Foundation Year Pharmacy – Clinical Practice Test

These questions are part of the practice quiz. Start practicing

• Semaglutide is an example of which drug class?
• Which factor in the 39-year-old woman's profile increases her risk of developing osteoporosis?
• A patient started on olanzapine 10 mg daily is asked which side effects to monitor. Which is the most important side effect to highlight at dispensing?
• Which components are contained in Ultibro Breezhaler?
• A 45-year-old man with hypertension on ramipril reports swollen lips, a dry cough, and shortness of breath. What is the most appropriate advice?
• A young adult has fever and swelling on one side of the face; which diagnosis should be considered?
• According to national guidelines, how many alcohol units can a man drink per week to keep health risk low?
• A patient has been prescribed a metered dose inhaler with a duration of action of approximately 4–6 hours. He reports a bitter metallic taste after use. Which inhaled medication is most likely responsible for this side effect?
• What is the maximum fine Miss R may be required to pay if she does not inform the DVLA about her epilepsy?
• In the Helicobacter pylori regimen described, the antibiotic is given at 400 mg twice daily. What is the total daily dose of this antibiotic?
• What is the minimum age at which the herpes zoster vaccine is routinely offered under the NHS?
• Among the following conditions, which would be a contraindication to prescribing an antimuscarinic medication?
• When dispensing a medicinal product, which of the following is NOT a legal requirement for a dispensing label?
• In a pregnant patient with suspected bacterial vaginosis, which treatment is most appropriate?
• In managing gastro-oesophageal reflux disease, if a prescription drug is suspected of exacerbating symptoms, what is the recommended approach?
• Which of the following is NOT an appropriate treatment for the described ringworm?
• For malaria prophylaxis with chloroquine, what is the correct regimen for a trip of three weeks, given OTC packaging of 20 tablets?
• Which GPhC Standard for Pharmacy Professionals is best demonstrated when a pharmacy team member reports concerns and a safety incident is investigated?
• In stage 2 hypertension for a 52-year-old White British female with no other PMH, which antihypertensive is most appropriate to start?
• Failure to inform the DVLA about epilepsy before applying for a provisional driving licence may lead to what consequence?
• Which symptom is most indicative of bacterial vaginosis rather than candidiasis?
• Which statement best reflects thrush management in a pharmacy setting?
• Which of the following is an example of a rapid-acting insulin?
• Mouth ulcers scenario: which medication in this patient's regimen is most likely contributing to mouth ulcers?
• Ms B, a 16-year-old with an acute eczema flare, is prescribed a moderately potent topical corticosteroid. Which treatment would be most appropriate?
• Clinical governance is important to maintain accurate records in line with legislation. Which statement relating to the responsible pharmacist regulations is correct?
• A patient on ramipril presents with symptoms suggesting angioedema. What is the most appropriate action?
• What is the correct advice for giving paracetamol 120 mg/5 mL oral suspension to an 8-week-old around vaccination?
• In the amoxicillin regimen described for acute otitis media, how often is the dose given per day?
• A 3-year-old child presents with localized swelling on the upper eyelid and is tearing, with no eye pain or discharge from the eye. What is the most appropriate initial advice?
• Which of the following is most appropriate to advise with regards to ciclosporin and food?
• In pediatric paracetamol dosing, what interval is commonly used between doses?
• What statement best describes the interaction between atorvastatin and diltiazem?
• Which statement about using ketoconazole 2% shampoo is correct?
• A recorded supply of morphine 10 mg tablets in a Schedule 2 CD must be documented. How long should electronic CD registers be kept from the date of the last entry?
• Which preparation is most suitable for a 3-year-old with constipation?
• What is the maximum duration of supply on a single prescription for pregabalin?
• A 16-year-old girl seeks private consultation about emergency contraception within 96 hours. She has severe asthma and is taking systemic steroids for an exacerbation. Which of the following is MOST appropriate advice?
• A 47-year-old man with polydipsia and nocturia; diagnosis?
• Which of the following is correct when counselling on how to use Anbesol Adult Strength Gel?
• In a thyroid storm presenting in the ED with fever, tachycardia, confusion and elevated thyroid hormones, which immediate treatment is recommended?
• A 2-year-old boy with fever and irritability refuses to eat or drink and has a purplish rash that does not fade with a glass. What is the most appropriate course of action for this patient?
• What is the clinical difference between Clenil modulate and Qvar?
• Which drug should be avoided by women of childbearing potential due to potential fetal harm?
• An elderly man accompanied by a wife with dizziness, nausea, and an irregular pulse is taking Bisoprolol 5 mg twice daily, Digoxin 62.5 mcg once daily, Furosemide 40 mg once daily for two weeks then review, Ramipril 5 mg twice daily, and Spironolactone 50 mg once daily. Which is the most likely cause of her symptoms?
• Which of the following combinations does not cause a clinically significant drug interaction?
• In a healthy 30-year-old with a dry, persistent cough for 10 days and no fever or other symptoms, what is the most appropriate management?
• In a neonate born at 30 weeks with respiratory distress syndrome, which medication is most appropriate to appear on the baby's drug chart in the first few hours?
• Length of validity of a prescription for chlordiazepoxide hydrochloride?
• Which statin dose is recommended for secondary prevention in NICE guidance?
• Depo-Provera is delivered by which route?
• Which sulfonylurea is most appropriate in a patient with chronic kidney disease (eGFR ~50 mL/min) on metformin?
• Rivastigmine is best described as which class of drug?
• Which among Mrs T's medicines does not commonly cause diarrhoea?
• As part of a workshop on clinically significant drug interactions, which of the following inhibits hepatic enzymes?
• In a pregnant patient with threadworm, which statement is correct?
• A 32-year-old woman has been prescribed oral isotretinoin to treat severe acne. How long is this prescription valid for?
• Which interval is correct for routine tetanus vaccination in adults with uncertain status?
• For a drug with a half-life of 12 hours, after 12 hours the concentration is at what fraction of the initial level?
• A patient on warfarin for atrial fibrillation presents with severe bruising and haematuria. What is the most appropriate immediate action?
• Which statement about cancer risk and contraception is correct?
• How should doxycycline be taken to reduce swallowing difficulties?
• Codeine's analgesic effect is primarily due to its conversion to which active metabolite?
• Tadalafil can potentiate the hypotensive effect of GTN. Which option lists this as the correct drug?
• Which baseline test should be checked before initiating statin therapy due to risk of muscle effects?
• A 29-year-old man with IBS is prescribed a medication to relieve long-term symptoms. Which medicine is most likely prescribed?
• Which medication would be least likely to be prescribed after discharge for a patient with acute coronary syndrome?
• A patient undergoing chemotherapy complains of painful urination and blood in the urine. What is the most likely diagnosis?
• For moderate inflammatory acne not responding to topical treatment in a sexually active young woman using contraception, which antibiotic would be considered second-line?
• A 29-year-old woman requires medication to manage lower back pain while breastfeeding and has been using a heat rub. Which is the most appropriate to manage her symptoms?
• Regarding the treatment of infections, quinolones are what in patients with a history of tendon disorders?
• Which of the following are NOT considered signs of a serious side effect of methotrexate?
• When should peak and trough levels of gentamicin be taken?
• During the acute COPD exacerbation, which antibiotic was used initially?
• In COPD, a rescue pack includes six tablets immediate dose and six tablets every morning for 7 days; which drug is this rescue pack primarily predicated on?
• In the HFpEF patient described, which of the following current medications is a diuretic?
• A 21-year-old woman with asthma has an active systemic infection requiring urgent referral. Which medicine should be avoided?
• From what age is it generally recommended to introduce full-fat cow's milk to an infant?
• What creatinine value was reported for the patient on anticoagulation?
• Which statin dose is considered a high-intensity statin regimen suitable for post-MI secondary prevention?
• Which current medication should be reviewed when treating a Clostridioides difficile infection with vancomycin?
• If dietary and lifestyle changes fail to achieve target glucose in gestational diabetes after two weeks, what is the next step in management?
• Seretide is a fixed-dose inhaler containing which combination of medications?
• What is the most appropriate action when you notice signs of possible impairment and dispensing errors by a colleague?
• Which of the following is not a legal requirement for a CD requisition form?
• A 45-year-old woman with osteoarthritis is considering NSAIDs for pain control. She has mild dyspepsia and hypertension. Which NSAID strategy is most appropriate?
• Which statement best describes the interaction between ciclosporin and atorvastatin?
• Significant weight gain, thirst, and frequent urination after starting prednisolone likely indicate which adverse effect?
• A patient presents with drowsiness, dizziness, tinnitus and tremor while taking several medications including lithium. Which medication is the most likely cause of these symptoms?
• Which diuretic is commonly associated with erectile dysfunction as a side effect?
• If a 12 kg child is treated with paracetamol suspension at 15 mg/kg per dose every 6 hours with a maximum of four doses per day, what is the maximum total volume per day in milliliters for this child given a suspension of 250 mg/5 mL?
• The plasma drug concentration assay for this drug should be taken at least 6 hours after a dose has been administered. Which drug is this?
• A 19-year-old woman requests emergency hormonal contraception but you are not accredited to supply Levonelle 1500 via PDS. What is the most appropriate course of action?
• Which of the following is least likely to be a common symptom of sepsis?
• A 62-year-old man presents with ankle swelling after starting antihypertensive therapy. Which medicine is most likely contributing to the swollen ankles?
• Through which route should vinca alkaloids be administered?
• If a patient on edoxaban stops prior to surgery and the half-life is 12 hours, taking one more tablet and then stopping will take how long to reach 25% of the initial plasma concentration?
• A 14-year-old person under specialist care for gender dysphoria has a private prescription for GnRH analogues dated 21 June 2025. Which action is most appropriate to take?
• During basic life support training, what is the correct ratio of chest compressions to rescue breaths required for an adult who is unconscious and requires CPR?
• This medicine may make you sleepy. If this happens, do not drive or use tools or machines. Which medicine is this?
• A 30-year-old woman presents with fatigue, dizziness, shortness of breath, and brittle nails; blood tests show low haemoglobin and low ferritin. What is the most likely diagnosis?
• Patients taking Sulfasalazine should report any signs of which of the following?
• You are prescribing rapid acting insulin for a patient newly-diagnosed with type-1 diabetes mellitus. Which of the following is suitable to prescribe?
• Clobetasol propionate 0.05% cream falls into which potency category?
• In an 81-year-old patient with paroxysmal atrial fibrillation on apixaban 5 mg twice daily, weight 59 kg, and creatinine 120 mmol/L, what is the most appropriate apixaban dose to continue?
• A 63-year-old woman on ergocalciferol therapy asks which concomitant medication could cause a severe interaction. Which drug is most likely to cause a severe interaction with ergocalciferol?
• Under the General Sale List regulations, which method of sale would be least appropriate legally?
• A 5-year-old boy is prescribed amoxicillin 250 mg/5 mL suspension at a dose of 500 mg three times a day for 7 days, for a chest infection. Each bottle is 100 mL. What is an appropriate number of bottles to dispense to ensure he can complete the course?
• A 45-year-old patient asks for advice on promoting a healthy lifestyle. Based on current pharmacy policy, which recommendation is most appropriate?
• A 45-year-old man with type 2 diabetes is switched to dapagliflozin 10 mg daily as monotherapy. What is the mode of action of dapagliflozin?
• Which of the following is NOT a sign of liver toxicity in a patient taking methotrexate?
• Can a 17 year old be sold Amorolfine 5% nail lacquer?
• For rheumatoid arthritis management, how often is methotrexate typically prescribed in standard regimens?
• Which item counts as one portion toward the five-a-day goal?
• Can a man w/o ED be supplied sildenafil OTC?
• Which medicine is least appropriate for this patient for escalation of therapy in type 2 diabetes and heart failure?
• A 56-year-old man has recently been prescribed atorvastatin. You are reviewing his medication record. Which of the following drugs increases the risk of atorvastatin toxicity?
• A 20-year-old woman presents to the community pharmacy at 5 pm on a Friday evening, half an hour before closing. She explains that she had unprotected sexual intercourse 70 hours ago. She takes carbamazepine for trigeminal neuralgia and reports unexplained vaginal bleeding. What would be the most appropriate choice of emergency contraception?
• A 5-year-old boy presents with a rash behind the ear that has spread to the face and chest, with cold extremities and lethargy. Which infection is most likely?
• A patient with creatinine clearance of 13 mL/min is nauseous with two episodes of vomiting. Which anti-emetic is most suitable?
• Espranor buprenorphine tablets are primarily used for which purpose?
• A 6-year-old boy with heart failure weighs 18 kg and is started on spironolactone 1 mg/kg daily in two divided doses. The spironolactone solution is 25 mg/5 mL. How many millilitres are needed for a 28-day supply, to the nearest millilitre?
• On an orthopaedic ward, a patient with osteoarthritis requires an NSAID but cannot use a proton pump inhibitor (PPI) and takes dabigatran. Which NSAID is most appropriate?
• In a 58-year-old man with type 2 diabetes and LVH and microalbuminuria, what is the most appropriate initial treatment to address microalbuminuria?
• Which of the following medicines is a non-sedating antihistamine?
• In a palliative care patient receiving diamorphine for pain who has been vomiting for 24 hours despite haloperidol, which antiemetic is most appropriate?
• In chemotherapy-induced hemorrhagic cystitis, which metabolite is most likely responsible?
• A 36-year-old male has been diagnosed with more severe depression. Which antidepressant is most likely to be prescribed as first-line treatment given his migraines and use of sumatriptan?
• What is an essential counselling point for a patient newly prescribed amiodarone?
• Lithium therapy requires monitoring, and dialysis may be needed if lithium levels reach a certain concentration. At what concentration might dialysis be considered?
• In a pregnant patient with sickle cell disease, which condition requires ongoing folic acid supplementation throughout pregnancy?
• A patient recently started on a newly licensed biologic therapy for rheumatoid arthritis reports only mild injection-site redness. What is the most appropriate action regarding adverse drug reaction reporting under the MHRA Yellow Card Scheme?
• In the UK, schools may hold a stock of salbutamol inhalers for urgent asthma treatment. Which of the following is NOT a legal requirement for a written request from the school?
• The MMR vaccine should be given at what age?
• Can a 47 year old male with 3 affected nails be sold Amorolfine 5% nail lacquer?
• In the emergency setting for levetiracetam loading, which option reflects the maximum allowed loading dose?
• Which medication listed is a beta-blocker that can cause nightmares as a side effect?
• For a patient taking alendronic acid 70 mg weekly, what is the recommended administration to minimize esophageal irritation?
• In the management of acute deep vein thrombosis, which drug is not suitable as a sole therapy?
• A 24-year-old lady with episodes of throbbing headaches usually after gym; most appropriate diagnosis?
• Within how many days must the remainder of a partially fulfilled prescription be collected?
• A 34-year-old woman asks to purchase chloramphenicol eye drops for her 15-month-old baby with a sticky eye. According to licensing restrictions, what is the most appropriate action?
• Diarrhoea 24 hours: most appropriate recommendation?
• A 56-year-old woman with iron deficiency anaemia takes ferrous sulphate 200 mg daily and also calcium carbonate and alendronic acid. After 4 weeks, her fatigue persists. Which recommendation would improve ferrous sulphate efficacy?
• In a routine bowel cancer screening program using FIT, what is the recommended interval?
• A mother brings a 10-week-old infant with a mild cough and nasal congestion asking about cough syrup. What is the most appropriate response?
