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BIOMEDICAL SCIENCES

1 Folic acid has tetrahydrofolate coenzyme activity which is based on the:
a. pyrimidine ring.
b. purine ring.
c. pyrazine ring.
d. pteridine ring.
e. pyridine ring.

2 Enkephalins are peptides that:
a. have narcotic antagonist activity.
b. exert actions resembling those of opioids.
c. are found only in the central nervous system.
d. cause blood vessel wall relaxation.
e. transmit pain impulses.

3 β-Carotene is the precursor of:
a. retinol.
b. thiamine.
c. calciferol.
d. riboflavin.
e. retinoic acid.

4 True statements regarding transcription include which of the following?
a. The enzyme responsible for initiating transcription is RNA polymerase.
b. The enzyme responsible for initiating transcription is DNA polymerase.
c. During transcription, the genetic information contained in the nucleotide sequence 
of tRNA is translated into a protein structure.
d. The process of transcription includes the splicing of exons.
e. Following initiation, the next stage of transcription is termination.

5 Diphtheria is caused by:
a. Plasmodium.
b. Vibrio.
c. Shigella.
d. Neisseria.
e. Corynebacterium.

6 Which of the following blood vessels transports nutrient rich blood from the intestines to the liver?
a. Hepatic artery
b. Hepatic portal vein
c. Great saphenous vein
d. Inferior vena cava
e. Superior vena cava

7 The blood volume of the average adult is approximately:
a. 5 L.
b. 10 L.
c. 15 L.
d. 20 L.
e. 25 L.

8 Common etiologic agents of community-acquired pneumonia include:
I  Escherichia coli.
II Haemophilus influenzae.
III Mycoplasma pneumoniae.

a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III

9 Which of the following is the major inhibitory neurotransmitter in the brain?
a. Gamma-aminobutyric acid
b. Dopamine
c. Glutamate
d. Acetylcholine
e. Glycine

10 Which of the following enzymes catalyzes the synthesis of DNA from viral RNA?
a. Reverse transcriptase
b. DNA polymerase
c. RNA polymerase
d. Endonuclease
e. Aminoacyl-tRNA synthetase

11 Of the essential transition metal ions found in the human body, the one present at highest overall concentration is:
a. copper.
b. cobalt.
c. iron.
d. manganese.
e. zinc.

12 The optic disk is also called the:
a. blind spot.
b. cornea.
c. iris.
d. pupil.
e. macula lutea.

13 In cardiovascular physiology, LaPlace's law relates the tension achieved in a blood vessel wall to:
I  the length of the vessel.
II the radius of vessel.
III the intraluminal pressure.

a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III
 

PHARMACEUTICAL SCIENCES

14 Correct statements regarding reversed-phase high-performance liquid chromatography include which of the following?
I  The stationary phase is hydrophobic.
II The mobile phase is polar.
III The compound to be separated is very polar.

a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III

15 If the pKa of phenobarbital is 7.4, what approximate fraction of the drug would be 
ionized at pH 8.4?
a. 10%
b. 30%
c. 50%
d. 90%
e. 100%

16 All of the following statements concerning the lyophilization of a parenteral product 
are correct, EXCEPT:
a. there is minimal loss of activity in heat labile materials.
b. the liquid must be frozen to below the eutectic temperature.
c. the solute usually forms an amorphous glass.
d. the eutectic temperature is the freezing point of the drug solution.
e. water is removed from the frozen mixture by sublimation.

17 Dopamine is useful in the treatment of cardiogenic shock because it:
a. selectively dilates renal and mesenteric vascular beds.
b. does not induce peripheral vasoconstriction.
c. decreases the force of myocardial contraction.
d. delays the atrioventricular (AV) conduction time.
e. prolongs the QT interval on the ECG.

18 Concentration of a drug in breast milk exceeds that in plasma, if the drug:
a. is basic.
b. is protein bound.
c. is acidic but not protein bound.
d. has a small volume of distribution.
e. has a large volume of distribution.

19 Mercapturic acid derivatives in phase II metabolism can result from reactions of:
a. glutathione conjugates.
b. glucuronide conjugates.
c. glycine conjugates.
d. glutamate conjugates.
e. sulfate conjugates.

20 Tetrodotoxin is a selective inhibitor of the:
a. calcium ion channel.
b. sodium ion channel.
c. potassium ion channel.
d. chloride ion channel.
e. nicotinic ion channel.

