Bachelor in Pharmacy Licensure Exam preparation SET 2

Q1

What is the primary mechanism by which Thalidomide is believed to induce phocomelia?

A

Direct damage to fetal bone marrow

B

Disruption of placental circulation

C

Interference with limb bud development

D

Increased fetal metabolic rate

Q2

Determining the initial publication date of the Nepalese National Formulary is significant because it indicates:

A

An established framework for pharmaceutical information

B

Immediate adoption of global pharmaceutical standards

C

A solely government-controlled drug market

D

A focus on exclusively imported medications

Q3

What is the primary function of a pharmaceutical formulation's excipients?

A

To completely replace the active pharmaceutical ingredient.

B

To alter the drug's chemical structure.

C

To aid in drug delivery and stability.

D

To directly increase the drug's potency.

Q4

A pharmacist is checking a batch of Metformin tablets with a 'Last' expiry date of 30th March 2023. Which factor is MOST critical in determining their acceptability?

A

The number of tablets remaining in the container

B

The storage conditions of the packaging

C

The color of the tablets

D

Assessed degradation levels of the active ingredient

Q5

What is a common side effect of Atropine?

A

Dry mouth

B

Bronchoconstriction

C

Hypotension

D

Bradycardia

Q6

Which drug is commonly used as an adjunct in the initial phase of TB treatment specifically to prevent the emergence of resistance?

A

Pyrazinamide

B

Rifampicin

C

Ethambutol

D

Cycloserine

Q7

Which of the following best represents a clinical consequence directly associated with Protein-Energy Malnutrition?

A

Enhanced Cognitive Function

B

Improved Lymphocyte Proliferation

C

Increased Cardiac Output

D

Growth Retardation

Q8

The Drug Act of 2035/1978 in Nepal primarily focuses on:

A

Promotion of traditional health practices

B

Funding for pharmaceutical research

C

Regulation of drug manufacturing and sales

D

Standardization of medicinal plant cultivation

Q9

Paracetamol's analgesic action is predominantly mediated through which pathway?

A

Opioid receptor agonism

B

Inhibition of prostaglandin synthesis (COX pathway)

C

Direct nerve stimulation

D

Activation of TRP channels

Q10

According to the Drug Act provisions, what is the primary authority to prohibit the sale, distribution, export, or import of drugs?

A

Individual Pharmacists

B

Government

C

Pharmaceutical Manufacturers

D

Pharmacy Councils

Q11

Which macrolide is most associated with CYP3A4 inhibition and drug-drug interactions?

A

Tetracycline

B

Clarithromycin

C

Erythromycin

D

Azithromycin

Q12

What does the term 'coalescence' refer to in the context of aerosol formulation?

A

Increase in particle density

B

Separation of phases

C

Stabilization of the solution

D

Merging of small particles into larger ones

Q13

The limited anti-inflammatory effect of Paracetamol is mainly due to its:

A

Lack of significant COX inhibition

B

High opioid receptor affinity

C

Rapid metabolism to morphine

D

Strong effect on peripheral nerve conduction

Q14

The 'satellite pharmacy system' is best described as:

A

Pharmacy services provided at decentralized locations within the hospital

B

A dedicated pharmacy solely for pediatric patients

C

A method for controlling drug costs through bulk purchasing

D

A system for managing all medication orders from a single, central pharmacy

Q15

Which of the following is the primary mechanism of action of Praziquantel in treating helminth infections?

A

Inhibition of DNA synthesis in parasites.

B

Contraction of parasite muscle, leading to immobilization and death.

C

Directly killing the parasite with a toxic substance.

D

Increasing the parasite's metabolic rate.

Q16

Organophosphorus poisoning primarily affects the nervous system by inhibiting which enzyme?

A

Cytochrome P450

B

Acetylcholinesterase

C

Monoamine oxidase

D

Angiotensin-converting enzyme

Q17

Which of the following best describes the function of 'Menstrum' during the isolation of alkaloids?

A

It directly increases the potency of the extracted alkaloids.

B

It's used to completely destroy the plant material.

C

It selectively dissolves the desired alkaloids while leaving behind unwanted components.

D

It neutralizes any acidic components in the plant material.

Q18

Which system allows for direct patient medication administration at the bedside?

A

Bedside pharmacy

B

Satellite pharmacy system

C

Unit dose system

D

Floor/ward stock system

Q19

A primary function of a hospital pharmacy is to:

A

Manage hospital finances.

B

Dispense medications and provide drug information to healthcare professionals.

C

Perform diagnostic tests.

D

Conduct surgical procedures.

Q20

Which of the following is a correct conversion for the French scale?

