Australian Pharmacy Council Ltd

Intern Written Exam

Sample 1

This is an official Intern Written Examination sample paper produced by the Australian
Pharmacy Council Ltd (APC) for practice purposes only.

All questions in this sample paper are no longer used in live or actual examinations and have
been chosen to allow interns to gain exposure to the type of content and layout of questions
on the examination. Live or actual Intern Written Examinations delivered
contemporaneously will vary from this sample paper.

The Intern Written Examination is 125-questions long and candidates have 3 hours to
complete it.

Due to the frequent changes to the scope and content within the practice of pharmacy in
Australia, the APC does not guarantee that the information in this paper is accurate or
relevant once published publicly.

The actual Intern Written Examination is delivered by computer and interns should visit the
APC website for further information, including a link to an online tutorial:

https://www.pharmacycouncil.org.au/interns/prepare-for-an-exam/

Copyright © Australian Pharmacy Council Ltd.

The content of this document is the property of the Australian Pharmacy Council Ltd and
may not be reproduced
Q1

How much elemental calcium (MW = 40 g/mol) does a patient receive per day if taking calcium
carbonate (MW = 100 g/mol) 600 mg twice daily?

A 480 mg

B 2400 mg

C 1200 mg

D 600 mg

E 240 mg

Q2

A patient requires a 5-day course of a medicine, the dose of which is 500 mg once daily on day 1 and
250mg once daily on day 2 to day 5. The medicine is only available as a 150mg dispersible tablet and
is stable after dispersion for 6 hours. What is the minimum number of dispersible tablets required
for the 5-day course?

A 10

B 20

C 16

D 12

E 8

Q3

Phenytoin is available as 5 mL vials at a concentration of 50 mg/mL. The dose required is 15mg/kg

and the patient weighs 75kg. If the required rate of infusion of phenytoin is 40 mg/minute, how long
will it take to complete the infusion?

A 2.8 minutes

B 28 minutes

C 56 minutes

D 18 minutes

E 1.8 minutes
Q4

A patient who uses tramadol 200 mg SR orally mane and 50 mg orally twice daily regularly to control
breakthrough pain, is declared nil by mouth in hospital. What rate of IV morphine infusion would
provide equivalent opioid analgesia if the equieffective analgesia ratio of tramadol oral to tramadol
IV is 1.5:1 and the ratio of tramadol IV to morphine IV is 10:1?

A 16.6 mg/hour

B 694 micrograms/hour

C 187 mg/hour

D 833 micrograms/hour

E 69 mg/hour

Q5

What weight of an ingredient is required to produce 1000 mL of a solution such that 2.5 mL diluted
to 50 mL gives a 0.25% (w/v) solution?

A 5g

B 50 mg

C 50 g

D 25 mg

E 25 g

Q6

A female patient, who is 68 years old and weighs 68kg, presents with a serum creatinine of
0.178mmol/L. What is her approximate serum creatinine clearance rate?

A 10mL/min

B 30mL/min

C 45mL/min

D 60mL/min

E 80mL/min
Q7

A 30 year old female with a starting weight of 65 kg and a height of 160 cm has lost 10 kg. What is
the change in her Body Mass Index (BMI)?

A 1.6

B 2.6

C 3.9

D 1.9

E 4.5

Q8

A patient is prescribed a reducing prednisolone regimen of:

20 mg daily for 5 days, then reduce the daily dose by 5 mg every 3 days, then cease.

How many 5 mg tablets of prednisolone will the patient require for this regimen?

A 20

B 24

C 28

D 30

E 38
Q9

Which of the following is CORRECT, regarding the supply of Pharmaceutical Benefits Scheme (PBS)
prescriptions?

A the same PBS prescription identifying number must apply to each item on the prescription

B a repeat authorisation does not require endorsement by the pharmacist with his/her
approved supplier number

C a pharmacist cannot supply an alternative brand of medicine without reference to the

prescriber

D a pharmaceutical benefit cannot be supplied more times than specified in the PBS
prescription

E the original PBS prescription identifying number is not duplicated on a repeat authorisation
for an item

Q10

Methylphenidate is included in which of the following schedules?

A Schedule 2

B Schedule 3

C Schedule 4

D Schedule 7

E Schedule 8

Q11

For which Poisons Schedule is the following statement a general description?

“Substances with a low potential for causing harm, the extent of which can be reduced through the
use of appropriate packaging with simple warnings and safety directions on the label.”

A Schedule 2

B Schedule 3

C Schedule 4

D Schedule 5

E Schedule 6
Q12

A prescription item designated as a restricted PBS benefit is BEST described as medication…

A that has no PBS restriction on its therapeutic use

B with a low therapeutic index, which requires close monitoring

C that can only be prescribed on the PBS for specific therapeutic uses

D that is restricted and requires prior approval from the Medicare Australia or the Department
of Veterans Affairs for a specific condition

E with a high chance of adverse events, which requires the prescriber to consider carefully the
risk benefit ratio for each specific patient

Q13

The original supply and repeats of a pharmaceutical benefit may be supplied on the same day if the

A doctor has endorsed the prescription “Reg 19”

B doctor has endorsed the prescription “Reg 24”

C item is listed as an “unrestricted benefit”

D patient is the holder of a health care card

E patient has a safety net entitlement

Q14

For which Poisons Schedule is the following statement a general description?

“Substances, the use or supply of which should be by or on the order of persons permitted by State
or Territory legislation to prescribe and should be available from a pharmacist on prescription.”

A Schedule 2

B Schedule 3

C Schedule 4

D Schedule 5

E Schedule 6
Q15

A patient enters the pharmacy wishing to fill a prescription for morphine sulphate SR 30 mg (60),
having had a supply four days previously. What is the MOST appropriate action?

A dispense prescription as written

B ascertain why the patient needs the medication and contact the prescriber to authorise
supply if necessary

C decline to dispense the prescription, as the patient could be misusing the medication

D supply the patient with an over-the-counter (OTC) paracetamol/codeine medication in the

interim

E supply the patient with a restricted amount only

Q16

For which Poisons Schedule is the following statement a general description?

“Substances which should be available for use but require restriction of manufacture, supply,
distribution, possession and use to reduce abuse, misuse and physical or psychological dependence.”

A Schedule 2

B Schedule 3

C Schedule 4

D Schedule 5

E Schedule 8

Q17

Chicken pox vaccine should be completed at

A 3 months

B 6 months

C 18 months

D 5 years
Q18

Which of the following conditions would prevent the use of an angiotensin-converting enzyme
inhibitor?

A bilateral renal artery stenosis

B non-insulin dependent diabetes mellitus

C Ménière’s disease

D hyperlipidaemia

E lupus erythematous

Q19

Which of the following statements is CORRECT regarding paracetamol?

Paracetamol

A has significant anti-inflammatory activity

B induces inhibits cyclo-oxygenase

C is excreted largely unchanged by the kidneys

D can be given by intravenous infusion

E is contraindicated in pregnancy

Q20

Which of the following statements about doxycycline is INCORRECT?

Doxycycline

A can be used in the treatment of rosacea

B may decrease blood methotrexate concentration

C may be taken by children over 8 years of age

D should be taken in the morning rather than at night

E should not be taken after the first 18 weeks of pregnancy

Q21

Which of the following statements about doxycycline is CORRECT?

