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BPS Pharmacotherapy (Part1 and Part2) Sample Questions:

1. A 70-year-old 45-kg patient is admitted to the ICU with a diagnosis of digoxin intoxication. The patient complains of nausea, blurred vision, and fatigue that have been present for 3 days. A cardiac monitor reveals a HR of 42 bpm, an irregular rhythm, and a type second-degree heart block. Current medications include digoxin 0.25 mg and furosemide 40mg for heart failure, both taken daily at 0800. The patient remains adherent to all medications despite nausea, including today's doses. Blood is drawn at 1200 with the following results:
* Potassium: 6.0 mEq/L
* Creatinine: 2.3 mg/dL
* Digoxin: 1.7 ng/mL
Which of the following most appropriately describes the patient's digoxin concentration?

A) Reflects the effect of furosemide on the renal excretion of digoxin
B) A concentration within the desirable range
C) A pre-distribution digoxin concentration, which may be misinterpreted
D) A post-distribution digoxin concentration, which indicates significant toxicity

2. Which is the most effective method to improve the safety of the use of phytonadione in an institution with a 24-hour pharmacy?

A) Establishment of emergency preparedness kits containing phytonadione to be stored in the patient care areas where warfarin is used
B) Yearly in-service education and medical staff presentation about phytonadione use
C) Removal of phytonadione from all patient care areas of the facility coupled with strict usage guidelines
D) Computer order sets that default to using a standardized number of vials or amps of phytonadione per dose

3. A patient with previously well-controlled diabetes is suspected to be nonadherent with medication and diet. During the patient's last visit, the pharmacy student attempt to review education materials. However, the patient said that he forgot his reading glasses and asked if he could read through the information when he got home?
Which of the following is the best course of action for the patient at his next visit?

A) Provider the patient with additional materials to read at home.
B) Admit the patient to the hospital to optimize the diabetes regimen
C) Ask the patient to read and interpret the instructions on a prescription label to evaluate literacy
D) Ask the patient to follow up with his primary care provider.

4. A hospital's P & T Committee is considering whether a particular drug should be considered for therapeutic substitution. The pharmacotherapy specialist considers the acquisition cost of each medication and recommends using the drug with the lower cost. Which of the following types of analysis has the pharmacotherapy specialist used?

A) Cost-benefit
B) Cost-utility
C) Cost-effectiveness
D) Cost-minimization

5. A patient presents at a physician's office with gait unsteadiness and clumsiness. The patient has a history of type 2 diabetes mellitus, hypertension, and chronic numbness and tingling of the feet and fingertips.
Examination reveals mild distal wasting, glove-and-stocking sensory impairment, absent ankle jerks, brisk knee jerks, and bilateral Babinski reflexes. Gait is slightly ataxic.
CBC reveals a hemoglobin of 10.1 g/dL, WBC of 4,500 cells/mL, MCV 120 fL, and platelets
163,000 cells/ul.
Which of the following is the most important laboratory test for assisting in diagnosis?

A) Ferritin
B) Serum vitamin B12
C) Erythrocyte sedimentation rate
D) Folic acid

Solutions: