Deck 2: Clinical

Question 1

Which of the following drugs is contraindicated in a 25-year-old female taking oral contraceptives?

A)Macrolides
B)Ritonavir
C)Barbiturates
D)All of the above

Answer 1

All of the above

Question 2

An elderly patient comes to you saying that she is being treated for hypertension and wants you to answer some questions about adverse effects, but she cannot remember which drug she is taking. She only remembers that it is a pretty little pink, oval pill. Which of the following is most likely her medication?

A)5 mg Glucotrol
B)80 mg/12.5 mg Diovan HCT
C)125 mg Amoxil
D)5 mg Adderall

Answer 2

80 mg/12.5 mg Diovan HCT

Question 3

Which of the following life-threatening adverse effects is most important to discuss with a patient who is prescribed lovastatin (Mevacor/Altocor)?

A)Asthenia
B)Pruritus
C)Rhabdomyolysis
D)Flatulence

Answer 3

Rhabdomyolysis

Question 4

If a patient is considering switching from Catapres tablets to the Catapres patch, which of the following is the best suggestion you would give them?

A)Never use both the patch and the tablets together.
B)Use both the patch and the tablets for 2-3 days before stopping the tablets.
C)Stop using the tablets for 2-3 days before beginning the patch.
D)None of the above-the Catapres patch is ineffective.

Question 5

Which of the following drugs can be used prophylactically for migraines?

A)OTC products with caffeine
B)Antidepressants
C)Antipsychotics
D)OTC migraine analgesics

Question 6

A patient on Seasonale should be counseled that her periods will come every:

A)2 weeks
B)Year
C)6 months
D)3 months

Question 7

Rosiglitazone (Avandia) is a thiazolidinedione hypoglycemic agent. One of its off-label uses is for:

A)Polycystic ovary syndrome
B)AC_ne
C)Hypernatremia
D)Fatigue

Question 8

A patient with COPD is also determined to be H1N1 positive. Which of the following drugs would likely be recommended?

A)Tamiflu
B)Relenza
C)Zidovudine
D)Amantadine

Question 9

A patient arrives and asks you to fill his Xanax prescription. Which of the following is important to determine and why?

A)Does the patient smoke? Smoking decreases blood concentration of Xanax.
B)Does the patient drink alcohol? Alcohol increases blood concentration of Xanax.
C)Both A and B are correct.
D)Neither A nor B are correct.

Question 10

A patient is on iron supplements. They ask if they should take it with food. Your response is:

A)Iron is best absorbed on an empty stomach.
B)Iron should be taken with food to increase absorption and minimize gastric upset.
C)Iron is best taken with water only.
D)None of the above is correct. Iron should be taken only with grapefruit juice because the acidity of the grapefruit juice increases absorption.

Question 11

A patient on Lithium complains of stomach pains, stomach upset, and diarrhea. You can safely suggest to him to:

A)Eat yogurt when taking his Lithium to restore intestinal flora
B)Stop taking the lithium
C)Take Lithium with plenty of water and after meals to reduce upset.
D)Both A and C are correct.

Question 12

Which of the following conditions would indicate a need for caution in a patient on tamsulosin?

A)Alzheimer's Disease
B)Pre-existing cataracts
C)Elderly patients
D)Concurrent viral infections

Question 13

A woman comes into your pharmacy carrying a screaming baby. She has just started taking Xanax and is concerned about whether it is safe. Which of the following adverse effects would not be mentioned during your counseling session with her?

A)Suicidal ideation, mania, and hypomania
B)Dependency and abuse
C)Seizures, respiratory depression, and tachycardia
D)Hyperkalemia and hyponatremia

Question 14

A clinic specializing in congestive heart failure has a number of elderly patients and has asked you to monitor their outcomes. They have used both nesiritide and bosentan and would like your input on these drugs. You feel comfortable telling them:

A)Nesiritide should not be used in patients with an obstructive cardiomyopathy. Bosentan may be used in these patients. Nesiritide should not be used in patients with a systolic pressure under 90mm Hg.
B)Bosentan is an endothelin-receptor agonist and should be used cautiously in elderly patients with mitral stenosis.
C)Both A and B are correct.
D)B is correct, but A is incorrect. The systolic pressure may safely be less than 90mm Hg as long as the patient is continuously monitored.

