Bachelor in Pharmacy Licensure Exam preparation SET 2

Q1

A patient presents with symptoms including nausea, headache, and dizziness following the initiation of a new antihypertensive medication. Which of the following is the MOST appropriate initial step?

A

Prescribe a different medication with a similar mechanism of action.

B

Immediately discontinue the medication and administer antiemetics.

C

Conduct a thorough ADR monitoring and pharmacovigilance assessment.

D

Increase the dosage of the medication to overcome the side effects.

Q2

Which mechanism of action is characteristic of NSAIDs?

A

Inhibition of thromboxane synthase

B

Inhibition of cyclooxygenase (COX) enzymes

C

Inhibition of prostaglandin synthesis via PGE2

D

Activation of opioid receptors

Q3

Which of the following terms describes drug movement across an epithelial barrier by passing between adjacent cells through tight junctions?

A

Passive diffusion of lipid-soluble drugs directly through cell membranes

B

Carrier-mediated transport involving specific membrane transporter proteins

C

Vesicular uptake of large molecules via endocytosis

D

Paracellular transport, in which drugs pass between cells through tight junctions

Q4

Which organization regulates pharmaceutical practices in Nepal?

A

World Health Organization

B

Ministry of Health and Population

C

Nepal Health Council

D

Nepal Pharmaceutical Society

Q5

A patient is scheduled for an X-ray examination. Barium sulfate is administered to:

A

Decrease radiation exposure

B

Increase blood flow to the stomach

C

Reduce nausea

D

Enhance the visibility of the digestive system

Q6

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

Q7

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

Q8

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

Q9

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

Q10

Within the context of the Nepalese Drug Act and Pethidine classifications, 'Ka' indicates?

A

Lowest restriction and widest availability

B

Highest degree of regulation and prescription control

C

Availability solely for veterinary use

D

Restricted to specific research applications

Q11

The 'bedside pharmacy' service is primarily designed to:

A

Ensure patients receive their medications at the precise time of their scheduled dose

B

Reduce pharmacy staffing costs by eliminating central dispensing

C

Provide immediate medication administration support to clinicians

D

Store all medication for the hospital in patient rooms

Q12

A patient taking a drug metabolized by CYP3A4 exhibits a prolonged therapeutic effect. What potential factor could explain this observation?

A

Genetic polymorphism impacting CYP3A4 activity

B

Increased gastric emptying rate

C

Decreased intestinal transit time

D

Higher baseline hepatic enzyme activity

Q13

During a Phase 1 clinical trial, the primary focus is on:

A

Safety and tolerability.

B

Determining the optimal dosage.

C

Identifying potential interactions with other drugs.

D

Efficacy in patients with a disease.

Q14

Which of the following pharmaceutical companies is a well-known multinational corporation headquartered in the United States?

A

Chemidrug Laboratories

B

Lomus Pharmaceuticals

C

Quest Pharmaceutical

D

National Healthcare

Q15

Who is associated with the establishment of early pharmaceutical regulations in Nepal?

A

Dr. Asfeq She

B

Dr. P N Suwal

C

Mr. N R Joshi

D

Mr. Purna Prasad Lamsal

Q16

In which year of the Bikram Sambat (BS) calendar did the Council for Technical Education and Vocational Training (CTEVT) initiate the Diploma in Pharmacy program in Nepal?

A

2064 BS

B

2063 BS

C

2062 BS

D

2060 BS

Q17

Which of the following is a key consideration when selecting a viscosity modifier for a liquid dosage form?

A

Drug stability and patient acceptance

B

Color of the formulation

C

Particle size distribution

D

Cost of the excipient

Q18

A pharmacist is reviewing a patient's medication list and identifies a potential interaction between a newly prescribed drug and a previously prescribed medication. What is the FIRST step the pharmacist should take?

A

Document the potential interaction in the patient's chart.

B

Consult the drug interaction database.

C

Immediately notify the prescribing physician.

D

Advise the patient to reduce the dosage of both medications.

Q19

Codeine's primary use in cough management is based on its action as:

A

Anti-inflammatory

B

Bronchodilator

C

Mucolytics

D

Centrally acting cough suppressant

Q20

In thin-layer chromatography, which component of the system most directly influences the separation of analytes?

A

The sample's concentration

B

The stationary phase's polarity

C

The capillary tube's diameter

D

The solvent mixture's temperature

Q21

Which activity best reflects the MTC's focus on therapeutic decision-making?

A

Monitoring drug supply chain logistics

B

Reviewing and recommending drug use patterns for clinical optimization

C

Managing hospital pharmacy budgets

D

Analyzing drug pricing data

Q22

Considering the provided list, which drug's teratogenic effects are most directly linked to the congenital anomaly of phocomelia?

A

Barbiturates

B

Cyclophosphamide

C

Chloramphenicol

D

Thalidomide

Q23

Which of the following factors primarily influences the absorption of a drug following oral administration?

