Transcript Module 3: RATIONALIZATION

Module 3: RATIONALIZATION
Practice of Pharmacy
(Clinical Pharmacy, Hospital Pharmacy, Dispensing,
Incompatibilities, ADR, Pharmaceutical
Calculations)
1. It refers to the responsible provision of drug
therapy to achieve definite outcomes that are
intended to improve a patient’s quality of life:
a. Drug therapy assessment
b. Therapeutic drug monitoring
c. Pharmaceutical care
d. Professional-patient relationship
e. Formal documentation
Components of Pharmaceutical care:
• Equal responsibility (to patient and prescriber)
• Professional-patient relationship
• Formal documentation ( clinical interventions and
therapeutic outcomes )
2. A way of summarizing the health benefits and
resources used by competing health care
programs so that policy makers can choose
among them:
a. Cost-of-Illness Evaluation
b. Cost-Minimization Analysis
c. Cost-Utility Analysis
d. Cost-Effectiveness Analysis
e. Cost-Benefit Analysis
3. Any noxious, unintended, and undesired
effect of a drug that occurs at doses used in
humans for prophylaxis, diagnosis or therapy:
a. Allergy
b. Adverse drug reaction
c. Adverse drug event
d. Hypersensitivity
e. idiosyncracy
-adverse drug event is used to describe an injury
resulting from administration of drug
4. Patient R.S. had bone marrow transplant 5
years ago. This information belong in which
section of the patient’s medical chart:
a. ROS – Review of Systems
b. FH – Family History
c. HPI – History of Present Illness
d. PMH – Past Medical History
e. PMP – Patient Medication Profile
Duration
of Action
5. Which Insulin
of the following insulins
exert
the
A. longest
Short-acting
duration of action
1. Insulin Lispro
3-5 h
a. Humalog – Insulin Lispro
2. Insulin Aspart
3-5 h
b.
Lantus – Insulin Glargine
3. Regular
5-8 h
c.
Humulin R – regular Insulin
B. Intermediate-acting
1.
>14 h
d.NPH
Novo rapid – Insulin Aspart
C.
e. Long-acting
Insulin NPH
1. Glargine
2. Detemir
D. Pre mixed
1. Lispro mix 75/25
2. Aspart mix 70/30
24 h
6-23 h
14-24 h
18-24 h
6. Which of the following is not an objective
parameter:
a. Bilirubin
b. Creatinine
c. Urine output
d. Vertigo
e. CBG – Capillary Blood Glucose
7. When blood urea nitrogen (BUN) is above the
normal values, it indicates the following
conditions except:
a. Dehydration
b. GI bleeding
c. Liver disease
d. Renal disease
-BUN is the measure of the amount of nitrogen
in the blood in the form of urea, and a
measurement of renal function. Urea is a byproduct from metabolism of proteins by the
liver, and therefore removed from the blood by
the kidneys.
8. The clinical pharmacist functions focus on the:
a.
b.
c.
d.
e.
Product
Hospital
Diagnosis
Patient
Income
9. Which of the following provides the greatest
number of calories per gram:
a. Dextrose
b. Proteins
c. Fats
d. Ethanol
Fat: 1 gram = 9 calories
Protein: 1 gram = 4 calories
Carbohydrates: 1 gram = 4 calories
Alcohol: 1 gram = 7 calories
10. Exforge ® is an anti hypertensive agent which
is a combination of:
a.
b.
c.
d.
Amlodipine & valsartan
Telmisartan & HCTZ
Valsartan & HCTZ
Enalapril & amlodipine
11. Which of the following dosages of dopamine
is selected for its positive inotropic effects in
treating the patient with Heart Failure:
a. 40 mg/kg/min
b. 40 ug/kg/min
c. 10-20 ug/kg/min
d. 5-10 ug/kg/min
e. 2 ug/kg/min
12. Measures the electrical activity of the brain,
and helps to identify functional cerebral
changes underlying structural abnormalities:
a. CBG – Capillary Blood Glucose
b. EEG – Electroencephalogram
c. MRI – Magnetic Resonance Imaging
d. PET – Positron Emitting Tomography
e. CSF – Cerebro Spinal Fluid
- EEG serves as diagnostic tool in classifying
seizures.
