Community Pharmacist Situational Quiz

1. A patient comes in with a prescription for amoxicillin but mentions they had a rash after taking penicillin as
a child. What should you do?

A) Dispense the medication as prescribed

B) Call the prescriber to verify if an alternative is needed
C) Recommend an antihistamine to prevent allergic reactions
D) Tell the patient that penicillin allergies are not serious

✅ Answer: B) Call the prescriber to verify if an alternative is needed

Rationale: Patients with a history of penicillin allergy could have a cross-reaction to amoxicillin. While a mild rash in
childhood does not always indicate a true allergy, it is best to consult the prescriber before dispensing.

2. A customer requests Sudafed (pseudoephedrine) for nasal congestion but appears nervous and is
purchasing a large quantity. What should you do?

A) Refuse the sale and call the police immediately

B) Sell only the legal limit and record the sale
C) Ignore the signs and sell the medication
D) Sell extra amounts to help the patient stock up

✅ Answer: B) Sell only the legal limit and record the sale
Rationale: Pseudoephedrine is a regulated substance due to its potential use in methamphetamine production.
Pharmacists must follow legal limits, monitor suspicious purchases, and report concerns if necessary.

3. A pregnant woman asks if she can take ibuprofen for her headache. What should you advise?

A) Yes, ibuprofen is safe in all trimesters

B) No, ibuprofen should be avoided, especially in the third trimester
C) Recommend ibuprofen only if acetaminophen does not work
D) Suggest doubling the dose to increase effectiveness

✅ Answer: B) No, ibuprofen should be avoided, especially in the third trimester

Rationale: Ibuprofen can cause complications in pregnancy, especially in the third trimester, where it may lead to
premature closure of the ductus arteriosus in the fetus. Acetaminophen is the preferred analgesic during pregnancy.

4. A patient on warfarin asks if they can start taking herbal supplements for better circulation. What should
you do?

A) Approve any herbal supplement since they are natural

B) Warn the patient that some herbs may increase bleeding risk
C) Tell the patient to stop warfarin if they take herbs
D) Say there is no interaction and to proceed as they wish

✅ Answer: B) Warn the patient that some herbs may increase bleeding risk
Rationale: Many herbal supplements (e.g., ginkgo, garlic, ginger) can increase bleeding risk when taken with
warfarin. The patient should consult their doctor before adding new supplements.

5. A patient who recently started taking metformin complains of stomach upset. What advice should you
give?

A) Stop taking the medication immediately

B) Take metformin with food to reduce stomach upset
C) Switch to an over-the-counter antacid
D) Double the dose to build tolerance faster

✅ Answer: B) Take metformin with food to reduce stomach upset

Rationale: Metformin commonly causes gastrointestinal discomfort. Taking it with food can help minimize these side
effects. If symptoms persist, switching to an extended-release formulation may be an option.

6. A parent comes in worried that their 2-year-old child accidentally took a few extra doses of acetaminophen.
What should you do?

A) Reassure them that acetaminophen is harmless in small amounts

B) Advise them to seek immediate medical attention
C) Suggest waiting to see if symptoms develop
D) Recommend giving activated charcoal at home

✅ Answer: B) Advise them to seek immediate medical attention

Rationale: Acetaminophen overdose can cause liver toxicity, and early intervention with acetylcysteine can prevent
severe damage. The parent should be directed to seek medical care immediately.

7. A customer requests an antibiotic for their cold because they believe it will help them recover faster. How
should you respond?

A) Dispense an over-the-counter antibiotic

B) Explain that antibiotics do not treat viral infections like colds
C) Recommend a stronger antibiotic to ensure effectiveness
D) Suggest taking half a dose of an old antibiotic prescription

✅ Answer: B) Explain that antibiotics do not treat viral infections like colds
Rationale: Antibiotics are ineffective against viral infections. Educating patients on proper antibiotic use helps prevent
resistance and unnecessary medication use.

8. A patient with diabetes comes in with a prescription for glyburide. They mention frequent episodes of
dizziness and sweating. What should you do?

A) Counsel the patient on recognizing and managing hypoglycemia

B) Suggest stopping the medication immediately
C) Recommend an energy drink for quick sugar boost
D) Tell them to ignore the symptoms as they will subside over time

✅ Answer: A) Counsel the patient on recognizing and managing hypoglycemia

Rationale: Glyburide is a sulfonylurea that increases insulin secretion, potentially causing hypoglycemia. Patients
should be educated on symptoms, treatment (e.g., consuming glucose), and when to seek medical attention.

