Professional Documents
Culture Documents
model of the Pharmacist Qualifying Examination-Part I, in terms of difficulty and proportion of topics. However, individually, these
examples are intended to be representative in format and phrasing style of the types of questions found in the Qualifying
Examination-Part I. They also illustrate a variety of the competency areas contained in the examination blueprint. Please note that
these questions are reviewed and updated periodically.
See the bottom of the page for the answers to the sample questions.
recommend that the pharmacy use a blister packaging dosette to dispense RYs medications.
d. suggest that RY write down the answer to his question so that he does not need to phone again.
e. recommend that RY have his hearing and vision tested at his next physician visit.
2. AD is a 58 year old male with diabetes, angina and erectile dysfunction. His physician consults the pharmacist in order to
decide if AD would be a good candidate for sildenafil. The use of sildenafil is CONTRAINDICATED for AD if he takes:
a. isosorbide 5-mononitrate.
b. metoprolol.
c. glyburide.
d. ASA.
e. enalapril.
3. RP has a prescription for famciclovir for shingles (prescribed 2 days ago), and is uncertain about filling it, due to the high cost.
Based on the known effectiveness of famciclovir for herpes zoster, benefits that the pharmacist should discuss with RP include:
I
Escherichia coli.
II Haemophilus influenzae.
III Mycoplasma pneumoniae.
a.
I only
b.
III only
c.
I and II only
d.
e.
I, II and III
Ramipril
b.
Atenolol
c.
Moxifloxacin
d.
Ibuprofen
e.
Glyburide
6. Which of the following medications is the most appropriate choice for treatment of neuropathic rather than nociceptive pain?
a.
Nabilone
b.
Tramadol
c.
Ibuprofen
d.
Meperidine
e.
Nortriptyline
7. Appropriate auxiliary labelling for clarithromycin suspension includes which of the following?
a.
b.
c.
d.
Keep refrigerated.
8. The pharmacist fills a prescription for sumatriptan 100 mg tablets for a patient with migraine. 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.
c.
If the headache is partially relieved with a single tablet, the dose may be repeated after two hours.
d.
The maximum dosage of sumatriptan 100 mg in any 24 hour period is six tablets.
e.
If relief is not achieved, no other medication can be used for at least 24 hours.
9. JG has been taking metoclopramide 20 mg, po q6h for the past 3 days as part of her chemotherapy regimen. She normally
takes 4 doses daily, with each meal and at bedtime. This morning, she forgot to take her morning dose before leaving home for a
hospital check-up. When she arrives at the clinic, she asks the pharmacist what she should do about her missed dose, as she
expects to be home again around 11:00 am. The pharmacist should advise JG to:
a.
take the missed dose immediately when she gets home and continue as scheduled.
b.
c.
skip the missed dose and take the next scheduled dose at lunchtime.
d.
e.
space 4 doses into the remaining hours between when JG gets home and her bedtime.
10. EK is a 25 year old female who presents to the pharmacy requesting Plan B (levonorgestrel) for emergency contraception
following an episode of unprotected sex 12 hours ago. After speaking with EK, the pharmacist decides she is a good candidate to
receive Plan B. The pharmacist should include all of the following information in counselling EK, EXCEPT:
a.
b.
Plan B works mainly by dislodging an implanted fertilized egg from the endometrium.
c.
d.
side effects may include nausea, vomiting, breast tenderness, cramps and spotting.
e.
if vomiting occurs within one hour of dosing, a repeat dose may be warranted.
11. All of the following are reasons that elderly patients are more susceptible to drug-induced cognitive changes, EXCEPT:
a.
b.
c.
d.
e.
12. For a child with asthma, all of the following factors are indicators of poor control, EXCEPT:
a. number of visits to the Emergency Room.
b. limitations on daily activities.
c. awakening at night with asthma symptoms.
d. keeping one canister of salbutamol at home and one at school.
e. number of parent work days missed due to the child illness.
13. Assessment of a patient's asthma control should include all of the following factors EXCEPT:
a.
immunization status.
b.
inhalation technique.
c.
d.
e.
14. Which of the following liver enzymes is the first to be elevated in a case of an acetaminophen overdose?
a.
b.
c.
d.
e.
