THE PHARMACY SITUATIONAL

JUDGEMENT TEST
A Guide Tailored For Pharmacy
Situational Judgement Test Preparations

Faroukh Egbejobi MPharm, MRPharmS

Contents
COPYRIGHT
DISCLAIMER
PREFACE
INTRODUCTION
SJT GUIDANCE
SCENARIO CONSIDERATIONS
LAWS AND ETHICS
QUESTION TYPES
QUESTIONS
ANSWERS
GLOSSARY
NOTES
REFERENCES
Copyright:
Copyright © 2020 by Faroukh Egbejobi. All rights reserved.
No part of this publication may be reproduced, distributed, or
transmitted in any form or by any means, which includes recording,
photocopying, or other mechanical or electronic methods, without the
prior written permission of the publisher, except in the case of brief
quotations in critical reviews and certain other non-commercial uses.
First Ebook edition June 2020
Disclaimer:
Although the author and publisher of this book have tried to make
sure the information and content in this book are correct at the press
time, the authors assume no responsibility for errors or omissions of
any kind. Furthermore, the author and publisher do not assume any
liability to any party for any damages from the use of information in
this book. The information offered in this guide is only advisory. The
author and publisher accept no liability for the outcome of any
candidate’s pre-registration application and assessments.
This book has not been endorsed by any professional body,
pharmacy school, university or recruitment organisations. The author
and publisher also have no affiliation with any professional body,
pharmacy school, university or any recruitment organisations.
This work is purely fictional. Any names of characters have been
fabricated by the author’s imagination or used in a fictitious manner.
Any similarities to actual persons or actual events are purely
coincidental. The author and publisher have attempted to trace all
copyright holders of material in this book. If permission has not been
obtained to publish material within this book, please contact the
author and publisher to rectify any issues.
 Preface
The creation of this guide is inspired by the wisdom gained as the
pioneering group of the Pharmacy Oriel process. This guide aims to
pass on tips and advice to candidates embarking on the same
journey. A pre-registration pharmacist's specific guide, it is a chance
to gain insight into various scenarios faced by a training pharmacist.
Through answering each scenario and analysis of rationales, this
guide offers everyone the opportunity to think like a pre-registration
pharmacist.
 Introduction
Oriel pharmacy pre-registration Application:
The Oriel pharmacy pre-registration application involves three
different assessment types sat by prospective pre-registration
pharmacists. This includes multiple mini interviews (MMI), situational
judgement test (SJT) and pharmaceutical calculations. The overall
score is obtained from the MMI and SJT assessment. This score is
then used to assign ranks to candidates. The rank of a candidate and
their preferred pre-registration programme will determine their
placement allocation. Further information can be found in the
applicant handbook.
About this guide
The questions have been developed by qualified pharmacists who
have sat the Oriel SJT test. It aims to inspire candidates to think like
pre-registration pharmacists. The questions in this guide focus on the
pre-registration pharmacist professional attributes framework (PAF).
The full list of key attributes can be found in your applicant handbook.
It is important for candidates to understand information in this book is
relevant to when it was published. With time guidelines are updated
and best practices changes. Therefore, it is important for candidates
to verify information provided in this book.
The SJT Exam
The 52 questions presented in the SJT examination contribute a
significant 40% to your total score. Inevitably, failure to prepare for the
SJT could be devastating to your overall rank. What does this mean?
A thorough understanding of what the SJT is assessing is essential.
The SJT exam is not assessing your clinical prowess. For success in
the SJT, developing an understanding of making decisions as a pre-
registration pharmacist is crucial. The development is not a matter of
memorising key facts. It is built through the experience of handling
situations. Through answering potential scenarios faced by a pre-
registration pharmacist. This guide offers the opportunity for
applicants to develop their decision making ability for both the SJT
exam and in practice.
 SJT guidance
Framework familiarisation: The SJT focuses on four attributes from
the PAF. Familiarising yourself with the PAF is important. This means
reading the framework thoroughly and understanding precisely what
each attribute point means. This is also vital for the MMI component
of your application. Further information on the framework can be
found in the applicant handbook.
Timing: The exam consists of 52 questions which must be completed
within 104 minutes. This equates to 2 minutes per question. Having
checkpoints during the exam can help you keep track of time. For
example, at 20 minutes you should at least be on question 10. Any
questions which you find yourself spending too much time on, put a
star by the question, move on and come back to the question later.
Practice: For most exams, practice questions are a key feature in
exam preparations. The SJT is no different; ensure to answer several
SJT questions prior to the exam. This means utilising this guide and
other SJT resources for optimum revision.
 Scenario Considerations:
Preventing patient harm is a priority in every scenario. Therefore,
when answering questions consider the options which minimise
potential risk to patients. For example, ensuring a patient prescribed a
critical medication like Insulin has no delays in taking their medication.
Contrastingly, actions that are likely to cause patient harm will
generally be the least appropriate options.
Understand your limitation as a Pre-registration pharmacist. Pre-
registration pharmacists are pharmacists in training so are not fully
qualified to advise or do certain tasks. Please be aware of this by
answering the questions as a pre-registration pharmacist. For
example, if a nurse approaches you for advice on inserting cannulas,
you do not have the training to provide advice.
Taking responsibility in situations where you can. This means
being aware of scenarios where you do not need to refer to
colleagues or governing bodies.
Important to build and maintain trusting relationships with team
members.Therefore, think about actions which could affect
relationships with other team members
Adopt a patient centred approach. This is helping patients to be
more involved in their care and aiding patients to make informed
decisions regarding their care.
The order of escalation. As a pre-registration pharmacist, there will
be situations where you will need to consult with someone senior to
you. Initially, seeking advice from seniors within your team should be
the first group of people you seek guidance from. An example of
senior pharmacy staff includes senior clinical pharmacists.
Alternatively, you could consider seeking advice from seniors of other
medical teams such as consultants. Reporting to professional
regulatory boards should be the last option unless circumstance
deems this not possible. An example of this is when a senior staff
member is involved in an incident that needs reporting.
Communicating with patients and staff. Not speaking directly to
patients or other team members is not good practice. This means
preventing others to speak on your behalf to others. Speaking to
unnecessary parties regarding concerns of other team members
could affect professional relationships.
Keywords in the questions. The verbs used in the answers could
be useful hints to the appropriateness of the response. When faced
with a scenario where tension may be high, it is best to try to defuse
the situation by looking for actions such as exploring, explaining and
listening. Actions which could potentially aggravate a situation include
confronting and demanding.
Always do something. In most scenarios doing nothing is never an
option. Actions which include you not getting involved or not saying
anything are not expected attributes of a pre-registration pharmacist.
Adapting this principle towards scenarios will help identify
inappropriate actions. For example, if you witness bad practice from a
colleague you should not ignore the incident. There may even be
situations where a patient asks for assistance outside your
competence. Referring the patient to a trained colleague is better than
stating you cannot help them.
 Laws and ethics:
Laws and ethics should be considered when answering scenarios.
This includes:
Informed Patient consent: For consent to be valid the patient
must have the mental capacity to understand the provided
information. Additionally, the patient must be fully informed to
ensure they are aware of what they are consenting to.

Confidentiality: It is your duty to maintain patient confidentiality.

This means not disclosing information without patient consent.
However, there are instances where disclosure should occur.
For example if you do not disclose information that could cause
harm to the patient, yourself or others. Secondly, if you have
been instructed to disclose information by law. Lastly, if the
patient has consented to the information being disclosed.

Safeguarding: This means understanding that there are some

groups who are susceptible to abuse. This includes children and
the elderly. Therefore, you need to be able to identify potential
abuse in scenarios and take actions to protect these vulnerable
individuals.

Professionalism: As a pre-registration pharmacist there are

standards which you need to uphold. This includes always being
honest and having integrity. For example after making a mistake
you need to be honest with colleagues and patients.
Additionally, apologising when you are at fault is important.

(Guidance to support the standards for pharmacy professionals |

General Pharmaceutical Council, 2020)
 Question types
There are two question types in the exam:
Ranking questions
Ranking questions have five options which need to be ranked from
most appropriate (rank 1) to least appropriate (rank 5). You are
awarded 4 marks for each correctly placed option. Overall for ranking
questions, there are 20 marks available. You can still gain marks if an
option is ranked in the wrong position. These marks are awarded
based on the scoring system in figure 1. Negative marking does not
apply, meaning no points will be deducted for wrongly ranked options.
Example:
Rank
Correct order 1 2 3 4 5
D 4 3 2 1 0
A 3 4 3 2 1
E 2 2 4 3 2
C 1 2 3 4 3
B 0 1 2 3 4
Figure 1- Scoring matrix.
In figure 1 the correct order is DAECB. If a candidate was to rank
each option correctly, 20 marks would be awarded. If a candidate was
to answer DECBA they would receive 13 marks. The breakdown is as
follows:
D=4
E=2
C=3
B=3
A=1
Tip- A good method is to firstly select rank number one and rank
number five which narrows it down to three options in between.
Choosing three correct answers out of eight
options
This requires you to identify three appropriate actions to take out of a
possible eight options. You are awarded four marks for each correct
answer totalling to twelve marks per question.
Tip: By crossing out incorrect options, you break down the question.
This narrows the options down to potential correct answers.
 Questions
Context: The questions should be answered as a pre-registration
pharmacist.

Q1. You are on a clinical ward and notice a ward pharmacist has
recently been losing their temper with patients. Furthermore, one of
your colleagues tells you about a recent dispute she had with the
same ward pharmacist.
What are the three most appropriate actions to take?
A. Ask one of the dispensers to talk to the ward pharmacist.
B. Speak to fellow pre-registration pharmacist about the situation.
C. Praise the ward pharmacist for zero tolerance attitude.
D. Confront the ward pharmacist about the situation and explain
how unprofessional the behaviour is.
E. Discuss your concerns with the ward pharmacist to find out what
could be causing the recent events.
F. Tell the General Pharmaceutical Council (GPhC).
G. Let it pass, as the work is still getting done.
H. Discuss the situation with a senior pharmacist.
Q2. You are currently on a ward-based clinical rotation in a psychiatric
ward. A patient calls you over and explains she has been hit by a
nurse currently on shift. The patient shows you her arm which
appears to be bruised. She has a known history of self-harm.
What are the three most appropriate actions to take?
A. Ask the patient to further explain what happened.
B. Accuse the patient of self-harm.
C. Speak directly with the accused nurse.
D. Accuse the nurse of harming the patient.
E. Ignore the patient as she has harmed herself before.
F. Inform the nurse in charge of the ward about the situation.
G. Report the accused nurse to the nursing professional body.
 H. As you have a tight schedule, inform the patient you will be back
to discuss further as to what has happened.
Q3. You are on a clinical ward and notice one of the junior doctors is
wearing a watch. You are aware of the hospital infection control
policies which states watches should not be worn when on clinical
wards. A nurse highlights this to you as well.
What are the three most appropriate actions to take?
A. Explore why the junior doctor is wearing the wristwatch.
B. Wait till the end of your shift to discuss your concerns with the
junior doctor.
C. Highlight to the junior doctor the importance of infection control
referring to the hospital guidelines.
D. Advise the patients seen by the doctor to report the doctor for
not complying to the hospital’s infection control policy
E. Report the doctor to occupational health.
F. Recommend alternative methods of tracking time.
G. Report the doctor to the medical governing body.
H. Do nothing, as the doctor may have a legitimate reason.
Q4. You are on a clinical ward and a man approaches you explaining
his mum is vegan and does not want any animal containing products.
You check the patient’s medical notes and notice this has not been
recorded. You speak to the patient and she confirms she does not
want any animal containing products. The woman has just received
her medication for the duration of her hospital stay but has not taken
anything yet.
What are the three most appropriate actions to take?
A. Explain that when in hospital it is important to receive the best
treatment as the goal is to get better.
B. Inform the nurse in charge.
C. Speak to one of the senior pharmacists to check for any animal
containing products.
D. Review the medications to ensure there are no animal
containing products.
 E. Tell the patient’s son to try and convince his mum to not worry
about animal containing products.
F. Ensure the patient’s preference of no animal containing
products has been added to the patient’s medical notes.
G. Tell the consultant on the next ward round.
H. Tell the son to notify the nurse in charge.
Q5. A local newspaper released an article a week ago claiming
Medication X can cause cancer. A patient brings you this article and
asks for your opinion of Medication X, which she has just been
prescribed for diabetes. She explains she is scared of taking the
medication as her husband was recently diagnosed with cancer.
What are the three most appropriate actions to take?
A. Tell the patient to do what she feels is right.
B. Tell the patient to speak to the responsible pharmacist.
C. Dismiss the patient’s concern and avoid reading the article.
Explain there is nothing to worry about.
D. Refer the patient to her G.P.
E. Reassure the patient that the risks and benefits have been
assessed and she should continue to take her medication. Also
explain she should speak to her G.P at her next review.
F. Tell the patient to stop taking the medication for now before she
speaks to her G.P.
G. Advise the patient to speak to her G.P if she develops any
unusual side effects.
H. Tell the patient to go to an urgent care centre to get the
medication changed.
Q6. You are in a community pharmacy and the store is currently very
busy. You are in the middle of dispensing medication and a lady
interrupts you. She requests you to have a look at her rash. She looks
to be quite anxious.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Tell the patient you will have a look at the rash once you have
finished dispensing medication for the patients currently waiting.
 B. Tell the patient to try an alternative pharmacy as the store is
busy at the moment.
C. Refer the patient to another member of staff who is currently
completing administrative work.
D. Immediately attend to the patient.
E. Refer the patient to her G.P.
0
Q7. You are on a clinical ward. A nurse comes to you in distress and
tells you she gave a patient the wrong strength of a medication. She
explains the error occurred as she is very emotional from her recent
relationship breakup. She explains no harm has been done to the
patient.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Tell the nurse to solve the situation quickly or you will report her.
B. Record the mistake in the error log.
C. Directly inform a doctor about the error so the patient can be
reviewed. Then record the incident in the error log. Also, speak
to your pre-registration tutor about the incident.
D. Advise the nurse to inform the doctor to review the patient and
record what happened in the error log.
E. Directly inform a doctor of the error so the patient can be
reviewed. Then record the incident in the error log.
Q8. You are on a clinical ward and overhear a junior doctor speaking
to a consultant about a patient. The junior doctor asks the consultant
what to do if the patient has requested for no blood containing
medication. The consultant tells the junior doctor to not worry about
the request, and prescribe as usual.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Confront the junior doctor.
B. Confront the consultant.
C. Report the consultant to another consultant.
D. Report the consultant to your Pre-registration tutor.
E. Speak to another pre-registration pharmacist.
Q9. A patient approaches you in the pharmacy about the herbal
medicine that her friend uses for depression. Her friend has
recommended she should use herbal medicine instead as it is
“natural and effective”. She was prescribed anti-depressants two days
ago and feels it is not having any effect and wants to try the herbal
medicine her friend is using. You know the anti-depressant she is
taking does take about two weeks to have an effect.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Advise the patient to continue to take the anti-depressants as
they take a while to have full effect and highlight herbal
medicines can interact with other medications.
B. Advise the patient to stop taking the anti-depressants and to try
the herbal medicine as it could help.
C. Stress to the patient she must not stop taking the
antidepressant and to continue taking the medication.
D. Advise the patient to book an appointment with her G.P as the
medication may not be suitable for her.
E. Advise the patient to continue taking the anti-depressants and to
research online about the medication.
Q10. A patient comes into the pharmacy for emergency
contraception. She is 21 years old. She explains she continuously has
to come into the pharmacy for emergency contraception as she is
scared to go on regular oral contraception due to side effects. She
claims she does not want to use condoms as it is uncomfortable.
What are the three most appropriate actions to take?
A. Tell her to start taking oral contraception meaning she would not
need emergency contraception.
B. Advise her to go to a walk-in clinic today for emergency
contraception and get advice about contraceptive options from a
doctor.
C. Explain to her if she uses condoms, she would not need oral
contraception.
 D. Advise her to get the emergency contraception from the
pharmacy, and to speak to the senior pharmacist about
contraceptive options.
E. Tell her to consider using condoms otherwise she could get
pregnant.
F. Advise her there are many contraceptive options available and
she will be assessed on what is best for her.
G. Ask her how often she has unprotected sex to work out if
regular oral contraception is worth it.
H. Tell her condoms help prevent sexually transmitted infections as
well as contraception.

