglycemia - B) Risk of lactic acidosis - C) Risk of weight gain - D) Risk of
hyperkalemia

54. A patient presents with symptoms of hypothyroidism. Which of the following medications is most
likely contributing to this condition? - A) Amiodarone - B) Levothyroxine - C) Lithium - D) Both A and C

55. Which of the following is the most appropriate treatment for a patient with atrial fibrillation and
a high risk of stroke? - A) Warfarin - B) Aspirin - C) Clopidogrel - D) Enoxaparin

56. A patient taking simvastatin reports muscle pain. What is the most appropriate next step? - A)
Increase the dose of simvastatin - B) Discontinue simvastatin and switch to a different statin - C)
Prescribe a muscle relaxant - D) Advise the patient to continue therapy as the pain will subside

57. A patient is diagnosed with community-acquired pneumonia and has no known drug allergies.
Which antibiotic is most appropriate for outpatient treatment? - A) Amoxicillin - B) Doxycycline - C)
Azithromycin - D) Ciprofloxacin

58. A patient with a history of peptic ulcer disease is prescribed ibuprofen for pain management.
What additional medication should be prescribed to prevent a recurrence of ulcers? - A) Ranitidine -
B) Omeprazole - C) Sucralfate - D) Misoprostol

59. Which of the following is the most appropriate therapy for a patient with chronic obstructive
pulmonary disease (COPD) and frequent exacerbations? - A) Short-acting beta agonist - B) Long-
acting muscarinic antagonist - C) Inhaled corticosteroid - D) Oral corticosteroid

60. A patient with heart failure is prescribed spironolactone. Which of the following is a key
monitoring parameter for this medication? - A) Serum potassium levels - B) Blood pressure - C) Heart
rate - D) Renal function

61. Which of the following is the most appropriate treatment for a patient with type 2 diabetes and
atherosclerotic cardiovascular disease? - A) Metformin - B) GLP-1 receptor agonist - C) SGLT2
inhibitor - D) Both B and C

62. A patient is prescribed clopidogrel after a myocardial infarction. Which of the following
statements is true regarding this medication? - A) It is a proton pump inhibitor - B) It is an antiplatelet
agent - C) It is a beta-blocker - D) It is a calcium channel blocker

63. A patient on lithium therapy presents with symptoms of nausea, vomiting, and tremors. What
should be the first step in managing this patient? - A) Increase the dose of lithium - B) Check serum
lithium levels - C) Discontinue lithium immediately - D) Prescribe an antiemetic
64. A patient with a history of deep vein thrombosis (DVT) is prescribed warfarin. Which of the
following foods should the patient avoid or consume consistently? - A) Spinach - B) Bananas - C)
Apples - D) Chicken

65. A patient with hyperthyroidism is prescribed methimazole. What is the main adverse effect to
monitor for? - A) Hypoglycemia - B) Agranulocytosis - C) Hypertension - D) Weight gain

66. A patient with chronic kidney disease is prescribed a phosphate binder. Which of the following
medications is most appropriate? - A) Calcium carbonate - B) Aluminum hydroxide - C) Sevelamer - D)
Magnesium hydroxide

67. Which of the following is a common side effect of long-term use of corticosteroids? - A)
Hyperkalemia - B) Osteoporosis - C) Hypoglycemia - D) Weight loss

68. A patient with bipolar disorder is being treated with valproic acid. What is a key laboratory test to
monitor? - A) Serum sodium levels - B) Liver function tests - C) Serum calcium levels - D) Renal
function tests

69. A patient on antipsychotic therapy presents with symptoms of tardive dyskinesia. Which of the
following is the best course of action? - A) Discontinue the antipsychotic - B) Prescribe a
benzodiazepine - C) Increase the dose of the antipsychotic - D) Switch to a different antipsychotic

70. A patient with atrial fibrillation is prescribed dabigatran. What is the main advantage of this drug
compared to warfarin? - A) No need for INR monitoring - B) Lower risk of bleeding - C) Shorter half-
life - D) Requires once-daily dosing

Section 4: Ethics and Professional Practice (10 Questions)