15. AJ is a 24 year old, married female, who is planning to become pregnant in the near future. AJ has no medical conditions, no
allergies, and is not currently taking any medications. What vitamin supplement should the pharmacist recommend to AJ to
prevent neural tube defects in her baby?
a.
Niacin
b.
Vitamin D
c.
Folic acid
d.
Pyridoxine
e.
Ferrous sulphate
16. Side effects which the pharmacist should monitor in DS, when looking for the effects of excessive topical corticosteroid use,
include:
I
pruritus.
II
telangiectasias.
III striae.
a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III
b.
take increased fluids and bed rest until the symptoms resolve.
c.
contact FRs physician to discontinue the ASA until these symptoms resolve.
d.
e.
18. DS is a 27 year old male who comes to the pharmacy seeking advice because, for the past 24 hours, he has experienced
abdominal cramping, mild fever and frequent, loose stools with some blood loss. DS thinks it may be related to the antibiotic he
has been taking for a dental abscess. Current medications include: clindamycin 150 mg QID x10 days, started 8 days ago, and
losartan 25 mg daily for hypertension, started 3 months ago. The most appropriate pharmacist response is that these symptoms:
a.
b.
are expected, transient side-effects of clindamycin; treat symptoms and continue medications.
may indicate an interaction between clindamycin and losartan; pharmacist call to dentist is warranted.
c.
d.
e.
are probably unrelated to DSs medications; treat for flu symptoms and follow-up if no improvement.
19. FD, a 58 year old male with hypertension, asks the pharmacist if cranberry juice would be useful for his current symptoms,
which include frequency and a large volume of urine, but no urgency, or painful urination. Further questioning reveals that for the
past 2 months he has also experienced polydipsia and polyphagia. The pharmacist should refer FD to his physician because
these symptoms are consistent with:
a.
cholelithiasis.
b.
c.
prostate hyperplasia.
d.
diabetes mellitus.
e.
20. A local physician approaches the community pharmacist to collaborate on a health promotion pamphlet addressing
medication adherence. Which of the following is NOT an appropriate topic for the pamphlet?
a.
The team relationship of the patient with both his physician and pharmacist
b.
The service of the pharmacy providing reminder calls for medication refills
c.
d.
e.
b.
c.
d.
e.
Veterinarians
b.
Nurse practitioners
c.
Podiatrists
d.
Midwives
e.
Physiotherapists
b.
do good to patients, placing the benefit of the patient over other factors such as cost.
c.
d.
act with fairness, to allow people to receive that to which they are entitled.
e.
24. 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.
Non-maleficence
c.
Justice
d.
Veracity
e.
Autonomy
25. Which of the following medications does NOT require witnessed destruction?
a.
Ketamine
b.
Nabilone
c.
Diazepam
d.
Testosterone
e.
Gabapentin
26. The Canada Health Act (1984) embodies all of the following principles, EXCEPT:
a.
affordability.
b.
accessibility.
c.
comprehensiveness.
d.
portability.
e.
universality.
27. ST is no longer satisfied with the service she has been getting at Pharmacy X across town, so she comes to your pharmacy
requesting a refill of 3 months supply on a prescription for an oral contraceptive that she originally had filled at Pharmacy X. What
is the correct procedure for obtaining the remaining refills?
a.
The pharmacist must contact Pharmacy X to get the prescription refills transferred, and document the transfer appropriately.
b.
The pharmacist cannot refill this prescription without phoning the prescribing physician.
c.
The pharmacist may refill the prescription as long as the patient provides you with the label from the original prescription.
d.
The pharmacist may refill the prescription and notify Pharmacy X within 24 hours that this has been done.
e.
Inform ST that the prescription resides at Pharmacy X and she must return there for refills.
28. According to federal legislation, which of the following examples shows a legally correct refill designation on a written
prescription for dexamphetamine?
a.
Repeat twice.
b.
Repeat monthly.
c.
Repeat as needed.
d.
e.
29. According to the Benzodiazepine and Other Targeted Substances Regulations, what is the expiry date for refilling a
prescription for lorazepam?
a.
b.
c.
d.
e.
