Mock Questions

Question 1

Recently, the Chief Medical Officer argued that persisting health inequalities and the rising burden of long-term conditions pose a challenge for public health systems, which requires a new wave of public health, also known as the ‘fifth wave’.

Which of the following is the fifth wave of public health?
A. Cultural: a culture for health
B. Social: social determinant of health
C. Clinical: lifestyle diseases
D. Biomedical: antibiotics, early vaccines
E. Structural: clean water, sewers and drainage

Answer 1

A. Cultural: a culture for health

Question 2

Making Every Contact Count (MECC), a proactive pharmacist started promoting weight loss among his patients.
Obesity can cause numerous health harms. Which of the following is not a health harm caused by obesity?
A. Diabetes type I
B. Diabetes type II
C. Mental health
D. Heart disease
E. Reproductive complications

Answer 2

A. Diabetes type l

Question 3

You were working in a busy pharmacy. A patient came to seek advice about their alcohol intake.
Please select the single best option that describe the ‘number of units in a drink’ from the options below:

A. The number of units in a drink is based on the size of the drink as well as its alcohol strength.
B. In order to calculate the number of units in a drink, you must know the alcohol by value
C. The number of units in a drink is the amount of alcohol the average adult can
process in a day
D. The number of units in a drink is mostly important in alcoholic cocktails only
E. The number of units in a drink is negligible in spirits

Answer 3

A

Question 4

Standard operating procedures (SOPs) help ensure best practice within a community pharmacy. They cover a range of activities including ordering, storing, preparing, selling, and supplying medicines.

Which one of the following essential services encompasses SOPs?
A. Dispensing Medicines
B. Clinical Governance
C. Public Health
D. Signposting
E. Disposal of Unwanted Medicines

Answer 4

B. Clinical Governance

Question 5

Statistics is important in the field of pharmacy as it provides tools to analyse collected data. For example, an industrial pharmacist investigating the effect of a new process for manufacturing medicines.

Which one of the following measures best describes the point where half the observations fall below?
A. Mean
B. Mode
C. Median
D. Range
E. Standard deviation

Answer 5

C. Median

Question 6

Otex ear drops are used to help remove hardened wax from the ear canal. The active ingredient is urea hydrogen peroxide. It works by breaking down the ear wax into small pieces

Which of the following timescales would you recommend a patient keeping their head tilted following administration of Otex ear drops?

Answer 6

E. 3 minutes

Question 7

You are a community pharmacist supervising a foundation trainee pharmacist. You have asked the trainee to investigate the pharmacokinetic properties of aspirin for a query you have been sent by one of your GP colleagues.
Each aspirin tablet contains 75 mg acetylsalicylic acid.

Which pharmacokinetic process would acetylsalicylic acid be in when it is bound to plasma proteins?
A. Administration
B. Absorption
C. Distribution
D. Metabolism
E. Excretion

Answer 7

C. Distribution

Question 8

You are helping another student on the course prepare for their upcoming OCSE, for which they are very nervous. You are both revising the topic of communication skills to prepare for this assessment.

Which of the following is NOT classed as a form of non-verbal communication?
A. Actively listening
B. Maintaining eye contact
C. Open body language
D. Nodding your head to show you are listening
E. Avoiding jargon

Answer 8

E. Avoiding jargon

Question 9

You are working as a community pharmacist when a 45-year-old customer presents asking to speak to you in private. She says that she is suffering with an itchy vulva and that there has been an inoffensive cottage cheese-like discharge from her vagina for
the last few days. She recently completed a course of antibiotics for a tooth abscess.
You take part in the common ailments scheme and see the patient under the terms of the scheme.
What is the most appropriate course of action?
A. Supply clotrimazole 1% external cream
B. Supply miconazole 2% external cream
C. Supply clotrimazole 500mg pessary
D. Supply fluconazole 150mg capsule
E. Refer to GP

Answer 9

D. Supply fluconazole 150mg capsule

Pessary should be supplied with clotrimazole 2% external cream and not be used alone.

Question 10

You are walking to university one morning when someone in the street suffers a suspected cardiac arrest.

Which of the following describes the correct “chain of survival” that is likely to give the person the best chance of survival?

