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CPJE Practice Exam Questions
A Pharmacist is dispensing new prescriptions for fosamprenavir, ritonavir, and truvada. In reviewing the patient's profile info, the pharmacist notes allergies to furosemide, glipizide, and bactrim. The pharmacist should call the physician to change: A. Truvada to combivir B. Fosamprenavir to Saquinavir C. Truvada to Atripla D. Fosamprenavir to tipranavir B Sulfa allergy: no darunavir, fosamprenavir, tipranavir A pharmacist is reviewing a patients medication profile prior to filling a new prescription for fentanyl transdermal patches. Which of the following presents a potential risk of interaction with fentanyl? A. Nicotine transdermal patches B. Carbamazepine 200 mg BID C. Brimonidine eye drops OU BID D. Finasteride 5 mg QDAY B Fentanyl is metabolized by the enzyme CYP3A4. Carbamazepine is a strong inducer of CYP3A4, which means that it can increase the metabolism of fentanyl, leading to reduced fentanyl levels in the bloodstream. This may reduce the effectiveness of fentanyl, potentially causing inadequate pain control or withdrawal symptoms in patients who are opioid-dependent A 67-year old man was started on ticlopidine 1 month ago for stroke prevention. The patient complains of recent fever, chills, sore throat. Which of the following is the MOST appropriate for the pharmacist to ask the physician? A. "Has the patient had an INR check recently?" B. "Has the patient had a CBC done yet?" C. "Has the patients diet changed over the past month?" D. "Has the patient had LFTs done in the past 2 weeks?" B Which of the following auxillary labels belongs on a bottle of Vivotif Berna? A. Refrigerate B. For external use only C. Avoid sunlight D. Shake well A
A patient has just been counseled on appropriate use of Niaspan. Which of the following statements would confirm patient understanding of the purpose for taking this medication? A. This medication will treat my high BP and lower risk of stroke. B. This medication will treat my high cholesterol and lower my risk of heart attack. C. This medication will treat my enlarged prostate and I won't have to get up at night to urinate. D. This medication will help keep my mood stable and allow me to sleep better at night. B A patient presents a prescription for Prevacid, but the pharmacy is out of this medication. Which of the following is MOST appropriate for the pharmacist to recommend to the physician as an alternative? A. Pantoprazole B. Aripirprazole C. Sulfisoxazole D. Mebendazole A Which of the following drugs require a pharmacist to include a medication guide when dispensing?
- Mefloquine
- Methocarbamol
- Digoxin
- Amiodarone A. 1 and 2 only B. 1 and 4 only C. 2 and 3 only D. 3 and 4 only B Mefloquine and Amiodarone both have significant risks and require a Medication Guide to be dispensed with them. Mefloquine is associated with serious neuropsychiatric side effects, and Amiodarone has potential risks for toxicity, especially pulmonary and hepatic, which necessitate providing a Medication Guide. A 37-year old patient with schizophrenia has been treated with clozapine 500 mg daily x 4 months. The patient has the following CBC results: June 30: wbc 10.1, neutrophils 7. June 22: wbc 10.7, neutrophils 7. June 16: wbc 6.5, neutrphils 3. June 9: wbc 6.3, neutrophils 3. June 2: wbc 6.7, neutrophils 3. Only July 7, the patients WBC is 7.2, and neutrophils are 4.3. The most appropriate recommendation for the pharmacist to make is to: A. Continue current therapy B. d/c therapy
C. invoice D. Medication lot number C A patient comes into the pharmacy with a prescription for erythromycin. During a consultation, the patient mentions that her new job in construction has made her allergies unbearable. The patient asks the pharmacist to call her physician for a new prescription for this condition. The physician asks for the pharmacists recommendation. Which of the following antihistamines should be suggested for this patient? A. Loratidine B. Clemastine C. Cetirizine D. Diphenhydramine A Loratadine is a 2G antihistamine that is non-sedating and less likely to cause drowsiness. This is beneficial for someone working in a job that requires alertness. Clemastine and Diphenhydramine are first-generation antihistamines, which are more likely to cause drowsiness and may not be suitable for someone working in construction. Cetirizine is a second-generation antihistamine as well, but it has a higher risk of causing drowsiness compared to Loratadine. A pharmacist is checking the accuracy of medications repackaged into unit dose form by pharmacy technician. The medication that was to be repackaged in monopril. Which of the following medications should have been used? A. quinapril B. Moexipril C. fosinopril D. benazepril C A new patient enrolling in an HIV adherance program is started on the following medications: Reyataz 300 mg PO QD Norvir 100 mg PO QD Videx EC 250 mg PO QD Viread 300 mg PO QD The dosing regimen that the pharmacist should give the patient is: A. Reyataz, Norvir, Videx EC, and Viread with breakfast B. Reyataz, Norvir, Videx EC and Viread at bedtime with empty stomach C. Reyataz, Norvir, Viread with breakfast, and Videx EC at bedtime with an empty stomach D. Videx EC and Viread with breakfast and Reyataz and Norvir at bedtime on empty stomach C
