Question 1: JT, a 52-year-old male with a history of major depressive disorder and hypertension, presents with electrocardiographic findings consistent with a second-degree atrioventricular (AV) block, Mobitz type I (Wenckebach)—characterized by progressive PR interval prolongation followed by a non-conducted P wave.
He is currently receiving pharmacotherapy for both conditions. Given the nature of his conduction abnormality, one of his medications is suspected to be contributing to AV nodal depression.
Which of the following medications is the most likely culprit and should be discontinued to prevent further AV nodal suppression?
A. Citalopram
B. Amlodipine
C. Verapamil
D. Sertraline
E. Lisinopril
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Answer: C
Question 2: A 70-year-old male with idiopathic Parkinson’s disease is started on levodopa/carbidopa. After 6 months, he develops involuntary choreiform movements. What is the most appropriate next step?
A. Increase the dose of levodopa
B. Add entacapone
C. Reduce the dose of levodopa
D. Start trihexyphenidyl
E. Add pramipexole
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Answer: C
Dyskinesias are a common side effect of long-term levodopa use and often resolve with dose reduction.
“Choreiform” describes movements that are rapid, irregular, and involuntary, like the jerky, writhing movements seen in chorea.
Question 3: A pharmacoeconomics study comparing drugs A and B concluded that drug A is superior to drug B. Which of the following factors most likely contributed to this conclusion?
A. Drug A has a higher market price than drug B.
B. Drug A has fewer side effects compared to drug B.
C. Drug A has a shorter shelf life than drug B.
D. Drug A is less effective than drug B but is preferred by patients.
E. Drug A requires more frequent dosing than drug B.
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Answer: B
Question 4: A pharmacist owns an independent pharmacy in a community. The pharmacist bought the name and there is no central purchase. Which of the following best describes the type of pharmacy?
A. Banner
B. Franchise
C. Associate franchise
D. Independent owner
E. Corporate
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Answer: A
Refer to the below-mentioned table if you have any confusion. If you don’t have any confusion, then skip the table and follow your notes.
| Type | Ownership | Characteristics | Examples |
| Corporate | Owned by large corporations | Standardized services, centralized management, central purchasing, extensive marketing, high brand recognition | Walmart, No-frills |
| Independent | Individually owned | Personalized service, flexibility in operations, strong community ties, local loyalty, independent purchasing | Local neighborhood pharmacies |
| Franchise | Individually owned under a franchise | Brand recognition, operational guidelines from franchisor, support in training and central purchasing | Shoppers Drug Mart, simply Shoppers Pharmacy |
| Banner | Independently owned under a common banner | Group purchasing advantages, shared marketing, retain operational control, some standardization | Guardian Pharmacy, I.D.A. Pharmacy |
Question 5: Which of the following needs a new drug submission from Health Canada?
A. Bioequivalent
B. Biosimilar
C. Generic
D. Interchangable
E. Repackaged drug
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Answer: B
Generic products do not need new approval. Biosimilars need new approvals. They are similar to reference biologics, but they are not the same. Hence, they need new approval.
Question 6: JT is a 54 year old female who comes to the pharmacy and tells the pharmacist that she has lots of medicines to take and she does not know how will she take all these medicines. Which of the below mentioned responses shows empathy?
A. Don't worry. I will help you take your medicines as easy as you can
B. Sorry, what's the problem again?
C. You must be overwhelmed from all these medicines
D. How old are you?
E. We can try to help you
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Answer: A
Question 7: Which of the following is an example of a pharmacodynamics effect?
A. Drug metabolism in the liver.
B. Drug absorption in the gastrointestinal tract.
C. Drug-receptor interactions.
D. Drug excretion through the kidneys.
E. Drug distribution throughout the body.
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Answer: C
The remaining options are from pharmacokinetics = ADME
Question 8: JT, a 24-year-old male patient, comes to the pharmacy with a new prescription for Olanzapine. Which of the following are positive symptoms of psychosis?
A. JT struggles to recall recent events or conversations
B. JT's judgement is impaired
C. JT has difficulty to communicate coherently
D. JT hears voices in his ears all the time
E. JT neglects personal hygeine and has started to isolatre himself
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Answer: D
Hearing voices is an auditory hallucination, and hallucination is a positive symptom.
Question 9: Pharmacist presenting marketing material to the doctor, comparing 2 drugs, saying that drug A is better than drug B. What on the material will make the doctor say it’s correct?
