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CLINICAL PHARMACY

E 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 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 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 4. Which of the ff. is a disadvantage of reviewing all available information about a patient before interviewing the
patient?
a. the pharmacists 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 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 d. loss of manual dexterity
b. recent weight loss e. gout
c. recent weight gain

D 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 7. Demographic patient information includes all of the ff. except:


a. age d. ethnic origin
b. height e. dietary restrictions
c. weight

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

B 10. Vital signs include all of the following except:


a. blood pressure d. respiratory rate
b. cardiac output c. heart rate
c. temperature

A 11. Cerebellar function is assessed using this test:


a. Romberg's test d. Weber's test
b. Doll's test e. Srellen's chart
c. Rinnes test

E 12. Which of the following are needed to monitor patient response to drug therapy?
a. knowledge of pharmacotherapeutics

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b. knowledge of pathophysiology
c. communication skills
d. physical assessment skills
e. all of the above

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

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

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

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

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

D 20. Which of the following is an noninvasive test or procedure?


a. venipuncture d. ultrasonography
b. angiography c. radionuclide studies
c. paracentesis

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

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

C 23. Which of the following is not a subjective parameter?

a. Anxiety d. Insomnia
b. Indigestion e. Pain

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c. Respiratory rate

A 24. Which one of the following is not an objective parameter?


a. vertigo d. hemoglobin
b. urine output e. ejection fraction
c. bilirubin

E. 25. Which of the following is not a step in the selection of specific therapeutic regimens?
a. Creation is 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 26. Which of the following is an objective parameter?


a. blurred vision d. tinnitus
b. temperature e. fatigue
c. headache

A 27. Which of the following is the fundamental moral principle on which all ethical behavior 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 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 29. For which kind of patient is the availability of monitoring date 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 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 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 32. Which of the following metallic ions is especially required in blood clotting process?
a. Ba c. Ca e. K
b. Na d. Mg

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

D 34. Most life-threatening adverse drug reactions affect the:


a. central nervous system d. cardiovascular and respiratory system
b. liver & kidney system e. gastrointestinal tract
c. bronchial smooth muscle

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C 35. The emergency treatment of patients with congestive heart failure


a. digitalis glycoside d. vasodilators
b. bed rest e. diuretics
c. inotropic agents

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

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

A 38. Infection acquired after at least 2 days in the hospital


a. nosocomial d. superinfection
b. superficial infection e. hirsutism
c. secondary infection

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

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

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

A 43. Cretinism is the result of a metabolic disturbance related to


a. hypothyroidism d. hyperparathyroidism
b. hyperthyroidism e. hyperfuncation of anterior pituitary
c. hypoparathyroidism

B 44. Tetracycline antibiotics may stain children:


a. one month in utero and three years
b. six month in utero and eight years
c. birth and ten years
d. one and half years

B 45. Which of the following may be a feature of acromegaly?


a. crowded teeth d. micrognathia
b. large tongue e. echma
c. hypoglycemia

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

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

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

C 49. Deficiency of Vitamin B12 in the body leads to:


a. hemolytic anemia, anoxeria, loss weight
b. mlicromatic anemia, los appetite
c. megaloblastic anemia,subacute combined degeneration and epithelial tissue abnormality
d. hyperthropy of skin, burning sensation of palm and sole

A 50. The most commonly used diuretic incombination with antyhypertensives


a. hydrochlorothiazide c. ethacrynic acid
b. furosemide d. am iloride

A 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
mg/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 52. Second line anti-tuberculosis drugs are the following, except:


a. ethionamide, cycloserine, pas c. pza,streptomycin,ethambutol
b. kanamycin, viomycin,capreomycin d. none of the above

C 53. Ranitide (Zantac) is effective in treating duodenal ulcer because it;


a. strengthens the productive coating in the intestinal wall
b. is an agonist at H2 receptor and therefore reduce pepsin
c. blocks histamine stimulation of gastric acid secretion by H2 blocker
d. none of the above

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

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

C 56. The following are alkanizing potassium salts, Except:


a. potassium citrate c. potassium chloride
b. potassium acetate d. potassium gluconate

D 57. Which analgesic is useful for patients with myocardial infarction?


a. mefenamic acid d. aspirin
b. acetaminophen e. meperidine
c. morphine

B 58. Mode of transmission of gastrointestinal infection


a. dust
b. consumption of contaminated food and water
c. aerosolize droplets
d. mosquito bite

D 59. Throbbing headache is characteristically produced by which of the following drugs?


a. procainamide d. glyceryl trinitrate
b. propranolol e. nifedipine
c. verapamil

D 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

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D 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 reactions
c. name and description of causative agent
d. all of the above

A 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 c. hallways
b. public areas d. elevators

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

C 64. Patient-focused practice area


a. outpatient clinic c. geriatrics and long term care
b. community pharmacies d. patient's home

A 65. As a health care team, the pharmacist provide 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. provide in-service education informally on rounds

B 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 sensitiveness and interactions
c. Reflect the methods for drug administration
d. all of the above

D 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 68. Non-compliance to therapeutic regimens may result in the ff. except:


a. additional diagnostic evaluation c. hospitalization
b. prevention of disease/symptoms d. unnecessary multiple regimens

A 69. Are unwanted pharmacological effects associated with medication


a. adverse drug reaction c. toxidrome
b. side effects d. all of the above

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

C 71. Tetracycline is contraindicated for children because:


a. it causes discoloration of teeth c. both of the above
b. severe gastric disturbance d. none of the above

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

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

B 74. Interpret the drug orders from the chart:


a. nurse c. phycisian
b. pharmacist d. all of the above

C 75. Associated with intense marrow erythropoitic acticity


a. Basophilic stippling c. Nucleated RBCs

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b. Heinz bodies d. Schistocytes

C 76. Its increase is strongly correlated with coronary artery disease


a. Tryglicerides c. Low density lipoprotein
b. High density lipoprotein d. Lipids

