Question 1

Hilary Kaplan is a 4 month old child with congenital heart disease.

Demographics/Vitals:
Weight: 5 pounds 8 ounces

Medications:
Palivizumab (Synagis) 15 mg/kg IM Qmonth
Tobramycin 2 mg/kg IV Q8H

How many milligrams of tobramycin will the patient receive daily? (Answer must be numeric;
no units or commas; round the final answer to the nearest WHOLE number.)

Question 2

A patient is receiving 650 mL of 10% lipids. How many kcals is the patient receiving from the
lipids? (Answer must be numeric; no units or commas.)

Question 3

How many mL of polyethylene glycol 400 (SG = 1.13) are needed to prepare a prescription that
includes 54 g of the surfactant/emulsifier (polysorbate)? (Answer must be numeric; no units or
commas; include a leading zero when answer is less than 1; round the final answer to the
nearest TENTH.)

Question 4

A pharmacist is asked to compound 60 mL of an isotonic eye drop. Drug X (a liquid with an E-

value of 0.33) and sodium chloride will be used to prepare a final concentration of 1:500 (w/v).
How many milligrams of sodium chloride must be added to make the eye drops isotonic?
(Answer must be numeric; no units or commas; round the final answer to the
nearest WHOLE number.)

Question 5

A new patient is being seen today in the pharmacist-run disease state management clinic. She is
from France and just moved to the US. She is very knowledgable about her medical conditions.
She states that her most recent total cholesterol level was 5.2 mmol/L. The pharmacist knows
that his lab reports total cholesterol in mg/dL. He looks online and determines that the MW of
cholesterol is 387. What is the patient's total cholesterol in mg/dL? (Answer must be numeric;
no units or commas; round the final answer to the nearest WHOLE number.)
Question 6

Vance Buckly has an order for the following PN:

Item/Quantities:
Dextrose 250 g
Amino acids 50 g
Sodium acetate 16 mEq
Sodium chloride 38 mEq
Potassium 40 mEq
Magnesium sulfate 10 mEq
Phosphate 21 mmol
Calcium 4.45 mEq
MVI-12 5 mL
Trace elements 1 mL
Vitamin K-1 0.5 mg
Famotidine 10 mg
Regular insulin 40 units

Sterile water qs ad 980 mL

Question:
How many milliliters of 23.4% sodium chloride should be added to this PN? (MW of Na = 23;
MW of Cl = 35.5). (Answer must be numeric; no units or commas.)

Question 7

Renee Flannary is admitted to the hospital for worsening ascites and coughing up blood.

Admission Orders:
Protonix 80 mg IV bolus x 1
Protonix 80 mg/100 mL NS–
infuse at 8 mg/hr
Octreotide 50 mcg IV bolus x 1–
over 3 minutes
Octreotide 500 mcg/250 mL NS–
infuse at 50 mcg/hr
Furosemide 20 mg IV x 1

Labs:
Na (mEq/L) = 129 (135–145)
K (mEq/L) = 3.7 (3.5–5)
Cl (mEq/L) = 103 (95–103)
HCO3 (mEq/L) = 25 (24–30)
BUN (mg/dL) = 24 (7–20)
SCr (mg/dL) = 1.5 (0.6–1.3)
Glucose (mg/dL) = 122 (100–125)
Ca (mg/dL) = 9.1 (8.5–10.5)
Mg (mEq/L) = 2.1 (1.3–2.1)
PO4 (mg/dL) = 3.2 (2.3–4.7)
WBC (cells/mm3) =
13.6 (4–11x10^3)
Hgb (g/dL) = 8.8 (12–16 female)
Hct (%) = 24.2 (36–46 female)
Plt (cells/mm3) =
143 (150–450x10^3)
Procalcitonin (ng/mL) = 27 (≤ 0.15)
AST (IU/L) = 38 (10–40)
ALT (IU/L) = 29 (10–40)
Albumin (g/dL) = 2.8 (3.5–5)
INR = 2.8
Alk Phos (IU/L) = 225 (33–131)
Ammonia (mcg/dL) = 92 (19–60)

Convert Ms. Flannary's procalcitonin level to mcg/mL so the medical team can use a published
treatment algorithm. (Answer must be numeric; no units or commas; include a leading zero when
the answer is less than 1.)

