Senior Comp
a pharmacist is preparing a 0.75% lidocaine solution. the pharmacy has a 50ml vial of lidocaine solution labeled 5mg/ml and a 20ml vial of lidocaine solution labeled 20mg/ml. how many milliliters of the 20 mg/ml solution must be mixed with the entire contents of the 50ml vial to prepare the desired percentage strength
10
a patient in the ICU is receiving a heparin drip. the current order is for heparin 25,000 units in 250ml d5w to infuse at 18 units/kg/hour. there are currently 100 milliliters remaining in the bag. assuming no rate changes, how many hours does the pharmacist have before the bag will be empty and the nurse will need to hang a new bag?
6
several days later, KL is ready to be transferred for stroke rehabilitation. her labs and vitals have remained relatively uncahnged since admission to the hospital. the neurologist recommends that KL's blood pressure be optimized. which of the following is the best choice to add to KL's home regimen for improved blood pressure control?
norvasc
which of the following medications is the patient taking for nausea and vomiting?
ondansetron
carbamazepine is associated with which of the following risks?
osteoporosis suicidality hyponatremia stevens johnson syndrome
XL is extremely anxious and crying constantly because the car accident was her fault. she has no family visiting her in the hospital. she is not sleeping. the team would like to give her something orally for anxiety during her hospital stay. which of the following would be the best choice for this patient?
oxazepam
which of the following best describes this study design?
parallel randomized controlled trial
which new medical problem should be added to the patient's profile? SJ
prediabetes
which medication/s on SJ's profile is/are contraindicated?
celebrex zyban
Which reference can be consulted to find room temperature stability information for MI's diabetes medication?
clinical pharmacology
which topical formulation contains bacitracin, neomycin, polymyxin B and hydrocortisone?
cortisporin
which lipid lowering regimen should be recommended for KL?
crestor 20mg daily
while at the nursing home, LD complains of severe mouth pain. On examination of her lower gums, there are several areas where bone is visible. which of LD's medications can cause this side effect?
prolia
tr is admitted to the emergency room with extreme right upper quadrant pain and is found to have an elevated AST and ALT. he has no past medical history, but he states that he takes " a bunch of natural products" for his health. he cant recall any of the names. which of the following natural products would best explain TR's lab abnormalities
kava
the admitting physician requests that sz's lasix be converted to an equivalent iv dose. what dose should the pharmacist recommend
lasix 40mg iv daily
which medication is preferred, in combination with metformin, for further lowering of BY's A1c?
liraglutide
what lab values are characteristic of metabolic acidosis?
low ph, low serum bicarbonate
today's date is January 31st. what is an appropriate BUD for this compounded preparation if it is stored in the refrigerator?
march 28th
what is the generic name of the medicaiton HB takes for arthritis?
meloxixam
which medication can be prescribed for a patient with narcolepsy?
modafanil
a pharmacist is using a crystalline powder for a compound. the crystals will not crush easily, so the pharmacist adds a solvent to dissolve the crystals. When the solvent evaporates and the powder recrystallizes, the particles are finer and easier to work with. the pharmacist used which compounding method?
pulverization
a new pharmacist is being trained on the requirements for monitoring patient absolute neutrophil counts prior to clozapine dispensing. this type of requirement for clozapine is an example of
risk evaluation and mitigation strategy required by the fda for certain high risk drugs
which of the following best describes the mechanism of action of the medication BH uses for the treatment of migraine?
serotonin agonist
what reference could the pharmacist consult to learn more about the criteria used to diagnose GJ's psychiatric condition
up todate diagnostic and statistical manual of mental disorders
which medication should be added to GJ's regimen
valsartan
ty is being seen today in the emergency department. which of the following is the most likely diagnosis based on his labs?
viral infection
which of BY's medications is most likely contributing to her insomnia
zyban
how many mcg/min of norepinephrine was LK receiving on february 6th?
5.9
how much volume is in the graduated cylinder below?
38
a pediatric patient is starting enteral nutrition with nutren 2.0 premixed formula. the patient weighs 21 pounds and requires 1.4 g/kg/day of protein. if nutren 2.0 provides 16g/dl of protein, how many milliliters of nutren 2.0 are required per day to meet the patient's protein requirement?
84
the hospital uses levemir vials. how many milliliters of levemir should the nurse inject for kl's bedtime dose?
