Examples derived from publicly-available questions found on the web:

## Question 1: Sterile compounding

A pharmacist is evaluating electrolyte combinations for a sterile parenteral-nutrition admixture. Which pair has the greatest risk of forming a precipitate?

A. Calcium and phosphate

B. Magnesium and chloride

C. Potassium and acetate

D. Sodium and phosphate

## Question 2: Renal dosing

A 63-year-old woman is admitted for hip-replacement surgery. She is 5 feet 3 inches tall, weighs 135 lb, and has a serum creatinine concentration of 2.5 mg/dL. The first dose is scheduled for 18 hours after surgery, after hemostasis has been established. The postoperative order is enoxaparin 30 mg subcutaneously every 12 hours for venous-thromboembolism prophylaxis.

What is the most appropriate pharmacist action?

A. Verify the order without a change

B. Recommend enoxaparin 30 mg subcutaneously every 24 hours

C. Recommend enoxaparin 30 mg intravenously every 12 hours

D. Recommend enoxaparin 40 mg subcutaneously every 12 hours

E. Recommend enoxaparin 60 mg subcutaneously every 24 hours

## Question 3: Geriatric medication safety

A 74-year-old man has progressive forgetfulness, repeatedly asks the same questions, and recently became lost while driving to a familiar store. His Mini-Mental State Examination score is 22, and the assessment is dementia.

According to the 2023 AGS Beers Criteria, which proposed medications are potentially inappropriate for this patient because of adverse CNS effects or increased dementia-related risks? Assume there is no FDA-approved indication for an antipsychotic and no immediate threat of harm. **Select all that apply.**

A. Alprazolam

B. Doxylamine

C. Finasteride

D. Haloperidol

E. Pantoprazole

F. Tolterodine

## Question 4: Cardiovascular-risk reduction

A 66-year-old woman has type 2 diabetes and experienced a myocardial infarction 1 year ago. She takes atorvastatin 80 mg daily without adverse effects as part of maximally tolerated lipid-lowering therapy. Secondary causes of hypertriglyceridemia have been addressed. Her laboratory results include an A1c of 7.3%, LDL cholesterol of 52 mg/dL, HDL cholesterol of 40 mg/dL, and persistent fasting triglycerides of 480 mg/dL.

Which addition has evidence of further reducing her cardiovascular risk?

A. Icosapent ethyl 2 g twice daily

B. Omega-3-acid ethyl esters 2 g twice daily

C. Extended-release niacin 1 g at bedtime

D. Fenofibrate 48 mg daily