A it increases the metabolism of phenytoin and should be used with caution in epilepsy

B it is effective as monotherapy in treating infection with Plasmodium falciparum

C it may reduce bone growth in young children

D it should not be used in the second trimester of pregnancy, due to risk of teratogenicity

E it is used at a dose of 100mg bd to treat acne

Q22

A female customer misses a dose of a progesterone only pill. Within how many hours does she have
to take the pill, before contraceptive cover is reduced?

A one

B three

C four

D six

E twelve

Q23

A patient has been taken off fluoxetine and prescribed venlafaxine and told by the doctor to ask the
pharmacist how long to wait before starting the new medication. The BEST advice would be to wait
for

A one day

B two days

C ten to fourteen days

D four to six weeks

E one to two months

Q24

Itching is NOT a symptom of

A allergic dermatitis

B scabies

C fungal infection

D acne vulgaris

E lichen planus

Q25

A worried father brings his 3 year old daughter into your pharmacy. She has had a bad cough and
mild fever spasmodically during the winter which has kept the whole family awake at night. She has
already used a whole bottle of expectorant, which had no effect.

He asks you for a good cough mixture and describes his daughter’s cough as a barking cough, which
is worse at night. There is no phlegm and she gasps for air after coughing.

From the scenario above, you advise the father to take his daughter to the doctor, as you suspect
her cough may be caused by

A pneumonia

B bronchitis

C croup

D post nasal drip

Q26

A female customer asks you about using St Johns Wort, saying she feels a bit ‘down’. You ask what
medications she is taking, as you are concerned about interactions. Which of the following
medications should MOST concern you regarding its combination with St Johns Wort?

A ibuprofen

B tramadol

C codeine

D paracetamol

E dextropropoxyphene
Patient Profile
____________________________________________________________________________________

Patient Name Dick Cross

Address 49 Caffers Place, SUBIACO WA 6051
Age 62 Height 170cm
Sex Male Weight 85kg
Allergies Nil known
____________________________________________________________________________________

DIAGNOSIS

Presenting complaint 1. Elevated blood glucose

Medical history 1. Diabetes Type II

2. Hyperlipidaemia
3. Insomnia
4. Constipation
____________________________________________________________________________________

LAB/DIAGNOSTIC TESTS
Date Test Reference Range
20/7 Urate 0.58 mmol/L (0.18 – 0.47 mmol/L)
20/7 Fasting Blood Glucose 9.0 mmol/L (
1/3 Creatinine 0.16 mmol/L (0.05 – 0.12 mmol/L)
1/3 Cholesterol 6.5 mmol/L (

____________________________________________________________________________________

MEDICATION RECORD
Date Medication & Strength Qty Sig
1/3 Atorvastatin 20 mg 30 i daily
16/1 Docusate 50 mg with Senna 8 mg 90 prn
16/1 Aspirin 100 mg 28 i daily

____________________________________________________________________________________

PHARMACIST’S NOTES
Date Comment
20/7 Patient has been placed on dietary restriction for his elevated blood glucose in the past 2
years. His most recent blood glucose indicates that dietary control alone has not been
adequate.
20/7 Asymptomatic elevated urate
Q27

The MOST appropriate option for the management of the patient’s hyperuricaemia is

A allopurinol started at a dose of 100 mg daily

B allopurinol started at a dose of 300 mg daily

C probenecid started at a dose of 500 mg twice a day

D no treatment be initiated

E colchicine 0.5 mg twice daily

Q28

Which of the following would be an additional risk factor for cardiovascular disease in this patient?

A low homocysteine level

B an elevated serum albumin

C hypertension

D postural hypotension

E waist measurement 75 – 85 cm

Q29

Which of the following medications would be the MOST appropriate to manage Mr Cross’ diabetes?

A metformin

B acarbose

C insulin

D glibenclamide

E rosiglitazone
Q30

Which of the following tests is the BEST indicator of ongoing blood glucose control?

A random blood glucose levels

B three monthly HbA1c levels

C weekly fasting blood glucose levels

D regular serum creatine measurements

E weekly urine testing

Q31

Which of the following primary health initiatives should you strongly recommend to Mr Cross?

A annual ocular examinations

B annual bone density measurement

C faecal occult blood test every 3 months

D prostate specific antigen test every 5 years

E creatine kinase levels every 3 months

END OF PATIENT PROFILE

Patient Profile
____________________________________________________________________________________

Patient Name : Jack Smithers

Address : Room 22, Garren Aged Care Facility
Age : 95 years Height : 180 cm
Sex : Male Weight : 73 kg
Allergies pencillin allergy (rash)
____________________________________________________________________________________

DIAGNOSIS
Presenting complaint 1. Swallowing difficulties and agitation
Medical history 1. Benign prostatic hyperplasia
2. Pacemaker
3. Depression
4. Prostate Cancer
____________________________________________________________________________________

LAB/DIAGNOSTIC TESTS
Date Test Reference Range
3/2 Blood pressure 140/80
____________________________________________________________________________________

MEDICATION RECORD
Date Medication & Strength Qty Sig
3/2 Buprenorphine 10 mcg/hour patch 2 Apply once weekly
3/2 Paracetamol 500 mg 100 2 qid
3/2 Docusate/senna 50 mg/8 mg 90 2 nocte
3/2 Tamsulosin SR 400 mcg 30 1 daily
3/2 Rabeprazole 20 mg 30 1 mane
3/2 Citalopram 20 mg 30 1 mane
3/2 Goserelin acetate 10.8 mg SC 1 Implant every 12 weeks
3/2 Aspirin 100 mg 112 1 mane
24/1 Metoclopramide 10 mg 25 1 tds prn
22/1 Cephalexin 500 mg 20 1 tds course completed
10/1 Roxithromycin 300 mg 5 1 daily course completed
10/1 Oxycodone 5 mg tablets 20 1 qid prn
12/12 Meloxicam 15 mg 30 1 daily - ceased
____________________________________________________________________________________

PHARMACIST’S NOTES
Date Comment
3/2 Visual and hearing impairment. Recent falls and wheelchair bound.
Nursing staff have advised of decreased cognition in patient.
24/1 GP noted no prior problems with cephalexin - cause of nausea unknown.

24/1 GP noted no prior problems with cephalexin - cause of nausea unknown.

Q32

Mr Smithers is becoming increasingly agitated each time tablets are given to him, due to difficulty
swallowing. Which of the following medications the patient is currently taking should NOT be
crushed?

A paracetamol

B citalopram

C aspirin

D oxycodone

E rabeprazole

Q33

Due to the patient’s swallowing difficulties, changes to his medications are necessary to alleviate this
problem. Which of the following recommendations is NOT appropriate?

A oxycodone immediate release tablets, liquid, suppositories or injections can be used

B roxithromycin tablets should not be crushed, but the dispersible tablets can be used

C docusate and senna tablets may be crushed, or other options include suppositories or
lactulose

D tamsulosin tablets may be crushed, or the tablets opened and dispersed in water

E dispersible proton-pump inhibitors should be used and include omeprazole, pantoprazole or

lansoprazole

Q34

Mr Smithers’ pain is currently well managed with regular therapeutic doses of paracetamol and a
weekly buprenorphine patch. If further treatment for chronic pain is required, which of the following
is NOT appropriate in light of the patient’s current medication regimen?

