[CLINICAL PHARMACY] MANOR SET 1

PROVERBS 16;3

E) reducing health care costs

1. Which of the ff is not an outcome included in the definition of pharmaceutical care?
   a) cure of disease
   b) elimination or reduction of symptoms
   c) arresting or slowing down of the disease process
   d) prevention of disease symptoms
   e) reducing health care costs

D) None of the above

2. Active listening consists of which of the following tasks?
   a) Focusing on what the other person says
   b) Assessing the way the other person communicates
   c) Conveying an open, relaxed, and unhurried attitude
   d) None of the above

B) the date or time the medication was stopped

3. Current prescription information included all of the ff. except:
   a) the name and description of the drug
   b) the date or time the medication was stopped
   c) the dosage of the drug
   d) the prescribed and actual dosing schedule
   e) the date and time the medication was started

C) the pharmacist may be too focused and overlook important issues

4. Which of the ff. is a disadvantage of reviewing all available information about a patient before interviewing the patient?
   a) the pharmacist feels more comfortable
   b) the pharmacist is prepared to address specific issues
   c) the pharmacist may be too focused and overlook important issues
   d) the pharmacist is completely unbiased about all aspects of the history
   e) this can be a very intimidating process

D) loss of manual dexterity

5. During the interview, the pharmacist observes that the patient's clothing has a predominance of Velcro-type fastenings. This may indicate which of the following?
   a) Photosensitivity
   b) recent weight loss
   c) recent weight gain
   d) loss of manual dexterity
   e) gout

D) all of the above

6. Skills required for patient-centered pharmacy practice include which of the following?
   a) therapeutic planning and monitoring skills
   b) physical assessment skills
   c) communication skills
   d) all of the above
   e) none of the above

E) dietary restrictions

7. Demographic patient information includes all of the ff. except:
   a) age
   b) height
   c) weight
   d) ethnic origin
   e) dietary restrictions

D) all of the above

8. What information should be documented regarding a suspected medication allergy?
   a) the date or time the reaction occurred
   b) the interventions performed to manage the reaction
   c) whether the patient has received similar medications
   d) all of the above

B) PMH

9. A patient had an appendectomy 40 years ago. This information belongs in which section of the patient case?
   a) HPI
   b) PMH
   c) SH
   d) FH
   e) ROS

B) cardiac output

📌Vital Signs include:

• Blood pressure

• Temperature

• Respiratory rate

• Heart rate

10. Vital signs include all of the following except:
    a) blood pressure
    b) cardiac output
    c) temperature
    d) respiratory rate
    e) heart rate

A) Romberg's test

11. Cerebellar function is assessed using this test:
    a) Romberg's test
    b) Doll's test
    c) Rinne's test
    d) Weber's test
    e) Snellen's chart

E) all of the above

12. Which of the following are needed to monitor patient response to drug therapy?
    a) knowledge of pharmacotherapeutics
    b) knowledge of pathophysiology
    c) communication skills
    d) physical assessment skills
    e) all of the above

C) Set therapeutic goals

13. Which of the following is the first step in the monitoring process?
    a) Monitor the response to therapy
    b) Assess the response to therapy
    c) Set therapeutic goals
    d) Integrate the monitoring plan

D) All of the above

14. Which of the following are important considerations when evaluating an original research article?
    a) Appropriateness of the study design
    b) Clinical significance of statistically significant data
    c) Study participant characteristics
    d) All of the above
    e) None of the above

D) all of the above

15. Which of the following are important components involved in the provision of drug information?
    a) determining the primary question
    b) developing an appropriate search strategy
    c) assessing available information
    d) all of the above
    e) none of the above

A) Adverse reaction

16. A consumer asks whether her new prescription drug is the cause of her insomnia. What type of drug information question is this?
    a) Adverse reaction
    b) Dosing
    c) Drug administration
    d) indication & therapeutic use
    e) poisoning and toxicology

