लुम्बिनी प्रदेश, सातौँ, फार्मेसी अधिकृत, २०८३/०५/२२

1. What medicines should be there in crash cart?

• A) Emergency medicines ✓

• B) High cost medicines

• C) Highly potent medicines

• D) Antibiotics

2. Which services are included in the National Health Insurance benefit package in Nepal?

• A) Coverage for essential drugs and healthcare services ✓

• B) Free private health care

• C) Only surgical interventions

• D) OTC medicines only

3. What are the primary objectives of cost recovery schemes in a hospital pharmacy?

• A) Maximize profits

• B) Partially recover the cost of drugs while providing affordable access ✓

• C) Provide drugs free of cost to all patients

• D) Reduce drug quality

4. What pharmaceutical products require strict cold chain management?

• A) Tablets

• B) Parenteral vaccines and biological ✓

• C) Ointments

• D) Capsules

5. The most reliable indicator for child dose calculation is:

• A) Body surface area ✓

• B) Sex

• C) Age

• D) Weight

6. Drug financing scheme free from out-of-pocket burden to consumer based on equity principle is known as:

• A) Cost recovery

• B) Cost sharing

• C) Insurance ✓

• D) Govt. free drug program ✓

7. Which of the following is the key outcome of the rational use of medicines?

• A) Improved patient outcomes ✓

• B) Increased treatment failure

• C) Increased medication adherence

• D) Greater prescription variability

8. Which factor can increase the risk of noncompliance in elderly population?

• A) Polypharmacy ✓

• B) Hypertension

• C) Male gender

• D) Expensive medicines

9. Diethylstilbestrol should never be used in pregnant women because it is associated with:

• A) Miscarriage

• B) Development of vaginal cancer in female offspring ✓

• C) Feminization of the external genitalia of male offspring

• D) Development of deep vein thrombosis in the pregnant woman ✓

10. Drug Utilization Review (DUR) is primarily implemented in healthcare settings to:

• A) Maximize financial returns from pharmaceutical services

• B) Evaluate and correct patterns of medicine used in clinical practice ✓

• C) Increase the total number of medicines prescribed per patient

• D) Promote use of newer and more expensive therapeutic agents

11. A major challenge in pharmaceutical logistics in Nepal is:

• A) Inaccurate computerized stock recording systems

• B) Difficult terrain and transportation barriers ✓

• C) Limited rural storage infrastructure

• D) Overconsumption of essential medicines

12. Signa means:

• A) Label

• B) Direction to patient ✓

• C) Dose

• D) Warning

13. Which of the following can be considered a commission error in prescriptions?

• A) Not writing patient age

• B) Using unclear abbreviations

• C) Omitting the route of administration

• D) Prescribing a drug despite a known allergy ✓

14. Which therapeutic goal is achieved through controlled-release dosage forms?

• A) Release drug in irregular intervals

• B) Maintain constant plasma drug concentration ✓

• C) Increase dosing frequency

• D) Improve taste masking only

15. A tablet shows delayed disintegration due to high compression force. Which excipient is appropriate to correct this issue?

