FPGEE Sample Questions PDF

Sample Questions (from NABP website) The following are examples of question types that candidates may encounter when taking the FPGEE. These questions are presented as examples to familiarize candidates with their formats and are not intended to represent content a...

Sample Questions (from NABP website) The following are examples of question types that candidates may encounter when taking the FPGEE. These questions are presented as examples to familiarize candidates with their formats and are not intended to represent content areas on the FPGEE. Every examinee is presented with the opportunity to take a tutorial at the testing center prior to initiating the FPGEE. The tutorial instructs examinees on how to respond to all of the types of questions that could be presented on the examination. Candidates are encouraged to take the tutorial in order to become familiar with how to submit responses in the computer-based examination. Multiple-Choice Question Format The Varicella vaccine, which is a live attenuated vaccine, is 1. Which of the following vaccines contraindicated in immunocompromised patients because their is contraindicated in weakened immune systems may not be able to handle even the immunocompromised patients? weakened form of the virus used in the vaccine, potentially leading A. Pneumococcal polysaccharide to serious complications. The other vaccines B. Varicella listed—Pneumococcal polysaccharide, Meningococcal conjugate, C. Meningococcal conjugate and Subcutaneous influenza (assuming it refers to the inactivated D. Subcutaneous influenza form)—are not live vaccines and are generally considered safe for immunocompromised patients. Multiple-Response Question Format When counseling a patient taking oral tacrolimus, the pharmacist 1. What counseling information should provide the following information: should a pharmacist provide to a Avoid live virus vaccinations: Tacrolimus suppresses the patient taking oral tacrolimus? immune system, so live vaccines could potentially cause an (Select ALL that apply.) infection. A. Avoid live virus vaccinations Avoid grapefruit and grapefruit juice: Grapefruit can B. Avoid grapefruit and interfere with the metabolism of tacrolimus, leading to grapefruit juice increased drug levels and a higher risk of side effects. C. If a dose is missed, double up Medication levels need to be monitored: Tacrolimus has on the next dose a narrow therapeutic index, so blood levels need to be D. Do not drink alcohol while regularly monitored to ensure they remain within the target taking this medication range. E. Medication levels need to be Do not: monitored If a dose is missed, do not double up on the next dose: This could lead to toxicity. Instead, the patient should take the missed dose as soon as they remember or skip it if it's almost time for the next dose. Avoid alcohol while taking this medication: Alcohol can increase the risk of liver toxicity and other side effects, so it is best avoided. Thus, the correct counseling points are: Avoid live virus vaccinations Avoid grapefruit and grapefruit juice Do not drink alcohol while taking this medication Medication levels need to be monitored Do not double up on the next dose if a dose is missed. Constructed-Response Question To determine how many milliliters of griseofulvin oral suspension Format should be dispensed, follow these steps: 1. Griseofulvin oral suspension 1. Calculate the total daily dose: The prescribed dose is 250  contains 125 mg/5 mL. A mg twice a day (bid). physician prescribed 250 mg bid Total daily dose = 250 mg × 2 = 500 mg for 2 weeks for a patient. How 2. Determine the number of milliliters needed per dose: many milliliters of griseofulvin The suspension contains 125 mg/5 mL. should be dispensed in order to To find out how many milliliters are needed for a 250 mg fill this prescription? (Answer 250𝑚𝑔 dose: Required mL per dose = ( 125𝑚𝑔 ) × 5mL = 10mL must be numeric; round the final 3. Calculate the total amount for 2 weeks: answer to the nearest WHOLE The patient needs 10 mL per dose, and there are 2 doses number.) per day. Total volume per day = 10 mL × 2 = 20 mL 280 mL of Griseofulvin The prescription is for 2 weeks (14 days). Total volume needed = 20 mL × 14 days = 280 mL Therefore, 280 mL of griseofulvin suspension should be dispensed. QUESTION ANSWER 1. The metabolic conversion of I to The metabolic conversion of compound I to compound II in the II represents: image involves the change from an aldehyde group (–CHO) in compound I to a carboxylic acid group (–COOH) in compound II. This transformation is typically achieved through an oxidative process where the aldehyde group is oxidized to a carboxylic acid. a. ester hydrolysis b. amide hydrolysis c. reductive cleavage d. oxidative cleavage 2. The flow of blood in the ascending VC progresses from the: The correct flow of blood from the ascending vena cava (superior vena cava) is: a. Right atrium to right ventricle to pulmonary vein to pulmonary Blood from the superior vena cava flows into the right artery atrium. b. Right atrium to right ventricle From the right atrium, it moves into the right ventricle. to pulmonary artery to The right ventricle then pumps the blood into the pulmonary vein pulmonary artery, which carries deoxygenated blood to the lungs. After oxygenation in the lungs, the blood returns to the heart via the pulmonary veins to the left atrium (not the right side of the heart). 3. Endometriosis is a condition caused Endometriosis is a condition characterized by the deposition and by the deposition of endometrial tissue growth of endometrial tissue (which normally lines the inside of the primarily in the: uterus) outside the uterine cavity. The most common location for a. arterial wall this ectopic endometrial tissue is the peritoneal cavity, including b. renal tubule areas such as the ovaries, fallopian tubes, and the tissue lining the  c. gastric mucosa pelvis. d. peritoneal cavity 4. A pharmacist is to prepare 150 mL of concentrated solution of benzalkonium chloride solution so that a 5-mL aliquot diluted to 500mL yields a 1:7500 solution. To prepare the concentrated solution, how many grams of benzalkonium chloride will be needed? a. 0.067 b. 0.34 c. 2 d. 10 I. Determine the concentration of the final diluted solution: The final solution is 1:7500, meaning 1 part benzalkonium chloride in 7500 parts solution. 1 Concentration= 7500 = 0.0001333 (fractional concentration) II. Calculate the amount of benzalkonium chloride in the final solution: The final solution volume is 500 mL. Amount of benzalkonium chloride in 500mL = 500mL × 0.0001333 = 0.06667 g III. Determine the concentration of the concentrated solution: You are taking a 5 mL aliquot of the concentrated solution and diluting it to 500 mL to achieve the final concentration. 0.06667 𝑔 Concentration of concentrated solution = 5 𝑚𝐿 = 0.013334 g/mL IV. Calculate the total amount of benzalkonium chloride needed for 150 mL of the concentrated solution: Total amount of benzalkonium chloride needed = 0.013334 g/mL × 150 mL = 2.0 g 5. The structure of the brain involved in The structure of the brain primarily responsible for temperature temperature regulation: regulation is the hypothalamus. The hypothalamus plays a critical role in maintaining homeostasis, including the regulation of body a. Hypothalamus temperature, hunger, thirst, and circadian rhythms. b. cerebral cortex c. arbor vitae tract d. spinothalamic tract 6. the complete set of genetic information for an organism is: The complete set of genetic information for an organism is called the genome. The genome includes all of the organism's genes as a. clone well as its non-coding sequences of DNA. b. genome c. codon d. oncogene 7. home ovulation tests can detect, in Home ovulation tests detect the preovulatory surge in luteinizing the urine, a pre-ovulatory surge in: hormone (LH) in the urine. The surge in LH triggers ovulation, making it a key indicator for identifying the most fertile period in a a. Oxytocin woman's menstrual cycle. b. prolactin c. progesterone  d. luteinizing hormone 8. Which of the ff is associated with the Prostaglandins are associated with the cytoprotection of the cytoprotection of the GIT? gastrointestinal tract (GIT). They play a crucial role in maintaining the integrity of the gastric mucosa by stimulating mucus and a. leukotrienes bicarbonate secretion, enhancing mucosal blood flow, and b. prostaglandins promoting cell regeneration, all of which help protect the stomach c. thromboxanes lining from acid and other harmful substances. d. interleukins 9. The lipoprotein particle that delivers Note: cholesterol to extrahepatic cells in the LDL – delivers cholesterol to EXTRAhepatic body it the: HDL – delivers cholesterol to hepatic (liver) VLDL – delivers triglyceride to EXTRAhepatic a. chylomicron Chylomicron – delivers triglycerides to hepatic (liver) b. low-density lipoprotein c. high-density lipoprotein d. intermediate-density lipoprotein 10. anaphylatoxins recruit inflammatory Anaphylatoxins recruit inflammatory cells to needed areas following cells to needed areas following the activation of the complement system. The complement activation of which of the ff systems: system is part of the immune system that enhances the ability of antibodies and phagocytic cells to clear pathogens. Anaphylatoxins a. kinin such as C3a, C4a, and C5a are small peptides released during the b. clotting activation of this system, and they play a key role in promoting c. fibrinolytic inflammation by recruiting immune cells like neutrophils and d. complement macrophages to sites of infection or injury. 