Diploma in Pharmacy Licensure Exam preparation SET 2

Q1

A nurse reports a concern about the storage conditions of a controlled substance. What is the MOST important first step for the pharmacist to take?

A

Immediately transfer the entire stock to a secure, locked location.

B

Perform a VED analysis to assess the environment and dispensing process.

C

Assume the issue is minor and simply monitor the stock for further problems.

D

Contact the hospital administration to file a formal complaint.

Q2

Which of the following is NOT a typical responsibility of a pharmacist?

A

Overseeing medication distribution

B

Providing emergency medical care

C

Ensuring legal compliance with drug regulations

D

Participating in the pharmaceutical industry

Q3

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.

Q4

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.

Q5

A patient reports nausea and vomiting after taking Praziquantel. This side effect is most likely due to:

A

The drug's emetic effect

B

Increased peristalsis

C

Drug interaction with food

D

A systemic allergic reaction

Q6

Which antifungal is preferred for oral thrush in immunocompromised patients?

A

Nystatin

B

Ketoconazole

C

Clotrimazole

D

Fluconazole

Q7

The use of Flumazenil in benzodiazepine overdose carries a risk of what adverse effect?

A

Seizures

B

Respiratory depression

C

Bradycardia

D

Hypotension

Q8

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

A

Increase blood flow to the stomach

B

Enhance the visibility of the digestive system

C

Reduce nausea

D

Decrease radiation exposure

Q9

Which antifungal is contraindicated in patients with liver disease?

A

Fluconazole

B

Nystatin

C

Ketoconazole

D

Griseofulvin

Q10

What does the acronym 'FIFO' represent in the context of pharmaceutical stock management?

A

First-in, First-Out - dispensing items in the order they were received.

B

Fastest Stock Number - prioritizing items with the lowest stock numbers.

C

First-Expiry, First-Out - dispensing items with the earliest expiry dates first.

D

Frequently Evaluated Order - prioritizing frequently ordered items.

Q11

What is the primary purpose of documenting medication allergies?

A

To prevent adverse drug reactions

B

To monitor laboratory tests

C

To identify drug interactions

D

To assess medication costs

Q12

Which drug is used in the treatment of constipation and works by increasing intestinal water content?

A

Psyllium

B

Lactulose

C

Senna

D

Docusate

Q13

Classifying hospitals based on criteria like size and services primarily impacts:

A

Patient satisfaction surveys.

B

The hospital's architectural design.

C

Staffing levels based on historical data.

D

Resource allocation and service delivery.

Q14

A patient complains of nausea and vomiting. Which antiemetic medication would be MOST suitable for immediate symptomatic relief?

A

Ondansetron

B

Domperidone

C

Diphenoxylate

D

Metoclopramide

Q15

The classification system 'Ga' predominantly focuses on:

A

Biologics

B

Prescription medications

C

Over-the-Counter medications

D

Generic pharmaceuticals

Q16

A pharmacist is advising a patient on a new medication. Which tablet type would be MOST suitable for administration immediately after a meal?

A

Sugar coated

B

Orodispersible

C

Film coated

D

Enteric coated

Q17

Which of the following is a pharmaceutical manufacturing company based in Nepal?

A

Lomus Pharmaceuticals

B

Pfizer

C

GlaxoSmithKline

D

Novartis

Q18

The provided information focuses on the establishment timeline of pharmaceutical companies. What type of update is represented by the revision of the 'Drug Act'?

A

A technological advancement in drug manufacturing

B

A change in personnel within the regulatory body

C

A legislative update

D

A marketing campaign for a specific drug

Q19

Understanding the therapeutic index helps clinicians primarily in:

A

Predicting drug absorption

B

Assessing drug synthesis pathways

C

Evaluating drug interactions

D

Determining safe dosage ranges

Q20

Aminoglycosides such as gentamicin may be given by several parenteral routes depending on the clinical situation. Which of the following routes is NOT used for systemic administration of aminoglycosides?

