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NAPSRx CNPR Exam |160 Questions with 100% Correct Answers (Revised 18th Edition) |Verified | Updated Answer Marked in Yellow Color what does a STAT order mean? - Correct Answer -a drug needed immediately and given only once what information does the overdosage section of the labeling provide? - Correct Answer -signs, symptoms and treatment of acute overdoses types of drug-drug interactions: - Correct Answer -duplication, opposition (antagonism) and alteration (p.51) tolerance vs resistance - Correct Answer -tolerance is the diminished response to a drug; resistance is the cells ability to resist the effects of the drug on them. abbreviated new drug application (ANDA) - Correct Answer -the process by which applicants must scientifically demonstrate to the FDA that their generic product is bioequivalent to or performs in the same way as the innovator drug, no duplicate testing (p. 75) the Hatch-Waxman Act of 1984 - Correct Answer --A.K.A. Drug Price Competition and Patent Restoration Act -made it easier to bring generic drugs to the market by requiring the FDA to only look at bioavailability studies in order to approve an ANDA. -gave protection to the research based manufacturers by providing a 30-month automatic cooling off period once an ANDA is challenged for patent infringement (p. 75) four basic transport mechanisms - Correct Answer -passive diffusion, facilitated diffusion, active transport, and pinocytosis (p. 95) potency vs efficacy - Correct Answer -potency: amount of drug necessary to produce desired effect efficacy: magnitude of maximal response that can be received from a drug *efficacy is almost always more important that potency* (p. 106) the four phases of clinical trials - Correct Answer -phases I-IV (P. 124-126) Key Parts Of A Clinical Paper (5) - Correct Answer -Abstract, Introduction, methods, results, discussion/conclusions (p. 128-129) reliability vs validity - Correct Answer -reliability = consistency and validity = accuracy (p. 138; 143) sampling error vs selection bias - Correct Answer -sampling error is unbiased and is randomly chosen from the population. selection bias is when the sample was specifically chosen based on particular characteristics (p.142-143) independent vs dependent variable - Correct Answer -An independent variable is the one that influences the variation. A dependent variable is the variable being tested and measured in a scientific experiment (the result of applying the independent variable). Drug Utilization Review (DUR) programs - Correct Answer --involve retrospective monitoring of physicians' prescribing patterns -more than 90% of HMOs require DURs -nowadays mostly monitors cost savings (p. 181) opportunity cost - Correct Answer -based on the premise that all resources are scarce, and therefore every time we choose to use a resource it reduces the possibility of it being used in another way. what type of DTC advertising is the only legal form in Europe? - Correct Answer -Disease-state or unbranded ads (provides public information on a disease, not a drug) (p. 223) can pharm sales reps offer doctors meals? (PhRMA code) - what is the Product Adoption Continuum? - Correct Answer -a framework for understanding how physician's (consumers) adopt new products when should you ask thought-provoking questions during a sales call? - Correct Answer -at the beginning of a call (p. 343) how can you set the mood for a successful speaker program during the event? - Correct Answer -Introduce the speaker and allow for a question-and-answer format how can pharmaceutical sales representatives leverage clinical evidence to address rumors? - Correct Answer -present current clinical studies that address concerns what is a key driver of the pharmaceutical industry's growth in the last few decades? - Correct Answer -heavy investment in R&D (p. 17) what does the term "anaphylaxis" refer to? - Correct Answer -severe allergic reaction what is the term for the pharmacy's submission of prescriptions by mail or fax, with the pharmacy mailing the filled prescription? - Correct Answer -mail-order pharmacy How are drugs sorted into therapeutic groups and classes? A. first by the conditions that they are used to treat. and then by their mechanisms of action B. first by their mechanisms of action. and then by their therapeutic effects C. first by their side effects. and then by their therapeutic effects D. first by their toxicity. and then by their effectiveness Bone marrow transplants... E. require that the patient first undergo chemotherapy or radiation to kill the diseased stem cells andpromote white blood cell production. F. are a type of stem cell therapy. unless patient's own cells are reinjected. G. are always a type of stem cell therapy. H. can help people with leukemia. a condition in which the body does not produce enough white bloodcells. What section of a drug's package insert describes situations in which the drug should not be used