21 Valproic acid is metabolized by aliphatic hydroxylation to the above two structures.
The relationship between the two metabolites illustrates the concept of:







a. conformational isomerism.
b. structural isomerism.
c. geometric isomerism.
d. optical isomerism.
e. diastereoisomerism.

22 Carbon monoxide binds to:
I  hemoglobin.
II myoglobin.
III cytochrome oxidase.

a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III

23 True statements regarding ipratropium bromide include all of the following, EXCEPT that ipratropium bromide:
a. is a competitive muscarinic antagonist.
b. exists as a quaternary ammonium compound
c. is poorly absorbed through airway epithelium.
d. requires nebulization for inhaled therapy.
e. enhances the bronchodilatory effects of theopyhlline.

24 Diazepam Injection U.S.P
Diazepam 5 mg/ml
Ethanol 10%
Propylene glycol 40%
Benzyl alcohol 1.5%
Water for Injection qs 100%

In the formulation given above, which of the following ingredients function as cosolvents?
I  Ethanol
II Propylene glycol
III Benzyl alcohol

a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III

25 Both isoxazole and oxazole rings are found as substituents in some bacteriostatic sulfanilamides. They are present in these structures specifically because of their:
a. sizes and shapes.
b. tautomeric activities.
c. enzymatic activities.
d. electron-donating effects.
e. electron-withdrawing effects.

26 The Michaelis-Menten equation will appear first order:
a. when the substrate concentration is much smaller than Km.
b. when Km is much smaller than the substrate concentration.
c. when Vmax is much smaller than Km.
d. when Vmax is much larger than Km.
e. when Km approaches Vmax.

27 With respect to bioequivalence, the parameter “Cmax” is:
a. affected by the extent of absorption only.
b. affected by the rate of absorption only.
c. affected by neither rate nor extent of absorption.
d. affected by both rate and extent of absorption.
e. the only significant parameter.

28 Which of the hydroxyls in the compound above is a tertiary alcohol?
a. Hydroxyl 1
b. Hydroxyl 2
c. Hydroxyl 3
d. Hydroxyl 4
e. Hydroxyls 1 and 2

29 The above structures are related to one another as:
a. bioisosteres.
b. enantiomers.
c. homologs.
d. rotamers.
e. positional (structural) isomers.

30 Five subjects given a single intravenous dose of a drug have the following elimination half-lives: 3, 9, 6, 5 and 4 h (hours). The mean half-life is:
a. 4 h.
b. 5 h.
c. 5.4 h.
d. 5.8 h.
e. 6 h.

31 Reasons for using coatings on tablets include all of the following, EXCEPT:
a. to mask the taste of the drug.
b. to mask the odor of the drug.
c. to improve the appearance of the tablet.
d. to increase the drug’s release rate.
e. to protect the drug from stomach acid.

32 Which of the following factors would be important in determining the concentration of drug that would be reached in the cerebrospinal fluid for treatment of meningitis?
I  Oil/water partition coefficient
II Binding to plasma protein
III pKa of the drug

a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III

33 Which of the following terms indicates a loss of moisture?
a. Deliquescence
b. Efflorescence
c. Hygroscopicity
d. Polymorphism
e. Condensation

34 Which of the following statements is FALSE regarding tablet formulation?
a. Diluents are fillers to add bulk to the tablet.
b. Lubricants help the patient to swallow the tablet more easily.
c. Binding agents may be added dry or in solution.
d. Disintegrants draw water into the tablet causing it to burst.
e. Glidants promote the flow of materials during compression.

35 Factors that determine bioequivalence of two brands of a drug include:
I the taste of the preparations.
II the physical appearance of the preparations.
III pharmacokinetic parameters of the preparations.
a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III

36 If the total body clearance of a drug is 200 mL/min in a normal healthy adult and the renal clearance is 10 mL/min then one may assume that:
a. the drug is extensively metabolized.
b. greater than normal drug accumulation would occur in patients with moderate renal failure
c. entero-hepatic recycling is significant.
d. the drug is not bound to plasma proteins.
e. the drug is concentrated in adipose tissue.

37 The major pathway for the biotransformation of the following compound is by hydrolysis. Identify the site which would be most susceptible to hydrolysis.

a. A
b. B
c. C
d. D
e. E




38 Mechanisms of drug interactions with acetylsalicylic acid (ASA) include:
a. induction of microsomal enzymes.
b. inhibition of microsomal enzymes.
c. inhibition of liposomal enzymes.
d. displacement of other drugs bound to serum albumin.
e. enhanced platelet aggregation.

