BCACP Cheat Sheet 2026

The 30 highest-yield BCACP facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. A patient starting on an SSRI for depression asks when they will begin to feel better. What is the most accurate response? → 2–4 weeks for mood improvement, up to 6–8 weeks for full effect
2. What is the recommended first-line pharmacotherapy for smoking cessation in an otherwise healthy ambulatory care patient? → Varenicline (Chantix)
3. A patient on warfarin for atrial fibrillation presents with an INR of 8.5 and no signs of active bleeding. What is the most appropriate management? → Hold warfarin, administer oral vitamin K 2.5 mg, and recheck INR in 24–48 hours
4. A patient with bipolar I disorder is stable on lithium but becomes pregnant. What is the primary concern with continuing lithium? → Risk of Ebstein's anomaly (cardiac defect) in the fetus
5. A diabetic patient develops a foot infection with purulent drainage. Which organism is most commonly responsible for mild-to-moderate diabetic foot infections? → Staphylococcus aureus
6. What is the primary mechanism of action of naltrexone when used for alcohol use disorder? → Opioid receptor blockade reducing reward from alcohol
7. Which drug is most likely to INCREASE warfarin's anticoagulant effect by inhibiting its primary metabolizing enzyme? → Fluconazole
8. Which of the following demonstrates a pharmacist’s role in promoting professional recognition and advancement of the ambulatory care pharmacy practice? → Conducting research and publishing in peer-reviewed journals
9. Which DOAC has the lowest proportion of renal elimination (~27%), making it most suitable in patients with chronic kidney disease? → Apixaban
10. Which hepatitis B vaccination series is recommended for an unvaccinated 45-year-old adult in the US per current ACIP guidelines? → 2-dose Heplisav-B series or 3-dose Engerix-B/Recombivax series
11. Which of the following clotting factors is NOT inhibited by warfarin? → Factor VIII
12. Which is a guideline-recommended first-line option for initial treatment of acute DVT in a patient with adequate renal function and no active cancer? → Rivaroxaban 15 mg twice daily for 21 days, then 20 mg daily
13. What is the minimum recommended duration of anticoagulation for a first provoked DVT associated with a reversible risk factor such as major surgery? → 3 months
14. A patient on lithium presents with tremor, polyuria, and a serum level of 1.6 mEq/L. What is the most appropriate action? → Hold lithium and assess for toxicity
15. Which antibiotic class is considered first-line for uncomplicated community-acquired pneumonia (CAP) in an outpatient adult with no comorbidities? → Macrolides (e.g., azithromycin)
16. Which vaccine requires a 2-dose series given 2–6 months apart and is preferred over the older zoster vaccine for shingles prevention in adults ≥50? → Shingrix (RZV)
17. For a stable warfarin patient who has had three or more consecutive therapeutic INRs, what is the standard recommended monitoring frequency per ACCP guidelines? → Every 4 weeks (monthly)
18. A patient with a penicillin allergy history (mild rash) needs treatment for streptococcal pharyngitis. What is the most appropriate antibiotic choice? → Azithromycin
19. Idarucizumab (Praxbind) is the FDA-approved specific reversal agent for which anticoagulant? → Dabigatran
20. Which medication is first-line for generalized anxiety disorder (GAD) pharmacotherapy in ambulatory care? → Buspirone or an SSRI/SNRI
21. Which of the following lifestyle modifications is consistently shown to have the most significant impact on lowering blood pressure? → Reducing dietary sodium intake
22. Which antimicrobial is first-line for treatment of Clostridioides difficile (C. diff) infection of non-severe initial episodes per IDSA/SHEA guidelines? → Oral vancomycin or fidaxomicin
23. What is the recommended duration of maintenance antidepressant therapy after a second episode of major depressive disorder? → At least 1 year
24. Which medication is recommended for alcohol withdrawal to prevent seizures in an ambulatory-eligible patient? → A long-acting benzodiazepine such as chlordiazepoxide or diazepam
25. What is the target INR range for a patient with nonvalvular atrial fibrillation on warfarin? → 2.0–3.0
26. A patient on warfarin dramatically increases consumption of kale, spinach, and broccoli. What is the most likely effect on their INR? → INR will decrease due to increased vitamin K intake
27. A pharmacist reviews a patient's chart and notes the patient has not received a Td booster in 12 years. What is the appropriate action? → Administer Td booster now if no previous Tdap history, otherwise Tdap
28. Which key counseling point should a pharmacist provide when dispensing oseltamivir (Tamiflu) for influenza? → It must be started within 48 hours of symptom onset to be effective
29. What is the correct target INR range for a patient with a bileaflet mechanical aortic valve and no additional thromboembolic risk factors? → 2.0–3.0
30. A patient asks about receiving the COVID-19 vaccine during a routine ambulatory visit. Which statement accurately reflects current vaccination guidance? → Updated COVID-19 vaccines can be co-administered with other vaccines at the same visit