Exam Practice - Test 4 (answers with explanation)
The 50 questions in this test are randomized each time you start, ensuring a different order every time
151. In clinical trials, what does the p-value represent?
A. The probability of a type I error occurring (false positive)
B. The probability of a type II error occurring (false negative)
C. The probability that the observed difference is clinically significant
D. The probability of a trial to detect a difference that truly exists
Answer: Only for registered users. Please login!
152. A 46-year-old female is assessed with right knee pain. She was instructed a couple of weeks ago to try capsaicin cream for mild to moderate pain. Past medical history includes GI bleed and chronic kidney disease. She has tried it a few times when her knee was aching but reports that it has not been effective. What is the most appropriate recommendation?
A. Keep using the capsaicin, but use at least three times daily for at least a few weeks
B. Self treatment is not recommended at this point
C. Recommend ibuprofen
D. Recommend glucosamine/chondroitin
Answer: Only for registered users. Please login!
153. Choosing only patients with severely high blood pressure for a study on hypertension medication that will help you prove statistical significance is an example of:
A. Observational bias
B. Selection bias
C. Recall bias
D. Interviewer bias
Answer: Only for registered users. Please login!
154. Variables X and Y have a correlation coefficient of -0.0024. What does this mean?
A. There is very little correlation
B. As X increases, Y tends to increase as well
C. Y is a dependent variable
D. An error was made in calculation
Answer: Only for registered users. Please login!
155. What is the distribution of water in the extracellular space?
A. 25/75 plasma/interstitial
B. 50/50 plasma/interstitial
C. 60/40 plasma/interstitial
D. None of the above
Answer: Only for registered users. Please login!
156. Which antibiotic can be used to promote GI motility?
A. Levofloxacin
B. Moxifloxacin
C. Clarithromycin
D. Erythromycin
Answer: Only for registered users. Please login!
157. A 65-year-old patient with diabetes presents to the ED with symptoms of excessive thirst and lethargy. The patient appears confused. His spouse reports that he has been like this for the last few hours. She also reports that he hasn’t been very good about taking his insulin recently and has also been “into the sweets” as they have been celebrating with family.
Labs:
● Blood glucose = 555 mg/dL
● Sodium = 134 mEq/L
● Potassium = 3.0 mEq/L
● Creatinine = 1.6 mg/dL
● pH = 7.23
Which of the following actions would be most appropriate to do first?
A. Initiate insulin
B. Initiate IV potassium replacement
C. Initiate oral hydration
D. Initiate sodium bicarbonate to raise pH
Answer: Only for registered users. Please login!
158. A 55-year-old male has been hospitalized for about 7 days following a recent hip surgery. He starts to develop increased coughing and a temperature of 38.2 degrees Celsius and is diagnosed with pneumonia. What is the most appropriate empiric pneumonia therapy?
A. Cefepime and gentamicin
B. Ertapenem
C. Piperacillin/tazobactam
D. Cefepime and linezolid
Answer: Only for registered users. Please login!
159. A 36-year-old male present with intractable hiccups. What medication is indicated for the treatment of this?
A. Lorazepam
B. Levetiracetam
C. Propranolol
D. Chlorpromazine
Answer: Only for registered users. Please login!
160. Which of the following drugs is paired with an incorrect target/site of action?
A. Macrolide: 50S ribosomal subunit
B. Tetracycline: 30S ribosomal subunit
C. Beta-lactams: cell wall synthesis
D. Fluoroquinolones: DNA topoisomerase I & III
Answer: Only for registered users. Please login!
161. In oncology, which one of the following medication regimens is least likely to cause chemotherapy induced nausea and vomiting?
A. Dacarbazine
B. Doxorubicin (< 60 mg/m2)
C. Cisplatin
D. Vincristine
Answer: Only for registered users. Please login!
162. A mother presents to the pharmacy with questions on different pain medications for her 8 month old infant. She believes her baby is teething and would like something to help with the pain. She will not use Tylenol as she is concerned that it will cause liver toxicity in her baby. Which of the following would be the best alternative?
A. Aspirin
B. Ibuprofen
C. Tramadol
D. None of the above
Answer: Only for registered users. Please login!
