Guild Intern Training Program

Oral Exam Practice – Mock Exam ONE – ANSWER Guide

Preamble
This resource has been developed to be delivered as a preceptor/mentor-led exercise, in a ‘mock’ Oral
Examination style. Please review the materials below prior to conducting the ‘mock exam’ with your
intern. Do not share this answer guide with your intern as it will negate the point of this resource.
For more information regarding the Pharmacy Board of Australia (PBA) Oral Exam, please refer to the
candidate guide available here

Instructions
• Set aside with your intern a suitable length of time for this exercise (approximately 35 minutes)
• This ‘mock exam’ will be separated into three (3) sections, as per the PBA Oral Exam:
1. Part A: Primary Healthcare (10 mins)
2. Part B: Legal and Ethical Practice (5 mins)
3. Part C: Problem Solving and Communication (20 minutes)
• The preceptor/mentor will be required to role-play as the assessor/patient/doctor throughout the
exercise and only provide information to interns if/when correct patient history taking is
conducted
• The preceptor resource will have the complete set of details, including the answers for each case:
o Note that this resource is a guide and is not intended to supply all possible
answers/interpretations for the cases.
o Additionally, unless otherwise stated, the intern would not necessarily need to provide
ALL of the possible counselling points/answers for each case to be deemed competent.
o The preceptor is welcome to add their own professional/clinical or anecdotal advice to the
intern throughout the role-play to add to the intern’s experience.
• The intern resource will only include the case description, with limited details. It will be up to them
to provide the correct answers and elicit the required medical histories from you when required.

Disclaimer
The Guild Intern Training Program has made every effort to ensure that, at the date of publication, this
document is free from errors or omissions. Note that the Guild Intern Training Program and/or any person
associated with the preparation of this document accepts no liability for loss which a user of this document
may suffer as a result of reliance on this document for:
• Using this document not for its intended purpose
• Any interpretations or opinions stated in, or which may be inferred from, this document
• Errors, omissions or inaccuracy of information in this document

Q.NITP.F89.V3 – Oral Exam Practice – Mock Exam ONE – Answer Guide – January 2022

Part A: Primary Healthcare
Closed Book, 10 minutes
Part A: Primary Healthcare – Wound Management
Scenario A female working at the local café comes into the pharmacy with a burn on her leg
Information Who is the patient?
Gathering
What are symptoms?
Duration of symptoms?
Action taken so far?
Other medication?
OTC/ complimentary
medications?
Medical conditions?
Allergies?
Pregnancy/Breastfeeding
Other notes (if asked):
Patient Identify condition and
Counselling explain nature of the
condition
Suitable product(s), how
they work and directions
Post Scenario Unsuitable product(s)
Questions (if not
already asked)
Referral to GP if/when
required
References APF 25 - Wound Management
Q.NITP.F89.V3 – Oral Exam Practice – Mock Exam ONE – Answer Guide – January 2022
Guild Intern Training Program
Herself (Age: 25 year old)
Small burn on leg, smaller than a 20 cent coin, bright pink, small
blister.
2 minutes
None- came straight into pharmacy seeking advice
Contraceptive pill.
Nil
Not that I know of.
Codeine
No
Burned by boiling water while making coffee; no other parts of body
affected.
• This appears to be a superficial burn that does not require referral
to a Dr.
• If at any time burn shows signs of infection refer the patient on
for medical attention.
• Since patient works locally; encourage to come back into
pharmacy if they have any queries or for follow up.
For simple superficial burn:
• Cool the area with cold running tap water for a minimum of 20-
30 minutes
• Apply a hydrogel (amorphous or sheet) for 48-72 hours.
• If the burn is a little inflamed consider applying a silver dressing
• Once burn is in healing phase, change to an adhesive fixation
sheet (e.g. Fixomull or Hypafix). Apply adhesive fixation sheet
directly to burn and leave in place for seven days.
• Can use simple oral analgesics if required for pain (e.g.
paracetamol 500mg tab 2 qid prn)
• Applying products before burn has been cooled sufficiently (at
least 20-30 minutes)
• Codeine-containing analgesic (codeine allergy)
• The airway is involved
• Burn involves hands, feet or genitals
• A superficial burn is larger than a 20 cent coin in an adult or 10
cent coin in a child
• You are unsure of the severity of the burn
 Guild Intern Training Program