30. The standard of publicly funded health care in Canada is mandated by:
a.
b.
c.
d.
e.
31. The pharmacist receives a phone call from a physician who wishes to leave a verbal prescription for 30 alprazolam 0.25 mg
tid, with 2 repeats. It is a new prescription for the patient. Which of the following statements is true?
a.
Prescriptions for benzodiazepines should be filed with the narcotic and controlled prescriptions.
b.
The prescription should not be dispensed because verbal prescriptions are not allowed for benzodiazepines.
c.
The prescription may be dispensed for the original quantity only, because refills are not permitted.
d.
Transfer of this prescription is permitted as long as the prescription is only transferred once.
e.
Keeping reports of sales in a manner that permits an audit is required for all benzodiazepines.
32. For a drug going through research and development processes in Canada, which of the following statements is true?
a.
Application for patent protection is granted for a maximum period of three years.
b.
c.
Clinical trials involve three phases assessing animal safety and efficacy.
d.
Each package size of a drug product must have a unique Drug Identification Number (DIN).
e.
Health Canada under the Food & Drugs Act & Regulations provides Notice of
Compliance.
33. Which of the following is the national voluntary organization for advocacy of pharmacists and patient care?
a.
b.
c.
d.
e.
Meta-analyses
b.
c.
Pharmacology textbook
d.
e.
35. Which information source would be most appropriate to consult first, to determine if labetalol is a cardioselective betablocker?
a.
b.
c.
d.
e.
Case reports
36. Type II statistical error in a study comparing 2 drug treatment regimens occurs when:
a.
b.
a statistically significant difference exists but the difference is not clinically important.
c.
the population under investigation does not represent the population with the disease.
d.
the data shows no difference between 2 treatment regimens and a difference actually does exist.
e.
the data shows a difference between 2 treatment regimens but a difference does not actually exist.
37. 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%.
38. 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 need 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 (i.e., NNT)
is:
a.
15.
b.
20.
c.
150.
d.
200.
e.
2000.
Influenza virus
II
Pneumococcus
III Meningococcus
a.
I only
b.
III only
c.
I and II only
d.
e.
I, II and III
40. All of the following are appropriate suggestions for a pharmacist to give to a patient with allergic rhinitis from multiple
environmental triggers, to minimize exposure to possible allergens, EXCEPT:
a.
b.
c.
d.
e.
41. DS wishes to protect her children from West Nile infection and requests information from the pharmacist regarding insect
repellents. All of the following are correct responses from the pharmacist, EXCEPT:
a.
b.
when needed, sunscreen should be applied to the skin prior to DEET application.
c.
DEET effectively binds to the skin and should not be reapplied after swimming.
d.
DEET should be washed off young children once they return indoors.
e.
42. A pharmacist is conducting public education sessions on the role of inhaled medications in patients with asthma. Which of
the following is the most appropriate indicator of improved asthma control?
a.
b.
c.
d.
e.
43. Which of the following medications is LEAST likely to cause embarrassment and worry about social stigma in a school-age
child?
a.
Insulin
b.
Phenytoin
c.
Venlafaxine
d.
Amoxicillin
e.
Methylphenidate
44. When counselling a patient who is upset over a new diagnosis and need for medications, which of the following strategies is
NOT appropriate for the pharmacist to use?
a.
b.
c.
d.
e.
45. Which of the following factors that vary with cultural diversity does NOT directly impact on pharmacist-patient dialogue and
communication?
a.
Eye contact
b.
Hand gestures
c.
Facial expressions
d.
Interpersonal space
e.
aminophylline.
b.
doxorubicin.
c.
magnesium sulfate.
d.
nitroglycerin.
e.
penicillin.
47. A physician wants to switch a terminally-ill patient from slow release morphine sulphate tablets, 15 mg twice daily, to a liquid
morphine sulphate dosage form because the patient has difficulty in swallowing tablets. If a morphine sulphate 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
48. A patient is currently taking 220 mg of anhydrous zinc sulphate. To receive the equivalent amount of elemental zinc, how
many milligrams of zinc sulphate heptahydrate (7 H 20) would the patient have to take? (Molecular weights: zinc 65, ZnSO 4 161,
H20 18)
a.
