PSI Clinical Pharmacy & OTC 4

Question 1

Which blood pressure reading is classified as hypertensive crisis requiring immediate referral?

Accepted Answer

Systolic ≥180 mmHg and/or diastolic ≥120 mmHg, especially with symptoms

Answer

A reading of ≥180/120 mmHg, especially with symptoms (headache, visual disturbance, chest pain), represents hypertensive crisis or emergency, requiring same-day emergency assessment.

Question 2

Which OTC nicotine replacement therapy formulation has the fastest onset of action for craving relief?

Accepted Answer

Nicotine mouth spray (reaches peak levels in 10–15 minutes)

Answer

Nicotine mouth spray (e.g., Nicorette Quickmist) provides rapid buccal absorption, achieving peak nicotine levels in 10–15 minutes. Patches provide slow sustained release.

Question 3

Which clinical question is most important when counselling a patient purchasing OTC omeprazole?

Accepted Answer

Have you had these symptoms before and have you seen your GP if they are new or persisting?

Answer

New or persistent dyspeptic symptoms — especially in patients over 55 — may indicate serious pathology (gastric cancer, oesophageal cancer). Pharmacists must screen for alarm features before recommending OTC PPIs.

Question 4

Which vitamin supplement is recommended by Irish health authorities for all adults during autumn and winter?

Accepted Answer

Vitamin D 400–1000 IU daily

Answer

Due to Ireland's northern latitude, sunlight is insufficient for cutaneous vitamin D synthesis from October to March. HSE and FSAI recommend vitamin D supplementation for all adults during this period.

Question 5

A mother asks for cough medicine for her 18-month-old child with a wet cough. The pharmacist should advise:

Accepted Answer

OTC cough medicines should not be used in children under 6 years — advise honey (over 12 months) and fluids instead

Answer

In Ireland/UK, OTC cough and cold medicines are not recommended for children under 6 (some say under 12). Honey (not before 12 months) and adequate hydration are safe, evidence-supported alternatives.

PSI Pharmacy Practice Test

PSI Pharmacy Practice Test

PSI Clinical Pharmacy & OTC 4