Free Foreign Pharmacy Graduate Equivalency Examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Foreign Pharmacy Graduate Equivalency Examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1A student reviewing cardiac electrophysiology before studying antiarrhythmic drugs is asked which structure, acting without any neural stimulation, rhythmically initiates impulses and establishes the basic rhythm of the heartbeat. Which structure is this?

   1. A. Bundle branches
   2. B. Atrioventricular (AV) node
   3. C. Atrioventricular bundle
   4. D. Sinoatrial (SA) node

   Answer: D

   Explanation: The NCI SEER module states: "Without any neural stimulation, the sinoatrial node rhythmically initiates impulses 70 to 80 times per minute. Because it establishes the basic rhythm of the heartbeat, it is called the pacemaker of the heart." The atrioventricular node, atrioventricular bundle, and bundle branches are other parts of the conduction system that coordinate contraction, but the sinoatrial node is the pacemaker.

   Source: SEER Training Modules: Physiology of the Heart — Conduction System section

2. 2The label for 0.9% Sodium Chloride Injection lists 154 mEq/L of sodium and 154 mEq/L of chloride. Assuming complete dissociation, what is the calculated osmolarity of this solution?

   1. A. 154 mOsmol/L
   2. B. 616 mOsmol/L
   3. C. 77 mOsmol/L
   4. D. 308 mOsmol/L

   Answer: D

   Explanation: Each mEq of a monovalent ion contributes 1 mOsmol, so 154 mOsmol/L of sodium plus 154 mOsmol/L of chloride gives 308 mOsmol/L. The label lists "Sodium 154" mEq/L and states "Calculated Osmolarity: 308 mOsmol/liter". 154 mOsmol/L counts only one ion, 77 mOsmol/L halves one ion, and 616 mOsmol/L double-counts both ions.

   Source: DailyMed: Sodium Chloride Injection, USP (0.9% and 0.45%) label — Description section, 0.9% Sodium Chloride Injection USP

3. 3A hospital pharmacist sends a patient's full medication history to the physician treating the patient in the emergency department. Under the HIPAA Privacy Rule, does the minimum necessary standard limit this disclosure?

   1. A. Yes; the patient must first sign a written HIPAA authorization
   2. B. Yes; only the drugs relevant to the emergency visit may be sent
   3. C. No; it is not imposed on disclosures to a provider for treatment
   4. D. No; minimum necessary applies only to payment-related disclosures

   Answer: C

   Explanation: HHS's summary states: "The minimum necessary requirement is not imposed in any of the following circumstances: (a) disclosure to or a request by a health care provider for treatment". The standard does apply to many other uses, including payment and health care operations, and treatment disclosures do not require authorization.

   Source: HHS: Summary of the HIPAA Privacy Rule — Uses and Disclosures, Limiting Uses and Disclosures to the Minimum Necessary

4. 4A patient's thyroid gland no longer makes enough thyroid hormone because of Hashimoto's disease. What does NIDDK describe as the replacement therapy for this hypothyroidism?

   1. A. Radioactive iodine, which destroys overactive thyroid tissue
   2. B. Methimazole, which blocks synthesis of new thyroid hormone
   3. C. Levothyroxine, identical to a hormone the healthy thyroid makes
   4. D. Potassium iodide, which restores the thyroid's iodine stores

   Answer: C

   Explanation: NIDDK states: "You will take levothyroxine, a thyroid hormone medicine identical to a hormone a healthy thyroid makes." Methimazole and radioactive iodine reduce thyroid hormone production and would worsen hypothyroidism; iodine deficiency is extremely rare in the United States.

   Source: NIDDK: Hypothyroidism (Underactive Thyroid) — Treatment section

5. 5While reviewing cardiac physiology for a heart failure pharmacotherapy module, a student is asked which valves close at the moment the ventricles contract so that blood does not flow back into the atria. Which valves close at that point?

   1. A. Venous valves of the arms and legs
   2. B. Pulmonary and aortic semilunar valves
   3. C. Tricuspid and bicuspid (mitral) valves
   4. D. Pulmonary semilunar and tricuspid valves

   Answer: C

   Explanation: SEER explains: "When the ventricles contract, atrioventricular valves close to prevent blood from flowing back into the atria. When the ventricles relax, semilunar valves close to prevent blood from flowing back into the ventricles." The atrioventricular valves are the tricuspid (right) and bicuspid or mitral (left) valves; the semilunar valves close during ventricular relaxation, and venous valves are in peripheral veins.