A

Skin pH

B

Kidney function

C

Liver blood flow

D

Gastric emptying rate

Q24

A patient receives ketamine, a dissociative anesthetic, and subsequently develops acute confusion and hallucinations consistent with drug-induced delirium. Which pharmacological mechanism BEST explains both the anesthetic and psychotomimetic (deliriogenic) effects of this drug?

A

NMDA receptor antagonism

B

GABA-A receptor positive allosteric modulation

C

Mu-opioid receptor agonism

D

Dopamine D2 receptor antagonism

Q25

The core duty of a pharmacist under the Pharmacy Council Act centers around:

A

Managing a pharmacy's financial performance.

B

Overseeing the manufacturing process of drugs.

C

Patient medication management.

D

Researching new medications for clinical trials.

Q26

Which antifungal is most strongly associated with severe hepatotoxicity and requires strict monitoring of liver enzymes?

A

Nystatin

B

Ketoconazole

C

Fluconazole

D

Clotrimazole

Q27

What is the primary justification for utilizing a stock rotation system based on the 'First In, First Out' (FIFO) principle?

A

To ensure a consistent supply of medications is always available.

B

To streamline the ordering process for new medications.

C

To minimize the risk of administering expired medications.

D

To guarantee the optimal storage conditions for all medications.

Q28

Which antifungal is most commonly used as a topical suspension for the treatment of oral thrush?

A

Griseofulvin

B

Clotrimazole

C

Nystatin

D

Fluconazole

Q29

Which of the following statements best describes the relationship between French size and the diameter of a peripheral IV cannula?

A

French size is irrelevant to cannula diameter.

B

Larger French sizes denote larger diameters.

C

French size represents the infusion rate.

D

Smaller French sizes correspond to wider canals.

Q30

The core function of the Drug Act, as related to drug distribution, is:

A

To ensure only patented drugs are available.

B

To provide free drug samples to healthcare professionals.

C

To subsidize drug manufacturing.

D

To regulate and control the market.

Q31

The clinical understanding of drug-induced diseases primarily focuses on identifying which type of adverse effect?

A

Adverse drug reactions

B

Pharmacotoxic effects

C

Drug interactions

D

Pharmacokinetic variations

Q32

Which neuraminidase inhibitor administered orally is effective against both influenza A and B viruses?

A

Ribavirin

B

Oseltamivir

C

Zanamivir

D

Amantadine

Q33

What is the primary function of a lubricant in tablet manufacturing?

A

Reduce lamination

B

Prevent sticking to punches

C

Enhance binding

D

Improve disintegration

Q34

According to regulations, what is the significance of the Nepal Pharmacy Council's authorization for domestic manufacturers bringing products into the market?

A

It primarily determines the drug's pricing.

B

It solely impacts the drug's advertising campaign.

C

It guarantees immediate acceptance by the public.

D

It's a critical requirement for legal sale and distribution.

Q35

What is the primary use of Anti-snake venom?

A

Prevention of insect bites

B

Prevention of snake bites

C

Treatment of scorpion stings

D

Neutralizing snake venom

Q36

Which of the following is NOT a standard criterion used to classify hospitals?

A

Ownership structure

B

Patient demographic profiles

C

Size and capacity

D

Specialization focus

Q37

Which presenting symptom, when combined with other findings, warrants immediate investigation for possible cardiovascular pathology?

A

Unexplained syncope with palpitations.

B

Localized muscle aches with elevated body temperature.

C

Mild abdominal discomfort with nausea.

D

A history of seasonal allergies with nasal congestion.

Q38

What is a core function of a computerized drug information and data storage system in a retail pharmacy?

A

Managing hospital billing and insurance claims.

B

Facilitating rapid access to detailed medication profiles and dispensing information.

C

Developing novel drug formulations.

D

Providing psychological support to patients taking medications.

Q39

Which of the following describes the main action of Diazepam in relation to organophosphate poisoning?

A

To manage anxiety and seizures

B

To directly reverse the organophosphate's action.

C

To reduce bronchospasm.

D

To increase heart rate.

Q40

A pharmacist identifies a patient experiencing symptoms of nausea, dizziness, and blurred vision following the initiation of a new medication. Which of the following is the MOST appropriate initial action?

A

Immediately discontinue the medication and notify the prescribing physician.

B

Prescribe a proton pump inhibitor to manage potential gastric upset.

C

Order a complete blood count to rule out anemia.

D

Assess the patient's vital signs and administer antiemetic therapy.

Q41

How does the MTC contribute to medication safety?

A

By establishing protocols for drug monitoring and adverse event reporting

B

By controlling prescription drug availability

C

By enforcing pharmaceutical advertising restrictions

D

By managing hospital IT systems

Q42

Which of the following statements best describes the relationship between analgesics and COX enzymes?