A

1Fr = 3 mm

B

1Fr = 1 mm

C

1Fr = 0.5 mm

D

1Fr = 0.33 mm

Q21

What is a primary goal of utilizing the 'Essential Drugs' concept in a healthcare setting?

A

To maximize the use of expensive, branded drugs.

B

To promote the development of novel, patentable drugs.

C

To ensure access to the most critical medications needed for effective treatment.

D

To minimize the cost of drug purchases.

Q22

What is the significance of a 'Brand Name' in pharmaceutical nomenclature?

A

It indicates the drug's chemical structure.

B

It represents the drug's potency.

C

It's the proprietary name assigned by the manufacturer.

D

It's automatically associated with the generic name.

Q23

Which of the following is a common adverse effect associated with the use of reversible cholinesterase inhibitors?

A

Bradycardia

B

Tachycardia

C

Hypertension

D

Muscle fasciculations

Q24

Cefotaxime's primary use is in treating infections caused by which type of bacteria?

A

Gram-negative bacteria

B

Gram-positive bacteria

C

Anaerobic bacteria

D

Fungi

Q25

A patient receiving gentamycin develops hearing loss. This is MOST likely a consequence of...

A

Neurotoxicity

B

Nephrotoxicity

C

Cardiotoxicity

D

Gastric Ulceration

Q26

Which indicator is MOST appropriate for titrating a strong base with a weak acid?

A

Methyl red

B

Crystal violet

C

Phenolphthalein

D

Methyl orange

Q27

Which side effect is commonly associated with Pilocarpine (cholinergic agonist)?

A

Tachycardia

B

Hypertension

C

Diuresis

D

Bradycardia

Q28

Which drug is associated with persistent nonproductive cough?

A

Enalapril

B

Metoprolol

C

Losartan

D

Amlodipine

Q29

What is the most important factor in determining the appropriate dose of Atropine in organophosphorus poisoning?

A

The time since exposure

B

The specific organophosphate involved

C

The patient's symptoms and severity of poisoning

D

The patient's age

Q30

What does the term 'Bioavailability' in the context of pharmaceutical sciences refer to?

A

The patient's perception of the drug's effectiveness.

B

The total cost of producing a pharmaceutical product.

C

The extent and rate at which a drug reaches the systemic circulation from the site of administration.

D

The drug's interaction with the patient's immune system.

Q31

What is the primary purpose of clinical pharmacy practice?

A

Regulatory compliance

B

Patient-centered care

C

Drug development

D

Hospital administration

Q32

According to the Pharmacy Council Act, a core role of a pharmacist primarily involves:

A

Dispensing medications accurately and safely.

B

Marketing and selling pharmaceutical products to healthcare professionals.

C

Negotiating drug prices directly with manufacturers.

D

Conducting extensive pharmaceutical research and development.

Q33

Which of the following best describes the intended action of an enteric coating?

A

To accelerate gastric emptying.

B

To mask the drug's taste.

C

To protect the drug from degradation in the stomach.

D

To increase drug solubility immediately.

Q34

Which of the following best describes the mechanism of action of penicillin derivatives?

A

Interference with bacterial metabolism

B

Inhibition of protein synthesis

C

Inhibition of DNA replication

D

Inhibition of bacterial cell wall synthesis

Q35

Organophosphates inhibit acetylcholinesterase. What is the primary pharmacological rationale for using Atropine in this context?

A

To block muscarinic receptors

B

To increase acetylcholinesterase activity

C

To induce vomiting

D

To directly reverse the organophosphate's effect

Q36

What term refers to a rough, uneven surface on the tablet caused by improper lubrication?

A

Sticking

B

Picking

C

Lamination

D

Binding

Q37

What is a core function of the Medication Therapy Committee (MTC) in a hospital setting?

A

Managing hospital administrative budgets

B

Conducting drug trials for new medications

C

Reviewing and optimizing medication therapy for patients

D

Designing hospital architecture

Q38

What is a common side effect of Prazosin?

A

Postural hypotension

B

Dry mouth

C

Bronchodilation

D

Bradycardia

Q39

A higher therapeutic index indicates:

A

Increased potency

B

Reduced dose variability

C

Greater safety margin

D

Higher efficacy

Q40

For diabetes management, which drug is typically included in a formulary?

A

GLP-1 receptor agonists

B

Sulfonylureas

C

Insulin glargine

D

Metformin

Q41

Which antifungal is associated with photosensitivity reactions and requires sun protection?

A

Ketoconazole

B

Nystatin

C

Griseofulvin

D

Fluconazole

Q42

The use of sulfonamides is most effective against bacteria that:

A

Depend on PABA for folate synthesis.