O
Q11. Your tutor asks you to counsel a patient on a new inhaler they
have just received as soon as possible, because the patient is in a
hurry. You have not seen the inhaler before, and you are not certain
about how to use the inhaler. Your tutor is checking prescriptions for
waiting patients.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Counsel the patient straight away and improvise as you go
along.
B. Counsel the patient after looking at the inhaler’s patient
information leaflet.
C. Explain to the patient you need to confirm how to use the inhaler
first by reading the patient information leaflet, and then
demonstrate how to use the inhaler.
D. Acknowledge that the patient is in a hurry and signpost the
patient to the inhaler’s patient information leaflet for instructions.
E. Tell your tutor you cannot counsel the patient as you do not
know much about the inhaler.
Q12. Today it is yourself and a locum pharmacist. Constantly, you are
finding yourself doing a lot more as the locum pharmacist is not
familiar with the store's computer systems. Patients are becoming
increasingly impatient.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Take responsibility for any task related to the computer system
for the day.
B. Recommend to teach the locum pharmacist the computer
system essentials.
C. Tell the locum pharmacist to learn how to use the computer
system.
D. Tell the locum pharmacist to read the company standard
operating procedures.
E. Tell patients to go to a different pharmacy as it is busy.

:
Q13 A regular patient comes into the pharmacy with his son asking
you for an explanation on how to best take the prescribed antibiotics
and any side effects to be aware of. The patient has a limited
understanding of English, but his son understands English and is able
to communicate with the patient in Arabic. The son is eight years old.
Your colleague who usually communicates with the patient is currently
on lunch and will be back in one hour. The patient’s prescriber can
communicate in Arabic.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Tell the son to act as a translator to his father.
B. Use an online translator to communicate with the patient.
C. Wait till your colleague comes back from lunch to translate.
D. Tell Son to use the internet to find out the information then
explain to the patient.
E. Contact the prescriber to translate to the patient.
Q14. It is the end of the day and you notice one of the dispensing
technicians placing a box of Paracetamol into her bag before leaving
to go home. There have been recent cases of staff stealing stock in
other branches of the company.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
 A. Ask the dispenser, what she is doing with the Paracetamol.
B. Inform the responsible pharmacist.
C. Report the technician to the GPhC, the technician is stealing.
D. Do not comment as the Paracetamol has been bought by the
technician.
E. Whilst the technician is leaving, request for the Paracetamol to
be returned.
Q15. A mother approaches you about a rash on her child, you
suspect it might be a case of eczema but the mother is adamant the
rash is chickenpox. The child is two years old and has had
chickenpox before.
What are the three most appropriate actions to take?
A. Get a second opinion from a colleague.
B. Tell the mother it might be chickenpox but it also might be
eczema.
C. Tell the mother you think it is eczema.
D. Tell the mother to get confirmation from G.P.
E. Tell the mother to go to a walk-in centre.
F. Ask the mother to search online for symptoms of eczema.
G. Refer the mother to a website explaining chickenpox symptoms.
H. Ask further questions about symptoms.
Q16. You are covering at a pharmacy that you do not usually work in.
A locum pharmacist is also covering today at the pharmacy. A patient
has been prescribed two packs of salbutamol inhalers. However, the
patient has accidentally left one inhaler in the pharmacy. Currently it is
only you and the locum pharmacist in the pharmacy. You will not be
coming back to the pharmacy any time soon and it is now closing
time.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Call the patient straight away.
B. Leave a message on the notice board for someone to call the
patient the next day.
 C. Come back the next day, once the store is open to pass on the
message to the pharmacy manager yourself.
D. Say nothing as the patient will call back.
E. Give a phone call to the pharmacy team the next day about the
inhaler.

:
Q17. You are conducting medicines reconciliation on a patient who is
eighty years old. She has been admitted to the hospital for a fall. On
asking her what medication she takes, she only remembers
Atorvastatin and cannot remember her other medications. She has
mild memory impairment but otherwise fine. She has been deemed fit
to consent. She requests you to call her daughter to confirm her
medications. However, you are not able to speak to her daughter but
her son is on his way to the hospital.
What are the three most appropriate actions to take?
A. Ask the patient if she is happy with you asking her son about her
medication history.
B. Wait till daughter calls back.
C. Try to ask the patient later to see if she can remember other
medications.
D. Tell the patient you cannot get hold of the daughter.
E. Explain to the patient the importance of considering all factors
for Thromboprophylaxis.
F. Ask a ward nurse for advice.
G. Ask your pre-registration tutor for advice.
H. Try to use cues to help jog her memory.
Q18. A regular patient comes in with a prescription for Diltiazem. The
brand the patient receives is currently not in stock, but an alternative
is available. You are sure Diltiazem needs to be brand specific but the
responsible pharmacist assures the patient the alternative brand is
fine.
What are the three most appropriate actions to take?
A. Agree with the responsible pharmacist as generic Diltiazem was
prescribed.
 B. Inform the responsible pharmacist about the need for using
brand specific Diltiazem.
C. Ask the patient if he is ok with other brands.
D. Discuss with the counter assistant about the importance of
using brand specific Diltiazem.
E. Ask the patient to get the prescription changed to the brand in
stock.
F. Use the BNF to support your claim.
G. Explain to the patient the reason for using the same brands.
H. Call superintendent pharmacist to inform the responsible
pharmacist about the importance of using the same brand.
Q19. A patient approaches you and explains one of the dispensers in
the pharmacy had sold her Ibuprofen. The patient has asthma and
tells you she has read the patient information leaflet which indicates
Ibuprofen is not suitable for asthmatics. She insists you report the
dispenser to your manager. She has taken one ibuprofen tablet.
What are the three most appropriate actions to take?
A. Dismiss her claims and carry on as normal.
B. Speak to another dispenser about the situation.
C. Leave a note on the error log.
D. Inform the dispenser of the error.
E. Tell the patient to go to Accident and Emergency for a check-up.
F. Notify the Responsible pharmacist.
G. Refer the patient to the dispenser who made the error.
H. Explain to the patient to not worry as she has only taken one
tablet
Q20. A patient comes into the pharmacy with a prescription for 28
Phenoxymethylpenicillin tablets. You only have 23 tablets in stock at
the moment. You have placed an order for more tablets but cannot
confirm as to when the rest of the tablets will be delivered by the
suppliers. The patient is insisting he will happily take 23 tablets and
does not mind not receiving the rest of the tablets.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
 A. Dispense 23 tablets for now and wait to see if remaining tablets
come in.
B. Dispense 23 tablets for now and do not dispense remaining
tablets.
C. Refuse to dispense and direct the patient to another pharmacy.
D. Refuse to dispense and call another pharmacy to see if they
have full quantity of tablets in stock.
E. Refuse to dispense and tell the patient to get the prescription
changed to an antibiotic you have in stock.
Q21. You are on rotation in a surgical ward. You overhear a nurse and
a consultant talking about drinking some wine during lunchtime to
help ease their stress. They both will continue to work after lunch.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Confront them both about drinking wine at lunch.
B. Ask your pre-registration tutor for advice.
C. Report them to another consultant.
D. Report to the doctors and nurses regulatory body.
E. Ignore what you heard.

O
Q22. A father comes into the pharmacy with his four year old child.
The child has symptoms which you are confident indicates a cold
however, the father is worried and believes the child needs antibiotics.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Explore the reasons for the worries and explain why antibiotics
are not needed for a cold virus.
B. Explain the child does not need antibiotics because the cold is
caused by a virus.
C. Refer the child to an urgent walk-in centre to help reassure the
patient.
D. Tell the father antibiotics is not needed.
E. Suggest the patient uses Paracetamol suspension for now and
come back if the patient gets worse.
Q23. A patient comes into the pharmacy requesting to buy some
Codeine linctus. You are aware that this is an item that regularly gets
abused. The patient looks generally well.
What are the three most appropriate actions to take?
A. Sell Codeine linctus.
B. Ask the patient about their symptoms.
C. Refer the patient to an urgent walk-in centre
D. Explore why the patient wants codeine linctus in particular.
E. Tell patient Codeine is not ideal and offer an alternative.
F. Tell the patient about the risk of dependency.
G. Refer the patient to a G.P.
H. Refuse to sell Codeine linctus.
Q24. You are on rotation in a respiratory ward. You witness on several
occasions one of the pharmacists on the ward providing incorrect
information to patients.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Confront the pharmacist about providing incorrect information.
B. Speak to your pre-registration tutor.
C. Speak to patients after pharmacist to relay the correct
information.
D. Speak to nurses about your observation.
E. Ignore the pharmacist practice.
Q25. Friday evening you spoke to a patient via telephone about
getting their medication delivered the same day. However, you forgot
to dispense the medication in time for delivery. It is currently Saturday,
and you do not work on the weekends.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Call the team on duty to deliver the medication.
B. Go into the pharmacy to deliver the patient’s medication today.
C. Learn from the mistake and create a diary to help manage daily
patient deliveries, and then deliver the patient’s medication on
 Monday.
D. Deliver the medication yourself on Monday.
E. Wait till Monday for the delivery driver to deliver the medication.
Q26. You are currently on rotation in a cardiology ward. A doctor
approaches you to confirm the dose of Rivaroxaban for Stroke
prophylaxis as he wants to prescribe Rivaroxaban to a patient. The
doctor is in a hurry as his bleep is bleeping. You checked a dose
earlier during your study break but do not remember if it was for
Edoxaban or Rivaroxaban. One of the pharmacy technicians on the
ward is adamant you checked the dose for Rivaroxaban. You want to
check your BNF but it is about a five minute walk away.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Tell the doctor you are not sure.
B. Tell the doctor the dose you remember from earlier on.
C. Retrieve your British national formulary (BNF) first then tell the
doctor.
D. Offer to find another doctor to prescribe the Rivaroxaban for the
patient.
E. Tell the doctor that is not your job.
Q27. A patient approaches you in the pharmacy and explains
Ibuprofen tablets have been wrongly put into their Dosette box. You
check the patient’s past medication history and notice the patient has
had Salbutamol before. You know Ibuprofen is not appropriate for
asthmatic patients.
Rank In order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Take out the Ibuprofen tablets from the Dosette box.
B. Ask your pre-registration tutor for advice.
C. Call the patient’s surgery for confirmation.
D. Tell the patient to get written confirmation from the doctor.
E. Show the patient the Ibuprofen tablets and explain to not take
them if they do not want to.
0
Q28. Emma, a dispenser approaches you and explains people think
John, another dispenser, is not dispensing enough which is increasing
other’s workload. Furthermore, Emma explains John sometimes
forgets to ask for Penicillin allergies when handing out Penicillin
based antibiotics.
What are the three most appropriate actions to take?
A. Report John to the responsible pharmacist.
B. Ask other staff members about John.
C. Report John to the chief pharmacist.
D. Suggest to Emma to explain her concerns to John.
E. Explain to John the importance of checking for Penicillin allergy
when handing out Penicillin based antibiotics.
F. Explain to John everyone needs to do their part in dispensing
otherwise it can increase stress levels for others.
G. Write a note on the staff notice board about the importance of
checking Penicillin allergy.
H. Tell John, Emma expressed her frustration about his low work
rate.

:
Q29. You have noticed the responsible pharmacist you have been
working with has been taking Paracetamol suspensions home. You
asked the pharmacist what he needs it for; he claims it is for his
housebound father’s prescription. You are certain you have not seen
a single prescription for his father.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Report responsible pharmacist to a senior pharmacist.
B. Report responsible pharmacist to a consultant.
C. Contact father to find out what is happening.
D. Ask colleagues if they have noticed the same thing.
E. Respect responsible pharmacist actions and do not pay
attention to it.
Q30. A work experience student approaches you and asks why a
nitrate free period is required with Isosorbide mononitrate on behalf of
a patient. You have a rough idea, but require confirmation through
your notes which is saved on your E-mail. The team is also down by
one member of staff today.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Signpost the patient to the relevant website.
B. Explain to the patient you will confirm the information and let
them know when you are free in store.
C. Retrieve the patient’s email address and then send details at the
end of the day.
D. Tell the work experience student what you can recall instantly.
E. Advise the work experience student to ask the store’s counter
assistant.

Q31. A patient approaches you asking how to use a peak flow meter.
The patient explains they initially spoke to one of your colleagues,
Jack, another pre-registration pharmacist, but could not understand
him.
What are the three most appropriate actions to take?
A. Explain to patient how to use a peak flow meter.
B. Establish from the patient what the issue was with Jack’s
explanation.
C. Tell Jack to find out about peak flow meters.
D. Tell the patient to speak to Jack again.
E. Inform Jack on the patient’s dissatisfaction and how to improve
peak flow meter consultations.
F. Ask the patient to address concerns to the responsible
pharmacist.
G. Inform the responsible pharmacist.
H. Apologise to the patient and provide a product information
leaflet.
Q32. You notice a patient purchasing Co-codamol a third time this
week. You have not noticed this before and are aware Co-codamol is
prone to abuse. Your colleague is about to sell another pack to the
patient.
What are the three most appropriate actions to take?
A. Report your colleague to the superintendent pharmacist.
B. Report the patient to the police.
C. Prevent the sale of the Co-codamol.
D. After the sale of Co-codamol tell your colleague to not sell to the
patient again.
E. Warn the patient about the risks of Co-codamol.
F. Report your colleague to the Responsible pharmacist.
G. Inform your colleague about the risks of Co-codamol.
H. Confront the patient if they come back for another pack within a
week.

O
Q33. A patient came in earlier in the day to collect her medication.
However, the prescription was not legally valid. The responsible
pharmacist relayed this to the patient and assured the patient a new
prescription will be retrieved from the surgery later on. The patient is
now back and the responsible pharmacist tells you to collect the
prescription from the surgery next door as he forgot. However, the
receptionist refuses to hand over the prescription due to insufficient
information. The senior pharmacist is currently with a patient in the
consultation room.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Explore why the receptionist refused the request.
B. Ask your colleague, a dispensing technician to speak to the
receptionist.
C. Ask a different receptionist.
D. Ask the responsible pharmacist to speak to the receptionist.
E. Wait for the responsible pharmacist to finish consultation then
ask the pharmacist to speak to the receptionist.
Q34. You are on a clinical ward and a patient has requested you to
counsel him on a newly prescribed inhaler. You notice the patient’s
words are slurred and determine this is caused by a medication he
has taken. You are due to leave the ward.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Contact the patient’s relative to explain the inhaler technique to
the patient later.
B. Write down technique for the patient to read later.
C. Ask another pharmacist on the ward to explain the technique to
the patient once drowsiness has stopped.
D. Clearly and slowly explain to the patient.
E. Ask a nurse to signpost patient to the inhaler patient information
leaflet once drowsiness has subsided.
Q35. You speak to the senior pharmacist about a patient who is
complaining about a dry cough. You tell the pharmacist about the
presenting symptoms and duration of the cough. The senior
pharmacist recommends a dry cough syrup mixture. As you are about
to sell the medication, a dispenser advises against the mixture and
claims the patient should go see a G.P, because of how long the
cough has been present for.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Do not sell the mixture and give the patient the dispenser’s
advice.
B. Ask the dispenser to speak to the patient about symptoms.
C. Ignore the dispenser’s concerns and sell the mixture, but make
notes about the dispenser’s recommendation in the patient’s
notes.
D. Tell the dispenser to speak with the responsible pharmacist
about the final decision.
E. Speak to the responsible pharmacist about the dispenser’s point
of view.

