Exam Practice Test 2 - 50 Questions (answers with explanation)
The 50 questions in this test are randomized each time you start, ensuring a different order every time
Answer the following 2 questions based on the information below:
A 78-year-old white male with a history of atrial fibrillation, hypertension, GERD, and CHF is currently
receiving metoprolol 25 mg twice daily, digoxin 0.25 mg daily, omeprazole 20 mg daily, Pepcid 40 mg at
bedtime, and aspirin 81 mg daily.
Recent labs reveal an elevation in creatinine of 1.8 mg/dL. 6 months ago, creatinine was 1.1 mg/dL.
Other information:
● Height = 6 feet 2 inches
● Weight 178 lbs
● Blood pressure = 128/78 mmHg
● Pulse = 62 bpm
● Respiration rate = 21 breaths per minute
51. Which of the following is not consistent with signs of digoxin toxicity?
A. Nausea
B. Vertical nystagmus
C. Bradycardia
D. Weight loss
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52. Rounding to the nearest whole number, what is the estimated creatinine clearance in this patient (mL/min)?
Fill In the Blank:
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53. A 66-year-old diabetes patient has been recently diagnosed with congestive heart failure. Which diabetes medication would be least appropriate given this new diagnosis?
A. Lantus
B. Pioglitazone
C. Glucotrol
D. Victoza
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54. A 7-year-old male weighing 24 kg is experiencing a significant fever of 103 degrees Fahrenheit. What is the most appropriate dose of Tylenol to initiate?
A. 100 mg
B. 300 mg
C. 500 mg
D. 700 mg
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55. A new medication for Parkinson’s disease is being investigated. Researchers are trying to identify the half-life of the drug. The elimination rate constant is 0.32 per hour. What is the approximate half-life?
A. Too little information to identify
B. 6 hours
C. 4 hours
D. 2 hours
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56. Approximately how many grams of NaCl would need to be added to 330 mL of pure water to create an isotonic solution?
A. 3 grams
B. 4 grams
C. 5 grams
D. 6 grams
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57. A 77-year-old female is currently on both Coumadin and aspirin with a history of MI and atrial fibrillation. Her neighbor is on a bunch of herbal supplements which she states really helps her feel better. Which of the following supplements would be the highest risk for her to try?
A. Glucosamine
B. Garlic
C. Thiamine
D. Vitamin C
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58. A 19-year-old female presents about 6 hours after ingesting a large, unknown amount of acetaminophen. She is extremely nauseated. What is the most appropriate initial course of action?
A. Administer activated charcoal
B. Give syrup of ipecac to induce vomiting
C. Check an acetaminophen level
D. Administer N-acetylcysteine
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59. Which of the following is not true regarding the use of long acting nitrates?
A. They can be given with or without food
B. They are not used for acute relief of angina
C. Monitoring blood pressure is warranted while on therapy
D. Can be used safely with with PDE-5 inhibitors
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Answer the following two questions based on the case:
A 45-year-old female with a history of epilepsy, hypertension, and diabetes is taking the following
medications. Dilantin 200 mg twice daily, lisinopril 10 mg daily, metformin 500 mg twice daily, and
glipizide 5 mg daily. She was prescribed fluconazole 100 mg twice daily for 14 days about 5 days ago. She
has been feeling weak, nauseated, slurring speech, and having difficulty with her gait.
Current labs reveal:
● CrCl = 78 mL/min
● Sodium 138 mEq/L
● Potassium 4.4 mEq/L
● Hemoglobin = 14.6 g/dL
● A1C = 7.7%
● Blood glucose = 99 mg/dL
● Dilantin level = 28 mcg/mL
60. What is the most likely cause of her symptoms?
A. Side effects from fluconazole
B. Hypoglycemia
C. Drug interaction
D. Anemia
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61. In the patient above, chronic Dilantin use can contribute to which deficiency?
A. Folate
B. B12
C. Vitamin C
D. Vitamin D
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62. A 66-year-old male with a history of congestive heart failure, diabetes, rheumatoid arthritis, and seizures is started on Mobic. Which disease state is this most likely to worsen?
A. Congestive heart failure
B. Diabetes
C. Rheumatoid arthritis
D. Seizures
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63. Approximately how many kcals are in 30 grams of lipids?