A

Intramuscular injection

B

Intravenous infusion

C

Intrathecal administration

D

Oral administration

Q21

Which dosage form is most suitable for administering large volumes of medication orally?

A

Syrups

B

Parenterals

C

Tablets

D

Capsules

Q22

Which year is the second latest publication year of the Nepalese National Formulary?

A

1997

B

2011

C

1995

D

2010

Q23

During a routine regulatory inspection of a pharmaceutical manufacturing facility, inspectors identify that a batch of a marketed drug has been adulterated. What is the primary regulatory goal or consequence of the inspection in this situation?

A

Imposition of penalties and enforcement actions against the manufacturer

B

Implementation of a new manufacturing process for the drug

C

Publication of research findings regarding the drug's effects

D

Modification of the drug's packaging materials

Q24

A patient with chronic obstructive pulmonary disease (COPD) presents with an acute exacerbation and is prescribed salbutamol (albuterol) via a metered-dose inhaler for relief of bronchospasm. Which dose range is appropriate for this patient, pending individual assessment of response and side effects?

A

400 mcg every 4 to 6 hours

B

100 mg every 2 hours

C

20 mg every 6 hours

D

500 mg intravenously twice daily

Q25

A patient complains of metallic taste and nausea while taking Metronidazole. This is most likely due to:

A

Hypersensitivity reaction

B

Drug-induced disulfiram-like reaction

C

Common adverse effect of metronidazole

D

Inadequate hydration

Q26

Which drug is primarily used for respiratory tract infections and is effective against Pseudomonas aeruginosa?

A

Ciprofloxacin

B

Nitrofurantoin

C

Levofloxacin

D

Norfloxacin

Q27

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

A

Insulin glargine

B

Metformin

C

GLP-1 receptor agonists

D

Sulfonylureas

Q28

Which dosage form is commonly used for medications that require rapid absorption?

A

Large sized tablets

B

Large volume syrups

C

Large volume parenterals

D

Large sized capsules

Q29

Sulphasalazine's main therapeutic application is in the treatment of:

A

Respiratory Tract Infections (RTIs)

B

Inflammatory Bowel Disease (IBD)

C

Urinary Tract Infections (UTIs)

D

Skin Infections

Q30

Which of the following is a first-line antitubercular drug?

A

PAS

B

Ciprofloxacin

C

Cycloserine

D

Rifampicin

Q31

What is the primary advantage of IV Regular insulin in the treatment of DKA?

A

Lower cost

B

Reduced patient nausea

C

Extended duration of action

D

Rapid onset of action

Q32

What legal requirement must be followed for compounding?

A

Adherence to FDA guidelines and local pharmacy laws

B

Using unapproved ingredients

C

Compounding without documentation

D

Ignoring regulatory standards

Q33

Which of the following is a major focus of Pharmacognosy, particularly relevant to the study of Nepali medicinal plants?

A

Large-scale pharmaceutical synthesis

B

Microscopic examination of plant tissues

C

Genetic modification of crops

D

Statistical analysis of drug efficacy

Q34

When advising a patient on dietary modifications alongside medication for hypertension, the pharmacist should primarily focus on:

A

The relationship between dietary changes and medication effectiveness.

B

The specific type of supplements to take.

C

The impact of sodium intake on blood pressure control.

D

The importance of consuming a purely vegetarian diet.

Q35

Which of the following best describes the primary reason for dose tapering with corticosteroids like Prednisolone?

A

To prevent adrenal suppression and rebound Cushing's syndrome.

B

To increase the drug's bioavailability.

C

To decrease the risk of infection.

D

To improve patient compliance.

Q36

A researcher is investigating the dissolution of a new drug product. Which dissolution media would be MOST appropriate for determining the rate of an oro-dispersible tablet?

A

Solutions with high pH.

B

Aqueous solutions with a low viscosity.

C

Solutions containing enzymes.

D

Oil-based solutions.