D) indication & therapeutic use

17. A colleague asks if ipratropium bromide is FDA approved for the treatment of asthma. What type of drug information question is this?
    a) Adverse reaction
    b) Dosing
    c) Drug administration
    d) indication & therapeutic use
    e) poisoning & toxicology

C) a standard pharmacy textbook

18. Which of the following is the most appropriate source of information regarding questions of fact such as usual dosage regimens?
    a) the pharmaceutical company
    b) a colleague
    c) a standard pharmacy textbook
    d) an on-line search of the published literature
    e) all of the above

D) all of the above

19. Which of the following types of questions should be avoided while interviewing the patient?
    a) Leading questions
    b) multiple questions
    c) excessive yes/no questions
    d) all of the above
    e) none of the above

D) ultrasonography

20. Which of the following is a noninvasive test or procedure?
    a) venipuncture
    b) angiography
    c) paracentesis
    d) ultrasonography
    e) radionuclide studies

C) potassium hydroxide preparation

21. Which one of the following is a laboratory test for fungal skin infections?
    a) rapid plasma reagin test
    b) venereal disease research laboratory test
    c) potassium hydroxide preparation
    d) white blood cell count with differential
    e) cold agglutinin titer

E) gram's stain

📌Gram's stain is a microscopic/microbiological evaluation

22. The macroscopic evaluation of sputum includes all of the ff. except:
    a) color
    b) viscosity
    c) volume
    d) odor
    e) gram's stain

C) Respiratory rate

📌It's a measurable, objective parameter, unlike anxiety, indigestion, insomnia, and pain, which are subjectively reported by the patient.

23. Which of the following is not a subjective parameter?
    a) Anxiety
    b) Indigestion
    c) Respiratory rate
    d) Insomnia
    e) Pain

A) vertigo

📌Vertigo is a subjective sensation reported by the patient (a feeling of dizziness/spinning), unlike urine output, bilirubin, hemoglobin, and ejection fraction, which are all measurable objective values.

24. Which one of the following is not an objective parameter?
    a) vertigo
    b) urine output
    c) bilirubin
    d) hemoglobin
    e) ejection fraction

E) Identification of objective and subjective patient parameters

📌Rationale:

• Identification of objective and subjective patient parameters — that's part of the patient assessment/data-gathering step, not the regimen-selection process itself,

25. Which of the following is not a step in the selection of specific therapeutic regimens?
    a) Creation of a list of therapeutic options for each problem
    b) Selection of an appropriate therapeutic regimen for each problem
    c) Identification of alternative regimens
    d) Creation of a monitoring plan and monitoring of the patient
    e) Identification of objective and subjective patient parameters

B) temperature

26. Which of the following is an objective parameter?
    a) blurred vision
    b) temperature
    c) headache
    d) tinnitus
    e) fatigue

A) do good and avoid evil

27. Which of the following is the fundamental moral principle on which all ethical behavior is based?
    a) do good and avoid evil
    b) Do what is best for society as a whole
    c) Obey all national laws
    d) Maintain patient confidentiality
    e) Obey all local laws

C) raising the voice as high as necessary to be heard

28. All of the following techniques are useful in communicating with the hearing-impaired elderly patient, except:
    a) sitting at eye level in front of the patient
    b) removing audible and visual distraction
    c) raising the voice as high as necessary to be heard
    d) repeating phrases to test comprehension
    e) writing down the question

C) a patient with stable, well-controlled mild hypertension

29. For which kind of patient is the availability of monitoring data limited?
    a) a hospitalized, critically ill patient
    b) a patient just started on insulin therapy
    c) a patient with stable, well-controlled mild hypertension
    d) a patient undergoing renal dialysis
    e) a postsurgical trauma patient

D) all of the above

📌Aspirin is DOC for:

• Transient ischemic attack

• Prevention of embolic events following coronary artery bypass surgey

• Dialysis access grafts

30. Aspirin is the drug of choice used in:
    a) Transient ischemic attack
    b) Prevention of embolic events following coronary artery bypass surgery
    c) Dialysis access grafts
    d) all of the above
    e) none of the above

