Medication Profile—Long-Term Care

Date of admission: 7/18
Patient Name: John Doe
Race: Caucasian
Address: 3213 Anywhere St.
Height: 5'9”
Age: 98
Weight: 179 lb
Gender: M
Allergies: NKA

Diagnosis
Primary: Urine sepsis
Secondary: Paranoia, dementia, depression, cardiomegaly,
bilateral chronic rotator cuff tears, degenerative joints, and constipation

Admission orders
 
Date
Name and Strength
Route
Sig
1.
7/18
Flagyl® 500 mg
PO
i q12h through 7/24
2.
7/18
LevaquinTM 250 mg
PO
i qd through 7/24
3.
7/18
Zoloft® 50 mg
PO
i qd
4.
7/18
Celebrex® 100 mg
PO
i qd
5.
7/18
Risperdal® 0.5 mg
PO
i qhs
6.
7/18
Ativan® 0.5 mg
PO
i qhs prn anxiety
7.
7/18
Darvocet-N®100
PO
i q4h prn pain
8.
7/18
Milk of magnesia 30 cc
PO
i qd prn constipation

Notes and patient information
1.
Fall precautions
 
Use the patient profile above to answer questions 1-8.

1.
Pharmacologic categories for Flagyl® include
A.
Amebicidal
B.
Topical antibiotic
C.
Anaerobic antibiotic
D.
Antiprotozoal
E.
All of the above


2.
Which of the drugs listed in Mr. Doe's admission orders is FDA approved to treat depression?
A.
Darvocet-N®100
B.
Zoloft®
C.
Risperdal®
D.
Ativan®
E.
Celebrex®


3.
Which of the drugs listed in Mr. Doe's admission orders can cause extrapyramidal reactions?
A.
Darvocet-N®100
B.
Zoloft®
C.
Risperdal®
D.
Ativan®
E.
Celebrex®


4.
Which agent is classified as a quinolone?
A.
Flagyl®
B.
LevaquinTM
C.
Celebrex®
D.
Ativan®
E.
Zoloft®


5.
Which of the following statements is true about Zoloft®?
I. It should not be used in combination with a monoamine oxidase inhibitor
II. It is a serotonin receptor agonist
III. It is FDA approved for post-traumatic stress disorder
A.
I only
B.
II only
C.
I and III
D.
II and III
E.
I, II, and III


6.
Drugs listed in Mr. Doe's admission orders that can inhibit the absorption of LevaquinTM if taken concomitantly include
I. Risperidone
II. Flagyl®
III. Milk of magnesia
A.
I only
B.
II only
C.
III only
D.
I and III
E.
II and III


7.
Drugs listed in Mr. Doe's admission orders that can also be given IV include
I. Zoloft®
II. LevaquinTM
III. Flagyl®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


8.
Drugs listed in Mr. Doe's admission orders that can cause a disulfiram-like reaction include
I. Zoloft®
II. Risperdal®
III. Flagyl®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


End of patient profile; continue the examination.

9.
Theophylline exerts its therapeutic effect by
I. Blocking phosphodiesterase, which ultimately causes release of epinephrine from adrenal medulla
II. Inhibiting degranulation of mast cells
III. Stimulating beta2 receptors, which causes relaxation of bronchial smooth muscle
A.
I only
B.
II only
C.
I and II
D.
I and III
E.
I, II, and III


10.
Products with zero-order absorption kinetics are better than products with first-order absorption kinetics because
I. Are more readily absorbed
II. Result in a longer half-life of the product
III. Offer steady plasma drug concentrations
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


11.
Which statements about asthma are true?
I. Is considered a hyperactivity of the airways resulting from physical, chemical, and pharmacologic stimuli
II. Chronic asthma is characterized by episodic dyspnea associated with wheezing
III. Emergency situations for acute severe asthma often represent the failure of an adequate therapeutic regimen for chronic asthma
A.
I only
B.
II only
C.
I and II
D.
I and III
E.
I, II, and III


12.
Which pharmacologic mechanisms represent that of bromocriptine?
I. Has dopaminergic activity
II. Inhibits prolactin secretion
III. Inhibits acetylcholinesterase
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


13.
Proton pump inhibitors that are available OTC include
A.
Lansoprazole
B.
Esomeprazole
C.
Omeprazole
D.
Pantoprazole
E.
All of the above


14.
Which of the following agents work by inhibiting calcium ions from entering slow channels or select voltage-sensitive areas of vascular smooth muscle and myocardium during depolarization?
I. Dilacor XR®
II. Inderal®
III. Teveten®
A.
I only
B.
II only
C.
I and II
D.
I and III
E.
I, II, and III


15.
Hypoglycemic agents available in extended-release dosage forms include
I. Metformin®
II. Glipizide
III. Acarbose
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


16.
The Cockcroft and Gault equation is used to determine
I. Glomerular filtration rate
II. Serum creatinine
III. Creatinine clearance
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


17.
Classic symptoms of diabetes include
I. Polyuria
II. Polyphagia
III. Polydipsia
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


18.
Drugs that can be used to treat constipation include
I. ReglanTM
II. Cascara sagrada
III. Surfak
A.
I only
B.
II only
C.
III only
D.
II and III
E.
I, II and III


19.
Antihistamines that are less likely to cause drowsiness include
I. Claritin®
II. Periactin®
III. Allegra®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I and III


20.
Drugs used to treat Parkinson's disease that are also ergot alkaloid derivatives include
A.
ReglanTM
B.
Imitrex®
C.
Parlodel®
D.
Amerge®
E.
Zomig®


Medication Profile—Long Term Care

Date of admission: 7/18
Patient Name: Shoni Doe
Race: Hispanic
Address: 1122 Everywhere St.
Height: 5'4”
Age: 63
Weight: 110 lb
Gender: F
Allergies: Paxil®, Claforan®

Diagnoses
Primary: Congestive heart failure, hypertension
Secondary: Anemia, scarlet fever, depression, and hernia, constipation, neurogenic bladder

Admission orders
Date
Name and Strength
Route
Sig
1.
6/29
Antivert® 25 mg
PO
i tid
2.
6/29
Ditropan® 5 mg
PO
i qam
3.
6/29
Ditropan® 10 mg
PO
i qhs
4.
6/29
Protonix® 40 mg
PO
i qd
5.
6/29
Catapres 0.1 mg
PO
i qhs
6.
6/29
Lanoxin® 0.1 mg
PO
i qd
7.
6/29
Muro 128
Ophthalmic
i gtt ou qd
8.
6/29
Catapres® 0.1 mg
PO
i prn
9.
6/29
Milk of magnesia
PO
30 cc qd prn constipation
 
Use the patient profile above to answer questions 21-30.

