AAHIVP Prep Course (AAHIVP): free quiz

1. Question 1 of 10

   An ambulatory HIV clinic pharmacist reviews a new ART order for a fictional patient with confirmed HIV: bictegravir/emtricitabine/tenofovir alafenamide 50/200/25 mg PO once daily. The patient takes dofetilide 500 mcg PO twice daily for atrial fibrillation; eGFR is 45 mL/min/1.73 m². No acute symptoms are reported. Within pharmacist scope and collaborative practice, which next step is best?

   Choose one answer

   ADispense bictegravir/emtricitabine/tenofovir alafenamide 50/200/25 mg PO once daily because the renal function is acceptable for the fixed-dose tablet.BRecommend dolutegravir 50 mg PO once daily plus emtricitabine/tenofovir alafenamide 200/25 mg PO once daily because dolutegravir is a guideline-preferred INSTI.CAsk the prescriber to reduce dofetilide to 250 mcg PO twice daily and dispense bictegravir/emtricitabine/tenofovir alafenamide 50/200/25 mg PO once daily.DHold and clarify the order with the HIV prescriber, recommending a noninteracting regimen such as raltegravir 400 mg PO twice daily plus emtricitabine/tenofovir alafenamide 200/25 mg PO once daily, if clinically appropriate.
2. Question 2 of 10

   An outpatient HIV question appears to favor a guideline-based management action. However, the vignette also includes new symptoms, abnormal laboratory results, and several concomitant medications. What should the candidate do before selecting the proposed action?

   Choose one answer

   AIgnore the additional details because the guideline principle has already been identifiedBVerify the safety of the action using symptoms, laboratory findings, interactions, and comorbiditiesCChoose whichever option reflects the local institution's usual workflowDRefer every outpatient management question without further analysis
3. Question 3 of 10

   A candidate correctly identifies the governing guideline principle in an HIV-care vignette but chooses an answer without considering a potentially important medication interaction mentioned in the stem. Which reasoning error is most evident?

   Choose one answer

   AFailure to verify safety before choosing the best next stepBFailure to use an institution-specific ruleCFailure to refer every patient with concomitant medicationsDFailure to choose the most intensive available intervention
4. Question 4 of 10

   During exam preparation, a clinician develops a four-step approach to best-next-step questions. Which sequence most closely matches the reasoning framework in the source pack?

   Choose one answer

   AChoose an intervention, review local policy, identify the task, then consider referralBIdentify the task and key facts, apply the governing guideline principle, verify safety, then account for scope and escalation needsCReview laboratory findings only, choose the most intensive action, then check whether it is guideline basedDApply the local institutional rule, ignore comorbidities, then refer if the answer remains uncertain
5. Question 5 of 10

   An ambulatory HIV pharmacist reviews a fictional patient taking bictegravir/tenofovir alafenamide/emtricitabine 50/25/200 mg PO once daily with persistent viremia. The clinician is considering adding maraviroc 300 mg PO twice daily. Which recommendation best connects the medication plan to the HIV life-cycle target?

   Choose one answer

   ASelect fostemsavir 600 mg PO twice daily as a routine first switch; it blocks gp120 attachment, but avoid coadministration with polyvalent cations.BUse maraviroc 600 mg PO twice daily immediately; boosted regimens require higher maraviroc exposure, and the drug blocks integrase-mediated viral DNA insertion.CConfirm CCR5-tropic virus before use; maraviroc blocks CCR5-mediated viral entry and requires dose adjustment with clinically significant CYP3A inhibitors or inducers.DSelect enfuvirtide 90 mg PO once daily after CCR5 tropism testing; it blocks gp41 fusion and should be reduced when creatinine clearance is below 50 mL/min.
6. Question 6 of 10

   In an ambulatory HIV clinic, a pharmacist reviews a 27-year-old patient using emtricitabine/tenofovir DF 200/300 mg by mouth once daily for PrEP. Two weeks after condomless receptive anal sex, the patient has fever, diffuse rash, pharyngitis, and tender cervical lymphadenopathy. A same-day rapid HIV antibody test is negative. Which next step is most appropriate?

   Choose one answer

   AContinue emtricitabine/tenofovir DF unchanged and reassure the patient that the negative antibody test excludes acute HIV.BSwitch immediately to cabotegravir 600 mg intramuscularly every 2 months because symptoms suggest poor adherence to oral PrEP.CArrange HIV-1 RNA testing with a laboratory HIV antigen/antibody assay and urgently coordinate HIV-experienced follow-up before changing PrEP.DStart ritonavir-boosted nirmatrelvir empirically because fever and pharyngitis are most consistent with an acute respiratory viral infection.
7. Question 7 of 10

   At an ambulatory HIV clinic pharmacy, you assess PrEP candidacy before dispensing emtricitabine/tenofovir disoproxil fumarate 200/300 mg by mouth once daily. A 29-year-old cisgender woman reports ongoing condomless receptive vaginal sex with partners of unknown HIV status. HIV antigen/antibody testing is negative today, she has no acute retroviral symptoms, estimated CrCl is 78 mL/min, HBsAg is negative, and she takes carbamazepine 400 mg by mouth twice daily for seizures. Which PrEP plan is most appropriate to recommend within scope?