A patient presents a prescription with legible license number, but the doctors name and signature are illegible. Which of the following is MOST appropriate advice for the pharmacist to give the staff? A. Ask if the patient remembers the doctors name B. Tell the patient the prescription cannot be filled C. Call the prescribers telephone number printed on the prescription D. Have the patient return the prescription to the doctor and ask for a legible name C A patientcalls the pharmacy for a refill of antihypertensive medication previously filled at a pharmacy that is no longer in business. The patient provides the pharmacy with the phone number of the previous owner who has kept the prescription files at his home. Which of the following is MOST appropriate action for the pharmacy? A. Take the verbal prescription as a transfer order and fill the prescription B. Verify the records are kept in a locked cabinent C. Notify the BOP D. Have the pharmacist fax the hard copy to the pharmacy C A woman asks a community pharmacist for advice on treating a cut on her child's face. The pharmacist notices that the woman seems very impatient. The child appears fearful and has several large bruises on his face, forehead, neck, and arms. Which of the following actions should the pharmacist take? A. Advise the woman to take her child to a physician for evaluation and treatment. B. Suggest a topical antibiotic ointment be applied twice a day to the wound if it does not appear to need suturing. C. Report the encounter to the police department or county Child Protective Services D. Establish a medication profile for the child and record all non-prescription products that are recommended for use C Which of the following options should the pharmacist recommend for a 72-year old woman who usually takes 0.2 mg of levothyroxine by mouth daily, who is currently intubated and on a ventilator? A. Levo 100 mcg IV daily B. Levo 200 mg IV daily C. Liothyronine 150 mcg IV daily D. Liothyronine 200 mcg IV daily A Levothyroxine (Levo) has an intravenous (IV) formulation that is typically dosed at about 50-75% of the patient’s oral dose when switching from oral to IV, due to higher bioavailability when given IV. This patient usually takes 0.2 mg (200 mcg) orally. Therefore, an appropriate IV dose would be 100 mcg daily (approximately 50% of the oral dose).
Dilaudid (hydromorphone) is a Schedule II controlled substance. Under federal regulations, for long- term care facility residents or patients with a terminal illness, partial filling of Schedule II prescriptions is allowed. The remaining quantity can be dispensed over a period of up to 60 days from the date of issue. Who can sign Forms 222?
- The person who signed the last DEA registration
- The person with the POA
- All pharmacists
- All pharmacy interns A. 1 and 2 only B. 1 and 4 only C. 2 and 3 only D. 3 and 4 only A The person who signed the last DEA registration: This person, typically the registrant or the individual who is officially authorized by the DEA, is authorized to sign DEA Forms 222 for ordering Schedule II controlled substances. The person with the Power of Attorney (POA): The registrant may grant Power of Attorney to another individual, allowing them to sign DEA Forms 222 on their behalf. This authorization is often used to designate other personnel who may need to order Schedule II substances. Which of the following tasks cannot be performed by a pharmacy technician? A. Pull Lipitor off the shelf, count it, and put it into a bottle B. Pull xanax off the shelf, count it, put it into a bottle C. Ask the patient if he/she would like to talk to the pharmacist about his/her new prescription D. Reconstitute an Augmentin suspension C Engaging in patient counseling or making decisions about counseling is a task that must be performed by a pharmacist. Pharmacy technicians cannot counsel patients or assess if counseling is needed; only the pharmacist can initiate or offer counseling. A mother is picking up a new antibiotics prescription for her child. Which of the pharmacy staff can provide an offer to counsel?
