PEBC Qualifying Exam Part I Practice
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A
1. A 65-year-old man with hypertension is started on thiazide
|| || || || || || || ||
therapy. Which lab change is most characteristic?
|| || || || || || ||
A. Decreased calcium ||
B. Decreased uric acid || ||
C. Increased potassium ||
D. Increased glucose ||
Answer: D. Increased glucose
|| || ||
Rationale: Thiazides can raise glucose and uric acid and lower sodium
|| || || || || || || || || ||
|| and potassium; they tend to increase serum calcium.
|| || || || || || ||
2. First-line agent for rate control in stable atrial fibrillation without
|| || || || || || || || ||
heart failure and with normal LVEF?
|| || || || || ||
, A. Digoxin
B. Amiodarone
C. Metoprolol
D. Diltiazem IV bolus then || || ||
infusion Answer: C. Metoprolol
|| || || ||
Rationale: β-blockers are preferred for rate control in stable AF with
|| || || || || || || || || ||
|| preserved EF; non-DHP CCBs are also options but β-blockers are
|| || || || || || || || ||
|| commonly first choice. || ||
3. Which antibiotic is safest in pregnancy (2nd trimester)?
|| || || || || || ||
A. Doxycycline
B. Ciprofloxacin
C. Amoxicillin
D. Trimethoprim-sulfamethoxazole
|| Answer: C. Amoxicillin
|| ||
Rationale: Penicillins are generally safe; tetracyclines and
|| || || || || ||
|| fluoroquinolones are avoided, TMP-SMX is used cautiously.
|| || || || || ||
4. Which statin has the highest risk of CYP3A4 interactions?
|| || || || || || || ||
A. Pravastatin
B. Rosuvastatin
C. Simvastatin
D. Pitavastatin
Answer: C. Simvastatin
|| ||
, Rationale: Simvastatin and lovastatin are extensively metabolized by
|| || || || || || ||
|| CYP3A4 and at higher interaction risk.
|| || || || ||
5. Which of the following is a NAPRA Schedule II medicine in
|| || || || || || || || || ||
many provinces (behind-the-counter, pharmacist-only sale)?
|| || || || ||
A. Ibuprofen 200 mg || ||
B. Nitroglycerin SL spray || ||
C. Pseudoephedrine
D. Loratadine 10 mg || ||
Answer: B. Nitroglycerin SL spray
|| || || ||
Rationale: Many provinces classify nitroglycerin SL as Schedule II
|| || || || || || || ||
|| (pharmacist intervention, no prescription). Sched III allows self-
|| || || || || || ||
|| selection in a pharmacy (often pseudoephedrine).
|| || || || ||
6. A 28-year-old with major depression starts sertraline. Which
|| || || || || || ||
adverse effect is common early and often transient?
|| || || || || || || ||
A. Weight gain ||
B. Sexual dysfunction ||
C. Hepatic failure ||
D. Agranulocytosis
Answer: B. Sexual dysfunction
|| || ||
Rationale: SSRIs commonly cause sexual dysfunction, GI upset,
|| || || || || || ||
|| and activation/insomnia early. Serious hematologic or hepatic
|| || || || || ||
effects are rare.
|| || ||
, 7. Which insulin has the longest duration of action?
|| || || || || || ||
A. NPH
B. Insulin detemir ||
C. Insulin glargine U-100 || ||
D. Insulin degludec ||
Answer: D. Insulin degludec
|| || ||
Rationale: Degludec is an ultra-long-acting basal with >24-hour
|| || || || || || ||
|| duration.
8. Best initial therapy for an adult with mild persistent asthma
|| || || || || || || || ||
per modern guidelines?
|| || ||
A. SABA as needed only || || ||
B. Low-dose ICS daily || ||
C. As-needed low-dose ICS-formoterol || ||
D. Theophylline
Answer: C. As-needed low-dose ICS-formoterol
|| || || ||
Rationale: Contemporary guidelines favor anti-inflammatory
|| || || ||
reliever (ICS-formoterol) to reduce exacerbations versus SABA-
|| || || || || || ||
only.