163. A patient with end stage COPD presents to the pharmacy with a sore throat and has just recently been to his primary care provider and has a prescription for Nystatin swish and swallow.
Which medication is most important to provide counseling on?
A. Symbicort
B. DuoNeb
C. Spiriva
D. Daliresp
Answer: Only for registered users. Please login!
Answer the following 3 questions based on the case below:
A 45-year-old male has a history of hyperlipidemia, gout, hypertension, and rheumatoid arthritis.
His current medications include:
● Lipitor
● Niacin
● Lisinopril
● Allopurinol
● Methotrexate
164. Which medication is most likely to exacerbate his gout?
A. Lipitor
B. Niacin
C. Methotrexate
D. Lisinopril
Answer: Only for registered users. Please login!
165. What is the mechanism of action for allopurinol?
A. Inhibits xanthine oxidase
B. Increases renal excretion of uric acid
C. Inhibits beta-tubulin polymerization in microtubules
D. Reduces inflammation via COX inhibition
Answer: Only for registered users. Please login!
166. Which of the following is a notable drug interaction that can occur when Lipitor and niacin are taken together?
A. Exacerbation of niacin-induced flushing
B. Muscle pain
C. Increase in triglycerides
D. Severe diarrhea
Answer: Only for registered users. Please login!
167. With respect to clinical trials, which of the following is true?
A. As sample size increases, power will increase as well
B. Bias most often increases the risk of type 2 error
C. Intention-to-treat analysis considers all subjects who received at least 1 dose of the test intervention
D. P-value threshold of 0.05 is generally used to determine clinical significance
Answer: Only for registered users. Please login!
168. Which of the following would not be an anticipated effect of epinephrine?
A. Increased heart rate
B. Anxiety
C. Headache
D. Hypotension
Answer: Only for registered users. Please login!
169. What is the mechanism of action of cyclosporine used in organ transplantation?
A. Inhibits calcineurin
B. Inhibits inosine 5’-monophosphate dehydrogenase
C. Inhibits T-lymphocyte activation by binding to FKBP-12
D. Binds to intracellular receptors and affect gene expression to reduce inflammation
Answer: Only for registered users. Please login!
170. An over the counter medication (solution) is 0.7% active ingredient. How many mg would be in a 30 cc bottle? Round to the nearest whole mg.
Fill in the blank:
Answer: Only for registered users. Please login!
171. What is the primary mechanism of action of olanzapine in the treatment of schizophrenia?
A. Serotonin receptor agonist
B. Alpha receptor agonist
C. Norepinephrine reuptake inhibitor
D. Dopamine receptor antagonist
Answer: Only for registered users. Please login!
172. A 48-year-old male presents with an acute exacerbation of his rheumatoid arthritis. He is currently on methotrexate 7.5 mg weekly. Which of the following would be most appropriate to acutely relieve the pain symptoms?
A. Increase methotrexate
B. Add Tylenol
C. Add ibuprofen
D. Switch to hydroxychloroquine Answer the following two questions using this information: A 134 kg patient with chronic kidney disease has an order written for Aranesp 0.45 mcg/kg once weekly. The concentration in stock at the pharmacy is 25 mcg/0.42 mL.
Answer: Only for registered users. Please login!
173. How many mL will be required to fill this order? Round to the nearest hundredth decimal place.
Fill in the blank:
Answer: Only for registered users. Please login!
174. Which of the following is a boxed warning for Aranesp?
A. Increased risk of severe hypercalcemia
B. Increased risk of severe hypocalcemia
C. Increased risk of serious cardiovascular events
D. Hypertensive crisis
Answer: Only for registered users. Please login!
175. Which one of the following medications could be used in atrial fibrillation and hypertension?
A. Terazosin
B. Calan
C. Amlodipine
D. Lisinopril
Answer: Only for registered users. Please login!
176. Which of the following would be most likely to interact with Coumadin and raise INR?
A. Metronidazole
B. Carbamazepine
C. St. John’s Wort
D. Rifampin
Answer: Only for registered users. Please login!
177. Which of the following medications has the potential to cause both hyponatremia and hyperkalemia?
A. Enalapril
B. Hydrochlorothiazide
C. Metoprolol
D. Aldactone
Answer: Only for registered users. Please login!
