Trial test · Pharmacist (Prometric)

Question 1 of 10

A patient with COPD continues to have frequent exacerbations despite regular LABA/LAMA therapy. Blood eosinophils are 380 cells/µL, and inhaler technique and adherence are satisfactory. Which escalation is most appropriate?

Add an inhaled corticosteroid to form triple therapy

Continue LABA/LAMA without adding another controller

Add long-term oral corticosteroid maintenance therapy

Replace both bronchodilators with inhaled corticosteroid alone

Question 2 of 10

A patient near the upper therapeutic phenytoin concentration receives a small maintenance-dose increase. Several days later the concentration rises far more than proportionally and neurologic toxicity appears. Which pharmacokinetic property best explains this response?

Saturable hepatic metabolism near capacity

Constant clearance across the therapeutic range

Decreased absorption at higher oral doses

Linear renal elimination at all concentrations

Question 3 of 10

An older adult with overactive bladder has bothersome urgency and frequency despite behavioral measures. Mild cognitive impairment is present, and avoiding additional anticholinergic burden is a priority. Which pharmacologic approach is most appropriate?

Use a tricyclic antidepressant

Add nightly diphenhydramine therapy

Use immediate-release oxybutynin

Use a beta3-adrenergic agonist

Question 4 of 10

An adult requests two OTC cold products. One contains acetaminophen 650 mg per dose and the other contains acetaminophen 500 mg per dose. The planned schedule would total 5,200 mg daily. What should the pharmacist advise?

Divide the same total into smaller doses

Alternate both products while keeping the same total

Take both products with food for protection

Avoid combining them because the total dose is excessive

Question 5 of 10

An adult with type 2 diabetes and established heart failure has an A1C already at the individualized target while taking metformin. Which medication class should still be considered for cardiovascular benefit independent of additional glucose lowering?

A sulfonylurea for additional glucose lowering

Acarbose for postprandial glucose control

An SGLT2 inhibitor with proven benefit

A short-acting meglitinide with meals

Question 6 of 10

A 75-kg adult without liver disease has scheduled acetaminophen 1,000 mg every 6 hours and a new hydrocodone/acetaminophen 5/325 mg prescription for two tablets every 6 hours PRN. If both are used at their maximum written frequency, what should the pharmacist do after reviewing total daily exposure?

Withhold and clarify total acetaminophen dosing

Dispense and advise both schedules together

Dispense and monitor only for sedation

Dispense and stagger doses by two hours

Question 7 of 10

A pharmacist is presented with a prescription for a regulated medicine that appears altered around the quantity and contains overwriting that cannot be authenticated. The patient asks for immediate dispensing because the clinic is closing. What should the pharmacist do?

Dispense the quantity that appears most likely

Supply a partial quantity without verification

Ask the patient to confirm the quantity

Withhold supply and verify the prescription

Question 8 of 10

An oral medicine has bioavailability of 50%. A patient requires the same systemic exposure produced by a 100 mg intravenous dose. Assuming linear pharmacokinetics, what oral dose would theoretically provide equivalent exposure?

Approximately 200 mg orally

Approximately 50 mg orally

Approximately 100 mg orally

Approximately 400 mg orally

Question 9 of 10

A patient with decreased-function SLCO1B1 transport activity is taking a statin that depends substantially on hepatic uptake by this transporter. Which pharmacokinetic effect is most likely?

Faster renal secretion of statin

Increased intestinal metabolism of statin

Higher circulating statin concentrations

Lower circulating statin concentrations

Question 10 of 10

A variable weekly regimen uses levothyroxine 50 microgram tablets: one tablet daily Monday through Friday and two tablets daily on Saturday and Sunday. What quantity is required for exactly six weeks?

42 tablets

48 tablets

54 tablets

60 tablets