Q37

A pharmaceutical analyst needs to calculate the fill weight of a capsule. The tapped density of the powder is 0.7 g/cm3 and the capsule size is 2. What fill weight should be achieved?

A

530

B

260

C

189

D

140

Q38

What is the key difference in therapeutic action between Flumazenil and Atropine?

A

Flumazenil reverses benzodiazepine effects, while Atropine blocks muscarinic receptors.

B

Both drugs act as benzodiazepine receptor antagonists.

C

Both drugs are used to treat respiratory depression.

D

Flumazenil treats anticholinergic toxicity, while Atropine treats benzodiazepine overdose.

Q39

What is the standard route of administration for the Anti-Rabies vaccine?

A

Intramuscular

B

Intravenous

C

Subcutaneous

D

Oral

Q40

Which application of computers in pharmacies directly supports clinical decision-making?

A

Generating financial reports

B

Printing prescription labels

C

Providing evidence-based drug information and dosing guidelines

D

Managing pharmacy inventory

Q41

In which year was the Nepal Pharmaceutical Association (NPA) founded?

A

1965

B

1970

C

1980

D

2000

Q42

Which of the following BEST describes the primary function of the Department of Drug Administration (DDA) in Nepal?

A

Managing public health campaigns focused on disease prevention

B

Funding research and development of new drugs

C

Direct provision of healthcare services

D

Regulation and control of pharmaceuticals

Q43

In which year was the Nepal Pharmaceutical Association (NPA) established?

A

1974

B

1982

C

1990

D

1995

Q44

In the autonomic nervous system, which neurotransmitter is stored in vesicles and released at the adrenergic synapse?

A

Acetylcholine

B

Dopamine

C

Norepinephrine

D

Histamine

Q45

A 0.10 M solution of sodium acetate (CH₃COONa) is mixed with 0.10 M acetic acid (CH₃COOH) in equal volumes. What is the pH of the resulting solution? (pKa of acetic acid = 4.76)

A

4.76

B

5.26

C

5.76

D

6.26

Q46

A patient weighing 70 kg is prescribed a drug dose of 5 mg per kilogram. What is the total dose in milligrams?

A

35 mg

B

350 mg

C

5 mg

D

700 mg

Q47

Which of the following ingredients is commonly used as a suspending agent in a medicated paste?

A

Carbomer

B

Zinc oxide

C

Liquid paraffin

D

Polyoxyethylene sorbitan monooleate

Q48

In filtration, the 'filter aid' is primarily added to:

A

Increase the viscosity of the liquid

B

Prevent the blinding of the filter medium

C

Decrease the pressure drop across the cake

D

Increase the purity of the filtrate

Q49

The term "critical quality attribute" (CQA) refers to:

A

Any characteristic of a product that can be measured using simple equipment

B

A property that directly influences the product's safety and efficacy

C

A parameter that is only relevant during the packaging stage

D

An attribute that is controlled solely by the marketing department

Q50

In a patient with atrial fibrillation and hypotension, which drug is preferred for initial rate control?

A

Digoxin

B

Verapamil

C

Atenolol

D

Amiodarone

Q51

Which of the following antibiotics is most appropriate for treating a patient with a suspected synergistic infection of the anaerobic bacteria in the abdomen?

A

Metronidazole

B

Gentamicin

C

Ciprofloxacin

D

Azithromycin

Q52

A parenteral solution contains 0.9% w/v NaCl. What is the primary purpose of this inorganic salt in the formulation?

A

To act as a preservative

B

To provide isotonicity with blood plasma

C

To enhance drug solubility by complex formation

D

To neutralize the solution pH

Q53

Which of the following reagents is used in the Liebermann-Burchard test for steroids?

A

Acetic anhydride and concentrated sulphuric acid

B

Concentrated nitric acid and sulfuric acid

C

Ferric chloride solution

D

Alkaline potassium permanganate

Q54

Which microscopic feature is most useful for distinguishing the bark of a woody plant used as a crude drug?