A. Confidence interval
B. Relative risk
C. Absolute risk
D NNT (Number Needed to Treat)
E. Sensitivity
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Answer: B
Relative risk and NNT are both used to compare 2 drugs. NNT gives the number of patients need to be treated to get 1 positive outcome, while RR can be useful in comparing 2 drugs in terms of positive outcomes as well as adverse drug reactions. Hence, RR is more appropriate answer for this question.
Question 10: Under which of the following circumstances should a pharmacist report adverse events from a vaccine?
A. Any time he is made aware of
B. Only the one he gives
C. Vaccine side effects reporting is not a pharmacist's duty
D. Any event even if he is not the one who gave it
E. Vaccine side effects are reported by patients to the doctor
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Answer: D
Vaccine adverse reactions are reported to the public health unit of the province using the AEFI (Adverse Event Following Immunization) forms.
Question 11: JT is a 54-year-old patient who has Alzheimer’s disease. His doctor prescribed him Risperidone for agitation. His other medications include Pantoprazole, Atorvastatin for hyperlipidemia, and Ibuprofen for osteoarthritis. JT’s son has come to the pharmacy to pick up his prescription. Answer the following questions based on the information given.
Question 11.1: Which of the following would be the pharmacist’s counseling for Risperidone?
A. It causes day time drowsiness
B. It causes insomnia
C. It increases mortality and stroke in patient's with alzheimer's disease
D. It is contraindicated with Atorvastatin
E. Stop taking Pantoprazole as it is not required
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Answer: C
Elderly patients with dementia-related psychosis are at an increased risk of death when treated with antipsychotics.
Question 11.2: What should the pharmacist tell JT’s son?
A. Don't worry. the nurses will take care of him
B. Recommend the doctor to change it
C. Give him the phone number of emergency care
D. Assure him that medicined do not have side effects
E. Ask the doctor to decrease the dose of Risperidone
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Answer: B
Question 11.3: What else in the prescription should get the pharmacist’s attention?
A. Metabolism of Atorvastatin can be decreased when combined with Risperidone
B. Risperidone's effect is increased by Atorvastatin
C. No other concern with the prescription
D. Risperidone increases the metabolism of Atorvastatin
E. Risperidone and Omeprazole are contraindicated
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Answer: A
The combination increases the risk of myopathy.
Question 12: JT is a 69-year-old female who came to the pharmacy complaining about pain in her left calf. Which of the following is the most probable cause of the pain?
A. Fecal Occult Blood Test 2 days ago
B. Long flight 1 week ago
C. Atherosclerotic check on his right knee 2 weeks ago
D. Taking Prednisone 50 mg for 5 days for COPD attack 2 days ago
E. Taking Thiazides for 2 days
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Answer: B
Question 13: A toxic dose of aluminum is considered to be 10 mg/kg. If a patient weighs 110 pounds, which of the following doses would be considered toxic?
A. 250 mg
B. 400 mg
C. 500 mg
D. 300 mg
E. 800 mg
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Answer: E
First step is to convert the patient’s weight from pounds to kilograms:
Weight in kg = 110 pounds / 2.2 = 50 kg
Next step is to calculate the toxic dose in mg:
Toxic dose=10 mg/kg * 50 kg = 500 mg
Since 800 mg is above the toxic threshold of 500 mg, it is considered toxic.
Question 14: A 77-year-old woman is diagnosed with moderate Alzheimer’s disease. She is started on donepezil. A few weeks later, she complains of nausea, insomnia, and vivid dreams. Which of the following medications may be better tolerated?
A. Rivastigmine capsules
B. Galantamine
C. Memantine
D. Rivastigmine patch
E. No alternative; continue donepezil
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Answer: D
The transdermal patch reduces GI and CNS side effects commonly seen with oral cholinesterase inhibitors.
Question 15: IM owns a community pharmacy. She delegated a task to one of her employees. Now, she wants to check her employee’s work. Which of the following is not the correct option to choose as a reference for her employee’s quality of work?
A. Pharmacy Policies and Procedures
B. Legal and Regulatory Requirements
C. Accuracy and Precision
D. Quality Assurance
E. Employees education credentials
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Answer: E
Employers can check the education credentials before offering the job. But in order to check the equality of work, education credentials have nothing to do with it.
Question 16: What is the mechanism of action of Adalimumab?
A. Inhibition of interleukin-6 (IL-6)
B. Blockade of tumor necrosis factor alpha (TNF-α)
C. Inhibition of Janus kinase (JAK) signaling
D. Antagonism of interleukin-17 (IL-17) receptor
E. Suppression of B-cell proliferation
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Answer: B
Question 17: Identify the given structure
A. Serotonin
B. Melatonin
C. Bufotenin
D. Tryptamine
E. N-Methyltryptamine
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Answer: D
Question 18: Which antibiotic is commonly used in culture and susceptibility testing to assess bacterial resistance patterns?