39 Which of the following diuretics is used to block the Na+-H+ exchange system of the renal tubule?
a. Furosemide
b. Hydrochlorothiazide
c. Spironolactone
d. Acetazolamide
e. Amiloride

40 Atropine poisoning can be recognized by all of the following signs or symptoms, EXCEPT:
a. dry skin.
b. flushed appearance.
c. delirium and restlessness.
d. mydriasis.
e. diarrhea.

41 The organophosphates commonly found in insecticides are thought to act by which of the following mechanisms?
a. Combining with acetylcholine
b. Potentiating the action of acetylcholinesterase
c. Forming a very stable complex with acetylcholinesterase
d. Reacting at the cholinergic receptor
e. Preventing the release of acetylcholine from the nerve ending

42 Acarbose smooths and lowers:
a. postprandial blood glucose levels by blocking absorption of carbohydrates.
b. postprandial blood glucose levels by delaying absorption of carbohydrates.
c. preprandial blood glucose levels by blocking absorption of carbohydrates.
d. preprandial blood glucose levels by delaying absorption of carbohydrates.
e. preprandial and postprandial blood glucose levels by blocking absorption of carbohydrates.

43 Which of the following statements is true regarding the use of monoclonal antibody drug therapies?
a. Flu-like symptoms commonly occur at the start of therapy.
b. T cells are stimulated and will initiate a host rejection process.
c. Adalimumab is a murine-derived immunoglobulin monoclonal antibody product.
d. Use of chimeric monoclonal antibodies is associated with increased immunogenicity.
e. Use of Fc fragments avoids raising an immune response against the FAB part.

QUESTIONS 44 TO 46 INCLUSIVE REFER TO THE FOLLOWING:

A 3 year old child was admitted to the hospital following ingestion of an overdose of acetylsalicylic acid. The child was semi-comatose, flushed and flaccid. Her pupils were fixed and dilated. Respirations were deep and rapid. Laboratory investigation indicated serum salicylate level of 5.8 μmol/L (80 mg/100 mL) and a urinary pH of 6.

44 The syndrome of deep and rapid respirations would initially lead to:
a. respiratory acidosis.
b. respiratory alkalosis.
c. renal excretion of acid.
d. marked reduction in body temperature.
e. increased chloride elimination in urine.

45 As a result of other mechanisms the child would likely progress to:
a. hyperglycemia.
b. hypoglycemia.
c. metabolic alkalosis.
d. systemic acidosis.
e. renal failure.

46 One form of therapy to hasten the excretion of salicylate involves the administration of:
a. vasopressin (ADH).
b. probenecid.
c. ammonium chloride.
d. sodium bicarbonate.
e. aluminum hydroxide.

***********

47 The fraction of bound receptors in a well-defined drug-receptor binding system is determined by:
I  the equilibrium drug-receptor dissociation constant.
II the free drug concentration.
III the total receptor concentration.

a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III

48 In some parenteral formulations, sodium metabisulphite is included as:
a. an antioxidant.
b. a chelator.
c. a solubilizer.
d. a cosolvent.
e. an emulsifier.

49 The carbonic anhydrase inhibitor dorzolamide is structurally classified as a:
a. biguanide.
b. butyrophenone.
c. sulfonamide.
d. sulfonylurea.
e. thiazolidinedione.

50 Which of the following statements is FALSE regarding virus vectors used in the production of biotechnology drugs?
a. Viruses can be introduced by nutrients.
b. Viruses can be generated by an infected production cell line.
c. The most frequent source of virus introduction is the growth media.
d. Viruses can be inactivated by physical or chemical treatment of the product.
e. There is a trend toward using better-defined growth media in which serum levels are significantly reduced.

51 Which of the following excipients is NOT commonly found in biotechnology formulations?
a. Albumin
b. Lysine
c. Tween 20
d. Saline
e. Phosphate

52 An angiotensin-converting enzyme (ACE) inhibitor for which both renal elimination and metabolism are important in the elimination of the drug and its active metabolites is:
a. enalapril.
b. fosinopril.
c. lisinopril.
d. quinapril.
e. ramipril.

53 Once daily dosing of aminoglycosides is effective due to:
a. prolonged residence of the antibiotic in the body.
b. post-antimicrobial effect.
c. enhanced tissue accumulation.
d. reduced renal clearance.
e. higher peak-trough differences.