13. Agent/s that inhibit smooth muscle
contractions in asthmatic patients is/are:
I.
II.
III.
IV.
a.
b.
c.
d.
e.
Beta adrenergic agonists
Methylxanthines
Glucocorticoids
Anticholinergics
I and IV
I, II and IV
II, III and IV
AOTA
I,II and III
Drugs that inhibit smooth muscle
contraction are often called
“quick relief medications”
ex. Beta adrenergic agonists,
methylxanthines, anticholinergics
Glucocorticoids are considered
“long term control medications”
Insulin
Onset of Action
14. It is a rapid-acting insulin preparation:
A. Short-acting
a.
Humalog
–
Insulin
Lispro
1. Insulin Lispro
Within 15 mins
b.
Lantus
– Insulin Glargine
2. Insulin
Aspart
Within 15 mins
3. Regular
30 – 60 mins
c.
Levemir – Insulin Detemir
B.
d. Intermediate-acting
Humulin N – Insulin NPH
1. NPH
2.5 – 3 h
e. Insulin NPH
C. Long-acting
1. Glargine
1.5 h
2. Detemir
3.4 h
D. Pre mixed
1. Lispro mix 75/25
0.25 – 5 h
2. Aspart mix 70/30
0.1 – 0.2 h
15. It is the hypermetabolic syndrome that occurs
from excessive production of thyroid hormone with
classic symptoms of weight loss despite increases
appetite, nervousness, palpitations, heat tolerance
and insomnia:
a. Thyrotoxicosis or “Hyperthyroidism”
b. Hypothyroidism
c. Graves disease – autoimmune disorder causing hyperthyroidism.
d. Cushing syndrome
e. Hashimoto’s disease
16. Which of the following types of questions
should be avoided while interviewing the
patient:
a.
b.
c.
d.
e.
Leading questions
Multiple questions
Excessive yes/no questions
AOTA
NOTA
17. The following are clinical functions of
pharmacists except:
a.
b.
c.
d.
Prepare medications
Taking inventories
Participate in patient education program
Assess drug interactions and ADRs
18. In hospital abbreviations, Pt. means:
a.
b.
c.
d.
Prothrombin Time
ProTime
Patient
Pint
19. Tx means:
a.
b.
c.
d.
Treatment
Therapeutic
Therapeutics
Therapy
20. Patient N.H. has a BMI of 27kg/m2, patient N.H.
is considered to be:
a. Underweight
b. Normal weight
c. Overweight
d. Obese
-BMI = weight in kg / (Height in meters)2
Interpretation: Underweight < 18.5
Normal weight = 18.5 - 24.9
Overweight = 25.0 - 29.9
Obese > 30.0
21. The successor of the first hospital
pharmacist that revolutionize the practice of
pharmacy and medicine in the hospital
setting:
a. Jonathan Roberts
b. John Morgan
c. Jason Bourne
d. Jonathan Morgan
22. First hospital pharmacy practice was
observed in which hospital?
a.
b.
c.
d.
Pennsylvania
Plymouth
San Antonio
Washington
23. The first hospital pharmacist:
a.
b.
c.
d.
Jonathan Roberts
John Morgan
Jason Bourne
Jonathan Morgan
24. A form of therapy offered as a substitute for
drug therapy that follows the biochemical
effects derived from essential oils:
a. Acupuncture
b. Aromatherapy
c. Massage
d. Chiropratic medicine
25. Patients who can walk and not bedridden:
a.
b.
c.
d.
Institutionalized
Inpatient
Ambulatory
Outpatient
26. A facility where patients who are not
confined are treated by a set of physician
practicing together:
a.
b.
c.
d.
