The sample questions that follow are NOT intended or designed to be

a sample examination and do NOT represent an exact model of the

Pharmacist Qualifying Examination-Part I, in terms of difficulty and
proportion of topics. However, individually, these examples are
intended to be representative in format and phrasing style of the
types of questions found in the Qualifying Examination-Part I. They
also illustrate a variety of the competency areas contained in the
examination blueprint. Please note that these questions are reviewed
and updated periodically.
See the bottom of the page for the answers to the sample questions.
COMPETENCY 1: Patient Care
1. RY is an 85 year old male who lives alone, currently takes 12
different medications. For the past 2 weeks he has telephoned to ask
the pharmacist what dose of diuretic he should be taking (this
medication looks similar to another tablet that he takes). He calls
again today with the same question. After answering his question, the
most appropriate pharmacist action should be to:
a. call RYs family doctor to suggest changing the diuretic to
something that looks different.
b. suggest that RY have the labels on his prescription bottles
changed to a bigger font for easier reading.
c. recommend that the pharmacy use a blister packaging dosette to
dispense RYs medications.
d. suggest that RY write down the answer to his question so that he
does not need to phone again.
e. recommend that RY have his hearing and vision tested at his next
physician visit.

2. AD is a 58 year old male with diabetes, angina and erectile

dysfunction. His physician consults the pharmacist in order to decide
if AD would be a good candidate for sildenafil. The use of sildenafil is
CONTRAINDICATED for AD if he takes:
a. isosorbide 5-mononitrate.
b. metoprolol.
c. glyburide.
d. ASA.
e. enalapril.
3. RP has a prescription for famciclovir for shingles (prescribed 2
days ago), and is uncertain about filling it, due to the high cost. Based
on the known effectiveness of famciclovir for herpes zoster, benefits
that the pharmacist should discuss with RP include:
I prevention of acute zoster-associated pain.
II faster healing time for rash.
III less and shorter duration of post-herpetic neuropathic pain.
a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III

4. Common etiologic agents of community-acquired pneumonia

include:
I Escherichia coli.
II Haemophilus influenzae.
III Mycoplasma pneumoniae.
a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III

5. Iron may decrease the absorption of which of the following

medications?
a. Ramipril
b. Atenolol
c. Moxifloxacin
d. Ibuprofen
e. Glyburide

6. Which of the following medications is the most appropriate choice

for treatment of neuropathic rather than nociceptive pain?
a. Nabilone
b. Tramadol
c. Ibuprofen
d. Meperidine
e. Nortriptyline

7. Appropriate auxiliary labelling for clarithromycin suspension

includes which of the following?
a. Shake well before using.
b. Take with plenty of fluids.
c. Avoid prolonged exposure to sunlight.
d. Keep refrigerated.
e. May cause discolouration of urine.

8. The pharmacist fills a prescription for sumatriptan 100 mg tablets

for a patient with migraine. Appropriate information to provide to the
patient includes which of the following?
a. If the sumatriptan does not relieve the headache within four
hours, ergotamine may be used.
b. If no relief is achieved in two hours, sumatriptan may be
repeated.
c. If the headache is partially relieved with a single tablet, the dose
may be repeated after two hours.
d. The maximum dosage of sumatriptan 100 mg in any 24 hour
period is six tablets.
e. If relief is not achieved, no other medication can be used for at
least 24 hours.

9. JG has been taking metoclopramide 20 mg, po q6h for the past 3

days as part of her chemotherapy regimen. She normally takes 4
doses daily, with each meal and at bedtime. This morning, she forgot
to take her morning dose before leaving home for a hospital check-
up. When she arrives at the clinic, she asks the pharmacist what she
should do about her missed dose, as she expects to be home again
around 11:00 am. The pharmacist should advise JG to:
a. take the missed dose immediately when she gets home and
continue as scheduled.
b. take two doses at lunchtime to make up for the missed dose.
c. skip the missed dose and take the next scheduled dose at
lunchtime.
d. skip todays medication and resume her normal schedule
tomorrow.
e. space 4 doses into the remaining hours between when JG gets
home and her bedtime.