54 The method of ionization of mass spectrometry which results in well-established diagnostic fragmentation patterns that are useful in the identification of compounds of unknown structure is called:
a. atmospheric pressure chemical ionization (APCI).
b. chemical ionization (CI).
c. electron impact (EI) ionization.
d. electrospray ionization (ESI).
e. fast atom bombardment (FAB) ionization.

55 An ophthalmic solution contains zinc sulfate 0.25%, phenylephrine HCl 0.12% and boric acid 1.1% (NaCl equivalents: zinc sulfate 0.15, phenylephrine HCl 0.32, boric acid 0.5). Relative to lacrimal fluid, the solution is:
a. isotonic.
b. hypotonic.
c. hypertonic.
d. hyperosmotic.
e. isoosmotic.

PHARMACY PRACTICE - Clinical Sciences

56 Which of the following statements is true regarding nitrate tolerance?
a. Tolerance does not occur with oral isosorbide dinitrate.
b. Tolerance does not occur in patients who are concurrently on metoprolol.
c. Tolerance is dependent upon the administration schedule of nitrate medication.
d. Tolerance does not occur with topical nitroglycerin ointment.
e. Tolerance does not occur with transdermal nitroglycerin.

57 The shock and airway edema of anaphylaxis are best treated with:
a. salbutamol.
b. diphenhydramine.
c. epinephrine.
d. acetazolamide.
e. aminophylline.

58 Which of the following statements is true regarding pioglitazone therapy?
a. It requires ongoing monitoring of renal function.
b. It does not depend on the presence of insulin for its action.
c. Multiple daily dosing is required due to its short half-life.
d. Pulmonary fibrosis is a rare but serious adverse effect.
e. It has shown benefits in reducing glycosylated hemoglobin levels.

59 Prednisone may produce all of the following effects, EXCEPT:
a. skeletal muscle weakness.
b. hypoglycemia.
c. sodium retention.
d. peptic ulceration.
e. lowered resistance to infection.

QUESTIONS 60 TO 61 INCLUSIVE REFER TO THE FOLLOWING:

SM is a 34 year old female who, while vacationing in Mexico, began prophylactic treatment for travellers' diarrhea. Shortly thereafter she complained of a feeling of fullness in her ears, black stools and a black tongue. SM’s previous history includes an allergy to sulfonamides.

60 Which of the following drugs could be the cause of SM's complaints?
a. Bismuth subsalicylate
b. Cotrimoxazole
c. Doxycycline
d. Amoxicillin
e. Loperamide

61 Organisms commonly implicated in the cause of travellers' diarrhea include:
I Bacteroides fragilis.
II Escherichia coli.
III Shigella sp.
a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III

**********

62 Which of the following medications requires monitoring for the adverse effect of hyperlipidemia?
a. Ciprofloxacin
b. Allopurinol
c. Isotretinoin
d. Ramipril
e. Raloxifene

63 In the International System of Units (SI), most drug levels are to be reported in the units of micromoles/litre (µmol/L). The therapeutic concentration range for theophylline (molecular weight 180) is 10-20 mcg/mL. The SI equivalent would be:
a. 0.055 - 0.11 µmol/L.
b. 27 - 55 µmol/L.
c. 55 - 110 µmol/L.
d. 110 - 220 µmol/L.
e. 180 - 360 µmol/L.

64 The mother of a 6 year old child presents to the pharmacist with a written prescription for amoxicillin that was ordered by the physician 3 days earlier. She states that her child was diagnosed with otitis media. Which of the following is the most appropriate pharmacist response?
a. Fill the prescription as written.
b. Refuse to fill the prescription as the antibiotic order is no longer current.
c. Indicate a need to contact the prescriber before filling the prescription at this time.
d. Fill the prescription for a quantity that is the ordered amount less three days’ supply.
e. Explain that, at this late date, antibiotic therapy will likely be ineffective for the child.

65 RF is an 80 year old female who developed CDAD (Clostridium difficile-associated diarrhea) after recent treatment of a urinary tract infection with ciprofloxacin. She is admitted to hospital with profound diarrhea (8 watery bowel movements per day), fever and severe abdominal pain. Based on her symptoms, which of the following is the most appropriate therapy choice for her?
a. Oral metronidazole
b. Intravenous metronidazole
c. Oral cholestyramine
d. Oral vancomycin
e. Intravenous vancomycin