• Which statement about gentamicin safety is true?
• Length of time required to keep an invoice for a Schedule Three controlled drug?
• Which monitoring requirement for amiodarone is incorrect?
• In drug interaction contexts, which medication is a known inhibitor of hepatic enzymes?
• Which medicine is most likely to provoke symptoms of gastro-oesophageal reflux disease (GORD)?
• A 62-year-old STEMI patient on edoxaban; what should be given immediately as part of early management?
• Ramipril belongs to which class of antihypertensive drugs?
• Which of the following is NOT a hormone therapy for prostate cancer?
• Which is the most appropriate source of information for administration of medicines in patients with swallowing difficulties?
• What is the primary aim of a root cause analysis following a safety incident in a healthcare setting?
• Which drug class is most commonly associated with peripheral edema, as illustrated by the hypothetically edema-inducing drug lercandipine?
• A 49-year-old man after partial knee replacement who has Parkinson's Disease and is taking co-careldopa; post-op meds include dalteparin, co-codamol, and metoclopramide. What is causing his current symptoms?
• What is the most appropriate advice for a patient with infected toenails?
• An 85-year-old man in palliative care on morphine is dehydrated. Which medicine may predispose to faecal impaction?
• A 74-year-old woman with atrial fibrillation on warfarin is advised about diet. Which statement is most appropriate?
• A 45-year-old woman is being treated for suspected TB and has noticed that her urine has turned a deep red colour. Which medication is most likely responsible for this adverse drug reaction?
• Which factor explains why stopping smoking can raise theophylline levels?
• In teething management for a 3-month-old infant, which OTC treatment would be the least appropriate to recommend?
• A patient with heart failure on multiple therapies develops acute gastroenteritis with vomiting. Which medication should be stopped temporarily to reduce risks?
• Headache is listed as a common side effect of Fostair?
• A patient starting systemic corticosteroid therapy asks about common adverse effects. Which statement best reflects a common adverse effect?
• Which component of the initial analgesia regimen is a non-steroidal anti-inflammatory drug?
• In renal failure-related anemia, which erythropoiesis-stimulating agent can be used as a longer-acting alternative to epoetin alfa?
• Which cytotoxic drug is most likely associated with urothelial toxicity requiring Mesna during treatment?
• A 12-year-old child with nasal vestibulitis and penicillin allergy. Which treatment is most appropriate?
• Which cautionary label is appropriate for flucloxacillin 500 mg capsules to inform the patient verbally?
• In the case of dexamethasone 0.1% w/v eye drops requested by an optometrist prescriber, what is an appropriate action for the pharmacist?
• A 78-year-old man uses a continuous glucose monitor; a new sensor shows persistently high readings compared with finger-prick tests. What is the most appropriate action?
• A 72-year-old male CKD patient with UTI is treated with gentamicin. With Cr 140 μmol/L and eGFR 30, which adjustment is most appropriate?
• A pregnant woman requests directions for fusidic acid 2% cream to treat non-bullous impetigo on the legs and asks if it's safe in pregnancy. Which is the most appropriate advice regarding dosing?
• Clonidine is used in the management of which condition as a migraine prophylaxis option?
• A 20-year-old man is advised to use permethrin cream for an itchy rash between the fingers; what is the diagnosis?
• Which vaccine is commonly given at around 12 months of age in routine schedules?
• What is the maximum recommended daily dose of paracetamol for adults?
• A patient on warfarin for atrial fibrillation presents with severe bruising and haematuria. What is the most appropriate course of action for the pharmacist to take?
• A 6-year-old boy with two weeks of constipation and hard stools every 3-4 days, with food and fluid intake decreasing. Select the most appropriate laxative.
• Which sulfonylurea has been discontinued in tablet form and is available only as an oral suspension for neonatal diabetes mellitus?
• Poorly controlled diabetes is associated with several complications. Which of the following is least likely to occur as a result of poor glycemic control?
• In a patient with atrial fibrillation and severe renal impairment (eGFR ~22), which direct oral anticoagulant is contraindicated due to renal function?
• An adult on paroxetine experiences dizziness and electric shock sensations after stopping the medication abruptly. The most likely explanation is?
• Which patient should be urgently referred to another healthcare provider?
• A 35-year-old type 1 diabetic, weighing 80 kg, on isophane insulin 100 units/mL in 3 mL pens, daily dose 0.9 units/kg. How many pens are needed for 30 days?
• In OTC vaginal estriol cream, maintenance dosing frequency?
• For acute deep vein thrombosis, which drug is least suitable as treatment?
• What is the concentration of amoxicillin oral suspension (250 mg/5 mL) in mg per mL?
• A patient upset warfarin stopped and a new medication, apixaban, prescribed instead. What is the most appropriate advice you would give?
• Which class of medication does Ozempic (semaglutide) belong to?
• A pregnant lady with allergic rhinitis, worse in the morning, with red itchy eyes and nasal congestion. Which would be the most appropriate treatment?
• What monitoring is recommended during gentamicin therapy to minimize toxicity?
• In a patient with deep vein thrombosis and a creatinine clearance of 35 mL/min, what rivaroxaban dose is most appropriate?
• A 60-year-old male patient with Parkinson's started on pramipexole; after a few weeks, he reports a side effect. What is the most likely adverse drug reaction?
• Which bolus dose would be most appropriate for alfentanil for Mrs H, considering ideal body weight reduction for dosing?
• A patient taking which drug should be instructed to maintain a constant and adequate salt intake?
• A 72-year-old man with COPD and ischaemic heart disease reports a sore mouth during hospitalisation. Which inhaled medication is the most likely cause of the sore mouth?
• To assess steady-state digoxin concentration after initiation, when should the blood sample be collected?
• A thin grey-white discharge with a fishy odor is most consistent with which infection?
• A patient needing treatment for endocarditis, which requires monitoring with peak and trough levels to ensure effectivity and safety. Which antibiotic is most appropriate?
• A 6-year-old child weighing 20 kg is prescribed amoxicillin oral suspension 250 mg/5 mL for acute otitis media. The recommended dose is 20 mg/kg three times daily for 5 days. What volume of amoxicillin oral suspension should be administered per dose?
• Ramipril is used to treat essential hypertension. Which statement correctly describes its drug class?
• Which of the following is a side effect that requires counselling when starting amiodarone?
• Which point is most appropriate to advise a patient starting alendronic acid 70 mg weekly?
• A 76-year-old man with heart failure and atrial fibrillation presents with blurred vision and a yellowish tint to his sight, along with fatigue and nausea; his potassium is low. Which medication is the most likely cause of this adverse drug reaction?
• For an elderly patient with atrial fibrillation and no renal impairment taking edoxaban, which regimen is most appropriate?
• If Testogel 16.2 mg/g is out of stock and the prescription must be changed, which alternative dose would deliver about 60 mg of testosterone per day?
• A worried patient recently started sertraline and reports leg tremors, weight loss, and GI upset after months of stress and heavy alcohol use. What is the most likely cause of these symptoms?
• Which inhaled medication functions as a rescue inhaler for acute bronchospasm?
• A patient on insulin therapy develops capillary glucose 15 mmol/L and ketones 4.5 mmol/L. What is the most appropriate immediate course of action?
• A 3-year-old child weighing 14 kg has a nitrofurantoin suspension dose of 10.5 mg four times daily for 7 days for an acute urinary tract infection. Three days later the mother reports the child’s urine is yellow-brown. What is the most appropriate advice to give to the mother?
• A 74-year-old man with stable angina and COPD has worsening edema and signs of heart failure. Loop diuretic therapy is started. Which laboratory parameter must be monitored regularly after starting treatment?
• Which medicine is most suitable to continue on the day of surgery?
• Which option represents the correct maximum daily dose of paracetamol for a child, expressed as mg/kg per day?
• A 7-year-old girl on low-dose ICS and SABA for three months still has symptoms three times a week and wakes at night once a week; she cannot manage MART. What is the next step in her asthma treatment plan?
• What is the most appropriate loading-dose schedule for apixaban in the treatment of acute DVT/PE?
• Mr O, a 32-year-old man with atopic eczema is using Tacrolimus ointment on affected areas. Which counselling point is most important to provide?
• Which of the following is NOT a key point for gentamicin therapy?
• When starting etanercept for RA in a patient with hypertension and AF on warfarin, what is the most important consideration?
• Which medication in the regimen is an antihistamine?
• Mr P receives a GP notification of a vitamin deficiency likely contributing to recurrent mouth ulcers and neurological symptoms such as pins and needles. Which vitamin deficiency is most likely responsible?
• While you are absent for 20 minutes during a work shift, which activity is permissible to be carried out by another staff member?
• A prescription written in Spanish from a doctor in Spain for midazolam 5mg/1mL oromucosal solution for status epilepticus. What is the most appropriate course of action?
• Ethosuximide is first-line treatment for which seizure type?
• Which medication should be avoided in children under 16 due to risk of Reye's syndrome?
• Which action is appropriate when a prescription from Japan for antibiotics for UTIs is to be used on an as-needed basis?
• For which of the following drugs would it be least important to measure plasma levels for the purpose of therapeutic drug monitoring?
• Which of the following is the most appropriate addition to Mr P's COPD treatment?
• In the quetiapine dose schedule described, what is the maximum daily dose reached?
• A patient on antidepressant therapy develops a seizure and has epilepsy. Which electrolyte abnormality is most likely to have contributed to the seizure?
• When supplying a prescription-only medicine due to stock shortage, which action must be recorded?
• Which factor increases the risk of nephrotoxicity with gentamicin?
• A man wants to buy three packs of pseudoephedrine 60 mg tablets for nasal congestion. Which statement is most appropriate?
• A breastfed baby with cow's milk allergy is identified. What is the most appropriate management for the mother to adopt?
• Due to supply issues for HRT, which alternative is most appropriate for a 52-year-old woman with hysterectomy?
• Which feature supports ketoacidosis in a patient with type 1 diabetes?
• A 2-year-old child has a mild rash on their body, and their parent is seeking advice on over-the-counter treatment. Which age group is hydrocortisone 1% cream licensed for over-the-counter use?
• What is the therapeutic range for phenytoin?
• A 9-year-old boy is diagnosed with generalized tonic-clonic seizures and myoclonic seizures. Which medication is most appropriate to start initially?
• Which option best reflects the general principle for handling foreign prescriptions in these scenarios?
• Which adverse effect should patients taking amiodarone watch for and report?
• A patient started on clopidogrel asks which medicine is most likely to interact with the therapy?
• A 75-year-old woman is using digoxin for atrial fibrillation. Her recent labs show potassium 4.8 mmol/L, calcium 2.4 mmol/L, eGFR 74 mL/min. Which of the patient's current parameters put her at an increased risk of digoxin toxicity?
• Which medication in the asthma regimen is a leukotriene receptor antagonist?
• A 52-year-old man is prescribed dutasteride 500mcg daily for BPH. Which statement best describes its mode of action?
• Which factor would require increasing the emergency contraception dose when taking an enzyme-inducing anticonvulsant?
• For a 67-year-old man at high risk of cardiovascular events with paracetamol ineffective, which NSAID has the lowest risk of cardiovascular events?
• In a patient with Parkinson's disease experiencing nausea, which antiemetic is preferred due to reduced risk of extrapyramidal symptoms?
• A patient presents for a Schedule 4 controlled drug (diazepam 5 mg tablets) prescription that was issued 30 days ago but could not be collected. According to current legal requirements, what is the most appropriate course of action?
• Lisinopril can potentiate the hypotensive effect of GTN. Which option lists this as the correct drug?
• Before starting a statin, which statement is correct regarding monitoring for muscle-related adverse effects?
• Which adjustment is recommended when emergency contraception levonorgestrel is taken with an enzyme-inducing anticonvulsant such as phenobarbital?
• In a patient with COPD who is 69 years old and up to date with pneumococcal and influenza vaccines, which vaccine status is described in this vignette?
• A patient presents with anxiety, weight loss, hyperactivity and insomnia. Routine tests diagnose hyperthyroidism. Which thyroid function test pattern is most likely?
• In a community pharmacy, you receive a private prescription for a controlled drug from a prescriber based in Portugal. Which controlled drug can legally be supplied on this prescription?
• Which of the following is least likely to indicate deep vein thrombosis?
• Which statement best describes the use of E45 cream in the patient’s regimen that lists it as 'to use when required'?
• Which set of foods, each portion weighing 80 g, would count toward the recommended five portions of fruit and vegetables per day?
• A 35-year-old man with type 1 diabetes presents with abdominal pain, vomiting, deep rapid breathing; blood glucose is 22 mmol/L and ketones are present in urine. What is the most appropriate diagnosis?
• In a patient with a burn wound on the hand showing redness, crusting, and leaking yellow pus, who is allergic to macrolide antibiotics, what is the most appropriate antibiotic treatment?
• A patient who recently received the pneumococcal polysaccharide vaccine shows mild swelling and low-grade fever. Which statement best reflects the expected course of these symptoms?
• A 62-year-old man recently discharged after a myocardial infarction has total cholesterol 6.2 mmol/L and LDL 4.1 mmol/L; he is on clopidogrel, aspirin, bisoprolol and lisinopril. What is the most appropriate lipid-lowering treatment?
• Vitamin K-rich foods can influence warfarin therapy. Which statement best describes this effect?
• Denosumab is used for fracture prevention in which condition?
• What is the most appropriate initial dose for a patient starting tirzepatide?
• Anoro contains which two pharmacologic classes?
• A 48-year-old man with H. Pylori infection requires triple therapy. He is penicillin-allergic and is taking clopidogrel. Which of the following drug combinations provides the most appropriate treatment?
• Mr M is switching ciclosporin brands due to manufacturing problem. What is the most appropriate advice?
• A 37-year-old woman with paresthesia in fingertips, toes and lips; stomach cramps; dry skin and nails breaking. Diagnosis?
• In an adult who collapses and is not breathing normally, how many chest compressions should be started and at what rate per minute?
• A 67-year-old woman is initiated on glyceryl trinitrate 400micrograms spray for the treatment of acute angina. She takes aspirin, atorvastatin, bisoprolol, clopidogrel and ramipril. Which statement is the most appropriate advice regarding use of the spray?
• A patient who has recently completed chemotherapy reports dysuria and haematuria. Which cytotoxic drug is most likely responsible?
• First-line antibacterial prophylaxis for recurrent urinary tract infections in a 6-year-old?
• For suspected fungal otitis externa in a steroid-sensitive child, which topical antifungal would be most appropriate as first line?
• In a traveler with diarrhoea lasting 6 days, what is the most appropriate action?
• Reduced risk of endometrial cancer is a health benefit associated with which form of contraception?
• A GP practice is calculating stoma-related supply quantities. A 39-year-old woman requires flange (baseplate) changes every two days with an additional 7 spares per month on a 28-day repeat. How many flanges should be added to the repeat prescription?
• Which food is commonly avoided in people with G6PD deficiency due to the risk of hemolysis?
• A 26-year-old pregnant patient asks about smoking cessation. Which option is most suitable to offer initially?
• Which drug should not be handled by women of childbearing age?
• Which of the following is a symptom of phenytoin overdose?
• A 35-year-old male seeks advice for managing nasal congestion associated with a cold. Which age group is pseudoephedrine licensed for over-the-counter sale?
• A 34-year-old woman with fever, tachycardia, and confusion; elevated T3 and T4 with suppressed TSH. Which is the most appropriate immediate treatment plan?