A increased oxycodone dose

B supplementary paracetamol

C higher strength buprenorphine patch

D replace paracetamol with combination paracetamol/codeine

E replace oxycodone tablets with suppositories

Q35

Mr Smithers required metoclopramide for the treatment of nausea. Which of the following
statements regarding metoclopramide is INCORRECT?

A tablets may be crushed

B drowsiness is a common side effect

C oral adult dose for nausea is 0.5 mg/kg every 4-6 hours

D reduce dose in the elderly to reduce risk of extrapyramidal effects

E avoid long term use in depressed patients, as mental state may worsen

END OF PATIENT PROFILE

Patient Profile
____________________________________________________________________________________

Patient Name Beryl Groper

Address 64 Highfield Drive, Thornlie
Age 49 Height 148cm
Sex Female Weight 55kg
Allergies Nil known
_____________________________________________________________________

DIAGNOSIS
Presenting complaint
1. Obstructive airways disease with shortness of breath
Medical history
1. Congestive cardiac disease
2. Glaucoma

_____________________________________________________________________

LAB/DIAGNOSTIC TESTS
Date Test Reference Range
16/10 Temp 37.8°C; Pulse 65bpm;
BP 120/65mm Hg

_____________________________________________________________________

MEDICATION RECORD

Date Medication & strength Qty Sig

2/10 Fluticasone 250mcg and Salmeterol 25mcg 120 ii puffs bd
30/9 Salbutamol nebules 5mg/2.5mL 60 5mg 4-hourly
30/9 Tiotropium 18mg capsules 30 inhale i daily
30/9 Prednisolone 5mg 60 40mg mane
15/9 Betaxolol eye drops 0.25% 5ml ii drops bd
8/8 Enalapril 10mg 30 i daily
6/7 Frusemide 40mg 100 i mane
6/7 Docusate sodium (50mg)and senna (8mg) 90 ii nocte
_____________________________________________________________________

PHARMACIST’S NOTES
Nil
Q36

Beryl recently consulted you at the pharmacy with apparent flu symptoms, which cleared within a
few days. However, three or four weeks later she is still suffering with a persistent, dry night time
cough that is disturbing her sleep pattern. She asks you for a cough suppressant. Which of the
following is the MOST appropriate action for you to take?

A advise her to use the tiotropium capsule at night before bed

B advise her to use the fluticasone/ salmeterol inhaler immediately before using the
salbutamol nebules, to increase activity of the salbutamol

C supply her with a pholcodine elixir, to be taken before bed

D contact her doctor to discuss the patient’s use of enalapril

E supply promethazine tablets, to be taken three times a day with the last dose before bed

Q37

Beryl arrives to collect her regular supply of medication and is complaining of swollen ankles, so
severe that she can’t fit into her shoes. The MOST appropriate action would be for you to

A advise her doctor and suggest Beryl’s frusemide and prednisolone be reassessed

B advise her to increase her frusemide dose to two tablets in the morning and to take a
potassium supplement

C recommend she wear graduated support stockings and elevate her legs more often

D advise her to use her salbutamol more regularly to allow her to undertake gentle walking to
improve her venous return

E advise her to reduce her dose of prednisolone to 5mg

Q38

Beryl later suffers muscle cramps. The MOST likely cause is

A hypocalcaemia due to the prednisolone

B hypokalaemia due to the frusemide and prednisolone

C hyperphosphataemia due to heart failure

D excessive fluid retention of feet and ankles

E drug interaction between enalapril and frusemide

Q39

To improve Beryl’s asthma the doctor could

A change the eye drops

B change the enalapril

C increase the frusemide

D change the tiotropium to an inhaler

E reduce and cease the prednisolone

Q40

You should ensure that Beryl’s prednisolone dose is reduced slowly because

A stopping quickly may induce an asthma attack

B inhaled steroids need to be increased slowly

C the adrenal glands may be suppressed

D electrolytes need to return to normal slowly

E the possibility of rebound wheezing

END OF PATIENT PROFILE

Patient Profile
____________________________________________________________________________________

Patient Name David Frost

Address 27 Christmas Parade, Wagga Wagga, NSW 2073
Age 70 Height 168cm
Sex Male Weight 75kg
Allergies Nil known
____________________________________________________________________________________

DIAGNOSIS
Presenting complaint 1. Diarrhoea

Medical History 1. Osteoarthritis

2. Hypertension
3. Cardiac Failure
____________________________________________________________________________________

LAB/DIAGNOSTIC TESTS
Date Test Reference Range
7/4 Potassium 6.0 mmol/L (3.5 – 5.0 mmol/L)
7/4 Creatinine 0.23 mmol/L (0.05 – 0.12 mmol/L)
7/4 Urea 36 mmol/L (3 – 8 mmol/L)
____________________________________________________________________________________

MEDICATION RECORD
Date Medication & Strength Qty Sig
31/3 Paracetamol 1 gram 100 tds
31/3 Celecoxib 200 mg 30 i daily
31/3 Frusemide 80 mg 100 i daily
6/1 Lisinopril 10 mg 30 i daily
6/1 Spironolactone 25 mg 100 i daily
6/1 Frusemide 40 mg 30 i daily
6/1 Glucosamine 1500 mg 60 i daily
__________________________________________________________________________

PHARMACIST’S NOTES
Date Comment
7/4 The patient was admitted to hospital following two days of severe diarrhoea, - one
week after the patient was started on celecoxib and the dose of frusemide was
increased.
Q41

The MOST likely cause of the results of the laboratory tests that have been provided for this patient
is

A liver failure

B acute renal failure

C respiratory distress

D hyperkalaemia

E worsening cardiac failure

Q42

Which of the following medications is MOST likely to cause gynecomastia in Mr Frost?

A lisinopril

B celecoxib

C frusemide

D glucosamine

E spironolactone

Q43

Mr Frost is on spironolactone for his cardiac failure. What is the usual recommended dose of this
medication in patients with cardiac failure?

A 400 mg daily

B 100 mg daily

C 25 mg twice a day

D 25 mg once a week

E 25 mg once a day
Q44

Which of the following combinations of medications is MOST LIKELY to cause acute renal failure in
this patient?

A spironolactone, frusemide, paracetamol

B frusemide, lisinopril, celecoxib

C paracetamol, frusemide, lisinopril

D celecoxib, lisinopril, glucosamine

E lisinopril, spironolactone, glucosamine

Q45

The patient is currently taking celecoxib, which is a selective inhibitor of cyclo-oxygenase type 2
(COX-2). What is the mode of action of this type of medication?