A 77. Proteinuria occurs with many conditions such as:


a. renal disease and bladder infection c. diabetes mellitus
b. multiple myeloma d. diabetes insipidus

A 78. Glucosuria usually indicates the presence of:


a. Diabetes mellitus c. Multiple myeloma
b. Diabetes myeloma d. Acute hepatitis

C 79. Alkaline phosphatase below normal value indicates


a. bone fracture
b. liver inflammation
c. hypothyroidism and growth retardation
d. bile duct obstruction

C 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 c. Hemolysis
b. Cirrhosis d. Iron deficiency anemias

C 81. When albumin level is above normal, it indicates:


a. Neoplastic disease c. Dehydration and shock
b. Hepatic insufficiency d. Malnutrition

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

A 83. Specific gravity of urine is elevated in the following conditions, except:


a. diabetes insipidus c. nephrosis
b. diabetes mellitus d. all of the above

D 84. Kenoturia 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 85. Above normal level of uric acid indicates


a. Urinary tract infection c. Acute hepatitis
b. Urethral contamination d. Gout

D 86. Below normal level of uric acid indicates


a. Urethral contamination c. Gout
b. Urinary tract infection d. Cystitis

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

D 88. Derived from the bone marrow, it provides humoral immunity and produce antibodies
a. Leucocytes c. T lymphocytes
b. Monocytes d. B lymphocytes

C 89. Consists of the hemoglobin, hematocrit, red blood cell count, WBC count, mean cell volume, mean cell
hemoglobin and mean cell hemoglobin count
a. Red blood cell inclusions c. Complete blood count
b. Blood smear d. Burr cells
A 90. When Blood Urea Nitrogen is above the normal values, it indicates the following conditions, except:
a. Liver disease c. Gastrointestinal bleeding
b. Renal disease d. Dehydration

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

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

B 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 c. potentiation
b. synergism d. heterergic

B 94. Primary sources of drug information, except:


a. Medical Journals c. Pharmacy and Pharmacology Journals
b. The Medical Letter d. none of the above

D 95. MAO enzymes inactivates:


a. adrenaline c. serotonin
b. noradrenaline d. all of the above

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

A 97. Drugs capable of inducing hemolysis, except:


a. arsenicals c. chlorampenicol
b. aspirin d. peobenecid

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

D 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 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

C 101. This is a metabolic disease caused by insufficiency on the levels of the enzyme phenylalanine hydroxylase:
a. ketoacidocis c. phenylketonuria
b. idiosyncrasy d. none of the above

B 102. It is an altered response that is caused in a cell by the drug:


a. drug action c. drug safety
b. drug effect d. drug interaction

C 103. It refers to the in-vivo phenomenon that occurs whenever an interactant chemical modifies the expected
therapeutics results of a drug.
a. Adverse drug reactions c. Drug interaction
b. Anaphylaxis d. Idiosyncrasy

B 104. It is a genetically determined abnormal response to ordinary doses of a drug


a. Anaphylaxis c. Drug allergy
b. Idiosyncrasy d. none of the above

D 105. Which of the following are important considerations when evaluating a literature review?

a. publication date
b. author expertise
c. way the author selected the primary research article
d. all of the choices

C 106. Defined as an organized, directed post –graduate training program in a define area of pharmacy practice:
a. training c. residency
b. practicum d. none of these

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A 107. Tour of a specific area with visits to the patient’s bedside together with the various members of the health care
team:
a. rounds c. KARDEX
b. training d. patient

B 108. A term used to denote hypersensitivity to specific substance:


a. antigen c. antibody
b. allergy d. ADR

E 109. A pathogen is:


a. a bacillus d. a septic substance
b. a virus e. any disease producing organism
c. a carcinogen

C 110. Outpatient health care settings include the following except:


a. clinics c. rehabilitation centers
b. day surgery units d. emergency rooms

A 111. The best way to deal with physically challenged patients is to do the ff:
a. treat them like any other patients c. stare at them
b. avoid making eye contact d. ignore them

B 112. The best way to deal with antagonistic patient is to do which of the following:
a. avoid them
b. limit the length of each interaction
c. talk with the legal guardians
d. speak slowly and distinctively

D 113. A patient’s states that he has smoked two packs of cigarettes a day for 30 years. What is the patient’s pack year
smoking history?
a. 2 packs c. 30 packs years
b. 15 packs years d. 60 packs years

A 114. Which of the following questioning techniques is least likely to result in accurate assessment of patient
compliance?
a. direct questioning c. sympathetic confrontation
b. gentle probing d. nonjudgemental questioning

B 115. Which of the following is a disadvantage of documenting a medication history using the freestyle format?
a. the format is inflexible
b. scanning the document for specific details is difficult
c. space may not be available for all patient information
d. all of the above

B 116. Is the act of transmitting facts, feelings and meanings by words, gestures or other actions:
a. counseling c. consulting
b. communication d. all of these

B 117. Can result in cancer or “birth defects” in cells of an offspring.


a. germ cell mutation c. replication
b. somatic cell mutation d. mitosis

B 118. A type of drug reaction which requires immediate treatment and is often fatal:
a. drug allergy c. tachyphylaxis
b. anaphylaxis d. none of the above

C 119. It is a legal document that includes section for hospital specific admission, initial history, physical exam, daily
progress notes, etc.
a. medical record c. both a and b
b. patient chart d. none of the choices

B 120. Responsible for the physical and psychosocial needs of patients and carry out physician directed orders
regarding patient care:
a. resident physicians c. clinical pharmacists
b. nurses d. dieticians

A 121. Diabetes mellitus should be considered in which of the following conditions, except:
a. shortness of breath d. frequent urination
b. blurred vision e. unexplained weight loss
c. monilial vaginitis

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B 122. The ability to shift attention in demand, adapting to the total flow of communication
a. clarification c. sequencing
b. flexibility d. none of the above

B 123. The following are true for health care team, except:
a. health teams include nurses, physicians, pharmacists, etc.
b. health care teams are health personnel from a single or common
discipline or specialization
c. members of a health care teams deal with various aspects of the
care and management of a patient