• A) PEG

• B) Talc

• C) Croscarmellose Sodium ✓

• D) Titanium dioxide

16. Which is the primary purpose of maintaining a pressure cascade in GMP cleanroom layout design?

• A) Rapid transfer of materials between processing areas

• B) Controlled unidirectional airflow and contamination prevention ✓

• C) Maintain uniform temperature in all cleanrooms

• D) Improve lighting and visibility in working areas

17. Which is the long-term stability condition for climatic zone IVb (hot & very humid) according to ICH?

• A) $25^\circ\text{C}/60\%\text{ RH}$

• B) $30^\circ\text{C}/65\%\text{ RH}$ ✓

• C) $30^\circ\text{C}/75\%\text{ RH}$

• D) $40^\circ\text{C}/75\%\text{ RH}$

18. What does the application of thermodynamics in pharmaceutics helps to study?

• A) Drug marketing

• B) Stability and solubility of drugs ✓

• C) Packaging design

• D) Bioavailability

19. The rate limiting step for the bioavailability of poorly water soluble drug is:

• A) Permeation through the intestinal membrane

• B) Dissolution ✓

• C) Disintegration

• D) Rate of gastric emptying

20. Which pricing strategy is common for generic drugs?

• A) Premium pricing

• B) Cost-plus pricing ✓

• C) Skimming pricing

• D) Psychological pricing only

21. What is compared during bioequivalence studies of drugs?

• A) Therapeutic index

• B) Safety profiles

• C) Rate and extent of drug absorption ✓

• D) Manufacturing cost

22. The "5P's" of GMP does not include:

• A) Premises

• B) Processes

• C) Price ✓

• D) Procedures

23. What does micromeritics deal with?

• A) Flow and packing of powders ✓

• B) Chemical reactions

• C) Drug metabolism

• D) Polymer degradation

24. Which ICH guideline discuss on standards for manufacturing APIs to ensure they meet quality and purity characteristics?

• A) ICH Q2

• B) ICH Q4

• C) ICH Q7 ✓

• D) ICH Q9

25. The structural defect in the tablet wherein it splits into two or more distinct layers is:

• A) Capping

• B) Lamination ✓

• C) Chipping

• D) Picking

26. The Millard reaction is shown by one of the following excipients:

• A) Lactose ✓

• B) Magnesium stearate

• C) Aerosol

• D) Talc

27. The best technique among the following for surface sterilization is:

• A) Gaseous sterilization ✓

• B) Autoclaving

• C) UV radiation

• D) Dry heat sterilization

28. Recombinant DNA technology involves:

• A) Protein synthesis

• B) DNA manipulation ✓

• C) RNA only

• D) Lipid synthesis

29. Which of the following is the most important limitation of the rabbit pyrogen test used in parenteral quality control?

• A) It detects only Gram-negative endotoxins

• B) It requires live animals with variable biological responses ✓

• C) It has limited ability to detect low-level pyrogen accurately

• D) It cannot detect any fever-inducing substances

30. Which of the following method is used to determine viable count of organisms?

• A) Breed method

• B) Proportional count method

• C) Turbidimetry

• D) Plate count technique ✓

31. What are interferons?

• A) Bacterial toxins

• B) Antiviral cytokines produced by host cells ✓

• C) Antibodies

• D) Vaccines

32. Species of medicinal plants promoted by government for cultivation include:

• A) Mentha

• B) Palmarosa

• C) Lemon grass

• D) All of the above ✓

33. What is the primary purpose of carrying out the pulverization of dried plant material?

• A) Increase moisture content

• B) Reduce extraction time and improve efficiency ✓

• C) Improve appearance

• D) Increase microbial load

34. The foaming index is related with:

• A) Alkaloids

• B) Saponins ✓

• C) Resin

• D) Glycoside

35. One of the following is not a plant based drugs:

• A) Aspirin

• B) Artemisinin

• C) Paracetamol

• D) Metformin ✓

36. Glycosides contain:

• A) Sugar + Non-sugar ✓

• B) Protein

• C) Fat

• D) Acid only

37. Ash value indicates:

• A) Purity ✓

• B) Colour

• C) Taste

• D) Size

38. What does Iodine value for oils and fats measure?

• A) Iodine presents in oils

• B) Extent of unsaturation ✓

• C) Extent of saturation

• D) Extent of saponification

39. Which of the following drug-action pairs is correctly matched?

• A) Quinine-Anticancer therapeutic agent

• B) Vincristine-Anticancer chemotherapeutic drug ✓

• C) Reserpine- Antiviral pharmacological agent

• D) Atropine- Antimalarial therapeutic drug

40. Which of the following pairs of phytochemical constituents and their corresponding qualitative tests is correctly matched?

