Advanced Pharm Final Exam
A 10 year old male patient present with uncomfortable constipation. Along with diet changes, a
laxative is ordered to provide more rapid relief of constipation. An appropriate choice of
medication for a 10 year old child would be:
A. PEG 3350 (Miralax)
B. Bisacodyl (dulcolax) suppository
C. Polyethylene glycol electrolyte solution
D. Decussate (Colace) suppository - ANS-Bisacodyl (dulcolax) suppository
A 19 year old female is a nasal staph aureus carrier and is placed on 5 days of rifampin for
treatment. Her only other medication is combined oral contraceptives. What education should
she receive regarding her medications?
A. She should use a back-up method of birth control such as condoms fro the rest of the current
pill pack
B. If she gets nauseated with the medications she should call the office for her antiemetic
prescription
C. Both medications are best tolerated if taken on an empty stomach
D. Serrate the oral ingestion of the rifampin and oral contraceptive by at least an hour -
ANS-She should use a back-up method of birth control such as condoms fro the rest of the
current pill pack
A 22 year old woman receives a prescription for oral contraceptives. Education for this patient
includes:
A. Advising a monthly pregnancy test for the first 3 months she is taking the contraceptive
B. Recommending a follow up in 1 week for re-evaluation
C. Advising that she may miss two pills in a row and not be concerned about pregnancy
D. Counseling regarding decreasing or not smoking while taking oral contraceptives -
ANS-Counseling regarding decreasing or not smoking while taking oral contraceptives
A 5 year old female patient presents to the clinic with a 48 hour history of nausea, vomiting, and
she diarrhea. She is unable to keep fluids down and her weight is 4 pounds less than her last
recorded weight. Besides IV fluids, her exam warrants the use of an anti nausea medication.
Which of the following would be the appropriate drug to order for this patient?
A. Prochlorperazine (Compazine)
B. Ondanestron (Zoran)
C. Promethazine (Phenergan)
D. Meclizine (Antivert) - ANS-Ondanesteron (Zofran)
,A 54 year old male with multiple risk factors has web on a high dose statin for 3 months to treat
his high LDL level. His LDL is 135 and his triglycerides are elevated. A reasonable change in
therapy would be to:
A. Discontinue the statin and change to eztimibe
B. Refer him to a specialist in managing patients with recalcitrant hyperlipidemia
C. Continue the statin and add in eztimibe
D. Discontinue the statin and change to a fabric acid derivative - ANS-Continue the statin and
add in eztimibe
A 6 month old female infant has severe eczema. She would benefit from topical corticosteroid
therapy. Instructions for using topical corticosteroids in children include:
A. Apply literally to all areas with eczema
B. Apply sparingly to eczema areas
C. Double the frequency of application when the eczema is severe
D. Cover the eczema area with an occlusive dressing after applying a corticosteroid -
ANS-Apply sparingly to eczema areas
A female patient calls the clinic with concerns that her acne is worse 1 week after starting
topical tretinoin. What would be the appropriate care for her?
A. Reassure her that the worsening of acne is normal and it should improve with continued use
B. Advise her to apply an oil based lotion to her face to soother the redness
C. Switch her to an oral antibiotic to treat her acne
D. Change her to a different topical acne medication as she is having an adverse reaction to the
tretinoin - ANS-Reassure her that the worsening of acne is normal and it should improve with
continued use
A female patient comes to the clinic with a request for oral contraceptives. She has successfully
used oral contraceptives before and has recently started dating a new boyfriend so would like to
restart contraception. She denies recent intercourse and has a negative urine pregnancy test in
the clinic. An appropriate plan of care would be:
A. Prescribe oral combined contraceptives and recommend she start them at the beginning of
her next period and use a back up method for the first 7 days
B. Discuss the advantages of using a topical birth control patch and recommend she consider
using the patch
C. Prescribe oral contraceptives and have her start the same day as the visit with a back up
method for the first 7 days
D. Recommend she return to the clinic at the start of her next menses to get a Depo Provera
shot - ANS-Prescribe oral contraceptives and have her start the same day as the visit with a
back up method for the first 7 days
A female patient had a deep vein thrombosis (DVT) and was on heparin in the hospital and was
discharged on warfarin. She asks her primary care prover NP why she was getting both
medications while in the hospital. The best response is to:
, A. Explain that warfarin is often started while a patient is still on heparin because warfarin takes
a few days to reach effectiveness
B. Encourage the patient to contact the Customer Service Department at the hospital as this
was most likely a medication error during her admission
C. Draw anticoagulation studies to make sure she does not have dangerously high bleeding
times
D. Contact the hospital as this is not the normal guideline for prescribing these two medications
and she may have had a more complicated case - ANS-Explain that warfarin is often started
while a patient is still on heparin because warfarin takes a few days to reach effectiveness
A female patient has been prescribed aspirin 320 mg her day for her atrial fibrillation. She also
takes pairing four or more times a day for arthritis pain. What are the symptoms of aspirin
toxicity for which she would need to be evaluated?