C 124. Area within the pharmacy curriculum which deals with patient care with emphasis on drug therapy:
a. dispensing pharmacy d. both a and c
b. radiopharmacy e. all of the above
c. clinical pharmacy

C 125. Reaction which arise from the known pharmacological action of the drug and may be due to excessive dose of a
drug
a. precaution d. type B ADR
b. contraindication e. drug interactions
c. type A ADR

B 126. This identifying information includes: color, birthplace, nationality, religion, and social status:
a. informant d. occupation
b. racial stock e. none of the above
c. admission

C 127. Best type or mode or questioning during the middle phase of interview:
a. questions answerable with yes or no
b. open question
c. open – ended question
d. direct question
e. any type

B 128. A basic component of clinical pharmacy practice where in the pharmacist gives advice on therapeutic matters to
the patient or other members of the health field.
a. communication c. consulting
b. counseling d. all

E 129. Before entering the patient’s room, the pharmacist should NOT:
a. note the patient’s social and occupational history
b. know the physical condition of the patient
c. make a mental preparation
d. learn the ID of the patient
e. none

A 130. The following statements are correct about the pharmacist conducting and interview, except:
a. he/she should be the only one asking questions
b. he/she should avoid repetition during interviews
c. he/she must also listen to the patient’s statements
d. none of the above

A 131. Tetracycline – Iron preparation produces complexation reaction when give concurrently, what is the best
management for this combination?
a. do not give them concurrently
b. replace iron with other vitamin supplement
c. drink plenty of water
d. replace tetracycline with other antibiotic

B 132. Care centers with diagnostic and treatment facilities that may or may not be attached to or associated with an
acute care hospital:
a. day care centers c. health centers
b. ambulatory care centers d. medical centers

C 133. Physical and emotional stress can trigger the production of:
a. asthma
b. angina pectoris, congestive heart failure
c. both of the above
d. none of the above

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A 134. A type of radiologic procedure wherein a substance is instilled into the rectum for the purpose of examining the
large intestines and the rectum:
a. Barium enema d. all of the above
b. barium meal e. none of the choices
c. barium chloride test

E 135. The triad of tremor, rigidity, and bradykinesia is associated with which one of the following?
a. rheumatoid arthritis c. angina pectoris
b. mania e. parkinsonism
c. hyperthyroidism

B 136. Primary means to achieve the goal of clinical interview


a. literary skills c. culinary skills
b. effective communication d. counseling

C 137. Generally, the presence of the impaired renal function or overt renal failure in a patient reduce his requirements
for:
a. all drugs
b. drugs that are reabsorbed from the kidney tubules
c. drugs that are directly excreted or which are actively metabolized
by the liver and are excreted by the kidney
d. b and c

D 138. A test for kidney function is:


a. CBC d. BUN
b. CHF e. EKG
c. KFT

C 139. Type of drug distribution system wherein the prescription is compounded and dispensed in the usual manner as
in the purchase of medicines from a local drug store
a. free floor stock
b. charge floor stock
c. individual prescription medication
d. unit dose dispensing
e. coordinated

A 140. The following are purposes of the admission history except:


a. to record the address of the patient unsettled account
b. to patient’s chief complaint
c. to record the description of his/her present illness
d. all of the above

D 141. The ff. are the qualities of the introduction in the interview process, except:
a. make positive identification of the patient
b. some respect to the patient
c. demonstrate confidence and strength of the interview
d. none of the above

D 142. The recognition of the disease by its signs and symptoms


a. prognosis c. diagnosis
b. diaphoresis d. assessment

B 143. Patients about to undergo electroconvulsive therapy (ECT) are usually given succinycholine
a. reduce the severity of the central nervous system (CNS) are usually given succinylcholine
b. modify muscular constractions to prevent injury to the patient
c. lengthen the duration of the convulsion
d. prevent hype

C 144. In this serve form of erythema multiforme, there is involvement of the oronasal anogenic mucosa.
a. exfoliative dermatitis c. Steven Jhonson’s syndrome
b. photosensitive eruptions d. all of these

D 145. Having a professional obligation to disseminate drug information appropriately


a. teacher c. sales clerk
b. medical practitioner d. pharmacist

B 146. Type of patient who requires the service of the hospital during the critical time of his illness or injury, a time he
may not be able to make his needs known:
a. home care patient d. self-care patient
b. intensive care unit e. none of the choices
c. chronic care patient

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A 147. Type of endocarditis which involves a more virulent organism and resists the body’s natural defense mechanism
a. acute endocarditis c. right sided endocarditis
b. subacute endocarditis d. none of the above

B 148. Introduction of a virus or disease producing microorganism into the body to give protection against certain
disease/s:
a. injection c. inspissation
b. inoculation d. none of the above

A 149. Which of the following is not a sign or symptom occurring in CHF?


a. Bradycardia d. decrease exercise capacity
b. Shortness of breath e. edema
c. Hepatomegaly

D 150. Major dimensions of clinical interview:


a. interpersonal experience c. communication
b. scientific inquiry d. both a and b

A 151. Foundation of clinical pharmacy, except:


a. compounding d. patient counseling
b. drug information e. patient education
c. drug monitoring

E 152. The following are fundamental functions of the hospital, except:


a. taking care of the sick and the injured
b. education of medical and allied health profession and the patients
c. research for the advancement of medical knowledge against disease
d. all of the choices
e. none of the choices

B 153. Most highly trained expert on drugs and has the best opportunity to keep up to date on developments in this field:
a. physician c. nurse
b. pharmacist d. medical technologist

D 154. Objectives of clinical pharmacy include the ff. except:


a. to study the patient’s disease and be able to identify problems
b. to describe the desired drug therapy including therapeutic alternatives
c. to be able to select the most appropriate treatment
d. none of the above

A 155. A patient who has recently suffered a myocardial infarction will most likely have elevated serum levels of:
a. createnine phosphokinase d. alkaline phosphatase
b. amylase e. cholinesterase
c. acid phosphatase