9. A patient asks if they can crush their extended-release medication for easier swallowing. What should you
tell them?

A) Yes, if they mix it with food or liquid

B) No, crushing extended-release tablets can cause dose dumping
C) Only crush half the dose to avoid side effects
D) Suggest skipping doses instead if swallowing is difficult

✅ Answer: B) No, crushing extended-release tablets can cause dose dumping

Rationale: Extended-release formulations are designed to release the drug gradually. Crushing them can lead to an
unintended rapid release, increasing the risk of side effects or toxicity.
10. A regular customer who takes alprazolam (Xanax) asks for an early refill. They claim they lost their
medication. What should you do?

A) Refill the prescription without question

B) Contact the prescriber before approving an early refill
C) Deny the request and tell them to manage their supply better
D) Offer an over-the-counter alternative

✅ Answer: B) Contact the prescriber before approving an early refill

Rationale: Alprazolam is a controlled substance with potential for misuse. Early refill requests should be verified with
the prescriber to ensure patient safety and prevent misuse or diversion.

11. A patient picking up their statin prescription complains of new muscle pain. What is the best course of
action?

A) Tell them muscle pain is normal and will go away

B) Advise them to stop taking the statin immediately
C) Recommend they report the symptom to their doctor
D) Suggest taking a pain reliever along with the statin

✅ Answer: C) Recommend they report the symptom to their doctor

Rationale: Muscle pain can be a sign of statin-induced myopathy or, in rare cases, rhabdomyolysis. The doctor may
need to adjust the dose or switch to a different statin.

12. A patient with asthma comes in complaining that their albuterol inhaler is not helping as much as before.
What should you advise?

A) Increase the frequency of inhaler use

B) Check inhaler technique and recommend a controller medication if needed
C) Switch to a different over-the-counter inhaler
D) Suggest stopping the inhaler and relying on natural remedies

✅ Answer: B) Check inhaler technique and recommend a controller medication if needed

Rationale: Improper inhaler use can reduce effectiveness. If symptoms worsen, a long-term controller medication
(e.g., inhaled corticosteroid) may be necessary. The patient should see their doctor.

13. A patient asks if they can take St. John’s Wort with their prescription antidepressant. What should you
advise?

A) Yes, St. John’s Wort enhances the effectiveness of antidepressants

B) No, it can interact and increase the risk of serotonin syndrome
C) Only take it if they have mild depression
D) Suggest stopping their prescription antidepressant first

✅ Answer: B) No, it can interact and increase the risk of serotonin syndrome
Rationale: St. John’s Wort can increase serotonin levels, potentially leading to serotonin syndrome when combined
with antidepressants. Patients should consult their doctor before adding herbal supplements.

14. A mother wants to buy cough syrup for her 1-year-old child. What should you do?

A) Recommend a cough syrup with dextromethorphan

B) Advise against cough syrups and suggest non-drug remedies
C) Suggest using a higher dose for effectiveness
D) Sell the syrup but warn about drowsiness
✅ Answer: B) Advise against cough syrups and suggest non-drug remedies
Rationale: Over-the-counter cough medications are not recommended for children under 2 years due to safety
concerns. Instead, saline drops, humidifiers, and hydration should be recommended.

15. A patient asks if they can drink alcohol while taking metronidazole. What should you tell them?

A) Alcohol is safe in moderation with metronidazole

B) Drinking alcohol can cause severe reactions and should be avoided
C) Alcohol will only reduce the effectiveness slightly
D) Suggest drinking alcohol but in small amounts

✅ Answer: B) Drinking alcohol can cause severe reactions and should be avoided
Rationale: Metronidazole interacts with alcohol, causing a disulfiram-like reaction (nausea, vomiting, headache,
flushing). Patients should avoid alcohol during treatment and for 48 hours after stopping the medication.

1. A prescription requires 250 mg of a drug, but you only have 500 mg tablets available. How many tablets
should you dispense per dose?

A) 1 tablet
B) ½ tablet
C) 2 tablets
D) ¼ tablet

✅ Answer: B) ½ tablet

2. A liquid antibiotic suspension contains 250 mg of drug per 5 mL. The doctor prescribes 500 mg per dose.
How many mL should the patient take per dose?