21.
Which of the drugs prescribed to Ms. Doe will treat her neurogenic bladder?
A.
Ditropan®
B.
Antivert®
C.
Catapres®
D.
Protonix®
E.
None of the medications listed in her profile because neurogenic bladder cannot be treated


22.
If you were given her admission orders to fill, which drugs would you call her physician about a possible drug-drug interaction?
I. Antivert®–Ditropan®
II. Catapres®–Lanoxin®
III. Antivert®–Lanoxin®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


23.
What drugs is this Ms. Doe taking to treat her congestive heart failure?
I. Lanoxin®
II. Antivert®
III. Catapres®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I and III


24.
Which mechanism of action best describes how Catapres® helps Ms. Doe's hypertension?
I. Reduces sympathetic outflow, producing a decrease in vasomotor tone and heart rate
II. Stimulates alpha2-adrenoceptors in the brain stem
III. Dilates the lungs
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I and III


25.
If you were given the admission orders to fill, which drug would you call about because of failure to provide a diagnosis?
I. Protonix®
II. Antivert®
III. Muro 128
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


26.
You should take into account the Claforan® allergy this patient has, if you were asked to fill a prescription for this patient for
A.
Rocephin®
B.
Zoloft®
C.
Pamelor®
D.
Tegretol®
E.
Naprelan®


27.
Drug therapy for acute or severe congestive heart failure consists of
I. Diuretics
II. Positive inotropes
III. Arterial vasodilators
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


28.
FDA approved uses for Protonix® include
I. Short-term treatment of erosive esophagitis associated with GERD
II. Acid indigestion
III. Sour stomach
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


29.
Dosage forms available for Catapres® include
I. Injection
II. Patch
III. Tablet
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


30.
If this patient were to be given Lanoxin® IV, the dosage would have to be
A.
Increased by 20%
B.
Decreased by 20%
C.
Increased by 40%
D.
Decreased by 40%
E.
No adjustment would be necessary


End of patient profile; continue the examination.

31.
Agents that decrease cholesterol include
I. Lescol®
II. Colestid®
III. Cordarone®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


32.
Monitoring parameters for atropine sulfate in the treatment of sinus bradycardia include
I. Heart rate
II. Blood pressure
III. Liver function
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


33.
What types of drugs are normally used during cardiopulmonary resuscitation?
I. Sympathomimetics
II. Adrenergic agonists
III. Calcium channel blockers
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


34.
Which drug selectively forms a protective coating that protects the gastric lining against peptic acid, pepsin, and bile salts, when it forms a viscous paste-like adhesive substance after it binds to positively charged proteins?
A.
Pepcid®
B.
Prilosec®
C.
Carafate®
D.
Pepto-Bismol®
E.
Milk of magnesia


35.
Drugs that can be used in the treatment of acute gouty arthritis as well as prophylactically include
I. Indomethacin
II. Deltasone®
III. Colchicine
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


36.
Which of the following is true about topical decongestants?
I. Topical decongestants act by inhibiting adrenergic receptors
II. They result in little or no systemic absorption
III. Prolonged use of topical decongestants result in severe nasal edema and reduced receptor sensitivity (rhinitis medicamentosa)
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


37.
Since calcium carbonate is 40% elemental calcium, the number of tablets you would need to use to supply 1 g of elemental calcium, if the tablet size is 650 mg, would be
A.
1 tablet
B.
2 tablets
C.
3 tablets
D.
4 tablets
E.
6 tablets


38.
Which of the following statements are true about Miacalcin® in the treatment of osteoporosis?
I. It eliminates the need for supplementation with calcium and vitamin D
II. Its effects on bone density may plateau or decrease after 12–18 months
III. Nasal administration produces fewer side effects than subcutaneous
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


39.
Drugs that are effective in the symptom relief of rheumatoid arthritis but do not slow disease progression include
I. Naprelan®
II. Aspirin
III. Sandimmune®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


40.
Calcium formulations that have acid independent absorption and, thus, are preferable for use in the elderly as supplement to decrease bone loss include
I. Calcium carbonate
II. Calcium citrate
III. Calcium chloride
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


Medication Profile—Community Pharmacy
Patient Name: Mike Tell
Race: Caucasian
Address: 334 Unknown St.
Height: 5'11”
Age: 60
Weight: 266 lb
Gender: M
Allergies: NKA

Diagnosis
Primary: Gout, hypertension
Secondary: Diabetes mellitus, constipation, knee replacement, dermatitis

Medication record
 
Date
RX No
Name and Strength
Route
Quantity
Sig
1.
6/8
11331
Indocin® 25 mg
PO
30
i tid
2.
6/8
11332
Aristocort cream
Topical
30 g
i tid
3.
6/23
12114
Amaryl® 1 mg
PO
30
i qd
4.
6/28
13103
Dyazide
PO
30
i bid
5.
6/28
13104
Micronase 5 mg
PO
60
ii qam
6.
7/20
14231
Micronase 5 mg
PO
30
i qpm
7.
9/7
15301
Coumadin® 4 mg
PO
30
i qd
8.
10/11
16241
Milk of magnesia
PO
480
30 cc prn
9.
11/5
17332
Dulcolax® supp 10 mg
PR
30
i qd prn
10.
11/5
17333
Vicodin® 5/500
PO
30
i q4h prn
11.
11/5
17334
Tylenol® 325 mg
PO
30
i q4h prn
 
Use the patient profile above to answer questions 41-52.