B

Utilize glucose as their primary energy source.

C

Possess a high metabolic rate.

D

Have a thick peptidoglycan layer in their cell wall.

Q43

The classification 'Gaa' for Pethidine signifies which of the following?

A

Controlled substance with highest restriction

B

Limited prescription requirements

C

Over-the-counter availability

D

Generally available without specific controls

Q44

A patient presents with symptoms consistent with an anaphylactic reaction. Which of the following medications should the pharmacist prioritize for immediate administration?

A

Diphenhydramine

B

Epinephrine

C

Aspirin

D

Acetaminophen

Q45

A pharmacist is evaluating different slugs for a large-volume syrup. Which property would be most critical in ensuring the syrup maintains its intended viscosity?

A

Slug's chemical composition

B

Slug's color intensity

C

Flow properties of the slug

D

Slug's density gradient

Q46

What aspect is most critical to evaluate during ethical clearance for Phase IV clinical trials?

A

Patient safety and data integrity throughout the surveillance process.

B

The availability of funding for the trial.

C

The investigator's research interests.

D

The pharmaceutical company's marketing strategy.

Q47

In Phase I clinical trials involving healthy human volunteers, the primary objective is to:

A

Assess safety and tolerability of the investigational drug.

B

Determine optimal dosage for a specific patient population.

C

Evaluate efficacy against a specific disease.

D

Analyze long-term effects of the drug.

Q48

What defines an adverse drug reaction (ADR)?

A

A side effect of a drug

B

A desired therapeutic effect

C

A drug's intended pharmacological action

D

An unintended, harmful response to a drug at therapeutic doses

Q49

Which of the following is evaluated as part of a patient's social habits?

A

Occupation

B

Alcohol and tobacco consumption

C

Income level

D

Education level

Q50

Which statement accurately describes sulphonamides' action on bacteria?

A

They are bacteriostatic

B

They induce bacterial lysis

C

They inhibit spore formation

D

They are bactericidal

Q51

Which regulatory body is primarily responsible for pharmacovigilance in the European Union?

A

World Health Organization (WHO)

B

U.S. Food and Drug Administration (FDA)

C

Centers for Disease Control and Prevention (CDC)

D

European Medicines Agency (EMA)

Q52

The primary characteristic of 'Menstrum' relevant to drug extraction is its:

A

Solvent properties.

B

pH level.

C

Color.

D

Sterility.

Q53

Which vaccine is used for the prevention of Hepatitis A?

A

Hepatitis C vaccine

B

Tetanus vaccine

C

Hepatitis A vaccine

D

Hepatitis B vaccine

Q54

The revised Drug Act in 2036BS (60) aimed to primarily address:

A

The development of drug research.

B

The distribution of pharmaceutical products.

C

Changes within the pharmaceutical regulatory framework.

D

The quality control of drug ingredients.

Q55

Which service is responsible for preparing and distributing sterile supplies for surgical procedures?

A

Unit dose system

B

Floor/ward stock system

C

Central sterile services

D

Satellite pharmacy system

Q56

Which drug is the primary antidote for organophosphorus poisoning?

A

Atropine sulphate

B

Diazepam

C

Adrenaline

D

Acetylcholine

Q57

Which drug is contraindicated in patients with a history of gastrointestinal bleeding?

A

Antacids

B

Nonsteroidal anti-inflammatory drugs (NSAIDs)

C

Proton pump inhibitors

D

Laxatives

Q58

The 'Ka' classification for Pethidine primarily addresses which aspect of drug management?

A

Controlled substance monitoring

B

Target patient demographic

C

Legal restrictions on distribution

D

Maximum allowable concentration

Q59

What is a key component of effective pharmacovigilance programs?

A

Robust reporting systems for ADRs.

B

Ignoring patient-reported symptoms.

C

Limiting the scope of investigation to only serious reactions.

D

Focusing solely on high-volume medications.

Q60

Pharmacovigilance primarily focuses on:

A

Detecting, assessing, understanding, and preventing adverse drug reactions.

B

Optimizing drug dosages based solely on clinical trials.

C

Managing patient adherence to medication regimens.

D

Only identifying and reporting known drug interactions.

Q61

Ciprofloxacin's primary mechanism of action involves inhibiting bacterial DNA gyrase. True or False?

A

False - It primarily inhibits RNA polymerase.

B

False - It has no direct impact on bacterial DNA.

C

True

D

False - It mainly affects cell wall synthesis.

Q62

What is the formula to calculate the diameter of a cannula in millimeters using the French scale?

A

diameter (mm) = French size * 3

B

diameter (mm) = French size / 3

C

diameter (mm) = French size + 3

D

diameter (mm) = French size - 3

Q63

What does the 'consumable expiry date range' refer to in relation to pharmaceutical dispensing?