A

COX activity only affects cardiovascular function.

B

COX enzymes are only involved in fever reduction.

C

COX activation increases pain thresholds.

D

COX inhibition reduces pain and inflammation.

Q43

A patient is diagnosed with Type 2 Diabetes. Their HbA1c is 8.5%. What does this result primarily indicate?

A

Normal glucose metabolism.

B

Optimal insulin sensitivity.

C

Suboptimal glycemic control.

D

Excellent glycemic control.

Q44

The Nepal Pharmacy Council serves which key function?

A

Regulating the practice of pharmacy and pharmacists.

B

Managing hospital budgets.

C

Providing free medication to the public.

D

Developing new pharmaceutical formulations.

Q45

During neuronal depolarization, a critical step involves the movement of ions through specific channels. The primary ion facilitating this process is:

A

Sodium ions

B

Chloride ions

C

Potassium ions

D

Calcium ions

Q46

Which macrolide is known to interact with warfarin, increasing the risk of bleeding?

A

Azithromycin

B

Erythromycin

C

Clarithromycin

D

All are equally interacting

Q47

What is the primary use of the Tetanus Toxoid (TT) vaccine?

A

Prevention of diphtheria

B

Prevention of tetanus

C

Prevention of pertussis

D

Treatment of tetanus

Q48

Which of the following BEST describes cyclopropane as an anesthetic?

A

Local anaesthetic

B

Antioxidant

C

General anaesthetic

D

Antibiotic

Q49

A drug name registered with the national pharmaceutical control authority (NPC) remains valid for how long before renewal is required?

A

1 year

B

3 years

C

5 years

D

7 years

Q50

A patient reports experiencing dizziness and blurred vision after initiating treatment with a newly prescribed diuretic. Which of the following physiological mechanisms is MOST likely responsible?

A

Activation of the sympathetic nervous system.

B

Increased cardiac contractility.

C

Direct vasodilation affecting cerebral circulation.

D

Hypovolemia and subsequent postural hypotension.

Q51

What legal process is initiated by 'Registration of Drug'?

A

Formal documentation and assessment of the drug's safety and efficacy.

B

Initial market research on the drug's potential demand.

C

The selection of the drug's brand name.

D

The company's financial projections for the drug's launch.

Q52

A healthcare professional suspects that a patient has been infected with Mycobacterium tuberculosis. Which diagnostic test is most directly used to screen for this infection by detecting a delayed-type hypersensitivity (cell-mediated immune) response?

A

A complete blood count (CBC)

B

A sputum culture

C

A urinalysis

D

The Mantoux (tuberculin skin) test

Q53

What is the primary purpose of initiating a complaint process related to a pharmaceutical product?

A

To issue marketing approvals.

B

To investigate potential safety or quality issues.

C

To provide customer feedback.

D

To determine market share.

Q54

A patient is admitted to the hospital with a suspected infection. Which of the following is the PRIMARY initial step in the drug distribution system?

A

Review of the patient's complete medication history from other sources

B

Prioritization of narcotics due to potential pain

C

Immediate dispensing of broad-spectrum antibiotics

D

Order placement and verification by a clinician

Q55

A pharmaceutical scientist is designing a sustained-release formulation. Considering solubility, which of the following best describes the impact of increasing temperature on the dissolution rate of a poorly soluble drug?

A

Decreased dissolution rate due to increased drug aggregation

B

Decreased dissolution rate due to reduced drug solubility

C

No significant change in dissolution rate

D

Increased dissolution rate due to enhanced thermal energy and increased solubility

Q56

Which individual is associated with the expansion of pharmaceutical services in rural Nepal?

A

Mr. N R Joshi

B

Dr. P N Suwal

C

Dr. Asfeq Shek

D

Mr. Purna Prasad Lamsal

Q57

Which antifungal agent is most commonly used for the treatment of candidiasis?

A

Ketoconazole

B

Clotrimazole

C

Fluconazole

D

Nystatin

Q58

Using computers for medication monitoring includes which of the following?

A

Performing physical drug compounding.

B

Automated verification of prescription details against patient records.

C

Conducting research into drug efficacy.

D

Managing the pharmacy's social media presence.

Q59

Which of the following is a key contraindication for the use of NSAIDs?

A

Chronic obstructive pulmonary disease

B

Active peptic ulcer disease

C

Hypothyroidism

D

Hypertension

Q60

Under the provisions of the Drug Act, which of the following best describes the primary role assigned to the government?

A

Control the manufacture, sale, and distribution of drugs

B

Fund pharmaceutical research and development programs

C

Determine the clinical dosage of newly developed medications

D

Provide free medicines to all citizens

Q61

Which factor significantly influences the selection of a particular chemotherapy regimen?

