Instructions to candidates
 For each question answer in the space provided.
 You should answer the questions as though you were a registered pharmacist, not a preregistration trainee.
 There are 40 calculation questions in this paper.
 The time allowance for this paper is 120 minutes.
 You should score one mark for each correct answer; no markswill be deducted for incorrect answers or omissions.
 Reference material may be provided for some questions,these are provided in the extract booklet.
 You may find the resource pack provided useful to answerquestions with this icon
 No additional reference sources may be used in this paper.
 Calculators are permitted in this assessment. .
Resource
Part 1 Resource Pack
Question 2
Question 4
Question 7
Question 9
Question 13
Question 19
Question 23
Question 27
Question 37
End of Resource pack
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Question 1 of 40
1. Question
1 point(s)A 55yearold male patient weighs 74 kg and has several comorbidities. The doctor wishes to estimate his creatinine clearance before starting venlafaxine for his depression. His serum creatinine is 170 micromole/L. Calculate his creatinine clearance (in L/hr) using the CockroftGault equation. Give your answer to two decimal places.

L/hr
CorrectIncorrect 

Question 2 of 40
2. Question
1 point(s)A 34yearold female patient, diagnosed with stage IV breast cancer, is to be given meptazinol 75 mg intramuscularly every 2 hours for acute pain. The nurse will administer the dose using U100 (100 units) insulin 1 mL syringes. How many units should be administered to the patient for a single dose? Give your answer to the nearest whole number.

units
CorrectIncorrect 

Question 3 of 40
3. Question
1 point(s)You are working in the manufacturing department of a pharmaceutical company where you are required to produce hydroxychloroquine sulfate tablets. Each tablet should contain 200 mg hydroxychloroquine sulfate with an excess of 5%. How many kilograms of hydroxychloroquine sulfate would be required to manufacture the batch of 3.5 million tablets? Give your answer to the nearest whole number.
kg
CorrectIncorrect 

Question 4 of 40
4. Question
1 point(s)A 55yearold male patient has been on FERROGRAD oncedaily tablet for irondeficiency anaemia (prophylaxis). FERROGRAD is unavailable and the doctor has agreed on your recommendation to switch to INORM drops for the convenience of the patient. Calculate the volume (in millilitres) of INORM drops this patient would require daily that will be equivalent to a oncedaily FERROGRAD tablet. Give your answer to one decimal place.Note: Ferrous sulfate 300 mg = 60 mg iron]

mL
CorrectIncorrect 

Question 5 of 40
5. Question
1 point(s)A 19yearold male patient (weight 33 kg) has been prescribed 200 mg voriconazole IV infusion every 12 hours for the first two doses and then 150 mg IV infusion every 12 hours. Following reconstitution with 19 mL water for injection, each 200 mg vial is 10 mg/mL. This needs to be further diluted with dextrose 5% to produce 500 mcg/mL final solution for infusion. How much dextrose 5% solution (in millilitres) would you add to the reconstituted vial for the first dose? Give your answer to the nearest whole number.
mL
CorrectIncorrect 

Question 6 of 40
6. Question
1 point(s)A 70yearold female weighing 58 kg has been on phenytoin.
Assuming:
 Vmax = 6 (68 mg/kg/day)
 Km = 6 (5.46.8 mg/L)
 CL = 20 L/day [calculated initially for this patient with the given dose]
The doctor would like to know if she is in the therapeutic range using the equation for Michaelis–Menten model.
where Vmax is the maximum metabolic capacity (mg/day) and Km is the plasma concentration at which the rate of metabolism is half the maximum (mg/L). Calculate the serum concentration (in microgram/mL) of phenytoin in this patient using the given pharmacokinetic parameters. Give your answer to one decimal place.

mcg/mL
CorrectIncorrect 
Question 7 of 40
7. Question
1 point(s)A 4yearold (weight 16 kg) has been brought to A&E due to consumption of an overdose of paracetamol 8 hours ago. A 3mL blood sample reveals 250 mcg of paracetamol. She is started on standard regimen of acetylcysteine IV infusion. How many grams of acetylcysteine will be administered to her in the first 10 hours? Give your answer to one decimal place.
g
CorrectIncorrect 

Question 8 of 40
8. Question
1 point(s)A GP practicebased pharmacist is preparing a presentation on the cost impact of steroid therapy in the practice. Prescribing data indicates that 65 patients are currently on prednisolone 10 mg tablets (one tablet daily). If these patients are switched to two 5 mg tablets of prednisolone once daily, what would be the cost reduction for the practice in one year (365 days)? Give your answer to the nearest whole number.
DT price of prednisolone 5mg tablet (28 tablet pack is £1.00)
DT price of prednisolone 10mg tablet (28 tablet pack is £9.66)