11. Which of the ff would NOT be true Statement I: "Distribution only occurs after absorption of the drug regarding drug distribution in the body? is complete" is NOT true. Distribution of a drug can begin as soon I. Distribution only occurs after as the drug enters the bloodstream, even before absorption is absorption of the drug is complete complete. Some drugs are distributed simultaneously with II. A drug that readily distributes into fat absorption. will have a relatively large apparent Statement II: "A drug that readily distributes into fat will have a volume of distribution relatively large apparent volume of distribution" is true. Drugs that III. A high degree of plasma protein accumulate in fat tissues tend to have larger volumes of distribution binding results in a relatively low volume because they spread out into a larger compartment. of distribution Statement III: "A high degree of plasma protein binding results in a relatively low volume of distribution" is true. Drugs that are highly a. I only bound to plasma proteins tend to remain in the bloodstream and do b. I and II only not readily distribute into tissues, leading to a lower volume of c. II and III only distribution. d. I, II, and III 12. Which of the ff factors does NOT influence the polymorphic form of the Polymorphism refers to the ability of a substance, such as a drug, drug? to exist in more than one crystal form. The formation of these different polymorphic forms is influenced by several factors: a. light b. temperature Temperature (b): Temperature affects the energy states of c. rate of cooling molecules during crystallization, which can lead to different d. solvent of recrystallization polymorphs. Rate of cooling (c): The speed at which a substance is cooled can influence which crystal form is favored. Solvent of recrystallization (d): The choice of solvent can affect how molecules arrange themselves in the crystal lattice, leading to different polymorphic forms. However, light (a) does not typically influence the polymorphic form of a drug. 13. Type II error occurs when a study: Type II error (also known as a "false negative") occurs A. finds a difference between groups when a study fails to detect a difference between groups, when there is a true difference even though a true difference exists. This is typically related B. finds a difference between groups to low statistical power. when there is no true difference Type I error (false positive) occurs when a study finds a C. fails to find a difference between difference between groups when there is no true difference groups when there is a true (option B). difference D. fails to find a difference between groups when there is no true difference 14. The cytokine used to treat virus-induced hepatitis is: Interferons (particularly Interferon-alpha, or INF-α) are cytokines used to treat virus-induced hepatitis, such as hepatitis B and C. a. INF Interferons boost the immune system's ability to fight viral b. IL-2 infections by enhancing antiviral defenses. c. IL-6 d. TNF IL-2 (Interleukin-2) is involved in the activation of immune cells like T cells and is used in some cancer therapies. IL-6 (Interleukin-6) plays a role in inflammation and immune responses, but it is not typically used for treating viral hepatitis. TNF (Tumor Necrosis Factor) is primarily involved in inflammation and immune system regulation, not in treating viral hepatitis. 15. Which of the following substances Tetracycline binds to divalent and trivalent cations, such as may safely be ingested concurrently calcium (in milk), iron (in ferrous sulfate), and aluminum (in with tetracycline? aluminum hydroxide), which significantly reduces its absorption in the gastrointestinal tract. a. milk b. ferrous sulfate Sodium chloride (table salt) does not interfere with the absorption c. sodium chloride of tetracycline, making it safe to ingest concurrently. d. aluminum hydroxide 16. For a drug following In a one-compartment pharmacokinetic model, the peak of the one-compartment model serum concentration versus time curve (also known as Cmax) pharmacokinetics, the peak of the occurs when the rate of drug absorption equals the rate of serum concentration versus time curve drug elimination. At this point, the drug concentration in the body approximates the: reaches its maximum. a. point in time when the maximum Here’s why the other options are incorrect: pharmacologic effect occurs b. point in time when absorption rate a. Maximum pharmacologic effect: This doesn’t always and elimination rate of the drug are coincide with peak serum concentration, as the equal pharmacologic effect depends on various factors, including c. maximum concentration of free drug receptor interactions and drug distribution. in the urine c. Maximum concentration of free drug in the urine: The d. time required for all the drug to be peak plasma concentration is unrelated to the concentration absorbed from the GIT of the drug in the urine. d. Time for complete absorption: The peak concentration happens before all of the drug is fully absorbed, as absorption and elimination are ongoing processes. 17. Which of the following materials should be used to absorb an aqueous When incorporating an aqueous drug solution into a cocoa butter drug solution before incorporation into a suppository, you need a material that can absorb water and blend cocoa butter suppository? well with the hydrophobic cocoa butter base. Anhydrous lanolin is a good choice because it has both hydrophilic and hydrophobic a. glycerin properties, allowing it to absorb the aqueous solution and still be b. petrolatum compatible with the fatty cocoa butter. c. anhydrous lanolin d. polyethylene glycol Here’s why the other options are less suitable: Glycerin is too hydrophilic and might not blend well with cocoa butter. Petrolatum is hydrophobic and would not absorb the aqueous solution effectively. Polyethylene glycol can absorb water, but it is a water-soluble base itself and not typically used with cocoa butter suppositories. 18. The principal extracellular anion “PiChO” is: Phosphate In, Chloride Out a. Cl- b. SO4 2- c. HCO 3- d. HPO4 2- 19. Given the following information, what is the absolute bioavailability of To calculate the absolute bioavailability (F) of a drug, you use the this drug? following formula: AUC (PO) = 75; Dose (PO) = 20 mg AUC (IV) = 50; Dose (IV) = 5 mg a. 27% b. 38% c. 51% d. 67% Given: AUC (PO) = 75 Dose (PO) = 20 mg AUC (IV) = 50 Dose (IV) = 5 mg Substitute the values into the formula: 75 𝑥 5 F = ( 50 𝑥 20 ) 𝑥 100 375 = ( 1000 ) 𝑥 100 = 0.375×100 = 37.5% 20. Extemporaneous preparation of Ophthalmic solutions must be sterile to avoid contamination ophthalmic solutions in retail settings is and potential eye infections. not typically advised for what reason? Tonicity adjustment (a) can be managed with appropriate formulations and techniques. a. tonicity cannot be adjusted in retail Cost-effectiveness (b) is a concern but not as critical as setting sterility. b. preparation is not cost-effective for Particle size reduction (d) can be addressed with the pharmacy specialized equipment, though it's important, it is less of an c. most retail pharmacies do not issue than maintaining sterility. have aseptic preparation areas d. appropriate levels of particle size reduction are not possible in this setting 21. Viroids are composed of: Viroids are infectious agents composed solely of a small, circular, single-stranded RNA molecule. They are known to cause a. single-stranded DNA diseases in plants. Unlike viruses, viroids do not encode proteins b. double-stranded DNA and rely on the host cell's machinery for replication. c. single-stranded RNA d. double-stranded RNA 22. A gel-based dosage form can be administered via ALL of the following Gel-based dosage forms are suitable for several routes of routes of administration EXCEPT: administration: a. Rectal Rectal: Gels can be used in suppositories or as a topical b. Ophthalmic application in the rectal area. c. Intravenous Ophthalmic: Gels are used as eye drops or ointments for d. Intramuscular ophthalmic applications. Intramuscular: Some gel formulations are designed for intramuscular injections, often as sustained-release or  depot preparations. However, intravenous administration is NOT suitable for gel-based dosage forms. Intravenous drugs need to be in a liquid form that can flow easily through veins, whereas gels are too viscous and not appropriate for this route. 