A

The specific genetic characteristics of the tumor

B

The patient's preferred flavor of antiemetic medication

C

The patient's socioeconomic status

D

The patient's overall body weight

Q62

Rifampicin is a key component of tuberculosis treatment due to its mechanism of action targeting:

A

Bacterial RNA synthesis

B

Inflammation pathways

C

Viral protein production

D

Cellular respiration

Q63

Which act regulates the sale and distribution of drugs in Nepal?

A

Drug Sale and Distribution Codes 2041 (1984)

B

Pharmacy Council Act 2057 (2000)

C

Drugs Act 2035 (1978)

D

Consumer Protection Act 2054 (1998)

Q64

Concerning controlled drug prescriptions, what is the primary regulatory consideration driving the need for restricted refills?

A

Cost considerations for the patient

B

Potential for misuse and abuse

C

Patient preference for extended therapy

D

Lack of long-term efficacy data

Q65

The disintegration time of a dispersible tablet is clinically significant for which of the following?

A

1 min

B

Drug absorption rate

C

Tablet stability

D

Patient compliance

Q66

Which of the following is a fundamental requirement for establishing a compounding area?

A

Integration with the hospital's electronic health record

B

A dedicated pharmaceutical technician

C

Designated and controlled location

D

High-speed internet access

Q67

Which antagonism is exemplified by a drug that binds to an inactive site on a receptor, preventing agonist activation?

A

Non-competitive antagonism

B

Physical antagonism

C

Physiological antagonism

D

Competitive antagonism

Q68

Which of the following is the most suitable solvent for the preparation of a parenteral formulation containing a heat-sensitive drug?

A

Water for injection

B

0.9% sodium chloride solution

C

5% dextrose solution in water

D

Ethyl alcohol

Q69

How many grams of lactose should be added to prepare 150 g of a 10% w/w ointment, assuming the base and other excipients contribute negligibly to the total weight?

A

10 g

B

15 g

C

150 g

D

100 g

Q70

Which coating process involves spraying a polymer solution onto tablets in a rotating perforated pan and drying with heated air?

A

Film coating

B

Sugar coating

C

Pan coating

D

Dip coating

Q71

Dr. Shanta Lal Joshi is significant in the history of the pharmacy profession in Nepal for his role as:

A

First Director General of the DDA.

B

Lead researcher at the Department of Ayurveda.

C

Head of the DDA's legal department.

D

Chief Pharmacist for the Ministry of Health.

Q72

Which of the following is a characteristic of 'Amber-colored' glass used in pharmaceutical packaging?

A

It prevents the entry of all electromagnetic radiation

B

It protects light-sensitive drugs from UV radiation

C

It is used exclusively for parenteral products

D

It increases the hydrolytic resistance of the glass

Q73

A 55-year-old man with community-acquired pneumonia is started on azithromycin. Which of the following adverse effects is most characteristic of macrolide therapy?

A

Prolonged QT interval

B

Nephrotoxicity

C

Peripheral neuropathy

D

Ototoxicity

Q74

Which drug is a loop diuretic that also has a strong vasodilatory effect and is useful in acute decompensated heart failure?

A

Bumetanide

B

Furosemide

C

Torasemide

D

Ethacrynic acid

Q75

In Therapeutic Drug Monitoring (TDM), a 'trough level' is ideally drawn at which point in the dosing schedule?

A

Immediately after intravenous administration

B

At the peak of drug concentration

C

Immediately before the next dose

D

Halfway between two doses

Q76

When providing counseling on inhaled corticosteroids for asthma, which instruction is essential to improve drug delivery?

A

Hold breath for 3 seconds after inhalation

B

Exhale forcefully through the mouthpiece before inhalation

C

Shake the inhaler vigorously for 5 seconds before use

D

Use a spacer device if the patient is a child

Q77

Which of the following statements correctly describes the structure-activity relationship (SAR) of angiotensin-converting enzyme (ACE) inhibitors such as enalapril?

A

They contain a phosphonate group that mimics the transition state of the peptide substrate

B

They possess a carboxylate group that binds the zinc ion in the enzyme's active site

C

They rely on a nitroaromatic ring for binding to the hydrophobic pocket

D

Their activity depends on a quaternary ammonium moiety that interacts with the enzyme's catalytic serine

Q78

In structure-activity relationship studies, replacing a hydrogen atom with a fluorine atom on an aromatic ring most commonly:

A

Increases metabolic stability

B

Decreases lipophilicity

C

Increases basicity

D

Reduces binding affinity

Q79

Levodopa is transported across the blood-brain barrier via which mechanism?

A

Large neutral amino acid transporter

B

Simple diffusion

C

Active transport of glucose

D

Osmosis

Q80

Which of the following detectors is NOT routinely used in gas chromatography?

A

Flame ionization detector

B

UV-Vis detector

C

Electron capture detector

D

Mass spectrometer

Q81

During validation, the selectivity of a UV-spectrophotometric method is examined by spiking the sample with common excipients. No change in the measured absorbance is observed. This demonstrates:

A

Precision of the method.