   Choose one answer

   A

   Use emtricitabine/tenofovir alafenamide 200/25 mg by mouth once daily because it is preferred whenever CrCl is above 30 mL/min.

   B

   Use cabotegravir 600 mg intramuscularly at months 0 and 1, then every 2 months, while continuing carbamazepine.

   C

   Use event-driven emtricitabine/tenofovir disoproxil fumarate 2 tablets before sex, then 1 tablet 24 and 48 hours later.

   D

   Use emtricitabine/tenofovir disoproxil fumarate 200/300 mg by mouth once daily with adherence counseling and routine monitoring.

8. Question 8 of 10

   An ambulatory HIV clinic pharmacist reviews a request for PEP: bictegravir/emtricitabine/tenofovir alafenamide 50/200/25 mg PO once daily for 28 days. The patient reports condomless receptive anal sex 80 hours ago with a partner whose HIV status is unknown. Baseline HIV Ag/Ab testing is pending, creatinine clearance is 82 mL/min, and the medication list includes carbamazepine 300 mg PO twice daily. What is the most appropriate recommendation?

   Choose one answer

   A

   Do not initiate PEP; arrange HIV testing follow-up, STI/HBV/HCV assessment, counseling, and a PrEP prevention plan.

   B

   Dispense bictegravir/emtricitabine/tenofovir alafenamide 50/200/25 mg PO once daily for 28 days immediately.

   C

   Dispense raltegravir 400 mg PO twice daily plus emtricitabine/tenofovir disoproxil fumarate 200/300 mg PO every 48 hours for 28 days.

   D

   Dispense dolutegravir 50 mg PO once daily plus emtricitabine/tenofovir disoproxil fumarate 200/300 mg PO once daily for 28 days.

9. Question 9 of 10

   In an ambulatory HIV prevention pharmacy visit, a 24-year-old began nPEP 5 days ago with tenofovir DF/emtricitabine 300/200 mg PO once daily plus dolutegravir 50 mg PO once daily after condomless receptive anal sex 36 hours before starting therapy. Baseline lab today: HIV-1/2 Ag/Ab nonreactive; creatinine clearance is 92 mL/min. The patient takes calcium carbonate 1,000 mg PO nightly and asks whether the negative result proves they can stop PEP. What is the best pharmacist response?

   Choose one answer

   A

   Continue dolutegravir 50 mg PO daily but reduce tenofovir DF/emtricitabine 300/200 mg to every 48 hours because early negative testing suggests lower drug exposure is sufficient during the window period.

   B

   Switch to tenofovir alafenamide/emtricitabine 25/200 mg PO daily plus dolutegravir 50 mg PO daily and allow dolutegravir with fasting calcium carbonate because TAF avoids kidney concerns and improves adherence.

   C

   Continue tenofovir DF/emtricitabine 300/200 mg PO daily plus dolutegravir 50 mg PO daily to complete 28 days, counsel on calcium separation or taking dolutegravir with food, and schedule follow-up HIV testing; add HIV RNA if acute symptoms develop.

   D

   Stop nPEP now because the nonreactive Ag/Ab result after exposure rules out acquisition; no repeat testing is needed unless symptoms develop.

10. Question 10 of 10

    A 29-year-old patient in an ambulatory HIV clinic has a reactive HIV-1/2 antigen-antibody test with HIV-1 differentiation positive. As the clinic pharmacist, you are reviewing a rapid-start plan for bictegravir/emtricitabine/tenofovir alafenamide 50/200/25 mg by mouth once daily. The patient is tearful and asks, “What happens now?” Which response best aligns with new-diagnosis counseling?

    Choose one answer

    A

    Use dolutegravir/lamivudine 50/300 mg by mouth once daily today because it is a complete two-drug regimen and does not require hepatitis B review before rapid start.

    B

    Increase bictegravir/emtricitabine/tenofovir alafenamide to 50/200/25 mg by mouth twice daily for an estimated glomerular filtration rate of 45 mL/min and postpone detailed counseling.

    C

    Start bictegravir/emtricitabine/tenofovir alafenamide 50/200/25 mg by mouth once daily today, but explain that sexual transmission risk remains unchanged until the CD4 count normalizes.

    D

    Deliver the result clearly and confidentially, assess immediate safety and emotional needs, support rapid linkage to HIV care, and counsel that effective ART with viral suppression prevents sexual transmission.

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