A

Presence of stone cells (sclereids)

B

Shape of the pollen grain

C

Size of the leaf epidermal cells

D

Number of stomata per mm²

Q55

Which of the following agents is a natural mucilage obtained from the seeds of Plantago ovata and is used as a demulcent?

A

Gum tragacanth

B

Guar gum

C

Isabgol (Plantain seed mucilage)

D

Gum acacia

Q56

Which vitamin is a precursor for the coenzyme NAD⁺, essential for dehydrogenase reactions?

A

Niacin (Vitamin B3)

B

Riboflavin (Vitamin B2)

C

Pantothenic acid (Vitamin B5)

D

Thiamine (Vitamin B1)

Q57

Which of the following best describes the mechanism of action of glutaraldehyde as a high-level disinfectant?

A

Disruption of cell membranes by lipid dissolution

B

Oxidation of sulfhydryl groups in proteins

C

Cross-linking of amino groups in proteins and nucleic acids

D

Denaturation of proteins by high pH

Q58

Which of the following best explains why diabetic patients have delayed wound healing?

A

Impaired neutrophil function and reduced growth factor production

B

Excessive platelet aggregation causing early clot dissolution

C

Hyperactive fibroblast activity leading to excessive scar tissue

D

Increased prostaglandin synthesis causing prolonged inflammation

Q59

Which of the following is a key role of the clinical pharmacist in a unit-dose distribution system?

A

Performing bedside medication administration

B

Conducting bulk inventory counts on the ward

C

Reviewing medication orders and ensuring appropriate dose preparation

D

Managing ward nurses' schedules

Q60

When a pharmacy receives a batch of radiopharmaceuticals, which of the following is the correct initial handling step?

A

Store them at room temperature in a regular cabinet

B

Place them in a lead-lined, locked storage area and record the batch in the radioactive material register

C

Dispose of any unused portion in the regular waste stream

D

Transfer them directly to the ward without documentation

Q61

The Naranjo algorithm is used for:

A

Assessing drug efficacy

B

Classifying drug interactions

C

Determining causality of an adverse drug reaction

D

Calculating dosage

Q62

The legal requirement for labeling an OTC medication sold in Nepal includes all EXCEPT:

A

Name of the drug

B

Dosage form

C

Batch number

D

Price

Q63

According to the Nepal Pharmacy Council Act, which of the following promotional activities is prohibited for prescription-only medicines?

A

Distribution of free samples to registered pharmacists

B

Displaying the brand name on pharmacy windows

C

Organizing a medical conference sponsored by the manufacturer

D

Advertising in a medical journal

Q64

A community pharmacy must display which of the following documents prominently at the premises?

A

the Nepal Pharmacy Act

B

the latest drug price list

C

the pharmacist's registration certificate

D

the pharmacy's annual financial report

Q65

Which of the following best describes the role of a pharmacist in handling over-the-counter (OTC) drug sales?

A

Sell any OTC drug requested without inquiry to maximize profit

B

Recommend the most expensive OTC product available on the shelf

C

Assess customer needs and recommend appropriate, safe OTC products

D

Refuse to sell any OTC medications to avoid responsibility

Q66

The crude drug "Amla" (Phyllanthus emblica) is rich in which vitamin, making it a popular antioxidant in Nepalese traditional formulations?

A

Vitamin C

B

Vitamin A

C

Vitamin D

D

Vitamin B12

Q67

Which intervention by a community pharmacist best promotes rational use of antibiotics in the community?

A

Dispensing antibiotics without prescription for common cold

B

Providing patient counseling on completing the full course

C

Selling antibiotics in loose form

D

Recommending higher doses for faster recovery

Q68

In an SN2 reaction used for drug synthesis, which of the following is a strong nucleophile?

A

Water

B

Acetate ion

C

Chloride ion

D

Methanol

Q69

A patient presenting with acute pulmonary edema and severe hypertension is treated with Nitroprusside. What is the primary mechanism of this drug?