because the risks outweigh the therapeutic benefits? I. adverse reactions J. contraindications K. overdosage L. warning/precautions What does AMA stand for? M. American Medical Academy N. American Medical Accreditation O. American Medical Association P. Association of Medical Assistants What is tertiary care? A. adding medications together to achieve a better clinical effect B. highly specialized medical and surgical care provided by a large medical center for unusual or complex medical problems C. receiving medical or surgical care that does not require an overnight stay in the treatment facility D. seeing a physician for routine checkups and general healthcare Which of the following is NOT one of the stages in the classic approach to brand development strategy covered in your manual? A. brand personality B. brand positoning C. brand quality D. brand values What are vasodilators used to do? A. decrease vascular resistance and increase blood flow B. mimic pathogens to stimulate the immune system C. narrow the blood vessels D. stimulate the CNS to make the heart beat faster What is the name of the condition that occurs after a specific dose of a drug is given at such regular intervals that absorption and elimination (and therefore drug plasma concentration) have become fairly constant? A. homeostasis B. steady state C. titration D. tolerance 9. Which statement is TRUE about ocular administration? A. Ocular administration is primarily for drugs that must cross the blood-brain barrier. B. Ocular administration is used primarily to treat the eye. B. about 60% C. about 70% D. about 95% According to a study discussed in your manual, how do most physicians prefer to receive their drug samples? A. by borrowing them from hospitals B. by ordering them over the Internet C. by trading them for services D. directly from sales representatives Which of the following is an example of a central value? E. I buy Advil to show that I'm a modern consumer. F. I like Advil because we were both born in the 80s. G. I prefer Advil because I like the flavor. H. I prefer Advil because it's easier to swallow. Which of the following specialties likely has the MOST emergency calls? I. cardiology J. psychiatry K. urology L. All specialists have the same number of emergency calls. What affects the rate of active transport? M. the availability of carriers. but not energy N. the availability of energy. but not carriers O. the availability of carriers and energy P. neither the availability of carriers nor the availability of energy Over the last few decades, what has happened to the FDA approval time for new drugs? Q. It has been lengthened to ensure safer drug products. R. It has been lengthened to limit DTC marketing S. It has been shortened to improve drug quality T. It has been shortened to reduce the cost of new drug development. Which of the following would NOT help improve compliance? U. patients liking their providers V. patients using only one pharmacist W. pharmacists understanding how generics differ from brand name drugs X. support groups Which entity chooses a drug's trade name? A. the drug's inventor B. the drug's manufacturer C. the FDA D. the United States Pharmaceutical Council What type of stem cells are obtained from embryos and can develop into any cell type? Y. multipotent Z. pluripotent AA. totipotent BB. All stem cells can develop into any cell type. As the price a patient pays for a prescription increases, what happens to the likelihood that the patient will fill it? CC. It decreases. DD. It increases. EE. It remains unaffected because the prescription is needed. FF.It remains unaffected because the prescription's increased cost is offset by its perceived value. Most involuntary movements come from which type of muscle tissue? GG. cardiac and smooth HH. only skeletal II. skeletal and cardiac JJ. skeletal and smooth Which of the following is NOT one of the body's major organ systems? KK. the cardiovascular system LL. the cellular system MM. the gastrointestinal system NN. the musculoskeletal system How do most drugs exert their primary physiological effects? OO. by activating synapses between different types of tissues PP. by binding to cell receptors that are sensitive to their presence QQ. by inhibiting synapses between different types of tissues RR. through genetic mutation What is the most reliable source of information for determining therapeutically equivalent drug products? A. AMA guide B. Blue Book C. FDA drug list D. Orange Book What does subcutaneous mean? SS. beneath the intervention TT. beneath the muscle tissue UU. beneath the outer skin VV. beneath the suture What should a sales representative do if all of the prime spaces in a drug cabinet are coccupied? WW. ask staff for permission to move some of the other products in the cabinet XX. ask staff for permission to throw away expired products in the cabinet YY. ask the doctor if he still needs some of the other products in the cabinet ZZ. surreptitiously move your largest competitors' products out of the way D. a graduate degree 27. How many names must a drug have? A. at most three B. at least three C. at most five D. at least five 28. How has a longer development time increased the cost of bringing a new drug to market? Answer: Increasing the cost of capital Explaination (Option Not taken so find out in below para): Lengthening development time dramatically increase the cost of bringing a new drug to market by increasing the cost of capital neededfor R&D. The cost of capital increases as companies are exposed to Economic Risk and uncertainty overa longer period of development time. Stringent FDA guideline and long approval times have greatly increased the cost of developing new drugs. 