A. Amoxicillin
B. Vancomycin
C. Gentamicin
D. Ibuprofen
E. Diphenhydramine
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Answer: C
Gentamycin, Penstrep, and a cocktail of Penicillin and Streptomycin are. used for susceptibility testing. Penicillin is often used as a control.
Question 19: A regular customer of the community pharmacy calls the pharmacy and asks about the symptoms of Pertussis. Which of the following is not a symptom of Pertussis?
A. Dark coloured urine
B. Sneezing
C. Nasal discharge
D. Cough
E. Watery eyes
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Answer: A
Question 20: JT is a 29-year-old woman who comes to the pharmacy with a new prescription of Floxetine for insomnia. Based on the given information, answer the following questions.
Question 20.1: JT wants to know when she can expect improvement. Which of the following is the correct answer?
A. 6 - 8 weeks
B. 1 - 2 weeks
C. 2 days
D. within a few hours of taking medicine
E. 2 - 4 weeks
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Answer: B
Question 20.2: After 8 weeks, her doctor wants to change her medicine from Fluoxetine to Citalopram. Which of the following is the right answer?
A. No need to washout while changing from SSRI to SSRI
B. Taper Fluoxetine for 5 weeks, washout for 5 weeks, and then start Citalopram
C. Wash out Fluoxetine for 5 weeks and then start Citalopram
D. Wash out Fluoxetine for 2 weeks and then start
E. Crosstaper for 4 weeks
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Answer: E
Question 21: JT, a 49-year-old patient is currently taking Phenytoin 100 mg capsule at bedtime. JT can no longer swallow these capsules. So the doctor requests an equivalent dose of Phenytoin suspension 125 mg/ml. To maintain similar blood levels of Phenytoin, what amount of suspension should be given to JT?
A. 3.7 ml
B. 4 ml
C. 5 ml
D. 4.2 ml
E. 4.7 ml
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Answer: A
Question 22: Idarucizumab is an antidote of which of the following drugs?
A. Heparin
B. Warfain
C. Dapgatran
D. Apixaban
E. Benzodiazepine
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Answer: C
Question 23: A pharmacy business owner is focusing on long-term planning to arrange finance. Which of the following is the most appropriate term to describe this?
A. Employee Training
B. Market Analysis
C. Setting Long-term Goals and Direction
D. Operational Management
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Answer: C
Question 24: After 8 weeks, her doctor wants to change her medicine from Fluoxetine to Citalopram. Which of the following is the right answer? A 28-year-old pregnant patient in her third trimester has an uncomplicated urinary tract infection. The best choice of antibiotics to treat her urinary tract infection from the following drugs would be
A. Nitrofurantoin
B. Trimethoprim + Sulfamethoxazole
C. Norfloxacin
D. Gentamycin
E. Methanamide
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Answer: A
- Amoxicillin for 3 – 7 days – if the organism is known to be susceptible
- Amoxicillin + clavulanate for 3 – 7 days
- Cefalexin or Nitrofurantoin
- Nitrofurantoin is avoided near term due to the risk of hemolytic anemia in patients with G6Pd deficiency
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Question 21: JT, a 49-year-old patient is currently taking Phenytoin 100 mg capsule at bedtime. JT can no longer swallow these capsules. So the doctor requests an equivalent dose of Phenytoin suspension 125 mg/ml. To maintain similar blood levels of Phenytoin, what amount of suspension should be given to JT?
how to get 3.7ml?
Question 20.2: After 8 weeks, her doctor wants to change her medicine from Fluoxetine to Citalopram. Which of the following is the right answer?
A. No need to washout while changing from SSRI to SSRI
B. Taper Fluoxetine for 5 weeks, washout for 5 weeks, and then start Citalopram
C. Wash out Fluoxetine for 5 weeks and then start Citalopram
D. Wash out Fluoxetine for 2 weeks and then start
E. Crosstaper for 4 weeks
why is not A
Switching between SSRI to SSRI needs crosstapering.
To simplify things, remember these 3 points:
1) No antidepressant can be stopped and replaced by another drug suddenly at regular dose
2) If MAO is involved than wash-out is must
3) In all other cases, taper or crosstaper
These 3 points will help you to answer these questions.
This is from my notes. Hope this helps.