178. What is the mechanism of action of memantine?
A. Dopamine agonist
B. NMDA receptor antagonist
C. Acetylcholinesterase inhibitor
D. Neuraminidase Inhibitor
Answer: Only for registered users. Please login!
179. Which of the following is not an adverse effect of Vyvanse?
A. Circulation problems
B. Increased oral secretions
C. Hypertension
D. Growth suppression
Answer: Only for registered users. Please login!
Answer the following three questions based on the information below:
A 49-year-old female presents to the pharmacy for a comprehensive medication review.
She is currently on the following medications:
● Doxepin
● Senna-S
● Oxycodone
● Diltiazem
● Lisinopril
● Saliva substitute
● Artificial tears
● Lumigan
● Restasis
Her current diagnoses include insomnia, constipation, pain, hypertension, xerostomia, and
keratoconjunctivitis sicca.
180. She has a very busy schedule and would like to do all her eye drops at one time. What is the most appropriate recommendation?
A. Artificial tears, Lumigan, and Restasis should all be ok to be given consecutively
B. She should wait at least 60 seconds between eye drops
C. She should wait 5 minutes between eye drops
D. She should wait at least 10-15 minutes between eye drops
Answer: Only for registered users. Please login!
181. Which of the following medications is likely to exacerbate her xerostomia and keratoconjunctivitis sicca?
A. Oxycodone
B. Diltiazem
C. Restasis
D. Doxepin
Answer: Only for registered users. Please login!
182. What is the medication class of Lumigan?
A. Alpha-2 receptor agonist
B. Prostaglandin analog
C. Beta-blocker
D. Corticosteroid
Answer: Only for registered users. Please login!
183. A 64-year-old female is receiving Oxycontin 80 mg twice daily for the management of back pain. She has been taking this medication for years, but has had some difficulty swallowing recently. The provider would like to switch Oxycontin to morphine oral solution. What would be the most appropriate equivalent conversion from Oxycontin 80 mg twice daily?
A. 240 mg oral morphine per day
B. 420 mg oral morphine per day
C. 120 mg oral morphine per day
D. 107 mg oral morphine per day
Answer: Only for registered users. Please login!
184. Which of the following is not an advantage of using Buspar over a benzodiazepine to treat anxiety?
A. Buspar works relatively quickly
B. Buspar has lower risk of abuse/addiction
C. Buspar is better tolerated in the elderly
D. Buspar is not a controlled substance
Answer: Only for registered users. Please login!
185. A doctor calls in a prescription to the pharmacy for a four-year old child weighing 45 lb for oseltamivir. The four-year-old child was diagnosed with influenza during the office visit that day.
Use the information below to determine an appropriate dose of oseltamivir.
Oseltamivir Prophylaxis
< 15 kg = 30 mg once daily for 10 days
15.1-23 kg = 45 mg once daily for 10 days
23.1-40 kg = 60 mg once daily for 10 days
≥ 40.1 kg = 75 mg once daily for 10 days
Oseltamivir Treatment
< 15 kg = 30 mg BID for 5 days
15.1-23 kg = 45 mg BID for 5 days
23.1-40 kg = 60 mg BID for 5 days
≥ 40.1 kg = 75 mg BID for 5 days
A. 45 mg BID for 5 days
B. 45 mg once daily for 10 days
C. 30 mg BID for 5 days
D. 60 mg once daily for 10 days
Answer: Only for registered users. Please login!
186. Regarding the use of oseltamivir, which of the following is false?
A. Prophylaxis typically lasts 7-10 days
B. Treatment usually lasts 5 days
C. Oseltamivir inhibits neuraminidase as its primary mechanism of action
D. Oseltamivir requires dose adjustments for hepatic impairment but are not for renal impairment
Answer: Only for registered users. Please login!
Answer the following two questions based on the following scenario:
An elderly gentleman has recently had cataracts removed from his eyes and still has complaints of visual
problems.
His current medication list includes:
● Terazosin 2 mg at bedtime
● Methotrexate 15 mg once weekly
● Prednisone 5 mg daily
● Ramipril 10 mg daily
● Metoprolol tartrate 25 mg BID
● Aspirin 81 mg daily
● Etanercept 50 mg weekly
187. Which medication is most likely responsible for contributing to his cataracts?
A. Prednisone
B. Ramipril
C. Methotrexate
D. Terazosin
Answer: Only for registered users. Please login!
