Canada Board Mcqs Qualifing Exam

8/10/2019 Canada Board Mcqs Qualifing Exam

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Thesample questions that follow are NOTintended or designed to bea sample examination and do NOTrepresent an exact model of thePharmacist Qualifying Examination-Part I, in terms of difficulty andproportion of topics. owe!er, individually, these examples are

intended to be representative in format and phrasing styleof thetypes of questions found in the Qualifying Examination-Part I. Theyalso illustrate a !ariety of the competency areas contained in theexamination blueprint. Please note that these questions are re!iewedand updated periodically.

"ee the bottom of the page for the answers to the sample questions.

COMPETENCY 1 Patient Care

#. $% is an &' year old male who li!es alone, currently ta(es #)different medications. *or the past ) wee(s he has telephoned to as(

the pharmacist what dose of diuretic he should be ta(ing +thismedication loo(s similar to another tablet that he ta(es. e callsagain today with the same question. fter answering his question, themost appropriate pharmacist action should be to

a. call $%/s family doctor to suggest changing the diuretic tosomething that loo(s different.b. suggest that $% ha!e the labels on his prescription bottleschanged to a bigger font for easier reading.c. recommend that the pharmacy use a blister pac(aging dosette to

dispense $%/s medications.d. suggest that $% write down the answer to his question so that hedoes not need to phone again.e. recommend that $% ha!e his hearing and !ision tested at his nextphysician !isit.

). 0 is a '& year old male with diabetes, angina and erectiledysfunction. is physician consults the pharmacist in order to decideif 0 would be a good candidate for sildenafil. The use of sildenafil isCONT!"#N$#C"TE$for 0 if he ta(es

a. isosorbide '-mononitrate.b. metoprolol.c. glyburide.d. ".e. enalapril.


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1. $P has a prescription for famciclo!ir for shingles +prescribed )days ago, and is uncertain about filling it, due to the high cost. 2asedon the (nown effecti!eness of famciclo!ir for herpes 3oster, benefitsthat the pharmacist should discuss with $P includeI pre!ention of acute 3oster-associated pain.II faster healing time for rash.III less and shorter duration of post-herpetic neuropathic pain.

a. I onlyb. III onlyc. I and II onlyd. II and III onlye. I, II and III

4. 5ommon etiologic agents of community-acquired pneumoniaincludeI Escherichia coli.II Haemophilus influenzae.III Mycoplasma pneumoniae.


'. Iron may decrease the absorption of which of the followingmedications6

a. $amiprilb. tenololc. 7oxifloxacind. Ibuprofene. 8lyburide

9. :hich of the following medications is the most appropriate choicefor treatment of neuropathic rather than nocicepti!e pain6

a. ;abiloneb. Tramadolc. Ibuprofend. 7eperidine


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e. ;ortriptyline

> am. The pharmacist should ad!ise @8 to

a. ta(e the missed dose immediately when she gets home andcontinue as scheduled.b. ta(e two doses at lunchtime to ma(e up for the missed dose.c. s(ip the missed dose and ta(e the next scheduled dose atlunchtime.d. s(ip today/s medication and resume her normal scheduletomorrow.


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e. space 4 doses into the remaining hours between when @8 getshome and her bedtime.

#>. E= is a )' year old female who presents to the pharmacy

requesting Plan 2A

+le!onorgestrel for emergency contraceptionfollowing an episode of unprotected sex #) hours ago. fter spea(ingwith E=, the pharmacist decides she is a good candidate to recei!ePlan 2A. The pharmacist should include all of the followinginformation in counselling E=, E%CEPT

a. the effecti!eness of Plan 2Ain E=/s situation is li(ely to be betterthan ?>B.b. Plan 2Awor(s mainly by dislodging an implanted fertili3ed eggfrom the endometrium.c. E= should ta(e two tablets of Plan 2Aas a single dose.d. side effects may include nausea, !omiting, breast tenderness,cramps and spotting.e. if !omiting occurs within one hour of dosing, a repeat dose maybe warranted.