41.
Based on this patient's profile, which diabetes type is he being treated for?
I. Noninsulin-dependent diabetes mellitus
II. Diabetes mellitus type 1
III. Diabetes mellitus type 2
A.
I only
B.
II only
C.
III only
D.
I and III
E.
I and III


42.
Pharmacologic classifications for Amaryl® include
I. Sulfonylurea agent
II. Hypoglycemic agent
III. Thiazolidinedione derivative agent
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


43.
Dyazide in this patient is being used to treat his
I. Gout
II. Hypertension
III. Dermatitis
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


44.
Parameters that should be monitored for patients taking Amaryl® include
I. Glucose and ketones in urine
II. Fasting blood glucose
III. Liver enzymes every two months for the first year of therapy
A.
I
B.
II
C.
III
D.
I and II
E.
II and III


45.
Reasons for this patient to be on Coumadin® include
I. Prophylaxis of systemic embolism from gout
II. Improve the management of his diabetes mellitus
III. Prophylaxis of systemic embolism after knee replacement
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


46.
Which choices best explain the addition of Micronase to this patient's profile on 7/20
I. Improve INR readings for Coumadin®
II. Improve fasting blood glucose levels
III. Improve serum uric acid levels
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


47.
Clinical presentation of patients experiencing diabetic ketoacidosis include
I. Changes in mental status
II. Nausea and vomiting
III. Fruity odor to the breath
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


48.
The dose for Micronase should be adjusted in patients with renal impairment. What lab values are taken into account for dosage adjustments in renal impairment?
I. Uric acid levels in the serum
II. Amounts of ketones in the urine
III. Creatinine clearance
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


49.
Based on his medical profile you could conclude that this patient is taking Indocin®, Tylenol®, and Vicodin® to treat his
I. Dermatitis
II. Knee replacement
III. Gout
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


50.
Based on his medical profile you could conclude that this patient is using Aristocort cream to treat his
I. Gout
II. Dermatitis
III. Knee replacement
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


51.
Which of the drugs listed in Mr. Doe's medication profile could interact with Coumadin® to increase his INR
I. Indocin®
II. Dyazide
III. Micronase
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I and III


52.
Drugs listed in Mr. Doe's profile that could decrease the effects of Micronase include
I. Coumadin®
II. Dyazide
III. Indocin®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I and III


End of patient profile; continue the examination.

53.
Dosage forms available for Sandostatin® include
I. Injection
II. Capsules
III. Tablets
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


54.
Pyridium is used in patients with urinary tract infections because of its
I. Antibiotic activity
II. Analgesic effects
III. Anesthetic effects
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II, and III


55.
Which statements about hepatitis C are true?
I. It is clinically indistinguishable from other types of hepatitis
II. Less than 25% of the patients develop jaundice
III. Approximately 60–70% progress to chronic infection
A.
I only
B.
II only
C.
I and II
D.
II and III
E.
I, II, and III


56.
Which of the following drugs is an immunosuppressant agent?
A.
Roferon-A®
B.
Prograf®
C.
Imitrex®
D.
Evista®
E.
Soma®


57.
Which medication treats gastroesophageal reflux by enhancing the response to acetylcholine of tissue in upper GI tract causing enhanced motility and accelerated gastric emptying without stimulating gastric, biliary, or pancreatic secretions?
A.
Prilosec®
B.
Pepcid®
C.
ReglanTM
D.
Carafate®
E.
Questran


58.
Mesna is an antidote used to treat hemorrhagic cystitis caused by which of the following drugs?
I. Ifex®
II. Cytoxan®
III. Adriamycin®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


59.
Which of the following products would you recommend to treat acne vulgaris?
I. Azelex®
II. Meclan®
III. LactiCare®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II and III


60.
Which of the following statements is true about gentamicin dosing?
I. All patients require a loading dose independent of renal function
II. Patients receiving hemodialysis should receive a lower loading dose
III. The loading dose should be the same regardless of the severity of the infection
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


Medication Profile—Community Hospital

Date of admission: 7/15
Patient Name: William Rivera
Race: Hispanic
Address: 1136 Nowhere St.
Height: 5'7”
Age: 55
Weight: 162 lb
Gender: M
Allergies: Penicillin

Diagnosis
Primary: Pulmonary edema secondary to CHF  
Secondary: Stroke, depression, hypercholesterolemic, anxiety, atrial fib, hypertension, constipation, urinary retention

Admission orders
 
Date
Name and Strength
Route
Sig
1.
7/15
Protonix®
PO
i qd
2.
7/15
Flomax® 0.8
PO
i qd
3.
7/15
CelexaTM 20 mg
PO
i qd
4.
7/15
Zocor® 20 mg
PO
i qhs
5.
7/15
Tums®
PO
i bid
6.
7/15
Xanax® 1 mg
PO
i bid
7.
7/15
Lactulose 20 g
PO
i am
8.
7/15
ASA 81 mg
PO
i qd
9.
7/15
Lopressor® 12.5 mg
PO
i bid
10.
7/15
Altace® 20 mg
PO
i qd
11.
7/15
Lasix® 20 mg
PO
i qd
12.
7/15
Zyprexa® 12.5 mg
PO
i qhs
13.
7/15
Oramorph® 60 mg
PO
i qam
14.
7/15
Oramorph® 30 mg
PO
i qpm
15.
7/15
Tylenol® 325 mg
PO
i 1-2 q4-6h prn
16.
7/15
Milk of magnesia 30cc
PO
i qd prn
17.
7/15
Dulcolax® supp
PR
i prn

Dietary considerations
Date
1.
7/15
Honey, thickened liquids
 
Use the patient profile above to answer questions 61-70.