123 mg
b.
220 mg
c.
300 mg
d.
392 mg
e.
545 mg
49. Given that 30 g of a mild corticosteroid ointment covers the entire surface of any adult for one application, how much
ointment (in grams) should be dispensed for an 18 year old patient who requires treatment on approximately 20% of her body with
twice daily application for 14 days?
a.
6g
b.
12 g
c.
84 g
d.
124 g
e.
168 g
50. BV is a 62 year old, obese female who visits a walk-in-clinic while her physician is away on vacation. She presents to the
pharmacist with the following prescription:
Losec (omeprazole) 30 mg
M: 30
Sig. i daily
The pharmacist knows that this product is only available in 10 mg or 20 mg strengths and that BVs profile shows that she was
previously on the 20 mg strength of this medication. The most appropriate pharmacist response is to:
a.
b.
ask BV why she visited the clinic today and what the physician told her about the prescription.
c.
dispense using omeprazole 10 mg and adjust the quantity and dose accordingly.
d.
assume the prescriber was thinking of Prevacid (lansoprazole) 30 mg and change the prescription accordingly.
e.
recommend to BV that she wait to see her regular physician when he returns.
51. Which of the following isLEAST appropriate to consider when a hospital pharmacy manager is organizing assigned
responsibilities for clinical pharmacists in the department?
a.
b.
c.
d.
e.
52. Which of the following pharmaceuticals is regulated federally under the Precursor Control Regulations of the Controlled
Drugs and Substances Act, as a precursor chemical for illicit drug use?
a.
Dextromethorphan
b.
Dimenhydrinate
c.
Diazepam
d.
Pseudoephedrine
e.
Testosterone
53. A patient has been taking an opioid analgesic for the past three months for back pain resulting from a workplace injury. All of
the following behaviours could be indicators of a developing addiction disorder, EXCEPT:
a.
b.
c.
d.
e.
54. In a hospital pharmacy, which of the following is the most effective strategy to enhance safety and minimize the incidence of
interpretation errors associated with verbal medication orders?
a.
b.
c.
d.
e.
55. Which of the following classes of medications is most likely to be administered by the intravenous piggyback method?
a.
Antibiotics
b.
Opioids
c.
Insulins
d.
e.
56. Which of the following actions would NOT contribute to promoting a safe medication use system in a pharmacy?
a.
b.
c.
d.
e.
II
I only
b.
III only
c.
I and II only
d.
e.
I, II and III
58. Which of the following is NOT a benefit of performing medication reconciliation activities in a hospital setting?
a.
b.
c.
d.
e.
II
I only
b.
III only
c.
I and II only
d.
e.
I, II and III
60. Which of the following criteria should be considered when reviewing a medication for addition to the hospital formulary?
a.
b.
c.
d.
e.
61. In deciding what medications are appropriate for its formulary, the hospital must consider a drugs efficacy, associated
workload, and acquisition cost. Several new intravenous antifungal agents (drug A, drug B, drug C, and drug D), all with equal
efficacy to drug E, have recently become available. Currently the hospital stocks drug E, which has been available for several
years. Data for the medications is as follows:
$2.50
B $2.25
C $5.00
D $2.25
E $2.25
A
QID
14
once daily
14
BID
BID
QID
Drug A.
b.
Drug B.
c.
Drug C.
d.
Drug D.
e.
Drug E.
The next section includes EXAMPLES OF THE CASE SCENARIO FORMAT, in which there are two or more questions in
sequence, which are related to the patient information provided in the (bolded) stem information shown at the top of the
case.
Bismuth subsalicylate
b.
Cotrimoxazole
c.
Diphenoxylate
d.
Loperamide
e.
Attapulgite
Bacteroides fragilis.
II
Escherichia coli.
I only
b.
III only
c.
I and II only
d.
e.
I, II and III
64. Which of the following is the most appropriate option for future prevention of traveller's diarrhea if SM is travelling to Mexico?
a.
Ciprofloxacin
b.
Tetracycline
c.
Erythromycin
d.
Trimethoprim
e.