A. Tinnitus
V. Seeing halos around lights
C. Diarrhea
D. Photosensitivity - ANS-Tinnitus
A female patient has been prescribed iron to treat her anemia. Education of patients prescribed
iron would include:
A. Take iron with milk if it upsets her stomach
B. Increase fluids and fiber to treat constipation
C. Antacids may help with the nausea and GI upset cause day iron
D. Iron is best tolerated if it is taken at the same time as her other medications - ANS-Increase
fluids and fiber to treat constipation
A female patient has diarrhea and is wondering if she can take her loperamide (Imodium) for the
diarrhea. Loperamide:
A. Slows gastric motility and reduces fluid and electrolyte loss from diarrhea
B. Can be given to patients of all ages, including infants and children, for viral gastroenteritis
C. Is the treatment of choice for the diarrhea associated with E. coli
D. May be used in pregnancy and by lactating women - ANS-Slows gastric motility and reduces
fluid and electrolyte loss from diarrhea
A female patient has type 2 diabetes and a high triglyceride level. She has gemfibrozil
prescribed to treat her hypertriglyceridemia. A history of which of the following might contradict
the use of this drug?
A. Reactive airway disease/asthma
B. Inflammatory bowel disease
C. Allergy to aspirin
D. Gallbladder disease - ANS-Gallbladder disease
A 10 year old male patient present with uncomfortable constipation. Along with diet changes, a
laxative is ordered to provide more rapid relief of constipation. An appropriate choice of
medication for a 10 year old child would be:
A. PEG 3350 (Miralax)
B. Bisacodyl (dulcolax) suppository
C. Polyethylene glycol electrolyte solution
D. Decussate (Colace) suppository - ANS-Bisacodyl (dulcolax) suppository
A 19 year old female is a nasal staph aureus carrier and is placed on 5 days of rifampin for
treatment. Her only other medication is combined oral contraceptives. What education should
she receive regarding her medications?
A. She should use a back-up method of birth control such as condoms fro the rest of the current
pill pack
B. If she gets nauseated with the medications she should call the office for her antiemetic
prescription
C. Both medications are best tolerated if taken on an empty stomach
D. Serrate the oral ingestion of the rifampin and oral contraceptive by at least an hour -
ANS-She should use a back-up method of birth control such as condoms fro the rest of the
current pill pack
A 22 year old woman receives a prescription for oral contraceptives. Education for this patient
includes:
A. Advising a monthly pregnancy test for the first 3 months she is taking the contraceptive
B. Recommending a follow up in 1 week for re-evaluation
C. Advising that she may miss two pills in a row and not be concerned about pregnancy
D. Counseling regarding decreasing or not smoking while taking oral contraceptives -
ANS-Counseling regarding decreasing or not smoking while taking oral contraceptives
A 5 year old female patient presents to the clinic with a 48 hour history of nausea, vomiting, and
she diarrhea. She is unable to keep fluids down and her weight is 4 pounds less than her last
recorded weight. Besides IV fluids, her exam warrants the use of an anti nausea medication.
Which of the following would be the appropriate drug to order for this patient?