A) 5 mL
B) 10 mL
C) 15 mL
D) 20 mL

✅ Answer: B) 10 mL

3. A child weighing 15 kg needs a medication dosed at 10 mg/kg. How many mg should be given per dose?

A) 100 mg
B) 125 mg
C) 150 mg
D) 200 mg

✅ Answer: C) 150 mg

4. A prescription calls for 0.25 grams of a drug. How many milligrams is this?

A) 2.5 mg
B) 25 mg
C) 250 mg
D) 2500 mg

✅ Answer: C) 250 mg
5. A patient needs 100 mL of a 25% dextrose solution. How many grams of dextrose does this solution
contain?

A) 10 g
B) 15 g
C) 20 g
D) 25 g

✅ Answer: D) 25 g

6. A doctor prescribes 500 mg of a medication that comes in a concentration of 200 mg per 2 mL. How many
mL should be given?

A) 2 mL
B) 4 mL
C) 5 mL
D) 10 mL

✅ Answer: C) 5 mL

7. A prescription calls for 3 oz of cough syrup. How many milliliters is this?

A) 30 mL
B) 60 mL
C) 90 mL
D) 120 mL

✅ Answer: C) 90 mL

8. A pharmacy technician needs to prepare a 1:1000 epinephrine solution. How many mg of epinephrine are in
1 mL?

A) 0.1 mg
B) 1 mg
C) 10 mg
D) 100 mg

✅ Answer: B) 1 mg

9. A patient is prescribed 250 mg of a drug every 6 hours. How many grams will they receive in 24 hours?

A) 0.5 g
B) 1 g
C) 2 g
D) 3 g

✅ Answer: B) 1 g

10. A medication is supplied as 100 mg per 5 mL. How many mg are in 15 mL?

A) 200 mg
B) 250 mg
C) 300 mg
D) 350 mg

✅ Answer: C) 300 mg

11. A prescription requires 1.5 g of a medication, but the pharmacy only has 500 mg tablets. How many tablets
should be given per dose?

A) 2 tablets
B) 3 tablets
C) 4 tablets
D) 5 tablets

✅ Answer: D) 5 tablets

12. A doctor prescribes 0.75 L of IV fluid. How many milliliters is this?

A) 75 mL
B) 750 mL
C) 7.5 mL
D) 7500 mL

✅ Answer: B) 750 mL

13. A patient is prescribed 2.5 mg of a drug, but the tablets available are 5 mg each. How many tablets should
be taken per dose?

A) 1 tablet
B) ½ tablet
C) 2 tablets
D) ¼ tablet

✅ Answer: B) ½ tablet

14. A medication comes as 125 mg per 5 mL suspension. How many mL are needed for a 500 mg dose?

A) 10 mL
B) 15 mL
C) 20 mL
D) 25 mL

✅ Answer: C) 20 mL

15. A solution is labeled 1:5000. How many mg of drug are in 250 mL of solution?

A) 50 mg
B) 100 mg
C) 200 mg
D) 500 mg

✅ Answer: A) 50 mg

16. A physician orders 30 mEq of potassium chloride. The available stock solution contains 20 mEq per 15
mL. How many mL should be given?

A) 10 mL
B) 15 mL
C) 20 mL
D) 25 mL

✅ Answer: C) 20 mL

17. A prescription requires 0.05 mg of a medication, but you have 50 mcg tablets available. How many tablets
should be dispensed per dose?

A) 1 tablet
B) 5 tablets
C) 10 tablets
D) 15 tablets

✅ Answer: C) 10 tablets
18. A patient is prescribed 3 tsp of a liquid medication per dose. How many mL is this per dose?

A) 5 mL
B) 10 mL
C) 15 mL
D) 30 mL

✅ Answer: C) 15 mL

19. A doctor prescribes 500 mL of a 10% dextrose solution. How many grams of dextrose does this contain?

A) 25 g
B) 50 g
C) 75 g
D) 100 g

✅ Answer: B) 50 g

20. A prescription calls for 2.5 L of normal saline. How many milliliters is this?

A) 1500 mL
B) 2000 mL
C) 2500 mL
D) 3000 mL

✅ Answer: C) 2500 mL

1. A prescription states: "Amoxicillin 500 mg cap, 1 cap PO BID x 7 days." How should the pharmacist instruct
the patient to take this medication?

A) Take 1 capsule by mouth every 12 hours for 7 days

B) Take 1 capsule by mouth once daily for 7 days
C) Take 1 capsule by mouth every 8 hours for 7 days
D) Take 2 capsules by mouth every 12 hours for 7 days

✅ Answer: A) Take 1 capsule by mouth every 12 hours for 7 days

Rationale:

 PO = By mouth (per os)

 BID = Twice a day (every 12 hours)
 x 7 days = For 7 days

Thus, the correct instruction is "Take 1 capsule by mouth every 12 hours for 7 days."