71. A patient asks you to refill a controlled substance prescription early, citing lost medication. What
is the most appropriate action? - A) Refill the prescription - B) Contact the prescriber for verification -
C) Refuse to refill the prescription - D) Report the patient to the authorities

72. A pharmacist discovers a dispensing error that has not yet resulted in harm to the patient. What
should the pharmacist do? - A) Ignore the error - B) Inform the patient immediately - C) Document
and report the error to a supervisor - D) Adjust the prescription without notifying anyone

73. A patient is upset about the cost of a medication and asks for a cheaper alternative. What should
the pharmacist do? - A) Offer a generic alternative if available - B) Refuse to help the patient - C)
Suggest the patient stop taking the medication - D) Tell the patient to ask their doctor

74. A physician asks a pharmacist to dispense an off-label medication. What should the pharmacist
do? - A) Refuse to dispense the medication - B) Dispense the medication without question - C) Verify
the physician's rationale and ensure it is in the best interest of the patient - D) Report the physician
to the medical board

75. A patient requests information about a dietary supplement they are considering. What is the best
response from the pharmacist? - A) "Supplements are not regulated, so I can't provide information."
- B) "I can provide information on the supplement and any potential interactions with your
medications." - C) "You should only take prescription medications." - D) "Supplements are safe, so
there’s no need for concern."
76. A pharmacist suspects that a patient is being abused based on visible signs and symptoms. What
is the appropriate course of action? - A) Report the suspicion to the appropriate authorities - B)
Ignore the signs and continue with the prescription - C) Confront the patient directly about the abuse
- D) Refuse to fill the patient's prescription

77. A pharmacist receives a prescription with an unclear dosage. What is the best course of action? -
A) Guess the dosage based on similar prescriptions - B) Contact the prescriber to clarify the dosage -
C) Dispense the lowest possible dose - D) Refuse to fill the prescription

78. A pharmacy technician is caught stealing medications. What should the pharmacist do? - A)
Confront the technician privately - B) Report the incident to the pharmacy manager or appropriate
authority - C) Ignore the incident to avoid conflict - D) Dismiss the technician immediately

79. A patient refuses counseling on a new medication. What is the pharmacist's responsibility? - A)
Document the refusal and respect the patient's decision - B) Force the patient to listen to the
counseling - C) Refuse to dispense the medication - D) Inform the patient’s physician

80. A pharmacist is asked to compound a medication for a patient. The pharmacist knows that a
commercially available product exists. What should the pharmacist do? - A) Compound the
medication as requested - B) Inform the patient and physician about the commercially available
product and use it if appropriate - C) Refuse to compound the medication - D) Compound the
medication and charge extra for the service

Section 5: Patient Management (10 Questions)

81. A patient is prescribed a medication that should be taken with food. The patient asks what will
happen if it’s taken on an empty stomach. What should the pharmacist advise? - A) The medication
may cause stomach irritation. - B) The medication will work faster. - C) The medication will not work
at all. - D) The medication's absorption will be unaffected.

82. A patient with asthma is prescribed an inhaled corticosteroid. What is the most important
counseling point? - A) Rinse the mouth after each use to prevent oral thrush. - B) Use the inhaler only
when symptoms occur. - C) Store the inhaler in the refrigerator. - D) Discontinue the inhaler if
symptoms improve.

83. A patient taking warfarin is prescribed an antibiotic. What should the pharmacist do? - A) Advise
the patient to stop taking warfarin. - B) Check for potential interactions and adjust the warfarin dose
if necessary. - C) Tell the patient to avoid leafy greens while on the antibiotic. - D) Tell the patient to
stop the antibiotic if bleeding occurs.

