KAPS Clinical Procedures and Protocols 3 â Questions and Answers
Question 1: Which ISO classification corresponds to the cleanroom environment required for compounding sterile preparations under USP <797>?
- ISO Class 3
- ISO Class 5 (Correct answer)
- ISO Class 7
- ISO Class 8
Correct answer: ISO Class 5
USP <797> requires an ISO Class 5 environment (âĪ3,520 particles âĨ0.5 Ξm per cubic meter) for critical compounding areas.
Question 2: A pharmacist counseling a patient on self-monitoring of blood glucose should recommend that a fasting blood glucose reading below which value indicates good control in a non-pregnant adult with type 2 diabetes?
- 180 mg/dL
- 140 mg/dL
- 130 mg/dL
- 80â130 mg/dL (Correct answer)
Correct answer: 80â130 mg/dL
ADA guidelines recommend a preprandial (fasting) blood glucose target of 80â130 mg/dL for most non-pregnant adults with diabetes.
Question 3: When converting a patient from IV morphine to oral morphine, the equianalgesic conversion ratio is approximately:
- 1:1 (IV:oral)
- 1:2 (IV:oral)
- 1:3 (IV:oral) (Correct answer)
- 1:6 (IV:oral)
Correct answer: 1:3 (IV:oral)
Due to extensive first-pass metabolism, the IV to oral morphine equianalgesic ratio is approximately 1:3 (10 mg IV â 30 mg oral).
Question 4: A medication error resulting in patient harm that requires intervention to sustain life is classified under the NCC MERP index as:
- Category E
- Category F
- Category G
- Category H (Correct answer)
Correct answer: Category H
NCC MERP Category H is defined as an error that required intervention necessary to sustain the patient's life.
Question 5: Which technique is used to estimate renal function in obese patients when calculating creatinine clearance using the Cockcroft-Gault equation?
- Total body weight
- Actual body weight
- Adjusted body weight (Correct answer)
- Lean body weight
Correct answer: Adjusted body weight
Adjusted body weight (ABW) is recommended for obese patients in the Cockcroft-Gault equation to avoid overestimating renal function.
Question 6: A pediatric patient requires a loading dose of phenytoin via IV infusion. The maximum infusion rate to prevent cardiovascular toxicity is:
- 0.5 mg/kg/min
- 1 mg/kg/min (Correct answer)
- 3 mg/kg/min
- 5 mg/kg/min
Correct answer: 1 mg/kg/min
Intravenous phenytoin in pediatrics should not exceed 1 mg/kg/min (maximum 50 mg/min in adults) to prevent hypotension and arrhythmias.
Question 7: In a pharmacokinetic consultation, a patient's measured trough vancomycin level is supratherapeutic. Which action correctly addresses this?
- Decrease the dose and shorten the interval
- Maintain the dose and extend the interval (Correct answer)
- Decrease the dose and maintain the interval
- Increase the interval and decrease the dose
Correct answer: Maintain the dose and extend the interval
A supratherapeutic trough with adequate peak suggests slow elimination; extending the interval allows more time for drug clearance before the next dose.
KAPS Clinical Procedures and Protocols 3
Which ISO classification corresponds to the cleanroom environment required for compounding sterile preparations under USP ?