61.
Which of the drugs listed for Mr. Rivera is being used to treat his urinary retention?
A.
CelexaTM
B.
Flomax®
C.
Zocor®
D.
Altace®
E.
Zyprexa®


62.
How many of the drugs listed in Mr. Rivera's medication profile are indicated to treat his hypertension?
A.
1
B.
3
C.
5
D.
6
E.
8


63.
The beneficial effects of Na+ and water retention in congestive heart failure include
I. Optimization of stroke volume via the Frank-Starling mechanism
II. Increase in sympathetic venous system activity
III. Ventricular hypertrophy
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


64.
Which of the following agents is a drug that is commonly used, as a prophylaxis in stroke, but has not been included in the medication profile for this patient?
A.
Indocin®
B.
Coumadin®
C.
Lanoxin®
D.
Lasix®
E.
Hep-Lock


65.
Which of the drugs listed in Mr. Rivera's profile inhibits the enzyme that catalyzes the rate-limiting step in cholesterol biosynthesis?
A.
Protonix®
B.
Flomax®
C.
CelexaTM
D.
Zocor®
E.
Xanax®


66.
Beta-adrenergic blockers listed in Mr. Rivera's medication profile include
I. Altace®
II. Lopressor®
III. Lasix®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


67.
Which of the drugs that Mr. Rivera is taking will help him relieve dyspnea of pulmonary edema
I. Zyprexa®
II. Lopressor®
III. Oramorph®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


68.
Which of the following agents could be used as adjunct therapy if his antilipemic agent did not prove effective in reducing serum cholesterol levels to desired levels?
A.
Pepcid®
B.
Plavix®
C.
TriCor®
D.
Colchicine
E.
Cozaar®


69.
At what LDL serum level should an antilipemic therapy be initiated on a patient with a history of coronary heart disease?
A.
> 80 mg/dL
B.
> 90 mg/dL
C.
> 100 mg/dL
D.
> 130 mg/dL
E.
> 160 mg/dL


70.
Factors that are considered risk factors for atherosclerotic disease include
I. Actively smoking cigarettes
II. Diabetes mellitus
III. Hypertension or taking antihypertensive medications
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


End of patient profile; continue the examination.

71.
The first line of therapy that should be used in managing acute attacks in patients with chronic stable angina include
I. Nitrates
II. Diuretics
III. ACE inhibitors
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II, and III


72.
Which of the following drugs should not be given to patients stable in anticoagulant therapy?
I. Activase®
II. Zovirax®
III. Avandia®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


73.
Which of the following statements are true about heparin?
I. It has the ability to bind and catalyze antithrombin III
II. Halts further growth and propagation of the thrombus
III. It should be monitored by the INR
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


74.
Oral treatments available to treat acne include
I. Sumycin®
II. Cleocin®
III. Accutane®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


75.
What is that pharmacologic classification of AvitaTM?
I. Retinoic acid derivative
II. Acne product
III. Dopaminergic agent
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


76.
Which of the following agents are keratolytic drugs indicated for the treatment of psoriasis
I. Anthra-Derm
II. Podocon-25
III. Retin-A®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I and III


77.
Which of the following drugs will improve myocardial oxygen supply by dissolving the thrombus associated with acute myocardial infarction and improve the likelihood of survival if taking within 4 hours of a myocardial infarction onset?
I. Eminase®
II. Retavase®
III. Plavix®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


78.
All of the following are angiotensin receptor antagonists EXCEPT
A.
Atacand®
B.
Diovan®
C.
Monopril®
D.
Cozaar®
E.
Avapro®


79.
Which of the following agents can be administered using a transdermal drug delivery system?
I. Habitrol
II. Anthra-Derm
III. Clinda-Derm
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


80.
Drug types that can induce constipation include
I. Opiates
II. Iron preparations
III. Anticholinergics
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


Medication Profile—Long-Term Care

Date of admission: 7/15
Patient Name: Marla Pass
Race: Black
Address: 545 Somewhere St.
Height: 6'1”
Age: 58
Weight: 230 lb
Gender: F
Allergies: NKA

Diagnosis
Primary: Crohn's disease  
Secondary: Low back pain, osteoarthritis, osteoporosis, and urinary incontinence, dry eyes, constipation

Admission orders
 
Date
Name and Strength
Route
Sig
1.
7/26
Theragran-M®
PO
i qd
2.
7/26
Purinethol® 25 mg
PO
i qd
3.
7/26
Feosol® 325 mg
PO
i qd
4.
7/26
Ascorbic acid 500 mg
PO
i qd
5.
7/26
Oyst-Cal 500
PO
i qd
6.
7/26
Ultram® 50 mg
PO
i bid
7.
7/26
Lovenox® 30 mg
PO
i bid
8.
7/26
Milk of magnesia 30 cc
PO
i qd prn constipation
9.
7/26
Tylenol® Gelcaps
PO
i tid
10.
7/26
Tears Natural II
Ophthalmic
i gtt ou tid
11.
7/26
Skelaxin® 400 mg
PO
i tid
12.
7/26
Colazal® 750 mg
PO
iii tid
13.
7/26
Fosamax® 70 mg
PO
i at 7 am qwk
14.
7/26
Rowasa® 500 mg supp
PR
i bid
15.
726
Tylenol® 650 mg
PO
i q3-4h prn
16.
7/26
Roxicet®
PO
i-ii PO q4-6h prn
17.
7/26
Deltasone® 5 mg
PO
i qd
18.
7/26
Detrol® 4 mg
PO
i qd

Notes and patient information
1.     Fall precautions


Use the patient profile above to answer questions 81-90.

81.
How many of the drugs listed in Ms. Pass's medication profile are indicated for the treatment for Crohn's disease?
A.
1
B.
2
C.
4
D.
6
E.
9


82.
What is the pharmacologic classification of Skelaxin®?
I. Skeletal muscle relaxant
II. Antianxiety agent
III. Anticonfulsant
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


83.
This patient is currently taking Colazal® to treat her
I. Osteoarthritis
II. Osteoporosis
III. Crohn's disease
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


84.
Roxicet® is a combination of which two drugs?
A.
Acetaminophen and codeine
B.
Acetaminophen and pseudoephedrine
C.
Oxycodone and aspirin
D.
Oxycodone and acetaminophen
E.
Morphine and acetaminophen


85.
Additional agents that are indicated to treat Crohn's disease but that are not listed in this patient's profile include
I. Imuran®
II. Remicade®
III. Cytoxan®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


86.
Which of the following statements are true about Crohn's disease?
I. Steroids can prevent the recurrence of Crohn's disease
II. The major agents used for maintenance of remission of Crohn's disease are sulfasalazine and mesalamine derivatives
III. Ulcerative colitis and Crohn's disease are exactly the same type of disease
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