Question 15

A hospital pharmacist is asked to monitor an elderly dialysis patient on IV Amphotericin B. Which of the following lab parameters needs to be determined to appropriately monitor the patient?

A)Serum magnesium and serum potassium levels
B)Creatinine clearance
C)INR
D)All of the above would be appropriate.

Question 16

A patient is taking 40 mg PO of lovastatin with his evening meal. He comes to you saying that for the last 2-3 weeks, his legs feel like they are cramping. Which of the following tests would be recommended?

A)A CBC (complete blood count) and a full Comprehensive Metabolic Panel (chemistries)
B)Lipid levels including VLDL levels
C)Total lovastatin serum concentrations
D)Creatine phosphokinase (CPK), the MM isoenzyme

Question 17

Which of the following medications would be appropriate to treat a Pseudomonas aeruginosa infection in a child of 12 years?

A)Tobramycin
B)Fluconazole
C)Ampicillin
D)Clindamycin

Question 18

Which of the following is considered the "drug of choice" for Clostridium difficile?

A)Metronidazole
B)Fluconazole
C)Ketoconazole
D)Ciprofloxacin

Question 19

Of the following organisms, which would be susceptible to Clindamycin?
I. Clostridia perfringens
II. Bacteroides fragilis
III. Pseudomonas aeruginosa

A)I and II only
B)I, II and III only
C)I and III only
D)I only

Question 20

For which of the following conditions would QVAR be indicated?
I. COPD
II. Asthma
III. Tuberculosis

A)I only
B)II only
C)III only
D)I and II only

Question 21

As you are reading a technical paper, you notice that the writers have included the statement that within a specific data set, p<0.001. How would you interpret the p value?

A)The data has no significance. The p-value is very small.
B)The data is highly significant. The p-value is very small.
C)The data is of unknown significance and may be due to random chance.
D)The p-value is positive and therefore insignificant.

Question 22

Which of the following statements accurately reflects the difference between accuracy and precision in measurements?
I. Accuracy is a measure of how close an experimental value is to the expected value.
II. Precision is a measure of how close a series of experimental values are to each other.
III. Accuracy is a measure of how close an experimental value is to the dependent variable.
IV. Precision is a measure of how close an experimental value is to the dependent variable.

A)I and II are true.
B)II and III are true.
C)I and IV are true.

Question 23

A pharmacist is asked about the mechanism of action of a particular drug. Of the following resources, which is the most appropriate source of valid information?

A)AHFS Drug Information
B)DSM-IV
C)IDC-9
D)Handbook on Injectable Drugs

Question 24

Which of the following statements is true concerning Phase I, II, or III clinical trials?

A)A phase I trial is often very small (N<30) and seeks to determine the safe dose range for a new drug.
B)A phase II trial is often larger than a phase I trial and seeks to determine if a new drug is effective enough to test in a phase III trial and to delineate adverse effects.
C)A Phase III trial compares a new treatment with an established treatment and is usually much larger than either a phase I or a phase II trial.
D)All three of the statements are correct.

Question 25

A woman comes into the pharmacy and tells you she has an at-home glucometer and regularly tests her blood sugar. It is sometimes a fasting blood sugar and sometimes not, but she remembers at least twice when she was fasting, her numbers were 128 and 134 mg/dL. What should you talk to her about?

A)Nothing-she doesn't have a blood glucose problem, but she probably should cut back on her sweets.
B)She probably has insulin resistance, but it's not very serious yet. She should come back in a few months with more glucose readings.
C)She probably is pre-diabetic, but can take her time getting any information.
D)She has diabetes and would benefit from a professional diagnosis and formal classes on living with diabetes.

Question 26

A patient is diagnosed with an H. pylori associated ulcer. Which is generally the first-line treatment with such an ulcer?

A)A proton pump inhibitor (PPI) plus antibiotics
B)A proton pump inhibitor alone
C)OTC NSAIDs
D)Infliximab

Question 27

Azathioprine is used as an immunosuppressant in GI disorders. Which of the following should be monitored in a patient on azathioprine?
I. Amylase and lipase levels
II. Liver Function Tests (LFTs)
III. CBC with differential
IV. Creatine phosphokinase levels

A)I only
B)II only
C)I, II and III only
D)IV only

Question 28

Which of the following is not a characteristic drug and delivery system used in the treatment of iron deficiency anemia?

