Diploma in Pharmacy Licensure Exam preparation SET 2

Q1

Which of the following is the primary purpose of FEFO (First Expiry, First Out) stock rotation?

A

To minimize wastage and reduce the risk of expired medications being dispensed.

B

To simplify inventory tracking.

C

To ensure all medications are used within their shelf life simultaneously.

D

To create a more visually appealing stock display.

Q2

Which drug is used in combination with antibiotics for Helicobacter pylori eradication?

A

Omeprazole

B

Lactulose

C

Domperidone

D

Metoclopramide

Q3

A patient presents with constipation. Stool softeners are a suitable initial treatment. Which drug is most appropriate?

A

Docusate Sodium

B

Magnesium Oxide

C

Bisacodyl

D

Lactulose

Q4

The primary mechanism of action of Atropine is to:

A

Promote histamine release.

B

Block muscarinic acetylcholine receptors.

C

Stimulate adrenergic receptors.

D

Increase intestinal motility.

Q5

A patient presents with acute asthma symptoms. Which bronchodilator is MOST appropriate for immediate relief?

A

Salbutamol

B

Guaifenesin

C

Codeine

D

Theophylline-Aminophylline

Q6

The selection of aminoglycosides for treatment is primarily based on _________ susceptibility.

A

Gram-positive bacteria

B

Gram-negative bacteria

C

Viruses

D

Fungi

Q7

The primary difference in spectrum of activity between Metronidazole and Tinidazole is:

A

Tinidazole has a broader spectrum against anaerobic organisms

B

Metronidazole is more rapidly absorbed

C

Tinidazole has a longer half-life

D

Metronidazole is more expensive

Q8

Formative evaluation in a health education program is best described as:

A

A comprehensive evaluation conducted only at the end of the program.

B

Primarily focused on statistical data analysis.

C

Ongoing assessment used to guide program improvement and adaptation.

D

A final assessment of the entire program's success.

Q9

The clinical definition of 'marasmus' is primarily based on the presence of:

A

Severe protein deficiency and calorie restriction

B

Chronic inflammation

C

Elevated blood glucose levels

D

Genetic mutations

Q10

Naloxone's primary clinical use is associated with which substance?

A

Antihistamines

B

Antidepressants

C

Opioids

D

Benzodiazepines

Q11

A pharmacist is formulating a new oral dosage form. Which factor would MOST influence the selection of a suspension versus a solution?

A

Cost of excipients

B

Drug solubility

C

Particle size and stability

D

Patient preference

Q12

What is the most appropriate indicator to use when titrating a weak acid with a strong base?

A

Methyl red

B

Phenolphthalein

C

Crystal violet

D

Methyl orange

Q13

What is the percentage of medicinal herbs collected from government-managed forests in Nepal?

A

Approximately 80%

B

Approximately 70%

C

Approximately 50%

D

Approximately 35%

Q14

What is the primary goal of the Drug Services and Supply Chain Management (CSSD) process?

A

Patient counseling

B

Patient education

C

Patient compliance

D

Correct dispensing

Q15

The key difference between Phase I and Phase IV clinical trials is:

A

Phase I focuses on disease progression, Phase IV on prevention.

B

Phase I involves healthy volunteers, Phase IV involves post-marketing surveillance.

C

Phase I trials exclusively assess drug efficacy.

D

Phase I trials are always smaller than Phase IV trials.

Q16

The Nepal Medical Council Act was originally published in which year?

A

1975BS (1962AD)

B

1964AD (2020BS)

C

1980BS (1957AD)

D

2000BS (1983AD)

Q17

The NPC's Name Registration Certificate ensures the legal operation of what specific pharmaceutical activity?

A

The approval of drug formulations.

B

The registration of a pharmacy name.

C

The licensing of pharmacists.

D

The regulation of drug pricing.

Q18

Identify the year of the founding of the Nepal Pharmaceutical Association (NPA).

A

1985 AD

B

2010 AD

C

1970 AD

D

1992 AD

Q19

Which of the following is a key concern when prescribing corticosteroids and considering dose tapering?

A

Decreased bone density

B

Elevated cholesterol levels

C

Adrenal insufficiency

D

Increased risk of edema

Q20

Which mechanism is primarily responsible for the anti-inflammatory effect of NSAIDs?