Hospital
In-house facility
ER
Clinic
27. Which is not a fundamental function of a
hospital?
a.
b.
c.
d.
Research
Wellness
Education
NOTA
28. ASHP stand for:
a.
b.
c.
d.
American Society of Hospital Pharmacist
American Society for Hospital Practitioners
Asian Society of Hospital Pharmacist
American Society of Health-system
Pharmacists
- New meaning of ASHP
29. Hospitals function in assisting their
communities the incidence of illness and
improve quality of life, is under what
fundamental function?
a. Research
b. Education
c. Patient Care
d. Wellness
30. The Hospital Pharmacist holds what position
in the P&T Committee?
a.
b.
c.
d.
Chair
Secretary
Treasurer
NOTA
31. The degradation reaction of ASA involves:
a. hydrolysis
b. racemization
c. oxidation
d. photolysis
e. Reduction
- in presence of moisture or water, ASA will
hydrolyze into acetic acid and salicylic acid.
32. The most serious drug-induced blood
disorder:
a. aplastic anemia
b. leukemia
c. agranulocytosis
d. Thrombocytopenia
- This is also referred to as pancytopenia resulting
from damaged pluripotent stem cells.
- It is characterized by acellular or hypocellular
bone marrow
33. Which is NOT true for camphor?
I. forms a eutectic mixture with menthol
II. can be powdered by rubbing with a small amount
of alcohol or ether
III. dissolves readily in water
a.
b.
c.
d.
e.
I only
III only
I and II only
II and III only
I, II, and III
-Camphor is soluble
in alcohol and
organic solvents but
is only slightly
soluble in water (1g
in 800 ml)
34. Which one of the following diluents is LEAST
suitable for reconstituting single-dose vials?
a. Bacteriostatic Sterile Water for Injection
(BSWFI)
BSWFI
should not be used for reconstituting
b. D5W
injection
single-dose units because the preservative present
c. N/S injection
would serve no useful purpose, and large amounts
d.
0.5preservative
N/S injection
of the
could increase the incidence or
severity
of Water
toxicity.for Injection (SWFI)
e. Sterile
The use of BSWFI may be appropriate if a
powder in a multidose vial is being reconstituted.
35. Methysalicylate is also known as:
a.
b.
c.
d.
e.
camphorated oil
peppermint oil
salicylamide
oil of wintergreen
sweet oil
-Methyl salicylate can
be used in small
quantities as flavoring
or perfuming agent.
-It is also included in
many topical products
such as rubbing
alcohol, gels and
liniments
36. Alcohol is suitable as a solvent for menthol and salicylic
acid when preparing which of the following dosage
forms?
I. lotions
II. ointments
III. Suppositories
a. I only
b. III only
c. I and II only
d. II and III only
e. I, II, and III
37. The ideal weight for a vaginal suppository
will be approximately:
a.
b.
c.
d.
e.
1g
2g
5g
10 g
15 g
- rectal suppositories: 2 grams
38. The most practical method for sterilizing the
ophthalmic solution is:
a. autoclaving for 15 minutes
b. autoclaving for 30 minutes
c. membrane filtration through 0.2-micron filter
d. membrane filtration through 5-micron filter
e. use of ethylene oxide gas
- Membrane filtration involves the passing of
solutions through a 0.2 micron filter using one
of the commercially available sterile filter units
such as Millipore's Millex or Swinnex units.
39. Boric acid is present in the formula as a (an) :
I. antioxidant
II. antimicrobial preservative
III. buffering agent
a.
b.
c.
d.
e.
I only
III only
I and II only
II and III only
I, II, and III
40. Ondansetron is available under the trade name
of :
a. Kytril - Granisetron
b. Marinol - Dronabinol
c. Reglan - Metoclopramide
d. Zofran
e. Zoloft – Sertraline (Antidepressant)
-all except Zoloft are used for nausea and vomiting
during chemotherapy
41-42.