Question 8

The pharmacy stocks FreAmine 8.5%. How many milliliters will be needed to provide 132 g of
protein? (Answer must be numeric; no units or commas; round final answer to the
nearest WHOLE number.)

Question 9

You have tablets that contain 125 mcg of digoxin per tablet. You are crushing the tablets and
mixing with an elixir for a 29-month old child weighting 44 lbs. How many digoxin tablets will
be needed to compound the following prescription?

Rx: Digoxin Liq. 0.1 mg/mL Disp. 20 mL Sig: 10 mcg per kg PO daily

(Answer must be numeric; no units or commas; round the final answer to the nearest WHOLE
tablet.)

Question 10

A patient in the Emergency Department is receiving D5 1/4 NS + 20 mEq KCl. The 1 liter bag is
being run with IV tubing that delivers 15 drops/mL. The patient has been receiving this for 8
hours at a rate of 12 drops/min. How many mEq of potassium has the patient received so
far? (Answer must be numeric; no units or commas; round the final answer to the nearest
TENTH.)

Question 11

JF is a 62 year old male admitted with diabetes and peripheral neuropathy.

Medications:
Janumet XR 100/1000 daily
Lyrica 50 mg TID
Lisinopril 10 mg daily
Norco 5/325 HS PRN
D5NS + 20 mEq KCl

The Emergency Department has 1 liter pre-mixed bags of D5NS + 20 mEq KCl. The first bag
was hung earlier today and the rate was not entered in the computer system. The pharmacist
wants to clarify the rate and notes on the infusion pump that the patient has received 640 mL in
the past 8 hours. Assuming the rate has been consistent since the bag was hung, at what rate
(mL/hr) is the fluid currently running? (Answer must be numeric; no units or commas.)

Question 12

Hilary Kaplan is a 4 month old child with congenital heart disease.

Demographics/Vitals:
Weight: 5 pounds 8 ounces

Medications:
Palivizumab (Synagis) 15 mg/kg IM Qmonth
Tobramycin 2 mg/kg IV Q8H

Question:
How many milligrams of palivizumab should the patient receive today? (Answer must be
numeric; no units or commas; include a leading zero when the answer is less than 1; round the
final answer to the nearest TENTH.)

Question 13

Carol Burns is a patient on the medical floor. Earlier today D5 1/2NS + 40 mEq KCl was ordered
to run at 75 mL/hr. Unfortunately, an error was made and her 1 liter bag has been running at only
45 mL/hr for the past 4 hours. How many extra mEq of KCl would Ms. Burns need to receive
now to equal what she would have gotten if the drip had been hanging at the correct rate for the
past 4 hours? (Answer must be numeric; no units or commas.)
Question 14

An order is written to add 600 mL of 10% amino acid solution to a PN. The only concentration
in stock is a 15% solution. How many milliliters of the 15% solution should the pharmacist
add? (Answer must be numeric; no units or commas; round final answer to the
nearest WHOLE number.)

Question 15

A pharmacist mixed 500 g of a liquid drug (SG = 0.662) in enough liquid to prepare 2 liters of a
final product. What is the percentage strength (v/v) of the final product? (Answer must be
numeric; no units or commas; round the final answer to the nearest WHOLE number.)

Question 16

Express 1:5000 as a percentage strength. (Answer must be numeric; no units or commas; include
a leading zero if answer is less than 1.)

Question 17

Renee Flannary is admitted to the hospital for worsening ascites and coughing up blood.

Admission Orders:
Protonix 80 mg IV bolus x 1
Protonix 80 mg/100 mL NS–
infuse at 8 mg/hr
Octreotide 50 mcg IV bolus x 1–
over 3 minutes
Octreotide 500 mcg/250 mL NS–
infuse at 25 mcg/hr
Furosemide 20 mg IV x 1