A

The period within which a drug remains within acceptable quality standards

B

The date the drug was manufactured

C

The date the drug was packaged

D

The date the drug is sold

Q64

What is the primary advantage of a properly deflocculated suspension compared to a flocculated suspension?

A

Reduced sedimentation rate.

B

Clear supernatant layer.

C

Increased drug solubility.

D

Enhanced drug stability.

Q65

Which process describes the conversion of a drug into a metabolite?

A

Distribution

B

Excretion

C

Absorption

D

Biotransformation

Q66

Which adverse effect is a known risk of long-term fluoroquinolone use?

A

Gastrointestinal upset

B

Phototoxicity

C

Tendon rupture

D

Hearing loss

Q67

Which technique is used to manage perishable drugs in a pharmacy?

A

FEFO (First Expired, First Out)

B

VED Analysis

C

FIFO (First In, First Out)

D

ABC Analysis

Q68

A pharmacist is troubleshooting a large-volume syrup formulation where the slug is causing inconsistent dispensing. What is the MOST likely underlying issue?

A

Tablet excipient interactions

B

Syrup pH imbalance

C

Capsule shell porosity

D

Slug particle size variation

Q69

What is a critical requirement for the location of a compounding area?

A

A public area

B

A storage room

C

A regular laboratory

D

A cleanroom with HEPA filtration

Q70

Which of the following is a key consideration when calculating the appropriate dosage of Praziquantel?

A

Patient's blood pressure.

B

Patient's age.

C

Patient's weight.

D

Patient's ethnicity.

Q71

Which of the following BEST describes bioavailability?

A

The total amount of drug administered.

B

The concentration of the drug in the blood after administration.

C

The fraction of unchanged drug that reaches the systemic circulation.

D

The rate at which a drug is metabolized in the liver.

Q72

The clinical presentation of 'marasmus' is MOST closely associated with:

A

Vitamin A deficiency

B

Hypoglycemia

C

Severe protein deficiency

D

Iron deficiency anemia

Q73

Which anthelmintic is used for the treatment of flukes?

A

Praziquantel

B

Pyrantel pamoate

C

Niclosamide

D

Albendazole

Q74

Which of the following is a key figure in the Nepalese pharmaceutical sector?

A

Mr. Purna Prasad Lamsal

B

Dr. Asfeq Shek

C

Mr. N R Joshi

D

Dr. P N Suwal

Q75

Which storage condition is MOST critical for maintaining the stability and efficacy of pethidine, considering SAMUHA guidelines?

A

Direct sunlight exposure

B

Room temperature (20-25°C)

C

Exposure to fluctuating temperatures

D

Temperature-controlled environment (2-8°C)

Q76

The establishment date of RDL provides a relative indication of...

A

The industry's evolution in Nepal

B

The current market share of Nepal's drug industry.

C

The number of pharmacists employed by RDL.

D

The patent protection status of drugs produced by RDL.

Q77

Which of the following best describes the impact of high humidity on Amoxycillin's stability?

A

Improved interaction with the patient's stomach acid.

B

Enhanced interaction with the packaging material.

C

Increased solubility.

D

Accelerated degradation and loss of potency.

Q78

A healthcare professional is calculating fluid replacement in a patient with renal failure. Given the potential for hypernatremia, which factor is MOST critical to monitor closely?

A

Plasma Creatinine Level

B

Blood Urea Nitrogen Level

C

Serum Sodium Concentration

D

Urine Output Volume

Q79

Which of the following best describes the primary rationale behind employing 'sympathetic listening' in a patient interaction, as a physician might initially utilize?

A

To establish a hierarchical authority within the patient-physician relationship.

B

To immediately diagnose the patient's condition based on symptoms alone.

C

To rapidly assess the patient's understanding of medical terminology.

D

Allowing the patient to explore economic concerns that may influence their health-related decisions.

Q80

Which of the following is NOT an anticancer compound?

A

Aspirin

B

Paclitaxel

C

Cisplatin

D

Cyclophosphamide

Q81

A pharmacist is reviewing a prescription for a narcotic product derived from cannabis. What is the MOST important regulatory consideration related to this product's sourcing?

A

Evaluate the product's flavour profile for consumer preference.

B

Assess the cannabis strain's THC content for potential therapeutic effects.

C

Confirm the product's price is competitive with other available cannabis-based medications.

D

Verify that the product's production adheres to all applicable legal regulations and control standards concerning controlled substances.

Q82

Which of the following represents the core concept of dosage adjustment based on patient-specific factors?