A 156. Inflammation of the tongue


a. glossitis c. tongusitis
b. tonsilitis d. both a & c

C 157. The admission sheet should contain the following except:


a. the unit record number c. laboratory test result
b. the patient’s name d. admission diagnosis

C 158. Hypothyroidism should be treated with daily administration of which one of the following thyroid hormone
preparations?
a. dextrothyroxine d. methimazole
b. propylthiouracil e. chlorpropamide
c. thyroxine

D 159. The conclusion of an interview should contain the ff. except:


a. request for additional information from patient
b. request for patients opinion
c. opportunity for the patient to make corrections if necessary regarding the interview
d. none of the above

C 160. The hematocrit measures the :


a. total number of blood cells per volume of blood
b. number of red blood cell per volume of blood
c. percentage of red blood cells per volume of blood
d. weight of hemoglobin per volume of blood

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e. weight of red blood cells per volume of blood

C 161. Patient who is able to walk:


a. in-patient d. hospitalized patient
b. ICU patient e. none of the above
c. ambulatory patient

D 162. A common result of “slow metabolic acetylation” of isoniazid is


a. enhanced sensitivity to theraphy and toxicity
b. peripheral neuropathy that is resistance to pyridoxine therapy
c. slow metabolism and enhance therapeutic response
d. slow acetylation but normal therapeutic response

B 163. Diabetes mellitus affects:


a. protein metabolism d. lipid metabolism
b. carbohydrate metabolism e. all of the above
c. purine metabolism

B 164. The inability to control elimination of urine and the feces:


a. defecation d. pyresis
b. incontinence e. diuresis
c. emesis

A 165. In monitoring drug theraphy, it must be ensured that the patient receives drugs that are:
a. effective, safe c. all of the above
b. least effective d. none of the above

C 166. A common disease affecting teenagers primarily, which is precipitated by occlusion of the dust-draining
sebaceous glands
a. psoriasis c. acne vulgaris
b. urticaria d. photoallergic reaction

C 167. The ff. are clinical functions of pharmacist except:


a. participate in in-service and patient education program
b. assessing for drug interaction and adverse reactions
c. taking quarterly physical inventory
d. preparation of medication

E 168. Which is not a sign and symptom of DM?


a. delayed wound healing d. excessive hunger and thrist
b. blurred vision e. tachypnea
c. dryness of skin

C 169. Htperalimentation is indicated for


a. Renal and Hepatic failure c. both of the above
b. Crohns disease d. none of the above

B 170. The protrusion of a loop or knuckle of an organ or tissue through an


Abnormal opening:
a. fracture c. puncture
b. hernia d. none of the above

B 171. Is the totality of services offered by all health disciplines:


a. social security system c. medicare
b. health care system d. all of these

A 172. Abnormal reactivity of the skin to sunlight,


a. photosensitivity c. multiforme eruptions
b. photosynthesis d. none of the these

B 173. The ff. are the clinical functions of the pharmacist except:
a. participation in the education of health care practitioners
b. diagnosis
c. preparation of medical history for patients medical record
d. participation in drug use review and other quality assurance program
e. patient education and counseling

B 174. Gross and microscopic examination of tissues or cells removed from a living patient, for the purpose of
determining the diagnosis or prognosis of disease, or the confirmation of normal conditions:
a. phlebotomy d. x-ray
b. biopsy e. none of the above

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c. surgery

C 175. Factors that influence the development of clinical pharmacy:


a. unresponsiveness of health care delivery systems to drug therapy problems
b. overeducated and under utilized pharmacist
c. both
d. neither

A 176. Pharmacists provide pharmaceutical care by


a. communicating with patients and other health care providers
b. treating patients
c. both
d. neither

B 177. The drug of choice for congestive heart failure is:


a. tetracycline c. quinidine
b. digitalis glycosides d. done

A 178. Should not be added to intravenous solutions of amphotericin B to prevent salting out of the drug:
a. electrolytes c. antibiotics
b. vitamins

A 179. A decrease in the hemoglobin content of the RBC’s


a. hypochromia c. macronomia
b. normochromia d. target cells

A 180. A 32-year-old man presents with repetitive generalized motor convulsions that continue for 35 minutes until 10
mg of diazepam are administered intravenously. The next course of action should be to administer:
a. phenytoin intravenously d. thiopental intravelously
b. carbamazepine orally e. propranolol intravenously
c. ethosuximide orally

B 181. Non-selective beta-blockers are the following, except:


a. Pindolol c. Nadolol
b. Metoprolol d. none of the above

D 182. Indicative of rapid gastrointestinal transit and malabsorption syndromes


a. black stools c. hard stools
b. gray stools d. water stools

B 183. These are drugs in chronic bronchitis, except:


a. sympathomimetic agents c. anticholinergic
b. beta-adrenergic blocking agent d. none

A 184. Focuses on preventing complications of disease conditions


a. secondary care c. tertiary care
b. primary care d. quaternary care

A 185. Which of the following hormones of the anterior pituitary act on other endocrine glands
1. growth hormone
2. antidiuretic hormone
3. adrenocorticotropic hormone
4. thyroid-stimulating hormone
a. 3 and 4 c. 2, 3, and 4
b. 1, 2 and 4 d. 1, 2, 3, and 4

C 186. The following statements are correct, except:


a. the interviewer should become familiar with what questions to ask
b. the interviewer should know the patient’s background
c. the interviewer should be persistent and should insist in getting the answer from the patient
d. the physical state of the patient should be considered before the start of interview

B 187. A patient wearing shoes with toes and other areas cut out may suggest a history of what disease:
a. photosensitivity c. recent weight loss
b. gout d. none of the above

C 188. Which drug is said to possess a high first pass liver metabolism?
a. Aspirin d. Digoxin
b. Amikacin e. Penicillin
c. Nitroglycerin

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A 189. The clinical pharmacist function focuses on


a. the patient c. educational and training
b. cost effective therapy d. drug product