£
CorrectIncorrect 

Question 9 of 40
9. Question
1 point(s)A diabetic patient has been on INSULTARD 30 units in the morning and 25 units in the evening. The independent prescriber wishes to switch it to once daily insulin glargine 300 units/mL. How many units of insulin glargine 300 units/mL per day would be required for this patient? Give your answer to the nearest whole number.
units
CorrectIncorrect 

Question 10 of 40
10. Question
1 point(s)A 74yearold female patient, weighing 62 kg, is receiving diamorphine by slow IV infusion following myocardial infarction. She is to receive 2.5mg followed by 1.25mg at the rate of 1 mg/min. How long (minutes and seconds) will it take to complete the infusion?Give your answers to the nearest whole numbers.
minutes
seconds
CorrectIncorrect 

Question 11 of 40
11. Question
1 point(s)Displacement volume of cefuroxime is 0.2 mL/300mg. How much water for injection (in millilitres) will be required to reconstitute 1.5 g vial of cefuroxime to produce a concentration of 94 mg/mL that is to be given as IV bolus? Give your answer to the nearest whole number.
mL
CorrectIncorrect 

Question 12 of 40
12. Question
1 point(s)Potassium permanganate solution 1 in 2000 is prepared from a stock solution that is 15 times this strength. How much potassium permanganate (in mg) will be needed to make sufficient stock solution if a patient uses 25 mL of the diluted solution each day for 5 days? Give your answer to one decimal place.
mg
CorrectIncorrect 

Question 13 of 40
13. Question
1 point(s)A 35yearold male, weight 75 kg, is going to have a business trip to Malawi for 5 days. He is prepared to start the prophylaxis for falciparum malaria 2 days before his visit. Using the resource provided, calculate how many MALARONE 250 mg/100 mg tablets he would be dispensed to provide complete prophylaxis. Give your answer to the nearest whole number.
tablets
CorrectIncorrect 

Question 14 of 40
14. Question
1 point(s)A 24yearold patient took three instead of one 300 mg tablet of theophylline this morning at 7 AM because of the worsening of his asthma symptoms. He realises that the GP asked him to be extra careful with the dosing of this medicine. He rushes to the nearest A&E to see any physician as the surgery is close at this time. The physician orders serum level of theophylline which is found to be 48 mg/L. At what time the levels are likely to be in the therapeutic range for this patient? Give your answer to the nearest whole number.
Theophylline therapeutic range: 1015 mg/L
Theophylline halflife: 8 hours

PM
CorrectIncorrect 

Question 15 of 40
15. Question
1 point(s)You have received an order in the hospital to prepare a 1000 mL infusion containing 40 mEq of KCl in dextrose 5% and 0.9% sodium chloride. The infusion is to run at the rate of 15 drops/min for 12 hours. The IV set provides 20 drops/mL. How many mmoL of KCl this patient will receive? Give your answer to the nearest whole number.
[Molecular weight of KCL: 74.5]

mmol
CorrectIncorrect 

Question 16 of 40
16. Question
1 point(s)A 6monthold baby (height 65.5 cm; weight 9 kg) has been prescribed Drug A which should be given as a daily dose of 3 mg/m^{2} in two divided doses. Drug A is available as a 250 mcg/mL oral solution. What will be the single dose (in millilitres) of Drug A for this patient? Give your answer to the nearest whole number.
mL
CorrectIncorrect 

Question 17 of 40
17. Question
1 point(s)A 54yearold woman has been started on warfarin for deep venous thrombosis. She has been prescribed the following regimen:
Warfarin 5 mg for the first three days
Then warfarin 4 mg and 3 mg on the alternative days
You have warfarin 1 mg tablets and warfarin 3 mg tablets in stock. Using 3 mg tablets wherever possible, how many 1 mg and 3 mg tablets you would dispense for 4 weeks, provided her INR remains constant? Give your answers to the nearest whole numbers.

1mg tablets
3mg tablets
CorrectIncorrect 

Question 18 of 40
18. Question
1 point(s)A 35yearold male patient (weight: 78kg) is being treated with gentamicin for bacterial meningitis. The peak plasma concentration achieved following the IV loading dose is 12 microgram/mL. The volume of distribution of gentamicin is 0.3 L/kg. Calculate the loading dose (in mg) that was given to this patient. Give your answer to one decimal place.
mg
CorrectIncorrect 

Question 19 of 40
19. Question
1 point(s)A doctor wishes to prescribe potassium citrate mixture for an 8yearold for cystitis. Using the resource provided, calculate how many grams of potassium citrate you would require for a 10day supply for this patient. Give your answer to the nearest whole number.
g
CorrectIncorrect 