##. ll of the following are reasons that elderly patients are moresusceptible to drug-induced cogniti!e changes, E%CEPT

a. they are more li(ely to ta(e multiple drugs.b. they may ha!e hepatic dysfunction.c. they may ha!e renal dysfunction.d. they are more sensiti!e to 5;" effects of drugs.e. they ha!e increased metabolic rates for producing psychoacti!emetabolites.

#). *or a child with asthma, all of the following factors are indicatorsof poor control, E%CEPT

a. number of !isits to the Emergency $oom.

b. limitations on daily acti!ities.c. awa(ening at night with asthma symptoms.d. (eeping one canister of salbutamol at home and one at school.e. number of parent wor( days missed due to the child illness.

#1. ssessment of a patientCs asthma control should include all ofthe following factors E%CEPT


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a. immuni3ation status.b. inhalation technique.c. use of inhaled D) agonist.d. use of inhaled corticosteroid.e. changes in en!ironmental triggers.

#4. :hich of the following li!er en3ymes is the first to be ele!ated ina case of an acetaminophen o!erdose6

a. actic dehydrogenase +0b. lanine transaminase +Tc. spartate transaminase +"Td. l(aline phosphatase +Pe. 8amma glutamyl transpeptidase +88T

#'. @ is a )4 year old, married female, who is planning to becomepregnant in the near future. @ has no medical conditions, noallergies, and is not currently ta(ing any medications. :hat !itaminsupplement should the pharmacist recommend to @ to pre!entneural tube defects in her baby6

a. ;iacinb. Fitamin 0c. *olic acidd. Pyridoxinee. *errous sulphate

#9. "ide effects which the pharmacist should monitor in 0", whenloo(ing for the effects of excessi!e topical corticosteroid use, include I pruritus.

II telangiectasias. III striae.

a. I only

b. III onlyc. I and II onlyd. II and III onlye. I, II and III

COMPETENCY & Professional Collaboration and Team'or(


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#


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months he has also experienced polydipsia and polyphagia. Thepharmacist should refer *0 to his physician because these symptomsare consistent with

a. cholelithiasis.

b. a urinary tract infection.c. prostate hyperplasia.d. diabetes mellitus.e. renal complications of hypertension.

)>. local physician approaches the community pharmacist tocollaborate on a health promotion pamphlet addressing medicationadherence. :hich of the following is NOTan appropriate topic for thepamphlet6

a. The team relationship of the patient with both his physician andpharmacistb. The ser!ice of the pharmacy pro!iding reminder calls formedication refillsc. d!ice to bring upcoming refill requests to scheduled physicianappointmentsd. The !arious (inds of reminder pac(aging a!ailable to assistpatientse. $eferral to industry-sponsored consumer websites forinformation regarding medications

)#. cademic detailing by pharmacists pro!ides a ser!ice tophysicians by

a. educating on impro!ed prescribing legibility.b. ad!ising on optimal patient inter!iewing techniques.c. recommending strategies to a!oid medication wastage.d. pro!iding current information on best prescribing practices.e. promoting the use of physician samples gi!en to patients.

COMPETENCY ) Ethi*al, +egal and Professional!esponsibilities

)). ccording to the ;arcotic 5ontrol $egulations of the 5ontrolled0rugs and "ubstances ct, which of the following practitioners mayprescribe narcotic drugs6


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a. Feterinariansb. ;urse practitionersc. Podiatristsd. 7idwi!ese. Physiotherapists

)1. The ethical principle of !eracity requires that pharmacists

a. respect the rights of others to ma(e choices.b. do good to patients, placing the benefit of the patient o!er otherfactors such as cost.c. a!oid, remo!e or pre!ent harm.d. act with fairness, to allow people to recei!e that to which they areentitled.e. act with honesty, without deception.