Q36. A female patient, who appears to be about fifteen years old,

comes into the pharmacy with a male who looks about thirty years
old. The male states the female requires emergency contraception.
You notice the girl looks socially withdrawn and nervous. Furthermore,
when asking the female direct questions, the man answers on her
behalf. The man has requested to speak to the Responsible
pharmacist.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Tell the man you will have to consult the police as he is abusing
the girl.
B. Take notes of your concerns and inform the responsible
pharmacist.
C. Ask one of the pharmacy dispensers to speak to the patient.
D. Speak to the patient privately and explain your concerns about
the man.
E. Speak to the man and explain your concerns about the patient.

Q37. You are currently completing a rotation on an acute medicines

ward. One of the senior pharmacists has requested for you to assist
in the outpatient dispensary urgently, as it is very busy. As you are
about to leave, a junior nurse asks you to carry out medicines
reconciliation on an elderly man who has just been admitted with
diabetic ketoacidosis.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Explain to the nurse once you help out in dispensary you will
complete the medicines reconciliation.
B. Complete medicines reconciliation first then help out in the
dispensary.
C. Ask an available pharmacy technician on the ward to complete
the medicines reconciliation whilst you help out in the
dispensary.
D. Explain to senior pharmacist once you complete the medicines
reconciliation you will help out in dispensary as the patient case
is urgent.
E. Ask the nurse to find somebody else to conduct medicines
reconciliation because you need to help out in the dispensary.
Q38. You are on rotation in a surgical ward and notice one of the
junior doctors constantly fails to fill out prescribed antibiotics on
patient’s drug charts.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Speak to the junior doctor about errors and advise her to read
hospital guidelines.
B. Speak to the junior doctor and highlight the consistent errors.
C. Leave a note for the junior doctor about the errors.
D. Ask one of the nurses on the ward if they have noticed the
errors.
E. Give it some time as with experience the junior doctor will stop
making errors.

:
Q39. You are on a clinical ward. A patient has just been prescribed
some Vancomycin by a consultant. You take a look at the patient’s
drug chart and notice she has no allergy recorded. However, you
recall the patient’s daughter telling you the patient is allergic to
Vancomycin. The first dose of the intravenous ( IV) infusion is due
soon.
What are the three most appropriate actions to take?
A. Tell consultant you recall patient’s daughter telling you patient is
allergic to Vancomycin.
B. Ask the patient if she is allergic to Vancomycin.
C. Consult with your pre-registration tutor about the situation.
D. Tell nurses the patient’s daughter has told you the patient is
allergic to Vancomycin.
E. Explain to the patient an antibiotic has been wrongly prescribed.
F. Trust the consultant’s judgement and attend to other patients.
G. Ask a senior pharmacist what to do in this situation.
H. Tell nurses you think a mistake may have been made.
Q40. A patient Mrs. James has presented a prescription for
Levothyroxine. Mrs. James explains that brand Blue Levothyroxine
did not agree with her and would prefer the brand Orange which she
 used initially. You know that brand Orange is more expensive than
brand Blue.
What are the three most appropriate actions to take?
A. Explore the patient’s experience.
B. Explore why the patient wants the brand Orange.
C. Write in the patient’s notes the unsuitability of brand Blue.
D. Explain to patient change cannot be made due to significant
price differences.
E. Dispense brand Orange and notify senior pharmacist about her
reasons for preferring brand Orange.
F. Dispense brand Blue and ask the patient to stop if she
experiences side effects again.
G. Tell the patient to try another pharmacy.
H. Verbally communicate with the team about Mrs James
unsuitability with brand Blue.

0
Q41. You are on a clinical ward. A patient has just been prescribed
Methotrexate which requires counselling. You are not familiar with
Methotrexate so you notify one of the senior pharmacists on the ward
to counsel the patient, which she agrees to. It is now the end of your
shift and the patient tells you he has still not received counselling.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Remind the senior pharmacist.
B. Ask another senior pharmacist on the ward.
C. Ask a nurse to remind the senior pharmacist.
D. Reassure the patient a senior pharmacist will counsel him.
E. Attempt to counsel the patient.
Q42. It is a busy afternoon in the pharmacy. Currently, the pharmacist
is in the consultation room with a patient. A gentleman approaches
you and requests if he can speak to you in private.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
 A. Ask the patient to wait to speak to you once the consultation
room is free.
B. Speak to the patient at the counter.
C. Tell the patient to come back later.
D. Take the patient to a quiet part of the pharmacy to speak.
E. Offer to telephone the patient once the pharmacy is quiet.
Q43. You are currently working in the outpatient’s dispensary with
another pre-registration pharmacist Ben. You notice he seems quite
lethargic and has made a few dispensing errors. You ask Ben if he is
ok, he reveals he had smoked cannabis before work because of
stress.
What are the three most appropriate actions to take?
A. Report Ben to the GPhC.
B. Explore Ben’s concerns.
C. Advise Ben to not let issues affect work.
D. Confront Ben’s actions.
E. Give Ben advice on how to stop drug use.
F. Consult with your pre-registration tutor.
G. Report Ben to the police.
H. Advise Ben to seek professional help.
Q44. You are working in a busy store with another Pre-registration
pharmacist Frank. The phone has been ringing frequently all day and
you notice Frank seems to avoid answering the pharmacy phone. You
also hear one of your colleagues complaining about this. You ask
Frank why he does not answer the phone. He states he has anxiety
talking to patients after a recent incident.
What are the three most appropriate actions to take?
A. Talk to your other colleagues to see if they have noticed your
observations.
B. Report Frank to the GPhC.
C. Explain to Frank the effect it could have on the team if he
ignores phone calls.
D. Discuss the issue with a senior colleague.
 E. Praise Frank for his honesty and tell your colleagues his reason
for not answering calls.
F. Encourage Frank to speak to a senior colleague about his
anxiety.
G. Take responsibility and answer all phone calls.
H. Tell Frank he needs to start picking up phone calls.
Q45. You are about to start a new rotation on an oncology ward.
Recently, your grandmother passed away due to lung cancer. As this
was a tough experience for you, starting this new rotation is giving
you some anxiety.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Face the challenge and complete the rotation.
B. Speak to your pre-registration tutor regarding the situation.
C. Speak to the chief pharmacist about the situation.
D. Speak to your G.P about the situation.
E. Refuse to complete the rotation.
Q46. You are currently on a paediatric ward. A child has just been
prescribed a Salbutamol inhaler which you are currently counselling
the child’s mother on. However, during the discussion, the mother
shows you bruises on the child and suspects her partner who
struggles with drinking problems may be abusing the child.
What are the three most appropriate actions to take?
A. Write down all the details of the discussion.
B. Reassure the mother the child is not being abused.
C. Speak to someone senior about the consultation.
D. Do not comment on the child abuse claim.
E. Explore the mother’s concerns.
F. Ask other pre-registration pharmacists for advice.
G. Ask the mother for her partner's contact details.
H. Contact her partner to find out if he has been abusing the child.

O
Q47. You are currently on a clinical ward. Your colleague Emily has
just started her first shift as a nurse. She is required to insert a
peripheral cannula into a patient. She is currently struggling and
seems quite anxious
What are the three most appropriate actions to take?
A. Express your concerns to a consultant.
B. Offer to help her insert a cannula.
C. Ask another nurse to assist Emily with the cannula.
D. Tell Emily to not worry about cannulas for now.
E. Reassure Emily that she will improve with practice.
F. Remind Emily this is a skill she needs to perfect soon.
G. Advise Emily to speak to a senior nurse for advice.
H. Express your concerns to the Nursing governing body.
Q48. It is a busy morning and you notice your colleague an
experienced dispenser, is using an incorrect technique when
measuring water for antibiotics reconstitution.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. No action needed as he is experienced so the volume must be
correct.
B. Ask the responsible pharmacist to speak to the dispenser.
C. Advise the dispenser of the appropriate technique.
D. Advise the dispenser at lunchtime of the correct technique.
E. Ask another dispenser to speak to the dispenser.
Q49. A patient comes into the pharmacy and requests to speak to the
senior pharmacist. You overhear the patient asking for a steroid
cream to use for eczema located on his face. The senior pharmacist
is about to make the sale of the cream even though you are aware
steroid creams should not be sold over the counter for use on the
face.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Politely interrupt and explain to the senior pharmacist that you
think the patient should be referred to a G.P.
 B. Politely interrupt and explain to the senior pharmacist sale of
steroid creams over the counter is not licensed for use on the
face.
C. Do not say anything as the senior pharmacist must be aware.
D. After the sale of the steroid cream, explain to the senior
pharmacist the reason you think the sale should have not been
made.
E. Interrupt the sale and explain to the patient he should not apply
the steroid cream on his face.
O
Q50. The mother of a regular fifteen year-old patient calls to confirm
her daughter's regular prescribed medications, as her daughter has
just been admitted to hospital with acute exacerbation of asthma. The
mother confirms the hospital her daughter has been admitted to.
What are the three most appropriate actions to take?
A. Tell the mother her daughter's regular medication.
B. Ask to speak to the daughter.
C. Refuse to tell mother the information.
D. Explain you cannot reveal the information due to confidentiality
issue.
E. Explain to the mother she should not be calling the pharmacy for
other patient’s medication records.
F. Only give her information that is essential.
G. Contact a health care professional from the hospital the patient
has been admitted to.
H. Tell the mother it is not her duty to confirm her daughter’s
medication.
Q51. You overhear a group of nurses complaining about a new
pharmacist. One of the nurses complains the pharmacist is struggling
with basic clinical advice and is worried the pharmacist has limited
clinical knowledge.
What are the three most appropriate actions to take?
A. Confront the nurses and tell them to stop bullying the
pharmacist.
B. Speak to the pharmacist to ask how he is settling in.
 C. Raise your concerns with the GPhC about the pharmacist.
D. Advise the pharmacist to be careful as a group of nurses are
concerned about his skills.
E. Highlight the situation to a senior pharmacist.
F. Closely watch the pharmacist and see if he improves.
G. Advise the nurses to address their concerns with the
pharmacist.
H. Tell the pharmacist to defer tasks to others if he is struggling.
Q52. A new dispenser has just started working in your pharmacy. You
both get along quite well. However, you notice the dispenser
becoming increasingly friendly and often spending large periods of
time speaking to you. You are starting to become uncomfortable.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Address your concerns to your pre-registration tutor.
B. Address your concerns to the dispenser.
C. Address your concerns to another dispenser.
D. Entertain the conversations to not hinder your professional
relationships.
E. Try to avoid the dispenser as often as you can to minimise talks.
Q53. A patient comes into the pharmacy requesting to speak to the
senior pharmacist. The pharmacist is currently having lunch in the
staff room. You explain to the patient that the pharmacist is not
available but the patient is insisting he needs to urgently speak to the
senior pharmacist.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Explain to the patient you cannot help him.
B. Ask the patient to explain the situation so you can see how to
help.
C. Ask the pharmacist to speak to the patient.
D. Tell the patient to come back at the time the pharmacist is back
from lunch.
E. Ask the patient if he can wait till pharmacist finishes lunch.
O
Q54. A regular patient John Blue comes into the pharmacy to return
the incorrect bag of medications he was given. You check the bag
label and confirm it is for Joan Blue. He tells you he collected the
prescription from the new dispenser who started a week ago. He tells
you he has not taken any of the medications and is not harmed.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Highlight the error to the dispenser and explain ways to prevent
this. Also, notify the senior pharmacist about the incident.
B. As the patient has not been harmed, dismiss incident to avoid
damaging the dispenser’s confidence.
C. Discuss the error with the work experience student.
D. Highlight the error to the dispenser.
E. Indirectly tell the dispenser of error by writing on the staff notice
board and how to prevent this.
Q55. A regular patient who you usually have interesting conversations
with, comes in to collect his medication. You notice today the patient
seems withdrawn and has worn an odd pair of trainers. You ask the
patient how he is but receive no response. The patient is elderly.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Write your concerns on the patient's notes.
B. Speak to someone senior.
C. The next time you see the patient check to see if there is any
improvement.
D. Call the patient and let the patient know they may be developing
dementia.
E. Refer the patient to a G.P.
Q56. You are working on a clinical ward and you overhear a
consultant and a nurse making a racist joke about an elderly patient.
The patient looks to be upset.
What are the three most appropriate actions to take?
A. Confront the nurse.
 B.Confront the consultant.
C.Confront both consultant and nurse.
D.Report both consultant and nurse to another consultant.
E.Console the patient.
F.Tell the patient to tell the consultant and nurse about how they
feel.
G. Ignore the situation to avoid making things worse.
H. Ask another pre-registration pharmacist about what to do in this
situation.