- The pharmacist interns
- The pharmacy technicians
- The pharmacists
- The pharmacy clerk A. 1 and 2 B. 3 and 4
C. 1 and 3 D. 2 and 4 C ST is a female, 66 years of age, who is having a mammogram procedure, which is billed to her insurance. She works part-time as a hostess at a restaurant near her home. Who can receive PHI from this procedure without additional authorization?
- The radiologist who is analyzing the patient's mammogram
- The patients sister
- The patients medical insurance company
- The patients employer A. 1 and 2 B. 3 and 4 C. 1 and 3 D. 2 and 4 C A physician has written an order for Crestor, which is not on the hospital's formulary. The pharmacist will substitute the drug, according to the hospital's therapeutic interchange protocol. Which of the following medications is a reasonable substitution for this drug? A. Nystatin B. Vytorin C. Bio-statin D. Lipitor D Which of the following medications should have the auxillary label, "Do not eat grapefruit or drink grapefruit juice at any time while using this medicine" applied to the bottle? A. Dexilant B. Buspirone C. Cozaar D. Carbidopa/levodopa B Buspirone is known to interact with grapefruit and grapefruit juice. Grapefruit inhibits the CYP3A enzyme, which can increase the levels of buspirone in the blood, potentially leading to increased side effects or toxicity. Which of the following medications should have the auxillary label, "May cause drowsiness. Use care when operating a car or dangerous machinery" applied to the bottle? A. Wellbutrin B. Altoprev
Levofloxacin (FQ antibiotic). It can bind to calcium, magnesium, iron, and other minerals found in dairy products and supplements, which can significantly reduce its absorption and effectiveness. separate levofloxacin by at least 2 hours before or 4-6 hours after taking the medication. Which of the following medications should have the auxiliary label "Medication should be taken with plenty of water" applied to the bottle EXCEPT: A. Alendronate B. Coreg C. Boniva D. Bactrim B Alendronate (a bisphosphonate), Boniva (another bisphosphonate), and Bactrim (an antibiotic) all require plenty of water when taken: Alendronate and Boniva: These medications can cause esophageal irritation or ulcers, so they should be taken with a full glass of water to help them pass into the stomach quickly. Bactrim: Drinking plenty of water helps prevent crystal formation in the urine, which can lead to kidney stones or kidney damage. Which of the following auxiliary labels should be applied to a medication container of Roxicodone?
- Caution: federal law prohibits the transfer of this drug to any person other than the patient for whom it was prescribed.
- Do not drink alcoholic beverages
- Do not crush or chew.