)4. @;, a #< year old male with a highly resistant form of testicularcancer, is in hospital for treatment. e is an intelligent, articulateyoung man. is parents are insisting that the physician treat him withthe latest experimental therapy, but @; does not want to undergo thetreatment. If the physician goes ahead and gi!es the experimentaltherapy what ethical principle will ha!e been !iolated the most6

a. 5onfidentialityb. ;on-maleficencec. @usticed. Feracitye. utonomy

)'. :hich of the following medications does NOTrequire witnesseddestruction6

a. =etamineb. ;abilone

c. 0ia3epamd. Testosteronee. 8abapentin

)9. The 5anada ealth ct +#?&4 embodies all of the followingprinciples, E%CEPT


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a. affordability.b. accessibility.c. comprehensi!eness.d. portability.e. uni!ersality.

)


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e. ;o specific expiry date at the pharmacist/s discretion

1>. The standard of publicly funded health care in 5anada ismandated by

a. the 5anada ealth ct.b. indi!idual pro!inces and territories.c. ealth 5anada/s ealth En!ironment and 5onsumer "afetydirectorate.d. 5anadian gency for 0rugs and Technologies in ealth.e. ;ational ssociation of Pharmacy $egulatory uthorities.

1#. The pharmacist recei!es a phone call from a physician whowishes to lea!e a !erbal prescription for 1> alpra3olam >.)' mg tid,

with ) repeats. It is a new prescription for the patient. :hich of thefollowing statements is true6

a. Prescriptions for ben3odia3epines should be filed with thenarcotic and controlled prescriptions.b. The prescription should not be dispensed because !erbalprescriptions are not allowed for ben3odia3epines.c. The prescription may be dispensed for the original quantity only,because refills are not permitted.d. Transfer of this prescription is permitted as long as theprescription is only transferred once.e. =eeping reports of sales in a manner that permits an audit isrequired for all ben3odia3epines.

1). *or a drug going through research and de!elopment processesin 5anada, which of the following statements is true6

a. pplication for patent protection is granted for a maximum periodof three years.b. ;ew 0rug "ubmission must be filed in order to start clinical

trials.c. 5linical trials in!ol!e three phases assessing animal safety andefficacy.d. Each pac(age si3e of a drug product must ha!e a unique 0rugIdentification ;umber +0I;.e. ealth 5anada under the *ood M 0rugs ct M $egulationspro!ides ;otice of


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5ompliance.

11. :hich of the following is the national !oluntary organi3ation forad!ocacy of pharmacists and patient care6

a. 5anadian *oundation for Pharmacyb. 5anadian Pharmacists ssociationc. 5anadian Patient "afety Instituted. Institute for "afe 7edication Practicese. ;ational ssociation of Pharmacy $egulatory uthorities

COMPETENCY $rug, Therapeuti* and Pra*ti*e #nformation

14. :hich of the following would be the most useful reference tolearn what combination of antiretro!iral agents is currently

recommended as a first line therapy to treat IF infection6a. 7eta-analysesb. $andomi3ed, controlled trialc. Pharmacology textboo(d. 5linical practice guidelinese. 5ompendium of Pharmaceuticals and "pecialties

1'. :hich information source would be most appropriate to consultfirst, to determine if labetalol is a cardioselecti!e beta-bloc(er6

a. 5ompendium of Pharmaceuticals and "pecialtiesb. $andomi3ed, controlled trial datac. 7eta analysis of beta bloc(er therapyd. 5ochrane ibrary databasee. 5ase reports

19. Type II statistical error in a study comparing ) drug treatmentregimens occurs when

a. the control drug is not a Ngold standardN treatment.

b. a statistically significant difference exists but the difference is notclinically important.c. the population under in!estigation does not represent thepopulation with the disease.d. the data shows no difference between ) treatment regimens anda difference actually does exist.e. the data shows a difference between ) treatment regimens but a


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difference does not actually exist.

1B.b. #'B.c. )'B.d. 4>B.e. '>B.

1&. In an adequately powered, randomi3ed controlled trialconducted o!er 1 years, a specific serious side effect +i.e. reduction inleu(ocytes with con!entional therapy is seen in >.'B of the studysample. In patients who recei!e a newly disco!ered drug, only >.4'Bexperience the same side effect. 2ased on these results, theminimum number of patients that would need to recei!e the new drugfor 1 years to statistically demonstrate the pre!ention of one episodeof this side effect in at least one patient +i.e., ;;T is

a. #'.b. )>.c. #'>.d. )>>.e. )>>>.