A

Inhibition of cyclooxygenase (COX) enzymes

B

Blocking of voltage-gated sodium channels

C

Inhibition of histamine release

D

Activation of G-protein coupled receptors

Q21

What is a contraindication for the use of NSAIDs?

A

History of peptic ulcer disease

B

Mild hypertension

C

Mild renal impairment

D

Seasonal allergies

Q22

What is the typical adult dose of Dextromethorphan for cough?

A

10 - 20 mg every 4 - 6 hours

B

10 mg every 8 hours

C

50 mg daily

D

200 mg every 12 hours

Q23

Which anthelmintic inhibits ATP synthase in helminths?

A

Pyrantel pamoate

B

Mebendazole

C

Niclosamide

D

Praziquantel

Q24

What is a key criterion for selecting audio-visual media in health education?

A

Relevance to the target audience and the message

B

Cost-effectiveness

C

Technical complexity

D

Availability of equipment

Q25

Which evaluation type assesses the design of a health education program before implementation?

A

Outcome evaluation

B

Process evaluation

C

Formative evaluation

D

Summative evaluation

Q26

Which media selection criterion prioritizes the target audience's needs?

A

Technical feasibility

B

Message clarity

C

Cost-benefit analysis

D

Audience suitability

Q27

Which test is used to identify cardiac glycosides through hydrolysis?

A

Killer-Killani test

B

Saponification test

C

Hager's test

D

Wagner test

Q28

Which classification under the Nepalese Drug Act is associated with the highest legal penalties for possession?

A

Kha

B

Gaa

C

Ka

D

Gha

Q29

Which factor is most likely to cause capping in an emulsion?

A

Temperature fluctuations

B

Improper storage conditions

C

Inadequate emulsifier concentration

D

High shear during mixing

Q30

Which strategy best prevents capping in emulsions?

A

Optimizing emulsifier-to-liquid ratio

B

Adding stabilizers

C

Increasing storage temperature

D

Reducing mixing time

Q31

Which dosage form is commonly used for administering high-potency medications?

A

Large sized tablets

B

Large sized capsules

C

Large volume syrups

D

Small volume parenterals

Q32

Which of the following is a pro-drug?

A

Ticlopidine

B

Warfarin

C

Aspirin

D

Clopidogrel

Q33

What is a key contribution of the Medication Therapy Committee (MTC) structure to patient care?

A

Increasing pharmacy staffing levels

B

Offering discounts on prescription medications

C

Promoting rational drug utilization

D

Automating all pharmacy dispensing processes

Q34

Which substance is transported across the blood-brain barrier by the large neutral amino acid transporter?

A

Dopamine

B

Serotonin

C

Glutamate

D

Levodopa

Q35

Which issue involves the separation of tablet layers during compression?

A

Sticking

B

Lamination

C

Binding

D

Picking

Q36

What issue occurs when the powder in the die fails to flow properly, leading to poor tablet formation?

A

Lamination

B

Picking

C

Binding

D

Sticking

Q37

Which computer application is most vital for data storage in pharmacy systems?

A

Local file storage for paper records

B

Secure cloud-based databases for audit trails and compliance

C

Social media platforms for patient engagement

D

Printed inventory logs for manual tracking

Q38

Which statement best explains the core purpose of categorizing drugs using the Samuha Kha system?

A

To classify drugs based on their therapeutic effects and potential for interaction.

B

To determine drug pricing strategies.

C

To assess patient satisfaction with medication.

D

To track pharmaceutical manufacturing processes.

Q39

What does the term 'half-life' of a drug refer to?

A

The time required for the drug to reach maximum plasma concentration.

B

The time required for the plasma concentration of a drug to decrease by half.

C

The time required for the drug to be completely eliminated from the body.

D

The time required for the drug to achieve steady-state concentration.

Q40

Which statement correctly differentiates NSAIDs from DMARDs?

A

NSAIDs reduce inflammation, while DMARDs modify the disease process

B

NSAIDs are used for chronic pain, while DMARDs are for acute pain

C

NSAIDs target immune cells, while DMARDs inhibit enzymes

D

NSAIDs are only used in rheumatoid arthritis

Q41

Which cholinergic drug is PREFERRED for the long-term treatment of myasthenia gravis?