A) The pharmacist should have considered other patient problems

31. A patient with a dry hacking cough asks the pharmacist to recommend a cough medication. The pharmacist, who does not know the patient, recommends a popular nonprescription cough suppressant without checking the patient's medication profile. What error did the pharmacist commit?
    a) The pharmacist should have considered other patient problems
    b) The pharmacist should have recommended an expectorant
    c) The pharmacist should have advised the patient to see a physician
    d) The pharmacist should have recommended a decongestant
    e) The pharmacist should have obtained a prescription for a cough suppressant from the patient's doctor

C) Ca

32. Which of the following metallic ions is especially required in blood clotting process?
    a) Ba
    b) Na
    c) Ca
    d) Mg
    e) K

B) peptic ulcer disease

33. An endoscopy may provide a helpful clue for the diagnosis of which of the following?
    a) endocarditis
    b) peptic ulcer disease
    c) aplastic anemia
    d) diabetes mellitus
    e) constipation

D) cardiovascular and respiratory

34. Most life-threatening adverse drug reactions affect the:
    a) central nervous system
    b) liver & kidney
    c) bronchial smooth muscle
    d) cardiovascular and respiratory
    e) gastrointestinal tract

C) inotropic agents

35. The emergency treatment of patients with congestive heart failure:
    a) digitalis glycoside
    b) bed rest
    c) inotropic agents
    d) vasodilators
    e) diuretics

D) insulin

36. The responses of which of the following drugs should be monitored when it is used simultaneously with propranolol?
    a) digoxin
    b) quinidine
    c) chlorothiazide
    d) insulin

D) vitamin K

37. Warfarin anticoagulation is used for a variety of cardiac conditions. Each of the following medications increases the anticoagulant effect of warfarin, except:
    a) cimetidine
    b) quinidine
    c) phenylbutazone
    d) vitamin K
    e) none of the above

A) nosocomial

38. Infection acquired after at least 2 days in the hospital:
    a) nosocomial
    b) superficial infection
    c) secondary infection
    d) superinfection
    e) hirsutism

E) penicillin

39. The action of which of the following drugs will most likely be impaired by concurrent administration of tetracycline?
    a) chloramphenicol
    b) sulfonamide
    c) lincomycin
    d) erythromycin
    e) penicillin

C) vitamin A

40. A child shows evidence of poor growth, night blindness, dryness of the conjunctiva, keratinization of the cornea and a dry scaly skin. Which preparation is indicated for therapy?
    a) calciferol
    b) dried yeast
    c) vitamin A
    d) thiamine
    e) pantothenic acid

D) it lacks anti-inflammatory properties

41. Acetaminophen has limited value in the treatment of rheumatoid arthritis because:
    a) it frequently produces gastric irritation and bleeding
    b) it is not potent enough as an analgesic
    c) chronic usage may lead to renal damage
    d) it lacks anti-inflammatory properties
    e) it may cause methemoglobinemia

B) trihexyphenidyl

42. Drugs to be avoided by a Parkinson patient include all of the following except:
    a) reserpine
    b) trihexyphenidyl
    c) physostigmine
    d) chlorpromazine
    e) pyridoxine

A) hypothyroidism

43. Cretinism is the result of a metabolic disturbance related to:
    a) hypothyroidism
    b) hyperthyroidism
    c) hypoparathyroidism
    d) hyperparathyroidism
    e) hyperfunction of anterior pituitary

B) six months in utero and eight years

44. Tetracycline antibiotics may stain children:
    a) one month in utero and three years
    b) six months in utero and eight years
    c) birth and ten years
    d) one and a half years

B) large tongue

45. Which of the following may be a feature of acromegaly?
    a) crowded teeth
    b) large tongue
    c) hypoglycemia
    d) micrognathia
    e) eczema

E) hyperthyroidism

46. A patient is wide-eyed, very nervous with an increased systolic pressure, increased pulse rate, fine skin and hair, and loss of body weight. He is probably suffering from:
    a) diabetes
    b) hyperpituitarism
    c) hyperparathyroidism
    d) hypothyroidism
    e) hyperthyroidism