41. How many mg of codeine base is in each dose of the
cough product? (mol. wt.: codeine = 299; codeine
phosphate = 406)
a. 6 mg
b. 8 mg
c. 11 mg
d. 16 mg
e. 24 mg
42. How many mg of codeine phosphate are being
consumed daily by a patient taking the
prescription as directed?
a. 6.25 mg
b. 8.25 mg
c. 19 mg
d. 25 mg
e. 33 mg
(E) Because the volume of a standard teaspoon
is considered to be 5 mL, the patient in this
prescription is receiving four daily doses for a
total of 20 mL.
43. A hospital pharmacy technician has written
the following formula for inclusion into the
master manufacturing formula book.
Codeine sulfate
Aspirin
Hydrocortisone
Lactose
Mix and make 30 capsules
0.5 gr
1.6 gr
120 mg
qs 6 grams
(cont..) When reviewing this formula, the
pharmacist should comment upon which of the
following expressions?
I. 0.5
II. gr
III. qs
a.
b.
c.
d.
e.
I only
III only
I and II only
II and III only
I, II, and III
44. Alcohol has many pharmaceutical uses and is
available in several concentrations. What is
the concentration (% v/v) of diluted alcohol?
a. 49%
b. 70%
c. 92%
d. 95%
e. 100%
45. How many grams of glacial acetic acid
(99.9% w/w) must be added to 1 gal purified
water to prepare an irrigation solution
containing 0.25% wt./vol. acetic acid?
a. 1.2 g
One gallon contains 3,785 mL; thus
b. 9.5 g
3,785 mL × 0.25% = 9.46 or 9.5 g.
c. 12 g
Because the volume contributed by
the acetic acid is insignificant when
d. 20 g
compared
to
3,785
mL,
it
does
not
e. 95 g
enter into the calculation of the final
volume.
46. A nurse adds a 4-mL Tubex unit containing
2.4 M units penicillin suspension to a 20-mL
vial containing 10 mL of normal saline. What is
the new concentration of penicillin expressed
as units/mL?
2.4
megaunits
is
2.4
million
a. 170
units or a total of 2,400,000
b. 240
units. The final dilution will
c. 170,000
have a volume of 14 mL.
d. 240,000
e. 600,000
2,400,000
 171,400 units/mL or 170,000 units/mL.
14 mL
47. A hospital pharmacy needs 1 qt of an
antibacterial solution containing 92% v/v
alcohol. How many mL of alcohol USP will be
needed?
a. 458 mL
[Q1][C1]= [Q2[C2]
b. 870 mL
[x mL][95% vol./vol.]= [946 mL][92% vol./vol.]
c. 916 mL
95x = 92,000
d. 920 mL
x = 916 mL
e. 968 mL
Rx
Sodium thiosulfate
1.2%
Sodium chloride
qs
Purified water
qs 100 mL
48. How much sodium chloride is needed to adjust
the following prescription to isotonicity? (E value
for sodium thiosulfate is 0.31.)
a. 0.37 g
b. 0.45 g
c. 0.53 g
d. 0.31 g
e. 0.90 g
Step 1—Determine amount of sodium thiosulfate in the Rx:
100 mL × 1.2% = 1.2 g or 1,200 mg
Step 2—Multiply the amount of chemical by its “E” value:
1,200 mg × 0.31 = 372 mg (equivalent amount of
NaCl)
Step 3—Determine amount of NaCl needed as if no other
chemical was present:
100 mL × 0.9% = 900 mg
Step 4—Subtract contribution by chemical (Step 2) from
amount of NaCl (Step 3):
900 mg – 372 mg = 528 mg = 0.53g
(The amount of NaCl needed to
render the solution isotonic.)
49. How many grams of pure hydrocortisone
powder must be mixed with 60 g of 0.5%
hydrocortisone cream if one wishes to prepare
a 2.0% w/w preparation?
a. 0.90 g
b. 0.92 g
c. 0.30 g
d. 1.2 g
e. 1.53 g
Because the amount of 0.5% hydrocortisone cream is
exactly 60 g, the final weight of the cream will be
greater when hydrocortisone powder is added.
