FPGEE Pharmacy Practice 5 — Questions and Answers
Question 1: A pharmacist receives a prescription for amoxicillin 250 mg/5 mL suspension, dispense 150 mL. After reconstitution, what storage instruction should be provided?
- Store at room temperature for up to 30 days
- Refrigerate and discard after 14 days (Correct answer)
- Store at room temperature and discard after 7 days
- Freeze and thaw as needed
Correct answer: Refrigerate and discard after 14 days
Reconstituted amoxicillin suspension is stable for 14 days when refrigerated; beyond this, potency declines significantly.
Question 2: Which law requires pharmacies to report dispensing errors that cause patient harm to regulatory authorities?
- OBRA '90
- The Poison Prevention Packaging Act
- The Drug Quality and Security Act
- State pharmacy practice acts (Correct answer)
Correct answer: State pharmacy practice acts
State pharmacy practice acts govern professional standards including error reporting requirements; federal law does not mandate a uniform error-reporting system for pharmacies.
Question 3: A patient asks about potential interactions between St. John's Wort and their oral contraceptive. What should the pharmacist advise?
- No interaction exists between herbal products and prescription drugs
- St. John's Wort induces CYP enzymes, potentially reducing contraceptive efficacy (Correct answer)
- St. John's Wort inhibits CYP3A4, increasing hormone levels
- Use of St. John's Wort enhances contraceptive effectiveness
Correct answer: St. John's Wort induces CYP enzymes, potentially reducing contraceptive efficacy
St. John's Wort is a potent CYP3A4 and P-glycoprotein inducer, which accelerates metabolism of ethinyl estradiol and progestin, potentially causing contraceptive failure.
Question 4: During a drug utilization review (DUR), a pharmacist identifies a patient receiving both an ACE inhibitor and a potassium-sparing diuretic. What is the primary concern?
- Additive antihypertensive toxicity causing excessive hypotension
- Hyperkalemia due to additive potassium retention (Correct answer)
- Hypokalemia worsened by the ACE inhibitor
- Reduced efficacy of both medications
Correct answer: Hyperkalemia due to additive potassium retention
ACE inhibitors decrease aldosterone, retaining potassium; combined with potassium-sparing diuretics (e.g., spironolactone), dangerous hyperkalemia can result.
Question 5: What is the correct needle gauge to use when administering a subcutaneous (SQ) injection to an average-weight adult?
- 16–18 gauge
- 20–22 gauge
- 25–27 gauge (Correct answer)
- 30–32 gauge
Correct answer: 25–27 gauge
Subcutaneous injections in adults typically use a 25–27 gauge needle to minimize tissue trauma while delivering medication into the subcutaneous fat.
Question 6: A pharmacist is performing medication therapy management (MTM) for an elderly patient on multiple medications. Which tool is MOST commonly used to identify potentially inappropriate medications in older adults?
- The Naranjo Algorithm
- The Beers Criteria (Correct answer)
- The STOPP/START criteria
- The CIOMS guidelines
Correct answer: The Beers Criteria
The Beers Criteria, published by the American Geriatrics Society, lists medications that are potentially inappropriate for adults aged 65 and older.
Question 7: Which type of medication error involves a drug being administered via the wrong route (e.g., IV instead of IM)?
- Omission error
- Wrong dose error
- Wrong route error (Correct answer)
- Prescribing error
Correct answer: Wrong route error
A wrong route error occurs when a medication is given by a route other than that specified, which can cause serious harm (e.g., vincristine given intrathecally).
FPGEE Pharmacy Practice 5
A pharmacist receives a prescription for amoxicillin 250 mg/5 mL suspension, dispense 150 mL.
After reconstitution, what storage instruction should be provided?