10. EK is a 25 year old female who presents to the pharmacy

requesting Plan B (levonorgestrel) for emergency contraception
following an episode of unprotected sex 12 hours ago. After speaking
with EK, the pharmacist decides she is a good candidate to receive
Plan B. The pharmacist should include all of the following
information in counselling EK, EXCEPT:
a. the effectiveness of Plan B in EKs situation is likely to be better
than 90%.
b. Plan B works mainly by dislodging an implanted fertilized egg
from the endometrium.
c. EK should take two tablets of Plan B as a single dose.
d. side effects may include nausea, vomiting, breast tenderness,
cramps and spotting.
e. if vomiting occurs within one hour of dosing, a repeat dose may
be warranted.

11. All of the following are reasons that elderly patients are more
susceptible to drug-induced cognitive changes, EXCEPT:
a. they are more likely to take multiple drugs.
b. they may have hepatic dysfunction.
c. they may have renal dysfunction.
d. they are more sensitive to CNS effects of drugs.
e. they have increased metabolic rates for producing psychoactive
metabolites.

12. For a child with asthma, all of the following factors are indicators
of poor control, EXCEPT:
a. number of visits to the Emergency Room.
b. limitations on daily activities.
c. awakening at night with asthma symptoms.
d. keeping one canister of salbutamol at home and one at school.
e. number of parent work days missed due to the child illness.

13. Assessment of a patient's asthma control should include all of

the following factors EXCEPT:
a. immunization status.
b. inhalation technique.
c. use of inhaled 2 agonist.
d. use of inhaled corticosteroid.
e. changes in environmental triggers.

14. Which of the following liver enzymes is the first to be elevated in

a case of an acetaminophen overdose?
a. Lactic dehydrogenase (LDH)
b. Alanine transaminase (ALT)
c. Aspartate transaminase (AST)
d. Alkaline phosphatase (ALP)
e. Gamma glutamyl transpeptidase (GGT)

15. AJ is a 24 year old, married female, who is planning to become

pregnant in the near future. AJ has no medical conditions, no
allergies, and is not currently taking any medications. What vitamin
supplement should the pharmacist recommend to AJ to prevent
neural tube defects in her baby?
a. Niacin
b. Vitamin D
c. Folic acid
d. Pyridoxine
e. Ferrous sulphate

16. Side effects which the pharmacist should monitor in DS, when
looking for the effects of excessive topical corticosteroid use, include:
I pruritus.
II telangiectasias.
III striae.
a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III

COMPETENCY 2: Professional Collaboration and Teamwork

17. FR is a 70 year old female client who presents to the
pharmacist, complaining of nausea, diarrhea and dizziness for the
past three days. Her medication profile includes: ASA, digoxin,
enalapril, and amiodarone. She denies any recent diet changes and
the only change to her medications was the addition of amiodarone
last week. She believes she must have picked up a stomach bug
and would like something for symptom relief. The most appropriate
pharmacist recommendation for FR is to:
a. take loperamide and dimenhydrinate for symptom relief.
b. take increased fluids and bed rest until the symptoms resolve.
c. contact FRs physician to discontinue the ASA until these
symptoms resolve.
d. contact FRs physician to discontinue amiodarone until these
symptoms resolve.
e. contact FRs physician to suggest that a digoxin level be taken.

18. DS is a 27 year old male who comes to the pharmacy seeking

advice because, for the past 24 hours, he has experienced abdominal
cramping, mild fever and frequent, loose stools with some blood loss.
DS thinks it may be related to the antibiotic he has been taking for a
dental abscess. Current medications include: clindamycin 150 mg
QID x10 days, started 8 days ago, and losartan 25 mg daily for
hypertension, started 3 months ago. The most appropriate
pharmacist response is that these symptoms:
a. are expected, transient side-effects of clindamycin; treat
symptoms and continue medications.
b. may indicate an interaction between clindamycin and losartan;
pharmacist call to dentist is warranted.
c. may indicate clindamycin-related pseudomembranous colitis;
seek immediate medical attention.
d. may indicate losartan-related pseudomembranous colitis; seek
immediate medical attention.
e. are probably unrelated to DSs medications; treat for flu
symptoms and follow-up if no improvement.