COMPETENCY - Communi*ation and Edu*ation

1?. *or elderly patients with chronic respiratory conditions, which ofthe following !accinations are usually recommended on a yearly

basis6I Influen3a !irusII PneumococcusIII 7eningococcus

a. I onlyb. III onlyc. I and II only


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d. II and III onlye. I, II and III

4>. ll of the following are appropriate suggestions for a pharmacist

to gi!e to a patient with allergic rhinitis from multiple en!ironmentaltriggers, to minimi3e exposure to possible allergens, E%CEPT

a. open windows to get fresh air into the home.b. clean and !acuum on a regular basis.c. wash bed linens regularly in hot water.d. use mattress and pillow co!ers.e. remo!e any carpets, if possible.

4#. 0" wishes to protect her children from :est ;ile infection and

requests information from the pharmacist regarding insect repellents.ll of the following are correct responses from the pharmacist,E%CEPT

a. 0EET is the most effecti!e insect repellent a!ailable.b. when needed, sunscreen should be applied to the s(in prior to0EET application.c. 0EET effecti!ely binds to the s(in and should not be reappliedafter swimming.d. 0EET should be washed off young children once they returnindoors.e. products containing citronella oil ha!e a !ery short duration ofeffect.

4). pharmacist is conducting public education sessions on the roleof inhaled medications in patients with asthma. :hich of thefollowing is the most appropriate indicator of impro!ed asthmacontrol6

a. decrease in the number of bronchodilator doses used prior to

exercise.b. decrease in the number of bronchodilator doses used permonth.c. decrease in the number of corticosteroid doses used permonth.d. n increase in the number of bronchodilator prescriptions filledper month.


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e. n increase in the number of corticosteroid prescriptions filledper month.

41. :hich of the following medications is +E".Tli(ely to cause

embarrassment and worry about social stigma in a school-age child6a. Insulinb. Phenytoinc. Fenlafaxined. moxicilline. 7ethylphenidate

44. :hen counselling a patient who is upset o!er a new diagnosisand need for medications, which of the following strategies is NOT

appropriate for the pharmacist to use6a. Pro!iding a pri!ate en!ironment for the interactionb. d!ising the patient that things will be o(ayc. Probing to clarify the patient/s concernsd. etting the patient !ent hisOher feelingse. Ending with an encouraging statement

4'. :hich of the following factors that !ary with cultural di!ersitydoes NOTdirectly impact on pharmacist-patient dialogue and

communication6a. Eye contactb. and gesturesc. *acial expressionsd. Interpersonal spacee. Personal learning style

COMPETENCY / $rug $istribution

49. biological safety cabinet would be the best choice when

preparing a parenteral formulation of

a. aminophylline.b. doxorubicin.c. magnesium sulfate.d. nitroglycerin.


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e. penicillin.

4day supply to pro!ide the same pain relief as the tablet regimen6

a. )> mb. 9> mc. &> md. #>> me. #)> m

4&. patient is currently ta(ing ))> mg of anhydrous 3inc sulphate.To recei!e the equi!alent amount of elemental 3inc, how manymilligrams of 3inc sulphate heptahydrate +< )> would the patientha!e to ta(e6 +7olecular weights 3inc 9', n"L4#9#, )> #&

a. #)1 mgb. ))> mgc. 1>> mgd. 1?) mge. '4' mg

4?. 8i!en that 1> g of a mild corticosteroid ointment co!ers theentire surface of any adult for one application, how much ointment +ingrams should be dispensed for an #& year old patient who requirestreatment on approximately )>B of her body with twice dailyapplication for #4 days6

a. 9 gb. #) g

c. &4 gd. #)4 ge. #9& g

'>. 2F is a 9) year old, obese female who !isits a wal(-in-clinicwhile her physician is away on !acation. "he presents to thepharmacist with the following prescription


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osecA+omepra3ole 1> mg7 1>"ig. i dailyThe pharmacist (nows that this product is only a!ailable in #> mg or)> mg strengths and that 2F/s profile shows that she was pre!iouslyon the )> mg strength of this medication. The most appropriatepharmacist response is to

a. tell 2F that the physician has made a prescribing error.b. as( 2F why she !isited the clinic today and what the physiciantold her about the prescription.c. dispense using omepra3ole #> mg and adJust the quantity anddose accordingly.d. assume the prescriber was thin(ing of Pre!acidA+lansopra3ole1> mg and change the prescription accordingly.

e. recommend to 2F that she wait to see her regular physicianwhen he returns.

'#. :hich of the following is+E".T appropriate to consider when ahospital pharmacy manager is organi3ing assigned responsibilities forclinical pharmacists in the department6

a. 0iseaseOmedical area of interest of the indi!idualb. 5ommunication and interpersonal s(ills of the indi!idualc. d!anced training or credentials of the indi!idual

d. Indi!idual/s length of employment at the hospitale. :illingness of the indi!idual to upgrade learning and s(ills

'). :hich of the following pharmaceuticals is regulated federallyunder the Precursor 5ontrol $egulations of the 5ontrolled 0rugs and"ubstances ct, as a precursor chemical for illicit drug use6

a. 0extromethorphanb. 0imenhydrinatec. 0ia3epam

d. Pseudoephedrinee. Testosterone

'1. patient has been ta(ing an opioid analgesic for the past threemonths for bac( pain resulting from a wor(place inJury. ll of the


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following beha!iours could be indicators of a de!eloping addictiondisorder, E%CEPT

a. incidents of lost prescriptions.b. frequent requests for early refills.

c. prescriptions from multiple physicians.d. patient concerns regarding side effects.e. patient concerns regarding lac( of efficacy.

'4. In a hospital pharmacy, which of the following is the mosteffecti!e strategy to enhance safety and minimi3e the incidence ofinterpretation errors associated with !erbal medication orders6

a. Rse of bar code technology on medication ordersb. Rse of tall man lettering on medication orders

c. Rse of automated dispensing technologyd. $equirement for a read-bac( to the prescriber of all !erbal orderse. $estricting the acceptance of !erbal orders to oral medicationsonly

''. :hich of the following classes of medications is most li(ely to beadministered by the intra!enous piggybac( method6

a. ntibioticsb. Lpioids

c. Insulinsd. Erythropoiesis regulating hormonese. ;euromuscular bloc(ing agents

'9. :hich of the following actions would NOTcontribute topromoting a safe medication use system in a pharmacy6

a. Pro!iding patients with information on medicationsb. ttention to en!ironmental conditions in the pharmacyc. Lffering de!elopmental programs for staff education

d. $otating staff regularly to assume different responsibilities andtas(se. 7aintaining processes for documentation of medication incidents

COMPETENCY 0 nderstanding Management Prin*iples

'


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opportunities. is manager, now wanting to delegate a new technicalproJect to him, shouldI discuss suggested steps to accomplish the proJect.II negotiate a time schedule for completion of the proJect.III pro!ide support and follow-up as required.


'&. :hich of the following is NOTa benefit of performing medicationreconciliation acti!ities in a hospital setting6

a. $eduction of medication errorsb. $eduction of in!entory pilferagec. $eduction of pre!entable ad!erse effectsd. ssessment of patient adherence to therapye. Enhanced accuracy of patient allergy information

'?. *actors that determine bioequi!alence of two brands of a drugincludeI the taste of the preparations.II the physical appearance of the preparations.III pharmaco(inetic parameters of the preparations.


9>. :hich of the following criteria should be considered when

re!iewing a medication for addition to the hospital formulary6a. The amount of samples pro!ided to hospital physiciansb. $esearch funds donated to the hospital by the pharmaceuticalcompanyc. ;ational ad!erse drug reaction reportsd. :hether it is a gluten-free oral formulation


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e. The length of patent period remaining

9#. In deciding what medications are appropriate for its formulary,the hospital must consider a drug/s efficacy, associated wor(load, and

acquisition cost. "e!eral new intra!enous antifungal agents +drug ,drug 2, drug 5, and drug 0, all with equal efficacy to drug E, ha!erecently become a!ailable. 5urrently the hospital stoc(s drug E,which has been a!ailable for se!eral years. 0ata for the medicationsis as follows

Drug

Cost/day

Dosing

Frequency

Treatment Duration

(days)

A S2.50 QID 14

B S2.25 once daily 14

C S5.00 BID 7

D S2.25 BID 7

E S2.25 QID 7

The most appropriate choice for the hospital is

a. 0rug .b. 0rug 2.c. 0rug 5.d. 0rug 0.

e. 0rug E.