0.1
a pharmacist receives an order for a parenteral nutrition formula containing 30mg of elemental calcium. a vial of calcium gluconate provides 0.465meq (9.3mg) of elemental calcium per millimeter. how many milliequivalents of calcium will the patient receive?
1.5
what is LD's recommended daily intake of elemental calcium?
1200mg
a patient was started on d51/2ns continuous IV infusion at a rate of 55 ml/hr at 1100. if it is currently 1600 hoe many more hours will a 1 liter bag of d51/2ns last?
13 hours
a patient in the surgical ICU is receiving 1675ml of d20w, 725,l of freamine 8.5%, 224ml of 20% intralipid and 50ml of electrolytes/mineral. what percentage of the total daily calories is represented by the protein component?
13.4
which of the following is the correct enoxaparin dose for by? 1mg/kg
130 q12
the hosptital uses premixed heparin bags (25,000 units/250ml) what rate (ml/hr) should the continuous infusion of heparin be started at
14
a patient is receiving 1250 kcal from dextrose in his PN solution that is running at 84ml/hr over 24 hours. what is the concentration (% w/v) of dextrose in this PN solution?
18
a worried parent walks into a community pharmacy and asks to speak with the pharmacist. her 6-month old infant (15lbs) has a fever and she was advised by her pediatrician to purchase tylenol infant suspension to reduce the fever. tylenol comes in a 160mg/5ml suspension for infants. the pediatrician recommended 10mg/kg/dose. how many milliliters should be given for each dose?
2
a patient takes one imitrex 50mg tablet. when can the patient take a second dose, if needed?
2 hours
how many milligrams of hydroquinone are needed to make 60 grams of a 4% hydroquinone cream?
2400
BH calls the pharmacy for clarification about how to store her rapid acting insulin vials. How long are her "in use" vials stable when stored at room temperature?
28 days
a patient will receive 60meq of potassium chloride in 1 liter of 0.9% nacl. the hospital has IV tubing sets that deliver 20 drops/ml and the patient's infusion is running at 111 drops/min. how many hours will it take to complete the infusion?
3
how many patients need to be treated with nicotine e-cigarettes vs. placebo e-cigarettes to achieve verified abstinence in one patient?
32
How many milliliters of fluid did LK receive from all intravenous sources on February 6th?
3476
A 78 year old female patient is being started on cefepime. Her labs and the dosing recommendations for cefepime are below. What is the patient's estimated CrCl and recommended cefepime dose?
36 mL/min, 1 gram IV Q24
a patient will receive 2 grams of magesium selfate in 1 liter of 0.9% nacl over 4 hours. the hospital has IV tubing sets that deliver 15 drops/ml.how many drops/min will the patient receive?
62.5
a pharmacist is preparing a 1.25% hydrocortisome ointment from commercially available 2% ointment and petrolatum. how many grams of petrolatum should be added to 12 grams of the 2% ointment to prepare the 1.25% strength?
7.2
which of the following medications come as a capsule meant for inhalation?
Arcapta Neohaler spiriva handihaler
which inhaler should be cleaned at least once per week by rinsing the mouthpiece under warm running water?
Atrovent HFa
which scoring system should be used to verify MI's need for anticoagulation?
CHAD2DS2VASc
which metabolic pathway is responsible for production of the toxic metabolite NAPQI?
CYP450 2E1
which medications used for ADHD are not controlled substances?
Daytrana and Strattera
while verifying the inpatient pharmacy orders, the pharmacist receives a safety alert that one of the medications is contraindicated due to a risk for QT prolongation. Which medication does the pharmacist need to contact the prescriber about?
Dolasetron
which medicaiton is most likely responsible for the symptoms that brought GJ to the clinic today?
invega
on january 20th, a 4 year old child was hospitalized for 7 days with kawasaki disease. during the hospitalization she received 80 mg/kg/day or oral aspirin, 30mg/kg/day of IV methylprednisolone and IV immune globulin (privigen). She is scheduled for a visit with her pediatrician on march 10th for routine vaccinations. which vaccine should not be administered on march 10th given the treatments received during her hospitalization?
MMR
a patient approaches the pharmacist for advice on over the counter cough and cold products. Her physician recommended that she purchase a decongestant for her symptoms. Which product contains a decongestant?
Mucinex D
a pharmacist is compounding a soft lozenge. which of the following would be an appropriate ingredient to prepare the lozenge base?