23. The basis for the use of saw Saw palmetto is used in the treatment of benign prostatic palmetto in the treatment of benign hyperplasia (BPH) primarily because it is believed to inhibit the prostatic hyperplasia is to: enzyme 5-alpha reductase, which is responsible for converting testosterone into dihydrotestosterone (DHT). Elevated levels of a. Stimulate testosterone reductase DHT are associated with the development and progression of BPH. b. Inhibit testosterone reductase By inhibiting this enzyme, saw palmetto may help reduce the levels c. Stimulate the androgen receptor of DHT and thus alleviate symptoms of BPH. d. Inhibit the androgen receptor 24. Complete ulcer healing occurred in 28 of 36 patients who received an The chi-square test is appropriate for determining if there is a antacid versus 17 of 38 patients who significant difference between the healing rates of two received a placebo. The most categorical groups (in this case, patients who received an appropriate method to determine if the antacid versus those who received a placebo). It compares the difference in healing rates is statistically observed frequencies of outcomes in each group to the expected significant is: frequencies if there were no difference between the groups. a. a chi square test Here’s why the other options are less appropriate for this scenario: b. a Student’s t-test c. Friedman’s analysis Student’s t-test (b): This test is used for comparing means d. a Kaplan-Meier analysis between two groups, not for categorical data like the presence or absence of ulcer healing. Friedman’s analysis (c): This is used for comparing multiple related samples or repeated measures, not for comparing two independent groups. Kaplan-Meier analysis (d): This is used for time-to-event data (survival analysis), which is not applicable in this case as you’re comparing categorical outcomes rather than time-to-event data. 25. An important metabolic complication that can arise frequently in patients with Patients with anorexia are at high risk for hypokalemia due to anorexia is: several factors, including inadequate dietary intake of potassium, excessive use of diuretics or laxatives, and vomiting. Hypokalemia a. hypokalemia can lead to severe complications such as cardiac arrhythmias, b. hyperglycemia muscle weakness, and other electrolyte imbalances. c. increased T3 levels d. adrenal insufficiency Here’s why the other options are less relevant: Hyperglycemia (b): Typically, patients with anorexia are more prone to hypoglycemia rather than hyperglycemia. Increased T3 levels (c): Anorexia often leads to decreased  levels of thyroid hormones, including T3, due to a decreased metabolic rate. Adrenal insufficiency (d): While anorexia can affect adrenal function, hypokalemia is a more frequent and direct metabolic complication associated with the condition. 26. Heroin use may result in a prolongation of bleeding time due to: Heroin use can lead to abnormal platelet aggregation, which affects the blood’s ability to clot properly, thereby prolonging a. leucopenia bleeding time. This effect is related to the drug’s impact on b. bone marrow suppression platelet function rather than its effects on blood cell production or c. splenic infarction other factors. d. abnormal platelet aggregation Here’s why the other options are less relevant: Leucopenia (a): While heroin use can affect white blood cell counts, it is not directly linked to prolongation of bleeding time. Bone marrow suppression (b): This could potentially affect blood cell production, but heroin’s primary impact on bleeding time is through platelet function rather than bone marrow suppression. Splenic infarction (c): Although heroin use can affect the spleen, it is less commonly associated with bleeding time prolongation compared to its direct effects on platelets. 27. A drug has the ff log Kobs versus pH plot, it can be concluded that the drug To determine which mechanism the drug does not undergo based undergoes catalysis by ALL of the ff on the log Kobs​versus pH plot, let's analyze the shape of the graph. mechanisms EXCEPT: The plot shows a "V" shape, indicating that the log of the observed rate constant (logKobs​) changes with pH. This "V" shape suggests that there are two different regions where the reaction rate is dependent on pH: one for acidic conditions and one for basic conditions. Here's what the different mechanisms imply: Specific acid catalysis: The reaction rate increases with a decrease in pH (more acidic conditions), usually seen as a downward slope to the left. Specific base catalysis: The reaction rate increases with an increase in pH (more basic conditions), typically seen as a. Specific acid (downward slope an upward slope to the right. to the left) General acid/base catalysis: Involves proton donors b. Specific base (upward slope to (acids) or acceptors (bases) other than water that can the right) influence the reaction rate across a range of pH values. c. General acid/base General hydrolysis: Refers to a reaction with water that is  d. General hydrolysis independent of pH and involves breaking a bond using water. Given the "V" shape of the plot, this suggests that the reaction rate is influenced by both specific acid and specific base catalysis. The absence of a flat region in the plot (where the rate would be independent of pH) suggests that general hydrolysis is not the mechanism involved. Thus, the drug undergoes catalysis by all of the mentioned mechanisms except general hydrolysis (option d). 28. Which of the ff is an example of passive immunization? Passive immunization involves the administration of preformed antibodies to provide immediate protection against a. polio dead virus a specific disease. This contrasts with active immunization, where b. diphtheria toxoid the body's immune system is stimulated to produce its own c. hepatitis A immunoglobulins antibodies in response to a vaccine containing antigens, such as a d. hepatitis B attenuated live virus dead or attenuated virus, or a toxoid. Given the options: a. Polio dead virus: This is an example of active immunization. The dead virus stimulates the immune system to produce its own antibodies. b. Diphtheria toxoid: This is also an example of active immunization. A toxoid is a toxin that has been inactivated but can still induce an immune response in the body to produce antibodies against the actual toxin. c. Hepatitis A immunoglobulins: This is an example of passive immunization. Immunoglobulins are pre-formed antibodies that provide immediate protection by directly neutralizing the pathogen. d. Hepatitis B attenuated live virus: This is an example of active immunization. An attenuated virus is a weakened form of the virus that stimulates the immune system to produce its own antibodies without causing the disease. 29. A drug useful for the management esmolol - antidote of arrhythmias associated with amphetamine or cocaine intoxication is: Let's consider the options: a. sodium bicarbonate a. Sodium bicarbonate: This is used primarily for metabolic b. naloxone acidosis and certain types of drug intoxications, such as tricyclic c. physostigmine antidepressant overdose. While it can be beneficial in some cases d. esmolol of cardiac toxicity due to cocaine, particularly to counteract sodium channel blockade effects, it is not primarily indicated for  arrhythmias. b. Naloxone: This is an opioid antagonist used to reverse opioid overdose. It is not effective for managing arrhythmias associated with amphetamine or cocaine intoxication. c. Physostigmine: This is an acetylcholinesterase inhibitor used primarily in anticholinergic toxicity. It is not typically used for arrhythmias from sympathomimetic intoxications like amphetamines or cocaine. d. Esmolol: This is a short-acting beta-blocker. It is often used for the management of supraventricular tachycardia and certain arrhythmias. Esmolol can be effective in treating arrhythmias associated with cocaine or amphetamine intoxication because it counteracts the excessive sympathetic stimulation caused by these drugs. Correct answer: d. Esmolol. Esmolol is preferred because it can help control heart rate and reduce arrhythmias by blocking beta-adrenergic receptors, which are overstimulated in cases of cocaine or amphetamine toxicity. 