A

Identification of patients at risk for sub therapeutic response

B

Performance of specific lab tests such as plasma drug concentration, urine analysis at time intervals

C

Determination of patient specific dosing

D

Generic drug selection

Q83

The WHO quality control parameters for herbal drugs are designed to ensure:

A

Optimal aesthetic appeal of the product.

B

Consistent pharmacological activity and safety profiles across different batches of the same product.

C

Maximum shelf life irrespective of storage conditions.

D

Complete elimination of any trace contaminants.

Q84

Which of the following best describes the primary pharmacological action of a standard non-prescription demulcent commonly used for sore throat relief?

A

Reducing inflammation in the throat lining.

B

Providing local soothing and cooling effects.

C

Increasing mucociliary clearance.

D

Directly neutralizing bacterial pathogens.

Q85

A patient presents with symptoms of anxiety, including restlessness, muscle tension, and difficulty concentrating. Which initial pharmacological approach is MOST appropriate, considering current evidence-based guidelines?

A

Opioid analgesics - due to their anxiolytic effects.

B

Benzodiazepines - for immediate, short-term relief only.

C

Beta-blockers - primarily targeting physical symptoms like tachycardia.

D

Selective serotonin reuptake inhibitors (SSRIs)

Q86

A pharmacist counseling a patient about adherence strategies should prioritize:

A

Ensuring the patient has a preferred brand of medication.

B

Reminding the patient about the medication's dosage schedule.

C

Patient understanding of the medication's purpose and potential side effects.

D

Suggesting alternative, more aesthetically pleasing medications.

Q87

What is the core relationship between Quality Assurance, Good Manufacturing Practices (GMP), and Quality Control?

A

They represent interconnected elements working together to ensure product quality.

B

Quality Assurance is a substitute for GMP.

C

Quality Control is a separate, independent process.

D

They are mutually exclusive and do not influence each other.

Q88

What is the key significance of utilizing plasma and urine data to assess pharmacokinetic parameters from an i.v. bolus injection?

A

Predicting metabolic pathways

B

Assessing distribution volumes

C

Calculating elimination rates

D

Determining absorption rates based on one compartment model

Q89

The use of macrolides, like erythromycin, is commonly employed in the treatment of H. pylori infection. What structural feature is characteristic of macrolide antibiotics?

A

Large macrocyclic Lactone ring

B

Benzene Ring

C

Catechol ring

D

Microcyclic ring

Q90

A formulation scientist is investigating the solubility of a drug in water. Understanding the 'common ion effect' is important. What does this effect primarily indicate?

A

Increasing the concentration of a common ion will decrease the solubility of the drug.

B

The common ion effect has no impact on drug solubility.

C

Increasing the concentration of a common ion will increase the solubility of the drug.

D

The common ion effect primarily affects drug stability.

Q91

Which of the following is the MOST accurate description of ketamine's influence on the autonomic nervous system?

A

CNS stimulant

B

Dissociative anesthetic

C

Partial anesthetic

D

ANS stimulant

Q92

What does the term 'turnover ratio' relate to within the context of economic order quantity calculations?

A

The storage capacity of the pharmacy.

B

The price of the substance relative to demand.

C

Cost of goods and averages of opening and closing inventories

D

The number of orders placed during a specific timeframe.

Q93

A researcher is investigating the potential of a traditional herbal remedy. Which aspect of the crude drug is MOST crucial for determining its potential pharmacological action?

A

The presence of specific bioactive compounds.

B

The drug's color and texture.

C

The drug's source region.

D

The drug's overall weight.

Q94

A pharmacy experiences frequent stockouts of a specific medication. Which inventory approach would MOST effectively address this issue?

A

Pegboard method

B

Manual inventory audits

C

Non-automated method

D

Automated method

Q95

Which of the following is NOT a typical consequence directly attributed to severe protein-energy malnutrition?

A

Impaired wound healing

B

Decreased skin turgor

C

Muscle weakness

D

Night blindness

Q96

The efficacy of sulphonamides is compromised when bacteria develop resistance. What is a common mechanism of resistance?

A

Decreased membrane permeability.

B

Enhanced uptake of nutrients.

C

Increased production of enzymes that degrade the drug.

D

Increased bacterial cell wall thickness.

Q97

Which of these drugs is NOT a core component of standard antitubercular therapy?

A

Ciprofloxacin

B

Ethambutol

C

Pyrazinamide

D

INH

Q98

Phase inversion in emulsions is most likely to occur when:

A

The viscosity of the dispersed phase is markedly higher than the continuous phase.

B

The surfactant concentration is insufficient to maintain the initial phase.

C

The temperature of the continuous phase is significantly increased.