- May be opened and placed into a small amount of applesauce A. 1 and 2 only B. 1 and 4 only C. 2 and 3 only D. 1 and 3 only A Caution: federal law prohibits the transfer of this drug to any person other than the patient for whom it was prescribed: This statement is required by law on all Schedule II-IV controlled substances, including Roxicodone (oxycodone). Do not drink alcoholic beverages: Roxicodone is an opioid pain medication, and consuming alcohol with opioids can increase the risk of dangerous side effects, such as respiratory depression and sedation. Therefore, this warning is necessary. Do not crush or chew: This warning is typically applied to extended-release formulations of opioids, as crushing or chewing can lead to a rapid release of the drug, increasing the risk of overdose. Roxicodone is an immediate-release formulation, so this warning is not required. May be opened and placed into a small amount of applesauce: Roxicodone is an immediate-release tablet, not a capsule that can be opened. Therefore, this label is not applicable. Which of the following medications should have the auxillary label "Finish all this medication unless otherwise directed by a prescriber" applied to the bottle? A. Sildenafil
B. Percocet C. Phenazopyridine D. Valcyte D Valcyte (valganciclovir) is an antiviral medication often prescribed for the treatment of cytomegalovirus (CMV) infections, particularly in immunocompromised patients. It is essential to finish the full course of antiviral therapy to ensure the infection is properly treated and to reduce the risk of resistance. antivirals, antifungals and antibiotics Which of the following medications should have the auxillary label "swallow whole. do not chew or crush" applied to the bottle? A. Roxicodone B. Klonopin C. Concerta D. Lopressor C Concerta (methylphenidate ER) is a medication for ADHD. It must be swallowed whole to maintain the extended-release effect. Chewing or crushing the tablet would destroy this mechanism, leading to the entire dose being released at once, which could increase the risk of side effects and reduce the effectiveness of the medication over time. Roxicodone: IR oxycodone, so it does not need to be swallowed whole and can be taken as directed by the healthcare provider. Klonopin (clonazepam): is typically an ODT or tablet that does not require an "do not chew or crush" label, as it is not an extended-release formulation. Lopressor (metoprolol tartrate): IR beta-blocker. If the formulation were Toprol XL (metoprolol succinate), which is ER, label would apply. Which of the following products will require the pharmacist to affix an auxiliary label that says "Shake well before using"? A. Robitussin DM B. Guaifenesin with codeine C. Advair D. ProAir HFA D (technically A too) all suspensions, most asthma aerosol inhalers, nasal steroid sprays, and lidocaine viscous topical liquid Robitussin DM: This is a liquid suspension containing guaifenesin and dextromethorphan. Liquid suspensions typically require shaking to ensure the active ingredients are evenly distributed, so the "Shake well before using" label is indeed appropriate. Guaifenesin with codeine: This is typically a syrup or solution rather than a suspension. Solutions do not require shaking because the ingredients are uniformly dissolved, so this would generally not need a "Shake well" label unless specifically stated otherwise by the formulation.
Each of the following medications should have the auxiliary label "warning: if your stool becomes soft and watery after using this antibiotic, contact your doctor immediately" applied to the bottle EXCEPT: A. Cleocin B. Levaquin C. Flagyl D. Augmentin C clindamycin, quinolones, and broad-spectrum antibiotics (e.g. Augmentin)) require this label Each of the following medications should have the auxiliary label, "may cause discoloration of the urine, skin, and sweat" applied to the bottle EXCEPT: A. Dexmedetomidine B. Phenazoperidine C. Rifampin D. Nitrofurantoin A Phenazopyridine: This is a urinary analgesic that commonly causes urine discoloration, typically turning it a reddish or orange color. Rifampin: This antibiotic is well known for causing discoloration of bodily fluids, including urine, sweat, and tears, which can turn red or orange. Nitrofurantoin: This antibiotic, often used to treat urinary tract infections, can sometimes cause brown or dark yellow urine. Which of the following medications should have the auxillary label "take with food" applied to the bottle? A. Boniva B. Levothyroxine C. Voriconazole D. Naproxen D Which of the following medications must have the auxiliary label "CAUTION: do not take alcohol when using this medicine?" applied to the bottle? A. Lotensin B. Xyzal C. Nucynta ER D. Symbicort C Nucynta ER (tapentadol extended-release) is an opioid pain medication. Alcohol should not be consumed with opioids, especially extended-release formulations, because it can increase the risk of