A)Iron sucrose, PO
B)Ferrous sulfate, PO
C)Dextran 40, IV
D)Sodium ferric gluconate, IV

Question 29

Cytarabine is a nucleoside analog used as a chemotherapeutic agent. Which of the following should be co-administered to limit chemically induced arachnoiditis on intrathecal injection?

A)Nothing. Chemically induced arachnoiditis does not occur with cytarabine use.
B)Dexamethasone should be co-administered to reduce arachnoiditis.
C)Nothing. Chemically induced arachnoiditis only occurs if the cytarabine is given too slowly. Otherwise, it is not a problem.
D)An OTC analgesic should be co-administered with the cytarabine to limit chemically induced arachnoiditis.

Question 30

Which of the following statements is true concerning Tamoxifen?

A)Bone pain may be indicative of a good therapeutic response.
B)One needs to monitor a patient on tamoxifen for possible thromboembolic events.
C)Statement B is true, but statement A is false.
D)Both statements A and B are true.

Question 31

Which of the following would be an effective anti-androgen therapy in a 58 year old patient with prostate cancer?
I. Bilateral orchiectomy.
II. A testosterone antagonist such as bicalutamide only.
III. An LHRH antagonist such as cetrorelix.

A)I only
B)III only
C)I and/or III
D)II only

Question 32

A woman comes into the pharmacy and tells you she has been diagnosed with bipolar disorder. Which of the following would be the best approach therapeutically?

A)A mood stabilizer such as lithium or lamotrigine
B)An antipsychotic such as buspirone
C)An anxiolytic such as oxcarbazepine
D)None of the above would be used to treat bipolar disorder.

Question 33

Which of the following drugs is used to treat osteoarthritis?

A)Diclofenac
B)Celecoxib
C)Acetaminophen
D)All of the above

Question 34

What information do the Commission E monographs provide?

A)Supplements
B)Vitamins only
C)Herbal/botanical medicines
D)Over the counter medications

Question 35

Which of the following is an appropriate agent and dosing schedule for a newly-diagnosed patient with depression?

A)Carbamazepine, 100mg, PO, bid
B)Ezetimibe, 10 mg, PO, qd
C)Hydroxocobalamin, 500mcg, PO, qd
D)Venlafaxine, 37.5 mg, PO, bid

Question 36

Of the following lab value and medication, which are incorrectly matched?

A)ECG, moricizine
B)Liver function tests, erlotinib
C)EEGs, filgrastim
D)Liver function tests, lovastatin

Question 37

Which of the following requires monitoring of serum concentrations of the drug?
I. Risperidone
II. Valproic acid
III. Lamotrigine

A)I only
B)II only
C)I, II and III
D)III only

Question 38

Migraine prophylaxis is most likely to be obtained with which class of medication?

A)Antidepressants
B)ACE inhibitors
C)Angiotensin II receptor blockers
D)There is no prophylactic treatment for migraines

Question 39

What is liothyronine used to treat?

A)Grave's disease
B)Hyperthyroidism
C)Hypothyroidism
D)Adrenal fatigue

Question 40

Which of the following is an appropriate agent and dosing schedule for managing obesity?

A)Orlistat, 120mg,PO, tid
B)Omeprazole, 20 mg, PO, qd
C)Piroxicam, 20mg, PO, qd
D)Ranitidine, 50mg, IM, q 6-8 hrs

Question 41

When discussing antibiotic treatment (Amoxicillin, 500 mg, PO, tid) with a patient, which of the following is true?
I. There are no interactions to be concerned about with Amoxicillin.
II. If a patient is on oral contraceptives, it is strongly suggested a backup means of contraception is used.
III. If a patient is on oral contraceptives, it is strongly suggested that they stop using the contraceptives immediately.
IV. Taking oral contraceptives along with Amoxicillin is fine as long as you double up on the oral contraceptive.

A)I only
B)II only
C)III only
D)IV only

Question 42

A patient is newly diagnosed with rheumatoid arthritis. What is the current recommendation for the use of DMARDs (Disease Modifying Anti-Rheumatic Drugs)?

A)DMARDs are used as a drug regimen of "last resort."
B)DMARDs should only be initiated after monoclonal antibody treatment has been unsuccessful.
C)DMARDs are ineffective.
D)DMARDs should be begun within 3 months of diagnosis.

Question 43

In the TNM staging system, what does the "T" stand for?