A 190. Counsels clients and support persons about social problems such as finances, marital difficulties and adoption of
children
a. social worker c. physician
b. chaplains d. physchologist

B 191. This is a disorder marked by permanent alveolar enlargement distal to the terminal bronchioles and there is
inflammation and excessive mucuous secretion which cause air trapping in the alveoli:
a. chronic bronchitis c. pulmonary
b. emphysema d. none

A 192. The alternative drug for meclizine HCL;


a. scopolamine c. eserine
b. hyoscyamine d. ergotamine

D 193. Which psychotropic drug has a long duration of action in the geriatric patient because of lipid storage
a. Digoxin d. Chlorpromazine
b. Cipsplatin e. Aspirin
c. Amikacin

B 194. A young male patient who is receiving medication for hypertension complains of mental depression, tremors and
rigidity of limbs, and impairment of sexual function. This patient is most likely being treated with:
a. guanethidine c. propranolol
b. reserpine

B 195. Complete blood count consist of the following except:


a. hematocrit c. WBC count
b. platelet count d. hemoglobin

A 196. A nondrug theraphy for angine pectoris is:


a. avoiding strenuous exercise c. both
b. taking nitrates d. none

B 197. This anti-ulcer drug competitively inhibit the action of histamine, reducing the volume and hydrogen ion
concentration of gastric acid secretions
a. antacid c. anticholinergic
b. H2-receptor antagonist d. none

A 198. Tradionally called nursing homes


a. long term care facilities c. hospices service
b. rehabilitation centers d. day care centers

C 199. A chart based on the identified problem list, present or potential, with patient:
a. patient-oriented chart c. problem-oriented medical chart
b. source-oriented system chart d. computer assisted chart

D 200. Effective way of taking the patients medical history


a. direct questioning c. either
b. indirect questioning d. both

B 201. Which hormone aids in the conversion of glycogen to glucose in the liver:

a. insulin c. estrogen
b. glucagons d. parathormone

D 202. The pharmacist’s role in pharmaceutical care involves identifying, resolving and preventing drug related
problems that come from
a. under treatment c. inappropriate treatment
b. over treatment d. all of the above

B 203. The drug of choice for gout, since this drug decreases the formation of uric acid by inhibiting xanthine oxidase:
a. colchicines c. quinine
b. allopurinol d. all of the above

C 204. It means a slowness in performing common voluntary movements like standing or walking:
a. akinesia c. bradykinesia
b. gait d. none

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C 205. A condition that may happen if beta blockers are suddenly stopped:
a. bronchodilation c. reflex tachycardia
b. vasodilation d. none

C 206. Which of the following has no therapeutic use for the prophylaxis of classis migraine headache?
a. Methysergide c. Lithium
b. tolerance d. all of the above

A 207. “A pattern of effects associated with drug allergy” best describes the term:
a. hypersensitivity c. hyporeactivity
b. tolerance

C 208. This drug class is used for mild symptoms, predominantly tremors in parkinson’s disease:
a. dopamine agonist c. anticholinergics
b. dopamine precursor d. none

C 209. All of the following are adverse reactions to sulfonamides except:


a. skin eruption c. “gray baby” syndrome
b. kernicterus

B 210. Which of the following statement is true?


a. the probability of a drug interaction decrease with the number of drugs received by a patient
b. the probability of a drug interaction increase with the number of drugs received by a patient
c. both
d. none of these

C 211. In what order should the physical examination proceed?


a. head, vital signs, ears, eyes, skin
b. eyes, head, ears, skin, vital signs
c. vital signs, skin, head, eyes, ears
d. ears, eyes, head, skin, vital signs

B 212. This drug is to be used with caution for diabetics with hypertension because of its side effect which inhibit the
liver to convert glycogen to glucose:
a. alpha-adrenergic blockers c. both
b. noncardioselective beta blockers d. none

C 213. The following are symptoms of diabetes mellitus except:


a. polyphagia c. polyneuritis
b. polyuria d. none

C 214. What happen to the erythrocytes when the spleen of a person is removed?
a. the number of circulating old erythrocytes increase
b. the number of circulating abnormal erythrocytes increase
c. the number of circulating old and abnormal erythrocytes increase
d. the number of circulating old and abnormal erythrocytes decrease

B 215. This drug is contraindicated in patient with gastric ulcers because they prolong gastric emptying:
a. antacid c. sulcralfate
b. anticholinergic d. none

B 216. Ives is a first year medical student. One day, she was opening the neck of the cadver. She picked up a bottle
which she taught was her water canteen and accidentally drank the liquid. The liquid is usually used to prevent
the polymerization of formalin. She kept the incident to herself (she was worried that her classmates who were
elitists might make fun her). Two years later, she lost her eyesight. What was the poison?
a. ethylene glycol d. thinner
b. methanol e. acetone
c. chloroform

E 217. These are possible laboratory evaluation for hypertension, except:


a. electrocardiogram d. chest x-ray
b. BUN level e. microscopic enamination
c. cholesterol level

D 218. Which agent is flammable when electrical switches are used in its presence?
a. Aspirin d. Ether
b. Digoxin e. Penicillin
c. Amikacin

A 219. The mechanism of action of calcium channel blockers is:


a. decrease cardiac contractility c. increase the need of oxygen

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b. excretion of acetaldehyde d. none

A 220. Drinking beer after taking disulfiram causes flushing, nausea, and tachycardia. This occurs because disulfiram
inhibits the:
a. metabolism of acetaldehyde c. accumulation of acetaldehyde
b. excretion of acetaldehyde

D 221. All of the following statements concerning upper respiratory infections are true, except:
a. Most of these are caused by viruses
b. Symptoms may involved the sinuses, throat, larynx and airways
c. Treatment is primarily symptomatic
d. Prevention usually is achieved by timely immunization

