APC Written Exam - 2014 - pharmacy intern practice exam questions PDF

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Australian Pharmacy Council Ltd Intern Written Examination Sample Paper v1.2014 This is an official Intern Written Examination sample paper produced by the Australian Pharmacy Council Ltd (APC) for practice purposes only. All questions in this sample paper are no longer used in live or actual examinations and have been chosen to allow interns to gain exposure to the type of content and layout of questions on the examination. Live or actual Intern Written Examinations delivered contemporaneously will vary from this sample paper. The Intern Written Examination is 125-questions long and candidates have 3 hours to complete it. Due to the frequent changes to the scope and content within the practice of pharmacy in Australia, the APC does not guarantee that the information in this paper is accurate or relevant once published publicly. The actual Intern Written Examination is delivered by computer and interns should visit the APC website for further information, including a link to an online tutorial: https://www.pharmacycouncil.org.au/interns/prepare-for-an-exam/ Copyright © Australian Pharmacy Council Ltd 2013. The content of this document is the property of the Australian Pharmacy Council Ltd and may not be reproduced.

1

2

3

What volume of 2% potassium permanganate solution is required in order to provide 200ml of 75mg/5ml potassium permanganate solution? A

15ml

B

30ml

C

150ml

D

1500ml

E

450ml

In which schedule of the Standard for the Uniform Scheduling of Medicines and Poisons would you find codeine tablets 30mg? A

Schedule 2

B

Schedule 3

C

Schedule 4

D

Schedule 8

E

Unscheduled

Substances, the safe use of which requires professional advice, but which should be available to the public from a pharmacist without a prescription” is the general description statement for which ONE of the following Poisons Schedules? A

Schedule 2

B

Schedule 3

C

Schedule 4

D

Schedule 5

E

Schedule 6

4

5

6

What does Regulation 24 of the Pharmaceutical Benefits Scheme (PBS) refer to? A

No requirement for a patient co-payment

B

Application to patients with specific medical conditions only

C

Supply of original and all of the repeats to be supplied at the one time

D

Application to patients from a remote area where access to PBS supplies is limited

E

Increasing the maximum quantity or number of repeats of a prescription

A prescription item designated as an unrestricted PBS benefit item is BEST described as a medication: A

That has no PBS determinations on its therapeutic use

B

With a low therapeutic index, which requires close monitoring

C

That can only be prescribed on the PBS for specific therapeutic uses

D

That is restricted and requires prior approval from the Medicare Australia or the Department of Veterans Affairs for a specific condition

E

With a high chance of adverse events, which requires the prescriber to consider carefully the risk benefit ratio for each specific patient

According to the Standard for the Uniform Scheduling of Medicines and Poisons, what medicine is classified in Schedule 4? A

Prescription only medicine

B

Pharmacist only medicine

C

Controlled drug

D

Pharmacy medicine

E

Dangerous poison

7

8

9

What weight of potassium permanganate is required to produce 200 mL of solution such that 50 mL of this solution diluted to 200 mL will produce a 1 in 400 solution? A

0.2 g

B

0.4 g

C

1g

D

2g

E

4g

What is the ideal body weight for a 34 year old male who is 182 cm tall (of average frame)? A

77 kg

B

82 kg

C

87 kg

D

92 kg

E

97 kg

An adult patient is stabilised on 0.2g twice a day of an oral medicine. What is the intravenous dose of the same medicine where the IV equivalent dose is 30% of the total daily oral dose? A

1300mcg/hour

B

5000mcg/hour

C

6600mcg/hour

D

2750mcg/hour

E

500mcg/hour

10

11

12

An 8 year old child (weight 25 kg) has been diagnosed with meningitis. She has been prescribed dexamethasone at a dose of 0.6 mg/kg/day in four divided doses, for two days. What is the total DAILY dose of dexamethasone prescribed? A

6 mg

B

15 mg

C

25 mg

D

30 mg

E

90 mg

A baby (weighing 3.75kg) requires frusemide at 1.6mg/kg/day for 30 days. You have several 30mL bottles of frusemide solution (10mg/mL) in stock. What is the required total daily dose of frusemide solution? A

0.6 mL

B

3.0 mL

C

4.8 mL

D

6.0 mL

E

18 mL

ZINC AND CASTOR OIL OINTMENT Zinc oxide 7.5g Castor oil 50.0g Cetostearyl alcohol 2.0g White beeswax 10.0g Arachis oil 30.5g The wt/mL of castor oil is 0.95 g. The volume of castor oil required to make 500 g of this ointment is A

210mL

B

225mL

C

237mL

D

250ml

E

263mL

13

14

15

A patient (height 1.7 m, weight 69 kg) is being treated for Hodgkin's disease with dacarbazine 210 mg/m2 on day 1 and day 15 of each 28 day cycle. What dose of dacarbazine is administered on day 15 of the cycle? A

