Question 1
Which of the following medicines does NOT need to be withheld if a patient has a dehydrating illness?
Correct Answer:
Edoxaban
Explanation:
When a patient has a dehydrating illness, the safety concern centers on how reduced circulating volume and potential renal impairment affect drug clearance and risk of adverse effects. Drugs that can worsen dehydration or rely heavily on stable renal function are the ones you typically withhold. Lisinopril (an ACE inhibitor) can reduce renal perfusion further and lower blood pressure during dehydration, so it’s usually held. Metformin carries a risk of lactic acidosis when renal function is compromised or perfusion is reduced, so it’s held as well. Furosemide is a diuretic that can worsen volume depletion, making withholding appropriate in dehydration. Direct oral anticoagulants like edoxaban, while they carry a bleeding risk, are not automatically withheld solely because of dehydration. The decision hinges more on the patient’s bleeding risk and renal function rather than dehydration by itself. If rehydration improves perfusion and renal function, anticoagulation can be continued or resumed in many cases. Therefore, in the context of dehydration alone, edoxaban is the one that does not require automatic withholding, compared with the other medications listed.
Question 2
Which of the following combinations does not cause a clinically significant drug interaction?
Correct Answer:
Clarithromycin, Ramipril
Explanation:
Clinically significant interactions happen when one drug markedly changes the level or effect of another, either by altering metabolism/clearance (pharmacokinetic) or by producing a harmful additive effect (pharmacodynamic). The pairing of clarithromycin with ramipril does not create such a risk because ramipril is activated by esterases and not by CYP enzymes that clarithromycin inhibits, and there isn’t a shared adverse-effect threat that would be amplified here. In contrast, digoxin with amiodarone is a known interaction that raises digoxin levels and toxicity risk; lithium with bendroflumethiazide increases lithium levels and toxicity risk; while warfarin with ramipril is generally safe but can require monitoring due to individual variability. Therefore, clarithromycin with ramipril does not lead to a clinically significant interaction.
Question 3
Which medication in the elderly woman’s chart is most likely responsible for digoxin toxicity through electrolyte disturbance?
Correct Answer:
Furosemide
Explanation:
Electrolyte disturbances can amplify digoxin toxicity by changing how digoxin interacts with the Na+/K+ ATPase in heart cells. When potassium or magnesium levels drop, digoxin binds more readily to this enzyme, increasing its effects and the risk of dangerous arrhythmias. A loop diuretic like furosemide causes loss of potassium and magnesium in the urine, leading to hypokalemia and hypomagnesemia that predispose to digoxin toxicity. In an elderly patient, reduced renal function can further raise digoxin levels, but the key link is the electrolyte loss from the loop diuretic. Spironolactone raises potassium, ramipril can cause hyperkalemia, and bisoprolol doesn’t create the same electrolyte disturbances that promote digoxin toxicity.
Question 4
A 30-year-old woman in her second trimester of pregnancy presents with ongoing constipation. She has been eating more fibre and drinking more fluids, but this has not improved her symptoms. Which one of the following is the most appropriate recommendation?
Correct Answer:
Lactulose oral solution
Explanation:
Constipation in pregnancy often arises from slowed gut motility due to hormonal changes and iron supplementation. When lifestyle measures (more fiber and fluids) don’t help, the safest and most effective next step is an osmotic laxative that isn’t absorbed systemically. Lactulose works in the colon by drawing water into the stool, softening it and increasing bowel movements, and it has a long history of safe use in pregnancy with minimal systemic absorption. Stimulant laxatives like senna are generally avoided in pregnancy because they can stimulate uterine activity and cramping. Glycerol suppositories provide rapid, short-term relief and aren’t ideal for ongoing management. Docusate sodium helps soften stool but may not be sufficient for constipation with harder stools. So lactulose is the best option in this scenario.
Question 5
An 11-year-old child has a private prescription for melatonin tablets. Which statement regarding repeats is correct?
Correct Answer:
The prescription cannot be repeated unless the prescriber has added a direction for repeat
Explanation:
Repeats on private prescriptions aren’t automatic. The prescriber must explicitly add a repeat instruction to allow the pharmacy to dispense the medicine more than once. If no repeat instruction is given, the pharmacist may supply only a single course. Melatonin here isn’t inherently repeatable; its repeat status depends entirely on what the prescriber writes. That’s why the statement that the prescription cannot be repeated unless the prescriber has added a direction for repeat is the best answer. The other options misstate how private repeats work (whether they happen automatically, or are restricted for melatonin, or depend on the absence of a repeat instruction).
Question 1
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Prepare with the Foundation Year Pharmacy – Clinical Practice Test practice quiz. This question bank includes 10 questions covering drug, woman, year-old, second, and dose. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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Foundation Year Pharmacy – Clinical Practice Test

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