B 222. A previously healthy 68-year old woman develops auditory hallucinations. She cannot provide many details but
believes her mother is speaking to her. She has difficulty cooperating during the interview and physical
examination which is unremarkable. The most likely diagnosis is:
a. complex partial seizures d. hyperthyroidism
b. Alzheimer’s disease e. Peduncular hallucinations
c. Adverse medication effect

A 223. Iron, a necessary dietary constituent, functions primarily:


a. in oxidation-reduction system c. growth and repair of tissues
b. to maintain water and electrolysis d. to stimulate bone formation balance

C 224. An endocrine disease characterized by increased susceptibility to


Infection, increased fatigability, recessive inheritance and polyuria is:
a. Acromegaly d. Cushing’s disease
b. Grave’s disease e. Hashimoto’s disease
c. Diabetes Mellitus

E 225. Arguments against indiscriminate use of antibiotics as chemotherapeutic agents include the following except:
a. toxic effects of antibiotics
b. allergic reactions included in patients
c. development of drug resistance by an infectious agent
d. secondary effects experienced due to creation of an imbalance in the normal body flora
e. the cost of medication

D 226. Which of the following statements is correct regarding a patient recovered from hepatitis Type B infection?
a. the virus will be excreted in the feces
b. the patient is a good candidate for blood donation
c. the patient will have protective immunity to all viral hepatitis
d. detection of hepatitis B antigen in serum is indicative of the carrier state

A 227. Side effects occurring during the use of oral contraceptives include:
a. nausea c. increased glucose tolerance
b. weight loss d. none of the above

B 228. The most serious side effect of ergonovine use would be:
a. stimulation of the uterus c. nausea and vomiting
b. dry gangrene of fingers and toes

B 229. Which drug is notorious for causing hypersensitivity reactions?


a. Penicillin d. Amikacin
b. Aspirin e. Ether
c. Digoxin

C 230. Control of congestive heart failure can be achieved by:


a. reduction of cardiac workload
b. control of excessive salt and water retention
c. both of the above
d. none of the above

E 231. Which of the following drug classes has been definitely established to be teratogenic in humans?
a. salicylates d. barbiturates
b. antianginals e. antineoplastic agents

B 232. Which drug is used to treat gastrointestinal spasms and colic?


a. Warfarin d. Diazepam
b. Propantheline e. Mylanta
c. Phenytoin

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B 233. A disease associated with excessive mucus production by the tracheobronchial tree which results in airway
obstruction:
a. asthma c. emphysema
b. chronic bronchitis

B 234. Which of the following group of drugs does aggravate congestive heart failure?
a. estrogen c. Beta-blocking agents
b. Cardiac glycosides d. Corticosteroids

C 235. The emergency treatment of patients with congestive heart failure:


a. digitalis glycoside d. vasodilators
b. bed rest e. diuretics
c. inotropic agents

E 236. Patients on corticosteroids therapy should be given the ff. precautions, except:
a. appetite stimulation d. barbiturates
b. antianginals e. antineoplastic agents
c. local anesthetics

B 237. Levodopa should not be taken with the following drugs, except:
a. pyridoxine c. MAOI
b. carbidopa d. antipsychotics

E 238. Which is not a clinical manifestation of gastroenteritis?


a. fever d. diarrhea
b. vomiting e. night sweats
c. abdominal pain
C 239. In Schizoprenic syndrome, there is primarily:
a. increased cholinergic activity c. increased dopaminergic activity
b. decreased cholinergic activity d. decreased dopaminergic activity

E 240. In terms of its major pharmacologic effect, metropolol is most similar to


a. isoproterenol d. hydrochlorothiazide
b. metaproterenol e. propranolol
c. guanethedine

C 241. The ganglionic blocking agents are not extensively used as antihypertensive agents because
a. a. they cannot be administered PO
b. of their long duration of action
c. they do not selectively block sympathetic ganglia
d. they hypotensive effect is unpredictable and slow in onset
e. both A and D are correct

C 242. Completed hospital records or charts are the legal property of the:
a. patient d. patient’s representative lawyer
b. doctor in-charge e. insurance carrier
c. hospital

C 243. When rendering first aid care to a severely injured person, priority should be given to:
a. arresting hemorrhage
b. recognition and treatment of shock
c. recognition of associated head injuries
d. establishing and maintaining a patient airway

D 244. Administration of which of the following drugs would be contraindicted in patients with allergic bronchial asthma:
a. atropine d. propanolol
b. metacholine e. phentolamine
c. d-tubocurarine

B 245. When valporic acid is prescribed for petit mal epilepsy in a patient who is already receiving Phenobarbital
a. the Phenobarbital should be discontinued because Phenobarbital will inactivate valporic acid
b. the dose of Phenobarbital may have to be decreased because valporic acid will increase Phenobarbital
blood levels
c. ethosuximide should also be prescribed
d. valporic acid should be given in the morning and the Phenobarbital should be given at bedtime
e. the dose of both drugs may have to be higher than usual because each drugs may have to be higher
than usual because each drug enhances the metabolism of the other

D 246. An important potentialcomplication of corticosteroid therapy is


a. dissemination of local infection c. increased susceptibility to infection
b. masking symptoms of an infection d. all of the above

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C 247. Which of the following best describes the condition known as hypoprothrombinemia?
a. a diminished blood supply to the brain
b. blood clot formation in a peripheral blood vessel
c. a reduced capability for blood to clot
d. a low level of iron in the blood
e. a decrease in the production of red blood cells by the bone marrow

C 248. The clinical investigation of a new drug consists of four phases. Phase I of the clinical testing involves
administering the drug
a. to animals to determine side effects of the drug
b. to animals for toxicity studies
c. by select clinicians to healthy volunteers
d. by select clinicians to patients suffering from the disease
e. by general practitioners to patients suffering from the disease

A 249. Myxedema is what kind of state?


a. hypothyroid d. hyperparathyroid
b. hypoparathyroid e. hypopituitarism
c. hyperthyroid

D 250. A reversible cholestetic hepatitis with fever and jaundice that may be specific hypersensitivity to the drug has
been observe as an adverse drug reaction in patients taking erythromycin
a. stearate d. estolate
b. ethylsuccinate e. gluceptate
c. free base

