Pharmacist Prometric exam questions

The Pharmacist exam in every GCC country

From each regulator's own exam pages; anything a regulator does not publish says so. Assessment mode also depends on your licence title, so confirm your route on your eligibility notice.

12 worked Pharmacist practice questions

Original exam-style questions from the bank, spread across the blueprint domains. They are not real or recalled exam questions. Try each one, then open the answer for the rationale and reference. None of them appear in the free mock exam, so reading them will not spoil it.

1. Question 1 · Clinical Therapeutics & Disease-State Management

   A patient with HIV is being counseled that antiretroviral therapy involves a combination regimen rather than a single drug. What is the primary rationale for using combination antiretroviral therapy (typically three active agents)?

   1. ATo reduce the number of daily tablets to one
   2. BTo maximally suppress viral replication and prevent emergence of resistance
   3. CTo eliminate the need for adherence to therapy
   4. DTo cure the infection completely within weeks
   Show answer and explanation

   Correct answer: B. To maximally suppress viral replication and prevent emergence of resistance

   Combination antiretroviral therapy using agents from different classes achieves durable maximal viral suppression and prevents the emergence of drug resistance that would occur rapidly with monotherapy. ART controls but does not cure HIV, adherence remains essential, and pill burden reduction is a formulation convenience rather than the core rationale.

   Reference: DHHS Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV 2023; WHO HIV guidelines

2. Question 2 · Pharmaceutical Calculations & Compounding

   A disinfectant is prepared at a ratio strength of 1:2500. What is this concentration expressed in parts per million (ppm)?

   1. A40 ppm
   2. B250 ppm
   3. C400 ppm
   4. D2500 ppm
   Show answer and explanation

   Correct answer: C. 400 ppm

   A ratio strength of 1:2500 means 1 part in 2500 parts; dividing 1,000,000 by 2500 gives 400 ppm. The other options misplace the decimal or invert the ratio.

   Reference: Ansel's Pharmaceutical Calculations, 15th ed. (2017)

3. Question 3 · Medicinal Chemistry, Pharmacognosy & Dietary Supplements

   Levodopa is used in Parkinson's disease rather than dopamine itself. Which combined rationale best explains this choice?

   1. ADopamine is a prodrug that must be converted to levodopa peripherally
   2. BDopamine crosses the blood-brain barrier more readily than levodopa
   3. CLevodopa is the inactive D-isomer that is safer than dopamine
   4. DLevodopa is an amino-acid prodrug that crosses the blood-brain barrier via an active transporter and is then decarboxylated to dopamine centrally
   Show answer and explanation

   Correct answer: D. Levodopa is an amino-acid prodrug that crosses the blood-brain barrier via an active transporter and is then decarboxylated to dopamine centrally

   Dopamine does not cross the blood-brain barrier, so its metabolic precursor levodopa (L-DOPA) is given as a prodrug; being an amino acid, it is carried across the barrier by the large neutral amino-acid transporter and is then decarboxylated to dopamine within the CNS. It is the pharmacologically relevant L-isomer (not the inactive D-form), and it is levodopa, not dopamine, that penetrates the brain.

   Reference: Katzung Basic & Clinical Pharmacology, 15th ed. (2021), antiparkinsonian drugs

4. Question 4 · Nonprescription (OTC) & Self-Care / Counter Medication

   A patient presents with a minor superficial skin abrasion. Which self-care wound advice is most appropriate?

   1. AApply undiluted hydrogen peroxide daily to the healing wound
   2. BClean gently with water, keep it moist and covered, and refer if signs of infection develop
   3. CLeave it uncovered and apply an oral antibiotic
   4. DApply a potent topical corticosteroid to speed healing
   Show answer and explanation

   Correct answer: B. Clean gently with water, keep it moist and covered, and refer if signs of infection develop

   Minor abrasions should be gently cleaned (e.g., with clean water), kept moist and covered to promote healing, with referral if signs of infection (spreading redness, pus, fever) appear. Repeated undiluted hydrogen peroxide damages healing tissue, oral antibiotics are unnecessary for a simple abrasion, and topical corticosteroids can impair wound healing.