A. 12 kcals
B. 27 kcals
C. 120 kcals
D. 270 kcals
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64. A patient with confirmed HIV infection is starting antiretroviral therapy. Their HLA-B*5701 test is positive. Which of the following regimens would not be appropriate?
A. Biktarvy
B. Triumeq
C. Dovato
D. Dovato plus Viread
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65. Which of the following is considered a thiazide-like diuretic often used to augment fluid loss in the treatment of congestive heart failure?
A. Bumetanide
B. Triamterene
C. Metolazone
D. Ethacrynic acid
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66. What is the half-life of a medication if the concentration at 8 AM is 16 mg/L and 12 hours later at 8 PM the concentration is at 2 mg/L?
A. 1 hour
B. 2 hours
C. 3 hours
D. 4 hours
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67. Who may be eligible for PrEP therapy?
A. Person who has had vaginal or anal sex (with inconsistent condom usage) in the last 6 months with a partner of unknown HIV status
B. Person who uses injectable drugs (illicit substances) and shares injection equipment
C. Person who has been diagnosed with gonorrhea or syphilis in the past 6 months
D. All the above
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68. Which of the following is a common complication with the use of paclitaxel?
A. Retinopathy
B. Neuropathy
C. Rash
D. Cystitis
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69. A primary provider is asking you for your opinion on which would be the most appropriate antihypertensive in a patient who has frequent gout flares. Which would be least appropriate?
A. Metoprolol
B. Lisinopril
C. Chlorthalidone
D. Clonidine
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A 45-year-old male presents to the clinic with an inflamed and extremely painful left big toe.
Recent labs reveal:
● Creatinine = 1.1 mg/dL
● BUN = 19 mg/dL
● Hemoglobin =15 g/dL
● Platelets = 324,000/uL
● Uric acid = 13 mg/dL
● Potassium = 4.3 mEq/L
● Sodium = 136 mEq/L
70. What medication would be the most appropriate to use to treat this patient’s pain?
A. Allopurinol
B. Indomethacin
C. Tylenol
D. Methotrexate
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71. Which of the following medications should not be used in a patient who has a stated sulfa allergy?
A. Unasyn
B. Levaquin
C. Septra
D. Doxycycline
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72. What is the mechanism of action of Xarelto?
A. Inhibits Factor Xa
B. Bind to ADP receptors on platelets
C. Direct thrombin inhibitor
D. None of the above
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73. Which of the following medications would most likely increase the risk of deep vein thrombosis (DVT)?
A. Lopressor
B. Premarin
C. Diclofenac
D. Probenecid
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74. Questran causes drug interactions primarily via what mechanism?
A. CYP3A4 inhibition
B. P-glycoprotein inhibition
C. Blocking absorption in the gut
D. Reducing elimination via the kidney
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75. Which of the following statins can be considered high-intensity lipid lowering agents? Select all that apply.
A. Atorvastatin
B. Simvastatin
C. Pravastatin
D. Rosuvastatin
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76. Which of the following medications is used to stimulate the production of white blood cells following chemotherapy?
A. Aranesp
B. Erythropoietin
C. Remicade
D. Neupogen
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77. According to the DEA, which medication has the lowest potential for abuse?
A. Ativan
B. Methadone
C. Ritalin
D. Kadian
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78. Which of the following is LEAST likely to be a symptom of opioid withdrawal?
A. Anxiety
B. Nausea
C. Constipation
D. Sweating
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Answer the following three questions based on the following case:
A 67-year-old African American male has a history of hypertension and bipolar disorder. He is currently
taking hydralazine, hydrochlorothiazide, loratadine and lithium. He has been feeling a little off lately.
Labs/vitals reveal:
● Creatinine = 1.1 mg/dL
● Potassium = 4.0 mEq/L
● Sodium = 142 mEq/L
● TSH = 17.4 mIU/mL
● Lithium 0.9 mEq/L
● BP = 156/78 mmHg
79. What medication is most concerning in regards to the lab work and new symptoms?
A. Hydralazine
B. Lithium
C. Hydrochlorothiazide
D. Loratadine
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80. Of the other medications, which medication would be most likely to cause lithium levels to rise?
A. Hydralazine
B. Loratadine
C. Hydrochlorothiazide
D. None of the above would interact
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81. In the above case, which blood pressure medication would be most appropriate to replace hydralazine?
