Question 1: A 28-year-old female with treatment-resistant bipolar disorder is being prescribed valproic acid and lamotrigine. The pharmacist reviews Health Canada drug safety alerts and informs the prescriber about a rare but serious risk requiring patient monitoring. What is the primary adverse event being monitored in this combination?
A. Nephrolithiasis
B. SJS/TEN (Severe skin reaction)
C. Pancytopenia
D. Osteoporosis
E. Hepatic steatosis
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Answer: B
Explanation:
Valproate + lamotrigine increases the risk of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis. Health Canada and other agencies flag this combination for strict dose titration and patient monitoring.
Question 2: A 67-year-old man with status epilepticus is treated with phenytoin after two doses of lorazepam. He later develops hypotension and arrhythmias during the infusion. The physician had used IV phenytoin (not fosphenytoin). What is the most likely cause of the cardiovascular effects?
A. Phenytoin’s sodium channel blockade
B. Rapid infusion causing bradycardia
C. Accumulation of phenytoin active metabolites
D. Propylene glycol in the IV formulation
E. Inhibition of cardiac potassium channels
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Answer: D
Explanation:
IV phenytoin contains propylene glycol, which can cause hypotension and arrhythmias when infused too quickly. Fosphenytoin, a water-soluble prodrug, is safer for rapid loading.
Question 3: Which of the following is the most likely recommendation from an eye doctor to protect your eyes from cataracts?
A) Eat a diet high in processed foods
B) Wear sunglasses that block ultraviolet (UV) rays
C) Spend more time outdoors without eye protection
D) Smoke cigarettes regularly
E) Avoid regular eye exams
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Answer: B
Question 4: Which of the following is the causative organism for chancre?
A. Treponema palladium
B. Human simplex virus
C. Mycobacterium tuberculosis
D. Human papilloma virus
E. Candida albicans
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Answer: A
Chancre is a painless genital ulcer formed after about 21 days of getting infected with Treponema palladium, a gram-negative spirochete that causes syphilis.
Question 5: Jt is a 54 year old female taking Rosuvastatin for hyperlipidemia. Which of the following statements about Rosuvastatin is correct?
A. Decrease LDL and Vascular atherosclerotic inflammation
B. Decrease LDL and HDL
C. Increase triglycerides and decrease HDL
D. Increase HDL and Vascular atherosclerotic inflammation
E. Increase LDL, HDL, and triglycerides
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Answer: A
Question 6: JT is a 32-year-old female who was planting some trees in her garden. She had an itch that made her not sleep last night. JT does not have any itching or rash. What is the pharmacist’s recommendation?
A. Hydrocortisone cream
B. Dimenhydrinate
C. Desloratidine
D. Acetaminophen
E. Clobetasol
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Answer: B
Antihistamines are given to control itch (pruritus) because they block the action of histamine, a key chemical involved in the itch response.
🧪 Mechanism:
When the skin is irritated due to allergy, inflammation, or injury, mast cells release histamine.
Histamine binds to H1 receptors on sensory nerve endings in the skin, triggering:
• Itch sensation
• Redness
• Swelling
✅ Antihistaminics block these receptors and reduce the itch signal transmission to the brain.
Question 7: Which of the following would best describe the term dysphagia?
A. Difficulty is breathing
B. Difficulty in speaking
C. Difficulty in swallowing
D. Difficulty in defecating
E. Loose watery stool
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Answer: C
Dyspnea - Difficulty is breathing
Dysphonia - Difficulty in speaking
Dysphagia - Difficulty in swallowing
Constipation Difficulty in defecating
Diarrhea - Loose watery stool
Question 8: A 67-year-old patient with cardiovascular disease had a gout attack last night. He comes to the pharmacy with a prescription from his doctor. He is taking metformin for diabetes and an ACE inhibitor for hypertension. His diabetes and hypertension are in control. Based on the given information, answer the following questions.
Question 8.1: Which of the following drugs would be in the prescription?
A. Indomethacin with a Proton pump inhibitor
B. Naproxen with a protpn pump inhibitor
C. Ibuprofen with antacid
D. Colchicine
E. Prednisone
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Answer: D
If a patient with an acute gout attack comes within 36 hours, colchicine is the drug of choice.
Question 8.2: Which of the following would be the pharmacist’s counseling for the side effects?
A. Diarrhea
B. Blood in stool
C. Dark yellow coloured urine
D. Vaginal infection
E. Skin rash
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Answer: A
Side effects of colchicine: Nausea, Vomiting, Diarrhea, Abdominal pain, Hepatic and renal impairment, myopathy, neutropenia, and myelosuppression.
Question 8.3: For the above patient, which of the following would have been the correct recommendation if the patient had come after 3 days of a gout attack?
A. Indomethacin with a Proton pump inhibitor
B. Naproxen with a protpn pump inhibitor
C. Ibuprofen with antacid
D. Celecoxib with proton pump inhibitor
E. Prednisone with H2 blocker
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Answer: D
Question 9: Which type of drug receptors is involved in the regulation of gene expression?