188. Which of the following is the appropriate route of delivery for etanercept?
A. Oral
B. Intra-articular
C. IV infusion
D. Subcutaneous
Answer: Only for registered users. Please login!
Answer the following two questions based on the information below:
A physician orders a 3 mcg/kg/min drip of Drug A. This drug is typically put into a 250 mL bag of D5W. The
patient’s weight is 135 pounds.
189. How much Drug A in mg will this patient receive in 30 minutes? Round to the nearest tenth decimal place. Fill in the blank:
Answer: Only for registered users. Please login!
190. If the infusion ran continuously for 48 hours at the rate of 3 mcg/kg/min, how many bags of D5W, each containing 200 mg of Drug A, would the patient need?
Fill in the blank:
Answer: Only for registered users. Please login!
191. Which of the following is false regarding the Cockcroft-Gault equation?
A. A rise in serum creatinine will estimate a decrease in creatinine clearance
B. A higher lean body weight will estimate a lower overall creatinine clearance
C. Blood urea nitrogen does not factor into this equation
D. As age increases, estimated creatinine clearance will decrease
Answer: Only for registered users. Please login!
Answer the following 2 questions based on the scenario below:
With an increase in shortness of breath, JS presents to the emergency department. He has noticed that
swelling around his ankles has increased some over the last couple of days. He also reports frequent OTC
naproxen use because of a sore back.
His other diagnoses include COPD, GERD, history of myocardial infarction, heart failure, and atrial
fibrillation.
192. Which of the following monitoring parameters would be utilized to assess this patient for cardiac conduction abnormalities?
A. BNP
B. Chest X-Ray
C. Troponin
D. ECG
Answer: Only for registered users. Please login!
193. Current labs reveal:
● SpO2 = 92%
● Pulse = 98 BPM
● BP = 152/88 mmHg
● Respiratory rate = 36 resp/min
● BNP = 986 pg/mL
Which of the following agents would be most critical to administer first?
A. Nitroprusside
B. Digoxin
C. Labetalol
D. Torsemide
Answer: Only for registered users. Please login!
Answer the following two questions based on the following scenario.
The ambulance arrives at the emergency department with a 35-year-old male who was just in a car
accident. Because of the injuries to his chest, he is having an incredibly difficult time breathing and the
provider would like to intubate him.
194. Which of the following agents should be selected to ensure the most rapid intubation?
A. Dantrolene
B. Cisatracurium
C. Succinylcholine
D. Intrathecal baclofen
Answer: Only for registered users. Please login!
195. It is determined that the patient will need to be placed on a longer acting agent, pancuronium. Which of the following agents would be utilized as a reversal agent for pancuronium?
A. Pilocarpine
B. Succinylcholine
C. Fluorouracil
D. Neostigmine
Answer: Only for registered users. Please login!
196. Which of the following antihypertensive agents are considered safe for use during pregnancy?
A. Methyldopa
B. Labetalol
C. Nifedipine
D. All of the above
Answer: Only for registered users. Please login!
Answer the following 3 questions based on the scenario:
Jane is a 34-year-old female. She presents very excitedly as she recently found out she is pregnant after
years of trying. She has frequent headaches, about 4-6 per month, that range in severity. She is currently
on prophylaxis for headaches and also has severe depression.
Her current medications include:
● Sertraline
● Losartan
● Depakote
● TUMS (as-needed for heartburn)
● Nifedipine
197. Which medications should absolutely be discontinued today? Select all that apply.
A. Sertraline
B. Losartan
C. Depakote
D. Nifedipine
Answer: Only for registered users. Please login!
198. Jane is complaining of a migraine headache today and is wondering what she could take. Which is the safest initial option for abortive migraine therapy?
A. Acetaminophen
B. Ibuprofen
C. Sumatriptan
D. Fioricet
Answer: Only for registered users. Please login!
199. Three weeks later, Jane presents to the ER with a hypertensive emergency. Which of the following agents would be the best choice for immediate reduction of blood pressure and for the safety of the fetus?
A. Captopril
B. Spironolactone
C. Nitroprusside
D. Labetalol
Answer: Only for registered users. Please login!