PEG
a patient would be a candidate for a vancomycin tapered and pulsed regimen if they were experiencing which of the following?
a second episode of non severe clostidium difficile associated diarrhea (first episode treated with vancomycin)
which of the following compounded preparations would have the shortest beyond use date?
a water containing oral solution that is stored in the refrigerator
based on her complaints today, the pharmacist reviews HB's complete blood counts. what is the most likely diagnosis?
iron deficiency anemia
the workbench used to prepare this compound has which of the following characteristics?
airflow is vented to the outside of the building negative pressure airflow to protect the personnel compounding the product
which of the following drugs are compatible with saline only?
ampicillin dilantin invanz
a patient is scheduled to begin chemotherapy with etoposide and cisplatin. which antiemetic regimen is indicated for this patient?
aprepitant + aloxi + dexamethasone
which medication on LD's profile is administered at bedtime to decrease nausea?
aricept
which antibiotics cover atypical pathogens?
avelox biaxin vibramycin
pt should be counseled about which common side effects from this chemotherapy regimen?
diarrhea and mucositis
which medication is most likely causing the non respiratory symptoms that SZ has been experiencing recently?
digox
which of sz's medications can decrease her heart rate
digox coreg cr
a surgical patient has been receiving morphine for pain. over the past 48 hours, he received morphine 7.5mg IV q4h. his pain is increased before the end of the dosing interval and his surgeon would like to switch to dilaudid iv q2h before trying a pca. convert the morphine to an equivalent dose of dilaudid
dilaudid 0.6mg IV q2h
based on MI's medication regimen, what drug therapy problem requires immediate attention?
drug allergy
ca is a 38 year old pregnant female diagnosed with a right lower extremity venous thromboembolism. which treatment is preferred?
enoxaparin
the pharmacist is conducting admission medication reconciliation. what medication issue should be addressed immediately?
entacapone must be administered with carbidopa/levodopa
during the admission evaluation, providers note that LD is choking on her food and tablet/capsule medications. which of the following is in the same class as LD/s current dementia medication and is available in a patch formulation?
exelon
which of the following can be used to treat an accidental overdose of valium
flumazenil
YW is a healthy 32 year old female who has just learned that she is 12 weeks pregnant with her second child. the baby is due in february. she delivered a healthy baby 2 years ago and her medical records indicate that she received tdap during her first preganacy. what vaccines are recommended for administration during YW's second pregnancy?
fluzone and tdap
two days after admission, a caregiver at the nursing home reports that LD is sweating, confused, dizzy and complaining that she feels extreme hunger pains. which medication on her profile is the likely cause of these symptoms?
glyburide
which of HB's medical problems is durlaza being used for?
history of myocardial infarction
what is the purpose of ora-plus
suspending vehicle
MI is an 18 year old female (5'3", 122 lbs) who was recently diagnosed with type 1 diabetes. she eats 2 main meals per day and usually skips lunch. the physician writes for an initial daily dose of insulin at 0.6 units/kg/day. using an NPH regular insulin dosing strategy, calculate the amount of NPH insulin and the amount of regular insulin MI should take.
take nph 11 units and regular insulin 5 units, BID before meals
JA is a 37 year old female who is self treating diarrhea due to mild ulcerative colitis with otc imodium a-d. JA asks her pharmacist how she should take the tablets that she has purchased. which of the followingi s correct?
take two loperamide tablets after the first loose stool, then take one tablet after each subsequent loose stool. do not exceed 4 tablets daily
which of the following compounded preparations must be prepared in a negative pressure room?
testosterone gel
in which part of the nephron does the patient's diuretic exert its mechanism of action?
the distal convoluted tubule
which of the following counseling instructions should be provided for the prescription HB is getting filled today?
this medication should be kept in the original amber glass bottle and stored at room temperature
which of the following make KL ineligible for alteplase at this time?
time since symptom onset
a 21 year old college student asks the pharmacist for advice about a "rash" on his left lower leg and forearms. the pharmacist inspects the rash and notes a small patch on the right forearm and a few lesions on the left lower leg and left forearm. the lesions are in varying states of healing. they are red and circular with an inflamed border. as they spread, the middle heals and becomes clear. what is this condition and which OTC product should the pharmacist recommend?
tinea corporis, clotrimazole cream
what is the purpose of a sieve in pharmacy coumpounding?
to achieve uniform particle size
a 180 pound man receives flolan 56 ml/day. his cassette is made with three flolan 1.5mg vials and diluted to a total volume of 100ml. what is his dose in ng/kg/min?