A) G-protein-coupled receptors (GPCRs)
B) Ligand-gated ion channels
C) Enzyme-linked receptors
D) Nuclear receptors
E) Voltage-gated ion channels
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Answer: D
| Type of Drug Receptor | Explanation | Example Drug(s) | Example |
| A) G-protein-coupled receptors (GPCRs) | These receptors primarily regulate signaling pathways and cellular responses, not gene expression. | Propranolol (beta-adrenergic receptor antagonist) | Beta-adrenergic receptor |
| B) Ligand-gated ion channels | These receptors regulate ion flow across membranes but do not directly influence gene expression. | Nicotine (agonist at nicotinic acetylcholine receptors) | Nicotinic acetylcholine receptor |
| C) Enzyme-linked receptors | These receptors have enzymatic activity but are not directly involved in gene expression. | Insulin (activates insulin receptor tyrosine kinase) | Insulin receptor |
| D) Nuclear receptors | These receptors bind to DNA in the nucleus and regulate transcription of specific genes in response to ligand binding. | Prednisone (activates glucocorticoid receptor) | Glucocorticoid receptor |
| E) Voltage-gated ion channels | These channels regulate ion flow in response to changes in membrane potential, not gene expression. | Lidocaine (blocks sodium channels) | Sodium channel |
Question 10: Which of the following is the drug of choice in the prevention of stroke in a 70-year-old patient who has atrial fibrillation?
A. Warfarin
B. Alteplase
C. Dabigatran
D. Heparin
E. Streptokinase
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Answer: C
Dabigatran and Warfarin both can be used, but Dabigatran is preferred as warfarin needs INR monitoring, and it also poses a significant risk of bleeding.
Question 11: Which of the following is the correct order of metabolizing enzymes in order of their importance?
A. CYP3A4 > CYP2C9 > CYP2D6 > CYP1A2
B. CYP3A4 > CYP2D6 > CYP2C9 > CYP1A2
C. CYP2D6 > CYP2C9 > CYP1A2 > CYP3A4
D. CYP1A2 > CYP3A4 > CYP2D6 > CYP2C9
E. CYP2D6 > CYP1A2 > CYP3A4 > CYP2C9
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Answer: B
Mnemonic: 469 smokes (Smoking is for CYP1A2)
Question 12: Which of the following neurotransmitter does Granisetron inhibits?
A. Dopamine
B. Enkephalin
C. Epinephrine
D. Serotonin
E. Acetylcholine
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Answer: D
| Serotonin Receptor | Function | Examples of Agonists | Examples of Antagonists |
| 5-HT1 | Inhibitory; mood regulation, anxiety | – Sumatriptan (agonist at 5-HT1B/1D receptors) | – Pindolol (partial agonist/antagonist at 5-HT1A) |
| – Buspirone (partial agonist at 5-HT1A receptors) | – Methiothepin (non-selective antagonist at 5-HT1) | ||
| 5-HT2 | Excitatory; hallucinations, vasoconstriction | – LSD (agonist at 5-HT2A receptors) | – Ketanserin (antagonist at 5-HT2A receptors) |
| – Psilocybin (agonist at 5-HT2A receptors) | – Olanzapine (antagonist at 5-HT2C receptors) | ||
| 5-HT3 | Ionotropic; nausea, vomiting | – Ondansetron (antagonist at 5-HT3 receptors) | – Palonosetron (antagonist at 5-HT3 receptors) |
| – Granisetron (antagonist at 5-HT3 receptors) | – Dolasetron (antagonist at 5-HT3 receptors) | ||
| 5-HT4 | Gastrointestinal motility | – Cisapride (agonist at 5-HT4 receptors) | |
| – Mosapride (agonist at 5-HT4 receptors) |
Question 13: What is the profit margin of a pharmacy if its revenue is $200,000, the cost of goods sold (COGS) is $100,000, and operating expenses are $50,000?
A) 15%
B) 20%
C) 25%
D) 30%
E) 35%
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Answer: C
Just put the values in the formula:
% Profit Margin = [(Total revenue – Total expense)/Total revenue] * 100
Just put the values, and you will get the answer.
Question 14: A patient came to the pharmacy and wants to measure his blood pressure. What should the pharmacist tell him?
A. Refer to a doctor
B. Ask the patient to come back in the evening
C. Lie down for 30 minutes
D. Don't talk while taking the measurement
E. Ask the patient to do spot jogging for 10 minutes
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Answer: D
Question 15: JT is a 65-year-old male with angina and hypertension. Currently, JT is taking Valsartan for hypertension, but JT’s blood pressure is out of control. Which of the following drugs is the appropriate addition for JT?