A. Early defibrillation, cardio-pulmonary resuscitation, recovery position, hospital
care
B. Early recognition, cardio-pulmonary resuscitation, early defibrillation, hospital
care
C. Early recovery position, defibrillation, hospital care, early discharge to home
D. Early recognition, early medication, early defibrillation, hospital care
E. Immediate cardio-pulmonary resuscitation, call for help and wait, recovery position, hospital care

Answer 10

B

Question 11

You are working for the local health board undertaking a quality improvement project
related to the optimal prescribing of medication for asthma. One of the things that you
are trying to do is promote equity.
In the context of the quality improvement project, which of the following would represent “equity”?

A. Avoiding waste in prescribing
B. Using the lowest doses of all medicines
C. Ensuring that all people have access to optimal NHS care
D. Giving all patients a trial of a brand new medicine immediately that it comes to market
E. Treating all patients with exactly the same doses of the same medicines

Answer 11

C- Ensuring that all people have access to optimal NHS care

Question 12

Engaging with a young mother, who has expressed concern around the safety
of the MMR vaccination, providing reassurance and signposting to reputable sources for further information.

Select the option that identifies the type of intervention outlined by the question below:

A. Contributing to public awareness campaigns
B. Delivering opportunistic counselling
C. Delivering advanced services
D. Contributing to pharmacy interventions
E. Delivering essential services
F. Delivering medicines reviews
G. Delivering new medicine services
H. Delivering e-consultations

Answer 12

B. Delivering opportunistic counselling

Question 13

Having a conversation with a patient around the importance of Covid-19 vaccination, booking the patient in and administering the vaccination in the pharmacy.
Select the option that identifies the type of intervention outlined by the question below:

A. Contributing to public awareness campaigns
B. Delivering opportunistic counselling
C. Delivering advanced services
D. Contributing to pharmacy interventions
E. Delivering essential services
F. Delivering medicines reviews
G. Delivering new medicine services
H. Delivering e-consultations

Answer 13

C- Delivering advanced services

Question 14

A 58 years old patient comes to your pharmacy requesting to purchase miconazole for oral candidiasis. On questioning, you identified that the patient is on warfarin.
What do you do?

Answer 14

G. Do not supply the drug as it interacts with warfarin. You can supply an alternative

Question 15

A 27 years old patient comes to your pharmacy requesting to purchase miconazole for oral candidiasis. On questioning, you identified that the patient had oral candidiasis three times in the last six months.

Answer 15

H. Refer the patient to their GP

Question 16

In a recent CPD event you recognise that population health can be separated into domains including “general socio-economic, cultural, and
environmental conditions” and “individual lifestyle factors” You speak with one of your regular patients about their life during a consultation, one facet in particular would be considered an individual lifestyle factor

A. Agriculture and food production
B. Age
C. Education
D. Housing
E. Living and working conditions
F. Social and community
G. Unemployment
H. Water and sanitation

Answer 16

B. Age

Question 17

As a primary care pharmacist, you are trying to understand the nuances of population health. During your research, you recognise that this facet would be considered outside of the “general socio-economic, cultural, and environmental condition” and “individual lifestyle factor” domains.

A. Agriculture and food production
B. Age
C. Education
D. Housing
E. Living and working conditions
F. Social and community
G. Unemployment
H. Water and sanitation

Answer 17

F. Social and community

Question 18

Royal Pharmaceutical Society is the professional body for pharmacists. You notice that in an email they refer to you as a student pharmacist, and remember you must not use this title to give the impression that you are a registered pharmacist.

A. Health Act 2006
B. Human Medicines Regulations 2012
C. Medicines Act 1968
D. Medicines and Medical Devices Act 2021
E. Medicines (Pharmacies) (Responsible Pharmacist) Regulations
2008
F. National Health Service (Wales) Act 2006
G. Pharmacy Order 2010
H. Veterinary Medicines Regulations 2013

Answer 18

C. Medicines Act 1968

Question 19

You are working as a community pharmacist in a rural village. Your superintendent pharmacist advises that generic medicinal products (generics) are typically cheaper than branded medicines. They want reassurance that the products have the same composition, and the same pharmaceutical form as the reference product

A. Health Act 2006
B. Human Medicines Regulations 2012
C. Medicines Act 1968
D. Medicines and Medical Devices Act 2021
E. Medicines (Pharmacies) (Responsible Pharmacist) Regulations
2008
F. National Health Service (Wales) Act 2006
G. Pharmacy Order 2010
H. Veterinary Medicines Regulations 2013

Answer 19

B. Human Medicines Regulations 2012

Question 20

Mr Gatsby is attending a long covid clinic to assess his ongoing symptoms, particularly his blood oxygen levels
Which diagnostic tool would be used?