Labs:
Na (mEq/L) = 129 (135–145)
K (mEq/L) = 3.7 (3.5–5)
Cl (mEq/L) = 103 (95–103)
HCO3 (mEq/L) = 25 (24–30)
BUN (mg/dL) = 24 (7–20)
SCr (mg/dL) = 1.5 (0.6–1.3)
Glucose (mg/dL) = 122 (100–125)
Ca (mg/dL) = 9.1 (8.5–10.5)
Mg (mEq/L) = 2.1 (1.3–2.1)
PO4 (mg/dL) = 3.2 (2.3–4.7)
WBC (cells/mm3) =
13.6 (4–11x10^3)
Hgb (g/dL) = 8.8 (12–16 female)
Hct (%) = 24.2 (36–46 female)
Plt (cells/mm3) =
143 (150–450x10^3)
Procalcitonin (ng/mL) = 27 (≤ 0.15)
AST (IU/L) = 38 (10–40)
ALT (IU/L) = 29 (10–40)
Albumin (g/dL) = 2.8 (3.5–5)
INR = 2.8
Alk Phos (IU/L) = 225 (33–131)
Ammonia (mcg/dL) = 92 (19–60)

The octeotide drip is started at 1400. After infusing at the ordered rate for 2 hours, the prescriber
asks the nurse to titrate up to 50 mcg/hr. How many total hours will the initial bag last? (Answer
must be numeric; no units or commas.)

Question 18

If one 10 mL vial contains 0.05 g of diltiazem, how many milliliters should be administered to
provide a 150 mg dose of diltiazem? (Answer must be numeric; no units or commas; round the
final answer to the nearest WHOLE number.)

Question 19

Renee Flannary is admitted to the hospital for worsening ascites and coughing up blood.

Admission Orders:
Protonix 80 mg IV bolus x 1
Protonix 80 mg/100 mL NS–
infuse at 8 mg/hr
Octreotide 50 mcg/1 mL IV bolus
x 1 – over 3 minutes
Octreotide 500 mcg/250 mL NS–
infuse at 50 mcg/hr
NS 1 liter x 1 - over 2 hrs
Furosemide 20 mg IV x 1

Labs:
Na (mEq/L) = 129 (135–145)
K (mEq/L) = 3.7 (3.5–5)
Cl (mEq/L) = 103 (95–103)
HCO3 (mEq/L) = 25 (24–30)
BUN (mg/dL) = 24 (7–20)
SCr (mg/dL) = 1.5 (0.6–1.3)
Glucose (mg/dL) = 122 (100–125)
Ca (mg/dL) = 9.1 (8.5–10.5)
Mg (mEq/L) = 2.1 (1.3–2.1)
PO4 (mg/dL) = 3.2 (2.3–4.7)
WBC (cells/mm3) =
13.6 (4–11x10^3)
Hgb (g/dL) = 8.8 (12–16 female)
Hct (%) = 24.2 (36–46 female)
Plt (cells/mm3) =
143 (150–450x10^3)
Procalcitonin (ng/mL) = 27 (≤ 0.15)
AST (IU/L) = 38 (10–40)
ALT (IU/L) = 29 (10–40)
Albumin (g/dL) = 2.8 (3.5–5)
INR = 2.8
Alk Phos (IU/L) = 225 (33–131)
Ammonia (mcg/dL) = 92 (19–60)

Question:
Convert Ms. Flannary's ammonia level to mcg/mL so the medical team can use a published
treatment algorithm. (Answer must be numeric; no units or commas; include a leading zero when
the answer is less than 1.)

Question 20

What molar ratio (salt:acid) would be required to make a buffer solution of sodium acetate and
acetic acid with pH of 5.76. The pKa of acetic acid is 4.76. (Answer must be numeric; no units or
commas; do not enter the 1 and the colon; enter only the number before the colon, as shown here
with Xs: XXX:1.)

Question 21

Renee Flannary is admitted to the hospital for worsening ascites and coughing up blood.

Admission Orders:
Protonix 80 mg IV bolus x 1
Protonix 80 mg/100 mL NS–
infuse at 8 mg/hr
Octreotide 50 mcg IV bolus x 1–
over 3 minutes
Octreotide 500 mcg/250 mL NS–
infuse at 25 mcg/hr
Furosemide 20 mg IV x 1