2. A prescription states: "Metformin 500 mg tab, 1 tab PO QAM with food." What does "QAM" mean?

A) Every afternoon
B) Every morning
C) Every 8 hours
D) Before bedtime

✅ Answer: B) Every morning

Rationale:

 QAM = Every morning (quaque ante meridiem)

 PO = By mouth
 With food suggests taking it during breakfast to reduce gastrointestinal side effects

Thus, the correct instruction is "Take 1 tablet by mouth every morning with food."
3. A doctor prescribes: "Ibuprofen 400 mg tab, 1 tab PO Q6H PRN pain." What does "Q6H PRN pain" mean?

A) Every 6 hours as needed for pain

B) Every 8 hours as needed for pain
C) Every 6 hours regardless of pain
D) Every 6 hours before meals

✅ Answer: A) Every 6 hours as needed for pain

Rationale:

 Q6H = Every 6 hours

 PRN = As needed (pro re nata)
 Pain indicates the condition for which the medication should be taken

Thus, the correct instruction is "Take 1 tablet by mouth every 6 hours as needed for pain."

4. A prescription reads: "Losartan 50 mg tab, 1 tab PO QHS." When should the patient take the medication?

A) Every morning
B) Every afternoon
C) Every night at bedtime
D) Every 12 hours

✅ Answer: C) Every night at bedtime

Rationale:

 QHS = Every night at bedtime (quaque hora somni)

Thus, the correct instruction is "Take 1 tablet by mouth every night at bedtime."

5. A patient presents a prescription for "Hydrochlorothiazide 25 mg tab, 1 tab PO QOD." How often should
they take the medication?

A) Every day
B) Every other day
C) Twice daily
D) Three times daily

✅ Answer: B) Every other day

Rationale:

 QOD = Every other day (quaque altera die)

Thus, the correct instruction is "Take 1 tablet by mouth every other day."

6. A physician prescribes: "Prednisone 10 mg tab, 1 tab PO QID x 5 days." How many times a day should the
patient take this medication?

A) Once a day
B) Twice a day
C) Three times a day
D) Four times a day
✅ Answer: D) Four times a day
Rationale:

 QID = Four times a day (quater in die)

Thus, the correct instruction is "Take 1 tablet by mouth four times a day for 5 days."

7. A prescription states: "Atorvastatin 20 mg tab, 1 tab PO QPM." When should the patient take this
medication?

A) Every morning
B) Every evening
C) Every 12 hours
D) Every 6 hours

✅ Answer: B) Every evening

Rationale:

 QPM = Every evening (quaque post meridiem)

Thus, the correct instruction is "Take 1 tablet by mouth every evening."

8. A patient presents a prescription for "Albuterol inhaler, 2 puffs Q4H PRN wheezing." How often can the
patient use the inhaler?

A) Every 2 hours as needed for wheezing

B) Every 4 hours as needed for wheezing
C) Twice daily as needed for wheezing
D) Every 6 hours as needed for wheezing

✅ Answer: B) Every 4 hours as needed for wheezing

Rationale:

 Q4H = Every 4 hours

 PRN = As needed
 Wheezing is the symptom requiring treatment

Thus, the correct instruction is "Inhale 2 puffs every 4 hours as needed for wheezing."

9. A prescription states: "Warfarin 5 mg tab, 1 tab PO HS." When should the patient take the medication?

A) Every morning
B) At bedtime
C) Every 8 hours
D) After meals

✅ Answer: B) At bedtime
Rationale:

 HS = At bedtime (hora somni)

Thus, the correct instruction is "Take 1 tablet by mouth at bedtime."

10. A prescription states: "Omeprazole 20 mg cap, 1 cap PO AC." What does "AC" mean?

A) After meals
B) Before meals
C) At bedtime
D) Every 8 hours

✅ Answer: B) Before meals

Rationale:

 AC = Before meals (ante cibum)

Thus, the correct instruction is "Take 1 capsule by mouth before meals."

11. A prescription reads: "Docusate 100 mg cap, 1 cap PO PC." What does "PC" mean?

A) Before meals
B) After meals
C) At bedtime
D) Every 6 hours

✅ Answer: B) After meals

Rationale:

 PC = After meals (post cibum)

Thus, the correct instruction is "Take 1 capsule by mouth after meals."

12. A prescription states: "Lisinopril 10 mg tab, 1 tab PO OD." What does "OD" mean?

A) Once daily
B) Every other day
C) Twice daily
D) Four times daily

✅ Answer: A) Once daily

Rationale:

 OD = Once daily (omni die)

Thus, the correct instruction is "Take 1 tablet by mouth once daily."

