Specialist BCPS Practice Exam Questions

Board Certified Pharmacotherapy Specialist (BCPS) Practice Exam Questions And Correct Answers (Verified Answers) Plus Rationales 2026 Q&A | Instant Download Pdf

• A 65-year-old patient with a history of hypertension and chronic kidney

disease (CKD) stage 3 is being initiated on an ACE inhibitor. Which parameter is most important to monitor within the first 2 weeks?

• Liver function tests
• Hemoglobin A1c
• Serum creatinine and potassium
• Platelet count

Rationale: ACE inhibitors can cause hyperkalemia and worsen renal function,

particularly in patients with CKD. Early monitoring of serum creatinine and potassium is recommended. 1 / 4

• Which of the following antibiotics is most appropriate for empiric

treatment of community-acquired pneumonia in a patient with no comorbidities?

• Piperacillin-tazobactam
• Amoxicillin
• Vancomycin
• Levofloxacin

Rationale: For otherwise healthy outpatients, amoxicillin is recommended by

guidelines for empiric treatment of community-acquired pneumonia due to coverage of common pathogens like Streptococcus pneumoniae.

• A patient with atrial fibrillation is on warfarin and presents with an INR

of 6.2 but has no bleeding. What is the recommended management?

• Administer vitamin K orally and resume warfarin
• Discontinue warfarin indefinitely
• Hold 1–2 doses of warfarin and monitor INR
• Give fresh frozen plasma immediately

Rationale: For an INR >5 but <10 without bleeding, temporary cessation of

warfarin and close INR monitoring is recommended; vitamin K may be considered if risk of bleeding is high.

• / 4

• Which lipid-lowering agent has the greatest effect on lowering LDL

cholesterol?

• Gemfibrozil
• Ezetimibe
• Atorvastatin
• Niacin

Rationale: Statins, particularly high-intensity agents like atorvastatin,

provide the most significant LDL-C reduction compared to fibrates, ezetimibe, or niacin.

• Which is the preferred drug for long-term treatment of osteoporosis in a

postmenopausal woman?

• Calcitonin
• Alendronate
• Teriparatide
• Estrogen

Rationale: Bisphosphonates like alendronate are first-line for long-term

prevention and treatment of osteoporosis due to proven efficacy in reducing fractures.

• A patient with type 2 diabetes has an A1c of 9.2% on metformin

monotherapy. What is the next best step? 3 / 4

• Increase metformin dose only
• Add a second antihyperglycemic agent
• Switch to insulin immediately
• Start lifestyle modification only

Rationale: When A1c remains above target (>7%) despite metformin,

guidelines recommend adding a second agent, such as a GLP-1 receptor agonist, SGLT2 inhibitor, or sulfonylurea.

• A patient with acute asthma exacerbation is admitted with wheezing

and respiratory distress. Initial therapy should include:

• Oral montelukast
• IV aminophylline
• Inhaled short-acting beta-agonist (SABA)
• Oral corticosteroid only

Rationale: In acute exacerbations, rapid bronchodilation with inhaled SABAs

is first-line therapy; systemic corticosteroids are added if needed.

• Which of the following anticoagulants does NOT require routine

monitoring of coagulation parameters?

• Warfarin
• Apixaban
• / 4