30. Which of the following symptoms indicates theophylline toxicity? I. Vomiting: This is a common early symptom of theophylline I. Vomiting toxicity. It can occur due to the drug's irritating effects on the II. Seizures gastrointestinal tract and direct stimulation of the central nervous III. Tachycardia system. a. I only II. Seizures: Theophylline toxicity can cause seizures, which is a b. I and II only serious and potentially life-threatening manifestation. This occurs c. II and III only due to theophylline’s central nervous system stimulant effects. d. I, II, and III III. Tachycardia: An increased heart rate (tachycardia) is a common cardiovascular effect of theophylline toxicity due to its stimulant effects on the heart. Given these points, all three symptoms—vomiting, seizures, and tachycardia—are indicative of theophylline toxicity. 31. Local anesthetic products may include epinephrine in an effort to: Epinephrine is a vasoconstrictor, meaning it narrows blood a. reduce irritation vessels. When added to local anesthetics, it causes the following b. intensify analgesia effects: c. decrease local blood flow d. increase diffusion of anesthetic Reduce Irritation: This is not a primary reason for adding epinephrine to local anesthetics. Intensify Analgesia: While epinephrine does not directly intensify analgesia, it prolongs the effect of the anesthetic  by decreasing blood flow, which can lead to a more prolonged numbing effect. Decrease Local Blood Flow: This is the primary reason epinephrine is included in local anesthetic products. By causing vasoconstriction, epinephrine reduces blood flow to the area where the anesthetic is applied. This reduction in blood flow slows the absorption of the anesthetic into the bloodstream, prolonging its local effect and reducing the risk of systemic toxicity. Increase Diffusion of Anesthetic: This is not the purpose of epinephrine. In fact, by decreasing blood flow, epinephrine limits the diffusion of the anesthetic away from the site of injection, maintaining its localized effect. Thus, the correct answer is c. decrease local blood flow. 32. Which of the following is not a communicable disease? A communicable disease is an infectious disease that can be transmitted from one person to another, either directly or a. Hepatitis indirectly. Let's evaluate each option: b. influenza c. botulism a. Hepatitis: Hepatitis can be a communicable disease, especially d. diphtheria Hepatitis A, B, and C. Hepatitis A is typically spread through contaminated food or water, while Hepatitis B and C are often transmitted through blood or body fluids. b. Influenza: Influenza is a highly communicable respiratory disease caused by the influenza virus. It spreads easily from person to person through respiratory droplets when an infected person coughs, sneezes, or talks. c. Botulism: Botulism is caused by a toxin produced by the bacterium Clostridium botulinum. It is not typically considered a communicable disease because it does not spread from person to person. Botulism usually occurs from ingesting the toxin through contaminated food or from wound infections. d. Diphtheria: Diphtheria is a communicable disease caused by Corynebacterium diphtheriae bacteria. It spreads from person to person through respiratory droplets or contact with contaminated objects. The correct answer is c. botulism. Botulism is not a communicable disease because it is not transmitted from person to person. 33. Which of the ff would be the most susceptible to hydrolysis? Hydrolysis is a chemical reaction in which a compound reacts with water, leading to the breakdown of that compound. The susceptibility of a compound to hydrolysis depends on the stability a. Acid of the leaving group and the nature of the functional group b. Ester involved. c. Ether d. Amide Let's analyze each option: a. Acid: In the context of functional groups, an acid (like a In acidic hydrolysis carboxylic acid) is already in a hydrolyzed state and does not undergo further hydrolysis. water attacks the carbonyl carbon of the ester b. Ester: Esters are highly susceptible to hydrolysis, especially leading to the formation of a under acidic or basic conditions. In acidic hydrolysis, water carboxylic acid and an alcohol attacks the carbonyl carbon of the ester, leading to the formation of a carboxylic acid and an alcohol. In basic hydrolysis In basic hydrolysis (saponification) (saponification), the ester reacts with a hydroxide ion, producing a carboxylate ion and an alcohol. ester reacts with a hydroxide ion producing a carboxylate ion c. Ether: Ethers are generally stable compounds and are not easily and an alcohol hydrolyzed under normal conditions. They require more drastic conditions, such as strong acids or bases, to undergo cleavage. d. Amide: Amides can undergo hydrolysis, but they are generally more resistant to hydrolysis than esters due to the resonance stabilization of the amide bond. Hydrolysis of amides requires more extreme conditions (such as strong acids or bases and elevated temperatures) compared to esters. Among the options provided, esters are the most susceptible to hydrolysis under typical chemical conditions. 34. Which of the ff statements about pain is FALSE? a. Reaction to it is largely inborn, rather than acquired: This statement is false. The reaction to pain is not purely inborn; it is a. reaction to it is largely inborn, significantly influenced by an individual’s experiences, culture, and rather than acquired psychological state. While the perception of pain may have some b. the psychological threshold varies inborn components, the reaction to pain, including tolerance and from individual to individual emotional response, is largely acquired and shaped by personal c. reaction to it is associated with experiences and social factors. emotional factors d. it is typically associated with anxiety b. The psychological threshold varies from individual to individual: This statement is true. The psychological threshold for pain, which is the point at which a stimulus is perceived as painful, can vary greatly from person to person due to factors such as genetics, psychological state, previous experiences with pain, and cultural background. c. Reaction to it is associated with emotional factors: This statement is true. The reaction to pain is closely tied to emotional factors. Pain is not just a physical sensation but also has an emotional component that can be influenced by a person's mood,  anxiety levels, and past experiences with pain. d. It is typically associated with anxiety: This statement is true. Pain is often associated with anxiety. The experience of pain can lead to anxiety, and anxiety can, in turn, amplify the perception of pain. This creates a cycle where pain and anxiety can reinforce each other. Correct answer: a. reaction to it is largely inborn, rather than acquired. 35. Risk factors for development of coronary artery disease include ALL of Coronary artery disease (CAD) is primarily caused by the the following, EXCEPT: buildup of plaque in the coronary arteries, which can lead to reduced blood flow to the heart muscle. Several risk factors are a. smoking associated with the development of CAD, including lifestyle, b. hypertension genetic, and metabolic factors. c. diabetes mellitus d. diabetes insipidus Let's evaluate each option: a. Smoking: This is a well-known risk factor for coronary artery disease. Smoking damages the lining of the arteries, promotes plaque formation, and increases the risk of blood clots, all of which contribute to the development of CAD. b. Hypertension: Also known as high blood pressure, hypertension is a significant risk factor for CAD. High blood pressure can damage the arteries over time, making them more susceptible to the buildup of plaque and leading to narrowed or blocked coronary arteries. c. Diabetes mellitus: This is another major risk factor for CAD. People with diabetes have a higher risk of developing CAD because high blood sugar levels can damage the blood vessels and nerves that control the heart. d. Diabetes insipidus: This is not a risk factor for coronary artery disease. Diabetes insipidus is a condition characterized by an imbalance of fluids in the body, leading to excessive thirst and urination. It does not directly affect blood vessels or contribute to the development of CAD like diabetes mellitus does. Correct answer: d. diabetes insipidus. This is not a risk factor for the development of coronary artery disease. 