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1. A 60-year-old patient has a 15-year history of type 2 diabetes mellitus, hypertension, and dyslipidemia. The patient, who denies smoking or drinking, complains of early satiety, a full feeling, bloating, and vomiting, for the past 2 months. Current medications include glipizide, metformin, and atorvastatin. The most recent A1C was 9.8%. Liver and renal function test results are within normal limits.
Which of the following would be most appropriate for managing these complaints?

A) Start simethicone.
B) Begin intravenous fluids.
C) Start metoclopramide.
D) Discontinue metformin.

2. A pharmacy resident calculates the appropriate gentamicin dose and frequency for an elderly patient on hemodialysis. This skill reflects what type of residency learning?

A) Evaluation
B) Comprehension
C) Application
D) Analysis

3. In which of the following scenarios should the error be reported to the Institute for Safe Medication Practices?

A) A pharmacy technician fills a prescription incorrectly with a "sound-alike" product, but the error is caught by the pharmacist before being dispensed to the patient.
B) A patient receives a 30-day supply of a prescription written for twice daily dosing with only 30 tablets dispensed.
C) A shipment of influenza vaccine was received by the pharmacy and was not placed in a refrigerator until the following day.
D) A patient complains to a pharmacy manager that she did not receive an iPLEDGE brochure when receiving isotretinoin.

4. A patient presents at a physician's office with gait unsteadiness and clumsiness. The patient has a history of type 2 diabetes mellitus, hypertension, and chronic numbness and tingling of the feet and fingertips.
Examination reveals mild distal wasting, glove-and-stocking sensory impairment, absent ankle jerks, brisk knee jerks, and bilateral Babinski reflexes. Gait is slightly ataxic.
CBC reveals a hemoglobin of 10.1 g/dL, WBC of 4,500 cells/mL, MCV 120 fL, and platelets
163,000 cells/ul.
Which of the following is the most important laboratory test for assisting in diagnosis?

A) Serum vitamin B12
B) Erythrocyte sedimentation rate
C) Ferritin
D) Folic acid

5. From ethical and scientific validity standpoints, in addition to double blinding, which of the following research designs is best for determining a new medication's relative efficacy in treating acute stroke?

A) Placebo-controlled, randomized, parallel design
B) Placebo-controlled, crossover design
C) Parallel design comparing the new therapy with the best standard therapy
D) Crossover design comparing the new therapy with the best standard therapy

問題與答案：