Therefore, the problem may be solved by the
allegation alternate method or by simple algebra:
100%
HC
1.5
parts
2%
0.5% HC
98
parts
OR....
by algebra, let x = weight of 100% HC powder,
then
(x g) (100%) + (60 g) (0.5%)= (60 g + x g) (2%)
x + 0.3
= 1.2 + 0.02 x
x
= 0.92 g
50. A pharmacist adds 2 g of potassium chloride
to 1 L of D5W/1/2 normal saline. Estimate the
osmolarity (mOsm/L) of this solution
assuming the final volume is 1 L. (Atomic wt.:
sodium = 23, potassium = 39, chloride = 35.5,
dextrose = 198.)
a. 54 mOsm/L
b. 300 mOsm/L
c. 405 mOsm/L
d. 460 mOsm/L
e. 477 mOsm/L
Three chemicals are contributing to the osmolarity.
Potassium chloride
2 g ÷ 74.5 = 0.0268 mol or 26.8 mM
26.8 mM × i value of 2 = 53.6 mOsm
Dextrose
50 g ÷ 198 = 0.253 mol or 253 mM
253 mM × i value of 1 = 253 mOsm
Sodium chloride
1,000 mL 0.45% = 4.5 g
4.5 g ÷ 58.5 = 0.0769 mol or 76.9 mM
76.9 mM × i value of 2 = 153.8 mOsm
Total in 1 L = 53.6 + 253 + 153.8 = 460 mOsm/L
51. Primary function of P&T Committee:
a.
b.
c.
d.
Policy Development
Education
AOTA
NOTA
52. A type of drug distribution system that
makes medication available at nursing units of
hospitals and for which a charge is made to
the patient.
a. Charged Floor Stock
b. Free Floor Stock
c. Unit Dose Delivery
d. Complete Floor Stock
53. Focus of all Physician-Pharmacist-Nurse
interactions:
a.
b.
c.
d.
Hospital
Policy Implementation
Patient
AOTA
54. Function of P&T Committee, except:
a. Disseminate information on its action to all
healthcare staff
b. Establish program for safe and efficient drug
usage
c. Develop a formulary of drug
d. AOTA
e. NOTA
55. ABG stands for:
a.
b.
c.
d.
Arterial blood gradient
Arterial Blood gasses
C. Abdominal Bend Gauge
Acid-Base Gap
56. D &C stands for:
a.
b.
c.
d.
Discontinue
Dye and Color
Dilatation and Curettage
AOTA
57. HOPI stands for:
a.
b.
c.
d.
History of Present Illness
History of Past Illness
History of Patient Illness
AOTA
58. Drugs with indicated use together with a
“p.c” note should be taken when?
a.
b.
c.
d.
After meal
Before meal
Before sleeping
After waking-up
59. A type of hospital where all professional
services, private and charity are provided and
controlled by the active medical staff:
a. Closed Staff
b. Open Staff
c. Honorary Medical Staff
d. Consulting Staff
60. A private or public organization that provides
comprehensive healthcare services to
individuals enrolled to the organization:
a. Hospital
b. Health Management Organization
c. Health Maintenance Organization
d. Health Care Organization
61. 5%D/LR means:
a.
b.
c.
d.
5% Dextrose or Lactated Ringers
5% Dextrose and Lactated Ringers
5% Dextrose in Lactated Ringers
NOTA
62. PICU stand for what hospital department?
a.
b.
c.
d.
Pulmonary Intensive Care Unit
Patient Information and Concern Unit
Patient Information and Care Unit
NOTA
63. Which hospital in the Philippines is the
second hospital in Asia to be accredited by
JCIA, and is considered as a tertiary hospital
with a 650 bed capacity:
a. UST Hospital
b. St. Luke’s Medical Center
c. Manila Doctor’s General Hospital
d. Philippine General Hospital
64. A type of hospital that provides specific
services to specific and selected type of
patient or cases:
a.
b.
c.
d.