A. Prochlorperazine (Compazine)
B. Ondanestron (Zoran)
C. Promethazine (Phenergan)
D. Meclizine (Antivert) - ANS-Ondanesteron (Zofran)
,A 54 year old male with multiple risk factors has web on a high dose statin for 3 months to treat
his high LDL level. His LDL is 135 and his triglycerides are elevated. A reasonable change in
therapy would be to:
A. Discontinue the statin and change to eztimibe
B. Refer him to a specialist in managing patients with recalcitrant hyperlipidemia
C. Continue the statin and add in eztimibe
D. Discontinue the statin and change to a fabric acid derivative - ANS-Continue the statin and
add in eztimibe
A 6 month old female infant has severe eczema. She would benefit from topical corticosteroid
therapy. Instructions for using topical corticosteroids in children include:
A. Apply literally to all areas with eczema
B. Apply sparingly to eczema areas
C. Double the frequency of application when the eczema is severe
D. Cover the eczema area with an occlusive dressing after applying a corticosteroid -
ANS-Apply sparingly to eczema areas
A female patient calls the clinic with concerns that her acne is worse 1 week after starting
topical tretinoin. What would be the appropriate care for her?
A. Reassure her that the worsening of acne is normal and it should improve with continued use
B. Advise her to apply an oil based lotion to her face to soother the redness
C. Switch her to an oral antibiotic to treat her acne
D. Change her to a different topical acne medication as she is having an adverse reaction to the
tretinoin - ANS-Reassure her that the worsening of acne is normal and it should improve with
continued use
A female patient comes to the clinic with a request for oral contraceptives. She has successfully
used oral contraceptives before and has recently started dating a new boyfriend so would like to
restart contraception. She denies recent intercourse and has a negative urine pregnancy test in
the clinic. An appropriate plan of care would be:
A. Prescribe oral combined contraceptives and recommend she start them at the beginning of
her next period and use a back up method for the first 7 days
B. Discuss the advantages of using a topical birth control patch and recommend she consider
using the patch
C. Prescribe oral contraceptives and have her start the same day as the visit with a back up
method for the first 7 days
D. Recommend she return to the clinic at the start of her next menses to get a Depo Provera
shot - ANS-Prescribe oral contraceptives and have her start the same day as the visit with a
back up method for the first 7 days
A female patient had a deep vein thrombosis (DVT) and was on heparin in the hospital and was
discharged on warfarin. She asks her primary care prover NP why she was getting both
medications while in the hospital. The best response is to:
, A. Explain that warfarin is often started while a patient is still on heparin because warfarin takes
a few days to reach effectiveness
B. Encourage the patient to contact the Customer Service Department at the hospital as this
was most likely a medication error during her admission
C. Draw anticoagulation studies to make sure she does not have dangerously high bleeding
times
D. Contact the hospital as this is not the normal guideline for prescribing these two medications
and she may have had a more complicated case - ANS-Explain that warfarin is often started
while a patient is still on heparin because warfarin takes a few days to reach effectiveness
A female patient has been prescribed aspirin 320 mg her day for her atrial fibrillation. She also
takes pairing four or more times a day for arthritis pain. What are the symptoms of aspirin
toxicity for which she would need to be evaluated?
A. Tinnitus
V. Seeing halos around lights
C. Diarrhea
D. Photosensitivity - ANS-Tinnitus
A female patient has been prescribed iron to treat her anemia. Education of patients prescribed
iron would include:
A. Take iron with milk if it upsets her stomach
B. Increase fluids and fiber to treat constipation
C. Antacids may help with the nausea and GI upset cause day iron
D. Iron is best tolerated if it is taken at the same time as her other medications - ANS-Increase
fluids and fiber to treat constipation
A female patient has diarrhea and is wondering if she can take her loperamide (Imodium) for the
diarrhea. Loperamide:
A. Slows gastric motility and reduces fluid and electrolyte loss from diarrhea
B. Can be given to patients of all ages, including infants and children, for viral gastroenteritis
C. Is the treatment of choice for the diarrhea associated with E. coli
D. May be used in pregnancy and by lactating women - ANS-Slows gastric motility and reduces
fluid and electrolyte loss from diarrhea
A female patient has type 2 diabetes and a high triglyceride level. She has gemfibrozil
prescribed to treat her hypertriglyceridemia. A history of which of the following might contradict
the use of this drug?
A. Reactive airway disease/asthma
B. Inflammatory bowel disease
C. Allergy to aspirin
D. Gallbladder disease - ANS-Gallbladder disease