13. A prescription states: "Metoprolol 50 mg tab, 1 tab PO BID PC." How should the pharmacist instruct the
patient to take this medication?

A) Take 1 tablet by mouth twice daily before meals

B) Take 1 tablet by mouth twice daily after meals
C) Take 1 tablet by mouth every other day after meals
D) Take 1 tablet by mouth once daily with food

✅ Answer: B) Take 1 tablet by mouth twice daily after meals

Rationale:

 BID = Twice a day (bis in die)

 PC = After meals (post cibum)

Thus, the correct instruction is "Take 1 tablet by mouth twice daily after meals."
14. A prescription reads: "Acetaminophen 500 mg tab, 1 tab PO Q4-6H PRN fever." What does "Q4-6H PRN
fever" mean?

A) Every 4 to 6 hours with food

B) Every 4 to 6 hours only if the fever is above 100°F
C) Every 4 to 6 hours as needed for fever
D) Every 4 to 6 hours before bedtime

✅ Answer: C) Every 4 to 6 hours as needed for fever

Rationale:

 Q4-6H = Every 4 to 6 hours

 PRN = As needed (pro re nata)
 Fever = The symptom requiring treatment

Thus, the correct instruction is "Take 1 tablet by mouth every 4 to 6 hours as needed for fever."

15. A doctor prescribes: "Ciprofloxacin 500 mg tab, 1 tab PO Q12H x 10 days." How often should the patient
take this medication?

A) Every 12 hours for 10 days

B) Once daily for 10 days
C) Every 8 hours for 10 days
D) Three times daily for 10 days

✅ Answer: A) Every 12 hours for 10 days

Rationale:

 Q12H = Every 12 hours

 x 10 days = Duration of therapy

Thus, the correct instruction is "Take 1 tablet by mouth every 12 hours for 10 days."

16. A prescription states: "Furosemide 40 mg tab, 1 tab PO STAT." How should the pharmacist instruct the
patient?

A) Take 1 tablet by mouth as needed

B) Take 1 tablet by mouth immediately
C) Take 1 tablet by mouth at bedtime
D) Take 1 tablet by mouth before meals

✅ Answer: B) Take 1 tablet by mouth immediately

Rationale:

 STAT = Immediately (statim)

Thus, the correct instruction is "Take 1 tablet by mouth immediately."

17. A patient hands in a prescription for: "Levothyroxine 75 mcg tab, 1 tab PO QD AC." How should this
medication be taken?

A) Take 1 tablet by mouth once daily after meals

B) Take 1 tablet by mouth once daily before meals
C) Take 1 tablet by mouth every other day before meals
D) Take 1 tablet by mouth three times daily before meals

✅ Answer: B) Take 1 tablet by mouth once daily before meals

Rationale:

 QD = Once daily (quaque die)

 AC = Before meals (ante cibum)

Thus, the correct instruction is "Take 1 tablet by mouth once daily before meals."

18. A doctor prescribes: "Insulin glargine 10 units SC QPM." How should this medication be administered?

A) Inject 10 units under the skin every morning

B) Inject 10 units under the skin every evening
C) Inject 10 units into the muscle every evening
D) Inject 10 units into the vein every morning

✅ Answer: B) Inject 10 units under the skin every evening

Rationale:

 SC = Subcutaneous (under the skin)

 QPM = Every evening

Thus, the correct instruction is "Inject 10 units under the skin every evening."

19. A prescription states: "Tramadol 50 mg tab, 1 tab PO TID PRN pain." How often should the patient take
this medication?

A) Once daily as needed for pain

B) Every 8 hours as needed for pain
C) Every 6 hours as needed for pain
D) Twice daily as needed for pain

✅ Answer: B) Every 8 hours as needed for pain

Rationale:

 TID = Three times a day (ter in die)

 PRN pain = As needed for pain

Thus, the correct instruction is "Take 1 tablet by mouth every 8 hours as needed for pain."

20. A prescription states: "Hydralazine 25 mg tab, 1 tab PO QID PC." What does "QID PC" mean?

A) Four times a day before meals

B) Four times a day after meals
C) Four times a day at bedtime
D) Every 6 hours as needed

✅ Answer: B) Four times a day after meals

Rationale:

 QID = Four times a day (quater in die)

 PC = After meals (post cibum)

Thus, the correct instruction is "Take 1 tablet by mouth four times a day after meals."