A) myocardial infarction

47. Thrombolytic agents such as streptokinase are useful for patients with:
    a) myocardial infarction
    b) hypertension
    c) congestive heart failure
    d) angina pectoris
    e) arrhythmia

B) phenytoin

48. The drug of choice in the treatment of arrhythmia caused by digitalis intoxication:
    a) phenylephrine
    b) phenytoin
    c) diuretics
    d) methyldopa
    e) clonidine

C) megaloblastic anemia, subacute combined degeneration and epithelial tissue abnormality

49. Deficiency of Vitamin B12 in the body leads to:
    a) hemolytic anemia, anorexia, loss of weight
    b) microcytic anemia, loss of appetite
    c) megaloblastic anemia, subacute combined degeneration and epithelial tissue abnormality
    d) hypertrophy of skin, burning sensation of palm and sole

A) hydrochlorothiazide

50. The most commonly used diuretic in combination with antihypertensives:
    a) hydrochlorothiazide
    b) furosemide
    c) ethacrynic acid
    d) amiloride

A) continue the same treatment, as the clinical response is often delayed

51. A 48 year old man with a history of major depressive disorder has had a recurrence. His doctor treated him with a standard dose of nortriptyline for 4 weeks without response. His blood level of nortriptyline is reported to be 30 ng/mL. His doctor may do which of the following?
    a) continue the same treatment, as the clinical response is often delayed
    b) switch to lithium
    c) decrease the dose of nortriptyline
    d) increase the dose of nortriptyline

C) PZA, streptomycin, ethambutol

52. Second line anti-tuberculosis drugs are the following, except:
    a) ethionamide, cycloserine, PAS
    b) kanamycin, viomycin, capreomycin
    c) PZA, streptomycin, ethambutol
    d) none of the above

C) blocks histamine stimulation of gastric acid secretion by H2 blocker

53. Ranitidine (Zantac) is effective in treating duodenal ulcer because it:
    a) strengthens the protective coating in the intestinal wall
    b) is an agonist at H2 receptor and therefore reduces pepsin
    c) blocks histamine stimulation of gastric acid secretion by H2 blocker
    d) none of the above

A) infective endocarditis

54. Inflammation in the inner-membranous lining of the heart usually caused by bacteria and fungi:
    a) infective endocarditis
    b) angina pectoris
    c) congestive heart failure
    d) none of the above

B) arthritis

55. Methotrexate is used as an antineoplastic agent and also used for the treatment of:
    a) hyperuricemia
    b) arthritis
    c) goiter
    d) none of the above

C) potassium chloride

56. The following are alkalinizing potassium salts, except:
    a) potassium citrate
    b) potassium acetate
    c) potassium chloride
    d) potassium gluconate

C) morphine

57. Which analgesic is useful for patients with myocardial infarction?
    a) mefenamic acid
    b) acetaminophen
    c) morphine
    d) aspirin
    e) meperidine

B) consumption of contaminated food and water

58. Mode of transmission of gastrointestinal infection:
    a) dust
    b) consumption of contaminated food and water
    c) aerosolized droplets
    d) mosquito bite

D) glyceryl trinitrate

59. Throbbing headache is characteristically produced by which of the following drugs?
    a) procainamide
    b) propranolol
    c) verapamil
    d) glyceryl trinitrate
    e) nifedipine

D) all of the above

60. Active listening includes the following tasks:
    a) focusing on what the other person says
    b) assessing the way the other communicates
    c) conveying an open, relaxed and unhurried attitude
    d) all of the above

D) all of the above

61. What information should be documented regarding a suspected medication allergy?
    a) the date or time the reaction occurred
    b) the intervention performed to manage the reaction
    c) name and description of causative agent
    d) all of the above

A) counseling area

62. Conversation regarding specific patient information and general health care issues, discussions, and debates must not take place in the following areas, except:
    a) counseling area
    b) public areas
    c) hallways
    d) elevators