B

Specificity (selectivity) of the method.

C

Linearity of the method.

D

Robustness of the method.

Q82

The bitter principle strychnine belongs to which alkaloid class?

A

Quinoline alkaloid

B

Indole alkaloid

C

Pyridine alkaloid

D

Pyrrolizidine alkaloid

Q83

A herbal powder passes the following tests: loss on drying 8%, total ash 5%, acid insoluble ash 0.5%, and ethanol extractive value 12%. Which conclusion is most appropriate?

A

The powder meets typical quality specifications for a dried plant material

B

The powder is likely contaminated with inorganic salts

C

The powder has excessive moisture and should be re-dried

D

The ethanol extractive value is too low indicating poor active constituent content

Q84

In the pentose phosphate pathway, which product is the primary source of cellular reducing power?

A

NADH

B

FADH₂

C

NADPH

D

ATP

Q85

Why is Amlodipine generally contraindicated in pregnancy?

A

Increased risk of fetal arrhythmias.

B

Potential for fetal hypotension and reduced placental blood flow.

C

Direct interference with fetal hormonal regulation.

D

Promotion of fetal vasoconstriction.

Q86

What is the primary therapeutic goal when managing Type 2 Diabetes Mellitus?

A

Maintain blood glucose levels consistently below 70 mg/dl.

B

Achieve a fasting blood glucose level of 60 mg/dl.

C

Reduce blood glucose levels to below 50 mg/dl.

D

Maintain blood glucose levels between 80-130 mg/dl.

Q87

A patient with a urinary tract infection caused by Escherichia coli shows resistance to ciprofloxacin. The most likely mechanism of resistance involves:

A

Inhibition of bacterial DNA gyrase

B

Mutation of DNA gyrase and topoisomerase IV genes

C

Active efflux of the drug out of the bacterial cell

D

Production of quinolone resistance-determining enzymes

Q88

Which of the following is NOT required for PCR?

A

Template DNA

B

Taq polymerase

C

Primers

D

Restriction endonuclease

Q89

A patient with dysphagia (difficulty swallowing solid dosage forms) requires an oral medication. Which of the following is the primary rationale for formulating the medication as a liquid?

A

It allows accurate dose measurement and flexible adjustment for patients unable to swallow tablets or capsules

B

It ensures uniform distribution of the drug throughout the gastrointestinal tract

C

It reduces the risk of microbial contamination compared with solid dosage forms

D

It improves the taste of the drug, increasing patient acceptance

Q90

Which layout design encourages impulse buying by placing high-margin non-pharmaceutical items near the checkout counter?

A

Grid layout

B

Free-flow layout

C

Racetrack (loop) layout

D

Spine layout

Q91

Which binder is most commonly used in tablet formulation to improve compressibility and flow properties?

A

microcrystalline cellulose

B

starch

C

povidone

D

cyclodextrin

Q92

Which of the following tetracyclines has the longest half-life, allowing for once-daily dosing, and is also safe to use in patients with renal impairment?

A

Doxycycline

B

Tetracycline

C

Oxytetracycline

D

Chlortetracycline

Q93

A 52-year-old male presents with fatigue, cold intolerance, and weight gain. Laboratory tests reveal an elevated serum TSH and a low free T4. Which of the following is the most likely diagnosis?

A

Primary hypothyroidism

B

Secondary hypothyroidism

C

Graves' disease

D

Subacute thyroiditis

Q94

Which of the following statements is true regarding DNA vaccines?

A

They consist of attenuated virus particles encoding antigen

B

They contain plasmid DNA encoding microbial antigen under a eukaryotic promoter

C

They are made of purified recombinant protein

D

They contain mRNA coated with lipid nanoparticles only since 2020

Q95

In a hospital formulary committee, which of the following members is most likely to provide evidence-based drug information?

A

Nursing director

B

Finance officer

C

Clinical pharmacist

D

Hospital administrator

Q96

When a pharmacist receives a prescription for an extemporaneous preparation, which documentation is legally mandatory in Nepal?

A

Formula, ingredients used, quantity, method of preparation, and pharmacist's signature

B

Only the patient's name and address

C

A digital photograph of the prepared formulation

D

Verbal confirmation from the prescriber

Q97

In a preservative efficacy test (PET) for a multidose ophthalmic solution, which test organism is required by USP <51> to assess preservative activity against fungi?

A

Candida albicans

B

Aspergillus niger

C

Penicillium chrysogenum

D

Fusarium solani

Q98

In passive diffusion across a biological membrane, the rate is most directly proportional to which physicochemical property of the drug?