Question 20 of 40
20. Question
1 point(s)A 38yearold female weighing 58 kg has been started on sodium nitroprusside for hypertensive crisis. Sodium nitroprusside 50 mg has been diluted in 500 mL of 5% dextrose for the IV infusion. The initial rate of administration of the IV infusion is 0.5 mcg/kg/min which is to be increased every 5 minutes by 0.5 mcg/kg/min. What will be the rate of infusion (in mL/min) after 22 minutes? Give your answer to one decimal place.
mL/min
CorrectIncorrect 

Question 21 of 40
21. Question
1 point(s)A 58yearold patient, weighing 65 kg, is due to receive 2 mEq/kg of sodium chloride. What volume (in millilitres) of 0.9% w/v sodium chloride must be administered? Give your answer to the nearest whole number.
[Molecular weight of sodium chloride: 58.5]

mL
CorrectIncorrect 

Question 22 of 40
22. Question
1 point(s)Formula for ferrous sulfate 1.2% w/v oral solution paediatric BP:Ferrous sulfate 60 mg
Ascorbic acid 10 mg
Orange syrup 0.5 mL
Doublestrength chloroform water to 5 mL
The doctor wants you to prepare 2.5 L of ferrous sulfate 2% w/v oral solution. How many grams of ascorbic acid would be required if you are to prepare this order using the above formula? Give your answer to the nearest whole number.

g
CorrectIncorrect 

Question 23 of 40
23. Question
1 point(s)Due to unavailability, the dermatologist wishes to switch from DIPROSONE cream to BETNOVATE cream for a 24yearold patient with eczema. She asks you how many grams of BETNOVATE 0.1% cream will be equivalent to 30 g of DIPROSONE cream. Give your answer to the nearest whole number.
[Molecular weight of betamethasone dipropionate: 504.576
Molecular weight betamethasone valerate: 476.566]

g
CorrectIncorrect 

Question 24 of 40
24. Question
1 point(s)A 74yearold male has been taking lamotrigine 50 mg standard tablet twice daily for focal seizures. The doctor now wishes to switch to lamotrigine 100 mg dispersible tablet once daily due to his dysphagia. Using the information in the following table, calculate the extra cost that will be incurred for a 4week treatment with this switching. Give your answer to two decimal places.Lamotrigine formulation
Price per 56 tablets
Tablet 50 mg
£2.45
Dispersible tablet 100 mg
£13.63

£
CorrectIncorrect 

Question 25 of 40
25. Question
1 point(s)Drug A is 40% bioavailable when given orally and 75% bioavailable when administered via the transdermal route. If a patient is taking the drug 5 mg three times a day orally, how much (in grams) of 4% w/w transdermal gel must be applied to provide the daily equivalent dose of the drug? Give your answer to one decimal place.
g
CorrectIncorrect 

Question 26 of 40
26. Question
1 point(s)You receive an order to dispense 100 mL drug solution of 2.5 mg/mL concentration. The stock solution available in the pharmacy is 5% w/v which needs to be diluted with syrup. How much syrup (in millilitres) would you need to dispense this order? Give your answer to the nearest whole number.
mL
CorrectIncorrect 

Question 27 of 40
27. Question
1 point(s)A 74yearold woman (weight: 68 kg) has been admitted to the hospital for bacterial meningitis. She is to be started on IV infusion of meropenem as an empirical therapy. Her serum creatinine is found to be 140 micromole/L. Based on the CockroftGault equation and using the resource provided, calculate how many vials of meropenem 1000 mg will be required for 2 days. Give your answer to the nearest whole number.

vials
CorrectIncorrect 

Question 28 of 40
28. Question
1 point(s)A 65yearold woman with chronic obstructive pulmonary disease has been prescribed oxygen therapy at a high flow rate of 4 L/min for 2 days and then adjusted to 2 L/min. She has been dispensed three size F (1360 L) cylinders of oxygen to use for 5 hours a day. After how many days will she need another supply? Give your answer to the nearest whole number.
days
CorrectIncorrect 

Question 29 of 40
29. Question
1 point(s)A 50yearold patient weighing 65 kg was given 500 mg of Drug A orally. The drug is completely excreted unchanged in the urine. The urinalysis reveals 420 mg of the drug present in the urine. Calculate the bioavailability (in percentage) of this drug. Give your answer to the nearest whole number.
%
CorrectIncorrect 

Question 30 of 40
30. Question
1 point(s)A patient with severe pain following surgery requires an IV infusion of fentanyl at a rate of 6 mcg/kg/hour. The patient weighs 90 kg. The medication is available as a 50 mcg/mL solution, and the infusion pump delivers 15 drops/mL. What is the infusion rate in drops per minute? Give your answer to the nearest whole number.
drops/min
CorrectIncorrect 