General Hospital
Special Hospital
BOTH
NOTA
65. Hospital Pharmacy was said to evolve from
the early practice dated back in the times of
Hippocrates. Where did Hippocrates practice
Medicine and Pharmacy?
a. Temple of Kas
b. Temple of Kros
c. Temple of Kos
d. Temple of Kratos
66. When preparing a liquid dosage form, elixirs may be
preferred over syrups because elixirs have better
solvent properties for:
I. weak organic acids
II. weak organic bases
-Elixirs are clear,
III. flavoring oils
sweetened,
a. I only
usually flavored
b. III only
hydroalcoholic
solutions
c. I and II only
intended for oral
d. II and III only
use
e. I, II, and III
67. The process of wetting and smoothing zinc
oxide with mineral oil in preparation for
incorporation into an ointment base is:
a. attrition
b. levigation
c. milling
d. pulverization
e. trituration
68. Before placing a patient on IV fatty oil
emulsions, the clinical pharmacist should
confirm that the patient does NOT have:
a. egg allergies
b. sensitivities to bisulfite
c. milk intolerance
d. lactose intolerance
e. sensitivities to tartrazine
- Fatty oil emulsions are stabilized by the
presence of egg phospholipids. As such they
are usually contraindicated in those patients
with serious allergies to eggs.
69. The incompatibility between __________ is
a potential problem
a. potassium chloride and calcium gluconate
b. potassium chloride and insulin
c. potassium phosphate and calcium gluconate
d. potassium phosphate and zinc chloride
e. insulin and zinc chloride
70. Which of the following antacid cannot be
used by patients with heart failure?
a.
b.
c.
d.
sodium bicarbonate
Aluminum hydroxide
calcium carbonate
magnesium hydroxide
-This cannot be used because of sodium
content
71. Potential adverse effects of Aspirin include:
I. GI ulceration
II. hypersensitivity asthma
III. cardiac arrhythmias
a.
b.
c.
d.
e.
I only
II only
I and II
II and III
I, II, and III
- Cardiac arrhythmia
is not induced by ASA
72. Which of the chemotherapeutic agents is
most likely associated with pulmonary
toxicity?
a. Vincristine
b. Doxurubicin
c. Paclitaxel
d. Bleomycin
73. Which of the following mood stabilizers
would be most appropriate in a patient with
liver disease?
a. Lithium
b. Valproic acid
c. carbamazepine
d. AOTA
- Lithium is not known to cause hepatic
dysfunction nor is metabolized via the liver.
However
both
valproic
acid
and
carbamazepine can impair liver function
74. Levodopa is associated with which of the
following problems?
a. GI disturbances
b. Postural hypotension
c. Dystonia
d. Depression
e. AOTA
-Adverse effects of levodopa include GI
disturbances, cardiovascular,
musculoskeletal, CNS and haematological
effects
75. This anti-parkinsonian agent may cause a
first dose phenomenon that can trigger
sudden cardiovascular collapse:
a. Bromocriptine
b. Selegiline
c. Pergolide
d. Amantadine
e. NOTA
- Bromocriptine should be used with caution
in patients with a history of MI and
arrhythmias
76. Substances which absorb moisture from the
air but do not dissolve are called:
a. hygroscopic powders
b. effervescent powders
c. deliquescent powders
d. anhydrous powders
e. efflorescent powders
77. This contains the conditions to which the use
of the product is known to be associated to an
unacceptable risk:
a. warning
b. precaution
c. contraindication
d. indication
e. NOTA
78. These medications decrease the levels of
phenytoin, carbamazepine, Phenobarbital,
and primidoneby enhancing their metabolism:
a. oral contraceptives
b. oral hypoglycemics
c. glucocorticoids
d. TCAs
e. AOTA
-Other drugs that have same effect are
azathioprine, cyclosporine, quinidine,
theophylline, warfarin, doxycycline, and
levodopa
79. Characterizes the first exposure of the
fraction of the drug metabolized in the liver:
a. first pass effect
b. drug-receptor interaction
c. biotransformation
d. pharmacokinetics
e. clearance
80. Aminophylline is indicated for bronchial asthma
and for reversible bronchospasm associated with
chronic bronchitis and emphysema. It is
approximately 80 % theophylline. Which of the
following can cause precipitation of theophylline
from aminophylline solution?