D

The dispersed phase contains a high concentration of hydrophilic lipids.

Q99

Understanding hospital organizational structure is crucial for pharmacists. What does 'delivery system' within a hospital primarily refer to?

A

The hospital's legal compliance procedures.

B

The hospital's patient registration process.

C

The hospital's marketing strategy.

D

The path medications take from procurement to patient administration.

Q100

What is the primary mechanism of action of quinine in antimalarial therapy?

A

Inhibiting DNA synthesis

B

Interfering with protein synthesis

C

Blocking ion channels

D

Binding to heme in the parasite's erythrocytes

Q101

What is the maximum disintegration time for dispersible tablets as per pharmacopeial standards?

A

3 mins

B

15 mins

C

30 mins

D

1 min

Q102

Which of the following antifungal drugs exerts its effect by binding to ergosterol in the fungal cell membrane, forming pores that cause leakage of intracellular contents and cell death?

A

Clotrimazole

B

Ketoconazole

C

Fluconazole

D

Nystatin

Q103

A herbal drug formulation exhibits a high 'Foaming index'. Which phytochemical characteristic is MOST likely being assessed by this test?

A

The concentration of sugars in the formulation.

B

The presence of heavy metal contaminants.

C

The content of saponins, which form persistent foam upon shaking with water.

D

The pH level of the aqueous extract.

Q104

Which of the following anthelmintic drugs is used for the treatment of both tapeworms and flukes?

A

Pyrantel pamoate

B

Niclosamide

C

Praziquantel

D

Albendazole

Q105

A patient presents with markedly elevated blood pressure, significant peripheral edema, and shortness of breath. Current national health policy objectives for cardiovascular disease control emphasize integrating prevention, treatment, and equitable access to care. Which intervention is MOST directly aligned with these priority goals?

A

Providing antihypertensive therapy together with lifestyle counseling and measures that improve equitable access to ongoing care

B

Implementing lifestyle modifications alone while disregarding systemic barriers to healthcare access

C

Prioritizing pharmaceutical interventions over preventive strategies

D

Focusing solely on individual patient risk factors without addressing population-level determinants

Q106

The acetate (acetate - malonate) pathway of plant metabolism is primarily responsible for the biosynthesis of which of the following metabolites?

A

Fatty acids and polyketide-derived phenolic compounds

B

Glucose and other carbohydrates produced through photosynthesis

C

Lignin and other phenylpropanoid products of the shikimate pathway

D

Amino-acid-derived alkaloids such as morphine

Q107

Which of the following medications is considered the primary antidote for benzodiazepine overdose?

A

Flumazenil

B

Naloxone

C

N-acetylcysteine

D

Atropine

Q108

A patient exhibiting symptoms of severe wasting and malnutrition, including muscle loss, would most accurately be diagnosed with:

A

Rickets

B

Cachexia

C

Kwashiorkor

D

Marasmus

Q109

The establishment dates of key pharmaceutical bodies are important for historical context. Which year does APPON's founding align with?

A

1998AD (62)

B

2015AD (75)

C

1990AD (58)

D

1985AD (62)

Q110

Understanding the listed companies - 'Chemidrug Laboratories', 'Quest Pharmaceutical', 'National Healthcare', and 'Lomus Pharmaceuticals' - is crucial for understanding the structure of the pharmaceutical industry in Nepal. Which statement most accurately reflects this?

A

They represent only major international pharmaceutical brands.

B

They exclusively focus on drug regulation.

C

They represent various stages of the pharmaceutical value chain.

D

They are all solely engaged in research and development.

Q111

Which drug is a monobactam antibiotic?

A

Clavulanate

B

Cefuroxime

C

Sulbactam

D

Aztreonam

Q112

Which antifungal is a fungistatic agent effective against dermatophytes?

A

Fluconazole

B

Ketoconazole

C

Griseofulvin

D

Clotrimazole

Q113

The year 2036BS (60) reflects a regulatory update focused on:

A

Drug pricing controls.

B

Pharmacist training standards.

C

Pharmaceutical manufacturing processes.

D

Drug legislation and regulation

Q114

According to the Drug Act provisions, what is the primary power granted to the government regarding drugs?

A

Provide funding for pharmaceutical research.

B

Conduct routine inspections of pharmacies.

C

Recommend dosage adjustments to prescribers.

D

Prohibit sale, distribution, export, or import

Q115

What is the primary purpose of standard treatment guidelines derived from a formulary?

A

To eliminate the need for clinical judgment in medication prescribing.

B

To provide clinicians with recommendations for optimal drug selection in specific conditions.

C

To limit patient access to all medications based on cost.

