BCACP Medication Management 3

Question 1

A patient with type 2 diabetes and a history of heart failure with reduced ejection fraction (HFrEF) is not at goal A1c on metformin alone. Which agent is most preferred to add?

Accepted Answer

Empagliflozin

Answer

SGLT2 inhibitors like empagliflozin have demonstrated cardiovascular mortality reduction in HFrEF and are preferred by major guidelines for this patient profile.

Question 2

Which bisphosphonate formulation requires the patient to remain upright for 30 minutes after administration?

Accepted Answer

Alendronate oral tablet

Answer

Oral alendronate must be taken with a full glass of water on an empty stomach, and the patient must remain upright for at least 30 minutes to prevent esophageal irritation.

Question 3

A pharmacist is counseling a patient starting isotretinoin. Which program must the patient be enrolled in before dispensing?

Accepted Answer

iPLEDGE program

Answer

iPLEDGE is the mandatory REMS program for isotretinoin due to its severe teratogenic potential, requiring monthly pregnancy testing for females of reproductive potential.

Question 4

When converting a patient from oral oxycodone 30 mg every 4 hours to an IV morphine infusion, which step is critical?

Accepted Answer

Apply equianalgesic tables and then reduce by 25-50% for cross-tolerance

Answer

Equianalgesic conversion followed by a 25-50% dose reduction accounts for incomplete cross-tolerance and individual variation, reducing overdose risk during opioid rotation.

Question 5

A patient on phenytoin for seizure disorder is started on oral contraceptives. What counseling point is most critical?

Accepted Answer

Phenytoin induces CYP enzymes, reducing OCP plasma levels and efficacy

Answer

Phenytoin is a potent CYP3A4 inducer that accelerates metabolism of ethinyl estradiol and progestin, potentially leading to contraceptive failure.

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP Medication Management 3