Trial test · Pharmacist (Prometric)

Question 1 of 10

A prescription for rheumatoid arthritis reads: “Methotrexate 2.5 mg tablets, take six tablets by mouth daily.” The medication history shows the patient previously received methotrexate once weekly. What should the pharmacist do before dispensing?

Change the tablet strength

Dispense exactly as written

Supply a shorter quantity

Clarify the dosing frequency

Question 2 of 10

A weakly acidic drug undergoes passive tubular reabsorption in its nonionized form. If urine pH is increased, which change in renal handling is expected?

Renal clearance will decrease

Urinary excretion will decrease

Renal elimination will increase

Tubular reabsorption will increase

Question 3 of 10

A medicine is eliminated predominantly by active renal tubular secretion. A second drug competes for the same renal transporter. What pharmacokinetic consequence is most likely for the first medicine?

Increased renal clearance

Increased receptor potency

Increased first-pass metabolism

Reduced renal clearance

Question 4 of 10

A patient asks the pharmacist to alter the documented dispensing date on a regulated medicine record so that it appears to have been supplied earlier. The medicine was actually dispensed today. What should the pharmacist do?

Refuse and retain an accurate contemporaneous record

Leave the dispensing date blank to avoid conflict

Change the date because the patient requested it

Ask another staff member to enter the earlier date

Question 5 of 10

An older adult using glimepiride has repeated episodes of sweating, confusion, and capillary glucose values below 3.0 mmol/L, especially when meals are delayed. What medication-safety issue requires prompt review?

Caffeine deficiency during symptomatic episodes

Recurrent sulfonylurea-associated hypoglycemia

Harmless symptoms requiring no medication review

Inadequate glimepiride dosing before delayed meals

Question 6 of 10

A prescription specifies oral semaglutide 7 mg daily using the established tablet formulation. The pharmacy stocks a newer semaglutide tablet formulation in 4 mg strength, and staff propose substituting one 4 mg tablet because both contain semaglutide. What should the pharmacist do?

Do not substitute the formulations milligram for milligram

Substitute two 4 mg tablets for 7 mg

Substitute one 4 mg tablet for 7 mg

Split a 4 mg tablet to approximate 7 mg

Question 7 of 10

Photograph of a potassium chloride concentrate ampule labeled 15%, 150 mg/mL, 10 mL.

A compounded infusion requires 900 mg of potassium chloride concentrate before appropriate further dilution. Inspect the ampule concentration shown. What volume of concentrate supplies 900 mg?

Measure 8 mL of concentrate

Measure 4 mL of concentrate

Measure 5 mL of concentrate

Measure 6 mL of concentrate

Question 8 of 10

A patient receives an intravenous drug whose elimination depends almost entirely on renal clearance. After acute kidney injury, renal clearance falls by 50% while the apparent volume of distribution remains unchanged. What happens to elimination half-life?

It remains essentially unchanged

It increases approximately twofold

It decreases approximately twofold

It increases approximately fourfold

Question 9 of 10

A patient asks the pharmacist to recommend a treatment for a condition that requires specialist assessment. The pharmacist has only limited experience with the condition and cannot confidently evaluate the available options. What is the most appropriate professional action?

Give speculative advice with a disclaimer

Pretend confidence to reassure the patient

Choose the most popular treatment available

Explain the limitation and refer appropriately

Question 10 of 10

A delayed-release proton-pump inhibitor tablet is designed to protect the active ingredient from degradation in gastric acid. Which handling instruction best preserves the intended release characteristics?

Crush the tablet before swallowing

Swallow the tablet intact

Chew the tablet before swallowing

Dissolve the tablet in hot water