O
Q57. A patient approaches you on the ward and asks you to have a
look at their C-reactive protein (CRP) blood test result. You recall
having lessons on the topic during university but this will be your first
time seeing these results in practice.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Tell the patient you are not sure.
B. Research the topic using hospital resources to confirm how to
read CRP results.
C. Attempt to read results.
D. Ask a doctor to interpret the results for the patient.
E. Ask your pre-registration tutor to read results.
Q58. You have been situated in the dispensary at the back of the
store since you have started. It is now six months into your pre-
registration training. You speak to other pre-registration pharmacists
at other branches and notice at this point they are doing a lot more
than you. You feel like you have not learned much.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Express your unhappiness with your current training to your pre-
registration tutor.
B. Express your concerns to GPhC.
C. Express your concerns to the superintendent pharmacist.
D. Stay focus on dispensing.
 E. Focus on dispensing and if there are any potential gaps in
knowledge conduct research on the area.
Q59. You store away the new stock that has arrived today. However,
about ten minutes after you are done, you notice some Insulin
cartridges have been misplaced on one of the shelves in the
pharmacy. You know Insulin has to be stored in the fridge. You do not
know if you or somebody else misplaced the Insulin. Your colleague
feels it might have been the new pharmacy apprentice.
What are the three most appropriate actions to take?
A. If the Insulin cartridges still feel cold then place them in the
fridge.
B. Tell your colleague it is unfair to blame the pharmacy apprentice.
C. Report the pharmacy apprentice to the pharmacy manager.
D. Write a notice on the staff notice board asking who misplaced
the Insulin.
E. Dispose of the Insulin cartridges accordingly.
F. Tell the pharmacy apprentice to read the SOP of dispensing.
G. Ask the pharmacy apprentice if they left the cartridges there.
H. Check all shelves for more misplaced Insulin cartridges.
Q60. You are one month into your pre-registration year and have
difficulties with antibiotics displacement volume calculations. You
have tried to learn this before but struggled to comprehend the
method.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Ask your pre-registration tutor for help.
B. Wait till you are a fully qualified pharmacist to learn the
calculation method.
C. Defer any antibiotic displacement volume calculations to
colleagues.
D. Try to learn the method by yourself.
E. Ask a consultant for help.
:
Q61. You are working on a clinical ward and notice one of the nurses
being verbally aggressive with a patient. After the nurse leaves, the
patient then begins to cry and asks to speak to you.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Report the nurse to one of the senior nurses.
B. Report the nurse to your pre-registration tutor.
C. Record what happened on the patient’s notes.
D. Confront the nurse and remind the nurse this is against the
hospital policies.
E. Do not interfere as you do not know fully what happened.
Q62. You are on a clinical ward. It is a busy day with several patients
being admitted to the ward. You are completing medicines
reconciliation with a patient to ensure he receives the correct
medication. He states he prefers vegetarian friendly medication. One
of the doctors hears this and tells you to not waste time finding
vegetarian friendly medication. He explains there are limited
vegetarian friendly medications in stock.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Explain to the patient it is more important to take medications
on time.
B. Ignore request and ensure the patient receives correct
medications whether vegetarian friendly or not.
C. Explain to the patient it may take a while to get vegetarian
friendly medications but let the pharmacy team know of the
request.
D. Ask the senior pharmacist for advice.
E. Explain to patient there are limited vegetarian friendly
medications in stock and whether they will be willing to have
alternative options on this occasion.
Q63. It is a busy afternoon and stress levels are high. A patient who
has been waiting for some time asks you a question about their
medication. Unfortunately, you do not know the answer. The patient
expresses their unhappiness with you and proceeds to complain
about you to the Responsible pharmacist. You are currently very
angry.
What are the three most appropriate actions to take?
A. Tell the patient it is unfair they are complaining about you.
B. Tell the responsible pharmacist the patient is just annoyed
about waiting.
C. Ask the responsible pharmacist to give you constructive
feedback.
D. Express to the patient how angry you are with the situation.
E. Take a moment to cool down.
F. Use this experience to identify the knowledge gap.
G. Tell colleagues about the patient.
H. Ignore the patient’s complaints.
Q64. You are on a clinical ward. It is a busy day and there are loads
of newly admitted patients that you need to speak to. However, you
overhear a female patient shouting insults to another male patient.
Your Pre-registration tutor is currently on another clinical ward.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Console the male patient.
B. Confront the female patient and explain the behaviour is not
appropriate.
C. Ask one of the nurses on the ward to speak to the female
patient.
D. Ask your Pre-registration tutor to speak to the female patient.
E. Do not intervene in the conflict.
Q65. You and another pre-registration pharmacist, Jack have been
given an audit to complete. You find yourself having to do most of the
work. When you speak to Jack he explains he is struggling with his
pre-registration year.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
 A. Ask Jack for a further explanation on what aspects of Pre-
registration year is he struggling with.
B. Tell Jack he needs to help you more with the audit.
C. Advise Jack to speak to someone senior about pre-registration
year.
D. Ask another pre-registration pharmacist if they have also
struggled to work with Jack.
E. Console Jack and complete the audit yourself.
Q66. A patient asks if the responsible pharmacist is available, as she
would like some advice about something not serious. You ask if you
can help but she replies she would prefer to speak to a female. The
pharmacist is currently on a break.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Reassure the patient that you can help.
B. Suggest she speaks to a female pharmacy technician.
C. Suggest she speaks to a female work experience student who
will relay the query for you to answer.
D. Suggest she waits for the pharmacist to come back from break.
E. Ask the pharmacist to speak to the patient.
Q67. A patient has just been diagnosed with cellulitis and has been
prescribed antibiotics for the infection. However, the patient stresses
to the consultant he does not want to take any form of antibiotics
because he hates taking medicines unnecessarily. The consultant
insists he should take the antibiotics and then proceeds onto other
tasks.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Tell the patient you appreciate his opinion but to just take the
antibiotics.
B. Explore the patient’s concerns about taking the antibiotics.
C. Advise the patient to take the antibiotics.
D. Explain to the patient the reason antibiotics was prescribed.
 E. Signpost the patient to resources explaining how cellulitis is
treated.
O
Q68. Currently, in the pharmacy, it is only yourself and a pharmacy
apprentice in store. The responsible pharmacist is currently out of the
premise for lunch and will be back in an hour. A patient comes into
the pharmacy to pick up their prescribed medication. The apprentice
attempts to give the patient the medication, but you stop the
apprentice and explain you cannot legally give out a prescription
without a responsible pharmacist on site. The apprentice replies that
one of the other dispensers hands out prescribed medications when
the responsible pharmacist is not on site.
What are the three most appropriate actions to take?
A. Report the dispenser to the responsible pharmacist.
B. Notify the responsible pharmacist about the situation.
C. Report apprentice to superintendent pharmacist.
D. Hand over medication to the patient and tell the patient this is
only happening once.
E. Explain to the apprentice the laws of what is allowed if the
responsible pharmacist is not present.
F. Signpost apprentice to Medicines, Ethics and Practice handbook
(MEP).
G. Tell apprentice not to worry about it.
H. Tell apprentice to make sure the right medication is given to the
patient.
Q69. You have been allocated private study time during the last hour
of work. In the evening there are a total of three staff members in the
pharmacy, a dispenser, responsible pharmacist and yourself. This
week the dispenser has been absent due to sickness. Therefore, it is
only the pharmacist in the dispensary during the last hour. You still
want to use your allocated study time.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Suggest to the pharmacist to close the pharmacy.
 B. Suggest to the pharmacist to allow you to study earlier so you
can help in the evening.
C. Continue to study unless pharmacist requests for your
assistance.
D. Tell pharmacist you are available to help if needed.
E. Suggest to the pharmacist to get a colleague to come in whilst
the dispenser is off sick.
Q70. At lunchtime, you had a conversation with one of your
colleagues Joe. He told you he is currently having issues in his
relationship and feels he needs to end the relationship. You are now
back on the ward after lunch. Dianne another colleague asks you
what you and Joe were talking about. She claims it looked like an
interesting conversation.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Tell Dianne what was said and stress she should not tell
anyone.
B. Tell her you will get back to her later, then confirm with Joe if it is
ok to tell her.
C. Tell Dianne to stop being curious and you are going to report
her.
D. Tell Dianne you do not think it is fair to disclose what was said,
and that she would not like it if you told people her business.
E. Tell Dianne you were just discussing matters relating to
pharmacy.
Q71. Your delivery driver has just finished his delivery round. The
driver returns a delivery which contains a shower emollient that Mrs.
Dugary has missed. Mrs Dugary then calls the pharmacy and insists
you tell the delivery driver to return as she went out for some
shopping. The delivery driver is due to deliver other patient’s items at
another pharmacy branch. Mrs. Dugary is not housebound.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
 A. Tell the delivery driver to deliver Mrs. Dugary’s shower
emollient again.
B. Explain to Mrs. Dugary she will have to wait till tomorrow for
delivery.
C. Deliver items yourself.
D. Suggest to Mrs. Dugary if she needs the shower emollient
urgently then she should come into the pharmacy.
E. Tell Mrs. Dugary she will have to wait till tomorrow and
highlight the importance of being home when expecting a
delivery. Advise her to come into the pharmacy if she urgently
needs the emollient.

O
Q72. You are on a clinical ward and witness a nurse giving a patient a
liquid suspension. The patient expels the suspension and shouts “this
is not my medication”. The nurse realises this and gives him the
correct medication. You notice the incorrect suspension was
Amoxicillin which the patient is allergic to. The nurse tells you to not to
tell anyone.
What are the three most appropriate actions to take?
A. Note down the accident.
B. Tell the nurse not to worry.
C. Report incident to a senior nurse.
D. Joke about the situation.
E. Check on the patient’s well-being and advise the nurses on the
ward to keep an eye on the patient.
F. Do not tell anyone else.
G. Speak to another Pre-registration pharmacist about the incident.
H. Tell the patient to not tell anyone.
Q73. A new dispenser has just started in your store. It is his first day
and he has arrived to work in clothing that does not match the
company’s dress code policy. All staff are required to read the
company's dress code policy before starting.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. As it is the dispenser’s first day do not worry about it.
 B. Confront the dispenser and explain he is not complying with the
company’s dress code.
C. Suggest he reads the company’s dress code policy.
D. Highlight this to the responsible pharmacist.
E. Write on the staff notice “dress code policies need to be
followed”.
Q74. A regular patient comes into the pharmacy to collect her repeat
prescription for breath-actuated Salbutamol inhaler. However, recently
the patient’s surgery has announced they will only be issuing breath-
actuated prescriptions for specified patients. She has been issued a
standard-metered dose Salbutamol inhaler prescription not a breath-
actuated inhaler. She is insisting she should receive the breath-
actuated inhaler as she struggles with standard metered-dose
inhalers.
What are the three most appropriate actions to take?
A. Record her preferences in her records.
B. Tell her she does not need a breath-actuated inhaler.
C. Tell her breath-actuated inhalers are more expensive.
D. Call her G.P surgery to explain the situation.
E. Ask her if she would be happy for you to show her the new
inhaler technique in the meantime.
F. Tell her to contact her G.P surgery.
G. Tell her there is nothing you can do.
H. Ask the Responsible pharmacist if it is ok to dispense breath-
actuated instead of a standard metered-dose inhaler.
Q75. You are working on an oncology ward experiencing a fever,
migraine and flu-like symptoms. It is currently affecting your
concentration at work. Your Pre-registration tutor asks if you would
like to go home early, however, there is a lot of work you need to
complete.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Continue working and try to complete the work.
B. Go home and rest.
 C. Hand-over tasks to another pharmacist on the ward and go
home and rest.
D. Take a flu mixture and continue working.
E. Try to complete urgent tasks then go home.
Q76. You are working in a community pharmacy. A lady comes in
asking you to confirm if a methadone patient Jamie has been in today
to collect his daily dose. She insists she needs to confirm this as his
Key worker wants to know. You try contacting the patient’s key worker
but there is no answer. The responsible pharmacist is currently out
for lunch.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Tell the lady you can not disclose any information because of
confidentiality issues.
B. Tell the lady that you are not going to disclose the last time
Jamie came in for his methadone dose.
C. Tell the lady the last time Jamie came in for his Methadone
dose.
D. Ask the responsible pharmacist to speak to the lady once back
from lunch.
E. Signpost the lady to a website explaining why you can not
disclose information.
Q77. You are working on a clinical ward and there has been a recent
outbreak of Coronavirus. A patient has just been admitted to hospital
for suspected asthma exacerbation due to recent shortness of breath.
You conduct medicines reconciliation on the patient which they reveal
they have just arrived from a high-risk Coronavirus region. The patient
has only told you in the team.
What are the three most appropriate actions to take?
A. Do not disclose information to anyone else due to confidentiality
issues.
B. Reassure the patient you will not tell anyone.
C. Let the patient know you have to notify the health team.
D. Tell other patients to be careful as the patient has Coronavirus.
 E. Tell the patient he has Coronavirus.
F. Notify the nurse in charge of the ward.
G. Tell the patient you think their symptoms could be linked to
Coronavirus.
H. Advise the patient to go home.
Q78. You have just opened the pharmacy with a pharmacy dispenser.
The responsible pharmacist has not arrived yet, which means by law
you cannot hand out prescribed medication. However, a patient is
insisting you hand out his medication. The dispenser says you should
hand it out as it is only Paracetamol.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. As it is only Paracetamol hand the medication to the patient.
B. Ask the patient to come back later once the pharmacist has
arrived.
C. Advise the patient to come back later once the pharmacist
arrives but if desperate, try purchasing Paracetamol at the
supermarket next door.
D. Refuse to hand out the Paracetamol and tell the patient the
reason why. Additionally, explain to the dispenser handing out
the patient’s prescribed medication will not be legal.
E. Tell the patient you are not able to hand over the Paracetamol.
Q79. You are on a clinical ward. A patient with a strong alcohol scent
has just been admitted to the ward. You notice the patient has been
very demanding with the nurses. Furthermore, you attempted to carry
out medicines reconciliation with the patient. However, during the
consultation, he violently threatened you.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Try to finish the medicines reconciliation.
B. Call ward security.
C. Confront the patient.
D. Ask a senior pharmacist for advice.
 E. In the meantime leave the patient then attempt to speak to the
patient later.
Q80. A woman comes into the pharmacy with her five year-old child.
The mother describes the symptoms, which to you, indicates Hay-
fever. However, the mother believes the child has a Cold and would
like something for Cold symptoms. You tell her you believe it is Hay-
fever, but she is adamant it is a Cold.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Agree and sell her something for Cold symptoms.
B. Refuse to sell her anything.
C. Ask the senior pharmacist to speak to her.
D. Tell her to see a G.P.
E. Explain why it is not a Cold.
Q81. You are on a clinical ward. A patient approaches you and
complains their book has gone missing. The patient has been
diagnosed with Dementia.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Consult the ward security.
B. Help search the patient's belongings.
C. Search other patient areas in the ward.
D. Ask the ward manager.
E. Dismiss the patient’s concerns as the book will reappear.

O
Q82. You are working in the dispensary with a pharmacy technician.
He complains that you have been making too many mistakes. You are
a bit taken back as you can only recall two dispensing errors today.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Confront the technician and explain you have not made many
mistakes.
B. Ask other colleagues if you have been making a lot of mistakes.
 C. Read the company’s standard operating procedures (SOP) to
help improve your dispensing skills.
D. Explore the technician's reasons and ask for constructive
feedback.
E. Acknowledge technician’s opinion and continue dispensing.

0
Q83. You are on a clinical ward. A patient has been admitted to the
ward and has just been switched from their usual Beclometasone
inhaler to a cheaper alternative, at the same dose. However, you are
aware patients have to be kept on particular Beclometasone inhaler
brands as doses are not bioequivalent between brands. The patient
has had no issues with the original Beclometasone brand. A nurse
tells you the doctor changed the brand to save costs.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Speak to the doctor and highlight the importance of maintaining
particular brands.
B. Tell the nurse to let the doctor know about differences in brands.
C. As it is saving cost no action is needed.
D. Monitor the patient throughout the day for any side effects.
E. Ask the nurse caring for the patient to keep an eye on the
patient because of the change in brand.
Q84. You are currently in the dispensary and one of the dispensers
tells you they are plotting to put some hot sauce in one of your
colleagues’ coffee. They tell you it will be a funny joke.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Laugh with the dispenser during the prank.
B. Confront the dispenser about the situation.
C. Inform the colleague of the hot sauce in the coffee.
D. Tell the responsible pharmacist about the prank.
E. Swap the coffee with another cup to make sure your colleague
does not drink the hot sauce.
Q85. You have noticed the superintendent pharmacist has been
accepting excessive gifts from patients in exchange for medication
without a valid prescription. However, you have not witnessed any
controlled drugs being handed out.
What are the three most appropriate actions to take?
A. Take records of the incidents.
B. Report the superintendent pharmacist to the GPhC.
C. Confront the superintendent pharmacist.
D. Tell the patients to stop giving presents.
E. Ask the patients why they are giving presents.
F. Ask the Superintendent pharmacist if the patients have valid
prescriptions.
G. Focus on passing your pre-registration year.
H. Tell one of the dispensers about the situation.
Q86. You briefly go into the pharmacy stockroom to retrieve some
stock for the dispensary. On entering the stock room you see one of
the dispensers with an opened alcoholic beverage in their hand. The
dispenser is still on shift.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Warn the dispenser about drinking alcohol at work.
B. Speak to another dispenser to confirm if they have witnessed
the same behaviour.
C. Act like you noticed nothing.
D. Closely watch the dispenser to see if they drink again.
E. Report the dispenser to the responsible pharmacist.
Q87. The responsible pharmacist is currently on lunch. A patient
comes into the pharmacy with a prescription for anti-epileptic
medications, demanding you hand them the medications. However,
the responsible pharmacist is not back from lunch and the
medications must be signed off first by the responsible pharmacist.
The patient looks to be frustrated and is claiming he is in a hurry.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Dispense the medications and ensure the right medicines have
been dispensed by having another dispenser check the
medication then hand-over.
B. Tell the patient to come back once the pharmacist is back from
lunch.
C. Explain the situation to the pharmacist in the staff room.
D. Tell the patient to not worry and insist on the pharmacist signing
off the prescription.
E. Tell the patient you do not have the medication in stock.
Q88. It is a busy afternoon in outpatient’s dispensary and the patients
are becoming increasingly agitated. The responsible pharmacist tells
the team not to worry about creating labels for the patients to speed
up the dispensing process. However, you are unsure because you
know labelling medication is a legal requirement.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Raise your concerns with the responsible pharmacist and use
guidelines to support your claims.
B. Do not comment as you are sure the responsible pharmacist will
intervene if there is a problem.
C. Confront the responsible pharmacist and stress the
recklessness in his decision.
D. Report the responsible pharmacist to the GPhC.
E. Report the responsible pharmacist to your pre-registration tutor
once you finish your slot in the dispensary.
0
Q89. You do not have a social media account. However, one of your
colleagues shows you a post that a co-worker John posted about how
slow you are at work. This is your first time being aware of his
opinion.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Ignore the post.
 B. Speak to John directly at work.
C. Use this as constructive feedback to work on yourself.
D. Ask one of your colleagues if they feel the same way.
E. Confront John via social media.