29. Senior citizens consume over times as many pharmaceuticals as people under 65. A. three B. five C. ten D. fifteen 30. What agency regulates the distribution and use of narcotics? A. DEA B. FTC C. OI G D.TS A 31. What is passive diffusion? A. a type of pinocytosis B. membrane transport via vesicles C. the use of energy to help a substance pass from a low concentration gradient to a high one D. when a substance freely moves through a membrane from a high concentration gradient to a low one 32. What are the MAIN categories of drugs under FDA jurisdiction? A. active drugs and active placebos B. biopharmaceuticals and nutraceuticals C. non-prescription and nutraceuticals D. prescription and non prescription 33. Answer: Oxytocin 34. What are all metabolites? A. active substances B. inactive substances C. injections D. products of metabolism 35. When a drug is administered orally, where does first-pass metabolism occur? A. intestine B. liver C. pancreas D. stomach 36. What is the medical term for swelling? A. assay B. edema C. instillation D. protease 37. Which of the following is NOT part of the Seven Step Cascade of Emotion? A. be a consultant. not a rep B. identify what your product does C. reflect D. visualize the power of 10 38. Which part of a clinical research paper is frequently referred to as the road map? A. abstract B. findings C. letter to the editorD . methods 39. Which of the following is a main active ingredient in lung surfactants? A. animal lung extract B. germicides C. sympathomimetic drugs D. theophylline 40. What does parenteral mean? A. child prescriptions B. injection C. oral D. tablet 41. Which term denotes a type of substance that enhances the action of a drug or antigen? A. adjuvant B. indicated C. ligase Dpeptide 42. If a sales representative's product is placed on the second tier of a standard three-tier formulary, which of the following is most likely true? A. It has not been reviewed by the P&T committee. B. It is in a neutral position unless it is at parity with other drugs. C. sites of action besides the target sites of action D. the inert ingredients in a drug formulation 74. What is another term for the AWP? A. dock-to-dock price B. float price C. list price D. non-stock price 75. Which of these is the most likely use for a uterotonic agent? A. to induce labor B. to make the urine more alkaline C. to supplement oral food intake D. to treat hyperthyroidism 76. As of November 2013, which of these countries has legalized DTC advertising of prescription drugs? A. Canada B. Japan C. Spain D. none of these 77. Why are oral drugs often taken on an empty stomach? A. to be more wholly absorbed by the stomach B. to minimize absorption by the intestine C. to minimize nausea D. to pass through the stomach more quickly 78. What is one factor that differentiates community health centers from hospitals? A. Community health center formularies are more restrictive. B. Community health centers have higher reimbursement rates. C. Newer brand name drugs are easier to access at community health centers. D. None of these 79. How does drug sampling provide a social benefit? A. Doctors donate their unused drug samples to charities. B. Doctors often use drug samples to treat patients who otherwise could not afford it. C. It allows patients to try out different prescription medications before consulting with physicians. D. Drug sampling provides a social benefit in all of these ways. 80. Which medical term denotes the use of a stethoscope to listen to the heart? A. auscultation B. cardioversion C. catheterization D. echocardiography 81. What do enteric coatings do? A. facilitate vomiting B. help drugs dissolve in the stomach C. help drugs enter the bloodstream more quickly D. prevent dissolution in the stomach 82. What is the duration of exclusivity for orphan drugs? A. 6 months B. 1 year C. 7 years D. 15 years 83. What do National Account Managers do? A. act as the sales reps' primary point of contact with the rest of the corporation B. manage the FDA approval process C. negotiate contracts with MCOs and PBMs D. sell only to pharmacies 84. What does it usually mean if a drug recall is voluntary? A. Pharmacies may choose whether to return the drug or dispense it. B. The FDA