C 251. Nizatidine inhibits gastric acid secretion as a result of what kind of activity?
a. anticholinergic d. antianxiety
b. antiadrenergic e. anorectic
c. antihistaminic

B 252. A physician has decided upon a course of tetracycline therapy for a patient with renal impairment. Which of the
following drugs is least likely to accumulate in the patient’s blood?
a. demeclocycline d. oxytetracycline
b. doxycycline e. tetracycline
c. minocycline

B 253. Benztropine is often given to patients taking the anti-psychotic phenothiazines because benztropine
a. reduces the dose of phenothiazine required
b. is an anticholinergic drug that reduces the extrapyramidal side effects of the phenothiazine
c. eliminates the unpleasant GI irritation caused by the phenothiazine
d. is an antidepressant
e. reduces gut motility to ensure that the phenothiazine is completely absorbed

B 254. A clinically noticeable drug interaction resulting from the displacement of drug A by drug B from common plasma
protein binding sites is often seen when:
a. drug A has a high association constant for binding the protein
b. drug B has a high association constant forbinding the protein and is given in large doses
c. drug B has a low association constant for binding the protein and is given in large doses
d. drug B is more toxic than drug A
e. drug B is rapidly absorbed

A 255. Hemolytic anemia due to erythrocyte deficiency of glucose-6-phosphate dehydrogenase would most likely be
precipitated by:
a. primaqune d. phenytoin
b. ascorbic acid e. gentamicin
c. isoniazid

B 256. The anticoagulant action of heparin is monitored by the


a. whole blood count
b. activated partial thromboplastin
c. prothrombin time
d. bleeding time
e. antiplatelet clotting time

E 257. Two hours after receiving his last dose of heparin a patients begins bleeding from his gums after brushing his
teeth. What is the most appropriate therapeutic action?
a. inject 10 mg of phytonadione intravenously
b. inject 60 mg of protamine sulfate intravenously
c. inject 30 mg of protamine sulfate intravenously

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d. swab a small amount of epinephrine 1:100 onto the gun tissue to produce local vasoconstriction
e. wait for the anticoagulant effect to subside

B 258. Large overdose of acetaminophen is likely to cause:


a. tinnitus d. renal tubular acidosis
b, hepatic necrosis e. seizures
c. agranulocytosis

D 259. An adult patient who has ingested 30 acetaminophen tablets (325 mg/tab) six hours ago should be treated
with/by:
a. careful observation for signs of central nervous system toxicity
b. ipecac syrup
c. activated charcoal
d. N-acetylcysteine
e. glutathione

A 260. Which of the following would be most dangerous to use in a patient already receiving high doses of gentamicin?
a. ethacrynic acid d. hydroDIURIL
b. tetracycline e. pentobarbital sodium
c. propantheline bromide

B 261. Ticarcillin may be preferred to carbenicillin for patients with congestive heart failure and hypertension because it:
a. contains less sodium than does carbenicillin
b. is usually given in smaller doses than is carbenicillin
c. does not include hypokalemia
d. stimulates renal blood flow
e. has broad spectrum than does carbenicillin

D 262. A disadvantage of using cromolyn sodium powder for asthma is:


a. its brief duration of action
b. the development of rebound bronchoconstriction
c. the rapid development of tachyphylaxis
d. ineffective in treating acute attacks
e. poor GI absorption after administration of the capsule dosage form

C 263. Patients on lithium carbonate therapy should be advised:


a. to limit water intake
b. to stop taking the drug if they experience mild side effects
c. not to restrict their normal dietary salt intake
d. not to take the drug during manic phase of their cycle
e. not to take the drug with food

E 264. The best emergency advice that a pharmacist could give an individual who has just suffered burn is to:
a. apply butter to the burn
b. apply Vaseline to the burn
c. contact a physician immediately
d. immerse the burn area in warm water followed by cold water
e. immerse the burn area in cold water

D 265. Which of the following should not be administered to a patient being treated for narrow-angle glaucoma?
a. physostigmine d. homatropine
b. pilocarpine e. carbachol
c. phospholine iodide

E 266. Advantage(s) of timolol maleate over pilocarpine for the reduction of elevated intraocular pressure include (s):
a. longer duration of activity
b. little or no effect on visual acuity or accommodation
c. little or no effect on pupil size
d. no systemic side effects
e. A, B, & C

A 267. Epinephrine is a useful drug for lowering intraocular pressure in open angle glaucoma because it:
a. increase outflow of aqueous humor and inhibits the formation aqueous humor
b. causes miosis
c. causes mydriasis
d. inhibits carbonic anhydrase
e. dilates blood vessels in the eye

C 268. A patient with a documented allergy to morphine should not receive which of the following analgesics?
a. meperidine d. methadone
b. pentazocine e. butorphenol

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c. codeine

B 269. Hypertrophy refers to:


a. an abnormal increase in the number of cells in the tissue
b. an enlargement or overgrowth of an organ
c. excessive perspiration
d. increased motor activity
e. excessive sensitivity of the skin

D 270. Stenosis refers to:


a. hardening of tissue with a loss of elasticity
b. inflammation of the sternum
c. inflammation of the vertebrae
d. narrowing of stricture of a duct or canal
e. stoppage of blood flow in a part of the body

C 271. Phlevitis is most closely associated with which type of injections?


a. intradermal d. subcutaneous
b. intramuscular e. both IM and IV
c. intravenous

E 272. Which of the following antihypertensive drugs should be administered by slow intravenous infusion?
a. minoxidil d. prazosin
b. clonidin e. nitroprusside
c. hydalazine

D 273. Which of the following phenothiazines is least likely to produce extra pyramidal side effects?
a. chlorpromazine d. thioridazine
b. perphenazine e. trifluoperazinc
c. prochlorperazinc

D 274. The anti-emetic effect of which of the ff. drugs is the result of increasing the rate of gastric emptying?
a. amitriptyline d. metoclopramide
b. benztropine e. aluminum hydroxide gel
c. codeine

B 275. A patient is admitted to the ER with marked hypotension and appears to be in shock. The drug of choice to treat
the condition is probably:
a. dobutamine HCL d. nitroglycerine
b. dopamine HCL e. nitroprusside
c. epinephrine HCL

D 276. Which of the following is considered to be the drug of choice for treatingtrigeminal neuralgia:
a. niacin d. carbamazepine
b. pentazocine e. hydroxyzine
c. INH.

