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We have recently created new product for letting students familiar with sterile compounding and hazardous drugs. Below is the link for product information.

https://www.pharmacyexam.com/index.cfm/category/183/sterile-compounding--hazardous-drugs.cfm

You can also view sample questions related to this product by visiting following link:

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Pharmacy Exam


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We have recently created new product for letting students familiar with sterile compounding and hazardous drugs. Below is the link for product information.

https://www.pharmacyexam.com/index.cfm/category/183/sterile-compounding--hazardous-drugs.cfm

You can also view sample questions related to this product by visiting following link:

https://www.pharmacyexam.com/index.cfm?fuseaction=category.display&category_id=184

Pharmacy Exam


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A 35-year-old man who is a regular patient of yours comes to your pharmacy counter with a new prescription. His shoulders appear tense and his eyebrows are knit tightly.
 
He says to you, “I can’t believe I have to fill another prescription today. I was just in three weeks ago and spent $75 dollars on some fancy new medication that didn’t do a darn thing!” What might be an appropriate active listening response to this patient?
 
a. It must be very frustrating to have to try something new.
 
b. It’s too bad we can't take a prescription back for a refund.
 
c. I can provide you with a smaller quantity this time.
 
d. Your doctor is trying to find the best medication for you.

Answer (a). It must be very frustrating to have to try something new. Answer “b” does not acknowledge the patient’s feelings; answer “c” moves to finding a solution without acknowledging the patient’s feelings and “d” is placating.


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A 35-year-old man who is a regular patient of yours comes to your pharmacy counter with a new prescription. His shoulders appear tense and his eyebrows are knit tightly.
 
He says to you, “I can’t believe I have to fill another prescription today. I was just in three weeks ago and spent $75 dollars on some fancy new medication that didn’t do a darn thing!” What might be an appropriate active listening response to this patient?
 
a. It must be very frustrating to have to try something new.
 
b. It’s too bad we can’t take a prescription back for a refund.
 
c. I can provide you with a smaller quantity this time.
 
d. Your doctor is trying to find the best medication for you.


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A 35-year-old man who is a regular patient of yours comes to your pharmacy counter with a new prescription. His shoulders appear tense and his eyebrows are knit tightly.
 
He says to you, “I can’t believe I have to fill another prescription today. I was just in three weeks ago and spent $75 dollars on some fancy new medication that didn’t do a darn thing!” What might be an appropriate active listening response to this patient?
 
a. It must be very frustrating to have to try something new.
 
b. It’s too bad we can’t take a prescription back for a refund.
 
c. I can provide you with a smaller quantity this time.
 
d. Your doctor is trying to find the best medication for you.

Answer (a). It must be very frustrating to have to try something new. Answer “b” does not acknowledge the patient’s feelings; answer “c” moves to finding a solution without acknowledging the patient’s feelings and “d” is placating.


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A critical path is one that reaches an end goal in the most direct possible manner. Water in the natural world, will always follow the line of least resistance - riding gravity along the most direct path. Often, we’re hampered throughout our own routines to recognize and chase our daily critical paths. It can be difficult to uncover the best route, and often, even if it is laid out before us – our responsibilities inhibit our progression.


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A critical path is one that reaches an end goal in the most direct possible manner. Water in the natural world, will always follow the line of least resistance - riding gravity along the most direct path. Often, we’re hampered throughout our own routines to recognize and chase our daily critical paths. It can be difficult to uncover the best route, and often, even if it is laid out before us – our responsibilities inhibit our progression.


For a fortunate few though; for those selfless enough to sacrifice themselves for the care of the ill and the injured, there exists a beacon. This torch lighting the path of career progression for the CNA, is the “Nursing Ladder of Success”.  A career spent as a CNA, is very respectable. Few will work as hard. However, it is common for the CNA to climb higher through the ranks of the Nursing track.

Clinical settings are full of nursing professionals at various stages of career growth. As a CNA, buzzing through the hospital amongst a swarm of Medical Assistants, LPN’s, RN’s, and NP’s, we’re able to see exactly what’s possible if we continue with our training and coursework. As a pocket guide for the humming hospital hallway, we refer to our “Nursing Ladder of Success”. 

Citation: http://cnanursing.net


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The 2016 CDC guideline for prescribing opioids suggests to reassess the evidence of “individual benefit and risk” when increasing daily dose to above ____ morphine milligrams equivalent per day.
  
a. 30
b. 50
c. 90
d. 120


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The 2016 CDC guideline for prescribing opioids suggests to reassess the evidence of “individual benefit and risk” when increasing daily dose to above ____ morphine milligrams equivalent per day.
  
a. 30
b. 50
c. 90
d. 120

Answer(b): The 2016 CDC guideline for prescribing opioids suggests to reassess the evidence of “individual benefit and risk” when increasing daily dose to above 50 morphine milligrams equivalent per day, and avoidance of doses greater than 90 MME per day.