O
Q90. You are on a clinical ward. A patient has just received their
regular medications after a senior pharmacist told you to conduct
medicines reconciliation on the patient. However, the patient has not
received their regular eye drops as you forgot to ask about eye drops.
The patient is currently complaining about dry eyes.
What are the three most appropriate actions to take?
A. Carry on with other tasks you need to do.
B. Ask the senior pharmacist to investigate the presenting
complaints.
C. Apologise to the patient and ask about the required eye drops.
D. Ask one of the nurses on the ward to investigate the patient’s
presenting complaint.
E. Evaluate your medicines reconciliation strategy.
F. Ask one of the doctors to investigate the presenting complaint.
G. Explain error to patients care team.
H. Tell the patient they should have told you.
Q91. A new dispenser has just started. She is currently mixing
antibiotics, but you notice she is using a measuring cylinder which is
labelled “For Methadone dispensing”. She has just finished rinsing the
measuring cylinder and is about to add water for reconstitution of
antibiotics.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Explain why she should not use this measuring cylinder.
B. Advise her to read the company’s SOP on reconstituting
antibiotics.
C. Ask the responsible pharmacist to explain why she should not
use this measuring cylinder.
D. Tell dispenser to not be lazy as she is endangering patients.
E. Ensure it is just water in the cylinder.
:
Q92. A patient has just handed in a prescription for Prochlorperazine.
He politely requests for the prescription to be processed fast. In the
dispensary, there is currently only the branded Prochlorperazine on
the shelves. However, in the storeroom, there is the generic branded
Prochlorperazine which is about a two minute walk away. Your
colleague is about to dispense the branded Prochlorperazine. The
branded Prochlorperazine is twice the price of the generic branded.
What are the three most appropriate actions to take?
A. Advise colleague to get the generic brand from the storeroom.
B. Advise colleague to be quicker with dispensing.
C. Highlight to colleague speed is a priority.
D. Highlight the price difference to your colleague.
E. Advise colleague to bring some generic brands to the
dispensary.
F. Ask the responsible pharmacist to encourage your colleague to
dispenser faster.
G. Act like you did not see your colleague dispensing the branded
Prochlorperazine.
H. Reassure the patient your colleague will be quick.
Q93. You are working in a community pharmacy. A patient asks to
speak to you in the consultation room. He reveals to you he is
currently having suicidal thoughts. You have not dealt with a situation
like this before
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Reassure the patient that his feelings are not real.
B. Advise the patient to not worry because he will get better soon.
C. Speak to the Responsible pharmacist for advice.
D. Call the police.
E. Signpost patient to mental health crisis services.
Q94. A patient picks up his regular medications. He also requests for
any medication that has been prescribed for his daughter. This is the
first time he is attempting to pick up medication for his daughter. The
daughter is eighteen years old and has recently been prescribed
Sertraline.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Hand the daughter’s medication over.
B. Call the daughter to confirm she is happy with her dad collecting
her medication.
C. Ask him to call daughter so you can confirm whether she is
happy for her medication to be collected by her father.
D. Tell father you are not able to disclose any information.
E. Tell father to tell the daughter to come in and collect her
medication.
Q95. A patient approaches you and tells you she knows a patient who
is romantically interested in you. She asks you to write down your
phone number so the patient can contact you.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Explicitly refuse and let her know your unhappiness.
B. Politely refuse and explain why.
C. Write down a fake number.
D. Ask for the patient's contact details without intending to contact
the patient.
E. Write down your number.
Q96. You are on a clinical ward. A nurse approaches you to complete
a drug chart for a patient. She also explains she needs a break
because the patient’s family has just shouted at her. You know the
patient’s regular medication as you conducted medication
reconciliation with the patient earlier on in the day.
What are the three most appropriate actions to take?
A. Complete the drug chart.
B. Use the family as an additional source to confirm the patient’s
regular medications.
C. Report the family to a senior staff member.
 D. Tell the nurse to find somebody else to complete the drug chart.
E. Look for a doctor to complete the drug chart.
F. Explain to nurse you are not trained to complete drug charts.
G. Encourage the nurse to avoid the family.
H. Tell the patient to speak to their family about shouting at the
nurse.
0
Q97. A group of patients approach you and tell you a doctor has not
been polite when talking to them. They feel he is quite abrupt. You
have not witnessed this sort of behaviour from the doctor before.
What are the three most appropriate actions to take?
A. Tell the patients to write a formal complaint.
B. Confront the doctor to find out what has happened.
C. Report the doctor to a consultant.
D. Report the doctor to the doctor’s regulatory board.
E. Advise the patients to confront the doctor.
F. Explain to the patients there is nothing you can do.
G. Record everything they have told you.
H. Tell the patients they are not being reasonable.
Q98. A patient has just returned to the pharmacy after picking up his
prescription. He cannot find his phone and seems very anxious. He is
adamant a man who came in to collect his daily Methadone
instalment has stolen his phone. He describes the man as suspicious.
What are the three most appropriate actions to take?
A. Ask your colleagues if they saw anything.
B. Call the accused man.
C. Ask the patient where he last saw his phone.
D. Tell the patient to write a statement so it can be investigated
later.
E. Confront the patient about wrongfully accusing the man.
F. Speak to security.
G. Call the accused man's key worker.
H. Give the patient the accused man's contact number.
Q99. The responsible pharmacist you are working with today is a
locum pharmacist. She explains to you she is not comfortable with
you taking your hour study break today. She reveals she does not feel
comfortable with the computer systems. Your pre-registration tutor is
on holiday.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Call your pre-registration tutor to speak to the locum pharmacist.
B. Confront the locum pharmacist and insist you need to study.
C. Ask the locum pharmacist to close store whilst you study.
D. Agree to not taking your study break.
E. Ask to go during a quiet period.
Q100. You are on a clinical ward and notice a senior pharmacist and
the chief pharmacist by the controlled drug cupboard. You overhear
the chief pharmacist say “make sure you do not include the new pack
of Methylphenidate that has just been delivered in the controlled
register balance”.
Rank in order the following actions in response to this situation
(1= Most appropriate; 5= Least appropriate).
A. Speak to another pre-registration pharmacist.
B. Speak to a consultant.
C. Carry on with what you are doing.
D. Speak to a nurse on the ward.
E. Remind them it is illegal what they are doing.
 Answers
Question 1: DEH
Staff members losing their cool with patients and other team
members is wrong (C). Therefore, it is important to challenge this
behaviour (D). Reporting to someone senior ensures the issue is
taken up properly (H). Reporting to professional bodies is not required
at this point (F) and exploring sudden change in colleague’s mood is
being supportive of team members (E).
Question 2: ACF
As this is a big accusation, it is important to obtain a further
understanding of the situation before reporting (A, C). Accusing and
reporting the nurse to the nursing professional body is not
appropriate at this initial stage (D, G). Telling someone more senior
means the situation can be investigated properly (F). Assuming the
patient has harmed themselves on their history is discriminatory (B,
E).
Question 3: ACF
Establishing why the doctor is wearing the watch could allow you to
provide advice accordingly (A, C). As this is a new doctor he may
have forgotten about the rules, therefore a reminder of infection
control policies is important (F). Not communicating directly to the
doctor can affect your professional relationship with the doctor.
Question 4: BCF
Communicating with the care team and those in charge of the
patient’s care is essential (B). This should be done as soon as
possible (G). Recording the request in the patient’s notes ensures
relevant staff members have access to the information (F). Being
respectful of a patient’s beliefs is important (E). Therefore,
accommodating for the patient’s needs in this situation needs to be
prioritised (A). Better to refer the task to someone more experienced
(D) to identify animal containing products than yourself as a pre-
registration pharmacist (C).
Question 5: BEG
Referring query to a senior pharmacist is best in a scenario like this to
help confirm and support your suggestion (B). As a pre-registration
pharmacist, you are not trained to tell a patient to stop taking their
medication unless instructed to by a prescriber (E). Explaining to
patients where to go when unexpected side effects occur ensures
patients speak to the right people (G).
Question 6: ACDBE
You need to treat all patients fairly and as this is something that if
delayed is not life-threatening, you should attend to patients based on
queue position (A). If a member of staff is available you could ask for
support (C). Telling the patient to go somewhere else is unnecessary
and is not being considerate of the patient (B). Therefore, attending to
the patient is better than suggesting the patient goes somewhere else
(D). Before referring the patient to a G.P, the rash should firstly be
assessed by someone trained in the pharmacy team. This will ensure
the patient is only referred if needed (E).
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
C 3 4 3 2 1
D 2 2 4 3 2
B 1 2 3 4 3
E 0 1 2 3 4

Question 7: ECDAB
The priority is to ensure the patient gets reviewed in the fastest way
possible for any potential harm. Therefore, telling the doctor
immediately yourself is best (E, C). Although telling irrelevant people
about the incident may ruin the relationship between you and the
nurse. Record keeping of errors is important, especially when working
in a team (D). In this situation, you need to take responsibility for
reporting (A).
Rank
Correct order 1 2 3 4 5
E 4 3 2 1 0
C 3 4 3 2 1
D 2 2 4 3 2
A 1 2 3 4 3
B 0 1 2 3 4

Question 8: CDBAE
Patient centred care means acknowledging a patient’s request.
Therefore, the consultant needs to be confronted. Ideally, this needs
to be by someone senior, such as another consultant(C). Reporting to
your pre-registration tutor is an option (D), but reporting to another
consultant is better. You confronting the consultant is not ideal (B)
because the issue needs to be addressed further. Also, confronting
the junior doctor is not addressing the root of the problem which is the
consultant providing inappropriate advice (A). Speaking to another
pre-registration pharmacist is not useful (E).
Rank
Correct order 1 2 3 4 5
C 4 3 2 1 0
D 3 4 3 2 1
B 2 2 4 3 2
A 1 2 3 4 3
E 0 1 2 3 4

Question 9: ACEDB
In this scenario, the patient is distressed therefore reassuring the
patient about the prescribed medicine is key. Telling the patient how
long it takes for the medication to have effect encourages adherence
(A). Advising the patient to research online is not ideal as it does not
guarantee the patient will access reliable sources (E). Signposting to
specific reliable sources ensures the patient accesses accurate
information. Therefore, highlighting the importance of continuing drug
treatment is better(C). Never tell patients to stop taking prescribed
medication unless told to stop by the prescriber (B). Referring to G.P
is not necessary plus it could make the patient more frustrated (D).
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
C 3 4 3 2 1
E 2 2 4 3 2
D 1 2 3 4 3
B 0 1 2 3 4

Question 10: DHF

The priority is to not delay the patient receiving emergency
contraception any further (B). Therefore referring to the pharmacist in
this scenario is best (D). Explaining the full benefits of condoms to the
patient allows an informed decision to be made (H). Simply
highlighting the contraceptive purpose of condoms does not help the
patient make a more informed decision(C,E). Highlighting the
availability of other contraceptive options will help reassure the patient
(F). Advising the patient to take oral contraception is not an example
of a patient centred approach in this scenario, as the patient has
already expressed disinterest in using oral contraception. You need to
provide available alternative contraception options (A).
Question 11: CBEDA
Ensuring the patient uses the inhaler correctly is the priority. Being
aware of the patient’s situation is also important. Therefore, you
should check to see if they are willing to wait. Explaining to the patient
you need to check how to use the inhaler keeps them informed, and
checks if they are willing to wait (C, B). Telling tutor you are not sure
is not taking responsibility but it prevents you from providing incorrect
advice (E). Signposting the patient to patient information leaflet is also
useful but direct inhaler counselling is better (D). Improvising is not
appropriate as it does not guarantee the correct information is given
(A).
Rank
Correct order 1 2 3 4 5
C 4 3 2 1 0
B 3 4 3 2 1
E 2 2 4 3 2
D 1 2 3 4 3
A 0 1 2 3 4

Question 12: BDCAE

You doing all the work is not efficient (A). Therefore, offering training
to the locum pharmacist will help and supporting the locum
pharmacist’s learning is ideal where time is not luxury (B).
Signposting to learning resources is ideal for colleagues learning (D).
Highlighting the need to learn is good however, this does not fully
support the locum pharmacist’s learning (C). Turning patients away is
not the solution to the problem (E).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
D 3 4 3 2 1
C 2 2 4 3 2
A 1 2 3 4 3
E 0 1 2 3 4

Question 13: ECABD

Finding someone you can trust to understand and translate your
message is important (E, C). You may be able to contact the
prescriber immediately saving the patient from waiting. Using the
translator does not guarantee your intended message is accurately
translated (A, B). Passing on this responsibility to the child is not
reliable (D).
Rank
Correct order 1 2 3 4 5
E 4 3 2 1 0
C 3 4 3 2 1
A 2 2 4 3 2
B 1 2 3 4 3
D 0 1 2 3 4

Question 14: ABECD

Before accusing the individual of stealing, you need more information
to make a conclusion (A, E). Speaking to the individual directly is best
but getting someone senior to ask is better (B). Reporting to the
GPhC is the last resort and should only be done when you are certain
(C). Not taking action when bad practice is witnessed is not meeting
your professional standards (D).
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
B 3 4 3 2 1
E 2 2 4 3 2
C 1 2 3 4 3
D 0 1 2 3 4

Question 15: ACH

Asking further questions to confirm your judgement is important (H).
Often getting a second opinion can help convince patients of your
decision (A). Ultimately, you must be honest with parents instead of
trying to please them (C). Researching symptoms can worry parents
as eczema and chickenpox have similar symptoms (F, G). Referring
unnecessarily adds to the workload to other health care professionals
when it is not needed (D, E)
Question 16: ECBAD
As the patient has an inhaler already, letting the pharmacy team know
of the situation through a phone call is sufficient (E). Coming in the
next day also ensures the message gets passed on (C). Notice
boards are not often checked regularly, therefore this does not ensure
the team will receive the message on time (B). Calling the patient
alone does not help the situation because the pharmacy team also
needs to be aware of the situation (A). After making this mistake, you
have the responsibility to solve the problem rather than relying on the
patient (D).
Rank
Correct order 1 2 3 4 5
E 4 3 2 1 0
C 3 4 3 2 1
B 2 2 4 3 2
A 1 2 3 4 3
D 0 1 2 3 4