A

Molecular weight

B

logP (lipophilicity)

C

Melting point

D

pKa

Q99

The stomatal index, a parameter measured during microscopical evaluation, is determined by calculating:

A

The ratio of stomata to the total number of epidermal cells

B

The density of xylem vessels

C

The number of veins per unit area

D

The total number of chloroplasts per cell

Q100

What is the typical adult dose of Dextromethorphan for cough?

A

10 mg every 8 hours

B

20 mg every 4 - 6 hours

C

50 mg daily

D

200 mg every 12 hours

Q101

Which of the following describes a 'Serious Adverse Event' (SAE) as per international regulatory standards?

A

Any side effect that requires a dose adjustment

B

An event that results in death, hospitalization, or permanent disability

C

Any reaction that is listed in the drug's package insert

D

A mild rash that resolves within 24 hours

Q102

Which of the following best describes respiratory acidosis?

A

Decreased PaCO2, increased pH, decreased HCO3-

B

Increased PaCO2, decreased pH, increased HCO3-

C

Decreased PaCO2, decreased pH, decreased HCO3-

D

Increased PaCO2, increased pH, increased HCO3-

Q103

According to GMP, what must be documented for each stability pull point?

A

Test results

B

Date of analysis

C

Analyst signature

D

All of the above

Q104

A 58-year-old man on chronic NSAID therapy develops a sudden rash with blisters and mucosal lesions after ingestion of a new antibiotic. What is the most characteristic diagnosis?

A

Stevens-Johnson syndrome

B

Toxic epidermal necrolysis

C

Acute generalized exanthematous pustulosis

D

Acute interstitial nephritis

Q105

Which of the following spectroscopic techniques is most definitive for determining the exact carbon-hydrogen skeleton and the connectivity of atoms in an isolated phytochemical?

A

UV-Visible spectroscopy

B

Infrared (IR) spectroscopy

C

Nuclear Magnetic Resonance (NMR) spectroscopy

D

Flame photometry

Q106

Which gene region is most commonly used for DNA barcoding of medicinal plants in the Nepal Pharmacopoeia for species identification?

A

rbcL

B

matK

C

ITS2

D

COX1

Q107

A patient with seasonal allergic rhinitis asks for a non-sedating antihistamine. Which of the following is the preferred choice in Nepal's formulary?

A

Chlorpheniramine

B

Cetirizine

C

Diphenhydramine

D

Promethazine

Q108

Which of the following best describes the primary pharmacological action associated with alkaloids commonly found in plants?

A

Direct stimulation of muscle contraction

B

Inhibition of inflammatory pathways

C

Increased cellular glucose metabolism

D

Modulation of neurotransmitter receptors

Q109

Which stationary phase is most suitable for separating polar compounds on a GC column?

A

low-polarity

B

high-polarity

C

chiral

D

fluorinated

Q110

Which of the following is a mandatory acceptance criterion for a stability-indicating assay?

A

The method must separate all degradation products

B

The assay must be linear over at least three concentration levels

C

System suitability must be met for each run

D

All of the above

Q111

According to GPP, what is the 'correct' way to handle a medication error that has reached the patient?

A

Ignore it if the patient suffered no apparent harm

B

Hide the error to protect the pharmacy's reputation

C

Disclose the error to the patient and take corrective action

D

Blame the pharmacy technician to avoid legal liability

Q112

A generic product shows 95% CI of AUC ratio 82–121% and Cmax ratio 78–131%. What is its bioequivalence status?

A

Bioequivalence is established

B

Bioequivalence is not established

C

Partially bioequivalent

D

Study is inconclusive

Q113

Following actions related to cytotoxicity of Alkylating agents are true except:

A

Breakage of DNA strand

B

Cross linking of DNA strands

C

Abnormal pairing of Purine and Pyrimidine bases

D

Inhibition of DNA Isomerase

Q114

Cyclosporin act as an immunosuppressant:

A

TNF-alpha neutralizer

B

IL-2 Calcineurin inhibitor

C

DNA Synthesis inhibitor

D

Inhibition of beta-lymphocyte

Q115

Insulin causes reduction in blood sugar level by the following mechanisms, EXCEPT:

A

Increased glucose uptake in the peripheral tissue

B

Reduction of breakdown of glycogen

C

Diminished gluconeogenesis

D

Decreased glucose absorption from the gut

Q116

Which of the following statements correctly explains the relationship between the area under the serum concentration-time curve (AUC) and therapeutic efficacy?

A

AUC reflects only the amount of drug excreted unchanged by the kidneys

B

AUC reflects the amount of drug remaining in the original dosage form

C

AUC reflects only the rate of drug absorption and not the total extent of systemic exposure

D

Higher AUC generally reflects greater total systemic drug exposure and correlates with greater therapeutic effect

Q117

Antidote used for benzodiazepines overdose:

A

Phenobarbitone

B

Flumazenil

C

Chlorpromazine

D

Imipramine

Q118

Which drug would be most appropriate in a patient with suspected H. pylori infection and peptic ulcer disease?