21.4
a patient has received d5ns + 40mEq kcl running at 80ml/hr for 8 hours. if the hospital stocks 1 liter bags of d5ns + 40 meq of kcl, how many mmols of kcl has the patient received? (MW k=39; mw cl=35.5)
25.6
a patient in the ICU is receiving a phenylephrine infusion. what is the mechanism of action of phenylephrine and the clinical effect
alpha 1 agonist - increased blood pressure
which of the following drugs can cause follic acid deficiency?
methotrexate sulfamethoxazole/trimethoprim
which of the following medications require a "protect from light" cover while infusing
mycamine doxycycline
which of the following statements is correct regarding the endpoint of hospitalization involving hepatic encephalopathy?
patients receiving rifaximin 550mg twice daily experienced fewer hospitalizations involving hepatic encephalopathy than patients receiving placebo.
a patient with crohn's disease is scheduled to begin therapy with humira. all of the following statements about humira therapy are concerned except:
patients should preferentially receive live vaccines when indicated during treatment
which of the following oral treatments can be recommended to manage vasomotor symptoms in a woman with a uterus?
prempro
how many milligrams of sodium hydroxide(MW=40) are represented by 0.25 mmol?
10
what is the relative risk reduction for hospitalization involving hepatic encephalopathy? RRR= (control/placebo)/control
40
mr is a 65 year old female who arrives at the clinic pharmacy with a prescription for eliquis 5mg bid. she explains to the pharmacist that she was just diagnosed with a heart rhythm problem called fibrillation. which of the following is true
this is the correct dose of eliquis for this patient
tw has been taking phenelzine (nardil) for many years to treat depression. which drug will interact with TW's antidepressant?
tramadol
which of the following are treatment options for motion sickness in adults
transderm scop meclizine dimenhydrinate
lk's nurse calls the pharmacy to ask if zosyn can be infused via a y-site into the line being used for the norepinephrine infusion. what reference could the pharmacist consult for the answer
trissel's
How many mEq/kg IBW/day of sodium chloride did LK receive from her maintenance fluid on february 7th MW NaCl =58.5
2.2
calculate the absolute risk reduction for the primary efficacy endpoint.
2.2
calculate PT's absolute neutrophil count
429
a pne ounce bottle is labeled to contain 0.66ml of the active drug. what is the ratio strength (v/v) of this solution?
45
what is the number needed to treat to prevent one episode of overt hepatic encephalopathy? NNT always round up NNT= 1/ARR ARR= treatment - control
5
which statement is a correct drug therapy assessment based on the pharmacogenomic test result reported.
triumeq is safe to use in this patient
a pharmacist is counseling a patient with a new oxytrol patch prescription. how often should the patch be changed
twice weekly
the pharmacy stocks 150mg and 500mg Xeloda tablets. How many of each will TS need to take each day?
two 150 and eight 500
ER has a true allergy to penicillin. she required intubation after receiving it as a child. she could have a similar reaction to all of the following medications except
zithromax
the pharmacist performing admission medication reconciliation for the nursing home notes that the following medications do not have a documented indication in the patient's past medical history:
zoloft mirapex
what is the mechanism of action of zyloprim?
decreases uric acid production
the diagnostic test reported on SJ's profile is used to evaluate which of the following conditions?
depression
KP is a 58 year old female who is usually well controlled on a warfarin regimen of 6 mg daily. She has been sick for the past week but feels better today. She ate little during her illness and was barely able to take her antibiotics because of nausea. KP presents to the anticoagulation clinic to have her INR checked. Her inr is elevated today at 11.4. There is no noticeable bleeding and she has low bleeding risk. in addition to holding warfarin, choose the preferred course of action.
administer phytonadione 2.5mg orally
NI should bee counseled to monitor for signs and symptoms of bleeding with which medication?
apixaban
which of the following oral antibiotics, is/are appropriate for the pharmacist to recommend on June 8th? Select all that apply
bactrim DS Doxycycline
which medicaiton should be prescribed for MK?
bactrim ds 1 tablet po daily
LY develops a condition of severe, chronic diarrhea. which medication is the most likely causative agent?
benicar
which of the following assessments can the pharmacist make on february 8th?
the tobramycin trough level is too high
during the clinic visit, the pharmacist assesses MK's attempt to quit smoking. MK reports that he has stopped smoking and he has been using his current treatment for approximately 5 weeks. which of the following should the pharmacist recommend?