The next se*tion in*ludes E%"MP+E. O2 T3E C".E .CEN"!#O2O!M"T, in 'hi*h there are t'o or more 4uestions in se4uen*e,'hi*h are related to the patient information provided in the5bolded6 stem information sho'n at the top of the *ase7

8E.T#ON. /& TO / #NC+.#9E !E2E! TO T3E 2O++O:#N;

.M is a ) year old female 'ho, 'hile va*ationing in Mexi*o,began prophyla*ti* treatment for travellers< diarrhea7 .hortlythereafter she *omplained of a feeling of fullness in her ears,bla*( stools and a bla*( tongue7

9). :hich of the following drugs could be the cause of "7Cscomplaints6

a. 2ismuth subsalicylateb. 5otrimoxa3ole


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c. 0iphenoxylated. operamidee. ttapulgite

91. Lrganisms commonly implicated in the cause of tra!ellers/diarrhea includeI Bacteroides fragilis.II Escherichia coli.III Shigella sp.


94. :hich of the following is the most appropriate option for futurepre!ention of tra!ellerCs diarrhea if "7 is tra!elling to 7exico6

a. 5iprofloxacinb. Tetracyclinec. Erythromycind. Trimethoprime. 5lindamycin

8E.T#ON. /- TO /0 #NC+.#9E !E2E! TO T3E 2O++O:#N;

P8 is a 0- year old patient 'ho has =ust been diagnosed 'ithhypothyroidism7 3er past medi*al history is signifi*ant for*ongestive heart failure, type & diabetes mellitus, osteoporosisand *hroni* stable angina, all of 'hi*h are 'ell>*ontrolled7 3ermedi*ations in*lude

Metoprolol &- mg bidCal*ium *arbonate 1&-? mg bid

9itamin $ 1??? # daily;lyburide &7- mg bidEnalapril 1? mg bid2urosemide ? mg dailyNitrogly*erin .+ spray prn

9'. PQ should be started on a low dose of le!othyroxine because ofher


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a. age.b. gender.c. diabetes.d. metoprolol use.e. nitroglycerin use.

99. ppropriate counselling and follow-up for PQ with initiation ofle!othyroxine includes all of the following, E%CEPT

a. separate the le!othyroxine dose from calcium tablets by se!eralhours.b. ta(e le!othyroxine on a full stomach for greater absorption.c. impro!ed control of thyroid le!els may also impro!e her glycemiccontrol.d. physician follow-up is needed in 9-& wee(s to ha!e her thyroidfunction tests repeated.e. closer monitoring of her angina should be done during dosagetitration of le!othyroxine.

9


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e. 9> years.

9?. ipid profile screening is important in all patients who ha!e ahistory of

a. 5LP0.b. 8E$0.c. diabetes.d. osteoarthritis.e. li!er disease.

. :hich of the following is the primary assessment toolrecommended to quantify a patient/s #>-year ris( for totalcardio!ascular disease6

a. $eynolds ris( scoreb. *ramingham ris( scorec. "5L$E ris( estimatord. TI7I ris( scoree. 50" II score


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c. Insulind. 7etformine. carbose


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Part # > "ns'ers to .ample 8uestions

#. +c 1?. +a

). +a 4>. +a

1. +d 4#. +c

4. +d 4). +b

'. +c 41. +d

9. +e 44. +b

. +b

#1. +a '#. +d

#4. +c '). +d

#'. +c '1. +d

#9. +d '4. +d

#. +c


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)1. +e 9#. +d

)4. +e 9). +a

)'. +e 91. +d

)9. +a 94. +a

)

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Canada Board Mcqs Qualifing Exam

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