serious side effects, including respiratory depression, sedation, and potentially fatal overdose. Alcohol can also cause the extended-release mechanism to fail, releasing a potentially dangerous dose all at once Which of the following does NOT require refrigeration after reconstitution? A. Benzamycin B. Keflex C. Zithromax D. Augmentin C do not refrigerate label § Oral suspensions: azithromycin, cefdinir, clindamycin § IV (Dear Sweet Pharmacist, Freezing Makes Me Edgy): dexmedetomidine, Sulfamethoxazole/Trimethoprim (Bactrim), phenytoin, furosemide, metronidazole, moxifloxacin, enoxaparin Each of the following medications should have the auxiliary label "May cause blurred vision" applied to the bottle EXCEPT: A. Transderm-scop B. Vfend C. Diflucan D. Cialis C Transderm-Scop (scopolamine): This medication is used to prevent nausea and motion sickness and is known to cause side effects such as blurred vision and dry mouth due to its anticholinergic effects. Vfend (voriconazole): This antifungal medication can cause visual disturbances, including blurred vision, photophobia, and changes in color perception. Cialis (tadalafil): This medication for erectile dysfunction can cause visual side effects, including blurred vision, changes in color vision, and, in rare cases, vision loss. These are uncommon but notable side effects. Diflucan (fluconazole): This antifungal medication does not typically cause blurred vision. While it may have other side effects, visual disturbances are not commonly associated with it. Each of the following medications should have the auxiliary label "AVOID prolonged exposure to SUNLIGHT when using this medicine" applied to the bottle EXCEPT: A. Plavix B. Isotretinoin C. Furosemide D. Bactrim A
A. Monthly B. Quarterly C. Annually B. Biennially B Quarterly CII controlled substances inventory and biennial inventory (keep records for 3 years) § When conducting an inventory of controlled substances, counting should be performed as follows: · For sealed, unopened containers of all controlled substances, an exact count is needed · For opened containers: o All schedule I and II containers require an exact count o For schedule III-V containers that hold 1000 dosage units or LESS, counts can be estimated o For schedule III-V containers that hold 1000 dosage units or MORE, require an EXACT count A patient has clonidine 0.2 mg tablets at her house that she no longer needs. There is no local drug take-back program in her area. How can the pharmacist instruct her to dispose of this medication safely? A. Flush the tabs down the toilet B. Mix with water and an undesirable substance (i.e kitty litter), seal the bottle with tape and dispose of in the trash C. Give the tabs to a friend or family member who uses the same strength D. Mail the tabs back to the manufacturer B could be D or A? Pharmacy must dispose of it through takeback events, collection bin/receptacles, and mail back packages · Don't rush to flush: CA BOP campaign to avoid water pollution and reduce risk o Safely dispose of RX, OTC and veterinary meds by following the instructions below and depositing into designated drug disposal bins § Remove pills and other solid meds from containers and consolidate in a clear plastic zipper bag. Keep liquid and cream meds tightly sealed in original container. § Obscure personal information from containers and recycle containers in your household recycling § Bring zipper bag and any liquid creams to a don't rush to flush location and place in bin o Disposing of meds in trash § If above methods are not available: remove drugs from original containers, mix with undesirable substance that makes it unrecognizable and place mixture in a sealable bag or empty container, then throw in trash
Which of the following can be inventoried with an estimated count? A. Unopened bottle of Tylenol with Codeine #4, 500 tabs/bottle B. Opened bottle of Concerta, 100 tabs/bottle C. Unopened bottles of Marinol, 60 caps/bottle D. Open bottle of Provigil, 30 tabs/bottle D A. Unopened bottle of Tylenol with Codeine #4, 500 tabs/bottle: This is a Schedule III controlled substance, but since the bottle is unopened, the count is based on the manufacturer’s labeling and does not need to be estimated or exact by the pharmacy. B. Opened bottle of Concerta, 100 tabs/bottle: Concerta (methylphenidate) is a Schedule II controlled substance. All Schedule II medications require an exact count, regardless of the container size, so an estimated count is not permitted. C. Unopened bottles of Marinol, 60 caps/bottle: Marinol (dronabinol) is a Schedule III controlled substance, but since it’s unopened, the exact count is determined based on the manufacturer's labeled quantity rather than an estimated count. D. Open bottle of Provigil, 30 tabs/bottle: Provigil (modafinil) is a Schedule IV controlled substance. Since the container has fewer than 1,000 units, an estimated count is permitted for inventory purposes. The CA BOP requires that a pharmacy be equipped with the following items:
- A sink with hot and cold water
- A central heating system
- An accessible restroom
- Must be at least 2,000 square feet in size A. 1 and 2 B. 1 and 4 C. 1 and 3 D. 2 and 3 C A pharmacist is seeking recognition as an Advanced Practice Pharmacist. Which of the following are requirements for APh recognition?