200. A 58-year-old male is rushed to your emergency department with complaints of chest pain. He is diagnosed with unstable angina. Which of the following assessments would be most appropriate to determine the likelihood of a cardiac ischemic event and help determine the urgency for further intervention?
A. CHADS2-Vasc
B. TIMI
C. PHQ-9
D. CURB-65
Answer: Only for registered users. Please login!
201. Which of the following is the most appropriate initial urate-lowering therapy for a patient with a history of recurrent gout attacks?
A. Allopurinol
B. Febuxostat
C. Probenecid
D. Colchicine
Answer: Only for registered users. Please login!
202. With respect to medication errors, which of the following is true?
A. ‘Wrong patient’ errors are the most common medication errors
B. Medication omissions are usually the highest risk errors
C. Punitive action is the most effective strategy to improve patient safety
D. A strong emphasis should be placed on minimizing errors with high risk medications like insulin, opioids, and anticoagulants
Answer: Only for registered users. Please login!
203. Which of the following would be the least effective strategy in assessing nurses’ skill improvement following a presentation surrounding medication administration?
A. Pre and post-testing
B. Audit medication administration following presentation
C. Evaluation forms for the speaker presenting the information
D. Reviewing future medications error reports and comparing them to reports prior to the education
Answer: Only for registered users. Please login!
204. A 20-year-old female is seeking birth control. She has been reluctant to take birth control because her roommate complained about how it made her nauseous all the time. She is also worried about breakthrough bleeding. She would prefer a daily pill versus any other birth control administration method.
Which would be the most appropriate contraceptive option?
A. Levonorgestrel 0.1 mg/ethinyl estradiol 20 mcg once daily
B. Norethindrone 0.35 mg once daily
C. Mirena
D. Norgestrel 0.5 mg/ethinyl estradiol 50 mcg
Answer: Only for registered users. Please login!
Answer the following 2 questions based on the following scenario:
JT is a 54-year-old male with rheumatoid arthritis and hyperlipidemia. He presents with an LDL of 194
mg/dL, triglyceride level of 143 mg/dL, total cholesterol of 296 mg/dL, and HDL of 58 mg/dL. He has a
history of MI and is currently on simvastatin 20 mg daily.
205. Which action would be most appropriate?
A. Education regarding lifestyle changes to reduce cholesterol
B. Add Tricor
C. Add niacin
D. Recommend no changes
E. Change simvastatin to atorvastatin 40 mg daily
Answer: Only for registered users. Please login!
206. In addition to simvastatin, he is also on: ● Leflunomide ● Prednisone ● Omeprazole ● Famotidine ● Aspirin Which medication would be most likely to contribute to elevated triglycerides?
A. Leflunomide
B. Prednisone
C. Omeprazole
D. Famotidine
Answer: Only for registered users. Please login!
207. JS presents with increasing shortness of breath. He is 49 years old and has had pneumonia before, but not for a few years. He has not been recently hospitalized and has a mild fever of 101 degrees Fahrenheit. There is significant resistance to macrolide antibiotics in the community. Which of the following would be the most appropriate antibiotic selection for empiric treatment of community-acquired pneumonia?
A. Ciprofloxacin
B. Clarithromycin
C. Doxycycline
D. Vancomycin
E. Metronidazole
Answer: Only for registered users. Please login!
208. A 35-year-old female has a history of substance abuse. She also has major depression and is on sertraline 150 mg daily. She has tried 200 mg per day in the past but felt too sedated on that dose. Her PCP feels that she needs additional therapy and would like to try an atypical antipsychotic that will have a low risk for weight gain as well as sedation. Which of the following would be most appropriate?
A. Olanzapine
B. Quetiapine
C. Risperidone
D. Aripiprazole
Answer: Only for registered users. Please login!
Answer the following 4 questions based upon the scenario below:
A new medication has been developed to help with the management of fever. The medication was given
to one group of patients and a placebo was given to the other group of patients. The mean reduction in
body temperature was (0.9-2.4 degrees Fahrenheit) with a confidence level of 95%.
209. What type of data is body temperature?
A. Ratio
B. Nominal
C. Ordinal
D. Interval
Answer: Only for registered users. Please login!