Part B: Legal and Ethical Practice

Closed Book, 5 minutes

Guild Intern Training Program – Oral Exam Preparation – Part B: Legal and Ethical Practice

Scenario Your pharmacist colleague discloses to you that he has recently developed an intimate
(sexual) relationship with Sheryl, a regular patient of the pharmacy who comes in daily for
a staged supply pick up in the consult room. Are you obligated to do anything, or can you
turn a ‘blind eye’?
• This amounts to mandatory notification to AHPRA as you as a practitioner have
Discuss legal
reason to believe the practitioner is having sexual misconduct with the patient. (Even
considerations
if this is consensual).
• There is a power imbalance between practitioners and patients/carers.
Discuss ethical
considerations

Possible options for Appropriate

action (appropriate • Mandatory report the pharmacist to AHPRA for sexual misconduct
and inappropriate) • Contact indemnity insurer for legal advice
• Have a one-on-one conversation with the pharmacist and explain to them it’s against
AHPRA guidelines to have a sexual relationship with a patient
Inappropriate
• Warn the pharmacist that if they don’t stop their relationship with Sheryl soon you
will have to report them (but give them another chance first without reporting them)
• Don’t do anything (pretend you didn’t know)
• Mandatory report the pharmacist to AHPRA for sexual misconduct.
What is the action you
would take to produce • As a professional courtesy you may wish to inform the other pharmacist of your
a satisfactory outcome actions (but you do not have to do this).
and why? • In the above two inappropriate options, you as the pharmacist will also be liable if
AHPRA discovers the sexual misconduct for the other pharmacist.

• Pharmacist will be dealt with by AHPRA.

Describe
consequences all • Sheryl will most probably need to give a statement.
involved parties e.g.
patient, doctor,
colleague

How could this Health professionals should never engage in sexual activity with patients due to the
situation be prevented power imbalance between practitioners and clients.
in the future

References Australian Health Practitioner Regulation Agency. National Board Guidelines for
Registered Health Practitioner. Guidelines for Mandatory Notification, June 2020.
2.6 What is sexual misconduct?
For mandatory notifications, sexual misconduct is:
• in connection with the practice of the practitioner’s health profession, and
• with people under the practitioner’s care or linked to the practitioner’s practice of their
health profession.
It includes:

Q.NITP.F89.V3 – Oral Exam Practice – Mock Exam ONE – Answer Guide – January 2022
 Guild Intern Training Program

• sexual activity with a current patient or client, whether or not they give consent
• making sexual remarks
• touching patients or clients in a sexual way
• touching a patient in an intimate area without a clinical indication whether or not they
give consent, and
• engaging in sexual behaviour in front of a patient or client.
Because of the power imbalance between practitioners and their patients or clients, any
sexual activity with a patient or client is sexual misconduct, even with their consent.
Engaging in sexual activity with a person closely related to a patient or client under the
practitioner’s care may also be sexual misconduct. In some cases, that person (such as
the parent of a child patient or client) may also be considered a patient or client.
Engaging in sexual activity with a person formerly under a practitioner’s care after the
professional relationship has ended may also be sexual misconduct.
This depends on:
• whether the patient or client is vulnerable because of age, capacity or health conditions
• the means by which sexual activity was established (for example, whether a
practitioner used information obtained during a treating relationship to contact a patient
and commence sexual activity)
• the extent of the professional relationship (for example, a one-off treatment compared
to a long-term program of treatment), and
• the length of time since the practitioner–patient/client relationship ended. If you are a
treating practitioner, the conditions for making a mandatory notification about sexual
misconduct are different to other groups.
Please read section 3.5 When must I report sexual misconduct? to help you assess when
to report.
(Reference:
https://www.ahpra.gov.au/Notifications/mandatorynotifications/Mandatory-
notifications.aspx)
NB: Section 3.5 refers to a practitioner providing a health service to another
practitioner. In this case study you are the colleague of the practitioner (not the
practitioner of the practitioner) so you will follow section 4.5.