A

Antacids

B

Anti-H.pylori Drugs

C

Bulk Forming Laxatives

D

Diphenoxylate

Q119

In Nepal's pharmacy governance structure, the primary contribution of the Ministry of Health and Population (MOHP) is:

A

Formulating national health policies and providing overall policy oversight to regulatory bodies such as the Department of Drug Administration

B

Registering pharmacists and setting standards for pharmacy education through the Nepal Pharmacy Council

C

Directly regulating the import, manufacture, sale, and distribution of pharmaceutical products

D

Representing the commercial interests of domestic pharmaceutical manufacturers

Q120

The historical figure, Dr. Shanta Lal Joshi, held what key position within the DDA?

A

Research Director

B

First director general

C

Training Coordinator

D

Chief Pharmacist

Q121

Which of the following excipients is MOST likely to contribute to a longer disintegration time in a dispersible tablet?

A

Sodium starch glycolate

B

Mannitol

C

Large particle size fillers

D

Microcrystalline cellulose

Q122

Which of the following is the primary life-threatening complication that must be managed in a barbiturate overdose?

A

Respiratory depression

B

Cardiovascular support

C

Sedative-hypnotic activity

D

Central nervous system excitation

Q123

Which factor is MOST important when interpreting a pill count as an indicator of medication adherence?

A

It should be considered alongside other evidence, not as a sole determinant

B

It directly measures drug bioavailability

C

It provides absolute proof of medication intake

D

It identifies all medication discrepancies

Q124

A patient is discharged with a prescription for oral metoprolol. The floor/ward pharmacy's role in this situation is primarily to:

A

Dispense the medication and provide patient counseling.

B

Conduct a comprehensive review of the patient's entire medication list.

C

Order the medication from the central pharmacy for home delivery.

D

Perform advanced pharmacokinetic modeling to determine the optimal dosage.

Q125

Which of the following factors significantly impacts the nephrotoxic potential of aminoglycosides?

A

Patient Age

B

Dietary Intake

C

High Doses

D

Genetic Predisposition

Q126

Which mechanism of action is characteristic of quinolones/fluoroquinolones?

A

Inhibition of bacterial DNA gyrase and topoisomerase IV

B

Interference with protein synthesis

C

Inhibition of DNA polymerase

D

Inhibition of bacterial cell wall synthesis

Q127

Concerning the development of pharmaceutical policies in Nepal, which entity holds the power to issue and enforce regulations for drug distribution?

A

Department of Drug Administration (DDA)

B

Ministry of Health and Population (MOHP)

C

Association of Pharmaceutical Producers of Nepal (APPON)

D

Nepal Pharmacy Association (NPA)

Q128

A patient taking a benzodiazepine reports excessive daytime sleepiness and difficulty concentrating. This most closely aligns with which type of adverse drug reaction?

A

Delayed effect

B

Augmented effect

C

Effect seen on chronic use

D

Allergic effect

Q129

What aspect of patient compliance is *least* likely to be directly influenced by a simple reminder system?

A

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

B

Medicines and Medical device use

C

Patient motivation and engagement with their treatment plan.

D

Patient's willingness to communicate concerns to healthcare providers.

Q130

A researcher is investigating the mechanism of action of Mitomycin. Which organism is the primary source from which this drug is initially isolated?

A

Streptomyces griseus

B

Streptomyces caespitosus

C

Streptomyces nodosus

D

Streptomyces rimosus

Q131

Methylergometrine (methylergonovine) is commonly used clinically as a:

A

Uterotonic agent for prevention and treatment of postpartum hemorrhage

B

Tocolytic agent for suppression of preterm labor

C

Antiemetic agent for chemotherapy-induced nausea and vomiting

D

Antispasmodic agent for relief of smooth muscle spasm

Q132

A prescription for amoxicillin states 'dispense as written'. The amoxicillin bottle's expiration date is 30th February 2023. Considering this, what is the MOST appropriate action for the pharmacist?

A

Immediately return the medication to the supplier, as expiration dates are strictly enforced.

B

Dispense the medication, as the expiration date is still within the acceptable range for amoxicillin.

C

Refuse to dispense due to the impending expiration date.

D

Dispense the medication with a warning to the patient to consume it within 2 days of dispensing.

Q133

A patient's blood glucose level is outside the normal therapeutic range. What is the primary concern regarding this finding in the context of pharmacological interventions?

A

Decreased appetite.

B

Potential for drug interactions and altered efficacy.

C

Increased risk of infection.

D

Dehydration and electrolyte imbalance.

Q134

A pharmacologist is designing a drug strategy. Which factor is MOST relevant when considering the potential for enterohepatic recirculation?

A

The drug's intrinsic binding affinity to plasma proteins.

B

The route of drug administration (e.g., oral vs. intravenous).

C

The extent of drug metabolism by liver enzymes.