210. Which of the following would be false if the data follows a normal distribution?
A. 95% of the data would fall within 2 standard deviations of the mean
B. The mean is equal to the median
C. Normal distribution classically follows a bell-shaped curve
D. The standard deviation will equal the mode
Answer: Only for registered users. Please login!
211. Is this reduction in body temperature considered statistically significant?
A. Yes
B. No
Answer: Only for registered users. Please login!
212. After review, it was noted that the participants in the treatment group had a higher average temperature at baseline than the placebo group. What type of bias would this most likely be?
A. Recall
B. Analytical
C. Selection
D. Observer
Answer: Only for registered users. Please login!
Answer the following three questions based on the following scenario:
A clinical trial has been set up and two groups were compared for reduced pain in fibromyalgia. One
group received Fibrono 25 mg daily and the other received placebo. Fibrono significantly reduced the
Somatic Symptoms Scale-8 (SSS-8) score with a p-value <0.001 compared to placebo.
213. What type of clinical research does this represent?
A. Review article
B. Controlled clinical trial
C. Cohort
D. Case study
Answer: Only for registered users. Please login!
214. What type of data is the SSS-8 scale?
A. Ratio
B. Nominal
C. Ordinal
D. Interval
Answer: Only for registered users. Please login!
215. Within a research article, under which heading would the detailed description of doses used and timeframe of the study generally be listed?
A. Discussion
B. Results
C. Conclusion
D. Methods
Answer: Only for registered users. Please login!
Answer the following 5 questions based on the scenario below:
Researchers are looking at studying the use of hydrochlorothiazide as a preventative therapy for
osteoporosis. They have set up two groups. One group will receive placebo and one will receive
hydrochlorothiazide 25 mg daily. Over the course of one year, 25 of the 950 study participants in the
hydrochlorothiazide group developed osteoporosis. In the placebo group, 33 of the 934 study
participants developed osteoporosis.
The p-value reported for the difference was 0.031 (alpha=0.05).
216. Did hydrochlorothiazide reduce the risk of osteoporosis?
A. Yes
B. No
C. Too little information to tell
Answer: Only for registered users. Please login!
217. Calculate the absolute risk reduction. Round to the nearest tenth of a percent.
Fill in the Blank:
Answer: Only for registered users. Please login!
218. What is the relative risk? Round to the nearest hundredth decimal place.
Fill in the Blank:
Answer: Only for registered users. Please login!
219. What is the relative risk reduction in percentage? Round to the nearest whole percentage.
Fill in the Blank:
Answer: Only for registered users. Please login!
220. What is the number needed to treat (NNT)?
Fill in the Blank:
Answer: Only for registered users. Please login!
221. A prescription arrives for 1.5% triamcinolone cream. The only available strengths are 3% and 0.5%.
How much 3% cream (in grams) will this compound require if the order is written for 30 grams?
Fill in the Blank:
Answer: Only for registered users. Please login!
222. A female patient comes into the pharmacy to pick up her husband’s prescriptions. She is of child bearing age. Which medication should the patient not receive or touch?
A. Flomax
B. Pantoprazole
C. Finasteride
D. Tramadol
Answer: Only for registered users. Please login!
Answer the following three questions based on the information below.
Funnypenem 100 mg/kg per day IV has been ordered. The infusion is ordered every 12 hours.
Funnypenem comes in 2 gram vials.
To reconstitute 2 grams of Funnypenem, it requires 6.8 mL of diluent. After reconstitution, the vial will
contain 10 mL with a concentration of 200 mg/mL. Funnypenem is usually added to a 50 mL bag of
normal saline and infused over one hour.
The patient’s current weight is 111 kg.
223. How many vials per dose are necessary?
Fill in the Blank:
Answer: Only for registered users. Please login!
224. What is the final concentration in the infusion bag (mg/mL)? Round to the nearest tenth decimal.
Fill in the Blank:
Answer: Only for registered users. Please login!
225. What is the powder volume (mL) of the Funnypenem vial? Round to the nearest tenth decimal place.
Fill in the Blank:
{spoiler} 3.2 mL
To calculate the powder volume of the medication in the vial, subtract the diluent volume (6.8 mL)
from the total reconstituted volume (10 mL).
10mL - 6.8 mL = 3.2 mL/spoiler}