• Which of the following medicines is a statin?
• A triple-therapy inhaler like Trelegy is indicated for COPD patients with which feature?
• A 54-year-old woman on alendronic acid 70 mg weekly reports nausea if taken on an empty stomach. What is the most appropriate advice?
• A prescription for morphine sulfate 10 mg/5 mL oral solution is a single issue. How long is this prescription valid from the stated appropriate date?
• Diplopia is a symptom of phenytoin overdose. Which option lists a symptom of phenytoin overdose?
• Which statement about shingles is correct?
• Which is the most appropriate first-line treatment for absence seizures?
• A 67-year-old man with COPD presents with increased breathlessness, productive cough with green sputum, and mild wheezing. He has no fever or chest pain. What is the most appropriate action?
• A 17-year-old female asks for tranexamic acid for heavy menstrual bleeding. What is the most appropriate course of action?
• A 79-year-old patient on morphine SR 60 mg twice daily plus breakthrough doses is to receive parenteral diamorphine by syringe driver over 24 hours. What is the most appropriate 24-hour parenteral diamorphine dose?
• Which of the following is NOT a symptom of phenytoin overdose?
• A student midwife asks about vitamins to prevent haemorrhagic disease of the newborn. Which is the most appropriate to recommend?
• A 55-year-old woman on fluoxetine, carbamazepine and recently started cimetidine develops sore throat, mouth ulcers and fever. What is the most appropriate initial action?
• In the described postoperative regimen, which medication is an analgesic?
• Which of the following would be recommended first-line to manage a psoriasis exacerbation?
• What is the therapeutic range for gentamicin in IV therapy?
• A patient with an NG tube has several oral medicines; which of the following must not be crushed or dispersed for NG administration?
• Following receipt of discharge information, NICE recommends medicines reconciliation in primary care should be undertaken within what time frame?
• A 46-year-old male with COPD on Seretide is now prescribed a long-acting muscarinic antagonist due to persistent breathlessness. Which drug is he most likely prescribed?
• Which statement describes a regulatory function of the MHRA?
• Amitriptyline can potentiate the hypotensive effect of GTN. Which option lists this as the correct drug?
• An 11-year-old child has a private prescription for melatonin tablets. Which statement regarding repeats is correct?
• A 67-year-old man starting citalopram for treatment of depression. Which adverse reaction is most likely to be observed when taking or using the medication?
• A 28-year-old pregnant woman at 8 weeks is newly diagnosed with Graves' disease, with suppressed TSH and raised T3 and T4. Which is the most appropriate first-line treatment?
• Which medication among the following would typically require few to no plasma level checks in routine clinical practice?
• In epilepsy management, prescribing of a branded product versus a generic may be based on clinical judgement for which drug?
• A 71-year-old woman starting clozapine for schizophrenia. Which adverse reaction is most likely to be observed when taking or using the medication?
• Which medication in the regimen is an analgesic used PRN?
• Mr T, a 40-year-old man with bipolar disorder on lithium carbonate 800 mg daily, recently started ibuprofen for back pain and has reduced water intake. What is the most likely cause of his thirst, polyuria, tremors, and fatigue?
• Which electrolyte abnormality increases the risk of digoxin toxicity?
• Which color sputum could indicate congestive heart failure?
• Which patient group is more susceptible to systemic side effects from topical corticosteroids?
• What is the most appropriate lifestyle advice for this patient to reduce cardiovascular risk?
• Fostair contains which characteristic that makes it more potent than traditional inhalers?
• A mother brings her 5-year-old son with worsening symptoms including fever and a non-blanching rash. What is the most appropriate action?
• What is the recommended initial approach for constipation in a patient with no allergies or other medical conditions?
• In the familial hypercholesterolaemia case, what was the patient’s baseline LDL level?
• A 65-year-old man with diabetes and obesity on pioglitazone presents with dysuria, polyuria, and frank haematuria. What is the most appropriate reason for him to see his GP?
• Which antipsychotic is licensed to manage non-cognitive symptoms of dementia?
• For megaloblastic anaemia with a normal vitamin B12 level and a low serum folate level, which treatment is appropriate?
• Which statement best describes monitoring for carbimazole therapy?
• Which of the following is a classic symptom of phenytoin overdose?
• A 68-year-old woman with a toothache and several chronic medications requests over-the-counter relief. What is the most appropriate course of action?
• Can a 37 year old male with Diabetes be sold Amorolfine 5% nail lacquer?
• Ergocalciferol 1.25 mg capsules are prescribed. How many international units does one capsule contain?
• Two-month contraception case: how long was the contraception planned?
• 38-12345
• In the management of lipid lowering after a myocardial infarction, which drug class is considered first-line for lipid lowering?
• In pregnancy, which regimen is appropriate for treating bacterial vaginosis when topical therapy is preferred?
• What was the initial dose of doxycycline given for the COPD exacerbation?
• A 2-year-old child has not yet received the MMR vaccine. The mother asks for the appropriate age for the first dose. Select the most appropriate age for immunisation.
• A prescription written in Greek from Greece for salbutamol inhaler for asthma is presented for urgent relief. What is the correct action?
• Can a man taking isosorbide mononitrate be supplied sildenafil OTC?
• Betamethasone valerate 0.025% cream is considered to have which potency?
• Which factor can potentiate the hypotensive effect of GTN?
• A 62-year-old man with chronic pancreatitis; fecal elastase test shows significantly reduced levels; what does this indicate?
• Which antibiotic should be avoided with methotrexate to reduce the risk of myelosuppression?
• Which combination of symptoms is most indicative of glandular fever in a teenager?
• Which enzyme deficiency would cause severe toxicity during thiopurine treatment if reduced?
• How many sprays of a glyceryl trinitrate spray should be used before seeking emergency help if chest pain persists?
• Which drug combination is described as causing a clinically significant interaction?
• Which packaging requirement applies to the lawful sale of General Sale List medicines?
• Creon (pancreatin) is best described as which type of medication?
• A 45-year-old man with irritable bowel syndrome experiences abdominal pain and bloating and is prescribed a medication to relieve smooth muscle spasm. Which drug would most likely be prescribed?
• A 28-year-old female presents with thin, grey discharge and fishy odour consistent with BV. What is the most appropriate treatment?
• An OTC vaginal cream contains estriol for vaginal atrophy. What is the maintenance dose?
• Which description best matches the ringworm lesion described in the child?
• A 7-year-old girl has a salbutamol metered-dose inhaler with a large-volume spacer. Her parent asks how the spacer should be cleaned to ensure it continues to work properly and does not build up static, which may affect drug delivery. Which of the following is the most appropriate advice regarding cleaning the spacer?
• A 22-year-old woman presents with ringworm; which over-the-counter medication would be most suitable?
• Among the medications this patient takes, which is an antimuscarinic that could cause dry mouth and constipation?
• Which of the following is an essential component for continued registration as a registered pharmacy professional?
• Which antihypertensive is most appropriate to manage high blood pressure in a pregnant patient at 25 weeks’ gestation?
• A 45-year-old patient with asthma on beclometasone 100 mcg/dose, 2 puffs twice daily, and frequent SABA use has poor control. What is the next step in treatment?
• Which laxative is osmotic and commonly used for constipation?
• Which route is preferred for rapid relief in an acute pediatric asthma attack when quick effect is needed?
• Which statement is true about the preparation of an oral rehydration sachet for consumption?
• A patient started on fluoxetine two weeks ago reports increased anxiety and no mood improvement. What is the most appropriate course of action?
• Orlistat can be sold to adults with a body mass index at least:
• A 60-year-old woman with chronic pancreatitis is prescribed a medication to aid digestion of fats and proteins. Which medication would that be?
• Which drug in the patient’s regimen is an ACE inhibitor?
• Which therapy is most appropriate as dual therapy alongside metformin for a patient with a history of myocardial infarction and no symptomatic hyperglycaemia?
• A lady presents with period pain suspected to be primary dysmenorrhoea. Which is the least appropriate question to ask?
• A 30-year-old woman in her second trimester of pregnancy presents with ongoing constipation. She has been eating more fibre and drinking more fluids, but this has not improved her symptoms. Which one of the following is the most appropriate recommendation?
• Which of the following is a valid inpatient thromboprophylaxis option?
• For a 68-year-old man with CKD and diabetes and an ACR of 75 mg/mmol, which is the most appropriate target blood pressure?
• Mr A has post-operative cataract surgery and is using Tobradex and Yellox. When two different eye preparations must be used at the same time, what is the recommended interval between drops?
• For desmopressin used to treat primary nocturnal enuresis, what is the recommended fluid restriction around dosing?
• In Mr A’s cataract surgery eye drop regimen, how many times per day should Tobradex be used in Week 1?
• Prior to prescribing valproate, what must have been demonstrated regarding alternative therapies?
• For the Salbutamol inhaler in the described regimen for the 8-year-old, what is the maximum number of puffs per day that could be used?
• A 33-year-old male has been taking bendroflumethiazide 5 mg daily for peripheral oedema for the past month and reports a side effect.
• A 69-year-old man with newly diagnosed COPD smokes 25 cigarettes per day. Which is the most appropriate initial management option?
• Which statement is least likely to affect INR control in a patient taking warfarin?
• Which safety concern is most associated with combining erythromycin with citalopram?
• A 29-year-old woman on carbamazepine requests emergency contraception 4 days after unprotected sex. What is the most appropriate action?
• Which antidepressant is most likely to cause weight gain?
• Licensed beta-blockers for heart failure include which of the following?
• In the disposal scenario, which statement is true regarding controlled drugs?
• An elderly man taking warfarin notices his tablets are blue instead of brown and he started the new batch four days ago. He has bruising on his legs. What is the most appropriate advice?
• Pioglitazone, used for type 2 diabetes, belongs to which class of antidiabetic drugs?
• Which drug would you not expect to see on a discharge prescription after an acute coronary syndrome?
• An 83-year-old with Parkinson's disease needs an antiemetic to control nausea and vomiting. Which agent would be preferred?
• A 50-year-old Black African woman with newly diagnosed stage 2 hypertension has a clinic BP of 164/91 mmHg. According to NICE guidance, which is the most appropriate first-line antihypertensive treatment?
• What is the reason for taking alendronic acid in the morning with a full glass of water and remaining upright for 30 minutes?
• In the Prochaska & DiClemente cycle of change, which stage involves preparing to take action in the near future?
• A 58-year-old patient with type 2 diabetes presents with new hypertension. Which medication is most appropriate to start to address both blood pressure and diabetic kidney protection?
• How many units are contained in a single 3 mL pen of 100 units/mL insulin?
• For a 16-week pregnant woman with dyspepsia, which option is most suitable?
• A 64-year-old man recently started on atorvastatin 40 mg daily asks what symptoms should prompt urgent reporting. Which symptom is the most important to report?
• What DEET concentration is recommended for protection against malaria when used with sunscreen?
• If isotretinoin is prescribed, for how long after stopping treatment should contraception be used according to recommended safety guidelines?
• Ventolin inhalers are primarily used for what purpose?
• A 28-year-old woman with lower abdominal pain, fever, and vaginal discharge; recent unprotected sexual intercourse and a history of chlamydia one year ago; which antibiotic is most appropriate?
• Which of the following is an example of an off-label use of a licensed medicine?
• Before dispensing isotretinoin, which pregnancy-related check is essential?
• After initiating clozapine, what is the recommended blood count monitoring frequency?
• Which factor contributes to the increased cardiovascular risk in the described patient with diabetes and smoking?
• Which disease is not covered by the 6-in-1 vaccine?
• You are undertaking a medication review for a 25-year-old male patient taking sodium valproate for epilepsy who plans to start a family within a year. Which option would be most appropriate?
• A prescription from the USA for tamsulosin; patient needs medication; what is the best course of action?
• An electronic prescription for oxycodone was dispensed last month but not collected; the patient returns after 28 days. Which is correct?
• A 36-year-old pregnant woman with gestational diabetes has a BMI of 33 kg/m2. How would this BMI be classified?
• In the described postoperative regimen, which drug is the antiemetic?
• Terbinafine cream is licensed for over-the-counter sale for individuals of which minimum age?
• A 15-year-old girl asks to speak privately about the morning-after pill. What is the first most appropriate consideration?
• A 26-year-old woman with cystitis reports burning on urination and increased frequency, no fever. What is the most appropriate initial management?
• How many millilitres of adrenaline injection are needed to supply a 0.3 mg dose when the concentration is 100 micrograms per millilitre?
• Which antibiotic has a therapeutic serum range of 3-5 mg/L?
• What is the usual daily dose of tamoxifen in this setting?
• A 32-year-old woman comes to your pharmacy seeking advice for her wife’s constipation. What is the most suitable course of action?
• If a baby still needs paracetamol two days after vaccination, what should you do?
• If a prescription is written in Welsh and you cannot understand it, what is the most appropriate course of action?
• During the evaluation of the 58-year-old man with type 2 diabetes and LVH, what was his recorded blood pressure?
• Which of the following is a key toxicity risk associated with gentamicin therapy?
• A 23-year-old woman is newly diagnosed with asthma. According to updated guidelines for patients aged 12 and over, what would be the most appropriate first-line treatment option?
• As the Responsible Pharmacist, which activity can staff legally perform while you are not physically present on the premises?
• A 60-year-old woman with type 2 diabetes undergoing abdominal surgery is nil by mouth post-operatively. Her last HbA1c was 85 mmol/mol and inpatient glucose readings are elevated. She reports fatigue, thirst, and polyuria. Select the most appropriate antidiabetic medication.
• In an audit of antibiotic prescribing on a hospital ward, which activity would best meet the aim of checking alignment with local prescribing protocols?
• Which over-the-counter medication is most appropriate for rapid relief of outdoor-triggered allergic rhinitis symptoms in an adult?
• A 45-year-old woman presents with features including a round, red face, facial fullness, and fat buildup around the neck and shoulders. Which condition is most likely responsible for these symptoms?
• Which is the most likely cause of the elderly patient’s signs (productive cough, pink sputum, breathlessness) given the scenario?
• What is the correct dosing for Mebeverine in irritable bowel syndrome?
• Which beta blocker is least likely to cause nightmares and sleep disturbances?
• Which statement regarding the Medicines and Healthcare products Regulatory Agency (MHRA) is correct?
• What is the most appropriate reason for advising a patient to take warfarin at the same time each day around 6pm?
• What is the maximum period a Responsible Pharmacist may be absent from the pharmacy?
• What is the most appropriate method for administering injections with insulin pens?
• Among study designs, which has the greatest quality of evidence?
• During a controlled drugs audit, which medicine in the CD register requires legal storage under safe custody in a community pharmacy?
• Tiotropium belongs to which drug class?
• A patient presenting in a community pharmacy is prescribed trimethoprim for a UTI and also takes a medication that can interact fatally with trimethoprim. Which medication is this?
• A patient on long-term lansoprazole presents with fatigue, muscle tremors and spasms. Which electrolyte abnormality is most likely the cause?
• Which statement correctly describes the purpose of an oral rehydration solution in diarrhoeal illness?
• Which action is most appropriate when a patient on simvastatin starts clarithromycin for a chest infection?
• If a patient on isosorbide mononitrate reports headaches shortly after dosing, what is the recommended course of action?
• An 84-year-old man with Alzheimer's disease has progressed from mild to moderate; which additional treatment is most likely to be added to his current therapy?