Clindamycin
age.
b.
gender.
c.
diabetes.
d.
metoprolol use.
e.
nitroglycerin use.
66. Appropriate counselling and follow-up for PQ with initiation of levothyroxine includes all of the following, EXCEPT:
a.
b.
c.
improved control of thyroid levels may also improve her glycemic control.
d.
physician follow-up is needed in 6-8 weeks to have her thyroid function tests repeated.
e.
closer monitoring of her angina should be done during dosage titration of levothyroxine.
67. Which of the following parameters is the most appropriate for PQ's self-evaluation of the effectiveness of levothyroxine
therapy?
a.
Increased energy
b.
Weight loss
c.
Improved vision
d.
e.
50 years.
d. 55 years.
e. 60 years.
69. Lipid profile screening is important in all patients who have a history of:
a. COPD.
b. GERD.
c.
diabetes.
d. osteoarthritis.
e. liver disease.
70. Which of the following is the primary assessment tool recommended to quantify a patients= 10-year risk for total
cardiovascular disease?
a. Reynolds risk score
b. Framingham risk score
c. SCORE risk estimator
d. TIMI risk score
e. CHADS II score
71. Which of the following is the most appropriate bio-marker to assess patients who are at intermediate risk for cardiovascular
diseases and who do not otherwise qualify for lipid-lowering therapy?
a. Homocysteine
b. Creatinine clearance
c.
Lipoprotein-associated phospholipase A2
This change is appropriate, as clozapine may help for patients who fail on other antipsychotics.
b.
This change is appropriate, as most patients with schizophrenia will eventually require clozapine.
c.
This change is not appropriate, as clozapine will likely produce the same effect as quetiapine.
d.
This change is not appropriate, as the cost of monitoring and risk of adverse effects with clozapine is too high.
e.
This change is not appropriate, because the preferred recommendation is to add clozapine to the current quetiapine.
73. HM is concerned about the possible adverse effects from clozapine. When discussing monitoring with HM, which of the
following statements is the most appropriate to include?
a.
Severe problems affecting the blood occur in about 5% of patients taking clozapine.
b.
Problems affecting the blood do occur rarely and regular blood labwork would be recommended.
c.
The risk of this problem occurring is the highest after one year or more of treatment.
d.
Blood labwork done monthly will help to avoid any adverse effects from clozapine.
e.
The prescriber has already assessed this risk and has determined that the risk for HM is low.
Gliclazide
b.
Sitagliptin
c.
Insulin
d.
Metformin
e.
Acarbose
75. If the anti-hyperglycemic agent chosen for WW is having its intended benefit, the most appropriate therapeutic outcome would
be:
a.
b.
c.
d.
e.
76. WW would like advice regarding self-monitoring of his blood glucose. Which of the following statements is most appropriate
for WW at this time?
a.
Blood glucose should be tested upon arising and before each meal
b.
c.
d.
Self-monitoring will help WW to adjust the dosing of oral therapy in relation to meal size.
e.
1.
(c)
39. (a)
2.
(a)
40. (a)
3.
(d)
41. (c)
4.
(d)
42. (b)
5.
(c)
43. (d)
6.
(e)
44. (b)
7.
(a)
45. (e)
8.
(c)
46. (b)
9.
(c)
47. (e)
10. (b)
48. (d)
11. (e)
49. (e)
12. (d)
50. (b)
13. (a)
51. (d)
14. (c)
52. (d)
15. (c)
53. (d)
16. (d)
54. (d)
17. (e)
55. (a)
18. (c)
56. (d)
19. (d)
57. (e)
20. (e)
58. (b)
21. (d)
59. (b)
22. (a)
60. (c)
23. (e)
61. (d)
24. (e)
62. (a)
25. (e)
63. (d)
26. (a)
64. (a)
27. (a)
65. (a)
28. (e)
66. (b)
29. (c)
67. (a)
30. (a)
68. (b)
31. (d)
69. (c)
32. (e)
70. (b)
33. (b)
71. (e)
34. (d)
72. (a)
35. (a)
73. (b)
36. (d)
74. (d)
37. (d)
75. (a)
38. (e)
76. (b)