19. FD, a 58 year old male with hypertension, asks the pharmacist if
cranberry juice would be useful for his current symptoms, which
include frequency and a large volume of urine, but no urgency, or
painful urination. Further questioning reveals that for the past 2
months he has also experienced polydipsia and polyphagia. The
pharmacist should refer FD to his physician because these symptoms
are consistent with:
a. cholelithiasis.
b. a urinary tract infection.
c. prostate hyperplasia.
d. diabetes mellitus.
e. renal complications of hypertension.

20. A local physician approaches the community pharmacist to

collaborate on a health promotion pamphlet addressing medication
adherence. Which of the following is NOT an appropriate topic for the
pamphlet?
a. The team relationship of the patient with both his physician and
pharmacist
b. The service of the pharmacy providing reminder calls for
medication refills
c. Advice to bring upcoming refill requests to scheduled physician
appointments
d. The various kinds of reminder packaging available to assist
patients
e. Referral to industry-sponsored consumer websites for
information regarding medications

21. Academic detailing by pharmacists provides a service to

physicians by:
a. educating on improved prescribing legibility.
b. advising on optimal patient interviewing techniques.
c. recommending strategies to avoid medication wastage.
d. providing current information on best prescribing practices.
e. promoting the use of physician samples given to patients.

COMPETENCY 3: Ethical, Legal and Professional

Responsibilities
22. According to the Narcotic Control Regulations of the Controlled
Drugs and Substances Act, which of the following practitioners may
prescribe narcotic drugs?
a. Veterinarians
b. Nurse practitioners
c. Podiatrists
d. Midwives
e. Physiotherapists

23. The ethical principle of veracity requires that pharmacists:

a. respect the rights of others to make choices.
b. do good to patients, placing the benefit of the patient over other
factors such as cost.
c. avoid, remove or prevent harm.
d. act with fairness, to allow people to receive that to which they are
entitled.
e. act with honesty, without deception.

24. JN, a 17 year old male with a highly resistant form of testicular
cancer, is in hospital for treatment. He is an intelligent, articulate
young man. His parents are insisting that the physician treat him with
the latest experimental therapy, but JN does not want to undergo the
treatment. If the physician goes ahead and gives the experimental
therapy what ethical principle will have been violated the most?
a. Confidentiality
b. Non-maleficence
c. Justice
d. Veracity
e. Autonomy

25. Which of the following medications does NOT require witnessed

destruction?
a. Ketamine
b. Nabilone
c. Diazepam
d. Testosterone
e. Gabapentin

26. The Canada Health Act (1984) embodies all of the following
principles, EXCEPT:
a. affordability.
b. accessibility.
c. comprehensiveness.
d. portability.
e. universality.

27. ST is no longer satisfied with the service she has been getting at
Pharmacy X across town, so she comes to your pharmacy requesting
a refill of 3 months supply on a prescription for an oral contraceptive
that she originally had filled at Pharmacy X. What is the correct
procedure for obtaining the remaining refills?
a. The pharmacist must contact Pharmacy X to get the prescription
refills transferred, and document the transfer appropriately.
b. The pharmacist cannot refill this prescription without phoning the
prescribing physician.
c. The pharmacist may refill the prescription as long as the patient
provides you with the label from the original prescription.
d. The pharmacist may refill the prescription and notify Pharmacy X
within 24 hours that this has been done.
e. Inform ST that the prescription resides at Pharmacy X and she
must return there for refills.

28. According to federal legislation, which of the following examples

shows a legally correct refill designation on a written prescription for
dexamphetamine?
a. Repeat twice.
b. Repeat monthly.
c. Repeat as needed.
d. Repeat twice as required.
e. Repeat twice at 14 day intervals.