84. A patient with diabetes is experiencing hypoglycemia. What should the pharmacist recommend
as the first step? - A) Take a dose of insulin - B) Consume 15 grams of fast-acting carbohydrates - C)
Skip the next meal - D) Drink plenty of water

85. A patient with chronic pain is prescribed a transdermal fentanyl patch. What is the most
important counseling point? - A) Apply the patch to the same spot each time. - B) Cut the patch to
adjust the dose. - C) Avoid heat sources, as they can increase drug absorption. - D) Change the patch
every 72 hours without regard to pain relief.
86. A patient with hypertension is prescribed a thiazide diuretic. What should the pharmacist
monitor regularly? - A) Blood glucose levels - B) Serum potassium levels - C) Liver function tests - D)
White blood cell count

87. A patient on bisphosphonate therapy for osteoporosis asks how to take the medication. What is
the correct advice? - A) Take it with food to avoid stomach upset. - B) Take it with a full glass of water
and remain upright for 30 minutes. - C) Take it at bedtime. - D) Take it only when experiencing bone
pain.

88. A patient is prescribed a nasal corticosteroid for allergic rhinitis. What is the most important
counseling point? - A) Use the spray only when symptoms are severe. - B) Prime the spray before first
use and if not used for a while. - C) Tilt the head backward while using the spray. - D) Share the spray
with family members if they have similar symptoms.

89. A patient with chronic kidney disease is prescribed erythropoietin. What is the main goal of this
therapy? - A) To treat anemia - B) To improve kidney function - C) To reduce blood pressure - D) To
prevent bone disease

90. A patient with heart failure is prescribed an ACE inhibitor. What is the most important side effect
to monitor for? - A) Dry cough - B) Hyperglycemia - C) Weight gain - D) Tachycardia

Section 6: Miscellaneous (10 Questions)

91. Which of the following is the primary goal of antiretroviral therapy in HIV-positive patients? - A)
Cure the infection - B) Suppress viral load to undetectable levels - C) Increase CD4 count above 1,000
cells/mm³ - D) Prevent opportunistic infections

92. Which of the following is an appropriate counseling point for a patient taking a statin? - A) Avoid
grapefruit juice - B) Take the medication in the morning - C) Avoid foods high in potassium - D) Stop
the medication if muscle pain occurs

93. Which of the following is true regarding the use of insulin in type 1 diabetes? - A) Insulin is used
to replace endogenous insulin production. - B) Insulin is used to stimulate the pancreas to produce
more insulin. - C) Insulin is used only when oral medications fail. - D) Insulin therapy is optional in
type 1 diabetes.

94. A patient with rheumatoid arthritis is prescribed methotrexate. What is the main reason for
prescribing folic acid alongside methotrexate? - A) To enhance the efficacy of methotrexate - B) To
prevent methotrexate-induced folate deficiency - C) To reduce the absorption of methotrexate - D) To
improve joint mobility

95. A patient on anticoagulant therapy presents with excessive bruising. What is the most likely
cause? - A) Increased clotting factors - B) Excessive anticoagulant effect - C) Vitamin K deficiency - D)
Infection

96. Which of the following is a key counseling point for a patient using a metered-dose inhaler (MDI)
for asthma? - A) Exhale fully before using the inhaler. - B) Use the inhaler only when experiencing
symptoms. - C) Shake the inhaler before each use. - D) All of the above

97. Which of the following is an appropriate counseling point for a patient taking iron supplements? -
A) Take with dairy products to enhance absorption. - B) Take on an empty stomach if tolerated. - C)
Take with calcium supplements for better absorption. - D) Take at bedtime to reduce side effects.
98. A patient with a history of gout is prescribed allopurinol. What is the main purpose of this
medication? - A) To reduce pain during gout attacks - B) To lower uric acid levels - C) To increase renal
excretion of uric acid - D) To treat acute gout attacks

99. A patient taking levothyroxine for hypothyroidism asks how long it will take for the medication to
start working. What should the pharmacist advise?
Section 1: Pharmacology (30 Questions)

1. B) Metoprolol
Explanation: Metoprolol is a beta-blocker commonly used to manage hypertension by reducing heart
rate and the heart's workload.

2. A) Vancomycin
Explanation: Vancomycin is the drug of choice for treating MRSA infections due to its effectiveness
against this resistant strain of bacteria.

3. B) Ibuprofen
Explanation: Ibuprofen, an NSAID, can increase the risk of bleeding in patients on warfarin by
interfering with platelet function and irritating the gastrointestinal tract.