• Which of the following statements best describes digoxin management in patients with reduced renal function and potential electrolyte disturbances?
• Seretide Accuhaler contains which two active ingredients?
• A 36-year-old pregnant woman with gestational diabetes at 19 weeks’ gestation and BMI 33 kg/m2 is advised on pharmacological treatment. Which is the most appropriate initial pharmacological therapy?
• A 29-year-old man presents with ear pain and muffled hearing in his right ear for the past 3 days. He frequently uses cotton swabs to clean his ears and the ear canal is visibly blocked. Which management is most appropriate?
• The parent of a 6-week-old preterm infant asks about the timing of the first dose of Infanrix (DTPa-Hib-IPV-HepB). Select the most appropriate age for immunisation.
• In the event of symptoms suggestive of bone marrow suppression, what is the most appropriate course of action?
• For Mr C with newly diagnosed type 2 diabetes and a BMI of 29.9 kg/m2, which therapy is most appropriate to initiate?
• A patient started on isosorbide mononitrate reports throbbing headaches shortly after taking the dose. What is the most appropriate advice?
• Which statement about acrolein is true in the context of chemotherapy-related bladder toxicity?
• Which SSRI has the longest half-life?
• Which parameter is routinely monitored for patients on olanzapine?
• Alteplase works as a fibrinolytic by which mechanism?
• A 55-year-old patient with numbness in the feet and a history of type 2 diabetes; which medication is licensed for diabetic peripheral neuropathy pain?
• Which of the following beta-blockers is not listed among the licensed heart failure therapies?
• An adult who is following a vegan diet, should take this vitamin as a supplement.
• For an infant with colic, which active ingredient is commonly found in an OTC product recommended after non-pharmacological measures?
• Which diabetes drug carries a known risk of bladder cancer?
• A 66-year-old woman with atrial fibrillation is not currently on anticoagulation. Which medication would be most appropriate for stroke prevention in this patient?
• Which inhaled medication is an inhaled corticosteroid used for asthma management?
• A woman with breast cancer is receiving doxorubicin and reports fatigue, shortness of breath, and swollen ankles. What is the most appropriate action?
• In a 5-year-old child with fever, productive cough, and signs suggestive of pneumonia, what is the most appropriate first-line antibiotic?
• A 75-year-old woman with cardiac arrhythmia on digoxin. Which medicine should be avoided to prevent adverse interactions?
• Which statement about sepsis is true?
• When starting amiodarone, which baseline tests are appropriate as part of monitoring?
• Which is the most appropriate baseline test prior to initiation and monitored regularly during methotrexate treatment?
• Which statement most accurately describes a symptom not expected in phenytoin overdose?
• Which antiemetic is most suitable to recommend for nausea and vomiting in pregnancy?
• A patient with rheumatoid arthritis on weekly methotrexate asks which of her current medications has a severe interaction with methotrexate.
• While working alone, you decide to initiate colchicine for a patient with a new gout diagnosis. Which action is most appropriate?
• Based on current guidelines, what home blood pressure target should Mrs B aim for?
• Which medication overdose is associated with liver damage, potential encephalopathy, hypoglycemia, and right subcostal pain?
• With mild injection-site reactions to a newly licensed biologic therapy, what is the recommended course of action?
• A first dose of this vaccine should be given at 12-13 months of age and a second dose before starting school at 3 years and 4 months to 5 years of age.
• Which statement about Koplik spots and the measles rash progression is correct?
• A 3-year-old girl with suspected meningitis has fever, purpuric spots, lethargy and is cephalosporin-allergic. Which antibiotic would be most appropriate to recommend intravenously?
• What precaution should patients on doxycycline take regarding sun exposure?
• Which electrolyte disturbance is associated with long-term use of proton pump inhibitors such as lansoprazole?
• Which medication in the elderly patient’s regimen is a potassium-sparing diuretic?
• Which statement best describes montelukast's adverse effects in children as stated in the material?
• A 3-week-old baby weighing 2.4 kg requires continuous IV infusion of glyceryl trinitrate at 0.2 microgram/kg/min. What is the hourly infusion rate?
• Which antibiotic is commonly used with amoxicillin for synergy in endocarditis therapy?
• Which action is the most appropriate when a member of the public brings in a box of unused and expired medicines for disposal, including a sharps bin with used syringes?
• Which antidepressant is noted as having potential serotonin syndrome risk when used with sumatriptan?
• Filgrastim is used in chemotherapy patients to reduce the risk of neutropenia by stimulating production of which type of blood cells?
• Which condition requires caution with aminoglycosides due to possible neuromuscular weakness?
• A 12-year-old girl with recurrent thrush infections, fruity breath, unintentional weight loss and nocturia. Diagnosis?
• Which symptom would necessitate a referral instead of selling Canesten thrush cream due to suspected bacterial vaginosis?
• A patient with a drug Z half-life of 30 minutes and current plasma concentration of 200 mcg/mL asks how long to fall to 25 mcg/mL. How many minutes?
• Which test is most appropriate to monitor methotrexate therapy for potential liver toxicity?
• A 26-year-old man presents with insomnia, having trouble falling asleep and waking several times at night. What is the most appropriate first-line treatment?
• Which pharmacokinetic principle is demonstrated by a drug with a half-life of 30 minutes, where the concentration halves every 30 minutes?
• In a patient taking warfarin, what is the primary reason to maintain a consistent intake of vitamin K–containing foods?
• Codeine 240 mg is metabolized to approximately 30 mg of which active metabolite?
• Which statement about carbimazole is NOT true?
• Which antipsychotic is licensed to manage non-cognitive dementia symptoms?
• For the 20 kg child described in the amoxicillin scenario, what is the total daily dose in mg?
• Vincristine sulfate is administered by which route?
• A pregnant woman is exposed to an infection that could affect both mother and baby; which infection is most likely?
• A 53-year-old man with depression on citalopram 40mg daily is newly prescribed naproxen 250mg three times daily for gout. What is the most likely consequence of this drug interaction?
• Under the MHRA Yellow Card Scheme, which statement best describes reporting for newly licensed medicines?
• In rivastigmine patch therapy, which parameter should be monitored to assess tolerability and effectiveness?
• Which of the following drugs is an ACE inhibitor commonly used to treat hypertension?
• Which antiepileptic drug is most likely responsible for antiepileptic hypersensitivity syndrome in a 13-year-old recently started on a new drug?
• A patient on metformin reports polyuria, polydipsia and weight gain after 6 months of therapy. What is the most appropriate next step?
• A 32-year-old woman presents with vaginal discharge that is white, thick, and odourless. She recently completed broad-spectrum antibiotics. Which is the most likely cause?
• Which medication would warrant an immediate referral to the patient’s GP for a review given her desire to conceive and complex medical history?
• A 30-year-old woman has asthma not well controlled on a low-dose ICS and montelukast. What is the next step in her treatment?
• Which of the following is a contraindication to Nintedanib?
• A patient with atrial fibrillation has a HAS-BLED score of 2. What does this indicate about bleeding risk?
• An 82-year-old woman with suspected ischaemic stroke is being considered for antiplatelet therapy. Which regime is most appropriate to initiate?
• Which enzyme in pancreatin is primarily responsible for fat digestion?
• Which patient scenario could be safely managed with over‑the‑counter antifungal treatment in a community pharmacy?
• Entacapone is co-administered with Madopar to achieve what pharmacologic effect?
• Which statement about vitamin K-rich foods and warfarin is true?
• How long does it take to reach half the level of the inactive form of clopidogrel after a dose?
• Mr Q, 42-year-old man post-renal transplant on Mycophenolate 720 mg twice daily, needs contraception advice. Which is most appropriate?
• Pancreatin is prescribed to aid digestion of which nutrients?
• A 30-year-old man presents to A&E with confusion and rapid heartbeat. He has Type 1 diabetes and has not eaten all day. Capillary blood glucose is 2.4 mmol/L. What is the most appropriate immediate management?
• There are many insulin regimens; which is an example of rapid-acting insulin?
• A breastfeeding mother on antiepileptic therapy asks which drug may accumulate in a breastfed infant due to slower metabolism. Which drug is it?
• Isophane insulin is an example of which insulin category?
• For pertussis in an infant with incomplete vaccination, which antibiotic is recommended?
• Which statement best describes the interaction between lithium and NSAIDs like ibuprofen?
• A patient visiting the community pharmacy requests treatment for chlamydia. Which medicine is most appropriate for the presenting condition?
• In a COPD patient with an acute exacerbation on doxycycline and prednisolone, which change would optimally optimize therapy?
• If a patient on Microgynon ED experiences sudden disturbance of vision, what should be done?
• Which antidiabetic drug carries a risk of lower limb amputation, prompting heightened foot care and hydration advice?
• A 19-year-old man develops hypopigmented patches on the trunk. What is the most appropriate fungal treatment?
• How often should a patient take ibandronic acid 50 mg?
• A 22-year-old woman on a combined oral contraceptive forgets to take the last pill and is 14 hours late in the third week of her pack. What is the most appropriate advice?
• You have been asked to conduct an audit about the prescribing and administration of antibiotics on the hospital ward so that you can identify areas for improvement. You have set yourself an aim of identifying whether local prescribing protocols are being met. Which of the follow processes is most appropriate to complete as part of an audit cycle?
• Which antihistamine is most appropriate for a 22-year-old with allergic rhinitis who did not respond to loratadine 10 mg?
• Which mechanism best explains thrush developing after antibiotics?
• A patient with ear blockage and recent history of cerumen buildup is advised on management. Which option is recommended?
• An 8-year-old boy with asthma and penicillin allergy requires antibiotics for an acute chest infection. Which antibiotic is most appropriate?
• Which statement about the constants used in the Cockcroft-Gault equation is correct?
• A 72-year-old woman brings a bag of unused medication to the pharmacy and mentions fentanyl 25 microgram patches. Which is the most appropriate action regarding destruction of the controlled drug?
• Which vitamin can be used to prevent Wernicke's encephalopathy?
• An elderly patient describes his diabetes medication as a cloudy liquid in a vial. Which insulin preparation fits this description?
• A patient taking ibandronic acid should be told to remain upright for how long after taking?
• An 8-year-old with severe acute asthma signs (peak flow 45%, SpO2 89%, HR 132, RR 33). What is the correct action?
• Which statement best reflects vitamin D management in hyperparathyroidism?
• Which statement best reflects the prescriber’s role during a consultation?
• A 55-year-old man with asthma is on high-dose ICS, LABA, and LTRA and has had two severe exacerbations requiring oral steroids in the last three months. What is the most appropriate next step?
• The decision whether this antiseizure drug should be prescribed as brand rather than generic is based on clinical judgement. Which drug is it?
• Which medication should be avoided with lithium treatment due to potential interaction?
• Which of the following statements about administering glyceryl trinitrate spray is correct?
• An adolescent who develops hallucinations after taking morphine is to be switched to an oral alternative. Which option is most appropriate?
• When prescribing NSAIDs, the risk of GI toxicity is higher in which group?
• A 25-year-old woman is prescribed folic acid 5 mg daily with maternity exemption. Which condition would require continuing folic acid throughout the entire pregnancy?
• A patient is prescribed antibiotics and should avoid taking with iron within two hours before or after a dose. Which antibiotic requires this warning?
• How long should a thermometer be placed under the tongue for an accurate oral temperature reading?
• Concerning stock salbutamol for schools, which statement is true about the written request?
• A 67-year-old man with benign prostatic hyperplasia is newly diagnosed. Which medication is most appropriate for first-line treatment?
• When updating an antimuscarinic prescribing policy, which condition would contraindicate its use?
• Methotrexate is best described as which type of drug?
• Which combination is most likely to cause deterioration due to antifolate interaction?
• Before starting azathioprine in Crohn’s disease, which enzyme activity should be tested to avoid toxicity?
• Which statement best characterizes potential adverse effects of long-term amiodarone use?
• Which cytotoxic drug is highly emetogenic?
• A 40-year-old woman presents with itchy, white vaginal discharge and vulval irritation. She has no fever or abdominal pain. What is the most appropriate treatment?
• In a signed order from a local primary school, which is the legal requirement for a supply to be made against this type of signed order?
• A patient aged 66 who is eligible for the herpes zoster vaccine would be considered within the NHS routine vaccination scheme. Is this statement true or false?
• Which clinical finding is most indicative of meningitis?
• When treating endocarditis with gentamicin, which monitoring is essential to ensure efficacy and safety?
• Which statement best explains why digoxin toxicity occurred in the elderly patient described?
• A patient newly started on a medication with capsules that must not be opened due to risk of overdose. Which drug is most likely?
• What is the recommended dosing guidance for a second dose of sumatriptan if the migraine recurs?
• A 16-year-old girl is starting minocycline for acne. What instruction is most likely to be included on the handout?
• A pregnant woman at 13 weeks with a urinary tract infection is treated. What is an appropriate first-line antibiotic regimen?
• A 62-year-old woman on amlodipine also takes simvastatin, bendroflumethiazide and paracetamol. She reports a side effect. Which is most likely?
• Four Dioralyte sachets are dissolved in 200 mL of water each. If each sachet contains 300 mg of sodium, how many millimoles of sodium ions are consumed in total when four sachets are used (nearest millimole)?
• How should doxycycline be dosed to ensure effectiveness?
• Which statement about methotrexate and folic acid scheduling is correct?
• BCG vaccination should be given within what timeframe after birth in settings where routine BCG is given?
• In a 76-year-old man with stage 4 chronic kidney disease (eGFR 22 mL/min/1.73m2) who needs an oral anticoagulant for stroke prevention in atrial fibrillation, which drug would be contraindicated based on his renal function?
• What is the standard interval for a tetanus booster in adults who have completed their primary vaccination series?
• What is the recommended fluid restriction window around desmopressin 240 microgram oral lyophilisate?
• Which factor in this stye-related scenario increases the risk of developing a stye?
• A 32-year-old woman requests Migralev Yellow (paracetamol 500 mg and codeine) for migraines. She is a CYP2D6 extensive metabolizer. What is the most appropriate action?
• In routine breast cancer screening, how frequently is screening offered to eligible individuals?
• A regular patient requests an emergency supply of all repeats; Which statement is correct regarding emergency supply?
• An elderly male presents with a sore throat; which drug is most likely to be the cause of the adverse reaction?
• A 38-year-old female presents with facial redness, visible blood vessels, and occasional burning. What is the most appropriate treatment?
• A 64-year-old man on amiodarone 200 mg daily develops a dry cough and breathlessness on exertion. What is the most appropriate course of action?
• If a patient on warfarin reports that a batch of tablets has changed color from brown to blue and notes bruising, what is the safest course of action?
• When a registered pharmacist takes a break, what detail should be recorded in the pharmacy record?
• Which adjustment is most appropriate for a patient with cirrhosis and ascites on spironolactone who remains symptomatic despite a low-sodium diet?
• For inpatient thromboprophylaxis during pregnancy, which drug is most appropriate.
• Which clinical test is required before initiation of amiodarone treatment?
• A patient with toothache who is also taking calcium carbonate, alendronic acid weekly, atorvastatin, folic acid, ramipril and a beta-agonist inhaler requests OTC analgesics. What is the most appropriate action?
• Which detail must be included on the dispensing label for a veterinary prescription under the veterinary cascade?
• Which of the following is most likely a side effect of lisinopril therapy?
• A patient who has had an acute ischaemic stroke is to be treated with alteplase. Within what time frame must treatment be given after onset?