29. According to the Benzodiazepine and Other Targeted

Substances Regulations, what is the expiry date for refilling a
prescription for lorazepam?
a. Six months from the date written
b. Six months from the date originally filled
c. One year from the date written
d. One year from the date originally filled
e. No specific expiry date; at the pharmacists discretion

30. The standard of publicly funded health care in Canada is

mandated by:
a. the Canada Health Act.
b. individual provinces and territories.
c. Health Canadas Health Environment and Consumer Safety
directorate.
d. Canadian Agency for Drugs and Technologies in Health.
e. National Association of Pharmacy Regulatory Authorities.

31. The pharmacist receives a phone call from a physician who

wishes to leave a verbal prescription for 30 alprazolam 0.25 mg tid,
with 2 repeats. It is a new prescription for the patient. Which of the
following statements is true?
a. Prescriptions for benzodiazepines should be filed with the
narcotic and controlled prescriptions.
b. The prescription should not be dispensed because verbal
prescriptions are not allowed for benzodiazepines.
c. The prescription may be dispensed for the original quantity only,
because refills are not permitted.
d. Transfer of this prescription is permitted as long as the
prescription is only transferred once.
e. Keeping reports of sales in a manner that permits an audit is
required for all benzodiazepines.

32. For a drug going through research and development processes

in Canada, which of the following statements is true?
a. Application for patent protection is granted for a maximum period
of three years.
b. A New Drug Submission must be filed in order to start clinical
trials.
c. Clinical trials involve three phases assessing animal safety and
efficacy.
d. Each package size of a drug product must have a unique Drug
Identification Number (DIN).
e. Health Canada under the Food & Drugs Act & Regulations
provides Notice of
Compliance.

33. Which of the following is the national voluntary organization for

advocacy of pharmacists and patient care?
a. Canadian Foundation for Pharmacy
b. Canadian Pharmacists Association
c. Canadian Patient Safety Institute
d. Institute for Safe Medication Practices
e. National Association of Pharmacy Regulatory Authorities

COMPETENCY 4: Drug, Therapeutic and Practice Information

34. Which of the following would be the most useful reference to
learn what combination of antiretroviral agents is currently
recommended as a first line therapy to treat HIV infection?
a. Meta-analyses
b. Randomized, controlled trial
c. Pharmacology textbook
d. Clinical practice guidelines
e. Compendium of Pharmaceuticals and Specialties

35. Which information source would be most appropriate to consult

first, to determine if labetalol is a cardioselective beta-blocker?
a. Compendium of Pharmaceuticals and Specialties
b. Randomized, controlled trial data
c. Meta analysis of beta blocker therapy
d. Cochrane Library database
e. Case reports

36. Type II statistical error in a study comparing 2 drug treatment

regimens occurs when:
a. the control drug is not a "gold standard" treatment.
b. a statistically significant difference exists but the difference is not
clinically important.
c. the population under investigation does not represent the
population with the disease.
d. the data shows no difference between 2 treatment regimens and
a difference actually does exist.
e. the data shows a difference between 2 treatment regimens but a
difference does not actually exist.

37. An adequately powered, randomized controlled trial conducted

over 2 years demonstrated that the primary outcome (a serious
cardiovascular event) occurred in 15% of the patients who received
the new drug, whereas the primary outcome occurred in 25% of the
patients who received a placebo. The relative risk reduction achieved
with the new drug is:
a. 10%.
b. 15%.
c. 25%.
d. 40%.
e. 50%.

38. In an adequately powered, randomized controlled trial

conducted over 3 years, a specific serious side effect (i.e. reduction in
leukocytes) with conventional therapy is seen in 0.5% of the study
sample. In patients who receive a newly discovered drug, only 0.45%
experience the same side effect. Based on these results, the
minimum number of patients that would need to receive the new drug
for 3 years to statistically demonstrate the prevention of one episode
of this side effect in at least one patient (i.e., NNT) is:
a. 15.
b. 20.
c. 150.
d. 200.
e. 2000.