4. B) Fluoxetine
Explanation: Fluoxetine is an SSRI that works by increasing the levels of serotonin in the brain, which
helps improve mood.

5. B) Lisinopril
Explanation: Lisinopril is an ACE inhibitor that reduces blood pressure by preventing the formation of
angiotensin II, a substance that narrows blood vessels.

6. A) Simvastatin
Explanation: Simvastatin is a statin used to lower cholesterol levels and reduce the risk of
cardiovascular events.

7. B) Constipation
Explanation: Opioid analgesics like morphine can slow down gastrointestinal motility, leading to
constipation.

8. A) Fluconazole
Explanation: Fluconazole is commonly used to treat systemic fungal infections due to its broad
spectrum of activity and good oral bioavailability.

9. B) Montelukast
Explanation: Montelukast is a leukotriene receptor antagonist that helps prevent asthma attacks by
blocking the action of leukotrienes, which cause airway inflammation.

10. B) Decreases hepatic glucose production

Explanation: Metformin works primarily by reducing glucose production in the liver, improving insulin
sensitivity, and enhancing glucose uptake by muscles.

11. B) Omeprazole
Explanation: Omeprazole is a proton pump inhibitor (PPI) that reduces stomach acid production by
blocking the enzyme responsible for acid secretion.

12. B) Atorvastatin
Explanation: Atorvastatin is an HMG-CoA reductase inhibitor that lowers cholesterol levels by
inhibiting the enzyme involved in cholesterol synthesis in the liver.

13. B) Avoid lying down for 30 minutes after taking the medication
Explanation: Bisphosphonates can cause esophageal irritation, so it is important to stay upright for
30 minutes after taking them.
14. B) Insulin lispro
Explanation: Insulin lispro is a short-acting insulin that is typically taken before meals to control blood
glucose levels.

15. C) Furosemide
Explanation: Furosemide is a loop diuretic that works by inhibiting the reabsorption of sodium and
chloride in the loop of Henle, leading to increased urine output.

16. B) Escitalopram
Explanation: Escitalopram is an SSRI commonly used as a first-line treatment for generalized anxiety
disorder (GAD).

17. D) All of the above

Explanation: Levodopa/Carbidopa increases dopamine levels, Selegiline inhibits dopamine
breakdown, and Amantadine enhances dopamine release—all are used in Parkinson's disease
treatment.

18. B) Fluoroquinolones
Explanation: Fluoroquinolones, such as ciprofloxacin, have been associated with an increased risk of
tendon rupture, particularly in older adults.

19. D) All of the above

Explanation: Metoprolol, Digoxin, and Furosemide are all used in the management of heart failure.
Metoprolol reduces heart rate, Digoxin strengthens heart contractions, and Furosemide reduces fluid
overload.

20. A) Tiotropium
Explanation: Tiotropium is a long-acting muscarinic antagonist (LAMA) used to manage COPD by
relaxing the muscles in the airways and making breathing easier.

21. A) Haloperidol
Explanation: Haloperidol is an antipsychotic used to treat schizophrenia by blocking dopamine
receptors in the brain.

22. B) Thromboembolic disorders

Explanation: Oral contraceptives are contraindicated in patients with a history of thromboembolic
disorders due to the increased risk of blood clots.

23. C) N-acetylcysteine
Explanation: N-acetylcysteine is the antidote for acetaminophen overdose as it replenishes
glutathione stores and detoxifies the harmful metabolite.

24. B) Osteoporosis
Explanation: Long-term corticosteroid therapy can lead to osteoporosis by decreasing bone
formation and increasing bone resorption.

25. B) Dry mouth

Explanation: Anticholinergic medications can cause dry mouth by inhibiting saliva production.

26. D) All of the above

Explanation: Tamsulosin, Finasteride, and Dutasteride are all used in the treatment of benign
prostatic hyperplasia (BPH) by relaxing smooth muscles and reducing prostate size.
27. A) Asthma
Explanation: Beta-blockers can exacerbate asthma by causing bronchoconstriction, so they are
contraindicated in patients with asthma.