A

Selective alpha-1 blockade

B

Direct stimulation of beta-2 receptors

C

Release of nitric oxide causing balanced venodilation and arteriodilation

D

Inhibition of angiotensin-converting enzyme

Q70

Which of the following sulfonamides is primarily used for the treatment of burns and skin infections due to its high solubility?

A

Sulfadiazine

B

Sulfacetamide

C

Sulfamethoxazole

D

Sulfisoxazole

Q71

Which resin is obtained from the Boswellia tree and is used in religious ceremonies for its aromatic smoke?

A

Frankincense

B

Myrrh

C

Copal

D

Dammar

Q72

During a sterility test, growth is observed only in the Tryptic Soy Broth (TSB) and not in the Fluid Thioglycollate Medium (FTM). Which type of contaminant does this pattern suggest?

A

Obligate anaerobe

B

Facultative anaerobe

C

Obligate aerobe

D

Microaerophilic organism

Q73

Which activity exemplifies a clinical pharmacist's contribution to antimicrobial stewardship during a ward round?

A

Reviewing culture results and recommending de-escalation of therapy

B

Mixing antibiotics in the ward

C

Delivering patient discharge instructions

D

Managing pharmacy stock

Q74

The pH of human blood is maintained around 7.4 primarily by which buffer system?

A

Acetate - acetic acid buffer

B

Carbonate - bicarbonate buffer

C

Phosphate buffer

D

Borate buffer

Q75

A seronegative adult health-care worker is exposed to a patient with active varicella (chickenpox). Which antiviral is recommended for post-exposure prophylaxis?

A

Acyclovir

B

Valacyclovir

C

Famciclovir

D

Ganciclovir

Q76

Hydrolyzable tannins are esters of gallic acid with which polyol?

A

Glucose

B

Fructose

C

Sucrose

D

Mannose

Q77

Which bacterial shape is described as spherical cells arranged in clusters resembling grapes?

A

Cocci in chains

B

Staphylococci

C

Bacilli

D

Spirilla

Q78

How should a pharmacy technician respond to a broken ampoule of a hazardous drug inside a biological safety cabinet?

A

Leave the broken glass in the cabinet and continue work

B

Use a brush to sweep debris into the trash and resume work

C

Immediately stop work, evacuate the cabinet, and clean the spill using appropriate PPE and a spill kit

D

Neutralize the drug with a chemical antidote before cleaning

Q79

In TDM, what is the primary purpose of measuring a peak (maximum) drug concentration?

A

To confirm patient compliance

B

To ensure the dose is high enough to be therapeutic

C

To detect drug interactions

D

To assess renal function

Q80

Under the Narcotic Drugs and Psychotropic Substances (NDPS) Act, a "dangerous drug" is defined as:

A

Any substance that can be bought without a prescription

B

Any substance listed in Schedule I or II of the NDPS Act

C

Any herbal remedy used traditionally

D

Any drug classified as Schedule III

Q81

Which of the following is the primary reason for using a 'stiffening agent' such as cetyl alcohol in the formulation of a cream?

A

To increase the solubility of the drug

B

To act as a preservative

C

To increase the viscosity and stability of the emulsion

D

To decrease the melting point of the base

Q82

In the synthesis of serine from glycine, which vitamin-derived cofactor is required by serine hydroxymethyltransferase?

A

Tetrahydrofolate (THF)

B

Flavin adenine dinucleotide

C

Thiamine pyrophosphate

D

Pyridoxal phosphate

Q83

A clinical pharmacist conducting medication reconciliation on admission relies on which distribution system to access accurate dispensing records?

A

Floor stock with manual logs.

B

Unit-dose system with electronic dispensing records.

C

Outpatient pharmacy records only.

D

Patient-brought medication list.

Q84

Under the Nepal GPP guidelines, a community pharmacy must maintain a separate register for which category of drugs?