B) clinical pharmacist

63. The following provide health care services and perform tasks under the direction of the physician, except:
    a) cytotechnologist
    b) clinical pharmacist
    c) medical technologist
    d) occupational therapist

C) geriatrics and long term care

64. Patient-focused practice area:
    a) outpatient clinic
    b) community pharmacies
    c) geriatrics and long term care
    d) patient's home

A) selecting the most appropriate therapeutic agents for drug therapy

65. As a health care team member, the pharmacist provides drug information to physicians and other health professionals aimed at:
    a) selecting the most appropriate therapeutic agents for drug therapy
    b) providing needed drugs and supplies
    c) providing drug information to the physician
    d) providing in-service education informally on rounds

B) Check for drug sensitivities and interactions

66. Hospital pharmacists maintain medication profiles for in-patients and out-patients and use these to:
    a) Define the therapeutic goals and endpoints of drug therapy
    b) Check for drug sensitivities and interactions
    c) Reflect the methods for drug administration
    d) all of the above

D) All of the above

67. Chronic diseases diagnosed and stabilized by physician and maintenance care is provided by the pharmacist:
    a) Hypertension and Congestive Heart Failure
    b) Diabetes and Angina
    c) Mental health disorders and psoriasis
    d) All of the above

B) prevention of disease/symptoms

68. Non-compliance to therapeutic regimens may result in the ff. except:
    a) additional diagnostic evaluation
    b) prevention of disease/symptoms
    c) hospitalization
    d) unnecessary multiple regimens

A) adverse drug reaction

69. Are unwanted pharmacological effects associated with medication:
    a) adverse drug reaction
    b) side effects
    c) toxidrome
    d) all of the above

A) vitamin B12 deficiency

70. Pale red blood cells resulting from decreased hemoglobin content occurs in following conditions, except:
    a) vitamin B12 deficiency
    b) Thalassemia
    c) Microcytic anemia
    d) iron deficiency anemia

C) both of the above

71. Tetracycline is contraindicated for children because:
    a) it causes discoloration of teeth
    b) severe gastric disturbance
    c) both of the above
    d) none of the above

A) provide drug information

72. The purpose of patient-focused services is to improve patient's quality of life. The outcomes include the following, except:
    a) provide drug information
    b) cure of the disease
    c) prevention of disease
    d) elimination or reduction of symptoms

A) basic knowledge of laboratory tests and results

73. Requirements in order to properly implement the philosophy of pharmaceutical care, except:
    a) basic knowledge of laboratory tests and results
    b) a good understanding of disease process
    c) provision of drug information
    d) therapeutic planning skills

B) pharmacist

74. Interpret the drug orders from the chart:
    a) nurse
    b) pharmacist
    c) physician
    d) all of the above

C) Nucleated RBCs

75. Associated with intense marrow erythropoietic activity:
    a) Basophilic stippling
    b) Heinz bodies
    c) Nucleated RBCs
    d) Schistocytes

C) Low density lipoprotein

76. Its increase is strongly correlated with coronary artery disease:
    a) Triglycerides
    b) High density lipoprotein
    c) Low density lipoprotein
    d) Lipids

A) renal disease and bladder infection

77. Proteinuria occurs with many conditions such as:
    a) renal disease and bladder infection
    b) multiple myeloma
    c) diabetes mellitus
    d) diabetes insipidus

A) Diabetes mellitus

78. Glucosuria usually indicates the presence of:
    a) Diabetes mellitus
    b) Diabetes myeloma
    c) Multiple myeloma
    d) Acute hepatitis

C) hypothyroidism and growth retardation

79. Alkaline phosphatase below normal value indicates:
    a) bone fracture
    b) liver inflammation
    c) hypothyroidism and growth retardation
    d) bile duct obstruction

C) Hemolysis

80. Situation wherein there is an increase in total bilirubin; direct bilirubin is usually normal or slightly elevated and urine color is normal and no bilirubin is found in the urine:
    a) Biliary stone
    b) Cirrhosis
    c) Hemolysis
    d) Iron deficiency anemia