66 CC, a 72 year old female, complains to the pharmacist that her stomach has been bothering her recently. Current medications include: levothyroxine 0.1 mg daily (x 30 years), acetaminophen 500 mg qid (x 5 months), atorvastatin 40 mg hs (x 4 years), ibuprofen 400 mg tid prn joint pain (x 2 months) and zopiclone 3.75 mg hs prn (x 3 months). Which of the following drug therapy problems best describes CC’s current situation?
a. Too high a dosage of atorvastatin
b. Too high a dosage of zopiclone
c. Need for cytoprotection with ibuprofen
d. Drug interaction between atorvastatin and zopiclone
e. Too low a dosage of levothyroxine

67 A 27 year old patient presents to a community pharmacy for the first time and tells the pharmacist that he experienced an allergy to a penicillin product as a child. His symptoms included hives, wheezing and facial swelling, which resulted in hospitalized care. Which of the following is the most important reason for a community pharmacist to document this type of information in a patient’s medication profile record?
a. To provide drug allergy information to the patient’s insurance provider
b. To encourage the patient to fill future prescriptions at this pharmacy
c. To advertise relevant pharmacy products or services to appropriate patients
d. To enhance continuity of patient care regardless of the prescriber
e. To provide a record of cognitive services for insurance reimbursement

QUESTIONS 68 TO 69 INCLUSIVE REFER TO THE FOLLOWING:

TK is a 63 year old male with chronic kidney disease (Cr Cl = 29 mL/min/1.73m2) and gout. He experienced his last gout attack about 2 months ago. Today his toe is extremely painful, hot, red and swollen. At a walk-in clinic, he receives a prescription for naproxen 500 mg bid for 5 days. TK’ s other current medication is pravastatin 20 mg hs.

68 What drug therapy problem should the pharmacist identify for TK?
a. Naproxen is inferior to indomethacin for the treatment of acute gout.
b. The duration of naproxen treatment is too short.
c. Naproxen should be avoided in patients taking pravastatin.
d. Naproxen should be avoided in patients with renal dysfunction.
e. The frequency of naproxen dosing is too low.

69 Following successful resolution of the acute episode, TK’s physician decides that he should initiate allopurinol. TK should be advised to:
a. limit fluid intake.
b. take medication on an empty stomach.
c. use precautions to avoid photosensitivity.
d. report any skin rash or itching to the physician.
e. avoid dairy products or multivitamins within 2 hours of dose.

**********

70 All of the following have been implicated in causing toxic nephropathy, EXCEPT:
a. cyclosporine.
b. sulfonamides.
c. cisplatin.
d. penicillamine.
e. erythromycin.

71 In the treatment of a patient who has a solid tumour, which of the following side effects typically occurs 1 to 2 weeks after chemotherapy?
a. Neuropathy.
b. Cardiotoxicity.
c. Neutropenia.
d. Emesis.
e. Nephrotoxicity.

72 Lactose intolerance is classified as a(n):
a. allergy.
b. enzyme deficiency.
c. mineral deficiency.
d. transporter abnormality.
e. vitamin deficiency.

73 Parkinson's disease is characterized by a deficiency of:
a. acetylcholine in the motor cortex.
b. noradrenaline in the spinal motor neurons.
c. gamma amino butyric acid (GABA) in inhibitory pathways.
d. dopamine in the nigrostriatal pathway.
e. serotonin in the brain stem.

74 All of the following statements are true regarding chronic inflammation, EXCEPT:
a. it may develop as a granulomatous inflammation.
b. it may be caused by persistent infections such as tuberculosis.
c. it may occur with autoimmune diseases such as rheumatoid arthritis.
d. large numbers of macrophages are found in the infiltrate.
e. lymphocytes and eosinophils are rarely involved in its development.

75 Which of the following is characterized as an autoimmune disorder?
a. Alzheimer’s disease
b. Systemic Lupus Erythematosus
c. Osteoarthritis
d. Parkinson’s disease
e. Paget’s disease

76 A pregnant female presents with a prescription for an antibiotic for treatment of a urinary tract infection. She tells the pharmacist that she doesn’t know why the doctor gave her the medication, because she isn’t experiencing any symptoms. Her presentation is consistent with which of the following diagnoses?
a. Cystitis
b. Septicemia
c. Urinary retention
d. Pyelonephritis
e. Asymptomatic bacteriuria

77 A community pharmacist would like to begin a diabetic education program for local patients newly diagnosed with type 2 diabetes mellitus. Beneficial information for this group includes all of the following EXCEPT:
a. strategies to minimize cardiac risk factors.
b. facts on diabetes and its complications.
c. use of the various glucometers.
d. appropriate dietary recommendations.
e. technique for the mixing of insulins.