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Which of the following information is/are TRUE ABOUT Naloxone? [Select All That Apply].

a. Naloxone hydrochloride is a pure opioid antagonist that competitively binds to μ-opioid receptors only when opioids are present.

b. No tolerance or dependence is associated with naloxone use

c. When comparing the μ-opioid receptor affinity of naloxone with that of most opioids, including heroin, naloxone has a greater affinity to bind to the receptor site.

d. Naloxone has a short duration of activity about 30 to 90 minutes.


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Which of the following information is/are TRUE ABOUT Naloxone? [Select All That Apply].

a. Naloxone hydrochloride is a pure opioid antagonist that competitively binds to μ-opioid receptors only when opioids are present.

b. No tolerance or dependence is associated with naloxone use

c. When comparing the μ-opioid receptor affinity of naloxone with that of most opioids, including heroin, naloxone has a greater affinity to bind to the receptor site.

d. Naloxone has a short duration of activity about 30 to 90 minutes.

Answer: (a, b, c and d). Naloxone was patented in 1961, was first approved by the Food and Drug Administration (FDA) in 1971, and is currently on the World Health Organization’s List of Essential Medicines.

Naloxone hydrochloride is a pure opioid antagonist that competitively binds to μ-opioid receptors only when opioids are present and bound at the receptor site. Naloxone demonstrates no effect on mu, kappa, or delta receptors in a person who has not taken opioids. No tolerance or dependence is associated with naloxone use.

The reversal of opioid toxicity with naloxone is dose dependent. Individuals who have used a particularly potent opioid (e.g., fentanyl), have high concentration of opioids in their system, or have used a long-acting opioid may require more frequent and/or larger doses of naloxone to reverse symptoms.

When comparing the μ-opioid receptor affinity of naloxone with that of most opioids, including heroin, naloxone has a greater affinity to bind to the receptor site. This mechanism allows naloxone to remove the opioid from the receptor site and then bind it more securely. When this occurs, respiratory depression resolves partially or fully (depending on the amount, form, and route of opioids taken), hypotension resolves, and CNS depression abates.

Depending on the type of opioid used, the individual may be at risk for experiencing rebound opioid toxicity and/or acute respiratory depression because of the short duration of activity of naloxone (i.e., 30–90 minutes).

This effect most often occurs when an individual has taken a long-acting opioid such as methadone or extended-release oxycodone. Naloxone’s short duration of action is an important reason to convey to patients that receiving emergency medical care for an opioid overdose is important, even if the person has responded to the naloxone.

Naloxone is not effective in treating overdoses of non-opioid prescription medicines like benzodiazepines or barbiturates. It also is not effective in overdoses with stimulants, such as cocaine and amphetamines, or other non-opioid illicit drugs such as MDMA (Ecstasy, Molly), GHB (G), or ketamine (Special K). However, a polysubstance overdose that includes opioids warrants the use of naloxone.


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Which of the following are administered by Centers for Medicare & Medicaid Services (CMS)? [Select ALL That Apply]
 
a. Medicare
b. Medicaid
c. Clinical Laboratory Improvement Amendments (CLIA)
d. Children's Health Insurance Program (CHIP)



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Which of the following are administered by Centers for Medicare & Medicaid Services (CMS)? [Select ALL That Apply]
 
a. Medicare
b. Medicaid
c. Clinical Laboratory Improvement Amendments (CLIA)
d. Children's Health Insurance Program (CHIP)

Answer (a, b, c and d). The Centers for Medicare & Medicaid Services (CMS), a component of the Department of Health and Human Services (HHS), administers Medicare, Medicaid, the Children's Health Insurance Program (CHIP), the Clinical Laboratory Improvement Amendments (CLIA) and parts of the Affordable Care Act (ACA.
 
Along with the Departments of Labor and Treasury, CMS also implements the insurance reform provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and most aspects of the Patient Protection and Affordable Care Act (PPACA) of 2010 as amended.
 
The Social Security Administration is responsible for determining Medicare eligibility, eligibility for and payment of Extra Help/Low Income Subsidy payments related to Part D Medicare, and collecting some premium payments for the Medicare program.


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Which of the following information is/are TRUE ABOUT Essential Fatty Acids? [Select ALL That Apply]
 
a. Linoleic and alpha-linolenic are essential fatty acids.
b. Arachidonic acid is classified as ‘conditionally essential’ fatty acid.
c. Ideally, in the diet, the ratio of omega-6 to omega-3 fatty acids should be between 1:1 and 4:1.
d. Excessive intake of omega-6 fatty acids can cause the deficiency of omega-3 fatty acids.