• A 65-year-old man on modified-release oxycodone reports breathing difficulties and severe drowsiness with disorientation (keys found in the fridge). What is the most appropriate action?
• A patient on warfarin has an INR >8 but is not bleeding. What is the most appropriate course of action?
• Which combination is most likely to cause a clinically significant drug interaction?
• Which enzyme digests fats and is present in pancreatin?
• A 32-year-old man with idiopathic angioedema; which medication is contraindicated?
• A 62-year-old man with chronic pancreatitis; fecal elastase test indicates pancreatic exocrine insufficiency; Creon contains which enzymes?
• Bleeding gums, haematuria or unexplained bruising are considered signs of a serious side effect of methotrexate.
• In the clonidine shortage, which action is most appropriate?
• Semaglutide is an example of which class of medications?
• In a patient recently diagnosed with Parkinson's disease dementia, which medication is most likely to be prescribed?
• Which medication may require a dose adjustment if the patient starts smoking?
• In cardiovascular risk assessment, what does a QRISK3 score represent?
• In a patient with primary hyperparathyroidism, which blood parameter should be monitored regularly?
• Which symptom is commonly associated with aminoglycoside-induced ototoxicity?
• A 72-year-old patient with stage 5 chronic kidney disease on thrice-weekly haemodialysis has a haemoglobin of 86 g/L and low erythropoietin levels, with iron stores in range and no signs of active bleeding. Which treatment should be initiated first?
• Which interval is used for seasonal influenza vaccination in adults?
• A 40-year-old woman recently started a diabetic medication and reports recurrent flu-like symptoms. Which antidiabetic drug is associated with an increased risk of upper respiratory tract infections?
• Which medication cannot be given to Mrs H as an emergency supply?
• Clobetasone butyrate 0.05% is classified as which potency?
• Which symptom is a common anticholinergic side effect of oxybutynin?
• A patient receiving supervised methadone oral solution for opioid dependence fails to attend the pharmacy for 4 consecutive days. On the 5th day, the patient returns requesting their usual dose of 40 mg. According to national guidelines, what is the most appropriate action the pharmacist should take?
• A patient with uncontrolled postherpetic neuralgia pain has been taking paracetamol 1 g four times daily. Which medication is most appropriate as first-line therapy for neuropathic pain?
• Which medication is NOT suitable for immediate relief of a gout flare?
• What is the recommended frequency for seasonal influenza vaccination for adults?
• Clarithromycin is prescribed for a skin infection. Which statin would most likely have a serious interaction with clarithromycin?
• A 46-year-old male with a duodenal ulcer and H. pylori infection has a penicillin allergy. Which regimen would be most suitable as first-line treatment?
• Pharmacists are required to maintain a record of the acquisition and dispensation of POM‑V and POM‑VPS medicines. Which statement about recording keeping is correct?
• Which action best describes handling a prescription written in a language you cannot read, when the patient requires urgent medication?
• A 17-year-old male requests emergency hormonal contraception after unprotected intercourse with a 16-year-old girlfriend who cannot attend the pharmacy. What is the most appropriate course of action?
• Which laboratory result would indicate hyperthyroidism?
• A 60-year-old man with COPD presenting with an acute bacterial exacerbation is penicillin-allergic; which first-line antibiotic is most appropriate?
• Lithium is primarily used to treat which condition?
• In an 8-year-old with an acute asthma attack not responding well to inhaled salbutamol, what is the most appropriate first-line treatment?
• A 51-year-old patient asks for ibuprofen while on Edoxaban 60 mg daily and reports chest pain on inspiration. What is the most appropriate action?
• In the 54-year-old male patient’s regimen, which medication is a calcium channel blocker?
• An 18-year-old woman on isotretinoin reports mood changes and thoughts of self-harm. What is the most appropriate action?
• A patient on lithium who has recently started a thiazide diuretic should prompt urgent medical review due to potential toxicity. Which option describes the correct action?
• A 10-year-old boy has clusters of raised spots with a central dimple under the armpit area; what is the diagnosis?
• In a patient with hypertension and type 2 diabetes, which antihypertensive class is preferred for renal protection?
• A 74-year-old woman with HFpEF and multiple comorbidities has been optimising treatment. Which addition would be most appropriate?
• Which drug would be most appropriate to offer Mrs H as thromboprophylaxis as an inpatient?
• On regular monitoring during treatment for primary hyperparathyroidism, which nutrient is most likely to be monitored and potentially supplemented?
• Which factor is least likely to contribute to lithium toxicity?
• Which laboratory finding would most support the diagnosis of vulvovaginal candidiasis in a patient with a recent antibiotic course and thick white discharge?
• In an emergency levetiracetam loading scenario, which factor dictates the maximum dose?
• Shingles characteristically presents with which pattern?
• In travelers who have completed their primary tetanus vaccination, what is the recommended booster interval?
• Which medication is the first-line treatment for trigeminal neuralgia?
• Which medication may be the cause of nightmares and vivid dreams in the patient described?
• An HbA1c value of 85 mmol/mol indicates the poorest long-term glycemic control among the values listed. Which of the following corresponds to 85 mmol/mol?
• Which protective agent is given to prevent cyclophosphamide-induced urothelial toxicity?
• Infanrix (DTPa-Hib-IPV-HepB) is a combination vaccine. Which disease is NOT covered by this vaccine?
• Which statement best describes the COPD rescue pack described in the scenario?
• Which option best matches the recommended action for a patient with an infected toenail?
• What is the therapeutic serum range for lithium?
• Fentanyl patches are an example of which type of medication?
• An 82-year-old man with COPD and presumed pneumonia who has a penicillin allergy; which antibiotic is most appropriate?
• For chronic musculoskeletal pain in a patient with a history of ST-elevation myocardial infarction, which NSAID would be most appropriate?
• As the responsible pharmacist, you supply co-codamol 15/500 mg tablets for use in a clinic on a signed order. According to legal requirements, for how long must the signed order be retained in the pharmacy?
• A 68-year-old woman with type 2 diabetes and a history of heart failure with reduced ejection fraction, BMI 27, HbA1c 70 mmol/mol. Select the most appropriate antidiabetic medication for intensified therapy.
• This vitamin should not be taken in supplements or consumed in large quantities in the diet during pregnancy.
• Patients using Fostair should be advised to?
• In adults at high risk for influenza, how often should vaccination be given?
• When prescribing NSAIDs, which NSAID poses the greatest risk of gastrointestinal toxicity?
• MART in asthma management refers to what?
• Which parameter would be the least appropriate to monitor in a patient recently started on atorvastatin and lisinopril who has no symptoms?
• A wife reports husband with chest pain lasting over 20 minutes on the left side radiating to his back. What should you advise?
• In nocturnal enuresis treatment, what is the maximum daily dose of desmopressin when an initial dose needs to be increased?
• In a pregnant patient with Graves' disease and hyperthyroidism, which antithyroid drug is recommended as first-line treatment?
• A patient on methotrexate for psoriasis develops mouth ulcers; which adverse effect is most likely?
• The patient mentions he is also suffering from an ear infection and has been taking some antibiotics. He wants to ensure that he can take sildenafil at the same time as the antibiotics. Which antibiotic is most likely to result in a serious drug interaction?
• Can a man taking ritonavir for HIV be supplied sildenafil OTC?
• Which symptom is most typical of scarlet fever?
• Which class of antidiabetic medication has demonstrated cardiovascular benefits in heart failure with reduced ejection fraction?
• Which statement best describes sequential hormone replacement therapy?
• A mother asks for advice about infantile colic and a licensed product. Which is the most likely active ingredient?
• A nursing home wound initially showed signs of infection and was yellow with medium exudate. After antibiotics, the wound becomes pink but still has medium exudate. Which dressing type is most appropriate for this wound?
• What must be considered before prescribing sodium valproate?
• Within what time window should alteplase be administered for suspected acute ischemic stroke?
• In suspected methotrexate overdose, which rescue agent is used to counteract toxicity?
• A patient with severe osteoarthritis is due for major surgery. Which medication should be stopped temporarily before the operation?
• Which folic acid dose is recommended for pregnancy conceived while on anti-epileptic therapy?
• A 2-year-old boy has been prescribed paracetamol 120 mg/5 mL for fever. What is the appropriate single dose?
• When supporting a trainee pharmacist on OTC cough suppressants, which of the following medications is available over-the-counter as a cough suppressant?
• Which finding best indicates pancreatic exocrine insufficiency in pancreatitis?
• When a medication cannot be opened due to overdose risk, what is the safest dispensing approach?
• A 52-year-old woman asks about hormone replacement therapy. She has severe hot flushes, night sweats, low mood; intact uterus; last period 8 months ago. Which HRT type is most appropriate?
• A 68-year-old woman with osteoporosis on denosumab develops muscle cramps and tingling; which adverse effect is most likely?
• In the context of treating a UTI in pregnancy, what is the dosing frequency for nitrofurantoin used for seven days?
• What is the most likely adverse drug reaction associated with carbimazole treatment?
• Which drug for type 2 diabetes is available as a once-daily tablet or a once-weekly injection?
• The pharmacy should write the correct dosing day on both the label and box for which drug?
• A patient needing treatment for Helicobacter pylori to be taken alongside amoxicillin and omeprazole at a dose of 400 mg twice daily. Which antibiotic is most appropriate for the presenting condition?
• A 50-year-old woman is started on oral prednisolone 7.5mg once daily for arthritis. Which of the following is a common adverse effect of corticosteroid therapy?
• An 8-week-old baby develops fever after MenB vaccination. The parent asks how to bring the temperature down. What is the most appropriate dosing instruction?
• A 12-year-old child presents with symptoms of bacterial conjunctivitis; the parent is seeking an OTC solution. Which age group is chloramphenicol eye drops licensed for over-the-counter sale?
• Hydrocortisone 0.1%, 0.5%, 1.0% + 2.5% is of what potency?
• A male patient has recently started using a glyceryl trinitrate spray. Which of the following is the MOST appropriate advice to give?
• A 6-year-old child presents with a red, crusty rash around the mouth and nose, with golden-yellow crusts. What is the most likely diagnosis?
• In the morphine breakthrough pain preparation described, which preparation is specified as a 10 mg/5 mL solution?
• A patient with a severe deep-seated bone infection requires antibiotic therapy and has no known drug allergies. Which medicine is most appropriate?
• A 78-year-old patient with glaucoma who has limited dexterity asks how to improve eye drop administration. What is the most appropriate action?
• What would paramedics offer on the way to hospital for suspected acute coronary syndrome?
• A patient taking lithium is started on a thiazide diuretic. Which outcome is most likely?
• A 60-year-old man with asthma and an aspirin allergy requires antiplatelet therapy after a transient ischaemic attack. Which agent is most appropriate?
• Which sign or symptom should be advised for Mrs T to monitor while taking carbimazole?
• A daughter collects morphine on behalf of her terminally ill father and a controlled drugs register entry is made. Which detail is NOT legally required when making the entry?
• What is the most common adverse effect reported with simvastatin therapy?
• Mr J with leg cramps and low potassium (2.9 mmol/L) who takes ramipril, salbutamol, furosemide, amlodipine and digoxin. Which drug is most likely to have caused the effect?
• A 45-year-old patient presents with weight gain and features suggestive of hormonal imbalance. Which condition is most likely responsible for these symptoms?
• A 32-year-old pregnant woman with straining and hard stools. The most appropriate laxative to avoid abdominal cramping is which?
• Before supplying six Ventolin inhalers to a school, what information is required?
• A 28-year-old female who has been vaping wants to reduce vaping and stop before trying to conceive. Which stage of the Prochaska & DiClemente cycle of change is she currently at?
• A 70-year-old man post-hip replacement on morphine and taking lactulose and senna, yet he has hard stools. Select the most appropriate laxative.
• Co-prescribing methotrexate with trimethoprim can cause a serious interaction. What is the most likely consequence?
• In the same medication list, which drug is a beta-blocker?
• A 65-year-old man who recently had a myocardial infarction has elevated LDL cholesterol despite lifestyle changes. Which statin regimen would be most appropriate according to guidelines?
• Paracetamol 120 mg/5 mL suspension for a 2-month-old who has just received a MenB vaccination: what is the most suitable dose?
• In an elderly patient with urinary symptoms who is taking several antihypertensive medications, what is the most appropriate action when they request an alpha-blocker?
• Which drug pair is associated with a clinically significant interaction when the second drug is added to the first?
• A 48-year-old man presents with a sore mouth and inflamed oral mucosa; upon inverting the lip, an abnormality is seen. Which medication is most likely causing these symptoms?
• In chronic heart failure, which beta-blocker is typically initiated at 3.125 mg twice daily?
• A 37-year-old woman stopped taking paroxetine abruptly after feeling better and now experiences dizziness and electric shocks. What is the most likely explanation for her symptoms?
• Tobradex is a combination ophthalmic preparation. Which two active ingredients does it contain?
• Which mood stabilizer requires monitoring of serum levels in the range 0.6-0.8 mmol/L?
• In Mrs L with dyspepsia and coffee-ground vomiting while taking aspirin, which drug should be withheld until further investigations?
• What is a key principle of antimicrobial stewardship (AMS)?
• For an average-risk breast cancer screening in a standard program, what interval is used?
• Which antibiotic is least suitable to take when consuming alcohol?
• What is the recommended minimum period the responsible pharmacist record should be kept (electronic)?
• Which one of the following drugs is least likely to reduce the risk of cardiovascular disease?
• In bowel cancer screening using a faecal immunochemical test (FIT), what is the recommended interval?
• Before initiating amiodarone, which baseline test is recommended?
• Which drug class does candesartan belong to?
• A 50-year-old man with mild renal impairment and already taking morphine modified-release tablets is now being prescribed morphine 10 mg/5 mL solution for breakthrough pain. Which adverse reaction is most likely to be observed when taking or using the medication?
• In patients with chronic kidney disease, antibiotic dosing should be adjusted primarily based on which measure of renal function?
• Mercaptopurine maintenance in ALL is administered by which route in the described regimen?
• In iron-deficiency anaemia, which laboratory marker is typically decreased?
• Which of the following medicines does NOT need to be withheld if a patient has a dehydrating illness?
• A patient on antidiabetic therapy reports passing blood in urine for the past three days; which drug could cause this adverse effect?
• Which of the following is least likely to be a side effect of ramipril?
• Which agent blocks the P2Y12 receptor to inhibit platelet aggregation after a transient ischaemic attack when aspirin is not suitable?
• A 64-year-old man attends a warfarin clinic; he has an INR outside the normal range after starting antibiotics. Which effect is most likely to occur in relation to antibiotics and warfarin?
• Sodium Valproate must be dispensed in Whole packs. Which statement correctly reflects this dispensing requirement?
• Which juice is least suitable for a patient taking warfarin due to interaction risk?
• Amiodarone monitoring should include which of the following?
• Which insulin formulation is appropriate to start for basal coverage in type 1 diabetes?
• After a confirmed pancreatitis while on tirzepatide, what is the most appropriate action?
• Ferritin stores reflect iron stores; in iron deficiency, ferritin is low. Which statement is true?
• A mother brings her 5-year-old son with sneezing, itchy eyes, and runny nose, worse in summer. What is the most appropriate first-line management?
• Which antihypertensive can cause lip swelling and angioedema?
• In a STEMI within 10 hours where PCI capability is not available, which reperfusion therapy is most appropriate?