Question 17: ADG

This scenario is about maintaining patient confidentiality. Therefore,
as the patient has requested for her daughter to be contacted,
informed consent must be first received before talking to son. This
means explaining the full reason to the patient (A, D). However, using
jargon may confuse the patient (E) Asking for advice from someone
senior in situations like this can be helpful (G). As you are not aware
of what medication the patient is taking, waiting for information is not
appropriate (B, C). This is vital if the patient is taking medication that
can be harmful if delayed. Your pre-registration tutor is likely to have
experienced scenarios such as this before. Therefore, seeking advice
from your tutor will help you manage the situation appropriately (G).
Question 18: BFG
It is important to voice your opinion if you notice something incorrect
(A) directly to the person involve (B). Communicating your concerns
with the counter assistant or superintendent pharmacist initially is not
appropriate (D, H). In this situation communicating with the
responsible pharmacist first is important. Using supporting sources to
back claims is effective when explaining to colleagues (F). Educating
the patient about his medicine helps prevent him from taking a
different Diltiazem brand (G).
Question 19: CDF
Recording the errors will help reduce the chances of issues like this
arising in future (C). Informing your colleague that made the error will
help them reflect on the mistake (D). Speaking to another dispenser
about the situation should not be the initial step in this situation (B).
Notifying the responsible pharmacist will ensure the patient receives
proper assessment (F). As a pre-registration pharmacist you should
encourage patient to be assessed by someone trained, instead of
making judgement yourself (E,H). In situations like this, you need to
be sensitive to the patient’s state. They have approached you to
address the issue (A, G)
Question 20: DCEAB
Ensuring the patient completes the antibiotic course is important, so
referring to another pharmacy is best. Also, ensuring they have the
antibiotics in stock is ideal (D, C). Asking the patient to go back to the
doctor to change the prescription to a drug you have in stock is not
ideal and will cause further delays on the patient starting treatment
(E). Taking a gamble with medication is wrong (A). Ultimately,
encouraging patients to not complete antibiotics courses can cause
harm by making infections worse due to resistance (B).
Rank
Correct order 1 2 3 4 5
D 4 3 2 1 0
C 3 4 3 2 1
E 2 2 4 3 2
A 1 2 3 4 3
B 0 1 2 3 4

Question 21: ABCDE

Challenging this behaviour is important, as consuming alcohol at work
endangers patients (A). However, you do not know if they are being
serious, so reporting should not be the first action (C, D). Speaking to
someone senior like your tutor for advice is ideal (B). It is important to
not ignore something which could potentially put patients at risk (E).
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
B 3 4 3 2 1
C 2 2 4 3 2
D 1 2 3 4 3
E 0 1 2 3 4

Question 22: ABDEC

Empathy is important in this situation, so exploring the father’s
thoughts allows you to address any concerns. Additionally, explaining
your reasons helps the father trust your judgement (A, B). Being
honest with the father is important, but reassurance is also required in
this scenario. Therefore, letting him know antibiotics is not required is
better than just offering a solution (D, E). Referral to an urgent walk-in
centre is not necessary.
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
B 3 4 3 2 1
D 2 2 4 3 2
E 1 2 3 4 3
C 0 1 2 3 4

Question 23: BDF

Finding out the patient's symptoms to make a more informed decision
is important, as it allows you to identify if the patient needs codeine
(B). Gathering more information will help you gain a better
understanding of whether codeine is needed (D). Highlighting the risk
of dependency will help the patient make an informed decision (F).
You should not make a decision immediately if you are unsure (A, G,
H). This situation does not require referral to an urgent walk-in centre
(C).
Question 24: ABDCE
The information patients receive need to be accurate, therefore you
need to let the pharmacist know (A). Speaking to someone senior in
the same department will help, as they will know how to raise the
issue with the pharmacist (B). Speaking to nurses may also be
helpful, but they may not be able to handle the issue as well as a lead
pharmacist (D). Speaking to patients only will not solve the problem.
The issue needs to be raised with the pharmacist (C, E).
 Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
B 3 4 3 2 1
D 2 2 4 3 2
C 1 2 3 4 3
E 0 1 2 3 4

Question 25: ABCDE

Making sure the patient is contacted as soon as possible is important
because you are not aware of the patients’ situation. For example, the
patient may be out of critical medicines (A). It is more efficient to relay
the message to colleagues than going into work (B). Waiting till
Monday is risky because you do not know the patient's situation,
reviewing your mistake is a good way of constructive problem solving
(C). As you made the error, delivering to the patient yourself is taking
responsibility of the situation (D). It also allows you to apologies to the
patient.
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
B 3 4 3 2 1
C 2 2 4 3 2
D 1 2 3 4 3
E 0 1 2 3 4

Question 26: DAECB

In this situation, as you are unsure, providing an answer could be
dangerous for the patient if incorrect. Additionally, causing a delay in
this situation is risky, as we do not know the seriousness of the bleep,
so offering to find another doctor is best (D). Being honest with the
doctor will ensure the right dose is given (A) Ensuring you have the
right information is vital, but you need to be conscious about the bleep
(C). However, it is important to let the doctor know politely (E). Giving
information when not sure is dangerous and can cause patient harm
(B).
Rank
Correct order 1 2 3 4 5
D 4 3 2 1 0
A 3 4 3 2 1
C 2 2 4 3 2
E 1 2 3 4 3
B 0 1 2 3 4

Question 27: BCDEA

You do not know the full context of why Ibuprofen has been added to
the Dosette boxes. Therefore, you need to speak to someone who
may know. Your pre-registration tutor is a good source to start with
(B). The patient’s surgery is also likely to know (C). Gaining written
confirmation from the patient is unreliable as we cannot confirm if the
doctor has written the letter (D). Making changes to prescribed
medicines without gaining prescriber permission is not appropriate (E,
A).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
C 3 4 3 2 1
D 2 2 4 3 2
E 1 2 3 4 3
A 0 1 2 3 4
Question 28: DEF
It is important to communicate with other team members in the
workplace. Encouraging Emma to speak to John promotes good team
communications (D). Furthermore, this is contributing to John’s
learning. Overall, John’s limited contribution will increase the
workload of the team therefore, this needs to be highlighted (F).
However, this does not need to be escalated to seniors at this stage
(A, C). It is also vital, for patient safety, to explain to John the
importance of checking penicillin allergy with patients (E). Speaking
directly to team members is better than indirectly as the message is
less likely to be misunderstood (B, G). Not discussing issues directly
with team members does not help to maintain trusting relationships.
Question 29: ABDCE
Being idle in this scenario is unacceptable (E). The responsible
pharmacist actions should be reported to seniors, someone directly
senior is ideal (A, B). Speaking to other colleagues may be useful to
gain advice and help support your case when reporting (D).
Contacting the patient is not reliable, especially if the patient is aware
of the responsible pharmacist actions (C).
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
B 3 4 3 2 1
D 2 2 4 3 2
C 1 2 3 4 3
E 0 1 2 3 4

Question 30: BCAED

Making sure you are passing on correct information to the patient is
important (D). At the same time, you need to clarify if the patient is
happy to wait (B). Over e-mail is good but face to face interaction
allows any questions to be answered instantly (C). Signposting the
patient to information page is good but does not offer the opportunity
for the student to ask questions (A). Counter assistant is unlikely to
know the answer (E).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
C 3 4 3 2 1
A 2 2 4 3 2
E 1 2 3 4 3
D 0 1 2 3 4

Question 31: ABE

The patient must understand how to use the peak flow meter (A). As
the patient has highlighted an issue with your colleague’s explanation,
finding out the problem with the explanation can help you give
feedback to your colleague (B, C, E). This will also help with Jack’s
learning. Ideally, since the patient has asked you for an explanation,
providing the advice yourself is best, unless you are unsure (F, H).
This is as an issue that does not require escalation (F, G).
Question 32: CEG
Co-codamol is a medication that is prone to abuse. However, you
have not noticed the patient buying Co-codamol in this manner
before, so you cannot confirm the patient is intentionally abusing Co-
codamol. This means the patient should not be reported at this point
(B). Although, you should intervene now because the patient is using
the medication excessively which could lead to dependency issues
(C). Not informing the patient now puts the patient at greater risk of
developing dependency (D, H). This should also be explained to the
patient (E). Your colleague may not be aware of the previous sales of
Co-codamol to the patient this week, so reporting your colleague is
not appropriate at this point (A, F). Explaining the risk of Co-codamol
to your colleague supports your decision (G).
Question 33: ABEDC
Asking for further information is a way to proactively find a solution
(A). Asking the pharmacy technician is a good option as they are
likely to know how to deal with the situation (B). Ideally, you do not
want to interrupt the pharmacist whilst he is with a patient (E, D). This
is not putting patients care first. Asking another receptionist can
damage your relationship with the first receptionist as you are
undermining her work(C).
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
B 3 4 3 2 1
E 2 2 4 3 2
D 1 2 3 4 3
C 0 1 2 3 4

Question 34: CEBDA

Explaining the inhaler technique requires the patient to have the
mental capacity to understand the information. The patient is currently
drowsy so this is not the best time to explain the inhaler technique
(D). Handing over the task to another pharmacist is ideal in this
situation(C). Referring the patient to the patient information leaflet is
better than you writing out instructions. Writing out the instructions
may not be as clear as the inhaler’s patient information leaflet (E, B).
As a result of the drowsiness, the patient does not have the mental
capacity to consent to you contacting a relative (A).
Rank
Correct order 1 2 3 4 5
C 4 3 2 1 0
E 3 4 3 2 1
B 2 2 4 3 2
D 1 2 3 4 3
A 0 1 2 3 4

Question 35: DEBAC

Due to contradicting advice, the senior pharmacist and the dispenser
should discuss their opinions. Advising the dispenser to speak directly
to the responsible pharmacist is better than you relaying the message
to the pharmacist (D, E). Asking the dispenser to speak to the patient
will help the dispenser gain a better understanding of the patient's
case (B). In this situation, a decision should only be made after
receiving advice. It is better to not sell anything as the patient's
symptoms may be linked to something serious. Therefore, purchasing
a product could mask the symptoms of something that requires
investigation (A, C).
Rank
Correct order 1 2 3 4 5
D 4 3 2 1 0
E 3 4 3 2 1
B 2 2 4 3 2
A 1 2 3 4 3
C 0 1 2 3 4

Question 36: BCDEA

Recording your concerns and seeking advice from a senior
pharmacist is most appropriate as they would have experience in
identifying red flags. It is also important to judge non-verbal cues from
the patient to take required action if needed (B). Other staff members
may also be able to identify red flags(C). This could be a potential
safeguarding scenario. Asking to speak to the patient alone could
raise alarm bells if the man is an abuser (D). The man is unlikely to
reveal the truth if abuse is taking place (E). It is important to not
conclude what is happening without having sound evidence (A).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
C 3 4 3 2 1
D 2 2 4 3 2
E 1 2 3 4 3
A 0 1 2 3 4

Question 37: CEDBA

In this situation carrying out medicines reconciliation on the patient is
important. Although, you are needed in the dispensary allocating the
task to someone available is good teamwork (C). Ideally, you finding
someone for the nurse would be best (E). Potentially delays in the
patient’s medicines could be harmful especially as the patient is
diabetic (D, B). Patient safety should be a priority in this situation (A).
Rank
Correct order 1 2 3 4 5
C 4 3 2 1 0
E 3 4 3 2 1
D 2 2 4 3 2
B 1 2 3 4 3
A 0 1 2 3 4

Question 38: ABCDE

It is important to deal with the problem by speaking to the doctor
directly. As a way to support the junior doctor's learning, signposting
the junior doctor to a good source is better than only highlighting
issues (A, B). Speaking to the junior doctor directly is best because
leaving a note does not guarantee the doctor will read the
message(C). Asking the nurses if they have noticed mistakes is not
dealing directly with the issue, but highlighting the problem with
someone is better than doing nothing (D, E).
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
B 3 4 3 2 1
C 2 2 4 3 2
D 1 2 3 4 3
E 0 1 2 3 4

Question 39: ABD

Explaining the situation to people involved directly with the patient's
care first is important, as the time until infusion is close (C, G). This
ensures nothing is given until the allergy status of the patient is
confirmed. The prescriber should be notified so an alternative
medication can be prescribed if needed (A). Additionally, the nursing
team should be notified to prevent the initiation of the infusion until the
patient’s allergies have been confirmed (D). A reliable source to
confirm the patient's allergy status would be the patient, unless their
mental capacity is impaired (B). Telling nurses you think a mistake
has been made is not communicating fully to the team. You need to
describe the mistake, as it is one which could cause harm to the
patient (H).
Question 40: ACE
It is important to find out the patient’s experience to assess whether
she is experiencing drug-related side effects (A). Asking the question
again is not active listening, as the patient has explained why she
does not want the Blue brand (B). Furthermore, telling the patient to
try again is putting the patient at risk (F). Recording the patient's
experience is important as this will ensure the whole team has access
to the information. This includes those not present (C). Verbally,
communicating the information to the team currently present, does
not account for the absent team members (H). Ultimately, you need to
put the patient receiving care first, so cost should not be the deciding
factor (D, G). Letting the pharmacist know of the situation helps
prevent confusion (E).
Question 41: ABCDE
It is essential the patient receives counselling in good time. You
should not assume the pharmacist will counsel the patient after you
have left because the pharmacist may have forgotten (D). Therefore,
reminding the pharmacist is ideal (A). Asking another available
pharmacist is another option (B). Asking a nurse does not ensure a
pharmacist receives the message and does not consider the nurse’s
workload(C). Understanding your limitation is important as you want
to ensure the patient receives accurate information (E). Therefore,
you should not attempt to counsel the patient.
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
B 3 4 3 2 1
C 2 2 4 3 2
D 1 2 3 4 3
E 0 1 2 3 4

Question 42: AEDCB

The patient has asked for some privacy, so this needs to be
considered. Consultation rooms guarantee privacy (A). Speaking to
the patient over the phone also maintains privacy however, if you
recommend an item over the counter, the patient will have to return to
the pharmacy (E). Talking in a quiet part of the pharmacy does not
guarantee privacy (D). Asking the patient to come back later is not
being considerate(C). Speaking to the patient by the counter provides
no privacy (B).
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
E 3 4 3 2 1
D 2 2 4 3 2
C 1 2 3 4 3
B 0 1 2 3 4

Question 43: BFH

As Ben is not fit to work the situation needs to be addressed. Firstly,
you need to speak to someone senior within your team for advice on
how to manage this situation. Your pre-registration tutor will know the
required actions to take (B). Reporting to the GPhC or police is not
appropriate at this stage (A, G). Clearly, there are issues affecting
Ben, therefore, showing concern may help him (B) rather than
confronting him (D). Telling Ben to not let issues affect his work is not
being sensitive and will not solve the underlying problem (C). Finally,
as you are not trained to provide advice on illicit drug use you need to
refer Ben to a professional (H).
Question 44: CDF
In this situation, it is important to be understanding as Frank has
opened up to you. Therefore, it is best to be supportive and suggest
speaking to someone senior (F). Additionally, it is important to give
feedback to colleagues, as this will help ease workload pressures
(C). To maintain trust with colleagues who have opened up, it is best
to not speak to unnecessary people (A, E). Seeking advice from
seniors could help in managing the situation better (D).
Question 45: BCDAE
It is important to not neglect yourself during work as this could affect
your performance. Seeking support from seniors in your department
is ideal. This is because they will be aware of how to help you in line
with the requirements for your pre-registration training. Your pre-
registration tutor is a good place to start (B, C). Speaking to a G.P
can also help (D). Facing the challenge without seeking advice could
affect your well-being (A). Refusing to complete the rotation is
compromising your learning and does not solve the issue (E).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
C 3 4 3 2 1
D 2 2 4 3 2
A 1 2 3 4 3
E 0 1 2 3 4

Question 46: ACE

As this is a potential safeguarding issue it is important to record
details and let someone senior know about the situation (A, C). It is
important not to ask leading questions, but to allow the mother to
speak about her concerns (E). Furthermore, dismissing concerns is
not being compassionate (B, D). Confronting the accused yourself is
not maintaining trust with the mother (H, G).
Question 47: CEG
It is important to be supportive of Emily as being a newly qualified
nurse can be daunting. Therefore, reassuring Emily should be a
priority (E). Getting help from a senior nurse is ideal to ensure patient
care is not affected (C, G). Offering to help is putting the patient at risk
because you are not trained in this area as a pre-registration
pharmacist (B). As this is a skill Emily will need to learn, avoiding the
task will not help her learning (D). Reporting Emily is not being
supportive and can hinder your professional relationship with her (A,
H).
Question 48: CBEDA
Regardless of how experienced the dispenser is the poor practice
needs to be challenged. Speaking to the dispenser directly is most
appropriate(C). Asking someone senior like the responsible
pharmacist to speak to the dispenser is also a good option (B). Asking
another dispenser is ok, but someone senior is better (E). Not telling
the dispenser immediately is not ideal. This is because it allows the
dispenser to use the wrong reconstitution technique for a longer time
(D).
Rank
Correct order 1 2 3 4 5
C 4 3 2 1 0
B 3 4 3 2 1
E 2 2 4 3 2
D 1 2 3 4 3
A 0 1 2 3 4

Question 49: BAEDC

It is important to speak up when you observe an error. Therefore, you
should politely explain to the pharmacist why the sale is not suitable
for the patient (B). Only stating the need to refer the patient to a G.P
does not explain your suggestion (A). Also, this is supporting other
team members and ensures the patient receives the best care.
Interrupting impolitely is not professional (E). Not acting before the
sale of the cream is not protecting the patient (D, C).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
A 3 4 3 2 1
E 2 2 4 3 2
D 1 2 3 4 3
C 0 1 2 3 4

Question 50: CDG

Maintaining patient confidentiality should be a priority. Therefore, no
information should be disclosed (C) unless you can be certain the
patient has consented to this (A, F). Not disclosing confidential
information over the phone is good practice (B). Although you need to
maintain patient confidentiality, you need to be sensitive to the
mother’s feelings (E, H). She will be feeling distressed so politely
explaining the reasons for not disclosing the information is important
(D). Speaking to someone directly at the hospital ensures only staff
involved in the patient’s care receive the required information (G).
Question 51: BEG
Speaking up is important however accusing them of bullying when
you have not fully obtained sufficient information is wrong (A).
Advising the nurses to address their concerns to the pharmacist is
ideal when working in teams. Also checking on the pharmacist’s well-
being is important (B). Commenting about the pharmacist to other
people is a form of gossip (G). Also being harsh with the new
pharmacist may hinder his confidence (D). Ultimately, the issue needs
to be addressed with the pharmacist for patient safety and should not
be ignored (F). Relaying the information to senior staff will help the
pharmacist receive the required support (E). Advising to avoid tasks
will not help development (H).
Question 52: BACED
Situations making you feel uncomfortable need to be addressed.
Speaking directly to the person is best as this will help your
professional relationship with the person (B). Speaking to someone
senior like your pre-registration tutor can be helpful (A). Talking to less
senior people can be helpful as well but seniors are better for
situations like this(C). Trying to avoid the dispenser is better than
doing nothing however, this is not going to solve the issue (E, D).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
A 3 4 3 2 1
C 2 2 4 3 2
E 1 2 3 4 3
D 0 1 2 3 4

Question 53: BCEDA

Interrupting staff unnecessarily during lunch is not considerate,
establishing if you can help is ideal (B). If the patient does not want to
disclose the information, it is best to get the pharmacist as it could be
an urgent case(C). Asking the patient if they can wait till the
pharmacist finishes lunch provides options for the patient (E). Telling
the patient to come back is not accounting for the fact the situation
may be urgent (D). Not attempting to help the patient is inappropriate
(A).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
C 3 4 3 2 1
E 2 2 4 3 2
D 1 2 3 4 3
A 0 1 2 3 4

Question 54: ADECB

When an error is made the incident should not be ignored (B).
Notifying a new staff member about a mistake they have made is
supporting their learning. Telling a senior pharmacist will allow
someone experienced to assess the situation and make any changes
if needed (A, D). Writing on the staff notice board does not ensure the
individual will receive the message (E). Discussing with a work
experience student is inappropriate, as this does not help solve the
problem. Someone senior is required to be notified.
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
D 3 4 3 2 1
E 2 2 4 3 2
C 1 2 3 4 3
B 0 1 2 3 4

Question 55: BEACD

Safeguarding vulnerable patients is important. Speaking to someone
senior will ensure correct actions are taken (B). You are not trained to
diagnose Dementia (C, D), so it is best to refer the case to someone
trained (E). Recording notes is not as effective as directly telling
someone senior, but it is still accessible to others (A).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
E 3 4 3 2 1
A 2 2 4 3 2
C 1 2 3 4 3
D 0 1 2 3 4

Question 56: CDE

Racist jokes are a violation of professional conduct. Therefore, the
behaviour of both staff members should be challenged by you (C,).
Furthermore, it should be reported to someone senior (H), to ensure
the issue gets dealt with at a higher level (D). After an incident like
this occurs, checking on the patient's well-being is important (E). The
incident should not be ignored (G).
Question 57: DEABC
Understanding your limitations is important. Referring to someone
more knowledgeable is the most appropriate action (D, E). Telling the
patient you do not know, is better than passing on information which
you are not certain about (A). Overall it is best to refer the patient to
someone who is fully trained to interpret the results (B, C).
Rank
Correct order 1 2 3 4 5
D 4 3 2 1 0
E 3 4 3 2 1
A 2 2 4 3 2
B 1 2 3 4 3
C 0 1 2 3 4

Question 58: ACBED

The purpose of the pre-registration year is to learn the role of a
pharmacist. Speaking up if you feel your learning is being hindered is
imperative (D). Speaking to the person directly in charge of your
training is ideal (A). If not possible, escalating in a step-wise manner
should be done(C). Contacting the professional body should be the
last resort (B). Trying to identify learning gaps is good but will not
solve the problem (E).
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
C 3 4 3 2 1
B 2 2 4 3 2
E 1 2 3 4 3
D 0 1 2 3 4

Question 59: EGH

As you are not able to confirm how long the Insulin has been out of
the fridge, disposing the Insulin is best (E). The insulin cartridges
should still be disposed even if they feel cold (A). Furthermore,
looking for any other misplaced Insulin is important for patient safety
(H). Before accusing anyone of misplacing the Insulin, you need to
ask first (F). Your team member suggested it may be the apprentice,
which you could explore for confirmation (B). Asking the apprentice
directly creates an opportunity for you to contribute to his learning by
providing advice if he made the mistake (G). Writing important
messages on the staff notice board is not appropriate as notice
boards are not always read (D).The apprentice does not need to be
reported to the pharmacy manager(C).
Question 60: AEDBC
Filling this learning gap is essential and should be addressed sooner
than later (B). Seeking assistance is best, as you have attempted to
learn the method yourself before (D). Asking your pre-registration
tutor for help is most appropriate (A). You could also ask a consultant
who may know, however, your pre-registration tutor is more likely to
understand how to help with pharmaceutical questions (E). Deferring
displacement calculation task will not solve the problem(C).
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
E 3 4 3 2 1
D 2 2 4 3 2
B 1 2 3 4 3
C 0 1 2 3 4

Question 61: ABDCE

Being verbally aggressive with patients is never acceptable, the
incident needs to be reported to someone senior. Ideally, this should
be the nurse's direct seniors (A, B). Challenging the nurse is also
important, but this also needs to be reported for further action (D).
Overall the issue needs to be addressed directly with the nurse (C,
E).
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
B 3 4 3 2 1
D 2 2 4 3 2
C 1 2 3 4 3
E 0 1 2 3 4

Question 62: DCEAB

All patient's values need to be catered for. This is vital for patient
centred care. Someone more experienced will be able to handle the
request better (D). The patient's request should be acknowledged first
(C). Explaining to the patient the consequences of the request and
highlighting options is better than disregarding his request (E, A). Not
attempting to address the patient's concern is wrong (B).
Rank
Correct order 1 2 3 4 5
D 4 3 2 1 0
C 3 4 3 2 1
E 2 2 4 3 2
A 1 2 3 4 3
B 0 1 2 3 4

Question 63: CEF

In this situation, it is best to remain calm and use the experience
constructively for further development (C, E). Seeking feedback will
allow you to identify any gaps in your knowledge or competencies (F).
Reacting to the patient’s complaint through confrontation does not
help to defuse the situation (A, D). Acknowledging there is a learning
need in this situation is important for further progression (B). Ignoring
this or refusing to address your weakness will not solve the problem
(G, H).
Question 64: BCDAE
As a pre-registration pharmacist, it is important to challenge bad
behaviour if witnessed directly (B). Speaking to the patient directly
yourself is best, as adding more workload to others is not necessary
for this situation. Ideally, asking someone directly involved in the
patient's care is best (C, D). Consoling the patient is good however,
the disruptive patient needs to be cautioned as well (E).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
C 3 4 3 2 1
D 2 2 4 3 2
A 1 2 3 4 3
E 0 1 2 3 4

Question 65: CABDE

Referring Jack to someone who has had experience with mentoring
pre-registration pharmacists will mean Jack receives good advice (C).
Showing support for other team members is being a good team
member (A). However, not advising Jack to receive help is not
contributing to Jack’s learning and you taking on the added workload
is not fair on you (E). Speaking to another pre-registration pharmacist
is not needed and could damage the relationship you have with Jack
(D). Although, speaking to somebody else for advice is better than
not addressing the problem.
Rank
Correct order 1 2 3 4 5
C 4 3 2 1 0
A 3 4 3 2 1
B 2 2 4 3 2
D 1 2 3 4 3
E 0 1 2 3 4

Question 66: BDECA

Firstly, exploring if the patient is happy to speak to other female staff
members is most appropriate, as the pharmacist is on break.
Referring her to a female pharmacy technician is more appropriate
than a work experience student (B). Asking the work experience
student to relay the message to you is not appropriate, as the student
may not accurately relay the information to you(C). Therefore, direct
communication between the patient and a trained staff member is
more appropriate. The patient is not in any immediate danger so,
suggesting she waits for the pharmacist is better than interrupting the
pharmacist’s break (D, E). Finally, as the patient has requested to
speak to a female, insisting you can help is not acknowledging the
patient’s request (A).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
D 3 4 3 2 1
E 2 2 4 3 2
C 1 2 3 4 3
A 0 1 2 3 4

Question 67: BDEAC

The priority should be exploring the patient’s concerns first, and then
explaining the reason for antibiotics (B). Explaining the consultant’s
decision could help the patient understand the importance of taking
the antibiotics (D). Signposting the patient to information explaining
the reason for antibiotics can be helpful. On the other hand, verbally
explaining this to the patient ensures the patient receives the correct
information. It also allows you to clarify any uncertainty (E). The
patient has concerns and not addressing them will not encourage the
patient (A). Furthermore, reiterating the consultant's instruction to just
take antibiotics is not helpful(C).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
D 3 4 3 2 1
E 2 2 4 3 2
A 1 2 3 4 3
C 0 1 2 3 4

Question 68: ABE

Pharmacy laws must be adhered to (D, H). The dispenser is not
following pharmacy laws, so this needs to be reported to someone
senior, to address the situation with the dispenser (A, B). This also
needs to be clearly explained to the pharmacy apprentice (G). The
responsible pharmacist should be notified before the superintendent
pharmacist(C). To help the apprentice understand your objection,
stating the pharmacy laws will support your claims (E). Signposting
the apprentice to the MEP is good however, it does not guarantee the
apprentice will carry out research (F).
Question 69: BDCEA
Being aware of colleague’s workload is important and providing a
suggestion on how to address the problem is good (B). Confirming
your availability with the pharmacist is being sensitive to the situation
(D). Not acknowledging the pressures on the pharmacist is not good
teamwork and could cause issues between yourself and the
responsible pharmacist(C). Suggesting to call for assistance is not fair
on your colleagues and closing the pharmacy is not an option (E, A).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
D 3 4 3 2 1
C 2 2 4 3 2
E 1 2 3 4 3
A 0 1 2 3 4

Question 70: DBECA

Joe has entrusted you with personal information which you should not
disclose with other people. Telling other colleagues is inappropriate
and could ruin your work relationship with Joe (A). Explaining this to
Dianne is being honest and the information is not disclosed (D). If
unsure whether Joe is ok with Dianne knowing, seeking confirmation
first is best (B). Dismissing the information as just pharmacy related
stuff, keeps the information confidential, even if untrue (E).
Threatening Dianne is not a constructive way to provide feedback(C).
Rank
Correct order 1 2 3 4 5
D 4 3 2 1 0
B 3 4 3 2 1
E 2 2 4 3 2
C 1 2 3 4 3
A 0 1 2 3 4

Question 71: EDBCA

Not using emollient for a day is unlikely to cause any harm to the
patient(C). Additionally, it is important to be considerate of the driver’s
schedule knowing the impact this could have for other patients (A).
Therefore, explaining the effects to the patient will allow a better
understanding and reduce the chance of this occurring again (E).
Communicating the option to come into the pharmacy with the patient
is ideal as it gives the patient input on their care (D). Whereas, telling
the patient to wait for delivery is not showing empathy in this situation
(B).
Rank
Correct order 1 2 3 4 5
E 4 3 2 1 0
D 3 4 3 2 1
B 2 2 4 3 2
C 1 2 3 4 3
A 0 1 2 3 4

Question 72: ACE

An incident like this has to be reported for the safety of the patient.
Someone with adequate training of managing incidents like this
should be notified first (C). Furthermore, errors such as this need to
be recorded and should not be ignored (A). Not notifying anyone from
the care team about the error puts the patient’s safety at risk (F, H).
Ultimately, the patient’s well-being is a priority so notifying care team
will ensure relevant monitoring is done (E).
Question 73: BDCEA
As this is the dispenser's first day, it could be an innocent mistake.
Therefore, the violation of the dress code policy should be
communicated with the dispenser (A). Speaking directly to the
dispenser first will ensure the message is received (B). The
responsible pharmacist could also address the issue with the
dispenser (D). Suggesting the dispenser reads the dress code policy
does not guarantee it will be followed up on, especially if he did not
initially read the policy (C). Writing on the staff notice board does not
guarantee the dispenser will receive the message. Furthermore, the
dispenser may not be aware he is breaking the company’s dress code
policy (E). However, this is providing suggestions directly to the
dispenser.
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
D 3 4 3 2 1
C 2 2 4 3 2
E 1 2 3 4 3
A 0 1 2 3 4

Question 74: ADE

Whatever has been issued on the prescription is what needs to be
dispensed (H). Calling the patient’s surgery for a new prescription
could cause further delays (F), so offering to demonstrate technique
could save time (E). Recording clear notes helps others if a situation
like this occurs again (A). The patient has asked for your help so
downplaying the need for the inhaler is inappropriate (B). Overall, the
patient’s well-being is a priority so the issue requires addressing (B,
C, G).
Question 75: CBEDA
Oncology wards consist of patients with weakened immune systems.
To protect patients you should go home and hand over any
responsibilities to a colleague(C, B). Leaving the ward immediately is
the best option (E). Staying on the ward is dangerous for the patients,
and your lack of concentration increases chances of errors (D, A).
Rank
Correct order 1 2 3 4 5
C 4 3 2 1 0
B 3 4 3 2 1
E 2 2 4 3 2
D 1 2 3 4 3
A 0 1 2 3 4

Question 76: ADEBC

In this scenario, it is important to maintain the patient’s confidentiality
by not disclosing any information (A). If the lady is still insisting, you
could then ask the responsible pharmacist to support your point (D).
Signposting the lady to a website can be helpful but telling her directly
ensures she receives the correct information (E). Stating “you are not
going to reveal when Jamie last collected methadone” confirms he is
a methadone patient (B).
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
D 3 4 3 2 1
E 2 2 4 3 2
B 1 2 3 4 3
C 0 1 2 3 4

Question 77: CFG

Not saying anything puts other patients and staff at risk (A).
Therefore, relevant staff members need to be notified first, so the
appropriate steps can be taken (F). Being honest with the patient is
important, as the information needs to be disclosed (B). This is
because not disclosing the information puts others at risk (C). You are
not trained to diagnose Coronavirus (D, E), but stating you suspect it
might be Coronavirus will allow the patient to take necessary
precautions (G). The patient needs to be investigated before going
home (H).
Question 78: CDBEA
Adhering to the laws and regulations is important (A). Giving the
patient alternative options allows the patient to make an informed
choice, as you do not know the patient's situation. For example, the
patient may not be able to come back later(C). It is important to notify
team members of bad practices in case they are not aware (D).
Telling the patient to come back later is not being sensitive to the fact
the Paracetamol may currently be needed (B). Not explaining the
reason for your decision to the patient is not considerate and can
further aggravate the issue (E).
Rank
Correct order 1 2 3 4 5
C 4 3 2 1 0
D 3 4 3 2 1
B 2 2 4 3 2
E 1 2 3 4 3
A 0 1 2 3 4