COMPETENCY 5: Communication and Education

39. For elderly patients with chronic respiratory conditions, which of
the following vaccinations are usually recommended on a yearly
basis?
I Influenza virus
II Pneumococcus
III Meningococcus
a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III

40. All of the following are appropriate suggestions for a pharmacist

to give to a patient with allergic rhinitis from multiple environmental
triggers, to minimize exposure to possible allergens, EXCEPT:
a. open windows to get fresh air into the home.
b. clean and vacuum on a regular basis.
c. wash bed linens regularly in hot water.
d. use mattress and pillow covers.
e. remove any carpets, if possible.

41. DS wishes to protect her children from West Nile infection and
requests information from the pharmacist regarding insect repellents.
All of the following are correct responses from the pharmacist,
EXCEPT:
a. DEET is the most effective insect repellent available.
b. when needed, sunscreen should be applied to the skin prior to
DEET application.
c. DEET effectively binds to the skin and should not be reapplied
after swimming.
d. DEET should be washed off young children once they return
indoors.
e. products containing citronella oil have a very short duration of
effect.

42. A pharmacist is conducting public education sessions on the role

of inhaled medications in patients with asthma. Which of the
following is the most appropriate indicator of improved asthma
control?
a. A decrease in the number of bronchodilator doses used prior to
exercise.
b. A decrease in the number of bronchodilator doses used per
month.
c. A decrease in the number of corticosteroid doses used per
month.
d. An increase in the number of bronchodilator prescriptions filled
per month.
e. An increase in the number of corticosteroid prescriptions filled
per month.

43. Which of the following medications is LEAST likely to cause

embarrassment and worry about social stigma in a school-age child?
a. Insulin
b. Phenytoin
c. Venlafaxine
d. Amoxicillin
e. Methylphenidate

44. When counselling a patient who is upset over a new diagnosis

and need for medications, which of the following strategies is NOT
appropriate for the pharmacist to use?
a. Providing a private environment for the interaction
b. Advising the patient that things will be okay
c. Probing to clarify the patients concerns
d. Letting the patient vent his/her feelings
e. Ending with an encouraging statement

45. Which of the following factors that vary with cultural diversity
does NOT directly impact on pharmacist-patient dialogue and
communication?
a. Eye contact
b. Hand gestures
c. Facial expressions
d. Interpersonal space
e. Personal learning style

COMPETENCY 6: Drug Distribution

46. A biological safety cabinet would be the best choice when
preparing a parenteral formulation of:
a. aminophylline.
b. doxorubicin.
c. magnesium sulfate.
d. nitroglycerin.
e. penicillin.

47. A physician wants to switch a terminally-ill patient from slow

release morphine sulphate tablets, 15 mg twice daily, to a liquid
morphine sulphate dosage form because the patient has difficulty in
swallowing tablets. If a morphine sulphate solution containing 5 mg
per mL is prescribed q4h, what volume should be dispensed for a 20
day supply to provide the same pain relief as the tablet regimen?
a. 20 mL
b. 60 mL
c. 80 mL
d. 100 mL
e. 120 mL

48. A patient is currently taking 220 mg of anhydrous zinc sulphate.

To receive the equivalent amount of elemental zinc, how many
milligrams of zinc sulphate heptahydrate (7 H20) would the patient
have to take? (Molecular weights: zinc 65, ZnSO 4 161, H20 18)
a. 123 mg
b. 220 mg
c. 300 mg
d. 392 mg
e. 545 mg

49. Given that 30 g of a mild corticosteroid ointment covers the

entire surface of any adult for one application, how much ointment (in
grams) should be dispensed for an 18 year old patient who requires
treatment on approximately 20% of her body with twice daily
application for 14 days?
a. 6 g
b. 12 g
c. 84 g
d. 124 g
e. 168 g

50. BV is a 62 year old, obese female who visits a walk-in-clinic

while her physician is away on vacation. She presents to the
pharmacist with the following prescription:
Losec (omeprazole) 30 mg
M: 30
Sig. i daily
The pharmacist knows that this product is only available in 10 mg or
20 mg strengths and that BVs profile shows that she was previously
on the 20 mg strength of this medication. The most appropriate
pharmacist response is to:
a. tell BV that the physician has made a prescribing error.
b. ask BV why she visited the clinic today and what the physician
told her about the prescription.
c. dispense using omeprazole 10 mg and adjust the quantity and
dose accordingly.
d. assume the prescriber was thinking of Prevacid (lansoprazole)
30 mg and change the prescription accordingly.
e. recommend to BV that she wait to see her regular physician
when he returns.