A. Lisinopril
B. Amlodipine
C. Losartan
D. Aliskiren
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82. Which of the following statins is least likely to be involved in a drug interaction?
A. Atorvastatin
B. Simvastatin
C. Pravastatin
D. Rosuvastatin
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83. Which of the following medications is used to treat hyperkalemia?
A. Sodium polystyrene sulfonate
B. Vitamin K
C. PhosLo
D. Calcitriol
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84. A 25-year-old patient presents to the pharmacy stating she has a head cold and that she has been using Afrin for about 2 days since the symptoms started. She is not experiencing any benefit for her nasal congestion. She has no fever and she rates the pain at 2 on a scale of 1-10. What is the most appropriate course of action?
A. Recommend an oral nasal decongestant
B. Recommend a follow up with her primary physician
C. Recommend trying it for at least 5-10 days before switching if no relief in that timeframe, then see her primary physician
D. Recommend a mucolytic agent to take with Afrin for up to 10 days
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85. Which of the following is least likely to alleviate acute respiratory symptoms in COPD?
A. Albuterol
B. Xopenex
C. Flovent
D. Ipratropium
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86. Which of the following is false regarding Lidoderm patches?
A. Should be removed every 24 hours
B. Can be cut
C. You can use more than one patch at a time
D. They are meant to be placed at the location of the pain
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87. A 2-year-old male patient is diagnosed with acute otitis media. What is the recommended first line treatment?
A. Levofloxacin
B. Amoxicillin
C. Bactrim
D. Keflex
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88. A 33-year-old female has a history of hypertension, GERD, and depression. Current medications include: omeprazole, lisinopril, TUMS (as-needed), and Zoloft. She just found out that she is pregnant. Which of the following medications should be discontinued immediately?
A. Lisinopril
B. Omeprazole
C. Tums
D. Zoloft
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89. Which of the following medications works by selectively inhibiting serotonin reuptake inhibitors in the treatment of depression?
A. Effexor
B. Cymbalta
C. Luvox
D. Elavil
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90. A patient presents with symptoms of edema in his legs.
Which medication would least likely be the cause of the peripheral edema?
A. Amlodipine
B. Lisinopril
C. Ibuprofen
D. Gabapentin
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Answer the following two questions based on the scenario below.
An exhausted mother is with her 8 month old child. She has been crying and just got back from the
physician’s office in which they told her to use OTC pain meds as she is just teething. The 8 month old has
no known allergies and is 16 lbs.
91. What is the most appropriate dose of ibuprofen?
A. Ibuprofen 200 mg every 6 hours as needed
B. Ibuprofen 50 mg every 6 hours as needed
C. Ibuprofen 20 mg every 6 hours as needed
D. Ibuprofen 100 mg every 6 hours as needed
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92. With her stuffy nose, she is having an occasional cough. Her mother would like an option to help with this. What is the most appropriate recommendation?
A. Pseudoephedrine
B. Diphenhydramine
C. Dextromethorphan
D. Cough Drops
E. None of the above
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93. A 55-year-old male is diagnosed with Lyme’s disease. What is the most appropriate initial treatment?
A. Valtrex
B. Vancomycin
C. Doxycycline
D. Clindamycin
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94. Which bacteria is associated with the highest incidence of causing UTIs?
A. S. pneumoniae
B. S. aureus
C. P. aeruginosa
D. E. coli
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95. A 44-year-old male is on the following medications:
He has had a weight gain of 20 pounds in the last 6 months. Which medication is the most likely cause?
A. Hydrochlorothiazide
B. Tramadol
C. Quetiapine
D. Prozac
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96. Which of the following immunizations is recommended annually for patients greater than 65?
A. Pneumococcal
B. Influenza
C. Varicella
D. Prevnar
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97. A fast metabolizer via CYP3A4 would expect what effect on concentrations of erythromycin versus the normal population?
A. Higher
B. Lower
C. No change
D. None of the above
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98. What is the primary mechanism of action of famotidine?
A. Blocks Histamine type 1 receptors
B. Blocks proton pumps in the GI tract
C. Coats the lining of the stomach to produce its antacid effects
D. None of the above
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99. Which of the following is not a typical side effect of corticosteroids?
A. Hyperglycemia
B. GI upset
C. Liver toxicity
D. Insomnia
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100. Which of the following is not a live vaccine?
A. Varicella
B. FluMist
C. Tdap
D. MMR
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