Labs:
Na (mEq/L) = 129 (135–145)
K (mEq/L) = 3.7 (3.5–5)
Cl (mEq/L) = 103 (95–103)
HCO3 (mEq/L) = 25 (24–30)
BUN (mg/dL) = 24 (7–20)
SCr (mg/dL) = 1.5 (0.6–1.3)
Glucose (mg/dL) = 122 (100–125)
Ca (mg/dL) = 9.1 (8.5–10.5)
Mg (mEq/L) = 2.1 (1.3–2.1)
PO4 (mg/dL) = 3.2 (2.3–4.7)
WBC (cells/mm3) =
13.6 (4–11x10^3)
Hgb (g/dL) = 8.8 (12–16 female)
Hct (%) = 24.2 (36–46 female)
Plt (cells/mm3) =
143 (150–450x10^3)
Procalcitonin (ng/mL) = 27 (≤ 0.15)
AST (IU/L) = 38 (10–40)
ALT (IU/L) = 29 (10–40)
Albumin (g/dL) = 2.8 (3.5–5)
INR = 2.8
Alk Phos (IU/L) = 225 (33–131)
Ammonia (mcg/dL) = 92 (19–60)

Question:
Calculate the duration of infusion (in hours) for the Protonix drip. (Answer must be numeric; no
units or commas; include a leading zero when the answer is less than 1.)

Question 22

A pharmacist has a prescription for 90 compounded glycerin suppositories using the following
formula:

Glycerin 91 g
Sodium stearate 9 g
Purified water 5 g
M. ft. suppositories #50

How many mL of glycerin will be needed to prepare the desired number of suppositories? (SG of
glycerin = 1.25). (Answer must be numeric; no units or commas; round the final answer to the
nearest WHOLE number.)
Question 23

A pharmacist has a prescription for 90 compounded glycerin suppositories using the following
formula:

Glycerin 91 g
Sodium stearate 9 g
Purified water 5 g
M. ft. suppositories #50

How many mL of glycerin will be needed to prepare the desired number of suppositories? (SG of
glycerin = 1.25). (Answer must be numeric; no units or commas; round the final answer to the
nearest WHOLE number.)

Question 24

A pharmacist mixed 800 mg of a liquid drug (SG = 0.8) in enough liquid to prepare 2 liters of a
final product. What is the ratio strength of the final product? (Answer must be numeric; no units
or commas; do not enter the 1 and the colon; enter only the number after the colon, as shown
here with Xs: 1:XXX.)

Question 25

A patient is receiving 500 mL of 10% Intralipid on Saturdays along with his normal daily PN
therapy of 1,580 mL of D20W, 520 mL FreAmine 15% and 30 mL of electrolytes. What is the
daily amount of calories provided by the lipids? (Answer must be numeric; no units or commas;
round the final answer to the nearest TENTH.)

Question 26

Express 660 parts per million (PPM) as a percentage. (Answer must be numeric; no units or
commas; include a leading zero when answer is less than 1.)

Question 27

All of the epinephrine auto-injectors and prefilled syringes in the hospital have expired or been
recalled. The pharmacist must use epinephrine 1:1000 for a patient having an anaphylactic
reaction on the floor. The prescriber has ordered "epinephrine 0.5 mg SC stat". How many
milliliters of the available epinephrine product should be administered? (Answer must be
numeric; no units or commas; include a leading zero when answer is less than 1.)
Question 28

How many milligrams of caffeine will be contained in each caplet of the prescription below?
Rx: Acetaminophen 12 g Aspirin 12 g Caffeine 3.12 g M. ft. caps. no. 48 Sig. i-ii caplets prn HA

Question 29

Express 0.5% as a ratio strength. (Answer must be numeric; no units or commas; do not enter the
1 and the colon; enter only the number after the colon, as shown here with Xs: 1:XXX.)

Question 30

JF is a 62 year old male admitted with diabetes and peripheral neuropathy.

Medications:
Janumet XR 100/1000 daily
Lyrica 50 mg TID
Lisinopril 10 mg daily
Norco 5/325 HS PRN
D5NS + 20 mEq KCl

The hospital has 1 liter premixed bags of D5NS + 20 mEq KCl and JF's fluid has been running at
80 mL/hr for 8 hours. How many mmols of KCl has the patient received? (MW K = 39; MW Cl
= 35.5). (Answer must be numeric; no units or commas.)
Answers:
1. 15
2. 715
3. 47.8
4. 500
5. 201
6. 9.5
7. 0.027
8. 1553
9. 16
10. 7.7
11. 80
12. 37.5
13. 4.8
14. 400
15. 38
16. 0.02
17. 11
18. 30
19. 0.92
20. 10
21. 10
22. 131
23. 6
24. 2000
25. 78.6
26. 0.066
27. 0.5
28. 65
29. 200
30. 12.8