A. Stethoscope
B. Oximeter
C. Thermometer
D. Stethoscope and Sphygmomanometer
E. Blood glucose monitoring
F. Pregnancy test
G. Throat swab
H. Covid-19 lateral flow test

Answer 20

B. Oximeter

Question 21

Mrs Derry has attended her local pharmacy to obtain antibiotics for what she believes is bacterial tonsilitis. What diagnostic tool would be used?
A. Stethoscope
B. Oximeter
C. Thermometer
D. Stethoscope and Sphygmomanometer
E. Blood glucose monitoring
F. Pregnancy test
G. Throat swab
H. Covid-19 lateral flow test

Answer 21

G. Throat swab

Question 22

During a pharmacist-led diabetic clinic, Mr Williams highlights that he has been keeping his liraglutide, a medication that should be kept in the fridge, at room temperature for some time. You need to confirm whether this medication
is still safe to use despite not being stored correctly
Which resource do you use?
A. The British National Formulary
B. Newt Guidelines
C. The patient information leaflet
D. The renal drug handbook
E. The Drug Tariff
F. The Specialist Pharmacy Service website (SPS)
G. Medusa electronic guide
H. The Green Book

Answer 22

F. SPS

Question 23

Mr Green attended his local community pharmacy and has asked for your advice regarding the Japanese Encephalitis vaccination he may require before his upcoming holiday.
What resource do you use?

A. The British National Formulary
B. Newt Guidelines
C. The patient information leaflet
D. The renal drug handbook
E. The Drug Tariff
F. The Specialist Pharmacy Service website (SPS)
G. Medusa electronic guide
H. The Green Book

Answer 23

H. The Green Book

Question 24

A 56-year-old man wants to purchase an over-the-counter product to treat his oral thrush. He is taking warfarin for the management of atrial fibrillation. He has no known drug allergies.

Select the drug that will interact with the patient’s
medication and should not be given to them from the list above.

A. Aspirin 75mg tablets
B. Diclofenac 100mg suppositories
C. Naproxen 250mg tablets
D. Miconazole 2% oral gel
E. Paracetamol 500mg caplets
F. Ibuprofen 200mg capsules
G. Nystatin 100,000units/mL oral suspension
H. Ibuprofen 100mg/5mL oral suspension

Answer 24

D. Miconazole 2% oral gel

Question 25

A 37-year-old patient has strained their back whilst exercising. They are already taking co-codamol to manage the pain, but have no drug allergies

Select the drug that will interact with the patient’s
medication and should not be given to them from the list above.

A. Aspirin 75mg tablets
B. Diclofenac 100mg suppositories
C. Naproxen 250mg tablets
D. Miconazole 2% oral gel
E. Paracetamol 500mg caplets
F. Ibuprofen 200mg capsules
G. Nystatin 100,000units/mL oral suspension
H. Ibuprofen 100mg/5mL oral suspension

Answer 25

E. Paracetamol 500mg caplets

Question 26

A patient presents with a prescription for you to dispense for hydrocortisone 1% cream to manage their eczema flare up.

Select the most appropriate cautionary label that
should be included on the dispensing label for the product

A. Warning: this medicine may make you sleepy
B. Warning: do not drink alcohol
C. Do not take indigestion remedies 2 hours before or after you take this medicine
D. Warning: do not stop taking this medicine unless your doctor tells you to stop
E. Do not take milk, indigestion remedies, or medicines containing iron or zinc, 2 hours before or after you take this medicine
F. Do not take more than 2 at any one time. Do not take more than 8 in 24 hours.
G. Protect your skin from sunlight- even on a bright but cloudy day. Do not use sunbeds.
H. Spread thinly on the affected skin only.