• A) Carbohydrates- Dragendorff's reagent test

• B) Alkaloids- Mayer's reagent test ✓

• C) Proteins- Molisch's test reaction

• D) Lipids- Ninhydrin reaction test

41. Excessively slow drying of crude drugs is most likely to result in:

• A) Increased concentration of active constituents

• B) Fungal growth and enzymatic degradation of constituents ✓

• C) Improved retention of volatile constituents

• D) Enhanced stability of colour and appearance

42. The therapeutic index of a drug is a measure of its:

• A) Efficacy

• B) Safety ✓

• C) Potency

• D) Toxicity

43. Para-sympathomimetic drugs cause :

• A) Bronchodilation

• B) Mydriasis

• C) Bradycardia ✓

• D) Constipation

44. How do antimetabolite anticancer drugs exert their cytotoxic effect?

• A) Intercalating between DNA base pairs to prevent replication

• B) Interfering with RNA transcription by binding RNA strands

• C) Mimicking normal metabolites and disrupting nucleic acid synthesis pathways ✓

• D) Stabilizing microtubules and blocking mitotic spindle formation

45. The atropine poisoning includes all of the following symptoms except:

• A) Agitation and delirium

• B) Mydriasis, cycloplegia

• C) Hyperthermia, dry mouth, hot and flushed skin

• D) Bradycardia, orthostatic hypotension ✓

46. Which of the following is an example of pharmacodynamic interaction?

• A) ACE inhibitor with amiloride causes life-threatening hyperkalemia ✓

• B) Antacid reduce the absorption of fluoroquinolone

• C) Increased bleeding due to cimetidine and warfarin

• D) Probenecid increases half-life of penicillin

47. Disadvantages of inhaled steroids in asthma therapy include:

• A) Acne

• B) Hoarseness ✓

• C) Osteoporosis

• D) Adrenal suppression

48. What is the main immunosuppressive drug used post-kidney transplantation?

• A) Tacrolimus ✓

• B) Amoxicillin

• C) Ibuprofen

• D) Metformin

49. A patient develops red-orange discoloration of urine during TB therapy. Which drug is most likely responsible?

• A) Isoniazid ✓

• B) Ethambutol

• C) Rifampicin

• D) Pyrazinamide

50. Non-systemic antacid is:

• A) Sodium bicarbonate

• B) Potassium citrate

• C) Sodium citrate

• D) Magnesium hydroxide ✓

51. Which of the following is not bacteriostatic?

• A) Penicillin ✓

• B) Tetracycline

• C) Chloramphenicol

• D) Erythromycin

52. Grey baby syndrome is an adverse effects in infants which is due to:

• A) Chloramphenicol ✓

• B) Tetracycline

• C) NSAIDs

• D) Atenolol

53. Lactic acidosis is a possible risk factor associated with:

• A) Metformin ✓

• B) Glipizide

• C) Linagliptin

• D) Pioglitazone

54. A drug that binds to the receptor to show opposite maximal response is:

• A) Agonist

• B) Antagonist

• C) Inverse agonist ✓

• D) Partial agonist

55. Losartan produces its antihypertensive effect primarily by:

• A) Inhibiting angiotensin-converting enzyme (ACE), reducing angiotensin II formation