A stimulates the production of prostacyclin (PGI2)

B inhibits the production of prostacyclin (PGI2)

C stimulates the production of thromboxane (A2)

D inhibits the production of thromboxane (A2)

E inhibits both prostacyclin (PGI2) and thromboxane (A2)

END OF PATIENT PROFILE

Patient Profile
____________________________________________________________________________________

Patient Name Ms Cecily Weary

Address 17 Filamore Street, Portland, SA
Age 19 Height 160cm
Sex Female Weight 58kg
Allergies Nil known

_____________________________________________________________________
DIAGNOSIS

Presenting complaint 1. Emergency contraceptive advice

_____________________________________________________________________

MEDICATION RECORD
Date Medication & Strength Qty Sig

_____________________________________________________________________

PHARMACIST’S NOTES
Date Comment
Current Patient has had unprotected sex in the last 24 hours and has consulted her
doctor for advice, as she feels at risk of falling pregnant.
Q46

Ms Weary’s doctor has recommended oral levonorgestrel. Which of the following statements is
CORRECT regarding this method of emergency contraception?

A oral levonorgestrel must be taken within the first 72 hours after unprotected intercourse to
have a contraceptive effect

B levonorgestrel has more severe side effects when taken as emergency contraception
compared to its use as regular contraception

C levonorgestrel with ethinyloestradiol (2 doses of four tablets, 12 hours apart) is considered

to be as effective as the oral levonorgestrel regimen

D oral levonorgestrel emergency contraception has been shown to increase the risk of ectopic
pregnancy

E oral levonorgestrel does not induce a withdrawal bleed, although irregular bleeding may
occur occasionally

Q47

Ms Weary is breast-feeding her seven month old month old son. Which of the following is the MOST
appropriate advice to give the patient?

A milk supply will significantly decrease

B the child should not be breast-fed for at least 24 hours

C emergency contraception is safe to take during breast-feeding

D emergency contraception should not be taken if breast-feeding

E emergency contraception dose should be split over twelve hours to minimise excretion into
breast milk

Q48

Which of the following should you recommend to Ms Weary, regarding the MOST effective time to
take hormonal emergency contraception?

A immediately

B immediately after the next breastfeed

C within 12 hours of unprotected sex

D 72 hours after unprotected sex

E with the evening meal to increase absorption

END OF PATIENT PROFILE

Patient Profile
____________________________________________________________________________________

Patient Name Kay Sutton

Address 66 Argyle St Hackett
Age 23 Height 171 cm
Sex Female Weight 58 kg
Allergies Metoclopramide
____________________________________________________________________________________

DIAGNOSIS

Presenting complaint 1. Urinary tract infection

Medical history 1. Asthma

2. Type 1 diabetes
3. Bipolar Disorder
____________________________________________________________________________________

LAB/DIAGNOSTIC TESTS
Date Test Reference Range
12/1 Lithium 0.8 micromol/L 0.5 – 1.2 micromol/L
____________________________________________________________________________________

MEDICATION RECORD
Date Medication & Strength Qty Sig
12/1 Insulin glargine 20iu - bd
12/1 Insulin lispro 10 iu - tds
12/1 Lithium 250mg tab 100 2 tds
12/1 Ethinyloestradiol/levonorgestrol 4x28 1 daily
12/1 Salbutamol 100mcg MDI 1-2 inh prn

____________________________________________________________________________________

PHARMACIST’S NOTES
Nil
Q49

Ms Sutton presents to your pharmacy with a script for cephalexin. Which of the following is the
MOST appropriate advice?

A cease taking the oral contraceptive pill when taking this antibiotic

B avoid alcohol while taking this antibiotic

C start taking acidophilus to prevent vaginal thrush

D start taking cranberry juice to treat the urinary tract infection

E use barrier contraceptive measures while taking this antibiotic

Q50

Ms Sutton requests a product containing sodium citrotartrate to relieve the burning associated with
her urinary tract infection. Which of the following statements is CORRECT?

A the increase in urinary pH will decrease the renal clearance of lithium

B the renal clearance of lithium will increase with the use of sodium citrotartrate

C the antibacterial activity of cephalexin will be increased with the use of sodium citrotartrate

D the tubular reabsorption of lithium will increase with the use of sodium citrotartrate

E lithium and sodium citrotartrate granules can be safely used in combination

Q51

Regarding the Ms Sutton’s insulin, which of the following statements is INCORRECT?

A insulin lispro should be administered 30 minutes after each meal

B the vial in use can be stored at room temperature for 28 days

C insulin lispro is injected subcutaneously

D insulin glargine is referred to as a basal release insulin

E insulin glargine should not be mixed with insulin lispro before each injection
Q52

Ten days later Ms Sutton has been referred to your pharmacy by the doctor for a treatment for
vaginal thrush. Which of the following statements regarding oral fluconazole is CORRECT?

A it must be accompanied by topical antifungal therapy

B it must be taken on three consecutive days

C it is contraindicated in diabetes

D it is not recommended for use by pregnant woman

E the course should be repeated in seven days

Q53

Ms Sutton’s doctor contacts you for advice regarding her bipolar disorder therapy. He says that
while her condition is well controlled, she is complaining of nausea and fine tremor. Which of the
following recommendations is the MOST appropriate?

The lithium

A should be taken one hour before food

B could be changed to a sustained release preparation

C dose should be increased by 50%

D dose should be decreased by 50%

E should be replaced with olanzapine

END OF PATIENT PROFILE

Patient Profile
____________________________________________________________________________________

Patient Name Peter Barnard

Address Room 19, Garran Ward
Age 9 Height 120 cm
Sex Male Weight 25 kg
Allergies Nil Known
____________________________________________________________________________________

DIAGNOSIS

Presenting complaint 1. Urinary tract infection

Medical history 1. Chronic renal failure

2. Streptococcal glomerulonephritis
____________________________________________________________________________________

LAB/DIAGNOSTIC TESTS
Date Test Reference Range
16/11 Creatinine 0.42 mmol/l 0.02-0.06 mmol/l
16/11 Calcium 2.3 mmol/l 2.1-2.6 mmol/l
16/11 Phosphate 2.4 mmol/l 1.1-1.8 mmol/l
16/11 Potassium 5.8 mmol/l 3.5-5.0 mmol/l
16/11 Urinalysis: Pseudomonas aeruginosa detected
____________________________________________________________________________________

MEDICATION RECORD
Date Medication & Strength Qty Sig
16/11 Calcium Carbonate 1.5g 100 i bd cc
16/11 Calcitriol 0.25 mcg 100 i daily
16/11 Darbopoietin 30 mcg 5 i weekly subcut
16/11 Enalapril 5mg 30 i bd
16/11 Sodium bicarbonate 840mg 100 i tds
16/11 Ferrous sulphate 325mg 30 i daily
16/11 Folic acid 0.5mg 100 i daily
16/11 Nifedipine SR 30mg 30 i bd
16/11 Hydralazine 25mg 100 i tds
__________________________________________________________________________

PHARMACIST’S NOTES
Date Comment
17/11 Admitted to hospital with a urinary tract infection. Patient is pyrexial with a
temperature of 39oC and looks unwell”. BP is 130/90. Recently stable on peritoneal
dialysis.
Patient is on transplant waiting list awaiting renal transplant.
Patient has gum hypertrophy.
Q54

The patient has chronic kidney disease. Which of the following statements regarding this condition is
INCORRECT?