PHARMACY PRACTICE – Professional Practice Skills

78 Which of the following is NOT a benefit of performing medication reconciliation activities in a hospital setting?
a. Reduction of medication errors
b. Reduction of inventory pilferage
c. Reduction of preventable adverse effects
d. Assessment of patient adherence to therapy
e. Enhanced accuracy of patient allergy information

79 The Compendium of Pharmaceuticals and Specialties (CPS) is a useful resource for locating which of the following?
a. Clinical recommendations for dental prophylaxis of bacterial endocarditis
b. Detailed monographs for all prescription pharmaceuticals available in Canada
c. Approved indications for all prescription and nonprescription pharmaceuticals in Canada
d. Canadian consensus guidelines on drug therapies used to treat hypertension
e. Bioequivalence data comparing interchangeable pharmaceutical products

80 In dispensing, the Latin abbreviation for "before meals" is:
a. ac.
b. aa.
c. pc.
d. ic.
e. cc.

81 In dispensing, the English meaning for the Latin phrase “ex aqua” is:
a. with or in water.
b. extracellular fluids.
c. exact amount.
d. soluble in water.
e. out of water.

82 Aerosol OT (AOT) is used in veterinary medicine as a laxative. If 250 g of AOT is dissolved in 1 000 mL of glycerin (density of glycerin is 1.25 g/mL), the concentration of AOT in the solution is:
a. 12.5% w/w.
b. 16.7% w/w.
c. 20.0% w/w.
d. 23.8% w/w.
e. 25.0% w/w.

83 Appropriate quality control procedures to ensure product and patient safety in the pharmacy do NOT include which of the following?
a. Adhering to guidelines for cold chain management.
b. Maintaining a regular cleaning schedule for dispensary surfaces.
c. Cleaning counting trays and automated counting machines regularly.
d. Using TALLman lettering on all prescription labels.
e. Regulating the pharmacy’s indoor climate where medications are stored.

84 The hospital pharmacist is asked for advice from a physician after a newly admitted patient is diagnosed with ischemic stroke. In the selection of drug therapy for the initial management of this patient, the pharmacist would find all of the following resources useful, EXCEPT:
a. published clinical guidelines.
b. Harrison’s Principles of Internal Medicine.
c. primary journal articles.
d. Therapeutic Choices.
e. Compendium of Self-Care Products.

85 The pharmacist fills a prescription for sumatriptan 100 mg tablets for a migraine patient. Appropriate information to provide to the patient includes which of the following?
a. If the sumatriptan does not relieve the headache within four hours, ergotamine may be used.
b. If no relief is achieved in two hours, sumatriptan may be repeated.
c. If the headache is relieved but another headache occurs eight hours later, sumatriptan may be used for the second headache.
d. The maximum dosage in any 24-hour period is six tablets.
e. If relief is not achieved, no other medication can be used for 24 hours.

86 Which of the following is appropriate auxiliary labelling for allopurinol?
a. Take with plenty of fluids.
b. Take on an empty stomach.
c. Avoid concurrent intake of dairy products.
d. Avoid concurrent intake of grapefruit juice.
e. Exposure to sunlight may cause adverse reactions.

87 The recommended pediatric dosage for azithromycin therapy is 12 mg/kg once daily on Days 1 through 5. For a child weighing 8.3 kg, calculate the total volume needed for the total course of treatment, if a product supplying 200 mg/5 mL is supplied for this order.
a. 12.5 mL
b. 15 mL
c. 25 mL
d. 37.5 mL
e. 50 mL

88 A pharmacist is making a presentation on medication adherence and compliance to a group of clients. Which of the following would be the most appropriate indicator of the effectiveness of the presentation for these clients?
a. Increase in fill quantity for each prescription refill
b. Reduced number of prescriptions filled per month
c. Increase in number of nonprescription medications used
d. Reduced number of prescription refill dates per month
e. Prescription refill dates closer to expected fill intervals

89 Rx Timolol 0,25 % drops
Mitte : 15 mL
Sig: gtt. i o.d. BID
On the prescription label the instructions to the patient should read:
a. apply one drop into both eyes twice daily.
b. instil one drop into the left eye twice daily.
c. instil one drop into the right eye twice daily.
d. shake well and instil one drop into the left eye twice daily.
e. shake well and instil one drop into the right ear twice daily.