a. HCl
-Aqueos solutions are alkaline and
b. NaOH
display the incompatibilities of the
c. NaCl
alkalies. Acid cause a precipitation
d. Water
of
theophylline.
e. Na2SO4
81. A patient’s serum cholesterol value is
reported as 4 mM/L. What is this
concentration expressed in terms of mg/dL?
(mol. wt. of cholesterol = 386)
a. 0.154 mg/dL
b. 1.54 mg/dL
c. 154 mg/dL
d. 596 mg/dL
e. 1,540 mg/dL
In this problem, the mM/L concentration is
converted by recognizing that 1 mol of
cholesterol weighs 386 g and 4 mmol equals
0.004 mol.
386 x 0.004 mol = 1.544 g or 1,540 mg/L
1,540 mg/L = 154 mg/dL
82. The adult dose of a drug is 250 mg. What
would be the approximate dose for a 6-yearold child weighing 60 lb? (Use Young’s rule.)
a. 60 mg
b. 85 mg
c. 100 mg
d. 125 mg
e. 180 mg
83. A physician requests 1 av.lb of bacitracin
ointment containing 200 U of bacitracin per
gram. How many grams of bacitracin ointment
(500 U/g) must be used to make this ointment?
a. 182 g
b. 200 g
c. 227 g
d. 362 g
e. 400 g
84. Calcium chloride (CaCl2·2H2O) has a formula
weight of 147. What weight of the chemical is
needed to obtain 40 mEq of calcium? (Ca =
40.1; Cl = 35.5; H2O = 18)
a. 0.80 g
b. 1.47 g
c. 2.22 g
d. 2.94 g
e. 5.88 g
One equivalent of calcium chloride = 147 (mol.
wt.) divided by 2 (valence of calcium) = 73.5 g
and 1 mEq = 73.5 mg. Therefore, 40 mEq is 40
× 73.5 mg = 2,940 mg, which is 2.94 g. Or, the
problem can be solved by the following
equation:
85. A 250-mL infusion container contains 5.86 g
of potassium chloride (KCl). How many
milliequivalents (mEq) of KCl are present?
(mol. wt. of KCl = 74.6)
a. 12.7 mEq
b. 20 mEq
c. 78.5 mEq
d. 150 mEq
e. 157 mEq
86. The hospital protocol calls for additional
dosing when the trough level of tobramycin
(mol. wt. = 470) approaches 2 g/mL. The
concentration may also be expressed as how
many mol/L?
a. 2.1
b. 4.2
c. 6.4
d. 8.5
e. 0.04
87. -89
87. What flow rate must be programmed into the PCA unit
to obtain the desired amount of morphine per minute?
a. 0.01 mL/min
b. 0.05 mL/min
c. 0.1 mL/min
d. 0.1 mL/h
e. 1.0 mL/min
88. Upon consultation, the prescriber decides to
allow bolus PRN dosing of 2 mg with a lockout of 1h intervals. Assuming that the patient uses all
bolus-dosing intervals, approximately how long will
the PCA last?