87.
Nonpharmacologic approaches for the treatment of osteoporosis include
I. Decreasing caffeine ingestion to less than 2–5 cups of coffee
II. Performing aerobic and strengthening exercises
III. Discontinue smoking
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


88.
Which of the drugs listed in Ms. Pass's medication profile should not be administered within 4 hours of her taking Roxicet®?
I. Rowasa®
II. Tylenol®
III. Skelaxin®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


89.
The benefits of administering calcium supplements to patients diagnosed with osteoporosis include
I. Decrease in bone resorption
II. Increase in bone resorption
III. Increase in bone mass
A.
I only
B.
II only
C.
III only
D.
I and III
E.
II and III


90.
Drugs that should not be taken concomitantly with Ultram® include
I. Roxicet®
II. Tylenol®
III. Skelaxin®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


91.
Ms. Pass has been reported to be experiencing symptoms of depression. Which of the following drugs would be contraindicated to treat her depression, because it would produce a significant drug-drug interaction?
I. Parnate®
II. Prozac®
III. CelexaTM
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I and III


End of patient profile; continue the examination.

92.
Recommendations that you could make to a patient experiencing acute diarrhea include
I. Stopping solid foods for 24 hours
II. Increase the intake of dairy products
III. Drink water
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I and III


93.
Which of the following agents are recombinant human erythropoietin products that promote differentiation and proliferation of blood products?
I. Procrit®
II. Proleukin®
III. Prograf®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


94.
What types of antidepressants are more likely to decrease the seizure threshold in a patient with a history of seizure disorder?
I. Cyclic antidepressants
II. MAO inhibitors
III. Serotonin reuptake inhibitors
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


95.
Which of the following substances is classified as a strong electrolyte?
A.
KCl
B.
Glucose
C.
Creatinine
D.
Serum
E.
NaPO4


96.
Drugs that show high plasma protein binding usually show
A.
A very large apparent volume of distribution
B.
A very small apparent volume of distribution
C.
Higher incidence of side effects
D.
High urinary excretion
E.
Low hepatic metabolism


97.
What types of chemical compounds can undergo degradation through decarboxylation?
I. Carboxylic acids
II. Esters in liquid formulations
III. Electrolytes
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


98.
Which of the following drugs can minimize the number of reflux episodes in GERD by increasing lower esophageal sphincter pressure?
I. ReglanTM
II. Urecholine®
III. Prevacid®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


99.
Which of the following statements are true about hepatitis A?
I. The infection usually produces mild, self-limited illness, and rarely results in fulminant hepatitis or death
II. Clinical symptoms in children < 6 years old generally display a mild, influenza-like illness without clinical jaundice
III. Chronic hepatitis may develop over a period of years
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


100.
Products available for prevention of hepatitis include
I. Hepatitis B vaccine
II. Hepatitis B immune globulin
III. Roferon A®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


Medication Profile—Community Hospital

Date of admission: 2/13
Patient Name: Thomas Scott
Race: Caucasian
Address: 2523 Somewhere St.
Height: 5'9”
Age: 60
Weight: 162 lb
Gender: M
Allergies: NKA

Diagnosis
Atrial fibrillation, anemia, sigmoid diverticularis, glaucoma, hypertension, constipation, cough

Admission orders
 
Date
Name and Strength
Route
Sig
1.
2/13
Alphagan®
Ophthalmic
i gtt
2.
2/13
Citrucel®
PO
i tsp/8oz water qd
3.
2/13
Vitamin B12
IM
1000 mg qmo
4.
2/13
Timoptic® 0.5%
Ophthalmic
i gtt ou qam
5.
2/13
Xalatan® 0.005%
Ophthalmic
i gtt od qhs
6.
2/13
Lasix® 40 mg
PO
i qd
7.
2/13
Norvasc® 5 mg
PO
i qd
8.
2/13
Lotensin® 20 mg
PO
i qd
9.
2/13
Lanoxin® 0.125 mg
PO
i qd
10.
2/13
Coumadin® 4 mg
PO
i qd
11.
2/13
Senokot®
PO
ii qam
12.
2/13
Ferrous sulfate 325
PO
i qd
13.
2/13
Robitussin A-C®
PO
5–10 mL q4h
14.
2/13
Tylenol® 650 mg
PO
i q4h
15.
2/13
Adalat® 10 mg
PO
i prn if > 170/105
16.
2/13
Milk of magnesia 10 mL
PO
i qd prn
17.
2/13
Dulcolax® 10 mg supp
PR
i prn
 
Use the patient profile above to answer questions 101-111.

101.
Which of the drugs listed in Mr. Scott's profile is FDA approved to treat his atrial fibrillation?
I. Lanoxin®
II. Adalat®
III. Norvasc®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


102.
Types of drugs that are contraindicated for patients being treated for angle closure glaucoma include
I. Topical anticholinergics
II. Topical sympathomimetics
III. Calcium channel blockers
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


103.
Which of the agents being used to treat Mr. Scott's glaucoma is a prostaglandin F2-alpha agonist?
I. Alphagan®
II. Xalatan®
III. Timoptic®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


104.
At an early stage, vitamin B12-deficiency anemia is characterized by a
I. Decrease in red blood cell counts
II. Decrease in hematocrit values
III. Decrease in serum iron concentrations
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


105.
Mr. Scott has requested in his hospital meals more alfalfa and broccoli and would like to continue eating more of these kinds of vegetables from now on. In light of this change in his diet, the dose of which of the drugs listed in his profile would need to be adjusted?
I. Adalat®
II. Coumadin®
III. Lanoxin®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


106.
Dosage forms available for Norvasc® include
I. Tablet
II. Extended-release tablet
III. Capsule
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


107.
Which of the following agents can increase the hypotensive effects of Norvasc®?
I. Adalat®
II. Alcoholic drinks
III. Rifadin®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


108.
Lasix® is an effective therapy for all of the following EXCEPT
I. Hypertension
II. Management of edema associated with congestive heart failure
III. Nephropathy
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


109.
Which of the following drugs would be better indicated when atrial fibrillation is precipitated by a high adrenergic state?
I. Inderal®
II. Adalat®
III. Cardizem®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and II


110.
Active ingredients for Robitussin A-C® include
I. Guaifenesin
II. Codeine
III. Dextromethorphan
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


111.
Which of the medications listed for Mr. Scott is likely to cause constipation?
I. Robitussin A-C®
II. Ferrous sulfate
III. Citrucel®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


End of patient profile; continue the examination.