28. B) Colchicine
Explanation: Colchicine is used to treat acute gout by reducing inflammation and pain associated
with gout flares.

29. A) Muscle pain

Explanation: Statins can cause muscle pain, a condition known as myopathy, which may progress to
rhabdomyolysis in severe cases.

30. B) Propranolol
Explanation: Propranolol, a beta-blocker, is often used prophylactically to prevent migraines by
reducing the frequency and severity of attacks.

Section 2: Pharmaceutical Calculations (20 Questions)

31. A) 10 mL
Explanation: The patient requires 250 mg per dose, and the suspension is 125 mg/5 mL. To calculate
the required volume:
(250 mg / 125 mg) ×5 mL=10 mL\text{(250 mg / 125 mg) } \times 5 \text{ mL} = 10 \text{ mL}
(250 mg / 125 mg) ×5 mL=10 mL

32. B) 9 grams
Explanation: A 0.9% solution means 0.9 grams of sodium chloride in 100 mL. In 1 liter (1000 mL):
0.9 g×10=9 g0.9 \text{ g} \times 10 = 9 \text{ g}0.9 g×10=9 g

33. B) 100 mg
Explanation: The dosage is 5 mg/kg for a 20 kg child. Total dose:
5 mg/kg×20 kg=100 mg5 \text{ mg/kg} \times 20 \text{ kg} = 100 \text{ mg}5 mg/kg×20 kg=100 mg

34. A) 0.06 grams

Explanation: 1:500 w/v solution means 1 gram in 500 mL. For 30 mL:
1 g500 mL×30 mL=0.06 g\frac{1 \text{ g}}{500 \text{ mL}} \times 30 \text{ mL} = 0.06 \
text{ g}500 mL1 g×30 mL=0.06 g

35. C) 25 mg
Explanation: The half-life is 6 hours, so after 24 hours (4 half-lives), the remaining drug will be:
200 mg÷24=200 mg÷16=12.5 mg200 \text{ mg} \div 2^4 = 200 \text{ mg} \div 16 = 12.5 \
text{ mg}200 mg÷24=200 mg÷16=12.5 mg

36. C) 25 grams
Explanation: A 5% w/v solution contains 5 grams per 100 mL. For 500 mL:
5 g/100 mL×5=25 g5 \text{ g/100 mL} \times 5 = 25 \text{ g}5 g/100 mL×5=25 g

37. C) 20 mL
Explanation: To dilute 80% solution to 20%:
C1V1=C2V2⇒80%×V1=20%×60 mL⇒V1=15 mLC_1V_1 = C_2V_2 \Rightarrow 80\% \times V_1 =
20\% \times 60 \text{ mL} \Rightarrow V_1 = 15 \text{ mL}C1V1=C2V2⇒80%×V1=20%×60 mL⇒V1
=15 mL
38. C) 4 tablets
Explanation: The patient needs 1,000 mg, with each tablet being 250 mg. Required tablets:
1000 mg÷250 mg=4 tablets1000 \text{ mg} \div 250 \text{ mg} = 4 \
text{ tablets}1000 mg÷250 mg=4 tablets

39. C) 3.5 mL
Explanation: Dosage required:
0.5 mg/kg×70 kg=35 mg0.5 \text{ mg/kg} \times 70 \text{ kg} = 35 \text{ mg}0.5 mg/kg×70 kg=35 mg
If concentration is 10 mg/mL:
35 mg÷10 mg/mL=3.5 mL35 \text{ mg} \div 10 \text{ mg/mL} = 3.5 \
text{ mL}35 mg÷10 mg/mL=3.5 mL

40. B) 1.8 grams

Explanation: 0.9% w/v solution has 0.9 grams in 100 mL. For 250 mL:
0.9 g/100 mL×2.5=2.25 g0.9 \text{ g/100 mL} \times 2.5 = 2.25 \text{ g}0.9 g/100 mL×2.5=2.25 g