Answer 26

H. Spread thinly on the affected skin only.

Question 27

A patient presents with a prescription for you to dispense for metronidazole tablets for a tooth infection from their dentist.

Select the most appropriate cautionary label that
should be included on the dispensing label for the product

A. Warning: this medicine may make you sleepy
B. Warning: do not drink alcohol
C. Do not take indigestion remedies 2 hours before or after you take this medicine
D. Warning: do not stop taking this medicine unless your doctor tells you to stop
E. Do not take milk, indigestion remedies, or medicines containing iron or zinc, 2 hours before or after you take this medicine
F. Do not take more than 2 at any one time. Do not take more than 8 in 24 hours.
G. Protect your skin from sunlight- even on a bright but cloudy day. Do not use sunbeds.
H. Spread thinly on the affected skin only.

Answer 27

B. Warning: do not drink alcohol

Question 28

A 28-year-old woman has been prescribed hyoscine over the counter for the prophylaxis of travel sickness before a long journey. She suffers from intolerable adverse effects and stops using the product. However, the adverse effects continue for another 24 hours. How is the hyoscine most likely to have been administered?
A. transdermal patch
B. intra-muscular injection
C. subcutaneous injection
D. oral suspension
E. tablets
F. nasal spray
G. capsules
H. chewable tablets

Answer 28

A. transdermal patch

Question 29

A patient wishes to stop smoking and is provided with nicotine replacement therapy (NRT) by their GP. Which route of administration is most likely to be used for NRT?
A. transdermal patch
B. intra-muscular injection
C. subcutaneous injection
D. oral suspension
E. tablets
F. nasal spray
G. capsules
H. chewable tablet

Answer 29

A.Transdermal patch

Question 30

1. Pharmacists have a duty to maintain confidentiality.

A. Describe why it is important for pharmacists to maintain confidentiality (5 marks)
B. Provide examples of confidential information (5 marks)
C. Provide examples on when you would disclose confidential information without a patient’s consent (5 marks)

Question 31

You are reviewing the results of a trial of a medicine that is used to prevent fracture in people with osteoporosis. You see that the prevalence of osteoporotic fracture over 5 years in the treated patient group reduced from 10% to 8%. These results have further been reported as an absolute risk reduction (ARR), a relative risk reduction (RRR) and
a number needed to treat (NNT).

1) Define the term absolute risk reduction (ARR). (3 marks)
2) Define the term relative risk reduction (RRR). (3 marks)
3) Define the term number needed to treat (NNT). (3 marks)
4) Calculate the ARR. (2 marks)
5) Calculate the RRR. (2 marks)
6) Calculate the NNT. (2 marks)

Answer 31

Fill in answer from Mock

1) Straightforward difference between event rates
2) Difference between event rates relative to what you started with
3) Number of patients that must be treated in order for one patient to benefit. Must be the same time as the trial length.
4) 2%
5) 2/10 = 0.2 or 20%
6) 100/ARR - 100/2 = 50%

Question 32

Question 3 (15 Marks)
Additional endorsements are an important consideration when legally checking a
prescription. If endorsement is missing, the prescription should not be dispensed and
will not be passed for payment by NHS Prescription Services.
a. What resource gives a comprehensive overview of considerations relating to SLS and ACBS? (2 marks)
b. What does the endorsement SLS stand for? (2 marks)
c. Under what circumstances would a prescriber endorse a prescription
with SLS? (3 marks)
d. Give one example of a medicine requiring SLS endorsement and
describe your reasoning. (4 marks)
e. What does the endorsement ACBS stand for? (2 marks)
f. What type of items would need to be endorsed ACBS? (2 marks)

Answer 32

a. Drug Tariff (2 marks)
b. Selected List Scheme (2 marks)
c. Drugs that may be prescribed in certain circumstances (3 marks)
d. (4 marks)
Name of Medicine (e.g. Nizoral) (2)
Relevant circumstances (e.g. seborrheic dermatitis) (2)
e. The Advisory Committee on Borderline Substances (2 marks)
f. Borderline substances include certain foods and toilet preparations. ( 2 marks)

Question 33

Question 4 (15 Marks)