51. Which of the following isLEAST appropriate to consider when a

hospital pharmacy manager is organizing assigned responsibilities for
clinical pharmacists in the department?
a. Disease/medical area of interest of the individual
b. Communication and interpersonal skills of the individual
c. Advanced training or credentials of the individual
d. Individuals length of employment at the hospital
e. Willingness of the individual to upgrade learning and skills

52. Which of the following pharmaceuticals is regulated federally

under the Precursor Control Regulations of the Controlled Drugs and
Substances Act, as a precursor chemical for illicit drug use?
a. Dextromethorphan
b. Dimenhydrinate
c. Diazepam
d. Pseudoephedrine
e. Testosterone

53. A patient has been taking an opioid analgesic for the past three
months for back pain resulting from a workplace injury. All of the
following behaviours could be indicators of a developing addiction
disorder, EXCEPT:
a. incidents of lost prescriptions.
b. frequent requests for early refills.
c. prescriptions from multiple physicians.
d. patient concerns regarding side effects.
e. patient concerns regarding lack of efficacy.

54. In a hospital pharmacy, which of the following is the most

effective strategy to enhance safety and minimize the incidence of
interpretation errors associated with verbal medication orders?
a. Use of bar code technology on medication orders
b. Use of tall man lettering on medication orders
c. Use of automated dispensing technology
d. Requirement for a read-back to the prescriber of all verbal orders
e. Restricting the acceptance of verbal orders to oral medications
only

55. Which of the following classes of medications is most likely to be

administered by the intravenous piggyback method?
a. Antibiotics
b. Opioids
c. Insulins
d. Erythropoiesis regulating hormones
e. Neuromuscular blocking agents

56. Which of the following actions would NOT contribute to

promoting a safe medication use system in a pharmacy?
a. Providing patients with information on medications
b. Attention to environmental conditions in the pharmacy
c. Offering developmental programs for staff education
d. Rotating staff regularly to assume different responsibilities and
tasks
e. Maintaining processes for documentation of medication incidents

COMPETENCY 7: Understanding Management Principles

57. MT, a pharmacy technician, has worked in a community
pharmacy for 5 years. He is well-trained and welcomes new learning
opportunities. His manager, now wanting to delegate a new technical
project to him, should:
I discuss suggested steps to accomplish the project.
II negotiate a time schedule for completion of the project.
III provide support and follow-up as required.
a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III

58. Which of the following is NOT a benefit of performing medication

reconciliation activities in a hospital setting?
a. Reduction of medication errors
b. Reduction of inventory pilferage
c. Reduction of preventable adverse effects
d. Assessment of patient adherence to therapy
e. Enhanced accuracy of patient allergy information

59. Factors that determine bioequivalence of two brands of a drug

include:
I the taste of the preparations.
II the physical appearance of the preparations.
III pharmacokinetic parameters of the preparations.
a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III

60. Which of the following criteria should be considered when

reviewing a medication for addition to the hospital formulary?
a. The amount of samples provided to hospital physicians
b. Research funds donated to the hospital by the pharmaceutical
company
c. National adverse drug reaction reports
d. Whether it is a gluten-free oral formulation
e. The length of patent period remaining

61. In deciding what medications are appropriate for its formulary,

the hospital must consider a drugs efficacy, associated workload, and
acquisition cost. Several new intravenous antifungal agents (drug A,
drug B, drug C, and drug D), all with equal efficacy to drug E, have
recently become available. Currently the hospital stocks drug E,
which has been available for several years. Data for the medications
is as follows:
Drug Dosing Treatment Duration
Cost/day Frequency (days)
A $2.50 QID 14
B $2.25 once daily 14
C $5.00 BID 7
D $2.25 BID 7
E $2.25 QID 7
The most appropriate choice for the hospital is:
a. Drug A.
b. Drug B.
c. Drug C.
d. Drug D.
e. Drug E.