41. B) 2 mg/mL
Explanation: The concentration is 500 mg in 250 mL, so:
500 mg÷250 mL=2 mg/mL500 \text{ mg} \div 250 \text{ mL} = 2 \text{
mg/mL}500 mg÷250 mL=2 mg/mL

42. C) 50 grams
Explanation: A 5% solution contains 5 grams per 100 mL, so:
5 g×10=50 g5 \text{ g} \times 10 = 50 \text{ g}5 g×10=50 g

43. D) 150 mg
Explanation: The patient weighs 75 kg, and the dose is 2 mg/kg:
75 kg×2 mg/kg=150 mg75 \text{ kg} \times 2 \text{ mg/kg} = 150 \text{ mg}75 kg×2 mg/kg=150 mg

44. B) 10 grams
Explanation: A 1% solution means 1 gram in 100 mL, so in 1 L:
1 g×10=10 g1 \text{ g} \times 10 = 10 \text{ g}1 g×10=10 g

45. C) 3 tablets
Explanation: The patient needs 150 mg, and each tablet is 50 mg:
150 mg÷50 mg=3 tablets150 \text{ mg} \div 50 \text{ mg} = 3 \text{ tablets}150 mg÷50 mg=3 tablets

46. B) 0.2 grams

Explanation: 1:250 means 1 gram in 250 mL, so in 100 mL:
1 g250 mL×100 mL=0.4 g\frac{1 \text{ g}}{250 \text{ mL}} \times 100 \text{ mL} = 0.4 \
text{ g}250 mL1 g×100 mL=0.4 g

47. C) 10 mL
Explanation: Diluting a 10% solution to 2%:
C1V1=C2V2⇒10%×V1=2%×50 mL⇒V1=10 mLC_1V_1 = C_2V_2 \Rightarrow 10\% \times V_1 =
2\% \times 50 \text{ mL} \Rightarrow V_1 = 10 \text{ mL}C1V1=C2V2⇒10%×V1=2%×50 mL⇒V1
=10 mL

48. B) 20 mg/mL
Explanation: The concentration is 2 grams in 100 mL, so:
2000 mg÷100 mL=20 mg/mL2000 \text{ mg} \div 100 \text{ mL} = 20 \text{
mg/mL}2000 mg÷100 mL=20 mg/mL
49. A) 0.5 mg/mL
Explanation: The solution has 0.25 grams in 500 mL, so:
0.25 g÷500 mL=0.5 mg/mL0.25 \text{ g} \div 500 \text{ mL} = 0.5 \text{
mg/mL}0.25 g÷500 mL=0.5 mg/mL

50. B) 75 mL
Explanation: To dilute 70% solution to 10%:
C1V1=C2V2⇒70%×V1=10%×500 mL⇒V1=75 mLC_1V_1 = C_2V_2 \Rightarrow 70\% \times V_1 =
10\% \times 500 \text{ mL} \Rightarrow V_1 = 75 \text{ mL}C1V1=C2V2⇒70%×V1=10%×500 mL⇒V1
=75 mL

Section 3: Clinical Pharmacy (20 Questions)

51. B) To prevent nephropathy

Explanation: ACE inhibitors are preferred in diabetic patients for their kidney-protective effects,
preventing the progression of diabetic nephropathy.

52. C) Monitor serum digoxin levels

Explanation: The symptoms described are indicative of digoxin toxicity, so serum levels should be
checked and the dose adjusted if necessary.

53. B) Risk of lactic acidosis

Explanation: Metformin can accumulate in patients with renal impairment, increasing the risk of
lactic acidosis, a potentially fatal condition.

54. D) Both A and C

Explanation: Both Amiodarone and Lithium can cause hypothyroidism by affecting thyroid hormone
production and metabolism.

55. A) Warfarin
Explanation: Warfarin is commonly used to prevent stroke in patients with atrial fibrillation,
especially those at high risk.

56. B) Discontinue simvastatin and switch to a different statin

Explanation: Muscle pain is a common side effect of statins, and switching to another statin with a
different metabolic pathway might reduce this side effect.