A protein starts to pass into the urine

B anaemia is a complication that must be treated or prevented

C hypercalcaemia occurs due to deficient vitamin D production

D toxins such as urea and creatinine build up and cause problems

E risk factors include diabetes mellitus, hypertension and increasing age

Q55

Which of the following medications is MOST likely to be the cause of the patient’s gum hypertrophy?

A calcitriol

B enalapril

C ferrous sulphate

D nifedipine

E hydralazine

Q56

The patient is experiencing hyperkalaemia. Which of the following statements is CORRECT regarding
the patient’s condition?

A the patient’s potassium levels indicate severe hyperkalaemia

B the patient’s current medications are not likely to be a contributing factor

C oral frusemide can be given to promote potassium excretion

D muscle weakness, cardiac arrhythmia and myalgia are common symptoms

E the use of NSAIDs should be avoided in this patient

Q57

Which of the following IV antibiotics is the MOST suitable treatment against Pseudomonas
aeruginosa for this patient?

A amoxycillin

B vancomycin

C ceftriaxone

D ciprofloxacin

E gentamicin

Q58

The patient has hyperphosphataemia. Which medication dosage could be increased to reduce his
phosphate level?

A calcium carbonate

B calcitriol

C sodium bicarbonate

D darbepoetin

E enalapril

END OF PATIENT PROFILE

Patient Profile
____________________________________________________________________________________

Patient Name Janine Smitters

Address 2B Nursing Home
Age 72 Height 152 cm
Sex Female Weight 50 kg
Allergies Nil Known
____________________________________________________________________________________

DIAGNOSIS

Presenting complaint 1. Fractured neck of femur

Medical history 1. Rheumatoid arthritis

2. Hypertension
____________________________________________________________________________________

LAB/DIAGNOSTIC TESTS
Date Test Reference Range

____________________________________________________________________________________

MEDICATION RECORD
Date Medication & Strength Qty Sig
3/11 Enoxaparin 40mg/0.4mL 10 i daily subcut
3/11 Paracetamol 500mg/codeine 8mg 50 ii qid
22/10 Oxazepam 30mg 25 i bd
22/10 Diclofenac 25mg 50 i tds
7/10 Prazosin 5mg 100 ½ tds
5/9 Atenolol 50mg 30 i mane
5/9 Perindopril 4 mg 30 i daily
____________________________________________________________________________________

PHARMACIST’S NOTES
Date Comment
2/11 Patient admitted to acute care hospital after a fall.
Patient has been taking diclofenac for 2 years.
Q59

The doctor has decided to cease the oxazepam and asks for your advice. Mrs Smitters has been on
this medication for 3 years. The MOST appropriate advice to give the doctor is to

A stop the oxazepam immediately

B change to temazepam and reduce the dose over a few weeks

C reduce the oxazepam dose by 15mg a day for 4 days before ceasing

D change to an equivalent dose of diazepam and gradually reduce the dose over 3 weeks

E reduce the dose of the oxazepam to one tablet on alternative nights, over a 4-6 week period

Q60

Following Mrs Smitters’ fall, osteoporosis is suspected. Before initiating alendronate, all of the
following investigations should be undertaken EXCEPT

A bone mineral density

B vitamin D and calcium levels

C hepatic function

D renal function

E full dental assessment

Q61

Which of the following medications is LEAST likely to have contributed to Mrs Smitters’ fall and
subsequent fractured femur?

A prazosin

B atenolol

C diclofenac

D perindopril

E paracetamol/codeine
Q62

At a follow-up appointment, Mrs Smitters’ hypertension is found to have worsened. The MOST
appropriate management would be to

A increase the prazosin dose

B increase prazosin and atenolol dose

C initiate frusemide and potassium supplementation

D cease prazosin and initiate verapamil

E cease perindopril and initiate irbesarten

END OF PATIENT PROFILE

Patient Profile
____________________________________________________________________________________
Patient Name John Coles
Address 16 Adam Street, Hillcrest
Age 69 Height 173cm
Sex Male Weight 63kg
Allergies Penicillin
____________________________________________________________________________________
DIAGNOSIS
Presenting complaint
1. Ischaemic heart disease
2. Gout
Medical History
1. Mild left sided heart failure
2. Hypothyroidism
3. Transient Ischaemic attacks (TIA)
____________________________________________________________________________________

LAB/DIAGNOSTIC TESTS
Date Test Reference Range
____________________________________________________________________________________
MEDICATION RECORD
Date Medication & strength Qty Sig
20/6 Naproxen 500mg 50 bd prn
20/6 Diltiazem 180mg 30 1 mane
20/6 Aspirin 100mg 90 1 mane
15/5 Thyroxine 200mcg 200 1 mane
20/4 Temazepam 10mg 25 1 nocte
20/4 Frusemide 40mg 100 1 mane
20/4 Colchicine 0.5mg 100 1– 2hrly until pain
ceases
16/2 Thyroxine 100mcg 200 1 mane
____________________________________________________________________________________
PHARMACIST’S NOTES
Date Comment
20/6 Naproxen to be used until acute attack of gout settles.
Q63

Which of Mr Coles’ medications is MOST likely to cause deterioration of his heart failure?

A diltiazem

B thyroxine

C frusemide

D aspirin

E colchicine

Q64

The use of low dose aspirin by Mr Coles

A will reduce the effectiveness of the frusemide

B has the same gastrointestinal bleeding risk as placebo

C may mask the symptoms of hypothyroidism

D is indicated for TIA despite a possible adverse effect on his gout

E will be sufficient to reverse an acute attack of gout

Q65

Mr Coles has been prescribed naproxen to be used when needed for acute gout. Which of the
following statements is CORRECT?

A a single daily dose of naproxen would be more effective, so take two tablets at night when
necessary

B naproxen cannot be taken at the same time as aspirin in the morning, so take two tablets at
night when necessary

C naproxen should only be taken when necessary for gout pain. Continue the aspirin regularly

D cease naproxen

E aspirin should not be taken, whilst taking naproxen for gout

Q66

Since 15 May, Mr Coles has noticed an increased incidence of chest pain. Which of the following is
the MOST likely cause?

A the introduction of diltiazem

B interaction between frusemide and diltiazem

C excessive use of naproxen for gout

D interaction between frusemide and naproxen

E increased dose of thyroxine

Q67

Mr Coles is prescribed cefaclor for a respiratory tract infection. The incidence of cross sensitivity to
cephalosporin in patients with penicillin allergy is

A 1%

B 3%

C 10%

D 15%

E 20%

Q68

Mr Coles has previously been prescribed colchicine for acute gout. The MOST likely reason for
ceasing colchicine and commencing naproxen would be

A colchicine increased the elimination of thyroxine by causing diarrhoea

B an interaction between colchicine and frusemide, causing the precipitation of urate crystals
in the kidneys

C colchicine is contraindicated in patients with heart failure due to increased fluid retention

D for a patient with heart failure, it is more appropriate to use colchicine at lower doses for
prophylaxis

E that nausea, vomiting and diarrhoea occurred before appropriate symptom relief was
achieved

END OF PATIENT PROFILE

Medical Profile
_____________________________________________________________________

Patient Name Marilyn Jones

Address 5 Backus Avenue, WESTBOURNE, TAS 7001
Age 56 Height 168cm
Sex Female Weight 62kg
Allergies Nil known
_____________________________________________________________________

DIAGNOSIS

Presenting complaint 1. Tremor, nausea, vomiting and blurred vision

Medical history 1. Bipolar depression

2. Heart failure
3. Atrial fibrillation
_____________________________________________________________________

MEDICATION RECORD
Date Medication & Strength Qty Sig
7/10 Lithium Carbonate 250mg 200 i bd
Digoxin 62.5mcg 100 ii daily
Perindopril 4mg 30 i daily
Spironolactone 25mg 100 i daily
Frusemide 20mg 100 i daily
_____________________________________________________________________

PHARMACIST’S NOTES
Date Comment
7/10 Patient reports recent bout of dehydration and diarrhoea (suffered during her
holiday last week).
Q69

Which of the following is the MOST likely cause of Mrs Jones’ presenting symptoms?