has determined that the drug is perfectly safe. but ineffective. C. The manufacturer has recalled the product on its own. but negotiated with the FDA beforehand. D. The manufacturer has recalled the product without negotiating with the FDA. 85. Which phase of clinical trials is also known as the pivotal phase? A. Phase I B. Phase III C Phase IV D. Phase IX 86. During which phase of clinical trials is the new drug's safety and effectiveness first tested in the target group? A. preclinical B. Phase I C. Phase II D. Phase III 87. How do antacids work? A. by increasing blood flow to the stomach B. by lowering gastric pH C. by raising gastric pH D. by suppressing cholesterol formation by the liver 88. What is one of the biggest time wasters for a pharmaceutical sales rep? A. Caterers B. Pharcists C. receptionists D. travel time 89. What happens when equilibrium is reached? C. the inferiority of OTC drugs D. the severity of the disorder being treated and the effect it has on the patient's quality of life 100. Which entity assigns a new drug its generic names? A. the drug's inventor B. the Food and Drug Administration C. the United States Adopted Name Council D. the United States Pharmaceutical Council 101. Drugs can be used days beyond their expiration date. A. 2-7 days. depending on the most current monograph. B. 2-90 days. depending on state laws C. 7-90 days. depending on the type of drug and its therapeutic class. D. none of these 102. What is necessary for a drug to be excreted extensively via the kidneys? A. The drug must be water-soluble. and not bind too tightly to proteins in the bloodstream. B. The drug must have a phospholipid bilayer and be non-water-soluble. C. The drug must have a phospholipid bilayer and bind well to proteins in the bloodstream. D. The drug must not be water-soluble. 103. Which organization or individual initiates the clinical trial and finances the study? A. clinical research organization B. investigator C. researcher D. sponsor 104. The name describes the atomic or molecular structure of a drug. A. chemical B. generic C. pharmaceutical D. proprietary 105. Under PhRMA Code, is it acceptable or unacceptable for a pharmaceutical sales rep to take a physician and the physician's spouse to a fundraising dinner? A. acceptable if only the physician attends B. acceptable if only the physician attends. and the total is under $100 C. acceptable if the total is under $100 D. unacceptable 106. The Hatch-Waxman Act is considered the most significant drug-related affecting the pharmaceutical industry since 1962. A. experiment B. legislation C. process D. research 107. What term denotes the the extent, quality, or degree to which a substance is poisonous or harmful to the body? A. caliber B. chronicity C. indication D. toxicity 108. What issue has MOST encouraged consumers' desire to see more OTC medications? A. a weaker patients' rights movement B. lack of insurance coverage C. less reliance on the Internet D. proliferation of herbal remedies 109. What is the degree to which a medication produces a therapeutic effect? A. diffusion B. efficacy C. protease D. vector 110. What is the most important benefit of electronic prescribing? A. Choice B. cost C. inquiries D. safety 111. When does the FDA regulate generic drugs? A. only if they are branded generics B. only if they have been contested C. always D never 112. Which phase of trials largely determines the clinical dose? A. preclinical trials B. Phase II trials C. Phase III trials D. Phase IV trials 113. What is an advantage of inactivated vaccines over attenuated vaccines? A. Inactivated vaccines are less expensive to prepare. B. Inactivated vaccines have a higher probability of eliciting the desired immunological response. C. Inactivated vaccines have a more stable shelf life. D. Inactivated vaccines only require a single dose. 114. Which medical term denotes a low supply of oxygen due to low blood flow? A. potentiation B. ischemia C. TID D. titration B. ex vitro C. ex vivo D. intra vivo 126. The FDA requirements for nutraceuticals and medicinal herbs are just as stringent as for pharmaceuticals. A. TRUE B. FALSE 127. What is the estimated net gain of private-sector healthcare's contributions to increased U.S. life expectancy? A. $5-10 billion B. $40-50 billion C. $800-900 billion D. $ 2-5 trillion 128. Which statement is TRUE regarding post-approval drug monitoring? A. All side effects are determined during clinical trials. B. Drug manufacturers are only required to report adverse effects if they are severe or life-threatening. C. Drug manufacturers are only required to report adverse effects if they have been proven in clinicalstudies. D. The FDA can choose to withdraw their approval if new evidence arises. 