A

Pyridostigmine

B

Atropine

C

Pilocarpine

D

Neostigmine

Q42

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

A

Cycloserine

B

Pyrazinamide

C

Rifampicin

D

Ethambutol

Q43

Which antimalarial drug is primarily used for the radical cure of Plasmodium vivax?

A

Mefloquine

B

Artemisinin

C

Chloroquine

D

Primaquine

Q44

A hospital's management system is most directly related to:

A

Providing patient counseling services

B

Administering medications to patients

C

Performing medical research

D

Overseeing the efficient operation of the hospital to achieve its goals

Q45

What is the primary objective of conducting a VED analysis?

A

Assessing patient demand for specific drugs

B

Calculating the cost of procurement

C

Identifying factors affecting drug storage and dispensing

D

Determining optimal ordering quantities

Q46

Which of the following is a key consideration when documenting a patient's medication allergies in a clinical setting?

A

Patient's current medications.

B

Patient's age at the time of the reaction.

C

Patient's occupation.

D

Specificity of the allergic reaction (e.g., type I hypersensitivity).

Q47

What is the primary mechanism of action of Methotrexate in the treatment of rheumatoid arthritis?

A

Directly blocking pain signals.

B

Reducing histamine release.

C

Increasing prostaglandin production.

D

Inhibition of DNA synthesis in rapidly dividing cells.

Q48

Cefaclor belongs to which class of beta-lactam antibiotics?

A

Cloxacillin

B

Cephalosporins

C

Penicillins

D

Aztreonam

Q49

The addition of Sulbactam to Amoxycillin enhances its effectiveness by:

A

Decreasing the drug's affinity for bacterial penicillin-binding proteins

B

Blocking bacterial beta-lactamase activity

C

Increasing the drug's permeability across the bacterial membrane

D

Promoting bacterial cell wall synthesis

Q50

Which of the following is a key mechanism of action for macrolide antibiotics like erythromycin?

A

Direct lysis of bacterial cell membranes

B

Enhancement of bacterial DNA replication

C

Inhibition of bacterial protein synthesis

D

Promotion of bacterial cell wall synthesis

Q51

Ethambutol is frequently used in tuberculosis treatment to:

A

Alter DNA replication

B

Reduce inflammation

C

Enhance immune response

D

Inhibit bacterial cell wall synthesis

Q52

A patient on a tuberculosis treatment regimen exhibits signs of neurological symptoms. Which drug is MOST likely contributing to this effect?

A

Pyrazinamide

B

Ethambutol

C

INH

D

Rifampicin

Q53

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

A

Ciprofloxacin

B

Ethambutol

C

Pyrazinamide

D

INH

Q54

When considering cost-effective treatment, which document is most useful for pharmacists?

A

Drug compendia

B

Standard treatment guidelines

C

The formulary list

D

Pharmacokinetic databases

Q55

Which of these antifungals has the highest risk of drug interactions due to CYP450 metabolism?

A

Fluconazole

B

Nystatin

C

Ketoconazole

D

Clotrimazole

Q56

The primary goal of antiretroviral therapy (ART) is to:

A

Achieve and maintain viral suppression

B

Prevent the transmission of HIV to others

C

Eliminate all symptoms of HIV infection

D

Reverse all damage caused by HIV to the immune system

Q57

Which condition is NOT directly linked to the effects of Protein-Energy Malnutrition?

A

Anemia

B

Skin lesions

C

Night Blindness

D

Growth retardation

Q58

What is the MOST significant physiological impact of Protein-Energy Malnutrition on skin integrity?

A

Sebaceous Gland Overactivity

B

Increased Melanin Production

C

Impaired Barrier Function

D

Keratinization

Q59

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

A

Enhanced Cognitive Function

B

Increased Cardiac Output

C

Improved Lymphocyte Proliferation

D

Growth Retardation

Q60

What type of compound would you *least* likely extract using 'Menstrum'?