A hypertension

B gastroenteritis

C urinary tract infection

D decreased lithium and digoxin clearance

E increased lithium clearance and digoxin clearance

Q70

This patient has bipolar disorder. Which of the following may be a suitable medication to allow for a
decrease in lithium dose, while maintaining control of her psychiatric illness?

A diazepam

B oxazepam

C carbamazepine

D phenelzine

E chlorpromazine

Q71

Which of the following is CORRECT, with regards to using digoxin in atrial fibrillation (AF)?

A it has a high therapeutic index

B it should not be used as monotherapy

C it is no longer indicated for the treatment of AF

D the onset of effect occurs 2 – 3 hours after initial dose

E is useful in achieving satisfactory resting ventricular rate control in patients with chronic AF
Q72

Mrs Jones is commenced on venlafaxine. Her other medications remain unchanged. She suffers
confusion, hypermania and sweating. Which of the following may explain Mrs Jones sudden
deterioration?

A 'significant decrease in synaptic lithium concentration

B significant decrease in hepatic function

C decrease in synaptic adrenaline concentration

D increase in potassium concentrations

E 'precipitation of serotonin syndrome

Q73

Mrs Jones also complains of an irritating cough. Which of the following options is MOST likely to
address this issue without compromising the management of her medication?

A decrease perindopril to 2mg per day

B replace perindopril with lisinopril 5mg per day

C replace perindopril with candesartan 8mg per day

D increase frusemide to 80mg per day

E add irbesartan at 300mg per day

END OF PATIENT PROFILE

Patient Profile
_____________________________________________________________________

Patient Name Mr Brian Furter

Address 43 Albion Way BRIGHTON
Age 35 Height 174cm
Sex Male Weight 78kg
Allergies Nil known
_____________________________________________________________________

DIAGNOSIS

Presenting complaint 1. Red, inflamed, itchy rash on lower trunk of body

2. Slightly elevated temperature
_____________________________________________________________________

LAB/DIAGNOSTIC TESTS
_____________________________________________________________________

MEDICATION RECORD
Date Medication & Strength Qty Sig
_____________________________________________________________________

PHARMACIST’S NOTES
Date Comment
Patient indicated he first noticed the rash 24 hours ago and has just seen the doctor
and received a script for Valaciclovir for shingles.
Q74

The recommended dose of valaciclovir for the treatment of herpes zoster is

A 500mg twice daily for 5 days

B 500mg three times a day for 7 days

C 1g daily for 7 days

D 1g three times a day for 5 days

E 1g three times a day for 7 days

Q75

Which of the following statements is CORRECT regarding the effectiveness of the patient’s
treatment?

Treatment must

A not be commenced until rash clears

B be commenced within 12 hours of noticing the rash

C be commenced within 24 hours of noticing the rash

D be commenced within 72 hours of noticing the rash

E be commenced within 120 hours of noticing the rash

Q76

Which of the following statements is CORRECT regarding herpes zoster?

A early treatment reduces the incidence of post-herpetic neuralgia

B dosage adjustment of guanine analogues is required in hepatic impairment

C is not contagious after three days from the appearance of a rash

D herpes zoster is activated from a latent state

E topical aciclovir must be used as an adjunct to systemic antivirals, for the treatment of
herpes zoster ophthalmicus
Q77

The MOST effective topical treatment for the patient’s post herpetic pain is

A aqueous cream with menthol 3%

B diclofenac gel 1%

C paraffin based ointment with menthol 3%

D betamethasone gel 0.02%

E capsaicin ointment 0.05%

Q78

Which group of people in the community is MOST likely to contract herpes zoster with greater
severity?

A pregnant women

B adults > 65 years of age

C immuno-suppressed patients

D children up to the age of 14

E diabetics

END OF PATIENT PROFILE

Patient Profile
____________________________________________________________________________________

Patient Name Thomas Lipton

Address Room 9, Paediatric Ward
Age 7 years Height 125cm
Sex Male Weight 30kg
Allergies Carbamazepine (Agranulocytosis)
____________________________________________________________________________________

DIAGNOSIS

Presenting complaint 1. Fever (temperature 39.2oC)

2. Increased seizure activity
3. Vomiting

Medical history 1. Cerebral Palsy

2. Epilepsy (poorly controlled seizures)
____________________________________________________________________________________

LAB/DIAGNOSTIC TESTS
Date Test Reference Range
____________________________________________________________________________________

MEDICATION RECORD
Date Medication & Strength Qty Sig

17/3 Diazepam 5mg 50 i tds

17/3 Sodium Valproate 200mg 100 i bd
17/3 Lamotrigine 50mg 100 i bd
17/3 Vigabatrin 500mg 100 i daily
17/3 Phenytoin 30mg 100 i bd
17/3 Phenytoin 50mg 100 I bd
____________________________________________________________________________________

PHARMACIST’S NOTES
Nil
Q79

Which of the following statements regarding epilepsy in childhood is INCORRECT?

A epilepsy is one of the most common chronic neurological conditions of childhood

B the majority of children with a first unprovoked seizure will have a recurrence

C antiepileptic medication treatment should not be commenced routinely after the first
unprovoked seizure

D potential adverse effects of antiepileptic medications are a major determinant in the choice
of medication

E if seizure free for two or more years, withdrawal of antiepileptic treatment should be
considered

Q80

Which of the following would NOT be an appropriate treatment for someone with acute status
epilepticus?

A intranasal midazolam

B rectal diazepam

C rectal paraldehyde

D oral sodium valproate

E buccal midazolam

Q81

The doctors are concerned about whether the doses of anticonvulsants are appropriate and enquire
as to whether measuring blood levels of the patient’s anticonvulsants would be useful. For which of
the following anticonvulsants are plasma levels of MOST value in clinical practice?

A diazepam

B lamotrigine

C sodium valproate

D phenytoin

E vigabatrin
Q82

Which of the following anticonvulsants is MOST likely to be associated with visual field effects?

A diazepam

B lamotrigine

C sodium valproate

D phenytoin

E vigabatrin

Q83

In conversation with the medical staff, Thomas’ mother mentions that he has gained a lot of weight
recently. Weight gain is a well recognised side effect of which of the following anticonvulsants?

A sodium valproate

B lamotrigine

C phenytoin

D tiagabine

E phenobarbitone

END OF PATIENT PROFILE

Q84

A patient with epilepsy comes into your pharmacy and tells you she is pregnant. She is concerned
about the effect of her medication on the baby. Which of the following statements is the MOST
appropriate advice?