57. C) Azithromycin
Explanation: Azithromycin is effective against common pathogens in community-acquired
pneumonia and is preferred for its favorable side effect profile.

58. B) Omeprazole
Explanation: Omeprazole, a proton pump inhibitor, reduces stomach acid production and helps
prevent NSAID-induced ulcers.

59. B) Long-acting muscarinic antagonist

Explanation: A LAMA like Tiotropium is used to manage COPD with frequent exacerbations by
improving lung function and reducing symptoms.

60. A) Serum potassium levels

Explanation: Spironolactone is a potassium-sparing diuretic, so monitoring potassium levels is
essential to avoid hyperkalemia.
61. D) Both B and C
Explanation: GLP-1 receptor agonists and SGLT2 inhibitors have cardiovascular benefits and are
recommended in patients with type 2 diabetes and atherosclerotic cardiovascular disease.

62. B) It is an antiplatelet agent

Explanation: Clopidogrel is an antiplatelet agent that prevents blood clots by inhibiting platelet
aggregation, reducing the risk of heart attacks and strokes.

63. B) Check serum lithium levels

Explanation: The symptoms are indicative of lithium toxicity, so serum levels should be checked
immediately, and the dose adjusted.

64. A) Spinach
Explanation: Spinach is high in vitamin K, which can interfere with warfarin therapy by reducing its
anticoagulant effect.

65. B) Agranulocytosis
Explanation: Methimazole can cause agranulocytosis, a severe drop in white blood cells, increasing
the risk of infections.

66. C) Sevelamer
Explanation: Sevelamer is a non-calcium-based phosphate binder that is preferred in patients with
chronic kidney disease to manage hyperphosphatemia without increasing calcium levels.

67. B) Osteoporosis
Explanation: Long-term corticosteroid use can lead to decreased bone density, increasing the risk of
fractures and osteoporosis.

68. B) Liver function tests

Explanation: Valproic acid can cause liver toxicity, so regular monitoring of liver function tests is
essential.

69. A) Discontinue the antipsychotic

Explanation: Tardive dyskinesia is a serious side effect of antipsychotics, and discontinuation of the
offending drug is necessary to prevent worsening of the condition.

70. A) No need for INR monitoring

Explanation: Dabigatran, a direct thrombin inhibitor, does not require INR monitoring, making it
more convenient than warfarin for patients.

Section 4: Ethics and Professional Practice (10 Questions)

71. B) Contact the prescriber for verification

Explanation: Early refills of controlled substances raise red flags for potential misuse, so it's
important to verify with the prescriber before refilling.

72. C) Document and report the error to a supervisor

Explanation: Even if no harm has occurred, medication errors should be reported and documented to
prevent future occurrences and improve patient safety.
73. A) Offer a generic alternative if available
Explanation: Offering a generic alternative can reduce costs while providing the same therapeutic
effect, which is beneficial for the patient.

74. C) Verify the physician's rationale and ensure it is in the best interest of the patient
Explanation: Off-label prescribing is common, but it is important to verify that it is in the patient's
best interest and based on sound clinical evidence.

75. B) "I can provide information on the supplement and any potential interactions with your
medications."
Explanation: Providing information about supplements, including possible interactions with
prescription medications, is essential for patient safety.

76. A) Report the suspicion to the appropriate authorities

Explanation: Pharmacists have a legal and ethical obligation to report suspected abuse to protect the
patient and ensure they receive the necessary help.

77. B) Contact the prescriber to clarify the dosage

Explanation: If there is any uncertainty about a prescription, it is critical to clarify with the prescriber
to ensure patient safety.

78. B) Report the incident to the pharmacy manager or appropriate authority

Explanation: Theft of medications is a serious issue and must be reported to prevent potential harm
to patients and ensure compliance with legal requirements.

79. A) Document the refusal and respect the patient's decision

Explanation: While counseling is important, patients have the right to refuse it. However, the refusal
should be documented for legal and professional purposes.

80. B) Inform the patient and physician about the commercially available product and use it if
appropriate
Explanation: Using a commercially available product is often safer and more cost-effective than
compounding, and should be recommended if appropriate.