C) Dehydration and shock

81. When albumin level is above normal, it indicates:
    a) Neoplastic disease
    b) Hepatic insufficiency
    c) Dehydration and shock
    d) Malnutrition

C) Urinalysis

82. It provides basic information regarding renal function, urinary tract disease and the presence of certain systemic diseases:
    a) Creatinine clearance
    b) Blood urea nitrogen
    c) Urinalysis
    d) Renal function tests

A) diabetes insipidus

83. Specific gravity of urine is elevated in the following conditions, except:
    a) diabetes insipidus
    b) diabetes mellitus
    c) nephrosis
    d) all of the above

D) Starvation and zero low carbohydrate diets

84. Ketonuria usually indicates uncontrolled diabetes mellitus, but it may also occur with:
    a) Systemic bleeding disorder
    b) Gout
    c) Trauma and tumor
    d) Starvation and zero low carbohydrate diets

D) Gout

85. Above normal level of uric acid indicates:
    a) Urinary tract infection
    b) Urethral contamination
    c) Acute hepatitis
    d) Gout

D) Cystitis

86. Below normal level of uric acid indicates:
    a) Urethral contamination
    b) Urinary tract infection
    c) Gout
    d) Cystitis

D) Lymphocytes

87. It plays a dominant role in immunologic activity and appear to produce antibodies:
    a) Neutrophils
    b) Basophils
    c) Monocytes
    d) Lymphocytes

D) B lymphocytes

88. Derived from the bone marrow, it provides humoral immunity and produces antibodies:
    a) Leukocytes
    b) Monocytes
    c) T lymphocytes
    d) B lymphocytes

C) Complete blood count

89. Consists of the hemoglobin, hematocrit, red blood cell count, WBC count, mean cell volume, mean cell hemoglobin and mean cell hemoglobin concentration:
    a) Red blood cell inclusions
    b) Blood smear
    c) Complete blood count
    d) Burr cells

A) Liver disease

90. When Blood Urea Nitrogen is above the normal values, it indicates the following conditions, except:
    a) Liver disease
    b) Renal disease
    c) Gastrointestinal bleeding
    d) Dehydration

B) drug efficacy

91. This refers to the maximum effect a drug can produce, regardless of the dose required to produce the effect:
    a) drug potency
    b) drug efficacy
    c) drug threshold
    d) drug response

D) applicability

92. Refers to the likelihood that the study results can be useful for clinical decision making:
    a) reasoning
    b) validity
    c) evaluative
    d) applicability

B) synergism

93. This occurs whenever the combined effect of two drugs with different sites of activity is greater than the algebraic sum of their independent effects:
    a) summation
    b) synergism
    c) potentiation
    d) heterergic

B) The Medical Letter

94. Primary sources of drug information, except:
    a) Medical Journals
    b) The Medical Letter
    c) Pharmacy and Pharmacology Journals
    d) none of the above

D) all of the above

95. MAO enzymes inactivate:
    a) adrenaline
    b) noradrenaline
    c) serotonin
    d) all of the above

B) sulfisoxazole

96. Kernicterus is a drug induced disorder that may occur in the neonate following therapy with which of the following drugs?
    a) isoniazid
    b) sulfisoxazole
    c) phenytoin
    d) gentamicin

A) arsenicals

97. Drugs capable of inducing hemolysis, except:
    a) arsenicals
    b) aspirin
    c) chloramphenicol
    d) probenecid

A) assess the response to therapy

98. Which of the following is the last step in the monitoring process?
    a) assess the response to therapy
    b) monitor the response to therapy
    c) set therapeutic goals
    d) integrate the monitoring plan

D) a standard pharmacy textbook

99. Which of the following is the most appropriate source of information regarding questions of fact such as usual dosage regimens?
    a) a colleague
    b) drug manufacturer
    c) an on-line search of the published literature
    d) a standard pharmacy textbook

D) none of the above

100. Secondary and tertiary literature consist of the following, except:
     a) compiled databases
     b) review articles published in journals
     c) textbooks
     d) none of the above