Critical Care Pharmacy Sample Examination Items

These sample examination items are made available by BPS for the purposes of familiarizing certification candidates and other stakeholders with the structure and format of BPS certification examinations. This is not meant for use as a self-assessment. Performance on any of these items does not correlate with performance on the actual examination.

The content of these examples is meant to be illustrative of actual examination items, but these items do not appear on the certification examination and are not meant to identify the scope of the examination. For a more comprehensive indication of the scope of each certification examination, please refer to the Exam Content Outline for each specialty area.

Examination items are in multiple-choice format. The great majority of examination items are multiple-choice with a single response from among four options. Some examinations may include a small percentage of items that require selection of multiple (three or four) responses from among a larger set of available (up to eight) options. Examinations items may also be supplemented by an image.

Which of the following acute or chronic conditions would significantly increases the risk of ICU delirium in a patient with dementia?

Chronic obstructive pulmonary disease (COPD)
Alcoholism
Hypertension
Diabetes

Correct!

Incorrect!

What is the initial step of the evaluation of a potential stroke patient?

CT scan with contrast
Assessment of National Institutes of Health Stroke Scale score
Immediate stabilization of the airway, breathing, and circulation
Gathering past medical history and current medication

Correct!

Incorrect!

A patient in the ICU with evidence of acute kidney injury is being evaluated. The patient's relevant laboratory results are as follows:


















































Sodium 135 mEq/L
Potassium 4.2 mEq/L
Chloride 101 mEq/L
Bicarbonate 14 mEq/L
BUN 21 mg/dL
Creatinine 2.1 mg/dL
Glucose 99 mg/dL
pH 7.22
pCO2 30 mm Hg
pO2 85 mm Hg
Serum osmolality 330 mOsm/kg

The patient's serum creatinine was 0.8 mg/dL 3 days ago. Which intravenous medication is most likely responsible for this patient's laboratory values and acute kidney injury?

Lorazepam 12 mg/hr
Fentanyl 0.5 mcg/kg/hr
Cisatracurium 2 mcg/kg/min
Dexmedetomidine 1 mcg/kg/hr

Correct!

Incorrect!

Which patient is succinylcholine contraindicated?

Intoxicated man with diabetic ketoacidosis
Man with asthma attack after burning a fingertip on welding machinery
Woman with severe sepsis whose mother has a history of malignant hyperthermia
Adolescent woman with cerebral palsy who presents with closed radial fracture

Correct!

Incorrect!

Which medication can be administered via a postpyloric feeding tube?

Dabigatran
Nifedipine
Pancrelipase
Rivaroxaban

Correct!

Incorrect!

A 75-year-old male patient with a history of diabetes mellitus, hypertension, and paroxysmal atrial fibrillation is being resuscitated with intravenous crystalloids for severe sepsis. The patient initially demonstrated fluid responsiveness with improvements in mean arterial pressure (MAP) and pulse pressure variability, but is no longer responding appropriately to fluid challenge and has a persistently elevated lactate (5 mmol/L) with decreasing urine output.

Which treatment regimen is most appropriate?

Epinephrine titrated to maintain MAP ≥ 65 mm Hg
Norepinephrine titrated to maintain MAP ≥ 65 mm Hg
Vasopressin titrated to maintain MAP ≥ 70 mm Hg
Dopamine titrated to maintain MAP ≥ 70 mm Hg

Correct!

Incorrect!

A 65-year-old patient, who is intubated and sedated, is started on intravenous antibiotics, famotidine 20 mg intravenously twice daily, and enoxaparin 40 mg subcutaneously once daily. On day 2, blood-tinged fluid is observed in the nasogastric tube, and the patient's Hgb drops from 10.5 g/dL to 8 g/dL.


Which change to patient's current therapy is recommended?

Discontinue enoxaparin and add sequential compression devices.
Change enoxaparin to fondaparinux 2.5 mg subcutaneously daily.
Change enoxaparin to heparin 5000 units subcutaneously twice daily.
Change famotidine to pantoprazole 40 mg intravenously once daily.

Correct!

Incorrect!

Which is an accurate statement regarding tranexamic acid?

Tranexamic acid has been shown to reduce mortality due to bleeding when administered between 3 and 8 hours after injury.
Tranexamic acid has been shown to reduce transfusion requirements in trauma patients who received the medication within 8 hours after initial injury.
Tranexamic acid has no effect on blood transfusion requirements and increased thrombotic events in trauma patients when administered in the first 8 hours after initial injury..
Tranexamic acid has been shown to reduce all-cause mortality only when administered within 3 hours after presentation.

Correct!

Incorrect!

Which is an appropriate rapid-sequence intubation recommendation for a patient with stage 3 chronic kidney disease experiencing worsening respiratory distress secondary to septic shock?

Blood pressure is 76/42 mm Hg; use etomidate for induction.
Blood pressure is 76/42 mm Hg; use ketamine for induction.
Potassium is 5.7 mEq/L and creatinine is 2.4 mg/dL; use succinylcholine for neuromuscular blockade.
Potassium is 5.7 mEq/L and creatinine is 2.4 mg/dL; use rocuronium for neuromuscular blockade.

Correct!

Incorrect!

A pharmacist is designing a study in which the primary end point will be the number of patients with an accurate and complete medication history within 36 hours of hospital admission. A total of 100 patient charts will be evaluated, with 50 prior to implementation and 50 after implementation. Which is the most appropriate statistical test to evaluate the primary end point?

Student's t test
Fisher's exact test
Mann-Whitney U test
Logistic regression

Correct!

Incorrect!

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Critical Care Pharmacy Sample Questions

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