A

Generic medicines only

B

Schedule H (prescription-only) drugs

C

Narcotic and psychotropic substances

D

Free samples received from manufacturers

Q85

Which of the following inorganic salts is commonly used as a leavening agent in effervescent tablet formulations?

A

Sodium bicarbonate

B

Sodium chloride

C

Potassium permanganate

D

Calcium carbonate

Q86

Which of the following statements about customer complaints in a pharmacy is most accurate?

A

Complaints should be ignored if the customer is known to be difficult

B

Complaints provide valuable feedback for improving service quality and patient safety

C

Only written complaints need to be documented

D

Complaints should be forwarded to the manufacturer directly

Q87

The principle behind selecting a menstruum based on matching polarity of the solvent with the target phytoconstituent is known as:

A

Like dissolves like

B

Minimum solvent principle

C

Partition coefficient rule

D

Isotonic saturation law

Q88

Which of the following constitutes the 'Secondary Level' of healthcare in the Nepal health system?

A

Health Posts

B

District Hospitals

C

Tertiary Care Centers

D

Community Clinics

Q89

A lyophilized powder for injection is supplied in a glass vial sealed with a rubber stopper. Which characteristic of the glass type is most critical to prevent breakage during autoclave sterilization?

A

Type I (borosilicate) glass

B

Type II (soda-lime) glass

C

Type III (plastic) vial

D

Type IV (aluminum) container

Q90

When counseling a family on disposal of unused antibiotics, the most appropriate recommendation is to:

A

Flush them down the toilet

B

Discard them in household waste

C

Take them to a local pharmacy for disposal

D

Donate them to other families

Q91

The Golgi apparatus is primarily involved in which of the following cellular processes?

A

ATP production

B

Protein folding and modification

C

DNA replication

D

Lipid synthesis

Q92

The pharmacy student shall work under the guidance of Apprentice master who is a

A

Pharmacy Technician

B

Chemist

C

Regd. Pharmacist

D

Druggist

Q93

Which functional group in the structure of the drug Lidocaine prevents it from being rapidly hydrolyzed by plasma esterases compared to Procaine?

A

Amide group

B

Ester group

C

Amine group

D

Ether group

Q94

Which drug is a potent phosphodiesterase-5 (PDE-5) inhibitor used in the management of pulmonary arterial hypertension?

A

Sildenafil

B

Bosentan

C

Epoprostenol

D

Milrinone

Q95

How is the assay of a powder blend performed using the single‑standard addition method?

A

A known amount of standard drug is added to the sample and the increase in analytical response is used for calculation

B

The standard is added after the HPLC run

C

The standard is mixed only with the mobile phase

D

The standard is used to calibrate the pH meter

Q96

The enzyme 'Alcohol Dehydrogenase' belongs to which of the following enzyme classes?

A

Hydrolases

B

Transferases

C

Oxidoreductases

D

Isomerases

Q97

Which of the following is a characteristic of a Type A (Augmented) adverse drug reaction?

A

Occurs in a small percentage of the population

B

Usually severe and requires immediate hospitalization

C

Related to the known pharmacological action of the drug

D

Independent of the drug dose

Q98

Which of the following occurs during the 'Absorption Phase' of a drug's pharmacokinetic profile?

A

The rate of elimination exceeds the rate of absorption

B

The rate of absorption exceeds the rate of elimination

C

The drug reaches a steady state immediately

D

The drug is exclusively metabolized by the kidneys

Q99

Which of the following is the mechanism of action of Aminoglycosides (e.g., Gentamicin)?

A

Inhibition of cell wall synthesis

B

Binding to the 30S ribosomal subunit causing mRNA misreading

C

Inhibition of folic acid synthesis

D

Disruption of the fungal cell membrane

Q100

During the preparation of a plant extract, the investigator observes a stable froth that persists for several minutes after vigorous shaking. Which phytochemical class is most likely responsible for this property?

A

Tannins

B

Alkaloids

C

Saponins

D

Flavonoids