FPGEE Pharmacy Practice 4

Question 1

A patient with renal impairment (CrCl 20 mL/min) is prescribed vancomycin. How should the dosing be adjusted?

Accepted Answer

Decrease dose or increase dosing interval

Answer

Vancomycin is primarily renally eliminated; reduced CrCl requires dose reduction or extended dosing intervals to prevent accumulation and nephrotoxicity.

Question 2

Which immunization is CONTRAINDICATED in a patient who is 28 weeks pregnant?

Accepted Answer

MMR

Answer

MMR is a live attenuated vaccine and is contraindicated during pregnancy due to theoretical risk of fetal infection.

Question 3

A patient fills a prescription for sildenafil and also takes isosorbide mononitrate. What is the primary concern?

Accepted Answer

Severe hypotension due to additive vasodilation

Answer

Both sildenafil (PDE-5 inhibitor) and nitrates cause vasodilation; combined use produces severe, potentially fatal hypotension.

Question 4

According to USP <797>, what is the beyond-use date (BUD) for a compounded sterile preparation assigned Category 1?

Accepted Answer

12 hours at controlled room temperature or 24 hours refrigerated

Answer

USP <797> Category 1 CSPs have a BUD of 12 hours at controlled room temperature (CRT) or 24 hours refrigerated.

Question 5

A pharmacist is reviewing a medication profile and notices a patient on methotrexate is also prescribed trimethoprim-sulfamethoxazole (TMP-SMX). What is the clinical concern?

Accepted Answer

Both drugs inhibit dihydrofolate reductase, increasing methotrexate toxicity

Answer

TMP-SMX and methotrexate both inhibit dihydrofolate reductase, causing additive antifolate toxicity (myelosuppression, mucositis).

FPGEE Exam Practice Test

FPGEE Exam Practice Test

FPGEE Pharmacy Practice 4