• B) Selectively antagonizing angiotensin II type 1 ($\text{AT}_1$) receptors ✓

• C) Blocking voltage-gated L-type calcium channels in vascular smooth muscle

• D) Suppressing renin release from juxtaglomerular cells

56. Which of the following drugs prevents uric acid synthesis by inhibiting the enzyme xanthine oxidase?

• A) Aspirin

• B) Allopurinol ✓

• C) Colchicine

• D) Probenecid

57. The antibiotic which has lactam structure is:

• A) Chloramphenicol

• B) Aztreonam ✓

• C) Gentamicin

• D) Erythromycin

58. Acetylation of salicylic acid gives:

• A) Paracetamol

• B) Aspirin ✓

• C) Diclofenac

• D) Indomethacin

59. Starting material for paracetamol synthesis:

• A) Phenol

• B) Nitrobenzene

• C) P-aminophenol ✓

• D) Aniline

60. Which spectroscopic method is most suitable for identifying functional groups in organic compounds?

• A) UV spectroscopy

• B) IR spectroscopy ✓

• C) Fluorimetry

• D) Polarimetry

61. Progesterone is commonly obtained semi synthetically from:

• A) Glucose

• B) Diosgenin ✓

• C) Acetic acid

• D) Benzene

62. Nepal Pharmacy Council act was established in:

• A) B.S. 2051

• B) B.S. 2054

• C) B.S. 2057 ✓

• D) B.S. 2059

63. Which activity clearly falls outside the jurisdiction of Nepal Pharmacy Council?

• A) Enforcing pharmacist professional conduct standards

• B) Maintaining the national register of pharmacists

• C) Inspecting pharmaceutical manufacturing plants ✓

• D) Conducting licensing examinations for pharmacists

64. When was Nepal Ausadhi Limited resgistered?

• A) 2024 B.S.

• B) 2029 B.S. ✓

• C) 2036 B.S.

• D) 2040 B.S.

65. Which university in Nepal is the first institution to introduce pharmacy education?

• A) Kathmandu University

• B) Tribhuvan University ✓

• C) Pokhara University

• D) Purbanchal University

66. Which act is the primary legislation governing drug in Nepal?

• A) Health Act

• B) Drug Act, 2035 (1978) ✓

• C) Pharmacy Council Act

• D) Consumer Protection Act

67. What is the primary function of Department of Drug Administration?

• A) Manufacturing drugs

• B) Exporting pharmaceuticals

• C) Regulating drug quality, safety and efficacy ✓

• D) Conducting clinical trials

68. Which section of the National Drug Policy focuses on Essential Drug List (EDL)?

• A) Drug production ✓

• B) Drug selection

• C) Drug distribution

• D) Drug advertising

69. Which of the following has been a common policy and strategy of the NHP 2071?

• A) Health for all

• B) Sustainable development goals

• C) Hospital pharmacy should be managed by pharmacists

• D) Universal health coverage ✓

70. Which legislation specifically regulates the registration, licensing, and professional practice of pharmacists in Nepal?

• A) Drug Act, 2035

• B) Drug Policy, 2052

• C) Public Health Act, 2075

• D) Pharmacy Council Act, 2057 ✓

71. A Nepali pharmaceutical company plans to export its products. What is the most important requirement?

• A) Strong brand recognition in the domestic pharmaceutical market

• B) Consistently low production costs across all product categories

• C) Full compliance with international quality standards like WHO-GMP ✓

• D) Formal approval and recommendation from local medical practitioners

72. In pharmacopoeia, the identification of a compound in infrared spectroscopy is done by overlapping its spectra with the reference spectra in the range that lies in:

• A) Functional group region

• B) Fingerprint region ✓

• C) The complete spectra

• D) Mid infrared region

73. Microbiological assay of vitamins is based on:

• A) Chemical titration

• B) Growth response of microorganisms ✓

• C) Physical measurement

• D) Distillation

74. Stationary phase in TLC is usually:

• A) Paper

• B) Silica gel ✓

• C) Water

• D) Gas

75. What is the colour of Methyl orange in basic solution?

• A) Red

• B) Orange

• C) Yellow ✓

• D) Blue

76. What does the stability constant determines in complexometric titration with EDTA?

• A) Rate of reaction

• B) Sharpness of end point ✓

• C) Solubility of complex

• D) Colour of indicator

77. What is the retention time (tR) in gas chromatography?

• A) Time required for mobile phase to reach the detector

• B) Time between sample injection and detection of a compound ✓

• C) Time taken by carrier gas to leave the column

• D) Time taken for column cleaning

78. What is the major source of error in gravimetric analysis?

• A) Co-precipitation ✓

• B) Over-drying

• C) High temperature

• D) Dilute solutions

79. Which types of substances is polarimetry particularly useful for?

• A) Aromatic compounds

• B) Chiral drugs ✓

• C) Metals

• D) Volatile compounds

80. For a weak acid undergoing liquid-liquid extraction, maximum extraction into the organic phase occurs under which condition?