A epilepsy medications should be ceased during pregnancy

B epilepsy medications are safe to use during pregnancy

C the dosage of current medications should be reduced to minimum levels

D the risk to the baby is greater from uncontrolled epilepsy than from the medication

Q85

What is the recommended period (for females) for folate supplementation before conception and
during pregnancy?

A one week before conception and the 1st month of pregnancy

B one month before conception and the 1st month of pregnancy

C three months before conception and the 1st three months of pregnancy

D one month before conception and the 1st three months of pregnancy

E one month before conception and the entire duration of pregnancy

Q86

Which of the following is NOT a risk factor for cardiovascular disease?

A thyroid dysfunction

B increased HDL

C increased LDL

D hypertension

E diabetes
Q87

One of your regular patients presents a prescription for prednisolone 25 mg orally daily for the
treatment of asthma. What is the optimal time to take this medication?

A at lunchtime

B at bedtime

C on an empty stomach in the morning

D with or after breakfast

E anytime of the day without respect to food

Q88

Which of the following would be INAPPROPRIATE advice on caring for a pruritic rash?

A keep the area cool

B wash area with soapy water, prior to applying cream

C only use cotton clothing to cover the area

D avoid shampoos on the area

E avoid hot water

Q89

Alendronate can be taken

A daily or once weekly

B with milk to enhance absorption

C at bedtime to avoid possible drowsiness

D half an hour before food or one hour after a meal

E in the morning with breakfast to avoid stomach upset

Q90

With which of the following medications is it MOST important to maintain a high fluid intake?

A spironolactone

B ciprofloxacin

C indapamide

D cephalexin

E frusemide

Q91

Which of the following medications is MOST appropriate for the prevention of nausea and vomiting
in Parkinson’s disease?

A ondansetron

B domperidone

C metoclopramide

D prochlorperazine

E hyoscine

Q92

A male customer presents the following prescription for his recurrent urinary tract infection

Rx Norfloxacin tablets 400 mg mitte 14 + 1 Rpt

Sig i bd

Which of the following should NOT be included in your counselling of the patient?

A maintain a good fluid intake whilst being treated with norfloxacin

B take on an empty stomach one hour before or two hours after food

C avoid taking urinary alkalinisers during treatment with norfloxacin

D see your doctor as soon as possible in the event of muscle or tendon soreness or
inflammation

E take medication for three days and stop; recommence if symptoms recur within 48 hours
Q93

What advice should you give when a woman on a combined oral contraceptive presents with a
prescription for doxycycline for bronchitis? She should be advised that

A there will be a decreased risk of breakthrough bleeding

B doxycycline will increase the incidence of thromboembolic disorders and she should take
aspirin 100mg daily

C doxycycline may affect the efficacy of the ‘pill’ and she should take additional contraceptive
precautions this month

D the contraceptive pill may affect the efficacy of doxycycline and she should cease the pill and
use barrier contraceptive methods

Q94

Which of the following vitamins has antioxidant properties?

A ascorbic acid

B ergocalciferol

C pantothenic acid

D folic acid

E cyanocobalamine

Q95

A customer comes into your pharmacy complaining of a headache. You elicit other symptoms –
nausea, stiff neck, sensitivity to light and fever. Which of the following is MOST consistent with this
patient’s symptoms?

A tension headache

B cluster headache

C meningitis

D migraine

E sinusitis
Q96

A person presents with a twisted ankle which occurred an hour prior to visiting the pharmacy. What
advice should you give as first-aid treatment?

A suggest aspirin or another non-steroidal anti-inflammatory medication and apply a heat pack
with the foot elevated

B apply a cold pack for 15 minutes at a time, elevate the ankle and apply a compression
bandage

C try some gentle exercise to prevent the joint stiffening up and give ibuprofen

D massage frequently with methyl salicylate cream, apply heat and take
paracetamol/codeine/doxylamine tablets, elevate the ankle

E rest with the ankle elevated and apply a cold pack for 5 minutes every 30 minutes, for two
hours following the injury

Q97

A customer, who is 8 weeks pregnant, comes into the pharmacy for a worm treatment for her
family. Her children are showing signs of infestation. Her son is 6 years of age and her daughters are
18 months and 4 years of age. Which of the following treatments should you recommend?

A pyrantel embonate given to the whole family

B pyrantel embonate given to the son only

C mebendazole given to the whole family

D mebendazole given to the son only

Q98

Which of the following statements regarding oral electrolyte replacement fluids is CORRECT?

A the fluids relieve gas-related abdominal discomfort

B the fluids are first line for the treatment of diarrhoea in children

C the fluids bond toxins and bacteria and form a protective intestinal lining

D rice-based preparations reduce stool output in patients with non-cholera diarrhea, as

opposed to glucose-based preparations

E higher osmolality preparations are more effective than reduced sodium hypo- osmola
preparations
Q99

In what situation would the use of glucosamine plus chondroitin for osteoarthritis be considered
INAPPROPRIATE?

A sulfonamide allergy

B penicillin allergy

C asthma

D seafood allergy

E peanut allergy

Q100

All of the following could be used to treat motion sickness EXCEPT

A promethazine theoclate

B domperidone

C dimenhydrinate

D hyoscine hydrobromide

E pheniramine

Q101

A customer, who is six months pregnant, is concerned that she has been suffering mild constipation
over the last week. She says that she has not experienced this for a long time and feels sure that it
must be connected to her pregnancy. Which of the following treatments would be INAPPROPRIATE
for her constipation?

A bulk laxatives

B moderate exercise

C stimulant laxative

D high fibre diet

E increased fluid intake

Q102

With regard to maldison (malathion) head lice lotion, which of the following statements is CORRECT?

A hair must be wet before application

B allow hair to dry naturally after use

C the lotion must be rinsed out after 10 minutes

D the shampoo product is preferred to the lotion

E it is recommended as safe to use during pregnancy

Q103

In treating methotrexate overdose, what is the agent of choice?

A sodium bicarbonate

B acetylcysteine

C filgrastim

D folinic acid

E folic acid

Q104

A customer asks for your advice when purchasing a laxative for her husband who is taking morphine
for cancer pain. Which of the following would be the LEAST appropriate?

A docusate sodium 50 mg, total sennosides 8 mg

B bisacodyl

C docusate sodium 50 mg

D ispaghula husk in an effervescent base

E glycerin suppositories
Q105

What advice should you give to a customer requesting a decongestant nasal spray for a stuffy nose,
due to a head cold?

A use twice a day until nose is clear

B use once daily for 5 days

C do not use continuously for more than five days

D use three times a day for a minimum of one week until clear

E use on alternate days only until nose is clear

Q106

Which of the following statements is INCORRECT regarding scabies?

A symptoms include pimple-like irritations in skin folds

B treatment with permethrin requires 2 applications 1 week apart

C the itch generally lasts 2–3 weeks and is not a sign of ongoing infection

D a person remains infectious until 24 hours after treatment is commenced

E infestation occurs after brief contact with household items or pets

Q107

Which of the following is NOT a risk factor for Chronic Obstructive Pulmonary Disease?