D

To create a system for tracking drug costs across all healthcare facilities.

Q116

Which factor is LEAST likely to contribute to phase inversion?

A

An imbalance between the dispersed and continuous phase viscosities.

B

Maintaining a constant, high concentration of the surfactant throughout the process.

C

The presence of a suitable surfactant for the emulsion system.

D

Changes in the temperature of the continuous phase.

Q117

A patient requires a 20 gauge peripheral IV. Which French size is generally associated with this gauge?

A

22

B

14

C

16

D

18

Q118

A patient presents with symptoms of nausea, vomiting, and dizziness following the initiation of a new antihypertensive medication. Which of the following BEST describes the initial step in managing this situation?

A

Immediately discontinuing the medication without further investigation

B

Adjusting the dose of the antihypertensive drug to compensate for the adverse effects

C

Thorough ADR monitoring and pharmacovigilance

D

Prescribing an antiemetic medication to manage the symptoms

Q119

A patient asks for advice on managing a chronic condition with multiple medication needs. The pharmacist's most valuable contribution is:

A

Collaborative medication management support.

B

Referring the patient to a specialist immediately.

C

Providing a single, definitive solution to the patient's health problem.

D

Working with the patient to develop a personalized medication plan.

Q120

Which of the following best describes the primary rationale behind celebrating 'Pharmacist Day' on September 25th?

A

Acknowledgement of the increasing role of pharmacists in primary care.

B

Celebration of advances in drug delivery systems.

C

Recognition of historical contributions to pharmaceutical development and practice.

D

Promotion of pharmaceutical company advertising.

Q121

A patient presents with symptoms suggesting a possible allergic reaction. Which initial response is MOST appropriate?

A

Recommending a change in diet.

B

Administering corticosteroids without further assessment.

C

Administering epinephrine.

D

Administering antihistamines only.

Q122

If a compound consistently alters social interactions in a population of animals, and that alteration is observed only when the compound is presented to animals of a different species, which category of chemical product does it MOST likely represent?

A

Pheromones

B

Hormones

C

Neurotransmitters

D

Allomones

Q123

Considering the principles of herbal medicine, what is the primary rationale behind utilizing 'coppicing' as a bark collection method?

A

To reduce the risk of damaging the plant's root system.

B

To stimulate the plant's regenerative capacity and increase bioactive compound production.

C

To minimize the plant's photosynthetic activity.

D

To simplify the harvesting process.

Q124

An elevated white blood cell count is detected in a patient on a new immunosuppressant medication. What is the MOST likely pharmacological explanation for this finding?

A

Dehydration

B

Drug-induced immune stimulation

C

Kidney dysfunction

D

Increased infection risk

Q125

A pharmacist is dispensing a newly sourced crude drug. What is the MOST important consideration regarding quality control at this stage?

A

Assessment of the drug's origin country.

B

Assessment of packaging material.

C

Assessment of purity and potency.

D

Assessment of color and odor.

Q126

What is the fundamental purpose of utilizing an automated inventory system in a pharmacy setting?

A

To simplify the process of verifying patient prescriptions.

B

To minimize the risk of theft by reducing physical access to medications.

C

To streamline the process of tracking medication stock and facilitate efficient management.

D

To maintain a visually appealing pharmacy display.

Q127

Which antihelmintic is contraindicated in patients with severe hepatic impairment?

A

Parmatal pamoate

B

Albendazole

C

Niclosamide

D

Praziquantel

Q128

Which of the following best represents the relationship between a formulary and a medication order?

A

Medication orders are independent of the formulary and should always be prioritized.

B

A medication order must align with the approved medications and guidelines outlined in the formulary.

C

The formulary is simply a suggestion for medications, and the physician has complete autonomy.

D

The formulary dictates all medication orders within a hospital.

Q129

Which factor is MOST likely to cause 'sticking' between the tablet material and the compression punch?

A

Lamination

B

Picking

C

Binding

D

Sticking

Q130

The Anatomical Therapeutic Chemical (ATC) classification system is primarily important for understanding:

A

Patient preferences

B

Marketing strategies

C

Drug efficacy and interactions

D

Drug prices

Q131

A researcher is studying the interaction between two drugs that act on the same receptor. They observe that adding Drug A completely abolishes the response normally produced by Drug B, and this inhibition cannot be overcome even when the concentration of Drug B is markedly increased. Which type of antagonism is MOST likely being demonstrated?

A

Non-competitive antagonism

B

Physiological antagonism

C

Physical antagonism

D

Competitive antagonism

Q132

A patient develops gynecomastia while receiving chronic drug therapy. Which of the following medications is MOST likely responsible for this adverse effect?