36. Which of the ff medications is most Clonidine is an alpha-2 adrenergic agonist that decreases likely to cause bradycardia? sympathetic outflow from the central nervous system, leading to reduced heart rate and potential bradycardia. a. clonidine b. hydralazine c. hydrochlorothiazide d. Isosorbide mononitrate 37. What method should be used in determining the least expensive course Cost-minimization analysis is used when the outcomes of the of drug therapy, assuming that two interventions being compared are assumed to be equivalent, drugs are therapeutically equivalent? and the goal is to determine which intervention costs less. a. cost- utility analysis b. cost-benefit analysis c. cost-effectiveness analysis d. cost-minimization analysis 38. To verify that the organism A follow-up test is typically recommended at least 4 weeks (1 Helicobacter pylori has been eradicated, month) after completing therapy, but 2 months allows for ensuring how long after completing medication the infection has been adequately cleared and avoids false therapy should a patient have a follow negatives due to the residual effects of the treatment. up test? a. 3 days b. 1 week c. 3 weeks d. 2 months 39. Paraneoplastic syndromes associated with lung cancer include all The paraneoplastic syndromes associated with lung cancer of the ff EXCEPT: include: a. SIADH SIADH (Syndrome of Inappropriate Antidiuretic b. anorexia Hormone secretion) c. appendicitis Cushing's syndrome d. Cushing’s syndrome Anorexia (although more of a symptom than a specific paraneoplastic syndrome, it is common in cancer patients) However, APPENDICITIS IS NOT A PARANEOPLASTIC SYNDROME ASSOCIATED WITH LUNG CANCER. Paraneoplastic syndromes are conditions caused by the indirect effects of cancer, typically due to substances produced by the tumor or by an immune response against the tumor, which are not directly related to the local presence of cancer cells. Appendicitis, on the other hand, is an inflammation of the appendix, usually due to infection or obstruction, and is unrelated to lung cancer. 40. Which of the ff references is the most appropriate to explain the This resource is specifically designed for understanding the pathophysiology of heart failure? therapeutic management and underlying mechanisms of various diseases, including heart failure. It offers detailed explanations of a. Medline disease processes, making it ideal for learning about the b. Merck index pathophysiology of heart failure. c. MICROMEDEX d. Applied therapeutics: The clinical Other options like Medline provide a broad range of medical use of drugs literature, and MICROMEDEX is more focused on drug information, while the Merck Index is a chemical encyclopedia, not a resource focused on pathophysiology. 41. Losartan is an appropriate alternative therapy for a patient ACE inhibitors can cause a persistent, dry cough in some experiencing which of the ff patients due to the accumulation of bradykinin. Since Losartan is complications during ACE-inhibitor an angiotensin II receptor blocker (ARB), it does not inhibit the therapy? breakdown of bradykinin, and therefore does not typically cause a cough, making it a good alternative for patients who experience a. angioedema this side effect. b. renal failure c. hyperkalemia Angioedema can also occur with ARBs, although it is less d. intractable cough common than with ACE inhibitors, so ARBs are generally not recommended for patients who have experienced angioedema on ACE inhibitors. Renal failure and hyperkalemia are risks associated with both ACE inhibitors and ARBs, so switching to Losartan would not be appropriate for patients with these complications. Thus, the correct answer is d. intractable cough. 42. Which of the ff is the most Heat intolerance, weight loss, and palpitations are symptoms of appropriate recommendation for a hyperthyroidism or excessive thyroid hormone levels. These patient taking levothyroxine who symptoms suggest that the current levothyroxine dose might be complains of heat intolerance, weight too high, so reducing the dose would be the correct approach. loss, and palpitations? a. initiate methimazole b. initiate propranolol therapy c. increase the levothyroxine dose d. decrease the levothyroxine dose 43. The potential for weight gain Pioglitazone is a thiazolidinedione used to treat type 2 diabetes, associated with pioglitazone therapy is and it can cause fluid retention, which may lead to weight gain. increased when given to patients with: This risk is increased in patients with heart failure, as their ability to manage fluid balance is compromised. a. heart failure b. chronic anemia c. chronic lung disease d. peripheral vascular disease 44. Phase IV studies are also known as: Phase IV studies, or post-marketing surveillance studies, are a. pre-clinical studies conducted after a drug has been approved and is available on the b. clinical trials market. These studies monitor the drug's long-term effects, safety, c. animal studies and effectiveness in the general population. d. post-marketing surveillance 45. When considering the ability of While the volume of distribution, molecular weight, and protein hemodialysis to remove a drug, all of binding are important factors affecting a drug's removal by the ff parameters are important hemodialysis, the half-life of the drug is not directly related to EXCEPT: the efficiency of hemodialysis in removing it. Instead, the half-life indicates how long the drug remains in the body, which can a. volume of distribution be influenced by other factors including the efficiency of dialysis. b. molecular weight c. protein binding d. half life 46. Which of the ff features is LEAST likely to be promoted by a pharmacist? Pharmacists’ credentials: Pharmacists often promote their professional qualifications to build trust and credibility with a. pharmacists’ credentials patients and healthcare providers. b. pharmacy care services Pharmacy care services: Pharmacists actively promote c. low cost of prescriptions various pharmacy care services such as medication therapy d. fast filling of prescriptions management, immunizations, and health screenings to enhance patient care. Fast filling of prescriptions: Efficiency in prescription filling is a key aspect of pharmacy practice, and pharmacists often strive to provide timely service. Promoting the low cost of prescriptions is generally less emphasized by pharmacists themselves because pricing is often determined by the pharmacy's business policies, insurance coverage, and drug pricing structures. Pharmacists may assist in finding cost-effective options, but their primary role does not usually focus on the promotion of low prescription costs directly. 47. Which of the ff entities assigns a The Food and Drug Administration (FDA) assigns a “fast track” “fast track” designation to accelerate a designation to drugs that address unmet medical needs and drug’s review and approval? have the potential to treat serious conditions. This designation is intended to expedite the review and approval process for such a. Food and drug administration drugs. b. drug enforcement agency c. American Pharmacists Association D. Pharmaceutical Research and Manufacturers of America 48. Which of the ff best describes Capitation systems involve paying healthcare providers a fixed capitation systems? amount per patient per period, regardless of the number or type of services provided. This leads to predictable income for a. risk-free for providers providers, as they receive a set payment regardless of patient b. increased use of technology care needs. c. predictable provider income d. unpredictable patient population 49. Which of the ff medication regimens In New York Heart Association (NYHA) Class II heart failure, a would not be appropriate in a patient combination of medications is typically used to manage with New York Heart Association symptoms and improve outcomes. While furosemide, a Class II heart failure? diuretic, can be useful for symptom relief by reducing fluid overload, it is not sufficient as monotherapy for long-term a. losartan and carvedilol management. Instead, a combination of medications like ACE b. enalapril and metoprolol inhibitors (e.g., enalapril, lisinopril), beta-blockers (e.g., metoprolol, c. furosemide monotherapy carvedilol), and possibly angiotensin receptor blockers (e.g., d. lisinopril monotherapy losartan) are generally recommended for comprehensive heart failure management. [ACE-Is + BBs + ARBs] 50. Which of the ff dietary supplements Fish oil, which contains omega-3 fatty acids, has been shown may be useful in lowering to have potential benefits in reducing cardiovascular mortality. cardiovascular mortality? Studies have demonstrated that omega-3 fatty acids can lower a. fish oil the risk of cardiovascular events and may contribute to b. vitamin E improved heart health. Vitamin E, nicotinamide, and CoEnzyme c. nicotinamide Q10 have not shown consistent evidence of reducing d. CoEnzyme Q10 cardiovascular mortality in the same way. 51. Compensation programs can serve Compensation programs are designed to attract, motivate, to: and retain employees. They help in attracting qualified candidates I. attract employees by offering competitive salaries and benefits, motivate employees II. motivate employees by providing incentives and rewards for performance, and retain III. retain competent employees competent employees by ensuring competitive compensation packages that discourage them from leaving for better a. I only opportunities. b. I and II only c. II and III only d. I, II, and III 52. The statistical power of a study The statistical power of a study is the probability that the study defines the: will correctly reject the null hypothesis when there is a true effect or difference. In other words, it measures the study's a. risk of type 1 error ability to detect a true effect if it exists. b. blinding techniques used c. the probability of detecting a difference, if one exists d. randomization procedure followed 53. Which of the ff vitamin deficiencies Gastric bypass surgery can lead to deficiencies in vitamin B12 is most likely to occur ff gastric bypass due to decreased absorption. The surgery often involves altering surgery for morbid obesity? the digestive tract, which can affect the body's ability to absorb vitamin B12 from food. This deficiency can occur because intrinsic a. A factor, which is necessary for B12 absorption, may be reduced or b. B12 bypassed during the procedure. c. E d. K 54. A patient is started on enteral In a patient receiving enteral feeding via a nasogastric tube, an feeding by nasogastric tube. The best abdominal exam to assess for distention is an effective method to evaluate the possibility of method to evaluate the possibility of formula accumulation accumulated formula within the GI tract within the GI tract. Distention can indicate that the formula is not is to assess the patient’s: being properly absorbed or that there may be a blockage or other issue in the GI tract. a. chest x-ray b. development of diarrhea c. blood glucose monitoring d. abdominal exam looking for distention 55. The dosing guideline for acetaminophen are: For a 2-year-old patient, the appropriate single dose of acetaminophen is 160 mg. (1 TEASPOONFUL = 5mL) age (yr) single dose (mg) 2-3 160 Here’s how the different forms and doses compare: The following forms of acetaminophen are available: Acetaminophen infant drops (80 mg/0.8 mL): - Acetaminophen infant drops ○ 1 teaspoonful (5 mL) contains 500 mg (not 80mg/0.8mL appropriate for the 160 mg dose needed). - Acetaminophen toddler syrup ○ 1/2 teaspoonful (2.5 mL) contains 250 mg (also too 160mg/5mL high for the 160 mg dose). Acetaminophen toddler syrup (160 mg/5 mL): What dose is appropriate for a ○ 1 teaspoonful (2.5 mL) contains 80 mg, 2-year-old patient? subtherapeutic a. Acetaminophen infant drops 1/2 ○ 1 teaspoonful (5 mL) contains 160 mg, which teaspoonful (250mg - too high) matches the required dose. b. Acetaminophen infant drops 1 teaspoonful (500mg - too high) Thus, the correct dose for a 2-year-old patient would be: c. Acetaminophen toodler syrup ½ teaspoonful (80mg - too low) Acetaminophen toddler syrup 1 teaspoonful. d. Acetaminophen toodler syrup 1 teaspoonful 56. Which INR value is considered For patients receiving warfarin for the treatment of a proximal deep therapeutic in a patient receiving vein thrombosis (DVT), the therapeutic INR range is typically warfarin for proximal DVT? between 2.0 and 3.0. Therefore, an INR of 2.4 falls within this therapeutic range. a. INR= 1.2 b. INR = 1.7 c. INR = 2.4 d. INR = 3.3 57. Which of the following changes is The presence of a fatty streak is often one of the earliest the first to occur in the process of changes observed in the process of atherosclerosis. It involves atherosclerosis? the accumulation of lipid-laden foam cells in the intima of the blood vessel wall, which is a precursor to more advanced atherosclerotic a. smooth muscle cells moving from the lesions. media to the intima of the vessel wall b. presence of a fatty streak c. LDL-C diffusing into the vessel wall d. atheroma production 58. Uncontrolled hypertension can lead Uncontrolled hypertension can lead to blindness due to its to: impact on the blood vessels in the eyes, causing conditions a. blindness such as retinopathy or damage to the retina. High blood b. Splenomegaly pressure can result in vision loss or even blindness if not properly c. emphysema managed. Splenomegaly, emphysema, and cirrhosis are not d. cirrhosis typically direct consequences of uncontrolled hypertension. 59. All of the ff measures are Exercising in the evening can potentially exacerbate GERD appropriate non-drug treatment for symptoms, as physical activity can increase abdominal pressure GERD, EXCEPT: and promote acid reflux. The other measures—smoking a. smoking cessation cessation, avoiding fatty meals, and elevating the head of the b. avoiding fatty meals bed—are appropriate non-drug treatments for GERD. c. exercising in the evening d. elevating the head of the bed. 60. Statutes and regulations that govern The practice of pharmacy technicians is primarily governed by the practice of pharmacy technicians state legislation. Each state has its own set of laws and are found in: regulations that outline the scope of practice, responsibilities, and requirements for pharmacy technicians. Federal legislation and a. federal legislation local legislation may also impact pharmacy practice, but the b. state legislation specific regulations for pharmacy technicians are generally c. local legislation determined at the state level. d. professional standards 61. Which of the ff conditions increases Hypokalemia: Low potassium levels increase digoxin's effects on the risk of digoxin toxicity? the heart, making toxicity more likely. I. hypokalemia Hypomagnesemia: Low magnesium levels can enhance digoxin II. Hypomagnesemia toxicity, though this is less frequently noted. III. Hypercalcemia Hypercalcemia: High calcium levels can also increase digoxin toxicity, but this is generally a less emphasized factor compared to a. I only hypokalemia. b. I and II only c. II and III only d. I, II and III 62. In addition to pharmacists, which of the following health care professionals In general: are permitted by their license to dispense Rx drugs? Physicians: They are permitted to prescribe and dispense prescription drugs as part of their practice. I. Physicians Chiropractors: In some states, chiropractors are allowed to II. Chiropractor dispense certain medications, though this can vary by III. Physical therapist jurisdiction. Physical therapists: They typically do not have the a. I only authority to dispense prescription medications. Their role is b. I and II only generally limited to providing therapeutic services and c. II and III only interventions. d. I, II and III 63. All of the ff drugs are indicated in the mgt of hypertension in a Verapamil is a calcium channel blocker primarily used for patient with concurrent heart failure managing hypertension and certain types of arrhythmias, but EXCEPT: it is not typically preferred for patients with concurrent heart failure. a. Lisinopril b. Carvedilol For heart failure, the recommended drugs include: c. verapamil d. metoprolol Lisinopril: An ACE inhibitor that helps reduce symptoms and improve outcomes in heart failure. Carvedilol: A beta-blocker that is beneficial in treating both hypertension and heart failure. Metoprolol: Another beta-blocker used to manage heart failure and hypertension, specifically the metoprolol succinate formulation. Verapamil, while effective for hypertension, can be contraindicated in heart failure patients due to its negative inotropic effects, which can worsen heart failure symptoms. 