The next section includes EXAMPLES OF THE CASE SCENARIO

FORMAT, in which there are two or more questions in sequence,
which are related to the patient information provided in the
(bolded) stem information shown at the top of the case.
QUESTIONS 62 TO 64 INCLUSIVE REFER TO THE FOLLOWING:
SM is a 34 year old female who, while vacationing in Mexico,
began prophylactic treatment for travellers' diarrhea. Shortly
thereafter she complained of a feeling of fullness in her ears,
black stools and a black tongue.
62. Which of the following drugs could be the cause of SM's
complaints?
a. Bismuth subsalicylate
b. Cotrimoxazole
c. Diphenoxylate
d. Loperamide
e. Attapulgite

63. Organisms commonly implicated in the cause of travellers

diarrhea include:
I Bacteroides fragilis.
II Escherichia coli.
III Shigella sp.
a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III

64. Which of the following is the most appropriate option for future
prevention of traveller's diarrhea if SM is travelling to Mexico?
a. Ciprofloxacin
b. Tetracycline
c. Erythromycin
d. Trimethoprim
e. Clindamycin

QUESTIONS 65 TO 67 INCLUSIVE REFER TO THE FOLLOWING:

PQ is a 75 year old patient who has just been diagnosed with
hypothyroidism. Her past medical history is significant for
congestive heart failure, type 2 diabetes mellitus, osteoporosis
and chronic stable angina, all of which are well-controlled. Her
medications include:
Metoprolol 25 mg bid
Calcium carbonate 1250 mg bid
Vitamin D 1000 IU daily
Glyburide 2.5 mg bid
Enalapril 10 mg bid
Furosemide 40 mg daily
Nitroglycerin SL spray prn
65. PQ should be started on a low dose of levothyroxine because of
her:
a. age.
b. gender.
c. diabetes.
d. metoprolol use.
e. nitroglycerin use.

66. Appropriate counselling and follow-up for PQ with initiation of

levothyroxine includes all of the following, EXCEPT:
a. separate the levothyroxine dose from calcium tablets by several
hours.
b. take levothyroxine on a full stomach for greater absorption.
c. improved control of thyroid levels may also improve her glycemic
control.
d. physician follow-up is needed in 6-8 weeks to have her thyroid
function tests repeated.
e. closer monitoring of her angina should be done during dosage
titration of levothyroxine.

67. Which of the following parameters is the most appropriate for

PQ's self-evaluation of the effectiveness of levothyroxine therapy?
a. Increased energy
b. Weight loss
c. Improved vision
d. Less frequent angina
e. Less frequent urination

QUESTIONS 68 TO 71 INCLUSIVE REFER TO THE FOLLOWING:

A family health team is reviewing recent guidelines for
dyslipidemia and cardiovascular risks. Physician colleagues ask
the pharmacist for information on the recommendations for
monitoring patients in various categories.
68. The current recommendation for performing a baseline plasma
lipid profile in men is to screen all males over the age of:
a. 35 years.
b. 40 years.
c. 50 years.
d. 55 years.
e. 60 years.

69. Lipid profile screening is important in all patients who have a

history of:
a. COPD.
b. GERD.
c. diabetes.
d. osteoarthritis.
e. liver disease.

70. Which of the following is the primary assessment tool

recommended to quantify a patients= 10-year risk for total
cardiovascular disease?
a. Reynolds risk score
b. Framingham risk score
c. SCORE risk estimator
d. TIMI risk score
e. CHADS II score

71. Which of the following is the most appropriate bio-marker to

assess patients who are at intermediate risk for cardiovascular
diseases and who do not otherwise qualify for lipid-lowering therapy?
a. Homocysteine
b. Creatinine clearance
c. Lipoprotein-associated phospholipase A2
d. Soluble vascular cell adhesion molecule-1
e. High-sensitivity C-reactive protein

QUESTIONS 72 and 73 REFER TO THE FOLLOWING:

HM is a regular client at the pharmacy. He has been taking
quetiapine 300 mg bid for 8 months to help control his
schizophrenia symptoms but he has recently noticed that some
of his symptoms have been worsening. Prior to starting
quetiapine, HM took risperidone therapy for 2 years. HM tells the
pharmacist that now his psychiatrist would like to change his
regimen to clozapine.
72. In assessing the possible change to clozapine for HM, which of
the following statements is the most appropriate for the pharmacist to
consider?
a. This change is appropriate, as clozapine may help for patients
who fail on other antipsychotics.
b. This change is appropriate, as most patients with schizophrenia
will eventually require clozapine.
c. This change is not appropriate, as clozapine will likely produce
the same effect as quetiapine.
d. This change is not appropriate, as the cost of monitoring and risk
of adverse effects with clozapine is too high.
e. This change is not appropriate, because the preferred
recommendation is to add clozapine to the current quetiapine.

73. HM is concerned about the possible adverse effects from

clozapine. When discussing monitoring with HM, which of the
following statements is the most appropriate to include?
a. Severe problems affecting the blood occur in about 5% of
patients taking clozapine.
b. Problems affecting the blood do occur rarely and regular blood
labwork would be recommended.
c. The risk of this problem occurring is the highest after one year or
more of treatment.
d. Blood labwork done monthly will help to avoid any adverse
effects from clozapine.
e. The prescriber has already assessed this risk and has
determined that the risk for HM is low.

QUESTIONS 74 TO 76 INCLUSIVE REFER TO THE FOLLOWING:

WW is a 55 year old, obese male (BMI 35) with newly diagnosed
type 2 diabetes. His most recent fasting blood glucose is 9.6
mmol/L and A1C is 8%. He also suffers from hypertension and
osteoarthritis in his knees. His current medications are: ramipril
20 mg daily and acetaminophen 500 mg qid.
74. Which of the following agents is the most appropriate choice for
WW at this time?
a. Gliclazide
b. Sitagliptin
c. Insulin
d. Metformin
e. Acarbose

75. If the anti-hyperglycemic agent chosen for WW is having its

intended benefit, the most appropriate therapeutic outcome would be:
a. achieving target A1C at 3 months.
b. fasting blood sugars < 6.1 mmol/L within 1-2 weeks.
c. decreased BMI within 3 months.
d. improved blood pressure control.
e. decreased 10 year coronary event risk.

76. WW would like advice regarding self-monitoring of his blood

glucose. Which of the following statements is most appropriate for
WW at this time?
a. Blood glucose should be tested upon arising and before each
meal
b. Regular self-monitoring of blood glucose may help in achieving
optimal control.
c. WW should avoid testing at alternate sites (e.g., forearm) since
accuracy is reduced in obese patients.
d. Self-monitoring will help WW to adjust the dosing of oral therapy
in relation to meal size.
e. WW should test for nocturnal hypoglycemia at least 3 times
weekly.
Part I - Answers to Sample Questions

1. (c) 39. (a)

2. (a) 40. (a)
3. (d) 41. (c)
4. (d) 42. (b)
5. (c) 43. (d)
6. (e) 44. (b)
7. (a) 45. (e)
8. (c) 46. (b)
9. (c) 47. (e)
10. (b) 48. (d)
11. (e) 49. (e)
12. (d) 50. (b)
13. (a) 51. (d)
14. (c) 52. (d)
15. (c) 53. (d)
16. (d) 54. (d)
17. (e) 55. (a)
18. (c) 56. (d)
19. (d) 57. (e)
20. (e) 58. (b)
21. (d) 59. (b)
22. (a) 60. (c)
23. (e) 61. (d)
24. (e) 62. (a)
25. (e) 63. (d)
26. (a) 64. (a)
27. (a) 65. (a)
28. (e) 66. (b)
29. (c) 67. (a)
30. (a) 68. (b)
31. (d) 69. (c)
32. (e) 70. (b)
33. (b) 71. (e)
34. (d) 72. (a)
35. (a) 73. (b)
36. (d) 74. (d)
37. (d) 75. (a)
38. (e) 76. (b)