• If dry eye symptoms persist after regular use of carbomer gel, which of the following would be the most appropriate next step in treating dry eyes?
• A 63-year-old man with Addison's disease presents with vomiting, abdominal pain, low blood pressure, and dehydration following a chest infection. Which medicine should be administered urgently?
• The bioavailability between different brands of antiepileptic drugs can vary, potentially causing loss of seizure control. Which antiepileptic drug is recommended to be prescribed by brand?
• In an elderly patient with a chronic cough and weight loss, what is the most appropriate course of action?
• An 11-year-old boy with a respiratory condition needing medication to manage exacerbations. Which medicine should be avoided?
• A prescription written in Japanese from Japan for antibiotics for UTIs to be used when required. What is the most appropriate course of action?
• Which volume of water is recommended for dissolving a Dioralyte sachet according to the guidance presented?
• Hydrocortisone acetate 1% cream is considered to have which potency?
• A 65-year-old man has been started on lisinopril. Which adverse drug reaction could potentially occur?
• An 18-year-old patient weighing 76 kg requires a tablet form of emergency contraception 64 hours after unprotected intercourse. What would you give?
• In Week 2 of the cataract postoperative regimen, how often should Yellox be used?
• In a patient planning pregnancy who is taking levetiracetam, which folic acid regimen is recommended?
• Which statement best describes the correct approach to disposing of a mixed bag of medicines and sharps?
• In gestational diabetes treated with metformin, not meeting blood glucose targets, what is the most appropriate next step?
• A 6-year-old child has a circular patch of skin with a clear centre and a red, scaly outer edge that is very itchy. Which of the following is the most appropriate treatment?
• What type of evidence is most robust for evaluating unlicensed medications for a rare condition?
• A 16-year-old patient in status epilepticus is given a levetiracetam loading dose of 40 mg/kg (maximum 3 g). The patient weighs 76 kg. What dose should be given?
• A 68-year-old patient presents with mild swelling and redness at the injection site and a low-grade fever the day after pneumococcal polysaccharide vaccination. What is the most appropriate course of action?
• In a hypertensive emergency with signs of end-organ damage, which agent is most appropriate for immediate blood pressure reduction?
• Can a 61 year old female be sold Amorolfine 5% nail lacquer?
• Which combination is described as causing a clinically significant interaction?
• A 45-year-old woman with oestrogen-receptor positive breast cancer is prescribed tamoxifen 20 mg daily after a total mastectomy. What is the most appropriate counselling point for this patient?
• What is the most appropriate first-line course of action for an acute gout attack in a patient not on long-term prophylaxis?
• Which medicine is most likely to cause hyperkalemia?
• A 36-year-old man on Levemir (insulin detemir) and Humalog (insulin lispro) measures blood glucose before breakfast and finds it is low. What is the most likely cause?
• A 4-month-old boy has been prescribed paracetamol 120 mg/5 mL for post-immunisation fever. What is the appropriate dose per administration?
• What is true regarding the use of DEET and sunscreen when using an insect repellent containing DEET?
• In a patient with iron-deficiency anemia and significantly elevated tissue transglutaminase antibodies, which result would most strongly support a coeliac disease diagnosis?
• Which statement is true about destroying expired Schedule 2 controlled drugs?
• A 45-year-old woman presents with persistent heartburn and indigestion after meals, uses over-the-counter antacid tablets regularly for the last month, and reports a persistent dry cough and a sour taste in her mouth at night. What is the most appropriate action?
• In the atrial fibrillation case, what was the patient’s weight used to determine dosing?
• What is the most appropriate disposal method for unused fentanyl patches?
• A prescription written in Greek from a doctor in Greece for a salbutamol inhaler for asthma. The patient is coughing, wheezing and short of breath. What is the most appropriate course of action?
• Which cautionary label would you expect on a flucloxacillin 500 mg capsule label and inform the patient about verbally?
• Which counselling point is INCORRECT for azithromycin 15 mg/g eye drops to treat trachomatous conjunctivitis in a neonate?
• Which medication listed is a calcium channel blocker used for hypertension?
• A child is receiving the 6-in-1 vaccine, which provides protection against six diseases and is started at 8 weeks; when is the second dose given?
• A 28-year-old man taking sodium valproate for migraines is planning to start a family. Which reproductive effect is a known side effect of valproate in men?
• A 62-year-old man with non-Hodgkin lymphoma is undergoing chemotherapy and has neutropenia. Which medicine is most appropriate to prescribe to reduce the risk of neutropenic complications in future cycles?
• A 67-year-old man with chronic diarrhoea due to short bowel syndrome is prescribed a medication to reduce stool frequency. Which medication would that be?
• A 27-year-old man asks about an e-cigarette device he purchased; after one month the vapour irritates his eyes. What is the most appropriate action to take?
• Nitrofurantoin is an appropriate antibiotic for uncomplicated lower urinary tract infection in which patient group?
• You receive a prescription for a sugar-free oxycodone solution. Which excipient classifies a solution as sugared?
• Which blood pressure medicine should be initiated after ABPM shows 155/100 mmHg?
• What is the standard interval for a tetanus booster in adults with up-to-date vaccination?
• In estrogen-only hormone replacement therapy for a patient with an intact uterus, which step is recommended to reduce endometrial cancer risk?
• Which disease is most likely characterized by Koplik spots followed by a maculopapular rash starting behind the ears?
• A 58-year-old man with heterozygous familial hypercholesterolaemia has been taking Atorvastatin 80 mg and Ezetimibe 10 mg for the past 6 months. His LDL remains above 3.5 mmol/L despite good adherence. What is the most appropriate next step?
• A 50-year-old man with hypertension and a QRISK3 of 15% started Atorvastatin 20 mg three months ago. His baseline LDL was 4.2 mmol/L. What is the most appropriate next step?
• A 12-year-old girl newly prescribed quetiapine for symptoms of bipolar disorder begins at 25 mg twice daily, with the dose increasing up to 100 mg daily over a 7-day period. Which adverse reaction is most likely to be observed when taking or using the medication?
• Which statement best describes the effect of antibiotics on vaginal flora and candida balance?
• Which drug is NOT known to exacerbate psoriasis?
• Which medication would warrant urgent GP review due to teratogenic risk in a patient who plans to conceive?
• A 70-year-old patient with heart failure and reduced ejection fraction remains symptomatic on ramipril and bisoprolol. Which medication is most appropriate to add for symptom relief?
• Which antidepressant is least likely to cause weight gain?
• Which treatment would be least appropriate for a diagnosed bacterial vaginosis?
• A 4-year-old child with acute otitis media is prescribed paracetamol for pain with dosing every 4-6 hours. Which dose is most appropriate?
• Which of the following medicines is a thyroid hormone replacement?
• For a patient using 3 mL insulin pens containing 100 units/mL, daily dose 0.8 units/kg for 30 days, how many pens are required?
• A 62-year-old woman with heart failure who has recently started eplerenone needs monitoring for a potential electrolyte disturbance. Which parameter should be monitored most?
• In the cycle of change, which stage best describes someone who has decided to take action and is actively seeking treatment?
• Which of the following is NOT a symptom of phenytoin overdose?
• Which of the following is a counselling point for a patient starting methotrexate for rheumatoid arthritis?
• Which statement best describes how ciclosporin oral solution should be administered to reduce variability in absorption?
• During a New Medicines Service review, a 47-year-old man with type 2 diabetes and hypertension reports a dry cough since starting a medication. He takes metformin, ramipril, and atorvastatin. What is the most appropriate action?
• Which of the following is most important when dealing with young people accessing healthcare?
• A neonate weighing 2.4 kg is receiving nitroglycerin at 0.2 mcg/kg/min. What is the infusion rate in micrograms per minute?
• Which antidiabetic drug has an associated bladder cancer risk warning?
• In a breastfeeding mother and her 2-week-old infant, which vitamin supplementation is recommended for both?
• Which patient profile is most likely to be prescribed zolmitriptan for migraines?
• A patient with hyperkalemia should avoid which diuretic due to potassium-sparing effects?
• A 36-year-old woman who smokes and has high blood pressure who is looking for short-term contraception for the next two months. Which option is appropriate?
• Which statement best describes RP regulations regarding the Responsible Pharmacist (RP) in a retail pharmacy?
• In a patient with asthma and COPD on Relvar who has had two COPD exacerbations and a high CAT score, which COPD therapy would be most appropriate to use in place of Relvar?
• A patient with creatinine clearance of 13 mL/min is nauseated with two episodes of vomiting. Which antiemetic is most appropriate?
• After 10 years of estrogen-only HRT, the risk of endometrial cancer increases by approximately how many times?
• Which interaction is most important to consider when a patient is on theophylline and digoxin and drinks grapefruit juice?
• A patient requires topical treatment for bacterial vaginosis. The patient is not pregnant. Which medicine is most appropriate for the presenting condition?
• Which medicine is most appropriate to add to Mr R's carbidopa/levodopa regimen to reduce 'off' periods?
• In the same patient, which medication is a calcium channel blocker?
• Which dietary change is most likely to affect Parkinsonian symptoms due to interaction with Levodopa?
• In the asthma regimen Seretide (fluticasone and salmeterol) 250 mcg, one puff twice daily, which component provides long-acting bronchodilation?
• For primary immunisation of children aged between 2 months and 10 years, this vaccination is recommended in the form of 3 doses, separated by 1-month intervals and given in a combination vaccine with tetanus, pertussis, hepatitis B, poliomyelitis and haemophilus influenza type b.
• A 42-year-old woman with osteoporosis started on alendronic acid; which monitoring requirement is most appropriate?
• In the same patient, which medication is an ACE inhibitor?
• A 3-year-old boy presents with barking cough, mild stridor, hoarseness, is afebrile with SpO2 98% on room air. What is the most appropriate treatment?
• A patient with chronic heart failure and edema, with normal liver and kidney function, is prescribed a diuretic to relieve fluid retention. Which diuretic is commonly used?
• Which of the following statements about five-a-day portions is most accurate?
• Which statement about theophylline monitoring is least accurate?
• A 5-year-old girl presents with itching all over, a rash on the arm and neck, and tongue swelling shortly after lunch. What is the most appropriate immediate action?
• A 52-year-old man presents with a new, severe, constant headache located at the back of the head with slight vision changes; paracetamol has not helped. What is the most appropriate action?
• A 4-year-old child has been prescribed montelukast 4 mg tablets at night for the prophylaxis of his asthma. He cannot use inhalers. The father reports sleep disturbances and a stutter. What is the MOST appropriate advice to give to the father?
• In the pediatric pneumonia case, which auscultation finding was reported?
• Which NSAID is considered most appropriate for a patient with a history of myocardial infarction when NSAID use is necessary?
• Which patient profile is most likely to be prescribed zolmitriptan for a migraine?
• Which beta-blocker is most suitable for a patient with chronic heart failure with reduced ejection fraction who is taking atorvastatin, omeprazole, ramipril and metformin?
• Which of the following is a risk factor for osteoporotic fracture?
• In a patient on digoxin who is taking furosemide, which concomitant medication is most likely to contribute to symptoms such as yellow vision and tremors?
• In a 28-year-old pregnant woman in the second trimester with itching and thick, odourless vaginal discharge, what regimen is considered appropriate treatment for vaginal thrush?
• A patient on lisinopril reports a cough. Which side effect is most commonly associated with ACE inhibitors like lisinopril?
• For Helicobacter pylori eradication in a penicillin-allergic patient, which regimen is appropriate?
• Clobetasone butyrate 0.05% (Eumovate) is of what potency?
• Which combined oral contraceptive formulation would be appropriate for a patient with circulatory disease due to cardiovascular risk, requiring a reduced estrogen dose?
• Which safety check is correct when dispensing isotretinoin?
• Which agent is commonly used for acne vulgaris and is associated with skin dryness and irritation?
• Which drug requires plasma concentration monitoring due to narrow therapeutic window?
• Which statement best describes how to manage impulse-control disorder in a patient on a dopamine agonist?
• Which symptom combination is most indicative of perimenopause?
• Which bisphosphonate requires taking with water and staying upright for 30 minutes after to reduce esophageal irritation?
• Which statement best describes the interaction of ferrous sulphate with calcium carbonate?
• Which condition is a contraindication for starting ramipril in an adult with hypertension?
• What is the recommended monitoring period after stopping mycophenolate due to genotoxicity concerns?
• A 58-year-old woman has been prescribed cimetidine for the treatment of gastroesophageal reflux. She has tried two other proton pump inhibitors previously, but they have not eased her symptoms. You check her medical record and notice that she is also on metformin. What is the most likely interaction between cimetidine and metformin?
• A 72-year-old man with acute heart failure requires intravenous digoxin; what quantity of infusion solution should be used to dilute a 2 mL ampoule of digoxin 250 microgram/mL solution for injection/infusion?
• Which statement describes a packaging requirement for sodium valproate?
• A 35-year-old woman has recently started a new medication and is now suffering from facial flushing. Which medication is she most likely to have been started on?
• Which condition is a contraindication for spironolactone?
• A 74-year-old patient has been taking lansoprazole 30 mg daily for 20 years. Following blood tests, an electrolyte change is noted. Which disturbance is most likely?
• The patient has an EF of 55%. Which statement about the ejection fraction is correct?
• What is the primary purpose of maintaining a controlled drugs register in a pharmacy?
• Which statement best describes a pressurised metered-dose inhaler (MDI)?
• Which dietary change should patients avoid while taking lithium therapy?
• A 6-year-old child with ALL on mercaptopurine maintenance; the parent asks about taking the medication with warm milk to help him sleep. What is the most appropriate advice?
• A 53-year-old woman with iron-deficiency anaemia reports stomach discomfort after taking ferrous sulfate 200 mg twice daily. How should she take the tablets to improve absorption and tolerability?
• Which medication in the elderly woman’s chart is most likely responsible for digoxin toxicity through electrolyte disturbance?
• In a Boxing Day emergency supply scenario for a patient with epilepsy, which drug would you NOT supply at the patient’s request without a local service?
• A 60-year-old postmenopausal woman with osteoporosis and a prior wrist fracture; which of the following is the most appropriate first-line pharmacologic treatment to reduce fracture risk?
• In the management of familial hypercholesterolaemia, which of the following is administered by subcutaneous injection?
• A 65-year-old woman with stable angina and a QRISK3 score of 25% has been unable to tolerate multiple statins due to severe myalgia. She has been taking Ezetimibe 10 mg daily for 3 months, but her LDL remains high at 4.2 mmol/L. What is the most appropriate next step?
• Which antiepileptic drug is known to accumulate in infants due to slower metabolism?
• A 26-year-old woman with ulcerative colitis presents with abdominal pain and frequent loose stools mixed with mucus and blood. She is not on any regular medication. Which treatment should be initiated first?
• Canesten thrush cream is indicated to treat which condition?
• Which inhaler would be most appropriate for a COPD patient requiring regular maintenance therapy with normal eosinophil count and no asthma features?
• A 62-year-old woman starting methotrexate for rheumatoid arthritis has been prescribed folic acid. What is the most important counselling point?
• Which medication in this regimen is most likely associated with causing mouth ulcers?
• A 66-year-old man with renal disease is discharged on a diuretic for edema. Which thiazide-related diuretic is appropriate for a patient with an eGFR of 27 mL/min/1.73 m²?
• A 30-year-old female-to-male transgender patient on testosterone therapy has a side effect that may be addressed with an additional medication. Which drug could be prescribed?