64. The number of new cases of The number of new cases of a disease occurring in a specific Type 2 diabetes mellitus occurring in time period, such as one year, is referred to as the annual one year is referred to as the: incidence. This measure helps in understanding how frequently new cases of the condition arise within that time frame. a. annual incidence b. risk ratio c. annual prevalence d. risk index 65. Expectations regarding practice Role ambiguity occurs when there is uncertainty or lack of clarity activities that are NOT met upon about what is expected in a role, which can result from unmet entry to practice may result in: expectations regarding practice activities. This can lead to confusion about responsibilities and how to perform duties a. professional commitment effectively. b. role ambiguity c. professionalization d. role reversal 66. For which of the ff patients is parenteral nutrition most appropriate? Parenteral nutrition is most appropriate for patients who cannot meet their nutritional needs through enteral routes due a. NPO for 3 days post-trauma to severe gastrointestinal dysfunction or malabsorption. This b. during first week post –CVA includes conditions where the intestinal function is severely c. serum albumin concentration of 3 compromised, making it impossible for the patient to absorb g/dL nutrients effectively. d. Severely decreased intestinal NPO for 3 days post-trauma: Short-term fasting or NPO function causing malabsorption status might not require parenteral nutrition if the patient can resume oral or enteral feeding soon. During the first week post-CVA (cerebrovascular accident): Patients might still be able to tolerate enteral feeding during this time, depending on their condition. Serum albumin concentration of 3 g/dL: Low serum albumin can be indicative of various conditions but does not specifically determine the need for parenteral nutrition without additional context on gastrointestinal function. 1. Drugs that lead to high physical Schedule II drugs are classified as having a high potential for and psychological dependence physical and psychological dependence and abuse. These and abuse drugs are available by prescription but are strictly regulated due to a. schedule II their high abuse potential. Examples include opioids like b. schedule III morphine and oxycodone, and stimulants like amphetamines. c. schedule IV d. schedule V 2. Cost that lower than AWP: a. AAC (lower than AWP) The cost that is typically lower than the Average Wholesale Price b. WAC (lower than AWP (AWP) is: but higher than AAC) c. EAC a. AAC (Actual Acquisition Cost) d. DPC AAC (Actual Acquisition Cost): This is the actual price paid by pharmacies to purchase drugs, which is often lower than the AWP. WAC (Wholesale Acquisition Cost): This is the manufacturer's list price to wholesalers, generally lower than AWP but higher than AAC. EAC (Estimated Acquisition Cost): This is an estimate of the price pharmacies pay, often used by insurance companies and may be lower than AWP. DPC (Direct Price Cost): This is not a standard term in pharmacy pricing. It might refer to direct purchase costs but is not typically used in this context. AAC is usually lower than the AWP because AWP is a benchmark price, often considered inflated compared to the actual cost pharmacies pay for drugs. 3. Which organization control cases of varicella disease among children The organization that controls and monitors cases of varicella a. CDC (chickenpox) disease among children is the: b. FDA  CDC (Centers for Disease Control and Prevention) The CDC is responsible for tracking, controlling, and preventing infectious diseases in the United States, including varicella. It provides guidelines for vaccination, disease surveillance, and public health interventions to reduce the incidence of varicella among children and the general population. The FDA (Food and Drug Administration) is responsible for regulating vaccines and ensuring their safety and efficacy, but the CDC is the primary agency for disease control and prevention efforts. 4. All of this are examples of direct medical cost EXCEPT: ANSWER: Sick days Direct medical costs refer to expenses directly Indirect medical costs refer to the economic associated with the diagnosis, treatment, and losses associated with a medical condition that management of a disease or medical condition. are not directly tied to medical services or Examples include: treatment. Examples include: 1. Hospitalization Costs: Charges for hospital 1. Lost Productivity: Wages or income lost stays, including room and board, nursing due to a patient's inability to work while they care, and inpatient services. are sick or recovering from an illness or 2. Medications: Costs of prescription drugs, injury. over-the-counter medications, and any 2. Absenteeism: Costs associated with missed medical supplies needed for treatment. work days due to illness, which affects both 3. Physician Services: Fees for consultations, the employee and the employer. (Sick days) office visits, surgeries, and any other 3. Presenteeism: Reduced productivity when services provided by healthcare an employee is at work but not functioning at professionals. full capacity due to illness or ongoing 4. Laboratory Tests and Diagnostics: Costs treatment. associated with blood tests, imaging studies 4. Caregiver Costs: Economic value of time (e.g., X-rays, MRIs), and other diagnostic and resources provided by family members procedures. or friends who take care of the patient, 5. Surgical Procedures: Expenses for including lost wages if they must take time off surgeries, including the surgeon's fees, work. anesthesia, and operating room charges. 5. Transportation Costs: Expenses for travel 6. Emergency Room Visits: Costs related to to and from medical appointments, including receiving emergency care, including fuel, parking fees, or public transportation transport via ambulance if necessary. costs. 7. Rehabilitation Services: Costs for physical 6. Home Modifications: Costs of modifying a therapy, occupational therapy, and other home to accommodate a patient's needs, rehabilitative services. such as installing wheelchair ramps or 8. Home Health Care: Expenses for medical accessible bathrooms. care provided at home, including nursing 7. Long-Term Disability: Loss of income and care, physical therapy, and other in-home increased expenses related to long-term  medical services. disability that results from chronic illness or 9. Medical Equipment: Costs of durable injury. medical equipment such as wheelchairs, 8. Premature Death: Economic loss due to the oxygen tanks, or prosthetic devices. premature death of an individual, including the loss of future earnings and productivity. These costs are all directly related to the delivery of 9. Training Replacement Workers: Costs medical care to patients. incurred by employers for training new workers to replace those who are unable to continue working due to illness or injury. These costs are often less visible but can have a significant impact on both individuals and the broader economy. 5. Main function of poison control organization The main function of a poison control organization is to provide A: to help people in preventing immediate, expert guidance on managing and treating poisoning poisoning and discuss new poisons exposures. Key functions include: with population 1. Emergency Assistance: Offering 24/7 advice to the public and healthcare providers on how to handle poisonings and overdoses, including what immediate steps to take and whether medical attention is required. 2. Information and Education: Providing information on the toxicity of various substances, including household products, medications, chemicals, plants, and bites/stings, and educating the public on poison prevention. 3. Coordination of Care: Assisting healthcare professionals in managing poisoned patients by recommending appropriate treatment protocols based on the specific toxin involved. 4. Data Collection and Surveillance: Monitoring poisoning cases to track trends, identify emerging hazards, and provide data to public health agencies for preventive measures and policy development. 5. Public Health Alerts: Issuing warnings and information about potential poison hazards during public health emergencies, such as chemical spills or contamination incidents. 6. What does the poison prevention packaging Act require? The Poison Prevention Packaging Act (PPPA) requires the use of a. child-resistant container child-resistant containers for certain household products and b. child proof cap medications.  