• A) Solution pH has no effect on ionization state

• B) When the solution pH is equal to the pKa of the acid

• C) When the solution pH is lower than the pKa of the acid

• D) When the solution pH is higher than the pKa of the acid ✓

81. If the molar concentration of the sample is doubled and the length of the path of the light beam through the sample is made three times, then observed absorbance at a particular wavelength will become:

• A) 2 times

• B) 3 times

• C) 6 times ✓

• D) 2/3 times

82. Agreement among series of measurements obtained from multiple samplings of the same homogenous sample means:

• A) Accuracy

• B) Precision ✓

• C) Range

• D) Specificity

83. Riboflavin can be analyzed by:

• A) Nephelometry

• B) Fluorimetry ✓

• C) Flame photometry

• D) Phosphorimetry

84. Liquid-liquid extraction primarily depends on:

• A) Difference in melting points of the solute

• B) Difference in densities of the two liquid phases ✓

• C) Difference in boiling points of the solvents used

• D) Distribution of solute between two immiscible phases ✓

85. An effective audit trail system in a Good Laboratory Practice (GLP) complaint electronic system must include:

• A) Only final validated and approved data entries

• B) Periodic backup files without change history details ✓

• C) System generated data compression and storage logs

• D) User identity, timestamp, and record of all changes made

86. The error of rejecting the null hypothesis when it is true is known as:

• A) Type-I error ✓

• B) Type-II error

• C) Type-III error

• D) Type-IV error

87. Who is the member secretary of drug consultative council?

• A) Chief national medicine laboratory

• B) Chief drug administrator, DDA ✓

• C) Secretary, Minister of Health and Food Safety

• D) Person nominated by government of Nepal

88. Which of the following schedule is for the application to register prior to the importation of drug?

• A) Schedule 4C ✓

• B) Schedule 4D

• C) Schedule 4E

• D) Schedule 5C

89. Which section of the pharmacopoeia has information on storage and labeling?

• A) Monograph ✓

• B) General chapter

• C) Appendices

• D) Introduction

90. The following drugs are classified as narcotic drug except:

• A) Fentanyl

• B) Buprenorphine

• C) Diazepam ✓

• D) Codeine

91. The provision of pharmacy shop registration is given in which of the following section of drug act, 2035?

• A) 8

• B) 9

• C) 10 ✓

• D) 11

92. A medicine meets assay limits but fails impurity limits. Under the Drugs Standard Rules, it is:

• A) Fully compliant pharmacopoeial product

• B) Substandard pharmaceutical product ✓

• C) Bioequivalent generic pharmaceutical product

• D) Conditionally approved pharmaceutical product

93. Which procurement method is generally adopted as the standard method under the Public Procurement Act, 2063?

• A) Direct procurement

• B) Open competitive bidding ✓

• C) Negotiated procurement

• D) Force account

94. Which one of the following has five years validity period as per the Drug Act, 2035?

• A) Recommendation letter as per clause 7

• B) Product license as per clause 8 ✓

• C) Market authorization as per clause 8 ka

• D) Certificate as per clause 10

95. Which rule of the Drug Registration Regulation, 2038 specifies the product license to be manufactured?

• A) 1

• B) 2

• C) 3

• D) 4 ✓

96. Which of the following aspect is not included in preamble of Drug Act, 2035?

• A) Production

• B) Safety

• C) Advertisement

• D) Accessibility ✓

97. What is the main aim of patient counseling in hospital pharmacy?

• A) Reduce inventory costs

• B) Improve adherence and therapeutic outcomes ✓

• C) Increase sells

• D) Promote OTC drugs

98. While procuring drugs, the time that elapses between issuing on replenishment order and receiving the material in store is known as:

• A) Replenishment time

• B) Lead time ✓

• C) Supply time

• D) Purchase time

99. Vaccines are stored at:

• A) 0–2°C

• B) 2–8°C ✓

• C) 8–15°C

• D) 15–25°C

100. Why is dosage adjustment required in elderly patients?

• A) Increased metabolic rate

• B) Reduced renal and hepatic function ✓

• C) Increased drug absorption

• D) Faster gastrointestinal transit