A genetics

B smoking

C occupational pollutants (smoke, fumes)

D obesity

E alpha-1 antitrypsin (enzyme) deficiency

Q108

The local doctor phones your pharmacy for advice on treatment for his patient, who works as a
fireman and is suffering from his annual bout of seasonal allergic rhinitis. The patient is 6 weeks into
a 3 month course of ketoconazole. Which of the following treatments should you recommend as the
MOST appropriate, to manage his acute symptoms?

A pseudoephedrine 60mg three times daily

B promethazine 25 mg twice daily

C fexofenadine 60 mg twice daily

D prednisolone 5mg daily for 10 days

Q109

All of the following medications have been used for the treatment of attention deficit hyperactivity
disorder (ADHD) EXCEPT

A methylphenidate

B clonidine

C imipramine

D sertraline

E dexamphetamine

Q110

Which of the following statements regarding psoriasis is INCORRECT?

A treatment with dithranol is more feasible when plaques are large

B coal tar is photosensitising and may be irritating to the face, genitals and skin folds

C calcipotriol is useful in the treatment of resistant plaque psoriasis, as tolerance does not
occur

D salicylic acid assists in the removal accumulated scale to allow topical agents to penetrate
lesions

E topical corticosteroids have a slower onset of action than other topical treatments, but
prolong the period between relapses
Q111

Which of the following applies to oral typhoid vaccine?

The vaccine

A can be given concurrently with antibiotics

B can be given any time before commencing antibiotics

C can be given immediately after finishing a course of antibiotics

D should not be given within one week of taking antibiotics

Q112

Which of the following combinations of medications is MOST likely to cause hypokalaemia?

A indomethacin/salbutamol

B insulin/salbutamol

C insulin/amlodipine

D amlodipine/indomethacin

E insulin/propranolol

Q113

A number of medications interact with warfarin to cause life-threatening situations. Which of the
following medications is MOST likely to alter the INR?

A enalapril

B hydrochlorothiazide

C sulfamethoxazole-trimethoprim

D cephalexin

E propranolol
Q114

Which of the following statements is CORRECT with regard to analgesic nephropathy?

Analgesic nephropathy is

A characterised by chronic liver failure

B a chronic kidney disease that can lead to end stage renal failure

C an acute kidney disease caused by a high doses of analgesics

D characteristic of heavy aspirin dosage and not seen in association with other analgesics

E an easily reversible condition with little associated pathology

Q115

A regular patient in your pharmacy is stabilised on life-long warfarin therapy having had a mitral
valve replacement 6 months ago. He has just been found to have high serum triglyceride and
cholesterol levels and has a prescription for nicotinic acid 250mg tds. Which of the following
statements is CORRECT?

A the recommended dosage of nicotinic acid is 750mg once daily

B nicotinic acid is contraindicated in patients with mitral valve replacements

C fenofibrate is first line treatment for this patient

D nicotinic acid can increase the anticoagulant response to warfarin in some patients, so close
monitoring is required

E nicotinic acid does not interact with warfarin and is not contraindicated in this patient

Q116

The dosage of aciclovir should be adjusted on the basis of

A pre-existing hepatic impairment

B pre-existing renal impairment

C time since onset of symptoms

D occurrence of side effects

Q117

A 74 year old male patient has been on digoxin for heart failure for several years. His recently
measured digoxin plasma level was within the normal range. He presents you with a prescription for
phenytoin 200 mg bd, which is a new addition to his regular therapy. Which of the following is
CORRECT?

A phenytoin may induce the hepatic metabolism of digoxin

B phenytoin may decrease the hepatic metabolism of digoxin

C digoxin may decrease the hepatic metabolism of phenytoin

D digoxin may increase the unbound concentration of phenytoin in the blood

E phenytoin is unlikely to interact with digoxin, since digoxin is cleared largely by renal
excretion

Q118

Which of the following is NOT an adverse effect associated with long term corticosteroid use?

A weight gain

B increased susceptibility to infection

C rounding of the face

D osteoporosis

E hyperkalaemia

Q119

Which of the following tests should be carried out regularly for patients taking amiodarone?

A serum cholesterol and triglycerides

B ocular examination and thyroid function test

C thyroid function test and blood glucose

D thyroid function test and blood urea nitrogen

Q120

Which of the following BEST monitors the anticoagulant effect of heparin?

A the level of AST in serum

B international normalised ratio (INR)

C a complete blood examination

D the level of albumin in serum

E activated partial thromboplastin time (APTT)

Q121

Which of the following combinations may cause a clinically significant medication interaction?

A phenytoin, atenolol, hydrochlorothiazide, ranitidine

B lithium, fosinopril, frusemide, thyroxine

C amiodarone, ranitidine, pravastatin, metformin

D metoprolol, ramipril, frusemide, clopidogrel

Q122

Which of the following biochemical abnormalities can predispose patients to lithium toxicity?

A hypernatraemia

B hyponatraemia

C hypokalaemia

D hypermagnesaemia

E hypoalbuminaemia
Q123

Which of the following medications would NOT be used in the management of atrial fibrillation?

A warfarin

B verapamil

C digoxin

D amiodarone

E perhexiline (use ivabradine for CAOP)

Q124

Which ONE of the medication combinations could NOT account for symptoms of muscle pain,
weakness and/or dark coloured urine?

A gemfibrozil / glibenclamide

B pravastatin / metoprolol

C gemfibrozil / pravastatin

D glibenclamide / metoprolol

E glibenclamide / pravastatin

Q125

A female patient, 48, has just been prescribed oestradiol patches 37.5 mcg/24hour. In your
counselling to her, you should advise her to place a new patch

A on her chest every Monday morning and Thursday evening

B in a different place every day

C on her upper buttocks every three to four days

D in the same place twice a week

END OF EXAMINATION
Australian Pharmacy Council Ltd
Intern Written Exam
Sample 1: Answers
Question Correct Answer
1 A
2 D
3 B
4 D
5 C
6 B
7 C
8 E
9 D
10 E
11 D
12 C
13 B
14 C
15 B
16 E
17 C
18 A
19 D
20 B
21 C
22 B
23 C
24 D
25 C
26 B
27 D
28 C
29 A
30 B
31 A
32 E
33 D
34 B
35 C
36 D
37 A
38 B
39 A
40 C
41 B
42 E
43 E
44 B
45 B
46 E
47 C
48 A
49 E
50 B
51 A
52 D
53 B
54 C
55 D
56 E
57 D
58 A
59 D
60 C
61 E
62 E
63 A
64 D
65 C
66 E
67 C
68 E
69 D
70 C
71 E
72 E
73 C
74 E
75 D
76 D
77 E
78 C
79 B
80 D
81 D
82 E
83 A
84 D
85 D
86 B
87 D
88 B
89 A
90 B
91 B
92 E
93 C
94 A
95 C
96 B
97 A
98 B
99 D
100 B
101 C
102 B
103 D
104 D
105 C
106 E
107 D
108 C
109 D
110 E
111 D
112 B
113 C
114 B
115 E
116 B
117 E
118 E
119 B
120 E
121 B
122 B
123 E
124 D
125 C