A

Lipids

B

Highly polar, water-soluble salts

C

Alkaloids

D

Terpenoids

Q61

The fetal development anomalies associated with the medications listed (Chloramphenicol, Barbiturates, Thalidomide, Cyclophosphamide) collectively represent what clinical phenomenon?

A

Genetic Mutations

B

Developmental Delay

C

Teratogenic Effects

D

Neonatal Abstinence Syndrome

Q62

Considering the editions, the earliest publication date of the Nepalese National Formulary is:

A

1997

B

2011

C

2010

D

1995

Q63

If a healthcare professional requires a catheter to easily navigate a thin vein, what French size would be MOST suitable?

A

A larger French size (e.g., 24 or 26)

B

The smallest available French size.

C

A French size specifically designed for obese patients.

D

Smaller French size (e.g., 20 or 22)

Q64

Large-sized tablets are primarily utilized for which purpose?

A

Minimizing the risk of injection-site reactions

B

Convenient and economical delivery of medications

C

Rapid absorption due to their surface area

D

Enhanced patient compliance through complex coatings

Q65

What should a pharmacist instruct a patient regarding a suspension medication to maintain its effectiveness?

A

Store the suspension in a dark cupboard.

B

Administer the suspension with a large glass of water.

C

Filter the suspension through a coffee filter.

D

Shake the bottle vigorously before each use.

Q66

A pharmacist identifies that a suspension formulation is exhibiting flocculation. What is the MOST appropriate immediate action?

A

Add a thickening agent to the formulation.

B

Increase the temperature of the suspension.

C

Re-deflocculate the suspension using appropriate techniques.

D

Reduce the particle size of the drug.

Q67

Which of the following factors primarily influences the stability of a dry powder inhaler formulation?

A

Solution pH

B

Particle agglomeration

C

Container material type

D

Temperature fluctuations

Q68

Levodopa is transported across the blood-brain-barrier (BBB) by which transporter?

A

Large neutral amino acid transporter

B

Glucose transporter

C

Sodium-potassium pump

D

Organic anion transporter

Q69

Considering the given information, a drug inspector's priority is determined by...

A

Maintaining accurate inventory records

B

Promoting patient satisfaction

C

Penalty if expired drug / Narcotic drug/ Adulterated drug likely to cause organ damage

D

Ensuring staff competency in dispensing medications

Q70

Norfloxacin's pharmacokinetic profile is characterized by relatively rapid absorption and excretion. Is this correct?

A

True

B

False - It exhibits slow absorption and prolonged half-life.

C

False - It is primarily eliminated through the liver.

D

False - Its bioavailability is significantly reduced.

Q71

A junior nurse questions the use of the French scale. What is the MOST appropriate response?

A

Tell the nurse that French size is outdated.

B

Explain its importance for safe and effective IV access.

C

Suggest using a different measurement system entirely.

D

Ignore the question, as it's simply a standard convention.

Q72

Which of the following statements accurately reflects the impact of sulphonamides on human physiology?

A

They enhance folic acid synthesis

B

They directly strengthen the immune system

C

They stimulate the production of erythrocytes

D

They can induce a folic acid deficiency in the patient

Q73

A company is importing drugs. Which section's requirements MUST be met before importation can occur?

A

Section 9 (Import or export of drugs)

B

Section 8 (Product License)

C

Section 7 (Recommendation letter to establish drug industry)

D

Section 10 (Registration of name & Firm for sales and distribution of drug)

Q74

In the context of health education, what is the key difference between formative and summative evaluation?

A

There is no practical difference between the two types of evaluation.

B

Formative evaluation focuses on long-term outcomes, while summative focuses on short-term.

C

Formative evaluation is only used for large-scale programs, while summative is for smaller ones.

D

Formative evaluation provides feedback for program improvement, while summative evaluation assesses the overall program effectiveness.

Q75

What does a French size '20' cannula represent?

A

A catheter designed for pediatric use only.

B

A catheter made of polypropylene.

C

A catheter with a reinforced tip.

D

A catheter with a diameter of 20 French units.

Q76

The various Departments under the Health Ministry, including the Department of Drug Administration, collectively contribute to which overarching goal?

A

Maintaining the health and well-being of the Nepali population through regulated drug use.

B

Prioritizing scientific research over patient care.