A. Amlodipine
B. Hydrochlorothiazide
C. Atenolol
D. Clonidine
E. Spironolactone
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Answer: A
Explanation
In this case, you might be tempted to select Atenolol because of angina, but the question here is to control hypertension. Remember that DHP-CCBs are the best add-on drugs to ACE/ARBs. BB can also be added, but they are not the 1st line.
Question 16: JL is a pharmacist working in a community pharmacy. His employer dismisses him as a pharmacist because of a breach in contract. What is this called?
A. Employer's rights
B. Constructive dismissal
C. Habeas Corpus
D. Atrocity
E. Exploitation
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Answer: A
Employer’s Rights are the legal and ethical rights an employer has in the workplace, such as:
- Hiring and firing employees
- Setting work rules and expectations
- Managing operations and business decisions
- Ensuring productivity and workplace safety
Constructive Dismissal occurs when an employee resigns due to the employer’s conduct—such as a significant change in job duties, pay cut, or toxic work environment—forcing the employee to quit. It’s legally treated as a wrongful dismissal.
Habeas Corpus is a legal principle meaning “you shall have the body” in Latin. It protects individuals from unlawful detention or imprisonment by allowing them to challenge the legality of their arrest in court.
Atrocity is an act of extreme cruelty or violence, often involving gross violations of human rights, such as war crimes, genocide, or brutal assaults.
Exploitation is the unfair use of someone or something for personal gain, such as:
- Underpaying workers
- Taking advantage of vulnerable populations
- Using natural resources irresponsibly
Question 17: What cells are primarily responsible for producing antibodies?
A) T cells
B) B cells
C) Macrophages
D) Neutrophils
E) Natural Killer (NK) cells
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Answer: B
B cells are memory cells. (Clonal theory)
Question 18: Which of the following is not a symptom of Benign Prostatic Hyperplasia?
A) Frequent urination
B) Urgency
C) Weak urine stream
D) Jet urination
E) Incomplete bladder emptying
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Answer: D
Symptoms of Benign Prostatic Hyperplasia: Frequent urination, urgency, weak urine stream, hesitancy, incomplete bladder emptying, dribbling, straining, and intermittency.
Question 19: Which of the following is a symptom of hypothyroidism?
A. Dry skin
B. Palpitation
C. Weight loss
D. Shaky hands
E. Frequent bowel movements
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Answer: A
Mnemonic: MOM’S SO TIRED
| Symptom | Mnemonic Letter | Description |
| Memory loss | M | Cognitive impairment |
| Obesity | O | Weight gain |
| Menorrhagia | M | Heavy menstrual periods |
| Slowness | S | Mental and physical slowness |
| Skin and hair dryness | S | Dry skin and hair |
| Obvious muscle weakness | O | Muscle weakness |
| Tiredness | T | Fatigue |
| Intolerance to cold | I | Sensitivity to cold |
| Raised blood pressure | R | Hypertension |
| Energy levels low | E | Low energy |
| Depression | D | Depressed mood |
Do you know/remember the mnemonic for hyperthyroidism? It is covered in one of the previous articles.
Question 20: JT is a 29 year old female who smokes more than 20 cigarettes in a day. Her doctor has prescribed Bupropion for smoking cessation. When should JT start the medicine?
A. Begin on the selected quit date
B. Begin 2 days before the selected quit date
C. Begin 24 hours before the selected quit date
D. Begin 1 - 2 weeks before the selected quit date
E. Begin 30 days beore the selected quit date
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Answer: D
Question 21: It is recommended to apply sunscreen lotion before going out in the sun. This is done for which of the following statements?
A. Protect skin from Infrared rays
B. Protect skin from ultra violet A and ultra violet B rays
C. Protection from heat wave
D. Cosmetic enhancement
E. Protection from visible light rays
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Answer: B
Question 22: JT is a 54-year-old female with atrial fibrillation. Her doctor prescribed her a rate-control drug. Which of the following drugs is most likely her doctor prescribed?
A. Acebutolol
B. Digoxin
C. Quinidine
D. Amiodarone
E. Diltiazem
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Answer: E
Diltiazem and Acebutolol are rate control drugs, while others are rhythm control drugs. Acebutolol should not be used here as it also has intrinsic activist,y which can increase the heart rate.
Question 23: JT is a healthy adult who has just had a dental procedure done. Now, JT is diagnosed with endocarditis. JT does not have any other medical conditions. Based on the information given, answer the following questions.
Question 23.1: Which of the following is the most likely cause for JT’s endocarditis?
A. Treponema palladium
B. Staphylococcus aureus
C. Mycobacterium catarrhalis
D. Streptococcus viridans
E. Salmonella typhi
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Answer: D
Question 23.2: Which of the following is the mode of transmission for the causative agent?
A. Through feces
B. By mouth
C. Through urine
D. By blood transfusion
E. By sexual transmission
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Answer: B
Here is a list of all the published articles in this category: Link
PEBC Evaluating exam sample questions pdf link