Child-resistant containers are designed to be difficult for children under the age of five to open, but not too difficult for most adults to use properly. This includes mechanisms like caps that require simultaneous pressing and turning, or other designs that impede easy access by children, helping to prevent accidental poisonings. Child-proof caps are a common feature of these containers, but the broader term child-resistant packaging is used to encompass various designs that meet the safety standards set by the PPPA. 7. How can pharmacist counsel 5-year patient, he can use everything except: When counseling a 5-year-old patient, a pharmacist can use a. use stickers for appreciation techniques such as: b. use cartoon characters to explain something Use stickers for appreciation: This is a positive c. say that pharmacist will be reinforcement strategy that rewards the child for good disappointed if patient will not behavior, like taking their medication. take medications Use cartoon characters to explain something: This makes the explanation more engaging and understandable for a young child. However, a pharmacist should not: Say that the pharmacist will be disappointed if the patient will not take medications: This can create unnecessary pressure or fear in the child, which is not an appropriate or effective way to encourage adherence. It is better to use positive encouragement rather than guilt or disappointment. 8. Which website can we use to find information about fibrosis? To find information about fibrosis, you can use reputable medical websites such as: 1. Mayo Clinic: www.mayoclinic.org - Provides detailed information on various types of fibrosis, including symptoms, causes, and treatment options. 2. National Institutes of Health (NIH): www.nih.gov - Offers information through various institutes, such as the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) for liver fibrosis and the National Heart, Lung, and Blood Institute (NHLBI) for pulmonary fibrosis. 3. MedlinePlus: medlineplus.gov - A resource provided by the National Library of Medicine (NLM) that includes information on different types of fibrosis, treatments, and research updates. 4. American Lung Association: www.lung.org - Provides information specifically on pulmonary fibrosis and related  lung conditions. 5. American Liver Foundation: www.liverfoundation.org - Offers information on liver fibrosis and related liver diseases. These websites are reliable sources for up-to-date and comprehensive information on fibrosis. 9.The principle of pharmaceutical ethics that everybody has right for medical The principle of pharmaceutical ethics that emphasizes the right of treatment every individual to access medical treatment is known as "justice" or "equity". "justice" or "equity" Justice in pharmaceutical ethics refers to the fair distribution of resources and ensuring that all individuals have equal access to medical treatments and healthcare services, regardless of their socio-economic status, race, or other factors. It involves the ethical obligation to provide care and access to medications in a manner that does not discriminate against any individual or group. 10. Why do we need to make computerization of prescriptions? Computerization of prescriptions offers several key benefits: 1. Error Reduction: Computerized systems help reduce prescription errors caused by illegible handwriting or misinterpretation. They can include built-in checks for drug interactions, allergies, and dosage errors. 2. Efficiency: Electronic prescriptions streamline the process by allowing prescriptions to be sent directly to pharmacies, reducing the time spent on manual paperwork and phone calls. 3. Improved Accuracy: Electronic systems often have features that ensure accurate medication dosing and instructions, which can improve patient safety. 4. Enhanced Record-Keeping: Computerization allows for better tracking of prescription records, including medication history and refill information, which is valuable for both patient care and regulatory compliance. 5. Convenience: Patients can have prescriptions sent electronically to their preferred pharmacy, and healthcare providers can easily review and manage medications from their electronic health records. 6. Data Integration: Electronic prescription systems can integrate with other health information systems, allowing for more comprehensive patient care and coordination among healthcare providers. 7. Reduced Fraud: Electronic prescriptions are harder to forge or alter compared to handwritten prescriptions,  reducing the risk of prescription fraud. Overall, computerization enhances the safety, efficiency, and effectiveness of the prescribing process. 11. What type of radiation is highly (answer: gamma!!!!!) penetrating? Gamma radiation is highly penetrating and can pass through a. Alpha (least; can be stopped by a most materials, including human tissue. It requires dense sheet of paper or even the outer layer of materials like lead or several centimeters of concrete to effectively skin) shield against gamma rays. Consists of high-energy photons with b. Beta (B> A; can be stopped by a few high penetrating power. millimeters of plastic, glass, or aluminum) Alpha radiation is the least penetrating and can be c. delta stopped by a sheet of paper or even the outer layer of skin. d. Gamma (most; requires dense Consists of heavy, positively charged particles (alpha materials like lead or several particles) that have low penetrating power. centimeters of concrete to shield) Beta radiation is more penetrating than alpha but can be stopped by a few millimeters of plastic, glass, or aluminum. [Gamma > Beta > Alpha] Consists of high-energy, high-speed electrons or positrons (beta particles) with moderate penetrating power. 12. In Plan-Do-Study-Act what does Act mean: In the Plan-Do-Study-Act (PDSA) cycle, the "Act" phase is most a. Direction (ACT) closely associated with: b. Organization (Plan) c. Planning (plan) a. Direction During the "Act" phase, you make decisions on whether to adopt, adapt, or abandon the changes tested based on the results from the "Study" phase. It involves setting direction for implementing changes or making adjustments to improve processes or systems based on the insights gained. Here’s a brief overview of the PDSA cycle: Plan: Identify an area for improvement and develop a plan for testing changes. Do: Implement the changes on a small scale to test their impact. Study: Analyze the results of the test to understand the impact of the changes. Act: Based on the analysis, decide to implement the changes more broadly, adjust the plan, or explore other solutions. 13. If a terminally ill patient said that he will help all homeless people what would this condition be? When a terminally ill patient expresses a desire to help others, such as homeless people, it can be an indication of a psychological phenomenon known as: "Altruistic behavior" or "altruism" In the context of terminal illness, this behavior may also reflect a: "Final act of meaning" or "legacy project" These terms describe a desire to leave a positive impact or contribute to society in a meaningful way before death. This behavior is often motivated by the patient's wish to find purpose or make a difference as they face the end of life. It may also be a way of coping with their own situation by focusing on helping others. 14. H. pylori diagnosis tests a. urea breath test For diagnosing Helicobacter pylori (H. pylori) infection, the b. blood test following tests are commonly used: c. culture 1. Urea Breath Test: This non-invasive test detects the presence of H. pylori by measuring carbon dioxide in the breath after the patient ingests a substance containing urea. If H. pylori is present, it will break down the urea and release carbon dioxide. 2. Blood Test: This test detects antibodies to H. pylori in the blood. However, it is less commonly used for diagnosis now because it cannot distinguish between current and past infections and is less effective in detecting active infections. 3. Culture: This involves taking a sample from the stomach lining (often via endoscopy) and growing the bacteria in a lab to confirm the presence of H. pylori. It is used less frequently due to its complexity and the availability of other, simpler tests. In summary, urea breath test and culture are more specific for diagnosing active H. pylori infection, while blood tests can indicate past exposure but are less useful for current infections. 15. Which medication causes hypothyroidism? (answer was lithium) Several medications can cause or contribute to the development of hypothyroidism. Some common ones include: 1. Lithium: Used primarily for treating bipolar d