90 The following prescription is received in a community pharmacy:
Losec® 20 mg
S: Take 1 tab BID
M: 2 weeks
Which of the following is correct labelling for this prescription?
a. Take one tablet twice weekly (28 tablets).
b. Take one tablet twice weekly (4 tablets).
c. Take two tablets twice daily (56 tablets).
d. Take one tablet twice daily (28 tablets).
e. Take one tablet twice daily (14 tablets)

91 Which of the following statements is true regarding Tylenol Elixir With Codeine® (each 5 ml contains acetaminophen 160 mg and codeine 8 mg)?
a. It requires a written order from an authorized prescriber.
b. It is an example of a legally exempted codeine product.
c. Sale for self-medication use must involve a pharmacist.
d. It is regulated under the Benzodiazepines and Other Targeted Substances Act.
e. Authorized prescribers include chiropractors.

92 A physician wants to switch a terminally-ill patient from slow release morphine sulfate tablets, 15 mg twice daily, to a liquid morphine sulfate dosage form because the patient has difficulty in swallowing tablets. If a morphine sulfate solution containing 5 mg per mL is prescribed q4h, what volume should be dispensed for a 20 day supply to provide the same pain relief as the tablet regimen?
a. 20 mL
b. 60 mL
c. 80 mL
d. 100 mL
e. 120 mL

93 A vertical laminar flow hood (LFH) is preferred to a horizontal LFH when preparing a parenteral formulation of:
a. aminophylline.
b. doxorubicin.
c. magnesium sulfate.
d. nitroglycerin.
e. penicillin.

94 Which of the following drug orders is incomplete and requires follow-up with the prescriber?
a. Zithromax Z-Pak® (azithromycin 250 mg), 2 tabs day 1 and 1 tab days 2-5.
b. Flonase® (fluticasone) 100 mcg spray, 1 or 2 sprays in each nostril bid x 1 bottle
c. Actonel® (risedronate), 35 mg once weekly x 12 tabs
d. Cozaar® (losartan), 50 mg bid x 1 month
e. Zocor® (simvastatin), 1 tab hs for 3 months

95 In establishing a professional relationship with a patient, which of the following principles is the LEAST compatible with the philosophy of pharmaceutical care?
a. Autonomy.
b. Nonmaleficence.
c. Confidentiality.
d. Paternalism.
e. Veracity.

96 JN, a 17 year old male with a highly resistant form of testicular cancer, is in hospital for treatment. He is an intelligent, articulate young man. His parents are insisting that the physician treat him with the latest experimental therapy, but JN does not want to undergo the treatment. If the physician goes ahead and gives the experimental therapy what ethical principle will have been violated the most?
a. Confidentiality
b. Nonmaleficence
c. Justice
d. Veracity
e. Autonomy

97 Which of the following statements is correct regarding hypothesis testing?
a. A type I error frequently occurs when sample sizes are small.
b. A type II error is more serious than a type I error.
c. Small p-values suggest that the null hypothesis is likely to be true.
d. The larger the p-value, the more likely the null hypothesis is false.
e. P-value is the probability of wrongly rejecting the null hypothesis if it is in fact true.

98 An adequately powered, randomized controlled trial conducted over 2 years demonstrated that the primary outcome (a serious cardiovascular event) occurred in 15% of the patients who received the new drug, whereas the primary outcome occurred in 25% of the patients who received a placebo. The relative risk reduction achieved with the new drug is:
a. 10%.
b. 15%.
c. 25%.
d. 40%.
e. 50%.

99 In an adequately powered, randomized controlled trial conducted over 3 years, a specific serious side effect (i.e., reduction in leukocytes) with conventional therapy is seen in 0.5% of the study sample. In patients who receive a newly discovered drug, only 0.45% experience the same side effect. Based on these results, the minimum number of patients that would have to receive the new drug for 3 years to statistically demonstrate the prevention of one episode of this side effect in at least one patient is:
a. 15.
b. 20.
c. 150.
d. 200.
e. 2000.

100 In a study comparing 2 drug treatment regimens, a type II error occurs when:
a. the statistical conclusion is that there is a difference between the 2 treatment regimens when a difference does not actually exist.
b. the statistical conclusion is that there is no difference between the 2 treatment regimens when a difference actually does exist.
c. the p level is > 0.05.
d. the drug treatments studied are not appropriate comparators for the disease.
e. the exclusion criteria are too restrictive.

