Pre-reg Q&As: open book practice paper

 
Your pharmacy participates in a local primary care cardiovascular health project involving height and weight measurements of patients. A man whose height is exactly 6ft (six feet) and weighs exactly 12 stones:   

Answer

 
9
 
Multiple completion

Directions:  For the question below, ONE or MORE of the responses is (are) correct. Decide which of the responses is (are) correct. Then choose:
A if 1, 2 and 3 are correct
B if 1 and 2 only are correct
C if 2 and 3 only are correct
D if 1 only is correct
E if 3 only is correct
 

 
In A&E, a three-year-old child weighing15kg is to be given an intramuscular injection of pethidine hydrochloride to relieve acute pain. Which of the following fall within the recommended dosage range?

1.    0.8ml of a 10mg/ml injection

2.    0.3ml of a 50mg/ml injection

3.    0.6ml of a 50mg/ml injection
 

Answer

10
 
Multiple completion

Directions:  For the question below, ONE or MORE of the responses is (are) correct. Decide which of the responses is (are) correct. Then choose:
A if 1, 2 and 3 are correct
B if 1 and 2 only are correct
C if 2 and 3 only are correct
D if 1 only is correct
E if 3 only is correct
 

You are working in a community pharmacy in England and receive a prescription for some ear drops that you are not sure can be prescribed on the NHS. The item is allowable if it is listed in any of the following sections of the Drug Tariff:

1.      Part VIII

2.      Part IXA

3.      Part XVIIIA

Answer

________________________________________

Answers

1: E
 
Rationale
Reference: MEP. The regulation preventing sale of mineralised methylated spirits between the hours of 10pm on Saturday and 8am on the following Monday in Scotland was revoked from September 1, 2009.
 
Syllabus sections

1 Part IIa.

 
2: A
 
Rationale/calculation
Reference: BNF, section 2.7.2 and Appendix 6.
Dose for patient = 4 x 80 = 320micrograms/min = 0.32 mg/min
Maximum permitted infusion concentration = 3.2mg/ml (Appendix 6)
Therefore, infusion rate = 0.32 divided by 3.2 = 0.1ml/min
                                       
 
Syllabus section
2. Part IIa.


3: E
 
Rationale
Reference: MEP. Nitrazepam and lormetazepam are CD Schedule 4a and emergency supplies are permitted. Temazepam is CD Schedule 3, for which emergency supplies are not permitted.   
 
Syllabus section
1. Part IIa.
 
 
4: B
 
Rationale
Reference: BNF, Appendix 5.
Ciprofloxacin: amount in breast milk probably too small to be harmful but manufacturer advises avoid.
Codeine: amount usually too small to be harmful, but mothers vary considerably in their capacity to metabolise codeine with possible risk of morphine overdose in the infant.
Diclofenac: amount too small to be harmful.
A pharmacist would need to contact the prescriber about the first two.

Syllabus sections
2. Part If.
 
5: A
 
Rationale
Amoxicillin capsules are included in the Dental Prescribers Formulary (DPF), which can be found in the BNF and the Drug Tariffs, and may be prescribed on the NHS.   The DPF lists products by their generic titles and dentists are strongly encouraged to prescribe generically, but a product may be prescribed by its brand name providing that the brand is not ‘blacklisted'.

Zinnat (cefuroxime) is not listed in the DPF, but NHS dentists working in secondary care are not restricted to the DPF and can prescribe any drug or medical device that would normally be allowed on an NHS prescription.

Famvir (famciclovir) is not listed in the DPF, but dentists may legally prescribe privately any medicine.

Syllabus section
3a.
 

6: D
 
Rationale
Reference: Drug Tariff, Scottish Drug Tariff. A detailed explanation of Out of Pocket Expenses also appeared in the September 2009 issue of PSNC Community Pharmacy News (England and Wales).  
 
Syllabus section
3a.

 
7: D
 
Rationale
Reference: BNF. All, except Tildiem, are either drugs with a narrow therapeutic index and/or are modified release formulations where bioavailability may vary between brands of the same active drug. Patients should be maintained on the brand on which they have been stabilised and these drugs should not be prescribed generically.
 
Syllabus section:
2, Part I b).
 
8: D
 
Rationale/calculation
Reference: BNF. From conversion tables inside back cover,
6ft = 6 x 0.3 metres = 1.8 metres
12 stones = 76kg
Body mass index (BMI) = Weight in kg
                                       (Height in metres)²
                                       =       76                 
                                           1.8 x 1.8              
                                       =  23.8

Second statement correct because BMI is more than 22.

First statement incorrect because a BMI less than 25 is not considered as overweight.

Syllabus sections
2, Part Ik); Part IIa).

9: A

Rationale/calculation
From BNF, dose range for child = 0.5-2mg/kg.
For child weighing 15kg, dose range = 15 x 0.5mg to 15x 2mg = 7.5 to 30mg.

Option 1 contains 0.8 x 10 = 8mg.
Option 2 contains 0.3 x 50 = 15mg.
Option 3 contains 0.6 x 50 = 30mg.

Therefore, all options (1,2,3) are within the recommended dosage range.

Syllabus sections

2, Part II a)

10: B

Rationale
Reference: Drug Tariff.   Part VIII is the list of allowable drugs, Part IXA is the list of allowable registered medical devices, while Part XVIIIA is the list of drugs and other substances that are not allowable.

Syllabus section

3a.