112.
Antitussives that can be found in OTC preparations include
I. Codeine
II. Dextromethorphan
III. Pseudoephedrine
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


113.
Which of the following is a hypertonic parenteral product?
I. 0.45% NaCl
II. 0.9% NaCl
III. Dextrose 40%
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


114.
Drugs with a narrow therapeutic index include
I. Lyphocin
II. Augmentin®
III. Rocephin®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


115.
A patient that is being treated with an antibiotic therapy complains of ringing in his ears. This patient is most likely being treated with which of the following antibiotics?
A.
Rocephin®
B.
Omnicef®
C.
Cleocin®
D.
Lyphocin
E.
Ketoconazole


116.
A patient has just been diagnosed with hyperkalemia. Her physician has decided to prescribe Kayexalate®. The ion or ions present in this resin that allows for the binding of potassium ions, causing a decrease in potassium levels in the serum include
I. Sodium
II. Calcium
III. Magnesium
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


117.
The route of administration for Kayexalate® is
I. PO
II. IV
III. IM
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


118.
Which of the following agents is commonly used in patients with renal failure to treat hypophosphatemia?
I. Kayexalate®
II. Amphojel®
III. Calcium carbonate
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


119.
A filter syringe must always be used when drawing a dose from
I. Ampules
II. Glass vials with rubber stoppers
III. Plastic vials with rubber stoppers
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


120.
Normochromic normocytic anemia is usually seen in
I. Vitamin B12 deficiency
II. Chronic renal failure
III. Iron deficiency
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


Medication Profile—Community Pharmacy
Patient Name: Marjorie Ask
Race: Caucasian
Address: 3541 Perhaps St.
Height: 5'5”
Age: 60
Weight: 113 lb
Gender: F
Allergies: NKA

Diagnosis
Hip dislocation, essential hypertension, hypothyroidism, Parkinson's disease, osteoporosis, neurotic disorders, and anxiety

Medication record
 
Date
RX No
Name and Strength
Route
Quantity
Sig
1.
7/12
13311
Coumadin® 2 mg
PO
30
i noon
2.
7/12
13312
Synthroid® 100 mg
PO
30
i qd
3.
7/17
13314
Norvasc® 5 mg
PO
30
i qd
4.
8/28
13315
Sinemet® CR 50/200
PO
30
i bid
5.
8/28
13316
Fosamax® 70 mg
PO
4
i qwk
6.
9/20
13317
Neurontin® 300 mg
PO
90
iii qhs
7.
9/20
13318
Os-Cal® 500 + vit D 200 mg
PO
30
i bid
8.
11/11
13319
Niferex® 150 mg
PO
30
i qd
9.
11/15
13320
Colace® 100 mg
PO
30
i qd
10.
11/15
13321
Xanax® 0.25 mg
PO
90
i tid
 
Use the patient profile above to answer questions 121-130.

121.
The generic name for Niferex®-150 is
A.
Multiple vitamins
B.
Iron polysaccharide complex
C.
Ferrous sulfate
D.
Ferrous gluconate
E.
Ferrous fumarate


122.
You are aware that Ms. Ask is currently taking Neurontin® and she has asked you to recommend a good antacid for her gastritis. Which of the following recommendations should you make to her as her pharmacist?
I. Take the Neurontin® at least 2 hours after taking the antacid
II. Do not take antacids while you are taking Neurontin®
III. Take Tagamet® instead
A.
I only
B.
II only
C.
III only
D.
I and III
E.
II and III


123.
The most likely reason for administration of Neurontin® in this patient is
A.
Partial seizures
B.
Neurotic disorder
C.
Chronic pain
D.
Essential hypertension
E.
Parkinson's disease


124.
Active ingredients for Sinemet® include?
I. Levodopa
II. Carbidopa
III. Levocarnitine
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


125.
Clinical characteristics of idiopathic Parkinson's disease include all of the following EXCEPT
A.
Bradykinesia
B.
Dementia
C.
Bradycardia
D.
Rigidity
E.
Dysphagia


126.
Which of the following medications can extend the duration of action of levodopa and permit the reduction of levodopa dose?
I. Symmetrel®
II. Eldepryl®
III. CogentinTM
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


127.
Treatment alternatives that can be used in patients with Parkinson's disease that are unresponsive or allergic to levodopa include
I. Parlodel®
II. Eldepryl®
III. Lodosyn®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


128.
Treatment options that would not be available to Ms. Ask if she were taking Demerol include
I. Eldepryl®
II. Parlodel®
III. Symmetrel®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


129.
If Ms. Ask developed allergy to Xanax®, treatment options for her would include
I. BuSpar®
II. Ativan®
III. Benylin®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I and III


130.
Antianxiety drugs that are not generally recommended for immediate relief of anxiety because of their slow onset of action include
I. Ativan®
II. Serax®
III. Centrax
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


End of patient profile; continue the examination.