• Starting methotrexate requires which monitoring?
• A 70-year-old man presents with stomach cramps and diarrhoea that has lasted 6 days after returning from South America. He takes ramipril and naproxen. What is the most appropriate course of action?
• A 19-year-old university student presents with painful blisters on the lips and tingling sensation. This is her third episode this year. What is the most appropriate treatment?
• What is the correct individual dose of ibuprofen oral suspension for an 8-year-old?
• A 19-year-old woman with moderate inflammatory acne not responding to topical treatment, who uses a contraceptive patch. Which is the most appropriate second-line treatment?
• What is the interval for dose increases when initiating sodium valproate in this patient?
• Following surgery for a mechanical heart valve, which anticoagulant would be most appropriate to administer?
• Which is the most suitable contraceptive for a patient taking carbamazepine for epilepsy?
• If a migraine recurs after the first dose of sumatriptan, what is the maximum daily dose?
• Which activity must cease when the responsible pharmacist is not present but still signed in?
• Which drug pair is associated with a clinically significant interaction when the second drug is added to the first?
• A 60-year-old woman with rheumatoid arthritis is prescribed ibuprofen 400 mg four times daily for joint pain. Her regular meds include ramipril, furosemide, methotrexate weekly, and folic acid weekly. What is the most clinically significant concern when supplying her ibuprofen?
• Which of the following is the correct Cockcroft-Gault Equation for CrCl as provided?
• In a patient with asthma requiring step-up therapy, which option describes the role of an inhaled corticosteroid such as Beclometasone in management?
• For a patient started on theophylline, why is a blood test scheduled after 5 days?
• Mr P presents with painful mouth ulcers that developed two weeks ago. He has been using corticosteroid lozenges. New ulcers have formed with increasing pain and he reports pins and needles. A blood test has been requested. Which of the following is the most appropriate treatment to help manage Mr P's aphthous mouth ulcers at this stage?
• Which is the most appropriate treatment for a 6-year-old child with asthma presenting with wheeze and a peak expiratory flow rate of 60% of the best predicted value?
• Canagliflozin belongs to which drug class?
• A patient on ibandronic acid should be told to report any sign of which symptom?
• A pregnant woman presents at the pharmacy with burning on passing urine and increased urinary urgency. What is the most appropriate action?
• A 51-year-old woman asks for over-the-counter relief for haemorrhoids. Which product would be most appropriate to recommend given her prior response to Anugesic-HC?
• Doses should be taken with plenty of water while sitting or standing, on an empty stomach at least 30 minutes before breakfast or another oral medicine; patient should stand or sit upright for at least 30 minutes after administration. Which medicine has this instruction?
• A pregnant woman with exposure to an ill child worries about infection affecting both her and the baby; which infection is most likely?
• For a 4-year-old child with fever, which paracetamol dosing is suitable?
• An 68-year-old man asks to purchase Flomax Relief MR (tamsulosin 400 micrograms) for urinary symptoms. His current medications include multiple antihypertensives. What is the most appropriate course of action?
• In type 2 diabetes, what is a key reason that insulin therapy may become necessary over time?
• What is the legally required maximum timeframe for a doctor to provide a prescription in an emergency supply scenario?
• Tiotropium is which class of inhaled medication?
• A 44-year-old woman with deep vein thrombosis has moderate renal impairment (creatinine clearance 35 ml/min) and has completed 3 weeks of rivaroxaban. What is the most appropriate rivaroxaban dose for this patient?
• Which drug interaction should be prioritized for notification due to reduced antiplatelet effect when prescribing?
• Which statement is true regarding common insulin regimens?
• A 9-year-old girl with asthma is using a salbutamol inhaler daily and has peak expiratory flow rate 78% of best. The most appropriate next step is to start regular inhaled corticosteroid therapy. Which option describes the correct starting regimen?
• Which antidote would be used to treat loperamide overdose?
• A man faints and is unconscious but is breathing and has a pulse. What is the most appropriate immediate action?
• What is the recommended timing for the second dose of MMR vaccine?
• A 59-year-old woman with type 2 diabetes reports dizziness when standing, early satiety, and occasional diarrhoea with significant blood pressure drop on standing. What is the most appropriate diagnosis?
• Which of the following is a non-opioid analgesic?
• A patient requests a replacement Nitrolingual spray at 11:30 pm with no record of prescription. What is the most appropriate course of action?
• Sildenafil is available over-the-counter for erectile dysfunction. Which of the following patients can be safely supplied sildenafil OTC?
• Which action is most appropriate for a 68-year-old man with type 2 diabetes on ramipril with eGFR 28 and potassium 5.2 mmol/L?
• In the under-18 population, which drug has demonstrated efficacy in treating depression in clinical trials?
• Which statement most accurately reflects folic acid supplementation for someone planning pregnancy while on an antiepileptic?
• A regular patient requests chloramphenicol eye drops for their dog. Which action is most appropriate?
• A 49-year-old STEMI patient not eligible for reperfusion therapy with low bleeding risk; what is the most appropriate medical management to reduce complications?
• Why is it recommended to rinse the mouth after using inhaled corticosteroids?
• A 40-year-old man presents with features suggesting Cushing's syndrome. Which test is most appropriate to diagnose this condition?
• Which topical corticosteroid is considered mild potency?
• Which laboratory parameter is monitored regularly during methotrexate therapy to detect hepatotoxicity?
• Which combination constitutes the triple therapy for H. pylori in a penicillin-allergic patient?
• Duloxetine is licensed for which of the following conditions?
• A 4-year-old girl with tonsillitis is prescribed phenoxymethylpenicillin 125 mg QID for 10 days. If the suspension is 250 mg/5 mL, what is the total quantity in millilitres needed for the entire course?
• In the described postoperative regimen, which drug is the anticoagulant used for DVT prophylaxis?
• What is the recommended interval between instilling latanoprost eye drops and carbomer 0.2% eye gel?
• Which statement is correct regarding threadworm treatment in pregnancy?
• A GP would like to prescribe a moderate-potency corticosteroid but cannot recall a corticosteroid cream of this potency. Which would be suitable to recommend?
• In a 68-year-old woman with type 2 diabetes presenting with an acute uncomplicated lower urinary tract infection and normal renal function, which antibiotic is most appropriate?
• A 56-year-old woman has estrogen-only HRT and is aware that this can increase the incidence of certain cancers. By approximately how many times does the risk of endometrial cancer increase after 10 years of estrogen-only HRT?
• Can a 27 year old breastfeeding female be sold Amorolfine 5% nail lacquer?
• An 82-year-old woman with Alzheimer’s dementia is experiencing dry mouth, constipation, and falls. Which medicine is most important to review given these side effects?
• A 14-year-old girl presents with vaginal itching and cottage cheese-like discharge. The symptoms are new, and she has not been sexually active before. What is the most appropriate course of action?
• In a basal-bolus insulin regimen for type 2 diabetes, which insulin is most appropriate for bolus dosing before meals?
• What is the best course of action for fever in an 8-year-old with chickenpox?
• Risedronate belongs to which class of drugs used to treat osteoporosis?
• Diphtheria with Haemophilus influenzae, poliomyelitis, pertussis and tetanus should be administered at what age?
• A 62-year-old patient has a 10-year risk of cardiovascular disease of 14%. Their GP wishes to prescribe a lipid lowering medication for primary prevention. Which of the following would be the MOST appropriate treatment?
• A 60-year-old man on rivaroxaban 15 mg for DVT asks how to take it. What is the correct regimen?
• Which systemic corticosteroid is included in a COPD rescue pack for a short course?
• A 10-year-old girl has been prescribed paracetamol 250 mg/5 mL for toothache. What is the appropriate dose per administration?
• For seasonal influenza vaccination, which interval is recommended for adults?
• Which drug is an ACE inhibitor commonly used to treat hypertension and may cause a dry cough?
• In the described case of heart failure, which BNP level supports the diagnosis of heart failure with reduced ejection fraction?
• A 30-year-old male reports a tingling sensation followed by a rash that is painful and spreading around the back. Which condition is most likely?
• Which of the following is the most appropriate advice for a patient with a stye?
• A 21-year-old woman with type 1 diabetes visits your pharmacy; She is driving a long 6-hour drive tomorrow. Which is the MOST appropriate advice for this patient?
• A 55-year-old woman presents with fatigue, numbness in her hands and feet, and difficulty maintaining balance. Blood tests show macrocytic anaemia with low haemoglobin and an elevated MCV. Which deficiency is indicated?
• A 31-year-old woman, 10 weeks postpartum, BMI 36, not breastfeeding, requests an oral contraceptive method. Which is most appropriate?
• After a patient stops smoking while taking theophylline, what is the most likely change in theophylline plasma concentration?
• Which outcome is most likely when a patient on warfarin starts Metronidazole?
• An 68-year-old man with type 2 diabetes has gradual vision loss and hasn't attended diabetic eye screening for 3 years. What is the most appropriate diagnosis?
• A patient on statin therapy presents with muscle pain; which is the most common adverse effect of simvastatin at 40 mg daily?
• A 26-year-old pregnant woman with gestational diabetes and fasting plasma glucose of 6 mmol/L; what is the most appropriate initial treatment plan?
• A 15-year-old girl requiring sodium valproate for control of epilepsy after trying other anticonvulsants without success starts on 600 mg twice daily with dose increases every 3 days by 150–300 mg. Which adverse reaction is most likely to be observed when taking or using the medication?
• Which vitamin is routinely given to newborns at birth to prevent hemorrhagic disease?
• A 62-year-old man in ICU for severe sepsis with CKD stage 3 reports worsening hearing loss and tinnitus after 4 days of treatment. Which medication is the most likely cause?
• A patient on ibandronic acid should be told to report any sign of which symptom?
• A 7-year-old boy has a stiff neck and a purple non-blanching rash on the chest and arm, and discomfort with bright light. Which diagnosis is most likely?
• A 16-year-old presents with extreme fatigue, swollen glands, a high temperature and a sore throat. The tongue, uvula and epiglottis appear normal. Which condition is most likely based on these symptoms?
• Which statement about data protection and information governance is false?
• In a hospital cardiology setting, which beta-blocker is most appropriate to recommend for a patient with heart failure and reduced ejection fraction?
• Desmopressin is used for nocturnal enuresis because it is effective in reducing bedwetting in children. Which of the following is a prudent approach when starting therapy?
• Pink sputum in a patient with cough can indicate congestive heart failure. Which color sputum is associated with CHF?
• A 45-year-old woman on nitrofurantoin 100 mg MR capsules twice daily for a 3-day course reports that her urine has turned dark yellow-brown. What is the most appropriate response?
• A 36-year-old man with nut allergy experiences wheezy, lightheaded symptoms after eating at a restaurant. What is the most appropriate immediate action?
• Which intervention is recommended to counteract methotrexate toxicity in overdose?
• Espranor buprenorphine is primarily used for which purpose?
• Can a man w/ Peyronie’s disease be supplied sildenafil OTC?
• Doxycycline should be avoided with which interaction?
• For the treatment of depression in patients under 18 years old, which antidepressant has shown efficacy in clinical trials?
• In the cycle of change, which option best describes the stage labeled as Action?
• Which adverse effect is likely with semaglutide weekly injections for weight management?
• Which formulation corresponds to Ethinylestradiol 20 mcg / Gestodene 75 mcg?
• What is the primary goal of drug treatment for type 2 diabetes?
• Which symptom is most characteristic of rosacea and supports using topical metronidazole as treatment?
• In an end-stage renal disease patient starting dialysis, which laboratory value is most likely decreased and prompts intervention?
• In a patient with hypertension and diabetes, what renal-related benefit is associated with ACE inhibitors?
• Which of the following is not a symptom of phenytoin overdose?
• Under a patient group direction, which sore throat presentation would be eligible for antibiotic dispensing?
• Maximum duration of treatment permitted for phenobarbital under an emergency supply?
• A 57-year-old patient with intermittent chest pains has used ibuprofen 400 mg with little relief and has a history of hypertension and type 2 diabetes. What is the most appropriate course of action?
• Pneumococcal polysaccharide vaccine should be given at what age?
• A 15-year-old girl is prescribed a single dose of 1.5 mg levonorgestrel for emergency contraception. She has severe asthma and also takes phenobarbital for epilepsy. What should she do?
• A mother asks for a paracetamol suspension dose for her 4-year-old child with fever. What is the most appropriate dose and interval?
• A 56-year-old woman with COPD presents with shortness of breath but no fever or sputum production. Which pharmacological treatment is most appropriate for immediate symptom relief at this initial contact?
• Which vitamin deficiency is associated with macrocytic anemia and numbness?
• Which drug is not classified as an opioid analgesic?
• In overdose, which beta-blocker has an under-recognised risk of toxicity?
• A local community pharmacy has run out of stock of Olanzapine 5 mg orodispersible tablets (4 x 28). What detail must be recorded in the POM register when supplying this medicine?
• Desogestrel is an example of which type of contraception?
• Which medication is most likely to have caused haemolytic anaemia in a patient with G6PD deficiency?
• Which statement about Koplik spots is correct?
• A 41-year-old man with a 3-day history of sore throat requests antibiotics. According to national guidance, what is the most appropriate course of action?
• What interval is recommended for regular breast cancer screening in an average-risk older adult?
• What was the prescribed prednisolone regimen in the COPD case?
• 63-year-old woman with suspected digoxin toxicity; which medication is most likely responsible for the interaction?
• A 24-year-old woman visits the pharmacy requesting emergency contraception. Her last period was 10 days ago and unprotected intercourse occurred approximately 60 hours ago. She prefers an oral option and a single-dose method is acceptable. Which is the most appropriate emergency contraception option for this patient?
• As the pharmacist, what is the most appropriate action to take when a 14-year-old requests emergency contraception?
• Which factor can increase the plasma level of theophylline?
• In a 68-year-old man with non-valvular atrial fibrillation and a preference for once-daily dosing, which medication is most appropriate for stroke prevention?
• Which vitamin is used in the management of pernicious anemia?
• A 14-year-old girl with type 2 diabetes and BMI 30 has not achieved HbA1c targets after lifestyle changes. What is the most appropriate medicine to initiate as the next line of treatment?
• A 43-year-old regular patient with shoulder pain on Ramipril 10 mg and Amlodipine 5 mg asks for an OTC analgesic. Which option is most appropriate?
• Which adverse effect is most likely with a 10-day course of co-codamol following a back injury?
• Which of the following represents the correct dosing for cough-free dosing of paracetamol in infants after vaccination?
• In the Alzheimer's case, memantine is added to donepezil therapy when the disease progresses to which stage?
• A father brings a prescription for lactulose for a 6-month-old infant at 2.5 mL twice daily. Which option is the correct advice?
• Which infection presents as dome-shaped papules with central dimples in children?
• Which parameter is routinely monitored for patients starting olanzapine?
• A 69-year-old man with bipolar disorder is on lithium carbonate and bendroflumethiazide. He presents with confusion and slurred speech; lithium toxicity is suspected. Which finding is most likely to be observed?
• In a 4-year-old child with anaphylaxis after a wasp sting, what initial strength of adrenaline should be given intramuscularly, with repeat dosing as required?
• Which of the following is not a symptom that would occur in the event of a phenytoin overdose?
• A 65-year-old man with AF on clopidogrel 75 mg daily asks if he should continue the daily aspirin he was prescribed after MI 2 years ago. What is the best advice?