Patients of all ages will present at the community pharmacy requesting advice and treatment for a range of skin conditions. One such condition is tinea corporis, also known as ringworm.
1. What type of organism can cause a ringworm infection? (1 mark)
2. What are the symptoms of ringworm? (4 marks)
3. How is ringworm transmitted? (1 mark)
4. What is the first-line over-the-counter treatment for ringworm (name the drug and give an example of that as a product): (4 marks)
5. What symptoms or criteria would lead you to wanting to refer the patient to be reviewed by their GP? (5 marks)

Answer 33

1. Fungal (1 mark)
2. Any two from: (2 marks per point up to 4
   marks)
   * Circular, ring-like rash
   * Scaly/itchy / inflamed skin
   * Rash may look red, silver or darker than the surrounding skin
   * Rash can appear anywhere on the body
3. (1 mark) : Any one from
   * From an infected animal / person
   * Infected objects (bedsheets / combs / towels)
   * Infected soil (much less common)
4. (4 marks)
   2 mark for each of the following:
   * Imidazoles (will also accept miconazole)
   * Example: Daktarin 2% cream (will also accept miconazole 2% cream)
5. (5 marks)
   Any five of the following: (1 mark per point, up to 5 marks)
   * Treatment failure
   * Symptoms persisting beyond 2 weeks
   * Suspected bacterial infection
   * Diabetic patient
   * Ringworm is located on the scalp
   * Weakened immune system (e.g. HIV, chemotherapy)
   * Allergy to over-the-counter remedy

Question 34

You are a hospital pharmacist working on a busy elderly care ward and a nurse highlights a dispensing error regarding one of the patients blood pressure medication (Ramipril). As a result of the dispensing error, a patient has received a 5mg morning dose rather than a 2.5mg morning dose but no harm has come to the patient.

You notice that this is the 3rd time the error has occurred over the last 6 months and notice that the 2.5mg strength and 5mg strength of ramipril look very similar and are placed next to each other on the dispensary shelves.

1. As a pharmacy professional, you have a duty to report dispensing errors.

What 6 steps would you complete when reporting an error, outlining what you
would do as the pharmacist in this particular scenario. (15 marks)

Answer 34

1. Be open and honest (1 marks)
   a. explain to the patient what has happened and apologies (1marks)
   b. rectify the error by getting the correct strength dispensed (1marks)
2. Report (1 mark):
   a. report the incident via local reporting system (1 mark)
3. Learn (1 mark):
   a. investigate why this might have happened (1 mark)
   b. notify the individuals involved in the error
   (1 mark)
   c. ask the individuals involved to reflect on the error (1 mark)
4. Share (1 mark):
   a. share with others in the department to help them learn and avoid the error happening again (1 mark)
5. Act (1 mark)
   a. Make a change to prevent this from occurring (student must make a suggestion of what change they would make to gain full 1 mark)
   E.g.
   i.Move boxes away from each other
   ii.Put a Poster near boxes to inform people to be vigilant
6. Review (1 mark)
   a. Review whether the change made has had an impact on the number of dispensing errors involving ramipril (1 mark)

Question 35

In order to diagnose hypertension (high blood pressure - BP), it may be necessary to measure BP manually using a stethoscope and an aneroid sphygmomanometer.
1. Outline the steps needed to take a blood pressure using these devices (12 marks).
2. What is the unit of measurement for blood pressure? (1 mark)
3. What would be considered a “normal” blood pressure in a healthy adult at rest? (2 marks)

Answer 35

1. Steps in taking blood pressure:
   * Use correct cuff size
   * Locate brachial artery
   * Attach cuff with correct arrow for arm lined up with brachial artery
   * Palpate radial pulse
   * Inflate cuff until radial pulse no longer felt – this is estimate of systolic pressure
   * Deflate cuff
   * Position the diaphragm of the stethoscope over the brachial artery.
   * Re-inflate the cuff 20-30 mmHg above the systolic blood pressure you previously estimated.
   * Slowly deflate the cuff at around 2-3 mmHg per second.
   * Using your stethoscope, listen carefully for the onset of a pulsatile noise (Korotkoff sound) = systolic blood pressure
   * Continue to deflate the cuff while listening through your stethoscope until the pulsatile sound completely disappears (fifth Korotkoff sound) = diastolic blood pressure
   * Record BP
2. mm/Hg
3. Normal = 120/80mmHg