131.
Major toxicities for gentamicin include
I. Cardiotoxicity
II. Ototoxicity
III. Nephrotoxicity
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


132.
What vitamin is generally recommended to prevent the peripheral neuropathy associated with isoniazide administration in patients being treated for tuberculosis?
A.
Vitamin B12
B.
Vitamin A
C.
Vitamin B6
D.
Vitamin D
E.
Vitamin B1


133.
The volume of distribution of many drugs is generally increased in patients with
I. End-stage renal disease
II. Hepatic failure
III. Gallbladder disease
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


134.
Clinical characteristics of hypovolemia hyponatremia include
I. Tachycardia
II. Oliguria
III. Azotemia
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


135.
Hypervolemic hyponatremia in a patient is treated by
I. Restricting both water and salt
II. Loop diuretics
III. Normal saline administered IV
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


136.
Symptoms of hypernatremia include all of the following EXCEPT
A.
Spasticity
B.
Irritability
C.
Constipation
D.
Seizure
E.
Ataxia


137.
Agents that will reverse the ECG changes seen in severe hyperkalemia include?
I. Magnesium sulfate
II. Calcium chloride
III. Sodium phosphate
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


138.
Hypocalcemia associated with hypoalbuminemia requires
A.
No treatment
B.
Calcium chloride IV
C.
Calcium gluconate IV
D.
Normal saline IV
E.
Calcium phosphate IV


139.
Causes for hyperphosphatemia include
I. End-stage renal disease
II. Laxatives containing phosphate salts
III. Rhabdomyolysis
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


140.
Uremia is characterized by all of the following EXCEPT
A.
Nausea
B.
Vomiting
C.
Anorexia
D.
Polyuria
E.
Mental status changes


Medication Profile—Long Term Care

Date of admission: 4/30
Patient Name: Philips Doe
Race: African American
Address: 5342 Maybe St.
Height: 5'11”
Age: 59
Weight: 220
Gender: M
Allergies: NKA

Diagnosis
Chronic renal failure, hypertension, diabetes mellitus, peripheral vascular disease, anemia, angina

Admission orders
 
Date
Name and Strength
Route
Sig
1.
4/30
Dilantin® 100 mg
PO
i q8h
2.
4/30
Nicotine 14 mg/24 h patch
PO
i qd
3.
4/30
Isordil® 10 mg
PO
i tid
4.
4/30
Diabeta® 5 mg
PO
ii qam
5.
4/30
Diabeta® 5 mg
PO
i qhs
6.
4/30
ReglanTM 10 mg
PO
i qid
7.
4/30
Colace® 100 mg
PO
i bid
8.
4/30
Tylenol® 325 mg
PO
ii q4h prn
9.
4/30
Bisacodyl supp 10 mg
PR
i qd prn
10.
4/30
Milk of magnesia 80 mg/mL
PO
30 cc qd prn
11.
4/30
Nitrostat® 0.4 mg SL
SL
i q5min prn chest pain
12.
4/30
Ativan® 0.5 mg
PO
i-ii tab prn anxiety
13.
4/30
Ambien® 5 mg
PO
i hs prn insomnia

Notes and patient information
Date     Comments
6/28      Signs of gingival hyperplasia observed at am visit

Use the patient profile above to answer questions 141-150.

141.
Monitoring parameters for Dilantin® include
I. Blood pressure
II. Plasma phenytoin levels
III. Serum albumin levels
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


142.
Following a loading dose of phenytoin a level should be drawn within?
A.
2–6 h
B.
6–12 h
C.
12–24 h
D.
24–48 h
E.
48–96 h


143.
Routes of administration for phenytoin include
I. PO
II. IV
III. IM
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


144.
Which of the drugs listed for Mr. Doe may be responsible for his gingival hyperplasia
I. Dilantin®
II. Nicotine
III. Diabeta®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I and III


145.
Toxic levels of phenytoin are generally in the range of
A.
1 to 10 µg/mL
B.
10 to 20 µg/mL
C.
15 to 35 µg/mL
D.
30 to 50 µg/mL
E.
> 100 µg/mL


146.
Which of the drugs listed for Mr. Doe could give him chest pain and cause him to have to use Nitrostat to relieve it?
A.
Diabeta®
B.
Dilantin®
C.
Nicotine
D.
Isordil®
E.
ReglanTM


147.
Recommended dosing times for Isordil® include
I. 7 AM, 12 PM, 5 PM
II. 7 AM, 3 PM, 11 PM
III. 12 PM, 8 PM, 4 AM
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


148.
Mr. Doe has refused his last two meals because he says that he lost his appetite. Which of the drugs listed for Mr. Doe should be withheld at least until he starts eating his meals regularly?
A.
Nicotine
B.
Dilantin®
C.
Diabeta®
D.
ReglanTM
E.
Colace®


149.
Which of the drugs listed for Mr. Doe can accelerate gastric emptying without stimulating gastric, biliary, or pancreatic secretions?
I. ReglanTM
II. Diabeta®
III. Dilantin®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


150.
Which of the drugs listed for Mr. Doe is FDA approved for the symptomatic treatment of diabetic gastric stasis?
A.
Dilantin®
B.
Diabeta®
C.
ReglanTM
D.
Ativan®
E.
Colace®


End of patient profile; continue the examination.

151.
Syrups consist of all of the following ingredients EXCEPT
A.
Drug
B.
Water
C.
Sugar
D.
Alcohol
E.
Colorants


152.
Two moles of a drug dissolved in one liter of solution should be labeled as
A.
2 M
B.
2 m
C.
2% W/V
D.
2% V/V
E.
2% W/W


153.
The Hendersen-Hasselbalch equation is defined as
I. pH = pKa + log [base] / [acid]
II. pKa = pH + log [base] / [acid]
III. log [base] / acid = pH + pKa
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


154.
The serum level of Tegretol® is affected by
I. Tricyclic antidepressants
II. Augmentin®
III. Coumadin®
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


155.
What type of interaction describes the drug-drug interaction seen between an antacid that contains calcium and tetracycline?
A.
Synergism
B.
Antagonism
C.
Complexation
D.
Additive
E.
Ionic


156.
If 25 mL of a cotrimoxazole suspension are used to provide an equivalent dose of BactrimTM DS, the concentration of the solution consist of
A.
6.4 mg trimethoprim and 32 mg of sulfamethoxazole
B.
12.8 mg trimethoprim and 64 mg of sulfamethoxazole
C.
32 mg trimethoprim and 6.4 mg of sulfamethoxazole
D.
32 mg trimethoprim and 32 mg of sulfamethoxazole
E.
6.4 mg trimethoprim and 6.4 mg of sulfamethoxazole


157.
The active ingredient found in Orudis® is the same one found in
A.
Tylenol®
B.
Motrin®
C.
Oruvail®
D.
Naproxen
E.
Advil®