C 277. An advantage of loperamide over diphenoxylate as an anti-diarrheal is the fact that loperamide:
a. has a relatively short biologic T1/2 and is, therefore, not likely to be abused
b. has a direct effect on the CNS
c. does not appear to have opiate-ike effects
d. is not a control substance
e. can be given parenterally

D 278. Which of the following drugs used in the treatment of gout does not affect urate metabolism or excretion?
a. allopurinol d. colchicine
b. probenecid e. none of the above
c. sulfinpyrazone

C 279. An important advantage of using dopamine in cardiogenic shock is that dopamine


a. will not cross blood-brain barrier and cause CNS effects
b. has not effects on alpha and beta receptors
c. produces dose-dependent increase in cardiac output and renal perfusion
d. will not increase blood pressure
e. can give orally

B 280. Peripheral veins are seldom used for the administration of TPN fluids because
a. TPN fluids tend to infiltrate surrounding tissue
b. the blood flow in peripheral vessels is not great enough to protect the peripheral vessels from irritation
c. large-bore needles must be used
d. the vessels are easily occluded

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e. the hypotonic solution caused local hemolysis

C 281. Cyclosporine is a/an


a. aminoglycoside antibiotic d. fungicide
b. third-generation cephalosporine e. prostaglandin analog
c. immunosuppressant

B 282. Potential problem of using nalbuphine in a patient who is dependent on Codeine in the :
a. additive respiratory depression
b. precipitation of narcotic withdrawal symptoms
c. increase tolerance to codeine
d. impaired renal excretion of codeine
e. excessive central nervous system stimulation

C 283. Which of the following insulins would be expected to exert the longest duration of action
a. semilente d. lente
b. NPH e. regular lente
c. Protamin zinc

B 284. The most common cause of diabetic ketoacidosis and coma in the diagnosed and treated diabetic is:
a. insulin overdosage
b. failure of the patient to use insulin properly
c. electrolyte depletion
d. use of the wrong type of insulin
e. excessive physical activity

E 285. An elderly insulin-ependent diabetic is about to be placed on a beta blocker for his hypertension. Which of the
following would be most appropriate for this type of patient?
a. propanolol d. nadolol
b. pindolol e. atenolol
c. timolol

C 286. Which drug is used for the treatment of diarrhea and its resultant body fluid loss?
a. Meclizine d. Cyclizine
b. Diphenhydramine e. Terfenadine
c. Paragoric

D 287. The rate of exchange of drugs from one fluid compartment to another is influenced by the:
a. pka of the drug c. rate of blood flow
b. pH of the fluid compartment d. all of the above

D 288. The extent of protein binding is determined in vitro by:


a. dialysis c. molecular filtration
b. electrophoresis d. all of the above

C 289. The affinity of low molecular weight substances to macromolecular


Structure in blood and tissue influences the:
a. physical properties of the drug c. distribution equilibrium of drugs
b. chemical properties of the drug d. liberation of drugs

B 290. Compound used for the determination of secretory functions of the liver
a. phenolphthalein c. insulin
b. bromosuphthalein d. all of the above

D 291. Biliary recycling is influenced by:


a. rate of excretion of drug into the c. rate of loss of drug with feces bile
b. gall bladder function d. all of the above

B 292. The administration of the same dose of active ingredient in different galenic forms
a. always lead to the same therapeutic effect
b. does not necessarily lead to the same therapeutic effect
c. always lead to different therapeutic effect
d. none of the above

A 293. The larger the volume of distribution:


a. the more extensive the distribution
b. the faster the distribution
c. emptying of bile from the liver
d. the slower the distribution the higher the physiological significance emptying of bile from the gall
bladder

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D 295. Drugs which are excreted into the sweat include the following except:
a. antipyrine c. benzoic acid
b. alcohol d. gentamicin

C 296. When used to treat angina, nifedipine is much more likely than verapamil and diltiazem to cause:
a. hypokalemia d. mental depression
b. tachycardia e. bronchopasm
c. cardiac arrythmias

A 297. A 55-year old patient with a 5-year history of angina and a recent myocardial infarction is admitted to the hospital
because of malignant hypertension. Diazoxide should not be used in this patient because
a. of its cardiostimulating effects
b. of its slow onset of activity
c. it tends to increase uric acid levels
d. it is likely to cause orthostatc hypotension
e. of its hepatotoxicity

A 298. A 20-year old asthmatic patient has been treated with Theodur 500 mg.twice daily. Despite a good therapeutic
steady state serum concentration of 60 ug/ml, the patient has brief episodes of bronchospasm several times a
week. The physician would like to give the patient additional bronchodilator therapy with an oral beta-adrenergic
agent. Which of the ff. drugs would be least desirable?
a. ephedrine d. albuterol
b. metaproterenol e. isoetherine
c. terbutaline

B 299. An 80-year old woman with a history of congestive heart failure develops angina pectoris, her medications are
adjusted to include furosemide, Digoxin, nitroglycerin, propranalol and potassium supplements. Shortly
thereafter, she develops intermittent frontal throbbing headaches. What should the physicians do first?
a. perform a temporal artery biopsy
b. discontinue nitroglycerin
c. begin sublingual ergotamine
d. obtain a brain computed tomography (CT) scan
e. discontinue digoxin

A 300. Which of the fllowing events demand a change in dose size and dose requirement?
a. change in the normal excretion pattern
b. urinary recycling
c. both a and b
d. none of the above

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