continue the current treatment for 1 more week then switch to a 14 mg patch daily
KM's PCP prescribed proair hfa for prn use 5 months ago. today km returns to his pcp and describes his symptoms and activity over the past 3 months. he says he feels ok but he cannot always play outside with his son as much as he would like even when he uses his inhaler. intially he did not use the inhaler much, but not he uses it about 3 times per week to control his symptoms. he rarely wakes up at night with symptoms. which of the following is consistent with preferred treatment for km according to asthma guidelines?
flovent hfa
re has started to use ortho tri cyclen. all of the following medications would be expected to decrease the efficacy of ortho tri cyclen except:
gabapentin
a vegatarian patient brings a prescription to the compounding pharmacy. which ingredient, if included on the master formula, would need to be modified?
gelatin
which of the following is an approved treatment for multiple sclerosis
glatiramer acetate
which of the following is a requirement for gloves while preparing this compound?
gloves must be changed every 30 minutes while compounding two pairs of ASTM rated gloves are required the outer pair of gloves must be sterile
which of the following are cyp3a4 inhibitors?
grapefruit ritonavir diflucan
what criteria must be met to start procrit in this patient?
hemoglobin less than 10g/dl
assuming gj's medications are all being used for valid, fda approved indications, what medical problem is missing from her past medical history
hepatitis c
proper technique for use of SZs COPD medication includes all of the following except
hold the inhaler upright and press both side buttons until a click is heard
a test subject started receiving the investigational medication dosed at 250mg IV Q12h on tuesday at 0700 (dose #1). Assuming all doses are given on schedule and steady state is achieved after 5 half lives, when can the earliest trough level be obtained?
immediately before the 5th dose on thursday at 0700
what is the most likely cause of the ecg findings?
invega
a medical center has the following layout for the sterile compounding are. there is a separate room for preparing sterile, nonhazardous drugs and a separate are for preparing sterile, hazardous drugs. these two rooms share an ante room. what is the minimum ISO requirement for this ante room?
iso 7
which of the following is the best recommendation for empiric treatment of pneumonia in this patient?
levofloxacin
which medication should HB be counseled to take one hour before breakfast on an empty stomach?
levothyroxine
several days later, KL is ready to be transferred for stroke rehabilitation. her labs and vitals have remained relatively unchanged since admission tot he hospital. which of her home medications is contraindicated?
meformin
which medication is correctly matched with its mechanism of action?
metoclopramide- dopamine antagonist
Pt's healthcare provider would like to switch the zocor to an equivalent dose of an alternate statin in order to avoid a drug interaction with his hypertension medications. which of the following can be recommended?
pravastatin 80mg daily
which of the following outcomes demonstrated a statistically difference in this trial?
primary efficacy endpoint nonfatal myocardial infartion
what acid base disorder was this patient experiencing on february 6th?
respiratory acidosis
a 65 year old male patient approaches the pharmacist to ask about a sensitive issue. he is concerned that he has been unable to sustain an erection during intercourse with his wife, even though he is very attracted to her. this is a new problem. which of the following medication, if included on the patient's medication profile, might alert the pharmacist to possible drug induced sexual dysfunction?
risperdal
a patient read the package insert for her asthma medication online and came to her pharmacist very concerned. she read "right at the top" that her medication can increase her risk of "dying from asthma". which of the following medications could the patient be taking?
salmeterol
a mother calls the pharmacy asking for advice on something OTC to treat her daughter's fever. her daughter is 4 months old and weighs 10.6 pounds. her rectal temperature is 38.9 degrees celsius. what is the most appropriate recommendation?
seek medical care for the child immediately
which of the following is metabilized by monoamine oxidase
serotonin
which of the patient's medications can cause urine discoloration
sinemet CR
a patient has a new prescription for Kadian. the pharmacist has instructed the patient to open the Kadian capsule and sprinkle the beads on applesauce. The pharmacist should include this essential information in the counseling:
the applesauce must be eaten immediately; do not chew the beads
a 24 year old female is starting irsotretinoin treatment. which of the following is true?
the patient must have two negative pregnancy tests before starting treatment a consent form warning about birth defects must be signed before starting treatment two forms of birth control must be used during treatment
which of the following is true regarding SJ's antiepileptic treatment
the reported phenytoin level is within the goal range for safety and efficacy
which of the following statements about the study design is true?
the study was designed to detect a difference in the incidence of a composite outcome