Q.NITP.F89.V3 – Oral Exam Practice – Mock Exam ONE – Answer Guide – January 2022
 Guild Intern Training Program

Available from:
https://www.ahpra.gov.au/Notifications/mandatorynotifications/Mandatory-
notifications.aspx

Q.NITP.F89.V3 – Oral Exam Practice – Mock Exam ONE – Answer Guide – January 2022
 Guild Intern Training Program

Part C: Problem Solving and Communication

Open book (intern may use their resources), 20 minutes

Case Presentation (Intern has the same copy)

Complex Case Scenario

Case Presentation RX:

Mrs. Potter presents to your pharmacy with a prescription for
Estelle® which she would like to have filled.
Dr. Smith
Mrs. Potter

Estelle® (2mg/35mcg) 28 x 3
1 daily.

last rpt

Dispense History Medication Last dispense date Prescriber

Warfarin (Marevan®) 2 months ago Dr. Smith

mdu

Fluconazole 150mg Tab 3 months ago Dr. Smith

1 stat

Estelle® 5 months ago Dr. Smith

1 daily

Estelle® 8 months ago Dr. Smith

1 daily

Additional Information You note that this is the last repeat prescription available for Estelle®.

Q.NITP.F89.V3 – Oral Exam Practice – Mock Exam ONE – Answer Guide – January 2022
 Guild Intern Training Program

Case Details (for Assessor use only)

Information New Estelle® is not a new medication, she has had it before earlier this year. Mrs. Potter ran
Gathering and Medication(s) out of supply a couple of months ago and would like to re-fill the prescription.
Processing (incl. multiple)
- Estelle®: started approximately 8 months ago due to adult acne. Mrs. Potter
Medication
reports that it seemed to work very well.
History (incl.
- Fluconazole 150mg: Used stat for vaginal thrush. This has now resolved.
duration of
- Warfarin: started 2 months ago, has regular blood tests. Well managed.
therapy)
*Only if intern specifically asks: The patient is using warfarin as she developed a
VTE in her leg 2 months ago. The clot has dissolved but she is to continue on
warfarin for the next 6-12 months as a precaution (Dr. is monitoring)
OTC / Nil
Complimentary
Medications

Medical Adult acne – current concern

Conditions
Vaginal thrush – resolved 3 months ago
VTE - *if intern asks for more info: patient developed a VTE in her leg 2 months ago.
The clot has since dissolved but she is to continue on warfarin for the next 6-12 months
(Dr. is monitoring)

Patient Details Mrs. Potter is 42 years old.

Allergies Nil

Pregnancy/ No
Breastfeeding
(If the intern asks): Mrs. Potter already has 2 children and does not plan on having any
more. Mrs. Potter does not require additional contraceptive measures as her husband
had a vasectomy.

Product Medication Intern to identify:

Knowledge / issues
- Patient had a VTE 2 months ago (reason for being on warfarin)
Counselling /
Decision - PRIMARY ISSUE: Estelle® is contraindicated for patients with a history of VTE.
making Risk of cardiovascular disease and VTE is also increased since Mrs. Potter is over 40
years old.

Medication Intern should contact Dr. Smith:

change/contact
1. Recommend cessation of Estelle® since it is contraindicated for Mrs. Potter due
GP
to her previous VTE. Consider alternate agent such as doxycycline, erythromycin
or topical agents.

- Thank intern pharmacist for identifying issue with the old Estelle® script. Request that it be destroyed
GP Response
and explained to patient why she can no longer take COCs.
- Request that the patient book an appointment in 1-2 days with the GP to discuss adult acne.
- Inform patient to cease Estelle® (and the reason why this is the case)
Intern
- Recommend patient to see their GP in 1-2 days to follow up
Counselling
- Give lifestyle advice on management of adult acne

Q.NITP.F89.V3 – Oral Exam Practice – Mock Exam ONE – Answer Guide – January 2022
 Guild Intern Training Program

- Note that if the intern does not identify and resolve the primary issue (Estelle® is contraindicated),
Exam Result
that is considered a fail overall.
1. Rossi S editor. Australian medicines handbook. Adelaide: Australian Medicines Handbook Pty Ltd;
References
2021
2. eTG, Accessed 2021.

Q.NITP.F89.V3 – Oral Exam Practice – Mock Exam ONE – Answer Guide – January 2022