• Under RP regulations, which statement is true regarding the RP’s role?
• In a hospital setting, which chemotherapy agent is contraindicated for intrathecal use?
• A 45-year-old man experiences dry mouth and constipation. Which medicine should be avoided?
• Which diuretic is a loop diuretic used to rapidly relieve edema in heart failure?
• Which ocular symptom constitutes a red flag that requires urgent ophthalmology assessment?
• A 10-year-old child is prescribed gentamicin to treat a diabetic foot infection. Which condition would increase the risk of ototoxicity with aminoglycosides?
• What is the dose of Ulipristal acetate used for emergency contraception in the described case?
• In the same regimen, which component provides anti-inflammatory action?
• Which statement is NOT an appropriate counselling point for sulfasalazine?
• Fostair is a type of inhaler?
• A 5-year-old child presents with a barking cough and hoarse voice; what is the most appropriate action?
• A 27-year-old woman on sodium valproate is planning pregnancy and asks about contraception. Which method is most appropriate?
• An emergency supply request on a Saturday morning; which is the most appropriate course of action?
• The use of NSAIDs is associated with an increased risk of Cardiovascular events. Which of the following NSAIDs would be the least appropriate for a patient with a past history of Stroke?
• The dosing of morphine given as 2.5 mg every 2 hours regularly describes which pattern of analgesic administration?
• Which of the following is NOT considered a side effect of topical corticosteroids?
• Which combination of symptoms would most indicate potential cardiotoxicity in a patient receiving doxorubicin?
• A father asks how long lactulose will take to work in the 6-month-old. Which statement is correct?
• A 19-year-old woman is starting oral isotretinoin 20 mg daily for severe acne. She currently uses a progestogen-only contraceptive pill. What is the most appropriate advice before supplying isotretinoin?
• A 25-year-old woman presents with urinary frequency (including nocturia), burning on urination, and cloudy urine for two days. She is not pregnant. Which option would be most appropriate?
• Which of the following tasks is a staff member allowed to perform when the Responsible Pharmacist is away from the premises?
• Which serum biochemical parameter is most important to measure to determine if symptoms on amiodarone are drug-related?
• In STEMI when PCI is not available, which therapy restores myocardial perfusion?
• In a postpartum patient who is not breastfeeding and is obese, which statement is most accurate?
• A 50-year-old man presents with a red blistering rash that starts on the right torso and wraps around the belt line, with fever and tingling before the rash appears. What is the most likely diagnosis?
• Which estradiol regimen would be the most suitable alternative for travel for a patient requiring hand-luggage friendly packaging?
• A bipolar patient on lithium who has been started on bendroflumethiazide presents with nausea and tremors. What is the most appropriate action?
• A 58-year-old woman with type 2 diabetes and hypertension develops abdominal pain, dysuria, nocturia, and hematuria. She takes multiple meds including empagliflozin. Which medication is most likely responsible for these urinary symptoms?
• Which rescue therapy is indicated for methotrexate toxicity?
• A young girl presents with a pink, sandpaper-like rash on the chest, a swollen white-coated tongue described as 'strawberry tongue', and flushed cheeks with a high fever. Which diagnosis is most likely?
• When a patient on methotrexate is also taking an NSAID such as ibuprofen, which of the following is the most clinically significant risk to be aware of?
• Which medication risk is increased when combining simvastatin with amlodipine?
• In a 67-year-old man with type 2 diabetes who has vomiting and diarrhea and cannot keep fluids down, which of his regular medicines should be withheld temporarily during an acute illness?
• Which antianginal drug is prescribed for prophylaxis and is taken twice daily at 8 am and 4 pm?
• An 86-year-old woman with metastatic bowel cancer reports abdominal bloating; which laxative choice is least appropriate to prescribe for suspected opioid-induced constipation?
• A patient unknown to you visits the community pharmacy late on a Saturday evening asking for dexamethasone 0.1% w/v eye drops previously prescribed by an optometrist prescriber. What would be the most appropriate response?
• A 65-year-old woman with dysphagia due to Parkinson's Disease; which medication is contraindicated?
• Three days into nitrofurantoin therapy for a pediatric urinary tract infection, the child develops yellow-brown urine. What is the most appropriate advice?
• What is the minimum seizure-free period set by the DVLA before Miss R can learn to drive a car or motorbike?
• To optimize schizophrenia management when clozapine is considered after inadequate response to other antipsychotics, which regimen is appropriate?
• In a routine screening program, how often is colon cancer screening with FIT kit typically offered to average-risk adults?
• A 72-year-old man has an overdose of digoxin. Which of the following is the patient least likely to experience?
• A 29-year-old woman asks for co-codamol tablets; she has purchased co-codamol multiple times in the last two weeks from different staff members and appears irritable. What is the most appropriate course of action?
• Which interval is used for colon cancer screening with FIT kit in average-risk individuals?
• A 78-year-old man prescribed rivastigmine patches; during initial consultation, monitoring importance is explained. Which is a monitoring requirement for rivastigmine?
• The 15-year-old has developed pruritus after being started on 4-hourly Immediate Release Morphine sulphate tablets for palliative care treatment. The on-call consultant asks you for a suitable alternative to be administered orally. Which of the following options is the most appropriate alternative?
• Which statement is NOT a requirement for prescribing and dispensing sodium valproate?
• What is the standard single dose of levonorgestrel used for emergency contraception?
• The 6-in-1 childhood vaccine covers six diseases. Which set of diseases are included?
• A 45-year-old woman presents in your pharmacy not feeling very well. She has a past medical history of asthma. She tells you she has recently been started on a new medication for her asthma. She has been vomiting, is restless and has sinus tachycardia. Which of the options is a likely causative agent?
• Which condition is the most likely indication for a single oral dose of metronidazole 2 g?
• You are working with a newly qualified pharmacist who discloses they are uncomfortable supplying any form of contraception to patients due to their religious beliefs. They ask if you can support them in situations where a contraceptive is requested over the counter or prescribed on prescription. What is the most appropriate action to take in this situation?
• Which symptom described would indicate possible upper GI bleeding in an older adult?
• Which action is appropriate when presented with a Spanish language prescription for a benzodiazepine for status epilepticus?
• Which nasal spray would be considered the most appropriate non-sedating option for a student with hay fever seeking relief?
• A patient on amiodarone reports a dry cough. Which statement best describes the recommended action by a pharmacist?
• A 70-year-old man using an eye drop reports eyelash growth and a change in eye colour. Which anti-glaucoma medication could be responsible?
• A 55-year-old man presents with macrocytic anaemia and a vitamin B12 level of 90 ng/L, with a history of pernicious anaemia. Which treatment is most appropriate to initiate?
• Which lifestyle factor in osteoporosis risk is a known risk factor in the presented profile?
• Which medicine is a direct oral anticoagulant used for treatment of DVT/PE?
• A prescription for tramadol 50 mg capsules for a patient is dated 20 March 2025. The patient collects it on 21 April 2025, and this is their first collection. What is the most appropriate course of action?
• Which two drugs have a clinically significant interaction when used together, such as a calcium channel blocker with a beta-blocker?
• Eplerenone belongs to which class of drug?
• Chlamydia trachomatis is the organism addressed by azithromycin eye drops for trachomatous conjunctivitis in neonates. Which organism is correct for this condition?
• Which medication is most likely responsible for hyponatremia in this patient?
• Which medication holds a definite risk of haemolysis in most individuals with G6PD deficiency?
• Which is a common side effect of verapamil?
• In the same patient, which medication is an antidiabetic agent?
• Which adverse effect is commonly associated with long-term prednisolone use in rheumatoid arthritis?
• Which of the following best describes a potential interaction risk when combining an SSRI with NSAID therapy?
• Which antibacterial would cause decreased sodium valproate concentration?
• A 46-year-old man takes simvastatin 40 mg at night and amlodipine 10 mg daily. What should he do?
• A 29-year-old man with painful urination and urethral discharge; sexually active with multiple partners in the past 6 months. What is the most appropriate treatment?
• What does ACR stand for in a kidney-related context?
• Mercaptopurine is used as maintenance therapy for acute lymphoblastic leukemia. During which phase of ALL therapy is this agent typically used?
• A 5-year-old boy with asthma has mood changes and anxiety. Which medicine should be avoided when selecting treatment?
• A 52-year-old man with newly diagnosed type 2 diabetes, BMI 33 kg/m², HbA1c 58 mmol/mol, normal renal function, and a preference for a medication that supports weight loss. Select the most appropriate antidiabetic medication.
• Which scenario demonstrates a correct safety decision about Amorolfine 5% nail lacquer purchase according to the described age restrictions?
• If clarithromycin is prescribed to a patient who is taking simvastatin, what action is recommended?
• Which drug interaction with methotrexate is demonstrated by the material?
• Which of the following counselling points would be INCORRECT related to semaglutide?
• What is the therapeutic range for theophylline?
• An 83-year-old man with type 2 diabetes has clinic BP 142/88 mmHg. What is the most appropriate clinic BP target according to NICE guidelines?
• A 56-year-old man started on amlodipine reports a side effect 3 weeks into treatment. Which is the most likely?
• A 3-year-old child with localized swelling of the upper eyelid and tearing but no pain or discharge is most consistent with which condition?
• Which symptoms are most likely associated with perimenopause?
• A 79-year-old woman with Parkinson's disease is on Rotigotine patch; At a review she develops new impulse-control behaviours. What is the most suitable recommended action?
• Which of the following insulins is a rapid-acting analog used to control postprandial glucose?
• Do not take indigestion remedies, or medicines containing iron or zinc, 2 hours before or after you take this medicine. Which medicine is described?
• A patient presents a prescription from France for co-codamol 30/500 mg tablets in English. What is the most appropriate course of action?
• How often should alendronic acid be taken for osteoporosis?
• What is the most appropriate treatment for trigeminal neuralgia?
• Who should sign the valproate risk acknowledgment form?
• Which over-the-counter remedy is most appropriate to treat head lice itching?
• A 2-month-old infant presents with severe coughing fits, post-tussive vomiting, and inspiratory whoop; incomplete vaccination; coughing for two weeks. What is the most appropriate treatment?
• Vincristine is included as part of a chemotherapy regimen for a patient with acute lymphoblastic leukaemia. It is essential that the medicine is administered using the correct route to prevent a potentially fatal medication error. Which is the correct route of administration?
• A patient with weight gain, a sedentary lifestyle and moderate alcohol use asks for advice to reduce cardiovascular risk. Which dietary change is most appropriate?
• A 62-year-old woman on levothyroxine for hypothyroidism has a rise in TSH and a fall in T4 after increasing milk intake and starting an iron supplement. What is the most likely cause?
• In a case of diabetic ketoacidosis, which route of insulin administration is used to treat the patient?
• Which statement about the destruction of expired Schedule 2 controlled drugs is true?
• Which health benefit is associated with Combined hormonal contraception?
• A 28-year-old woman with a history of tendon disorders with quinolone use. Which antibiotic is contraindicated?
• To prevent urothelial toxicity from chemotherapy, which drug is most likely prescribed?
• To supply Salbutamol inhalers to a local school, which requirement must be met?
• In the Cycle of Change model, a person who acknowledges a problem and is considering taking action but has not yet begun making changes is in which stage?
• Which medication is used as a rescue inhaler for COPD symptoms in the described patient?
• A mother reports a mild fungal infection around a child’s ear with no otorrhoea and no fever, and the child is steroid-sensitive. What is the most appropriate first-line treatment?
• Why is GP referral considered appropriate for the elderly traveler with diarrhoea lasting 6 days?
• A first dose of this vaccine should be given at 2 months of age and the second at 3 months of age; the vaccine should not be started in children of 15 weeks of age or older.
• A 55-year-old man post abdominal surgery develops fever and signs of wound infection with MRSA colonisation; which antibiotic is most appropriate?
• When monitoring plasma digoxin concentration after a loading dose in a patient with heart failure, which is the most appropriate time to draw the blood sample?
• What is the standard dosing schedule for azithromycin 15 mg/g eye drops to treat trachomatous conjunctivitis in neonates?
• In a community pharmacy with a patient group direction, a patient presents with sore throat begun two days ago, fever 38.2°C, red and swollen tonsils with white pus, able to speak and swallow. What is the most appropriate course of action?
• Which antiviral is appropriate for episodic treatment of oral herpes?
• A 15 kg child requires amoxicillin 20 mg/kg per dose three times daily using an oral suspension of 250 mg/5 mL. What volume per dose is required?
• A 59-year-old man on warfarin is prescribed antibiotics for a suspected infection; which antibiotic is most appropriate with his warfarin?
• Naloxegol acts as a peripheral mu-opioid receptor antagonist with its effects primarily in which location?
• A patient on montelukast for asthma takes St John's Wort for low mood and experiences worsening asthma symptoms and increased use of inhalers. What is the most likely drug interaction?
• Which symptom would not typically be expected as part of phenytoin overdose?
• On night shift, you notice 14 morphine tablets are missing from the register; what is the most appropriate initial action?
• What does the black triangle on a newly licensed medicine indicate?
• What is the minimum age to switch from formula milk to full-fat cow's milk?
• A 13-year-old girl is prescribed benzoyl peroxide 5% gel for acne. Which of the following is a common side effect?
• Following surgery, a patient on maximum analgesia continues to have pain. Which action would be most suitable to manage her pain?
• A 4-year-old child weighing 20 kg is prescribed paracetamol oral suspension 250 mg/5 mL with a dosing guidance of 15 mg/kg per dose every 6 hours, up to four doses in 24 hours. What is the maximum total volume of paracetamol the child can receive in 24 hours?
• A patient with diabetic ketoacidosis is treated immediately. Which regimen is most appropriate to initiate?
• For a Canesten combi 500 mg pessary and 2% cream, how many prescription charges are payable if the patient is not exempt?
• A patient with heart failure who develops a persistent dry cough on an ACE inhibitor and cannot tolerate ARBs should start which combination as first-line therapy?
• Which statement about the initial management of acute ischemic stroke is correct?
• Which medication in Mr T’s profile is most likely causing his symptoms of loss of appetite and fatigue?
• Which statement accurately describes dispensing GnRH analogue private prescriptions in relation to the date 3 June 2024?
• Which symptom accompanying heartburn would most strongly suggest possible gastroesophageal reflux disease requiring medical evaluation?
• Which antiseizure medication has a therapeutic range commonly cited as 10-20 mg/L?
• A police officer asks you to confirm the identity of a patient receiving methadone and who was found with diazepam. What is the most appropriate action?
• A 34-year-old woman with a 3-month history of loose stools, bloating, and fatigue has iron-deficiency anaemia; tissue transglutaminase antibodies are significantly elevated and she awaits endoscopic biopsy. Which of the following would be the most appropriate initial advice?
• Which statement best describes the set of beta-blockers licensed for heart failure?
• In heart failure with preserved ejection fraction not adequately controlled by furosemide, which drug would be recommended?
• Semaglutide for weight loss is administered by injection at what frequency?
• Which drug in the described regimen is used to treat Parkinson's disease?
• Infant colic treatment commonly contains which active ingredient?
• Anoro contains which two pharmacologic classes?
• A patient on verapamil for cluster headaches needs a drug for hypertension. Which antihypertensive would likely cause the most serious interaction with verapamil?
• What is the purpose of 'sick day rules' for medicines with dehydration risks?
• Which statin dose is used for secondary prevention according to NICE guidance?