BCACP Prep Course (BCACP): free quiz

1. Question 1 of 10

   A 58-year-old adult with type 2 diabetes takes metformin 1000 mg by mouth twice daily and empagliflozin 25 mg by mouth once daily. A1c is 8.6%, BMI 34 kg/m², eGFR 82 mL/min/1.73 m², and there is no history of pancreatitis or medullary thyroid carcinoma. As the ambulatory care pharmacist, which medication recommendation is most appropriate to improve glycemic control and support weight loss?

   Choose one answer

   ARecommend starting semaglutide 0.25 mg subcutaneously once weekly and titrate as tolerated.BRecommend starting sitagliptin 100 mg by mouth once daily.CRecommend starting glyburide 5 mg by mouth once daily with breakfast.DRecommend starting pioglitazone 30 mg by mouth once daily.
2. Question 2 of 10

   A 58-year-old with diabetes takes empagliflozin 25 mg by mouth daily and metformin XR 1000 mg by mouth twice daily. At a routine call, the patient reports abdominal pain, nausea, rapid breathing, and poor oral intake for 2 days while continuing empagliflozin. What is the best pharmacist recommendation?

   Choose one answer

   AContinue empagliflozin and add sitagliptin 100 mg daily to improve glucose control.BRecommend urgent medical evaluation for possible ketoacidosis and advise holding empagliflozin pending clinician assessment.CReduce empagliflozin to 10 mg daily and follow up in 1 week if symptoms continue.DIncrease metformin XR to 1500 mg twice daily because hyperglycemia is the likely cause of nausea.
3. Question 3 of 10

   A 50-year-old adult with generalized anxiety disorder takes duloxetine 60 mg by mouth daily and reports bothersome nausea after a recent increase from 30 mg daily 5 days ago. Blood pressure is normal, and there are no alarming symptoms. As the ambulatory care pharmacist, which recommendation is most appropriate?

   Choose one answer

   AAdd linezolid to cover possible medication-related gastrointestinal infection while duloxetine is continued.BReturn to duloxetine 30 mg by mouth daily temporarily and reassess after the adverse effect improves.CStop duloxetine immediately and start venlafaxine extended release 225 mg by mouth daily the next morning.DIncrease duloxetine to 120 mg by mouth daily because nausea usually means the dose is still too low.
4. Question 4 of 10

   A 68-year-old patient with heart failure takes carvedilol 25 mg by mouth twice daily. During an ambulatory vaccination review, the pharmacist identifies risk factors for severe pneumococcal disease. Which condition most strongly increases invasive pneumococcal disease risk?

   Choose one answer

   AUse of artificial tears most strongly increases the risk of invasive pneumococcal disease.BCarvedilol 25 mg twice daily most strongly increases the risk of invasive pneumococcal disease.CA blood pressure of 128/74 mm Hg most strongly increases the risk of invasive pneumococcal disease.DA history of asplenia most strongly increases the risk of invasive pneumococcal disease.
5. Question 5 of 10

   A 48-year-old adult takes omeprazole 20 mg by mouth daily and naproxen 500 mg by mouth twice daily as needed for osteoarthritis. During an annual visit, the ambulatory care pharmacist reviews alcohol use case finding. Which screening approach is recommended in adults, including pregnant persons, in primary care settings when they can be provided brief counseling interventions?

   Choose one answer

   AScreen only if liver enzymes are elevated.BAvoid alcohol screening because counseling has no benefit.CScreen for unhealthy alcohol use with validated tools.DScreen only adults taking NSAIDs and proton pump inhibitors together.
6. Question 6 of 10

   A 61-year-old adult with venous thromboembolism takes rivaroxaban 20 mg by mouth each evening with food. Estimated creatinine clearance has declined to 24 mL/min, and there is no active bleeding. As the ambulatory care pharmacist, which recommendation is most appropriate?

   Choose one answer

   AReduce rivaroxaban to 10 mg by mouth each evening because any low creatinine clearance only needs a smaller dose.BAdd aspirin 81 mg by mouth daily and continue rivaroxaban because combined therapy protects against recurrence.CContinue rivaroxaban 20 mg by mouth each evening because food offsets renal impairment.DRecommend reassessing anticoagulant choice because rivaroxaban is not favored at this degree of renal impairment for this indication.
7. Question 7 of 10

   A 65-year-old patient with nonvalvular atrial fibrillation has been stable on warfarin 3 mg by mouth every evening with therapeutic INRs. The clinic receives a new pharmacogenomic report showing VKORC1 -1639 A/A. As the ambulatory care pharmacist, what is the best interpretation of this result?

   Choose one answer

   AThe genotype predicts lower warfarin dose requirements and is consistent with the patient’s relatively low maintenance dose.BThe variant affects only rivaroxaban and has little relevance to warfarin dosing.CThe genotype predicts warfarin resistance, so the current dose is likely subtherapeutic despite therapeutic INRs.DThe result means INR monitoring can be stopped because VKORC1 fully determines anticoagulation response.
8. Question 8 of 10

   A 52-year-old adult with chronic hepatitis B takes tenofovir alafenamide 25 mg by mouth daily. As the ambulatory care pharmacist, the patient reports missing doses because housing instability makes it hard to store medications safely and maintain a routine. Viral suppression has been inconsistent. Which pharmacist recommendation is best?

   Choose one answer

   ARecommend taking tenofovir alafenamide every other day to build a reserve supply during periods of unstable housing.BRecommend coordinating simplified refill timing, discreet storage solutions, and linkage to case management or social work support.CRecommend switching to entecavir 1 mg by mouth twice daily because more frequent dosing improves routine formation.DRecommend stopping therapy during unstable housing periods and restarting when the patient has permanent housing.
9. Question 9 of 10

   A patient taking omeprazole 20 mg by mouth every morning says, “I keep using it longer than planned because I get symptoms when I stop.” Which pharmacist response best demonstrates a neutral, curious approach?

   Choose one answer

   A

   “That means omeprazole 20 mg every morning has made you dependent on it.”

   B

   “You should taper omeprazole 20 mg every morning exactly the way I recommend.”

   C

   “Change omeprazole 20 mg every morning to pantoprazole because it is easier to discontinue.”

   D

   “Tell me what happens when you try stopping omeprazole 20 mg every morning and what concerns you most about those symptoms.”

10. Question 10 of 10

    A pharmacist in a family medicine clinic assesses a 63-year-old adult with gastroesophageal reflux disease taking omeprazole 20 mg by mouth every morning. The patient also takes clopidogrel 75 mg by mouth daily after coronary stent placement 2 months ago. Reflux symptoms persist despite adherence. Which acid-suppressive recommendation is most appropriate?

    Choose one answer

    ASwitch to cimetidine 400 mg by mouth twice daily.BIncrease omeprazole to 40 mg by mouth every morning.CAdd esomeprazole 20 mg by mouth at bedtime.DSwitch to pantoprazole 40 mg by mouth every morning.

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