The maximum volume used per hour will be
a. <2.5 days 0.01 mL/min 60 min = 0.6 mL plus bolus
b. 4 days
dosing of 2 mg (0.4 mL) = 1 mL total. Since
c. 7 days
the total volume in the PCA is 100 mL, it
d. 10 days
should last at least 100 h or 4.2 days.
e. >14 days
89. How many mL of a commercial morphine
sulfate vial (25 mg/mL) is needed to fill this
order?
a. 10 mL
b. 20 mL
c. 25 mL
d. 30 mL
e. 50 mL
90. Alcohol has many pharmaceutical uses and is
available in several concentrations. What is
the concentration (% v/v) of full strength
alcohol?
a. 49%
Alcohol USP, sometimes known as
b. 70%
grain alcohol, contains 94.9% v/v
or 92.3% w/w of C2H5OH. The
c. 92%
remaining portion is water. It may
d. 95%
be used as a solvent and as a
e. 100
source of alcohol for oral dosage
forms.
91. A prescription calls for the dispensing of a
4% Pilocar solution with the directions of “gtt i
OU TID.” How many mg of pilocarpine
hydrochloride is being used per day? Assume
that the dropper is calibrated to deliver 20
drops to the mL.
a. 4 mg
b. 6 mg
c. 12 mg
d. 24 mg
e. 60 mg
92. A nurse in a nursing home setting mixes 240
mL of a dietary supplement formula (400
mOsm/L) with 250 mL of D10W and 200 mL of
water containing 5 g calcium chloride (mol.
wt. = 111; mol. wt. of dextrose = 180). What is
the osmolarity of this solution?
a. 280 mOsm/L
b. 370 mOsm/L
c. 410 mOsm/L
d. 470 mOsm/L
e. 540 mOsm/L
93. How many mg of sodium chloride should be
added to the following medication order to
maintain isotonicity? “Atrovent Inhalation
Solution 0.02% 5 mL + SWF Injection 25 mL. Place
in nebulizer ut dict” (Note: Atrovent inhalation
solution is isotonic.)
a. 45 mg
b. 225 mg
c. 270 mg
d. 900 mg
e. 0 (since sterile water for injection is already
isotonic)
Since the 5 mL of Atrovent inhalation
solution is already isotonic, the
pharmacist has to render the remaining
volume of solution (diluent) isotonic.
30 mL – 5 mL= 25 mL
25 mL × 0.9% sodium chloride= 225 mg
94. A hospital clinic requests 2 lb of 2%
hydrocortisone ointment. How many grams of
5% hydrocortisone ointment should be diluted
with white petrolatum to prepare this order?
a. 18.2 g
b. 27.5 g
c. 45.4 g
d. 363 g
e. 545 g
95. How many mL of isopropyl rubbing alcohol
(70% v/v) will be needed to prepare 1 pt of
50% isopropyl alcohol?
a. 70 mL
b. 170 mL
c. 342 mL
d. 400 mL
e. 480 mL
96. Tuberculin syringe can measure up to:
a.
b.
c.
d.
1 mL
5 mL
10 mL
20 mL
97. Drug of Choice for Status Epilepticus:
a. Lamotrigine
b. Phenobarbital
c. Diazepam
d. Ethosuximide
e. Carbamazepine
-1st line of treatment, Diazepam 0.20.3mg/kg/dose then may repeat up to 3
doses until seizure stops
98. All are criteria for classification of Systemic
Lupus Erythematosus (SLE), except:
a.
b.
c.
d.
e.
Malar rash
Neurologic disorder
Arthritis
GI ulcerations
Oral ulcers
Criteria: Mnemonic
S - erositis
O -ral ulcer
A- rthritis
P- hotosensitivity
B-lood disorder
R- enal disorder
A- ntinuclear Antibodies
I- mmunologic disorder
N- eurologic disorder
M-alar rash
D-iscoid rash
99. It is a genetically determined abnormal
response to ordinary doses of a drug:
a.
b.
c.
d.
Anaphylaxis
Idiosyncracy
Sensitization
Drug Interaction
100. Vascor® is an anti hypertensive medication
classified as:
a.
b.
c.
d.
ACEIs – “prils”
ARBs – “sartans”
CCB – “dipines” ,verapamil,diltiazem
Beta blockers – “olols”
-Vascor is imidaPRIL