Section 5: Patient Management (10 Questions)

81. A) The medication may cause stomach irritation.

Explanation: Some medications can cause stomach irritation if taken on an empty stomach, so it's
important to take them with food to reduce this risk.

82. A) Rinse the mouth after each use to prevent oral thrush.
Explanation: Inhaled corticosteroids can increase the risk of oral thrush, so rinsing the mouth after
use is essential to prevent this side effect.

83. B) Check for potential interactions and adjust the warfarin dose if necessary.
Explanation: Some antibiotics can interact with warfarin, increasing the risk of bleeding, so it may be
necessary to adjust the warfarin dose and monitor INR levels.

84. B) Consume 15 grams of fast-acting carbohydrates

Explanation: Fast-acting carbohydrates, such as glucose tablets or juice, can quickly raise blood sugar
levels during hypoglycemia.
85. C) Avoid heat sources, as they can increase drug absorption.
Explanation: Heat can increase the absorption of fentanyl from the patch, potentially leading to an
overdose, so patients should avoid applying heat to the patch area.

86. B) Serum potassium levels

Explanation: Thiazide diuretics can cause hypokalemia, so monitoring potassium levels is important
to prevent this complication.

87. B) Take it with a full glass of water and remain upright for 30 minutes.
Explanation: Bisphosphonates can cause esophageal irritation, so it's important to take them with
water and remain upright to ensure they reach the stomach quickly.

88. B) Prime the spray before first use and if not used for a while.
Explanation: Priming ensures that the nasal spray delivers the correct dose of medication, which is
important for effective treatment.

89. A) To treat anemia

Explanation: Erythropoietin stimulates red blood cell production and is used to treat anemia,
particularly in patients with chronic kidney disease.

90. A) Dry cough

Explanation: A dry cough is a common side effect of ACE inhibitors due to the accumulation of
bradykinin, a byproduct of ACE inhibition.

Section 6: Miscellaneous (10 Questions)

91. B) Suppress viral load to undetectable levels

Explanation: The primary goal of antiretroviral therapy is to suppress the HIV viral load to
undetectable levels, improving the patient's immune function and reducing the risk of transmission.

92. A) Avoid grapefruit juice

Explanation: Grapefruit juice can inhibit the metabolism of statins, leading to higher blood levels and
an increased risk of side effects like muscle pain and rhabdomyolysis.

93. A) Insulin is used to replace endogenous insulin production.

Explanation: In type 1 diabetes, the body cannot produce insulin, so insulin therapy is necessary to
replace the hormone and control blood glucose levels.

94. B) To prevent methotrexate-induced folate deficiency

Explanation: Methotrexate inhibits dihydrofolate reductase, leading to folate deficiency, so folic acid
supplementation is necessary to prevent this.

95. B) Excessive anticoagulant effect

Explanation: Bruising is a common sign of excessive anticoagulation, which may indicate that the
patient is at risk of bleeding.

96. D) All of the above

Explanation: Proper technique for using an MDI includes exhaling fully before use, shaking the
inhaler, and using it correctly to ensure the medication is delivered effectively.
97. B) Take on an empty stomach if tolerated.
Explanation: Iron is best absorbed on an empty stomach, but if it causes stomach upset, it can be
taken with food, although this may reduce absorption.

98. B) To lower uric acid levels

Explanation: Allopurinol inhibits xanthine oxidase, reducing uric acid production and preventing gout
attacks.

99. C) 4 to 6 weeks
Explanation: It typically takes 4 to 6 weeks for levothyroxine to reach steady-state levels and for
patients to notice improvements in hypothyroid symptoms.

100. B) White blood cell count

Explanation: Chemotherapy can cause bone marrow suppression, leading to a decrease in white
blood cells, which increases the risk of infections, so monitoring WBC counts is critical.
- A) Immediate effect within hours - B) 1 to 2 days - C) 4 to 6 weeks - D) 2 to 3 months

100. Which of the following is a key factor to monitor in a patient receiving chemotherapy?

- A) Liver function tests - B) White blood cell count - C) Serum creatinine - D) All of the above