208 mg

B

379 mg

C

675 mg

D

1219 mg

E

1350 mg

According to the Standard for the Uniform Scheduling of Medicines and Poisons, what classification does cyproheptadine hydrochloride 4mg (50) tablets belong to? A

Prescription only medicine

B

Pharmacist only medicine

C

Unscheduled

D

Pharmacy medicine

E

Controlled drug

Where can items to be recorded on Prescription Record Forms (PRFs) be recorded? A

Community pharmacies and approved hospitals

B

Community pharmacies only

C

Medical clinics and community pharmacies

D

Approved hospitals and medical clinics

E

Community pharmacies and community health centres

16

17

18

Buprenorphine is classified in Schedule 8 in the Standard for the Uniform Scheduling of Medicines and Poisons. What sort of medicine is Buprenorphine? A

Prescription only medicine

B

Pharmacist only medicine

C

Controlled drug

D

Pharmacy medicine

E

Dangerous poison

What is the specific antidote for dabigatran? A

Protamine sulfate

B

Vitamin K

C

Antifactor Xa

D

Vitamin E

E

There is no specific antidote

Patients with chronic pain are occasionally enrolled in double blind analgesic infusion studies at pain clinics. The studies involve the infusion of a pseudorandom, equivolumetric sequence of normal saline, lignocaine, thiopentone and fentanyl. The effect on the pain score for each of these agents is reported by the patient. The patient is unaware of the sequence. Why is lignocaine included in these studies? A

It causes a diffuse pain state

B

It acts as a ‘truth serum’

C

A response suggests neuropathic pain

D

It causes euphoria similar to opioids

E

A response suggests opioid-resistant pain

19

20

21

When administered intravenously, which of the following medications should only be given by infusion? A

Ceftazidime

B

Hydrocortisone

C

Vancomycin

D

Metoclopramide

E

Adenosine

A patient is prescribed methotrexate for rheumatoid arthritis. Which of the following recommendations should you give them? A

Take 10mg of folic acid daily to prevent side effects

B

Start intramuscular or subcutaneous therapy

C

Continue the medication for at least 6 months to determine response

D

Have renal and liver function checked every 6 months during therapy

E

Avoid excessive or prolonged sun exposure

A patient with chronic back pain, related to a motor vehicle accident, is taking tramadol with good effect. She is started on an antidepressant, sertraline, by her doctor. In regards to these medications, the occurrence of which of the following side effects should MOST concern you? A

Visual disturbances, drowsiness

B

Constipation, sweating

C

Hyperreflexia, agitation

D

Hypertension, fatigue

E

Dizziness, insomnia

22

23

24

Children experience different Adverse Drug Reactions (ADRs) to adults. Which of the following statements regarding ADRs in children is INCORRECT? A

Severe skin reactions with lamotrigine are more frequently seen in children than in adults

B

There is a risk of tooth discolouration with tetracyclines used in children aged up to 8 years of age

C

Aspirin should not be used routinely in children because of the risk of Kawasaki's disease

D

Quinolones should be used with caution in children because of the risk of arthropathies

E

Valproate hepatotoxicity is seen most frequently in children less than 3 years of age

When used to treat congestive heart failure (CHF), frusemide A

Must be used with digoxin for optimal effect

B

Should be combined with an angiotensin converting enzyme inhibitor or an angiotensin II receptor antagonist

C

Can only be used if spironolactone is also prescribed

D

Is not as effective as a thiazide

E

Must be given with supplemental potassium

Which one of the following medications is the MOST appropriate for the treatment of trigeminal neuralgia? A

Tramadol

B

Carbamazepine

C

Morphine SR

D

Indomethacin

E

Paracetamol/codeine

25

26

27

A female customer has been taking digoxin for an extended period. She presents to your pharmacy with a prescription for herself that is a 10 day course of roxithromycin tablets. What is the MOST appropriate action to take? A

Dispense the prescription and counsel her on the use of her antibiotics over the next 10 days

B

Consult her general practitioner to advise that roxithromycin may decrease digoxin levels

C

Advise her to contact her general practitioner immediately, should she experience symptoms of digoxin toxicity

D

Consult her general practitioner to advise that the combination should be avoided due to a significant drug interaction

E

Advise her to take the medications separately to reduce the likelihood of potential drug interaction

Which of the following combinations of pharmacological effects would be produced by timolol? A

Inotropic, positive chronotrope

B

Not cardiovascular selective, positive chronotrope

C

Cardiovascular selective, positive chronotrope

D

Not cardiovascular selective, negative chronotrope

E

Cardiovascular selective, negative chronotrope

A 25 year old female customer presents you with a prescription for levocabastine eye drops 0.05% 1 drop twice daily for seasonal allergic conjunctivitis. Which of the following advice is INCORRECT? A