A)Degree of tumor differentiation
B)The severity of the primary tumor
C)Tumor size
D)Tumor type

Question 44

Which of the following drugs are used to treat bronchospasm?
I. Albuterol
II. Metaproterenol
III. Zoledronic acid
IV. Mirtazapine

A)All of the above
B)None of the above
C)I, II and III only
D)I and II only

Question 45

Which of the following are possible signs/symptoms/complications of a Vitamin A overdose?

A)Constipation
B)Muscle weakness or tenderness
C)Increased intracranial pressure
D)Seizures

Question 46

If a patient is on a thiazide diuretic, which of the following lab values should be monitored?

A)Electrolytes
B)Serum glucose
C)Blood pressure
D)Both blood pressure and serum electrolytes should be monitored.

Question 47

Which of the following conditions is a contraindication for the use of digoxin?
I. AV block
II. Ventricular arrhythmias that are not controlled
III. Constrictive pericarditis

A)I only
B)II only
C)III only
D)I, II, and III

Question 48

Which of the following would not be an option for the treatment of psoriasis?

A)Coal tar
B)Benzoyl peroxide
C)Anthralin
D)Light therapy (phototherapy)

Question 49

A clinical trial is studying the response of 4 independent groups. if numeric scales are used, which of the following would be the preferred mode of statistical analysis?

A)ANOVA
B)Two separate paired t-tests
C)Mann-Whitney
D)Chi-square.

Question 50

Which of the following is/are potential side effect(s) of clozapine?
I. Seizures
II. Myocarditis
III. Blood dyscrasias
IV. Neuroleptic malignant syndrome

A)I only
B)II only
C)I, II, and IV only
D)All of the above

Question 51

What is Cozaar used to treat?

A)Essential hypertension
B)Hyperthyroidism
C)Seasonal allergies
D)Seizure disorders

Question 52

Which of the following statement about sufentanil is untrue?

A)In adults, 8-30mcg/kg is given IV along with a muscle relaxant and oxygen.
B)It is never used as a primary anesthetic, only as an adjunct to maintain anesthesia.
C)Children younger than 12 should get 10-25mcg IV with oxygen.
D)Sufentanil may be given epidurally in combination with bupivacaine and epinephrine.

Question 53

In which of the following treatments could leucovorin be given as a rescue therapy?

A)Methotrexate
B)Doxorubicin
C)Cytarabine
D)None of the above.

Question 54

In her treatment for preeclampsia, a patient received an infusion of 50 mL of 10% (w/v) magnesium sulfate. How many mEq of magnesium did she receive? (MW of MgSO₄ = 246.4 g/mole)

A)24.64 mEq Mg²⁺
B)81.16 mEq Mg²⁺
C)40.58 mEq Mg²⁺
D)20.29 mEq Mg²⁺

Question 55

If a researcher wishes to increase the power of her study, which of the following approaches could be taken?

A)Increase the sample size.
B)Decrease the sample size.
C)Increase the length of time the study will take place.
D)Change the number and type of dependent variables.

Question 56

What is sildenafil used to treat?

A)Grave's disease
B)Erectile dysfunction
C)Hypercholesterolemia
D)Homocysteinemia

Question 57

Which of the following are possible adverse effects of oxycodone?
I. Circulatory depression
II. Apnea
III. Constipation

A)I and II only
B)II and III only
C)I and III only
D)All of the above are possible adverse effects.

Question 58

Which of the following is true of a Type II error?

A)Type II errors occur when a true difference between groups is not found.
B)Type II errors occur when a study has too much power designed into it.
C)Type II errors occur when a true null hypothesis is accepted.
D)None of the above is true of a Type II error.

Question 59

Which of the following is an appropriate diagnosis for the use of Gleevec?

A)Chronic Myelogenous Leukemia (CML)
B)Graft versus host disease
C)Oat cell carcinoma
D)Acute leukemias

Question 60

A patient is newly diagnosed with folic acid deficiency and megaloblastic anemia. What is the appropriate dosage for a child younger than 4 years old?

A)400 mcg qd, IV
B)5 mg/mL bid, IV
C)0)3 mg qd, PO
D)30 mg, qd, PO

Question 61

What might chlorpromazine be prescribed for?

A)Mild seasonal affective disorder (SAD)
B)Acute schizophrenia
C)Situational depression
D)Kaposi's sarcoma.

Question 62

If a patient is on phenazopyridine, what is the likely diagnosis?