101 A pharmacist has received information regarding a new drug to treat hypertension. The information is based on a 2 month, placebo controlled, randomized study of 1000 adults that showed a statistically significant average decrease in systolic pressure from 160 mm Hg to 141 mm Hg and in diastolic pressure from 98 mm Hg to 86 mm Hg. The most common adverse reactions were stomach upset and dizziness. Which of the following is the most significant limitation of this study?
a. The study size was too small to assess efficacy.
b. The patients did not achieve guideline targets for hypertension.
c. Blood pressure is a surrogate outcome.
d. Long term safety and efficacy were not assessed.
e. Placebo is not an appropriate comparator.

BEHAVIOURAL, SOCIAL AND ADMINISTRATIVE PHARMACY SCIENCES

102 In deciding what drugs are appropriate for its formulary, the hospital must consider a drug’s efficacy, associated workload, and acquisition cost. Several new antifungal IV drugs (drug A, drug B, drug C, and drug D), all with equal efficacy, have recently become available. Currently the hospital stocks drug E, which has been available for several years. Data for the medications is as follows:













The most appropriate choice for the hospital is:
a. Drug A.
b. Drug B.
c. Drug C.
d. Drug D.
e. Drug E.

103 Which financial statement could be used to determine the total value of prescription drug sales for a pharmacy during the course of a year?
a. Balance sheet
b. Statement of investments
c. Statement of changes in financial position
d. Income statement
e. Statement of equity

104 The standard of universal access to government insured health care in Canada is mandated by:
a. the Canada Health Act.
b. individual provinces and territories.
c. Health Canada’s Health Environment and Consumer Safety directorate.
d. Canadian Agency for Drugs and Technologies in Health
e. Public Health Agency of Canada.

105 The Canada Health Act (1984) embodies all of the following principles, EXCEPT:
a. affordability.
b. accessibility.
c. comprehensiveness.
d. portability.
e. universality.

106 Which of the following responsibilities can be appropriately delegated to a non-pharmacist manager of a community pharmacy?
a. Purchasing narcotic drugs
b. Selecting clinical decision software for the dispensary computer
c. Coordinating staff scheduling
d. Supervising pharmacy technicians
e. Determining workflow for the pharmacy’s professional services

107 Academic detailing by pharmacists provides a service to physicians by:
a. educating on improved prescription legibility.
b. advising on optimal patient interviewing techniques.
c. recommending strategies to avoid medication wastage.
d. providing current information on best prescribing practices.
e. promoting the use of physician samples given to patients.

108 A role of The National Association of Pharmacy Regulatory Authorities is to:
a. audit the financial performance of provincial pharmacy licensing bodies.
b. promote implementation of pharmacy practice standards across Canada.
c. establish a unified lobby voice for pharmacists from all types of practice settings.
d. provide mechanisms for the public to file complaints about pharmacy care providers.
e. accredit the pharmacy programs at Canadian universities.

 

Answers to Sample Questions

 

1. (d)

26. (a)

51. (c)

76. (e)

101. (d)

2. (b)

27. (d)

52. (b)

77. (e)

102. (d)

3. (a)

28. (b)

53. (b)

78. (b)

103. (d)

4. (a)

29. (c)

54. (c)

79. (a)

104. (a)

5. (e)

30. (c)

55. (b)

80. (a)

105. (a)

6. (b)

31. (d)

56. (c)

81. (a)

106. (c)

7. (a)

32. (e)

57. (c)

82. (b)

107. (d)

8. (d)

33. (b)

58. (e)

83. (d)

108. (b)

9. (a)

34. (b)

59. (b)

84. (e)

 

10. (a)

35. (b)

60. (a)

85. (c)

 

11. (c)

36. (a)

61. (d)

86. (a)

 

12. (a)

37. (c)

62. (c)

87. (a)

 

13. (d)

38. (d)

63. (c)

88. (e)

 

14. (c)

39. (d)

64. (a)

89. (c)

 

15. (d)

40. (e)

65. (d)

90. (d)

 

16. (d)

41. (c)

66. (c)

91. (a)

 

17. (a)

42. (b)

67. (d)

92. (e)

 

18. (a)

43. (a)

68. (d)

93. (b)

 

19. (a)

44. (b)

69. (d)

94. (e)

 

20. (b)

45. (d)

70. (e)

95. (d)

 

21. (b)

46. (d)

71. (c)

96. (e)

 

22. (e)

47. (c)

72. (b)

97. (e)

 

23. (d)

48. (a)

73. (d)

98. (d)

 

24. (c)

49. (c)

74. (e)

99. (e)

 

25. (e)

50. (c)

75. (b)

100.(b)