D

The drug's distribution volume in the body.

Q135

What is the primary reason for considering the enterohepatic route when determining a patient's drug exposure?

A

To prevent adverse drug reactions.

B

To optimize drug absorption in the gastrointestinal tract.

C

To account for the reabsorption of drug metabolites.

D

To reduce the overall amount of drug administered.

Q136

A pharmacist receives a prescription for 'Prednisolone 5mg, q8h'. What does 'q8h' signify?

A

Every 8 hours.

B

The method of administration (e.g., oral).

C

The total daily dose.

D

The preferred brand of Prednisolone.

Q137

Co-trimoxazole (trimethoprim - sulfamethoxazole) has activity against which of the following organisms?

A

Escherichia coli

B

Mycobacterium tuberculosis

C

Pseudomonas aeruginosa

D

Candida albicans

Q138

In computer-aided drug design (CADD), what does "predictive" refer to?

A

The immediate availability of a new drug to patients

B

A guarantee of clinical efficacy for a candidate molecule

C

The ability of a computational model to forecast a molecule's biological activity from its chemical structure

D

The overall accuracy of a drug's design process

Q139

What is the most important principle to remember when recommending a non-prescription remedy for a patient with a mild sore throat?

A

Considering the patient's individual needs and potential drug interactions.

B

Selecting the most expensive option for optimal results.

C

Immediately administering the remedy to provide rapid relief.

D

Ignoring any reported side effects from the patient.

Q140

Allomones are chemical messengers produced by one organism that benefit the producer while influencing the behavior of another species. In behavioral pharmacology research, which of the following scenarios best exemplifies the study of such compounds?

A

Administering an anti-inflammatory drug to reduce inflammation in patients

B

Monitoring blood pressure continuously during surgery

C

Using a benzodiazepine to treat anxiety disorders

D

Testing whether a compound alters social dominance hierarchies among different animal groups

Q141

A researcher is investigating the potential of aspirin to mitigate inflammation in a preclinical model. Which assessment would be MOST directly related to measuring the impact of aspirin's pharmacological action?

A

Serum albumin concentration

B

Cytokine levels

C

Heart rate variability

D

Blood pressure

Q142

What is the primary purpose of administering intravenous fluids containing electrolytes, in addition to maintaining fluid balance?

A

Increasing the patient's metabolic rate.

B

Correcting electrolyte imbalances.

C

Maintaining osmotic pressure.

D

Enhancing drug absorption.

Q143

A pharmaceutical manufacturing team identifies a significant increase in product wastage during a new process implementation. Which phase of the PDCA cycle should they prioritize?

A

Prepare – to gather initial data about the process parameters.

B

Do – to immediately stop the process to prevent further losses.

C

Act – to implement a generic solution without understanding the issue.

D

Check – to systematically analyze the root cause of the increased wastage.

Q144

Which of the following is the most appropriate base for an ointment intended to be easily washable from the skin and provide a cooling effect?

A

White soft paraffin

B

Hard paraffin

C

Hydrophilic petrolatum

D

Water-removable (O/W) cream

Q145

A patient presents with severe abdominal pain. Laboratory analysis shows a significant increase in serum lipase. Why is serum lipase preferred over serum amylase for the diagnosis of acute pancreatitis?

A

Lipase is produced only in the pancreas

B

Lipase remains elevated for a longer period

C

Lipase is excreted faster by the kidneys

D

Lipase is only found in the urine

Q146

When counseling a pediatric patient’s caregiver about an oral antibiotic, the pharmacist should emphasize

A

The importance of completing the full course even if symptoms improve

B

That the dosage can be reduced if the child feels better

C

That the antibiotic can be shared with siblings if needed

D

That the syrup taste is not important

Q147

Which modification in the structure of Morphine leads to the development of Naloxone, converting it from an agonist to an opioid antagonist?

A

Replacement of the 3-OH with a methoxy group

B

Replacement of the N-methyl group with an allyl group

C

Removal of the 6-OH group

D

Addition of a fluorine atom to the aromatic ring

Q148

In a sterile manufacturing facility, 'depyrogenation' of glassware is most effectively achieved by:

A

Autoclaving at 121°C for 15 minutes

B

Dry heat sterilization at 250°C

C

Washing with distilled water

D

Filtering with 0.22 micron filters

Q149

According to the Nepal Pharmacy Council Act, the primary goal of the Council is to:

A

Sell pharmaceutical equipment

B

Regulate the education and professional conduct of pharmacists

C

Fix the prices of medicines in retail stores

D

Manufacture generic medicines for the government

Q150

Which of the following is the most critical component of a 'Pharmacy and Therapeutics (P&T) Committee' in a hospital setting?

A

Managing the hospital's financial budget

B

Developing and maintaining the hospital formulary

C

Scheduling the shifts of pharmacy technicians

D

Performing daily inventory audits of the store