   Reference: Handbook of Nonprescription Drugs (APhA), 2021 - Minor wound care; NICE CKS Lacerations

5. Question 5 · Special Populations

   A 24-year-old woman with epilepsy controlled on valproate wishes to become pregnant. Regarding valproate use in pregnancy, which statement is most accurate?

   1. AValproate carries the highest risk of neural tube defects and impaired neurodevelopment among common antiepileptics
   2. BValproate is considered the safest antiepileptic in pregnancy
   3. CFolic acid supplementation eliminates the teratogenic risk of valproate
   4. DValproate should be switched to phenytoin, which is non-teratogenic
   Show answer and explanation

   Correct answer: A. Valproate carries the highest risk of neural tube defects and impaired neurodevelopment among common antiepileptics

   Valproate has the highest teratogenic risk among common antiepileptics, causing neural tube defects and a dose-dependent reduction in childhood IQ/neurodevelopment, so it should be avoided in women of childbearing potential when alternatives exist. Folic acid reduces but does not eliminate neural tube defect risk. Phenytoin is also teratogenic (fetal hydantoin syndrome), so it is not a non-teratogenic substitute.

   Reference: NICE Epilepsy Guideline NG217 (2022); MHRA Valproate Pregnancy Prevention Programme

6. Question 6 · Patient Assessment, Counseling, Drug Information & Evidence-Based Practice

   When appraising a randomized controlled trial for internal validity, which methodological feature MOST directly reduces the risk of selection bias?

   1. AAllocation concealment during randomization
   2. BUsing a large sample size
   3. CReporting results as relative risk
   4. DPublishing in a high-impact journal
   Show answer and explanation

   Correct answer: A. Allocation concealment during randomization

   Allocation concealment prevents those enrolling participants from knowing or influencing the next assignment, directly protecting against selection bias and ensuring comparable groups at baseline. A large sample improves precision but not freedom from bias, and the choice of effect measure or journal prestige does not address internal validity. Concealed allocation is a core determinant of a trial's methodological quality.

   Reference: Higgins et al., Cochrane Handbook for Systematic Reviews of Interventions, 2019

7. Question 7 · Pharmacy Practice Management, Medication Safety & Dispensing Systems

   According to USP <800>, which engineering control is required for compounding sterile hazardous drugs to protect both the preparation and the operator?

   1. AA horizontal laminar airflow bench blowing air toward the operator
   2. BA containment primary engineering control such as a biological safety cabinet or compounding aseptic containment isolator, in a negative-pressure room
   3. CAn open workbench with a desk fan
   4. DA standard fume hood vented into the pharmacy
   Show answer and explanation

   Correct answer: B. A containment primary engineering control such as a biological safety cabinet or compounding aseptic containment isolator, in a negative-pressure room

   USP <800> requires sterile hazardous-drug compounding within a containment primary engineering control (for example, a Class II biological safety cabinet or compounding aseptic containment isolator) located in an externally vented, negative-pressure containment area to protect both product sterility and the worker. A horizontal laminar bench blows contaminants toward the operator, and open benches, desk fans, or internally recirculating hoods provide no adequate containment.

   Reference: USP General Chapter <800> Hazardous Drugs - Handling in Healthcare Settings (2020)

8. Question 8 · Pharmacology, Drug Classes, ADRs & Drug Interactions

   A 65-year-old man with a history of tendon disorders needs treatment for a urinary infection. Which class carries a black-box warning for tendinitis and tendon rupture that should influence antibiotic choice?

   1. AFluoroquinolones
   2. BMacrolides
   3. CFirst-generation cephalosporins
   4. DNitrofurantoin
   Show answer and explanation

   Correct answer: A. Fluoroquinolones

   Fluoroquinolones carry black-box warnings including tendinitis and tendon rupture (risk increased in older patients and with concurrent corticosteroids), so alternatives are preferred when possible. Macrolides, cephalosporins, and nitrofurantoin do not carry this specific tendon-rupture warning.

   Reference: US FDA Drug Safety Communication on fluoroquinolones (2016, updated)

9. Question 9 · Pharmaceutics, Biopharmaceutics & Pharmacokinetics

   A drug is a weak acid that is filtered and undergoes passive tubular reabsorption. In an overdose, alkalinizing the urine with sodium bicarbonate enhances its elimination. What is the mechanism?