C

Reducing the cost of healthcare for all citizens.

D

Promoting the export of pharmaceutical products globally.

Q77

A patient is prescribed amoxicillin 500mg three times daily. What is the total daily dose in milligrams?

A

1500

B

150

C

2100

D

1050

Q78

Which factor is most directly linked to mottling in emulsions?

A

Incomplete dispersion of the dispersed phase

B

Phase separation

C

High viscosity

D

Emulsifier instability

Q79

What is the mechanism of action of zidovudine (an NRTI)?

A

Blocking viral entry

B

Chain termination

C

Inhibition of protease

D

Inhibition of integrase

Q80

What type of equipment is MOST essential for accurate measuring during extemporaneous compounding?

A

High-powered mixing blenders

B

Automated dispensing systems (for non-sterile products)

C

Calibrated scales and volumetric glassware

D

Temperature monitoring devices only

Q81

TT in vaccine formulations generally refers to:

A

BCG

B

Hepatitis, Anti Rabies, Anti-snake vaccines

C

DPT

D

Polio, Mefeals, TT

Q82

Which of the following antimicrobial agents is ineffective against methicillin-resistant Staphylococcus aureus (MRSA)?

A

Vancomycin

B

Linezolid

C

Daptomycin

D

Cefotaxime

Q83

Which of the following fluoroquinolones is most strongly associated with causing tendinitis (including Achilles tendon rupture) and peripheral neuropathy as adverse effects?

A

Ofloxacin

B

Ciprofloxacin

C

Norfloxacin

D

Levofloxacin

Q84

A pharmacist working in a Central Sterile Services Department (CSSD) is primarily responsible for which of the following activities?

A

Sterilization, disinfection, and quality control of surgical instruments and medical devices

B

Prescribing antimicrobial therapy for hospitalized patients

C

Counseling patients on adherence to chronic disease medications

D

Synthesizing new pharmaceutical compounds for clinical trials

Q85

In which year was the Association of Pharmaceutical Producers of Nepal (APPON) founded?

A

1980 AD

B

1970 AD

C

2010 AD

D

1990 AD

Q86

A core principle of the MTC's operation is adherence to:

A

The most frequently prescribed medications.

B

The lowest possible medication cost.

C

Best available clinical evidence.

D

The brand names of all pharmaceutical products.

Q87

Which test is used to detect the presence of cardiac glycosides through the formation of a red precipitate?

A

Saponification test

B

Keller-Kiliani test

C

Wagner test

D

Hager's test

Q88

The choice of Metronidazole over another antiprotozoal agent might be influenced by:

A

Its broader spectrum of activity

B

Its efficacy against anaerobic infections

C

Its superior bioavailability

D

Its lower cost compared to Diloxanide Furorate

Q89

Regarding the expiry of drugs, what is the primary driver for monitoring shelf life decreases?

A

Complying with regulatory requirements regarding packaging materials.

B

Tracking inventory management efficiency.

C

Maintaining the potency and efficacy of the medication.

D

Ensuring product labeling compliance.

Q90

A patient presenting with pain and inflammation, requiring potent anti-inflammatory effects, would likely be most appropriately treated with:

A

Paracetamol

B

Diclofenac sodium

C

Ibuprofen

D

Piroxicam

Q91

Which statement accurately describes the difference between a Side Effect and an Adverse Drug Reaction?

A

A side effect is predictable, while an ADR is unpredictable.

B

An ADR is always more serious than a side effect.

C

A side effect always requires immediate intervention.

D

Both terms refer to the same type of drug response.

Q92

Contraindications to Atenolol primarily involve affecting which physiological system?

A

Renal System

B

Gastrointestinal System

C

Cardiovascular System

D

Respiratory System

Q93

Which of the following is a key function of the Central Sterile Services Department (CSSD) in a hospital?

A

Compounding sterile creams and ointments for direct patient application

B

Decontaminating, sterilizing, and distributing reusable surgical instruments and medical devices

C

Preparing intravenous medications for direct administration

D

Dispensing prescription medications to hospitalized patients

Q94

In what year was the National Pharmaceutical Association (NPA) of India inaugurated?

A

1970

B

1975

C

2005

D

1988