A)Urinary tract infection
B)Diabetes, Type I
C)Hypertension
D)Hashimoto's thyroiditis

Question 63

Which of the following would not be an option for the treatment of genital herpes?

A)Acyclovir
B)Indinavir
C)Famciclovir
D)Valacyclovir

Question 64

Which of the following reference materials is the best source for obtaining information on the cost of a particular drug?

A)The Harriet Lane Handbook
B)The DSM-IV
C)The Physician's Desk Reference
D)Red Book

Question 65

What is Cytovene (Vitrasert) used to treat?

A)Essential hypertension
B)Cytomegalovirus infections
C)Seasonal affective disorder
D)Herpes infections

Question 66

A patient comes in with a prescription for fondaparinux. Which of the following is the most likely diagnosis?

A)Autoimmune Hashimoto's thyroiditis
B)Essential hypertension
C)Type II Diabetes
D)Deep Vein Thrombosis

Question 67

Which of the following life-threatening adverse effects is most important to inform a patient who is prescribed furosemide (Lasix)?

A)Severe hypoglycemia and seizures
B)Bradycardia and Torsades de pointes
C)Arrhythmias and hypochloremic acidosis
D)Anaphylaxis and hypertension

Question 68

A patient is taking gabapentin. Of the following, which is the most likely diagnosis?

A)Sleep disorder
B)Seizure disorder
C)Alzheimer's disease
D)None of the above

Question 69

Which of the following drugs can be used to treat Alzheimer's disease?

A)Milrinone
B)Galantamine
C)Miglitol
D)Pioglitazone

Question 70

What should be discussed when educating a patient about warfarin?

A)Indicate to the patient that warfarin is prescribed at a fixed dose.
B)They can feel free to take any over-the-counter medication they have a need for.
C)Nothing beyond dosing schedules. Warfarin is a very safe medication.
D)The patient will be getting repeated blood tests and they should report any bleeding or bruising to their physician.

Question 71

What is the zaleplon used to treat?

A)Premenstrual Dysphoric Disorder
B)Insomnia
C)Diabetes, Type I
D)Behcet's Disease

Question 72

A patient on simvastatin should be counseled about___________.

A)Signs and symptoms of a hypotension
B)Signs and symptoms of an infection
C)Signs and symptoms of an ulcer
D)Signs and symptoms of musculoskeletal problems

Question 73

Olanzapine (Zyprexa) is a thienobenzodiazepine used for schizophrenia, psychosis, and bipolar disorder. One of its off-label uses is:

A)Polycystic ovary syndrome
B)Borderline personality disorder
C)Depression
D)Insomnia

Question 74

Which of the following drugs is appropriate for IV infusion in a high-risk patient with community-acquired pneumonia?

A)Augmentin
B)Ceftriaxone plus a macrolide
C)Macrolides plus a broad spectrum anti-infective agent
D)Macrolides plus a 3rd generation cephalosporin

Question 75

The FDA (Food and Drug Administration) determines the use of a particular drug. Off-label uses are common, however. Which of the following is an off-label use of felodipine (Plendil)?

A)Hypertension
B)Atrial fibrillation
C)Increased intracranial pressure
D)Prinzmetal's angina

Question 76

A patient is on cholestyramine to control his serum lipids. Which of the following vitamins likely will need to be supplemented if he stays on the cholestyramine for an extended time?

A)Vitamin B₁₂
B)Vitamin D
C)Vitamin C
D)Vitamin B₆

Question 77

A patient is on cetirizine and paroxetine. Which of the following interactions between the two drugs is most likely?

A)Additive C_nS effects
B)Decreased absorption of the cetirizine
C)Diminished C_nS effects
D)None of the above - there are no interactions likely

Question 78

A patient is on nitazoxanide. Of the following infections, which is the most likely one the patient has?

A)Mycobacterium or histoplasmosis
B)Candida or Leishmania
C)Klebsiella or MRSA
D)Giardia or cryptosporidium

Question 79

Which of the following vitamins require caution in a patient with a history of renal calculi?

A)Vitamin C
B)Vitamin B₁₂
C)Vitamin B₂
D)Folic acid

Question 80

Which of the following vitamins are fat soluble and are excreted in the feces?
I. Vitamin C
II. Vitamin B₁₂
III. Vitamin D
IV. Vitamin E

A)I and II only
B)I and III only
C)III and IV only
D)II and IV only