9. A patient on warfarin begins TMP-SMX. What’s the likely effect?
|| || || || || || || || ||
A. Decrease INR ||
B. No change ||
C. Increase INR ||
D. Increase platelet aggregation || ||
|| Answer: C. Increase INR || || ||
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A
1. A 65-year-old man with hypertension is started on thiazide
|| || || || || || || ||
therapy. Which lab change is most characteristic?
|| || || || || || ||
A. Decreased calcium ||
B. Decreased uric acid || ||
C. Increased potassium ||
D. Increased glucose ||
Answer: D. Increased glucose
|| || ||
Rationale: Thiazides can raise glucose and uric acid and lower sodium
|| || || || || || || || || ||
|| and potassium; they tend to increase serum calcium.
|| || || || || || ||
2. First-line agent for rate control in stable atrial fibrillation without
|| || || || || || || || ||
heart failure and with normal LVEF?
|| || || || || ||
, A. Digoxin
B. Amiodarone
C. Metoprolol
D. Diltiazem IV bolus then || || ||
infusion Answer: C. Metoprolol
|| || || ||
Rationale: β-blockers are preferred for rate control in stable AF with
|| || || || || || || || || ||
|| preserved EF; non-DHP CCBs are also options but β-blockers are
|| || || || || || || || ||
|| commonly first choice. || ||
3. Which antibiotic is safest in pregnancy (2nd trimester)?
|| || || || || || ||
A. Doxycycline
B. Ciprofloxacin
C. Amoxicillin
D. Trimethoprim-sulfamethoxazole
|| Answer: C. Amoxicillin
|| ||
Rationale: Penicillins are generally safe; tetracyclines and
|| || || || || ||
|| fluoroquinolones are avoided, TMP-SMX is used cautiously.
|| || || || || ||
4. Which statin has the highest risk of CYP3A4 interactions?
|| || || || || || || ||
A. Pravastatin
B. Rosuvastatin
C. Simvastatin
D. Pitavastatin
Answer: C. Simvastatin
|| ||
, Rationale: Simvastatin and lovastatin are extensively metabolized by
|| || || || || || ||
|| CYP3A4 and at higher interaction risk.
|| || || || ||
5. Which of the following is a NAPRA Schedule II medicine in
|| || || || || || || || || ||
many provinces (behind-the-counter, pharmacist-only sale)?
|| || || || ||
A. Ibuprofen 200 mg || ||
B. Nitroglycerin SL spray || ||
C. Pseudoephedrine
D. Loratadine 10 mg || ||
Answer: B. Nitroglycerin SL spray
|| || || ||
Rationale: Many provinces classify nitroglycerin SL as Schedule II
|| || || || || || || ||
|| (pharmacist intervention, no prescription). Sched III allows self-
|| || || || || || ||
|| selection in a pharmacy (often pseudoephedrine).
|| || || || ||
6. A 28-year-old with major depression starts sertraline. Which
|| || || || || || ||
adverse effect is common early and often transient?
|| || || || || || || ||
A. Weight gain ||
B. Sexual dysfunction ||
C. Hepatic failure ||
D. Agranulocytosis
Answer: B. Sexual dysfunction
|| || ||
Rationale: SSRIs commonly cause sexual dysfunction, GI upset,
|| || || || || || ||
|| and activation/insomnia early. Serious hematologic or hepatic
|| || || || || ||
effects are rare.
|| || ||
, 7. Which insulin has the longest duration of action?
|| || || || || || ||
A. NPH
B. Insulin detemir ||
C. Insulin glargine U-100 || ||
D. Insulin degludec ||
Answer: D. Insulin degludec
|| || ||
Rationale: Degludec is an ultra-long-acting basal with >24-hour
|| || || || || || ||
|| duration.
8. Best initial therapy for an adult with mild persistent asthma
|| || || || || || || || ||
per modern guidelines?
|| || ||
A. SABA as needed only || || ||
B. Low-dose ICS daily || ||
C. As-needed low-dose ICS-formoterol || ||
D. Theophylline
Answer: C. As-needed low-dose ICS-formoterol
|| || || ||
Rationale: Contemporary guidelines favor anti-inflammatory
|| || || ||
reliever (ICS-formoterol) to reduce exacerbations versus SABA-
|| || || || || || ||
only.
9. A patient on warfarin begins TMP-SMX. What’s the likely effect?
|| || || || || || || || ||
A. Decrease INR ||
B. No change ||
C. Increase INR ||
D. Increase platelet aggregation || ||
|| Answer: C. Increase INR || || ||