A

Famotidine

B

Chloramphenicol

C

Bromocriptine

D

Vancomycin

Q133

The term 'over-the-counter (OTC)' is most closely related to:

A

Self-medication and accessible healthcare products.

B

Regulation of controlled substances and narcotics.

C

Research and development of novel prescription drugs.

D

Design and conduct of clinical trial protocols.

Q134

According to the Drugs and Cosmetics Act, 1940, the maximum punishment for a minor contravention involving improperly handled drugs (e.g., sale of expired drugs) that does NOT result in death or grievous harm is:

A

Imprisonment up to 2 years and fine up to ₹15,000

B

Imprisonment up to 1 year and fine up to ₹10,000

C

Imprisonment up to 3 years and fine up to ₹25,000

D

Imprisonment up to 6 months and fine up to ₹50,000

Q135

A patient taking a thiazide diuretic for hypertension reports increased thirst and frequent urination. What is the MOST likely underlying physiological mechanism driving these symptoms?

A

Inhibition of sodium reabsorption in the distal convoluted tubule, leading to increased urinary water excretion

B

Increased sodium retention by the kidneys

C

Reduced renal blood flow caused by the diuretic

D

Activation of the sympathetic nervous system

Q136

In which of the following populations is entecavir generally not recommended for use?

A

Patients with mild renal insufficiency

B

Patients with chronic hepatitis B infection

C

Patients with severe hepatic impairment

D

Pregnant women

Q137

Which of the following groups of vaccines is used to prevent diseases caused by bacterial pathogens?

A

DPT (diphtheria, pertussis, tetanus)

B

Polio, measles, rubella

C

Hepatitis B, rabies, influenza

D

Rotavirus, varicella, yellow fever

Q138

Which of the following best describes the primary mechanism responsible for the central nervous system depressant effects of barbiturates?

A

Stimulation of adrenergic receptors

B

Increased histamine release

C

Blockade of opioid receptors

D

Enhancement of GABAergic neurotransmission

Q139

A pregnant woman with epilepsy on long-term antiepileptic therapy develops a serious bacterial infection requiring antimicrobial treatment. Which antiepileptic drug's potent induction of hepatic cytochrome P450 enzymes can substantially lower blood concentrations of co-administered antimicrobials, posing a major challenge for managing concomitant infections during pregnancy?

A

Valproate

B

Levetiracetam

C

Lamotrigine

D

Phenytoin

Q140

Which type of glass is most commonly used for the manufacture of ampoules because of its high hydrolytic resistance and minimal leaching of alkali into the drug solution?

A

Soda-lime glass

B

Borosilicate glass

C

Lead glass

D

Sulfur-treated glass

Q141

Which of the following represents a punitive regulatory outcome under drug legislation?

A

Imposition of penalties for dealing in expired, narcotic, or adulterated drugs that are likely to cause organ damage

B

Minimizing adverse drug reactions

C

Increasing sales revenue

D

Optimizing drug utilization

Q142

Which of the following pharmaceutical companies was established most recently?

A

Standard Remedies (established 2020 BS)

B

Nepal Drug Limited (established 2028 BS)

C

Royal Drug Limited (established 2036 BS)

D

Apex Pharmaceuticals (established 2045 BS)

Q143

Which of the following companies is a pharmaceutical manufacturer based in Nepal?

A

Lomus Pharmaceuticals

B

National Healthcare

C

Chemidrug Laboratories

D

Sun Pharmaceutical Industries

Q144

Which antihelminthic is used for the treatment of flukes?

A

Praziquantel

B

Pyrantel pamoate

C

Niclosamide

D

Albendazole

Q145

What defines an adverse drug reaction (ADR)?

A

A side effect of a drug

B

A desired therapeutic effect

C

A drug's intended pharmacological action

D

An unintended, harmful response to a drug at therapeutic doses

Q146

A patient exhibiting symptoms of severe wasting and malnutrition, including muscle loss, would most accurately be diagnosed with:

A

Rickets

B

Cachexia

C

Kwashiorkor

D

Marasmus

Q147

Which antifungal is associated with photosensitivity reactions and requires sun protection?

A

Ketoconazole

B

Nystatin

C

Griseofulvin

D

Fluconazole

Q148

Which of these drugs is NOT a core component of standard antitubercular therapy?

A

Ciprofloxacin

B

Ethambutol

C

Pyrazinamide

D

Isoniazid (INH)

Q149

In Phase I clinical trials involving healthy human volunteers, the primary objective is to:

A

Assess safety and tolerability of the investigational drug.

B

Determine optimal dosage for a specific patient population.

C

Evaluate efficacy against a specific disease.

D

Analyze long-term effects of the drug.