   Source: SEER Training Modules: Structure of the Heart — Valves section

6. 6A pharmacist must report how much sodium chloride a patient receives from one 500-mL bag of 0.45% Sodium Chloride Injection. How many grams of sodium chloride does the bag contain?

   1. A. 4.5 g
   2. B. 0.45 g
   3. C. 2.25 g
   4. D. 22.5 g

   Answer: C

   Explanation: A 0.45% w/v solution contains 0.45 g per 100 mL; the label states "Each 100 mL of 0.45% Sodium Chloride Injection USP contains:" and "Sodium Chloride USP 0.45 g". For 500 mL: 0.45 g x 5 = 2.25 g. 4.5 g is the amount in 1000 mL, 0.45 g is the amount in only 100 mL, and 22.5 g results from treating the solution as 4.5%.

   Source: DailyMed: Sodium Chloride Injection, USP (0.9% and 0.45%) label — Description section, 0.45% Sodium Chloride Injection USP

7. 7A patient with angina asks that his prescription be dispensed without a child-resistant cap. Under the federal Poison Prevention Packaging Act regulations, which oral prescription dosage form is specifically exempt from special packaging?

   1. A. Extended-release tablets of isosorbide mononitrate
   2. B. Sublingual dosage forms of nitroglycerin
   3. C. Immediate-release tablets of metoprolol
   4. D. Chewable tablets of low-dose aspirin

   Answer: B

   Explanation: 16 CFR 1700.14(a)(10) requires special packaging for oral prescription drugs "except for the following:" and lists first "(i) Sublingual dosage forms of nitroglycerin." The other products are not on that exemption.

   Source: 16 CFR Part 1700: Poison Prevention Packaging — 16 CFR 1700.14(a)(10)(i)

8. 8Two patients have adrenal insufficiency: one has primary disease with adrenal damage, the other secondary disease from low ACTH. Why does the secondary patient usually not need fludrocortisone?

   1. A. Secondary adrenal insufficiency usually preserves cortisol production
   2. B. Secondary adrenal insufficiency usually preserves aldosterone production
   3. C. Fludrocortisone is contraindicated when ACTH levels are low
   4. D. Hydrocortisone alone replaces both cortisol and aldosterone fully

   Answer: B

   Explanation: NIDDK states that if the adrenal glands are not making aldosterone, patients take fludrocortisone, and that "People with secondary adrenal insufficiency usually make enough aldosterone, so they don’t need to take this medicine." Cortisol still must be replaced, most often with hydrocortisone.

   Source: NIDDK: Treatment of Adrenal Insufficiency & Addison's Disease — Hormone replacement section

9. 9A pharmacist explaining pulmonary arterial hypertension therapy describes the vessels that carry blood with a low oxygen content away from the right ventricle toward the lungs. Which vessels are these?

   1. A. Pulmonary veins
   2. B. Pulmonary arteries
   3. C. Systemic arteries
   4. D. Coronary arteries

   Answer: B

   Explanation: SEER states: "Pulmonary arteries transport blood that has a low oxygen content from the right ventricle to the lungs." Pulmonary veins return oxygenated blood to the left atrium, systemic arteries carry oxygenated blood from the left ventricle, and coronary arteries supply the myocardium.

   Source: SEER Training Modules: Classification & Structure of Blood Vessels — Arteries paragraph

10. 10For intraocular surgery, a pharmacist dilutes 1 mL of epinephrine 1 mg/mL (formerly labeled 1:1,000) in 100 mL of ophthalmic irrigation fluid. What is the approximate epinephrine concentration of the resulting solution?

    1. A. 1 mcg/mL
    2. B. 10 mcg/mL
    3. C. 100 mcg/mL
    4. D. 1 mg/mL

    Answer: B

    Explanation: 1 mg (1,000 mcg) in about 100 mL gives about 10 mcg/mL. The label directs: "Dilute 1 mL of epinephrine 1 mg/mL (1:1000) in 100 to 1000 mL of an ophthalmic irrigation fluid to create an epinephrine concentration of 1:100,000 to 1:1,000,000 (10 mcg/mL to 1 mcg/mL)." 1 mcg/mL corresponds to dilution in 1,000 mL, 100 mcg/mL is a tenfold decimal error, and 1 mg/mL ignores the dilution.

    Source: Epinephrine Injection USP, 1 mg/mL prescribing information — Section 2, Induction and Maintenance of Mydriasis during Intraocular Surgery