NZREX Pharmacology & Prescribing 3

Question 1

Under the New Zealand Medicines Act 1981, which of the following is correctly classified as a Prescription Medicine requiring a valid prescription?

Accepted Answer

Metoprolol 50mg tablets

Answer

Paracetamol 500mg tablets (available over-the-counter)

Answer

Ibuprofen 200mg tablets (pharmacy-only)

Answer

Chlorphenamine antihistamine syrup (pharmacy-only)

Question 2

A nurse practitioner in NZ wishes to use a standing order to supply a medicine to patients without an individual prescription. Which legislation primarily governs the use of standing orders?

Accepted Answer

Medicines Act 1981 and the Medicines (Standing Order) Regulations 2002

Answer

Health and Disability Commissioner Act 1994

Answer

New Zealand Public Health and Disability Act 2000

Answer

Misuse of Drugs Act 1975

Question 3

When adjusting medication doses for a patient with chronic kidney disease in NZ clinical practice, which parameter is most routinely used as it is automatically reported in NZ laboratory results?

Accepted Answer

Estimated Glomerular Filtration Rate (eGFR)

Answer

Serum creatinine alone

Answer

Creatinine clearance using the Cockcroft-Gault formula

Answer

Serum cystatin C

Question 4

Which prescribing principle is most critical when initiating new medications in a 78-year-old patient with multiple comorbidities and polypharmacy in New Zealand?

Accepted Answer

Apply 'start low, go slow' and conduct regular medication reviews to minimise polypharmacy risk

Answer

Always initiate at the maximum approved dose to achieve therapeutic effect quickly

Answer

Avoid all medications requiring renal dose adjustment regardless of the patient's eGFR

Answer

Prefer intravenous formulations over oral for reliability in elderly patients

Question 5

According to the New Zealand National Immunisation Schedule, which combination vaccine is administered to all infants at 6 weeks of age?

Accepted Answer

DTaP-IPV-Hib-HepB (Infanrix-hexa)

Answer

BCG vaccine alone

Answer

Hepatitis A and B combination vaccine

Answer

Meningococcal ACWY vaccine

Question 6

When initiating strong opioids for a patient with chronic non-cancer pain in New Zealand, which action is most consistent with current national opioid prescribing guidelines?

Accepted Answer

A documented opioid treatment agreement outlining goals, risks, and monitoring should be established

Answer

Opioids are first-line for chronic pain and should be initiated without delay

Answer

Opioid prescriptions in NZ have no specific documentation requirements beyond the standard prescription

Answer

Long-acting opioid formulations should always be commenced before short-acting ones

Question 7

Which of the following best reflects a culturally responsive approach to prescribing for Māori patients in New Zealand, consistent with Te Tiriti o Waitangi principles?

Accepted Answer

Addressing potential barriers to adherence including cost, access, health literacy, and cultural beliefs

Answer

Referring all Māori patients to a specialist before prescribing any new medication

Answer

Prescribing higher doses of medications routinely as Māori patients metabolise drugs more rapidly

Answer

Avoiding discussion of rongoā Māori (traditional medicine) as it is not clinically relevant