129. Which term denotes when tolerance to one medication causes increased tolerance to another medication? A. cell tolerance B. cross-tolerance C. indicated tolerance D. minimized tolerance 130. Patents expire years from the date of filing. A. ten B. fifteen C. twenty D. thirty 131. After a trade-name drug's patent expires, how may generic versions of it be sold? A. only under the branded generic name B. only under the generic name C. only under the original trade name D. under the original trade name or a generic name 132. What is required for a new pharmaceutical to be considered a viable therapy? A. It causes no serious adverse effects. B. It causes no side effects. C. It has an active placebo. D. It is more effective and/or causes fewer serious adverse effects than other drugs on the market. 133. Under the AMA guidelines, who is ultimately responsible for minimizing conflicts of interest? A. doctors B. lawyers and office managers C. pharmaceutical companies D. sales representatives 134. The act of dispensing a pharmaceutical alternative for the product prescribed is A. alternative licensure B. equivalence practice C. necessitated substitution D. pharmaceutical substitution 135. What does it mean if a drug is said to have a wide margin of safety? A. Its safety levels have yet to be adequately verified. B. Its safety varies widely among different types of patients. C. There is a greater chance of severe or life-threatening side effects. D. There is a lower chance of severe or life-threatening side effects. 136. Which of the following is the correct medical acronym for effective dose? A. DE B. ED C. EFD D. eff D 137. Why is one group of subjects given an active drug, while another group only receives a placebo? A. to assess patients' expectations B. to assess the drug's effectiveness C. to assess the professionalism of the study staff D. to assess the subjects' demographics 138. A generic version is likely to have some inactive ingredients that are different from those of the original drug. A. TRUE B. FALSE 139. Which of the following is an example of a functional value? A. I drink Coca-Cola because I am a citizen of the world. B. I drink Coca-Cola because I like looking like a traditionalist. C. I drink Coca-Cola because I like the taste. D. I drink Coca-Cola because it is an international brand. 140. Where are most drugs metabolized? A. interstitial spaces B. liver C. stomach D . the bloodstream 141. What is essential to the ethical requirement that subjects be selected fairly? A......do not produce enough insulin because they do not have enough B cells. B ..... have an autoimmune disease. C ..... produce enough insulin. but it is not as effective. D......rely on insulin from porcine sources. 152. Which DTC pharmaceutical marketing tactic is permitted in European countries? A. disease state ads B. branded billboards and disease state ads C. branded highway billboards D. branded radio ads 153. What is one way in which psychologists DIFFER from psychiatrists? A. Psychologists are more concerned with subconscious memories than conscious ones. B. Psychologists deal more with emotional than physical issues. C. Psychologists deal more with physical issues than emotional ones. D. Psychologists do not have graduate degrees. 154. What are PBMs? A. governmental organizations that provide healthcare B. organizations that design marketing campaigns C. organizations that negotiate between pharmaceutical companies and large drug purchasers D. organizations that write FDA new drug applications 155. How does the Hatch-Waxman Act protect research-based drug manufacturers? A. by limiting the competition B. by making it easier to bring generic drugs to market C. by providing a 30-month cooling off period D. by requiring the FDA to only look at bioavailability studies when approving an ANDA 156. What is the process of adjusting drug doses to achieve the maximum positive therapeutic effects while minimizing adverse or side effects? A. homeostatic maximization B. steady state administrationC.Sustained release D. Titration 157. Which of the following is studied more in pharmacodynamics than in pharmacokinetics? A. absorption. Distribution metabolism and excretion B. dose-response effects C. the transportation of the drug to the specific site for drug-receptor interaction D. the way the human body deals with a drug after it has been administered 158. How does the healthy human immune system use MHC markers? A. Substances with MHC markers are discerned as foreign and targeted for destruction. B. Substances with MHC markers as discerned as foreign and quarantined in the liver. C. Substances with MHC markers as discerned as foreign and quarantined in the pancreas. D. Substances without MHC markers are discerned as foreign and targeted for destruction. 159. What is a behind-the-counter drug? A. an OTC drug that must be closely monitored by the pharmacist B. another term for a generic prescription drug C. another term for a prescription drug D. another term for an OTC drug 160. When do MSLs meet with clinicians? A. at nearly any stage of the product's life cycle B. only after the district's sales representatives C. only prior to launch D. MSLs do not meet with physicians