Question 79: BDEAC

The danger is immediate so seeking assistance from trained
personnel is best if a patient becomes violent or threatening (B).
Asking for senior advice will allow you to manage the situation
appropriately (D). Giving the patient some space could help the
patient calm down (E). Continued conversation with the patient is
likely to not be beneficial (A). Confronting the patient is not
appropriate, as it could aggravate the situation endangering yourself
and others (C).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
D 3 4 3 2 1
E 2 2 4 3 2
A 1 2 3 4 3
C 0 1 2 3 4

Question 80: ECBDA

Being honest and providing accurate information to the mother should
be a priority (A). Confidently explaining why it is not a Cold could help
reassure the mother (E). Asking a senior pharmacist to speak to the
patient can help reiterate your point if the mother is still unsure(C).
Refusing to sell is better than giving the child medication that is not
needed (B). Referral to a G.P is unnecessary and would add
unnecessary workload to G.P (D).
Rank
Correct order 1 2 3 4 5
E 4 3 2 1 0
C 3 4 3 2 1
B 2 2 4 3 2
D 1 2 3 4 3
A 0 1 2 3 4

Question 81: BDACE

There is a chance the patient may have misplaced the book (B).
Therefore, searching around the patient’s vicinity is a good place to
start (D). Speaking to someone who may be aware of any items that
have been found is useful. Ward managers are good sources for this
sort of information. Security may also be aware, but ward managers
are likely to be more informed on ward activity (A). Searching other
patient’s belongings is not appropriate at first, as they may feel
accused of stealing(C). Ignoring the patient's concerns is not an
option as patients need to feel valued (E).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
D 3 4 3 2 1
A 2 2 4 3 2
C 1 2 3 4 3
E 0 1 2 3 4

Question 82: DCBEA

Using feedback for further development is important. Seeking advice
from colleagues will assist in identifying weaknesses (D). Reading the
company dispensing SOP is a good tool to evaluate dispensing
processes(C). Asking other colleagues will help to confirm whether
the technician’s claim is valid, but does not actively identify learning
gaps (B). Only acknowledging the feedback will not contribute to
further development (E). Denying criticism is not acting on advice for
learning (A).
Rank
Correct order 1 2 3 4 5
D 4 3 2 1 0
C 3 4 3 2 1
B 2 2 4 3 2
E 1 2 3 4 3
A 0 1 2 3 4
Question 83: ABEDC
Preventing the patient from taking the wrong brand should be the
priority. Speaking up is essential where a patient’s well-being is at risk
(A). You communicating directly to the prescriber is best, as you will
be able to explain the concerns accurately (B). If medication has been
taken, advising nurses in charge of the patient’s care is important (E).
Understanding your limitations and notifying someone fully trained is
essential (D). Patient’s safety always outweighs saving costs (C).
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
B 3 4 3 2 1
E 2 2 4 3 2
D 1 2 3 4 3
C 0 1 2 3 4

Question 84: BDCEA

Pranks such as this should not be entertained and should be
addressed by someone (A). Potentially the colleague could be allergic
to ingredients in the hot sauce which could be dangerous. Speaking
to the dispenser directly is the best option as the behaviour is
inappropriate (B, D). Telling the victim about the prank protects them.
Somebody else other than the victim confronting the behaviour
reinforces the inappropriateness of the joke(C). Swapping the drinks
is not communicating the problem with this sort of behaviour (E).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
D 3 4 3 2 1
C 2 2 4 3 2
E 1 2 3 4 3
A 0 1 2 3 4

Question 85: ABC

Accepting excessive gifts from patients is not appropriate. The
behaviour from the superintendent pharmacist is suspicious. This
should be recorded (A), and seniors such as the regulatory board
should be notified (B). Challenging the superintendent pharmacist is
better than asking if a prescription has been issued (C). This is
because the superintendent pharmacist is likely to be dishonest (F).
Speaking to the patients does not solve the issue (D, E).
Question 86: EABDC
Misconduct such as this must be confronted and preferably reported
to someone senior (A, E). Asking others for their accounts can
support your claim when reporting (B). The behaviour needs to be
addressed immediately to prevent this from occurring again (D).
Acting oblivious to the situation is not an option(C).
Rank
Correct order 1 2 3 4 5
E 4 3 2 1 0
A 3 4 3 2 1
B 2 2 4 3 2
D 1 2 3 4 3
C 0 1 2 3 4

Question 87: CBDEA

In this situation as the patient is not in any immediate danger, it is
important to be considerate of both the pharmacist and patient.
Therefore, firstly checking if the pharmacist is happy to sign off the
prescription during lunch is best(C). Asking the patient to come back
is not ideal, as this is not being sensitive to the patient’s situation.
However, this provides the patient with the option to wait and also
considers the pharmacist (B). Confirming the prescription will be
signed off before consulting the pharmacist is not being considerate.
Furthermore, the pharmacist could decline, which could cause further
problems with the patient (E). Handing out medication without the
pharmacist signing of medication is illegal and dangerous (A).
Rank
Correct order 1 2 3 4 5
C 4 3 2 1 0
B 3 4 3 2 1
D 2 2 4 3 2
E 1 2 3 4 3
A 0 1 2 3 4

Question 88: ACEDB

Not labelling the medication is putting the patients at risk as they may
not be aware of how to take the prescribed medication. Therefore,
you need to intervene (B). Using guidelines strengthens your claims
(A). Although describing the responsible pharmacist’s decision as
reckless may harm your professional relationship, intervention is
required instantly. Reporting to seniors is good, but it does not
prevent the immediate danger of patients receiving unlabelled
medication (D). Reporting to external bodies should be last resort (B).
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
C 3 4 3 2 1
E 2 2 4 3 2
D 1 2 3 4 3
B 0 1 2 3 4

Question 89: BEDCA

Speaking to John directly will help you understand his viewpoint.
Ideally, talking in person is best, because through messaging, things
can be misunderstood (B, E). Asking others can help confirm whether
John's point is valid (D). Speaking to John is a priority, although taking
feedback constructively is good (C). Ignoring the post is not
addressing the issue (A).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
E 3 4 3 2 1
D 2 2 4 3 2
C 1 2 3 4 3
A 0 1 2 3 4

Question 90: CEG

As the patient is not experiencing any life-threatening symptoms, this
is something you can resolve (C). It is important to take responsibility
for the mistake (B, D, F) rather than deflecting the complaint to others.
Especially as you are aware as to what the problem is. Furthermore,
this is an opportunity to review your medicines reconciliation strategy
(E). Honesty with the patient and staff is in the patient’s best interest
(G). Blaming the patient is unacceptable, as you are at fault in this
situation (H).
Question 91: ACBDE
It is important to intervene, as this practice can put patient’s health at
risk. Explaining to the dispenser why this is dangerous will reinforce
your point (A). Verbally communicating this to the dispenser ensures
the message is received (B). Asking someone else to explain is good,
but ideally, as you have witnessed this you should speak to the
dispenser directly(C). As you are not sure if the dispenser has seen
the warning label, you should not accuse the dispenser of ignoring
instructions (D). Overall, intervention is required to prevent
contamination of antibiotics and to support the dispenser’s learning
(E).
Rank
Correct order 1 2 3 4 5
A 4 3 2 1 0
C 3 4 3 2 1
B 2 2 4 3 2
D 1 2 3 4 3
E 0 1 2 3 4

Question 92: ADE

Being aware of the financial implications is important (A). Therefore,
suggesting to your colleague to retrieve the generic brand is ideal (A).
Explaining the cost of dispensing the branded medicine to your
colleague will allow a better understanding of your suggestion (D).
Furthermore, providing practical solutions to avoid this dilemma
occurring again will benefit everyone involved (E). Advising your
colleague to increase dispensing speed increases the chances of
dispensing errors (B, C, F). Falsely reassuring the patient provides
unrealistic waiting time expectations (H). Not taking the responsibility,
to educate your colleague who may not be aware of the price
difference is not appropriate (G).
Question 93: CDEBA
As this is something you are not trained for, seeking advice from
someone senior is best(C). Involving the police is also another option,
as they will have better knowledge on managing the situation (D).
Signposting to support services can help the patient, but it does not
guarantee the patient will follow up on your advice (E). Motivating the
patient is not a good idea as you are not trained to support patients in
this state (B). Invalidating the patient’s feelings when suicidal is
inappropriate (A).
Rank
Correct order 1 2 3 4 5
C 4 3 2 1 0
D 3 4 3 2 1
E 2 2 4 3 2
B 1 2 3 4 3
A 0 1 2 3 4

Question 94: BDECA

Maintaining patient confidentiality is a priority. Calling the daughter
directly from patient records ensures you are talking to the patient (B).
Furthermore, not confirming anything (D), even whether she has a
prescription is better than advising the father to tell his daughter to
collect her prescriptions (E). Asking the father to call is daughter does
not guarantee you are talking to the patient (C). The medication
should not be handed over without consent (A).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
D 3 4 3 2 1
E 2 2 4 3 2
C 1 2 3 4 3
A 0 1 2 3 4

Question 95: BACDE

Having romantic relationships with patients is completely
inappropriate (B, E). It is important to politely refuse and to remain
professional (A). Being honest deals with the problem, giving fake
numbers or asking for their contact does not communicate your
disinterest (C, D).
Rank
Correct order 1 2 3 4 5
B 4 3 2 1 0
A 3 4 3 2 1
C 2 2 4 3 2
D 1 2 3 4 3
E 0 1 2 3 4

Question 96: CEF

As you are not trained to prescribe, you should refer this to a qualified
prescriber (E). Finding a doctor to complete the drug chart is most
appropriate. This should be explained to the nurse who may not be
aware (F). Finding a prescriber for the nurse is being sensitive to the
fact the nurse may be in distress because of the abuse (D). The
family shouting at the nurse is not appropriate, therefore this needs to
be addressed by someone senior (C). Advising the nurse to avoid the
family is not ideal, as this could affect the patient’s care (G).
Question97: ABG
Multiple patients have made a complaint about the doctor, therefore
this needs to be examined. However, this does not confirm the claims
are true. The first step should be to investigate the claims (B) instead
of reporting (C, D). Advising the patients to submit a formal complaint
will ensure their claims undergo investigation (A). It is also important
to record everything they have told you (G). Not taking action on their
concerns is wrong (E, F). This is because patients expect their
concerns to be taken seriously (H).
Question 98: ACF
The patient's allegation is serious and requires investigating.
Dismissing the patient’s claim is not a demonstration of empathy (E).
The phone may have been misplaced, so asking a colleague is useful
(A). Asking the patient where they last saw the phone, could reveal
the location of the phone(C). Asking the pharmacy's security is also
useful, as they can check cameras to confirm if the phone was stolen
inside the pharmacy (F). Contacting the accused man assumes he
stole the phone, therefore this should not be done initially (B, G).
Giving the accused man’s contact number to the patient is not
appropriate, as this is a breach of confidentiality (H). Overall, the
situation needs to be investigated promptly as the patient will be
worried (D).
Question 99: DEBAC
Being able to adapt to the situation is vital. Missing one day of study
is not going to mean much (D). Ultimately, being sensitive to a
colleague’s situation is important when working in teams (B). Asking
to study during quiet periods is being sensitive to your colleague’s
workload (E). Calling your pre-registration tutor for something not
urgent whilst they are on holiday is insensitive (A). Closing the store
so you can study is not an option(C).
Rank
Correct order 1 2 3 4 5
D 4 3 2 1 0
E 3 4 3 2 1
B 2 2 4 3 2
A 1 2 3 4 3
C 0 1 2 3 4

Question 100: BDAEC

The situation should not be ignored (C). However, confronting them
yourself does not ensure the incident is investigated (E). Speaking to
someone for advice on how to handle this situation is best. Ideally, as
this incident is involving senior staff members’, speaking to someone
senior is ideal (B). A nurse is likely to have a better idea than a pre-
registration pharmacist on how to handle the situation (D, A).
Rank
Correct order 1 2 3 4 5
D 4 3 2 1 0
A 3 4 3 2 1
E 2 2 4 3 2
C 1 2 3 4 3
B 0 1 2 3 4
 Glossary

Acute medicines ward Patients admitted to this ward are those

who have developed acute medical complications
Bioequivalent When two or more drugs have the same efficacy
when administered at similar doses.
Bleep A device used to contact individuals
Breath-actuated inhaler A type of inhaler which is designed for
those who struggle with inhaler actuation and breathing
coordination.
Chief pharmacist A senior pharmacist who manages a large
team of pharmacist
Consultant A senior doctor who is a specialist within a clinical
area
C-reactive protein (CRP) blood tests A blood test marker that is
used to confirm the presence of inflammation in the patient’s body.
Diabetic ketoacidosis A serious complication that can occur in
diabetic patients if blood sugar levels become too high
Dosette box A compliance aid for patients which
compartmentalise medications
Key worker An individual who supports a patient undergoing
opioid substitution therapy
Locum pharmacist A pharmacist who temporarily covers the
position of the regular pharmacist for a period of time
Medicines reconciliation A process which involves a
professional confirming the regular medication a patient takes
through asking the patient and other agents. This ensures the
patient’s regular medication is up to date during their stay in
hospital
Oncology ward Patients with cancer related conditions are
admitted to oncology wards
Outpatient A patient who visits a hospital but does not require
long stays in the hospital such as overnight
Peak flow meter An instrument used to measure a patient’s lung
function
Peripheral cannula A tube which is inserted into a vein for the
administration of medication.
Pre-registration tutor An allocated pharmacist who supervises a
pre-registration pharmacist during the pre-registration year
Psychiatric ward Patients situated in a psychiatric ward often
have mental health related admissions.
Responsible pharmacist The pharmacist who is in charge of the
processes at a pharmacy premise at a given time.
Standard operating procedures Instructions which are
described in a step by step manner for routine processes.
Superintendent pharmacist A senior pharmacist who is involved
in the management of a pharmacy. This includes professional and
clinical responsibilities.
Thromboprophylaxis Treatment to prevent the formation of
blood clots.
 Notes:

References:

Guidance to support the standards for pharmacy professionals |

General Pharmaceutical Council. Pharmacyregulation.org. (2020).
Retrieved from
https://www.pharmacyregulation.org/guidance/guidance-support-
standards-pharmacy-professionals.
Oriel.nhs.uk. (2020). Retrieved from
https://www.oriel.nhs.uk/Web/ResourceBank
Health Education England. (2020). Retrieved from
https://www.lasepharmacy.hee.nhs.uk/national-recruitment/student-
zone/sjt-and-numeracy-tests.
Suggested reading:
Khan et al (2020). Oriel situational judgement test: what pharmacy
students need to know. Pharmaceutical Journal.
Person-centred care. Health Education England. (2020).
RPS Advice: Professional judgement. (2013).
Standards for pharmacy professionals | General Pharmaceutical
Council. Pharmacyregulation.org. (2020).
Message from the author:
Firstly, congratulations to you all for reaching this stage of sitting the
SJT assessment! The struggle to arrive at this position is one many
can attest to. Like any other exam, prepare your way to success. You
can never prepare too much. There is no denying the process may be
intimidating but being prepared significantly increases your chances
of success. Therefore, continue to remain positive throughout the
journey, and I wish you all good luck. Any questions regarding the
assessments or pharmacy in general, feel free to send queries to
Thepharmacysjt@gmail.com.