   1. AAlkaline urine converts the acid to its unionized form, increasing reabsorption
   2. BAlkalinization inhibits active tubular secretion of the drug
   3. CAlkalinization increases glomerular filtration rate directly
   4. DAlkaline urine ionizes the weak acid, trapping it in the tubular lumen and reducing reabsorption
   Show answer and explanation

   Correct answer: D. Alkaline urine ionizes the weak acid, trapping it in the tubular lumen and reducing reabsorption

   Raising urinary pH ionizes a weak acid (such as salicylate or phenobarbital); the ionized species is lipid-insoluble and cannot be passively reabsorbed, so it is trapped in the tubular lumen and excreted more rapidly (ion trapping). Alkalinization does not primarily change GFR or active secretion, and it decreases, not increases, reabsorption.

   Reference: Katzung, Basic & Clinical Pharmacology, 15th ed., 2021

10. Question 10 · Basic Biomedical Sciences

    A microbiology report describes an acid-fast bacillus that resists standard Gram staining because of its lipid-rich cell wall and requires the Ziehl-Neelsen stain. This staining property is due to a high content of which cell-wall component?

    1. ATeichoic acid
    2. BLipopolysaccharide
    3. CMycolic acid
    4. DLipoteichoic acid
    Show answer and explanation

    Correct answer: C. Mycolic acid

    Acid-fast organisms such as Mycobacterium species have cell walls rich in mycolic acids (long-chain fatty acids), which make them resist decolorization by acid-alcohol and require the Ziehl-Neelsen technique. Teichoic and lipoteichoic acids are gram-positive wall components, and lipopolysaccharide is a gram-negative outer-membrane component; none confer acid-fastness.

    Reference: Murray Medical Microbiology, 9th ed., 2021

11. Question 11 · Pharmacy Law, Ethics & Regulatory Affairs

    Which of the following adverse events should most clearly be prioritized for expedited pharmacovigilance reporting?

    1. AA serious, unexpected reaction such as an unlabeled anaphylactic or hepatotoxic event, especially with a newly marketed medicine
    2. BA mild, well-documented transient headache from a long-established drug
    3. CA patient's dislike of a tablet's taste
    4. DA minor, self-limiting reaction already described in the product label
    Show answer and explanation

    Correct answer: A. A serious, unexpected reaction such as an unlabeled anaphylactic or hepatotoxic event, especially with a newly marketed medicine

    Serious and unexpected (not previously labeled) reactions, particularly with newer medicines, warrant expedited reporting because they may reflect important new safety signals. Mild, well-characterized, expected, or trivial events such as taste complaints carry far less surveillance value and do not require expedited reporting.

    Reference: CIOMS/WHO pharmacovigilance reporting standards; WHO Pharmacovigilance guidance (2002)

12. Question 12 · Special Populations

    A patient is a CYP2C19 poor metabolizer. Which antiplatelet drug's effectiveness is most likely reduced, prompting consideration of an alternative agent after PCI?

    1. AClopidogrel
    2. BPrasugrel
    3. CTicagrelor
    4. DAspirin
    Show answer and explanation

    Correct answer: A. Clopidogrel

    Clopidogrel is a prodrug requiring CYP2C19 activation; poor metabolizers form less active drug, reducing antiplatelet effect and increasing cardiovascular events, so prasugrel or ticagrelor (not CYP2C19-dependent) are preferred alternatives. Aspirin acts by an unrelated mechanism (COX inhibition) and is unaffected by CYP2C19 status.

    Reference: CPIC Guideline for Clopidogrel and CYP2C19 (2013, updated 2022)

Pharmacist reference books and guidelines

Every question in this bank names the textbook or guideline its answer rests on. These are the sources our Pharmacist questions cite most often - the reading list to revise from alongside the bank.

Sitting the SPLE? SCFHS publishes its own list: SCFHS's SPLE reading list. Where your regulator publishes a reading list, use the editions it names. Exam questions are not taken from any one book.