Question 31 of 40
31. Question
1 point(s)A 4yearold girl weighing 16 kg is to be dispensed DIFFLAM spray for mouth ulcers. Using the resource provided, calculate how much (in mg) active ingredient of the drug she would receive in 2 days if she uses it every three hours. Give your answer to one decimal place.
mg
CorrectIncorrect 

Question 32 of 40
32. Question
1 point(s)You are asked to prepare sucralfate suspension 100 mg/mL using the following formula:Cherry syrup 80 mL
Sorbitol solution 80 mL
Purified water to 250 mL
Sig: 10 mL four times a day
How many 1 g sucralfate tablets should be used in preparing this order? Give your answer to the nearest whole number.

tablets
CorrectIncorrect 

Question 33 of 40
33. Question
1 point(s)You have received an order to prepare 40 clotrimazole pessaries using 2g mold. Each pessary must contain 100 mg clotrimazole. The displacement value of clotrimazole is 0.5. To allow for the wastage, it is recommended that you prepare an additional 20%. How many grams of the base would be required to prepare this order? Give your answer to one decimal place.

grams
CorrectIncorrect 

Question 34 of 40
34. Question
1 point(s)Drug A is used as a mouthwash at a concentration of 0.5% w/v. You have a stock available in the pharmacy that is 25% w/v. You are required to supply 100 mL of the intermediate solution such that when the patient dilutes this intermediate solution 1 in 20, it provides the accurate strength for the mouthwash before use. What would be the strength (in % w/v) of the intermediate solution? Give your answer to the nearest whole number.
w/v
CorrectIncorrect 

Question 35 of 40
35. Question
1 point(s)A 30yearold has been prescribed Sodium Chloride Compound Mouthwash BP for oral mucositis 20 mL to be used for gargling every 4 hours for three days. The order needs to be prepared using the formula in the given table.
Ingredient
Quantity
Sodium chloride
1.5 g
Sodium bicarbonate
1 g
Concentrated peppermint emulsion
2.5 mL
Doublestrength chloroform water
50 mL
Water
to 100 mL
You realise that you have run out of doublestrength chloroform water. How much chloroform concentrate (in millilitres) you would need to dispense this order? Give your answer to the nearest whole number.

mL
CorrectIncorrect 

Question 36 of 40
36. Question
1 point(s)A 2yearold requires 150 mcg of adrenaline intramuscularly for anaphylaxis. What volume (in millilitres) of 1 in 1000 solution of adrenaline should be given? Give your answer to two decimal places.

mL
CorrectIncorrect 

Question 37 of 40
37. Question
1 point(s)A 54yearold female weighing 72 kg has been prescribed tranexamic acid 15 mg/kg (the doctor insists on this dose) for general fibrinolysis to be given by slow IV injection. She has Type 2 diabetes for the last 20 years, and is also reported to have renal and hepatic impairment. Her recent serum creatinine is 130 micromole/L. Based on the appropriate frequency of tranexamic acid for this patient, calculate how many 5 mL ampoules of tranexamic acid 100 mg/mL will be required for the twoday treatment. Give your answer to the nearest whole number.
ampoules
CorrectIncorrect 

Question 38 of 40
38. Question
1 point(s)An infusion pump containing 250 mg dobutamine in 500 mL of Dextrose 5% and 0.45% sodium chloride solution is running at a rate of 1.5 mL/min for a patient weighing 75 kg. Convert this into mcg/kg/min to check if the dose has been calculated accurately. Give your answer to the nearest whole number.
mcg/kg/min
CorrectIncorrect 

Question 39 of 40
39. Question
1 point(s)A 62yearold female requires treatment with an IV antibiotic for the management of sepsis. The antibiotic is available as a powder for injection and is prepared by adding 8.5 mL of WFI to the vial followed by vigorous shaking to produce a solution with a volume of 10 mL. This solution is then drawn up and added to a 250 mL bag of 0.45% sodium chloride before administering the final product to the patient at a rate of 5 mg/mL/min. Calculate the displacement value (in g/mL) of the antibiotic powder for injection. Give your answer to two decimal places.
g/mL
CorrectIncorrect 

Question 40 of 40
40. Question
1 point(s)You are required to prepare a stock solution of 1.5 L potassium permanganate to supply to the patient, such that when 50 mL of this stock solution is diluted with water to 3 L, the resulting solution is 1 in 1000. Calculate the percentage strength w/v of the stock solution and the dilution factor. Give your answers to the nearest whole numbers.

w/v
(dilution factor)
CorrectIncorrect 