Use the drops regularly, as it may take several days for symptom relief

B

You may feel drowsy and the effects of alcohol may be increased

C

The drops are proven to be safe to use during pregnancy

D

Side effects may include stinging, mild eye irritation and headache

E

The frequency of use may be increased to three to four times daily if necessary

28

29

30

A male patient, aged 59 years, presents a prescription for sotalol 80 mg tablets, with a dose of 160 mg daily. He has never taken sotalol before. How should you advise him to take this medication? A

Once a day without regard to meals

B

Twice a day on an empty stomach

C

Once a day on an empty stomach

D

Twice a day with or immediately after food

E

Once a day at bedtime

With which of the following medications is it MOST important to maintain a high fluid intake? A

Spironolactone

B

Indapamide

C

Norfloxacin

D

Cephalexin

E

Frusemide

The refrigerator in the pharmacy that is used for storage of pharmaceutical products should be kept at a temperature of A

0-3 oC

B

2-8 oC

C

5-10 oC

D

6-12 oC

E

Minus 3-8 oC

31

A frail female customer presents with a repeat prescription for verapamil sustained release 240 mg tablets - half a tablet to be taken twice daily. She also presents a new prescription for erythromycin 250 mg qid (to treat a chest infection). What is the MOST appropriate recommendation to make to the prescriber?

32

A

Change the antibiotic to ciprofloxacin, because it is the medication of choice for upper respiratory tract infection

B

Change the antibiotic to doxycycline, because it is the medication of choice for community- acquired pneumonia

C

Increase the erythromycin to 500 mg qid, because verapamil increases the metabolism of erythromycin

D

Change to another antibiotic because erythromycin could lead to increased plasma concentration of verapamil in this patient

You make the following ointment for a female patient who has psoriasis Coal Tar Solution 8% Dithranol 0.25 % Yellow Soft Paraffin to 100 g The patient has not had this preparation before. Which of the following statements is INCORRECT?

33

A

Erythema may occur

B

Ointment may stain the skin and hair

C

Ointment may stain bed linen and clothing

D

Avoid contact with the eyes and any broken skin

E

Improvement of condition can be expected within a few days, if used regularly

With which of the following medications is it recommended that alcohol consumption be avoided? A

Digoxin

B

Ramipril

C

Sulphasalazine

D

Lorazepam

E

Aspirin

34

35

36

A patient comes into the pharmacy with a prescription for rifampicin 600mg. Looking through her profile you see she is on an oral contraceptive. Which of the following is MOST appropriate advice for this patient? A

Use a second method of oral contraception during treatment and for 4 weeks after the last dose

B

Skip any inactive tablets in the present pack and then proceed to the active tablets in a new pack

C

Use a second method of contraception and continue this until 7 days after completion of the course of rifampicin

D

A typical course of rifampicin does not affect oral contraception

E

A second method of contraception will only be required if the rifampicin causes breakthrough bleeding

A regular patient returns to the pharmacy complaining that her fluticasone inhaler dispensed last week isn't providing improvement of her asthma symptoms. What would be the BEST course of action? A

Contact the doctor and suggest a change to fluticasone/salmeterol inhaler

B

Suggest she continues the medication, but refer her to her doctor

C

Suggest she takes an antihistamine in addition to fluticasone and see her doctor if she has no relief in three to four days

D

Check her inhaler technique, advise her to continue treatment and see her doctor if there is no improvement

E

Recommend she commences regular salbutamol with a spacer and see her doctor in two days if no relief

A patient has heartburn. After questioning him, which one of the following factors would NOT necessitate a referral to a doctor? A

Sudden weight loss

B

Blood in stools

C

Difficulty swallowing

D

Bloating and reflux

E

History of taking NSAIDs

37

38

39

40

Which one of the following conditions has NOT been traditionally treated by Gingko? A

Vertigo

B

Memory loss

C

Poor concentration

D

Bloating

E

Chilblains

A patient with diverticular disease is instructed to take a laxative. Which of the following should you recommend? A

Senna tablets

B

Sodium picosulfate drops

C

Glycerol suppositories

D

Ispaghula husk sachets

E

Bisacodyl tablets

Which of the following is NOT a sign/symptom of head lice? A

Itch, especially toward back of neck

B

Blotchy flat, red rash behind ears and on face

C

Tiny dark lice on scalp

D

White specks stuck to base of hair shaft

E

White specks spread throughout hair

Which one of the following factors is LEAST likely to precipitate the onset of herpes labialis? A

Common cold

B

Sun exposure

C

Trauma to the lips

D

Dental decay

E

Immunosuppressi...