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Which of the following information is/are TRUE ABOUT Essential Fatty Acids? [Select ALL That Apply]
 
a. Linoleic and alpha-linolenic are essential fatty acids.
b. Arachidonic acid is classified as ‘conditionally essential’ fatty acid.
c. Ideally, in the diet, the ratio of omega-6 to omega-3 fatty acids should be between 1:1 and 4:1.
d. Excessive intake of omega-6 fatty acids can cause the deficiency of omega-3 fatty acids.

Answer (a, b, c and d). Essential fatty acids, or EFAs, are fatty acids that humans and other animals must ingest because the body requires them for good health but cannot synthesize them.
 
Only two fatty acids are known to be essential for humans: alpha-linolenic acid (an omega-3 fatty acid) and linoleic acid (an omega-6 fatty acid). Some other fatty acids are sometimes classified as "conditionally essential," meaning that they can become essential under some developmental or disease conditions; examples include docosahexaenoic acid and gamma-linolenic acid.
 
It is not only important to incorporate good sources of omega-3 and omega-6s in a diet, but also consume these fatty acids in the proper ratio. Omega-6 fatty acids compete with omega-3 fatty acids for use in the body, and therefore excessive intake of omega-6 fatty acids can inhibit the use of omega-3 fatty acids by the body.
 
Ideally, the ratio of omega-6 to omega-3 fatty acids should be between 1:1 and 4:1. Instead, most Americans consume these fatty acids at a ratio of omega-6: omega-3 between 10:1 and 25:1, and are consequently unable to reap the benefits of omega-3s.
 
This imbalance is due to a reliance on processed foods and oils, which are now common in the Western diet. To combat this issue it is necessary to eat a low-fat diet with minimal processed foods and with naturally occurring omega-3 fatty acids. A lower omega-6: omega-3 ratio is desirable for reducing the risk of many chronic diseases.
 
Arachidonic acid is not one of the essential fatty acids. However, it does become essential if there is a deficiency in linoleic acid or if there is an inability to convert linoleic acid to arachidonic acid.


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Identify the reacting enzyme in the following figure:
 
 
a. Dopa decarboxylase
b. Dopamine β hydroxylase
c. Tyrosine hydroxylase
d. n-Methyl transferase


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Identify the reacting enzyme in the following figure:
 
 
a. Dopa decarboxylase
b. Dopamine β hydroxylase
c. Tyrosine hydroxylase
d. n-Methyl transferase

Answer: Tyrosine hydroxylase.

 



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The laboratory finding reveals that 57 year-old patient is suffering from metabolic acidosis. What kind of metabolic acidosis is he suffering from?
 
ABG: 7.21/32/98   
100% O2 Sat on Room Air
Electrolytes: Na 145 mEq/L, K 4.5 mEq/L, Cl 105 mEq/L, HCO3 25 mEq/L  
 
a.            Anion-gap metabolic acidosis
b.            Non-Anion-gap metabolic acidosis
c.             Cation gap metabolic acidosis
d.            Non-Cation-gap metabolic acidosis


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The laboratory finding reveals that 57 year-old patient is suffering from metabolic acidosis. What kind of metabolic acidosis is he suffering from?
 
ABG: 7.21/32/98   
100% O2 Sat on Room Air
Electrolytes: Na 145 mEq/L, K 4.5 mEq/L, Cl 105 mEq/L, HCO3 25 mEq/L  
 
a.            Anion-gap metabolic acidosis
b.            Non-Anion-gap metabolic acidosis
c.             Cation gap metabolic acidosis
d.            Non-Cation-gap metabolic acidosis

Answer(a):  If the patient is suffering from metabolic acidosis (low pH with low HCO3), the next step is to calculate the anion gap because the anion gap helps determining the etiology of the metabolic acidosis.
 
The anion gap is the difference between the measured serum cations (positively charged particles) and the measured serum anions (negatively charged particles). The commonly measured cation is sodium and the measured anions include chloride and bicarbonate.
 
Anion gap = [Na+] - ([Cl-] + [HCO3-])
 
The normal anion gap value is between 8 and 12. An anion gap of greater than 12 is "increased".
 
The differential diagnosis for an elevated anion gap metabolic acidosis (simply called "anion gap acidosis") differs from the differential diagnosis for an non-elevated anion gap metabolic acidosis (simply called "non-anion gap acidosis").
 
So, in the above example:
 
Anion gap = [Na+] - ([Cl-] + [HCO3-])
 
Anion gap = 145 - (105 + 25)
 
Anion gap = 15
 
The calculated anion gap = 15(above the normal gap of 8-12), therefore there is an anion gap acidosis.


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