- Obtaining Board Certified Pharmacotherapy Specialist (BCPS) certification
- Completing a postgraduate residency program.
- Obtaining American Pharmacist Association vaccination certification
- Working in a specialty clinic for at least 12 weeks A. 2 and 3 B. 3 and 4 C. 1 and 4
A pharmacy receives a call from a retired pharmacist who has recently shut down his pharmacy and kept the pharmacy records in his home. The retired pharmacist is requesting to transfer a prescription on behalf of his former patient. What action should the receiving pharmacist take? A. Contact the BOP B. Take the transfer over the phone C. Request that the retired pharmacist fax a copy of the prescription D. Report the retired pharmacist to the prescriber A Pharmacists, interns, and technicians must wear name tags that meet the following requirements:
- The tag contains their name
- The letters are in 10-point font
- The tag has to be affixed to the upper right hand side of the staff's shirt
- The tag contains their license status A. 2 and 3 B. 1 and 3 C. 2 and 4 D. 1 and 4 D The patient has the following medications at home which have expired: hydrocodone-apap, pregabalin, Daytrana, Strattera, sertraline. She asks the pharmacist if she can flush them down the toilet. According to the FDA, it is permissible to flush which of the following medications? A. Daytrana B. Sertraline C. Strattera D. Pregabalin A FDA Flush List: Buprenorphine, Diazepam rectal gel, Fentanyl, Hydrocodone, Hydromorphone, Methadone, Methylphenidate transdermal patch (Daytrana), Morphine, Oxycodone, Oxymorphone, Tapentadol Which of the following tasks is matched with the correct frequency that it needs to be performed? A. Medication error investigation: within 2 days of the error B. Submit dispensing data to CURES: biweekly C. Controlled substance inventory: every 3 years D. Self-assessment form: every even-numbered year before July 1st A Which of the following records do NOT need to be kept for 3 years?
- Purchase invoices for all prescription drugs
- Patient acknowledgement of HIPAA
- Record documenting return of drugs to wholesaler or manufactuer
- Certificate of completion for continuing education 2,
- Purchase invoices for all prescription drugs: 3 years
- Patient acknowledgment of HIPAA: 6 years
- Record documenting the return of drugs to wholesaler or manufacturer: 3 years a
- Certificate of completion for continuing education: 4 years Therefore, the correct answer is 2 and 4, as these records do not need to be kept for exactly 3 years. An outpatient pharmacy operates within a large medical building. Drugs ordered in bulk are delivered to the pharmacy and stored in a locked storage room when the pharmacy is closed. This is acceptable if the following condition is met: A. A physician supervisor is granted access to the storage room in case of emergencies B. The individual delivering the drugs must provide the delivery receipt to an on-site supervisor C. Only pharmacy personnel have access to the storage room after the drugs have been delivered D. The storage area must be secure and located in the same building at the pharmacy D The pharmacy is responsible for the storage and security of the drugs/devices. Only the PIC or a pharmacist designated by the PIC can have access to the secure storage facility. In a community pharmacy setting, how many clerks is a pharmacist allowed to supervise at any one time? A. Two B. One C. There is no set maximum D. Three C Interns: 2 per pharmacist Techs (community setting): the first rph may supervise 1 tech; each additional rph may supervise 2 techs Techs (hospital setting): 2 per pharmacist Tech trainees: 1 per pharmacist for a 120-140 hour training period - externship can be up to 340 hours long if includes community and hospital pharmacy Clerks: reasonable number at the pharmacist's discretion A pharmacy filed a DEA form 106. According to California law, how long must the pharmacy keep a copy of this report? A. 6 years B. 3 years C. 1 year D. 30 days B theft and loss reports for controlled drugs