158.
Which corticosteroid preparation is available in oral, topical, and injectable forms?
I. Beclomethasone
II. Hydrocortisone
III. Dexamethasone
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II and III


159.
What is the ratio of the concentrations of the sodium acetate to acetic acid in a buffer solution of 7.4, if the pKa of the acetic acid is 4.8? Henderson-Hasselbalch equation: pKa = pH – log [base] / [salt]
A.
398 sodium acetate:1 acetic acid
B.
0.0025 sodium acetate:1 acetic acid
C.
200 sodium acetate:1 acetic acid
D.
1 sodium acetate:200 acetic acid
E.
1 sodium acetate: 398 acetic acid


160.
Conditions that are side effects of Risperdal® include
I. Extrapyramidal symptoms
II. Tardive dyskinesia
III. Weight loss
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I and III


Medication Profile—Community Pharmacy
Patient Name: Shirley Dunn
Race: African American
Address: 2235 Where St.
Height: 5'6”
Age: 50
Weight: 124 lb
Gender: F
Allergies: NKA

Diagnosis
Primary: Arthritis, glaucoma, depression, insomnia, spinal stenosis
Secondary: Constipation, macular degeneration, anemia, COPD

Medication record
 
Date
RX No
Name and Strength
Route
Quantity
Sig
1.
6/6
24333
Timoptic® 0.5%
Oph
15
i gtt ou bid
2.
6/6
24334
Ferrous sulfate 324 mg
PO
60
i bid
3.
7/1
26243
Ascorbic acid
PO
60
i bid
4.
7/1
26244
Wellbutrin® SR 150
PO
60
i bid
5.
7/1
26245
Celebrex® 200 mg
PO
30
i qd
6.
9/12
27443
Lortab® 5/500 mg
PO
60
i-ii q3-4h prn
7.
9/12
27444
Ambien® 5 mg
PO
30
i prn sleep x 10 d
8.
9/12
27445
Milk of magnesia
PO
480
30 cc qd prn
9.
9/12
27446
Tylenol® ES
PO
30
i q3-4h prn
 
Use the patient profile above to answer questions 161-170.

161.
Which of the drugs listed for Ms. Dunn is a hypnotic sedative?
A.
Timoptic® 0.5%
B.
Wellbutrin® SR
C.
Ambien®
D.
Lortab®
E.
Celebrex®


162.
How many of the drugs listed for Ms. Dunn are FDA approved to treat her macular degeneration?
A.
One
B.
Two
C.
Three
D.
Four
E.
None


163.
Common causes of insomnia include
I. Shift work
II. Endocrine
III. Beta-adrenergic blockers
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


164.
Pharmacologic classifications for drugs that treat insomnia include
I. Benzodiazepines
II. Antidepressants
III. Antihistamines
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


165.
Nonpharmacologic recommendations to treat insomnia include
I. Sleep only as much as necessary to feel rested
II. Discontinue or reduce the use of alcohol
III. Do not turn while lying in bed and close your eyes for as long as it takes to fall asleep
A.
I only
B.
II only
C.
III only
D.
I and II
E.
II, and III


166.
The generic formulation for Tylenol® ES is
A.
325 mg acetaminophen
B.
500 mg acetaminophen
C.
194 mg acetaminophen, 227 mg aspirin, 33 mg caffeine
D.
250 mg acetaminophen, 250 mg aspirin, 65 mg caffeine
E.
260 mg acetaminophen, 520 mg aspirin, 32.5 mg caffeine


167.
Dosages available for Wellbutrin® ER include
I. 75 mg
II. 150 mg
III. 300 mg
A.
I only
B.
II only
C.
III only
D.
II and III
E.
I, II, and III


168.
The generic name for Wellbutrin® is
A.
Buspirone
B.
Bupropion
C.
Buprenorphine
D.
Busulfan
E.
Zyban


169.
Which of the drugs listed for Ms. Dunn is a COX-2 selective inhibitor?
A.
Timoptic® 0.5%
B.
Celebrex®
C.
Wellbutrin®
D.
Ambien®
E.
Lortab® 5/500


170.
Which of the drugs listed for Ms. Dunn can acidify the urine?
A.
Wellbutrin®
B.
Celebrex®
C.
Ascorbic acid
D.
Tylenol® ES
E.
Ferrous sulfate


End of patient profile; continue the examination.

171.
The designation ou in the sig for Timoptic® 0.5% means
A.
Each eye
B.
Right eye
C.
Left eye
D.
Affected eye
E.
None of the above


172.
The best resource for identifying a drug equivalent for a patient that has received treatment for his high blood pressure outside of the U.S. would be
A.
The Red Book
B.
Pharmacist's Letter
C.
Martindale's Extra Pharmacopia
D.
Physician's Desk Reference
E.
Facts and Comparisons


173.
Hemodialysis is useful in removing drugs from a person that has been overdosed if the drug
A.
Is polar
B.
Has a large apparent volume of distribution
C.
Does not bind to plasma protein
D.
Is water soluble
E.
Has a small volume of distribution


174.
If you wish to increase the solubility of a weak base drug in water you could
I. Decrease the pH of the medium
II. Decrease the effective surface area of the drug
III. Slow the diffusion of drug molecules into the solvent by increasing the viscosity of the solvent
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


175.
The bioavailability of a drug from an extended release dosage form is related to the
I. Half-life of the drug
II. Solubility of the drug
III. Size of the dosage form
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


176.
Which of the following statements are true about suppositories
I. The suppository base should be compatible with a variety of drugs
II. It should dissolve easily in the fluid of the body cavity into which it is inserted
III. It should melt below 30oC
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


177.
A patient has changed physicians and you receive a call from her new physician who wants to know the number of mEq of potassium chloride she is taking on her current daily dose of 4 tablets of 400 mg (mol wt is 74.5). You tell him that she is currently taking
A.
10 mEq
B.
21 mEq
C.
30 mEq
D.
35 mEq
E.
42 mEq


178.
Which of the following natural products have antiplatelet effects?
I. Ginkgo biloba
II. Ginger
III. Ginseng
A.
I only
B.
II only
C.
III only
D.
I and II
E.
I, II, and III


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