CRAS Prep Course (CRAS): free quiz

1. Question 1 of 10

   During pharmacist-supervised medication reconciliation, a patient reports apixaban 5 mg by mouth twice daily for atrial fibrillation and newly prescribed clarithromycin 500 mg by mouth twice daily. The CRAS protocol says medication interactions or unclear anticoagulant orders must be documented and escalated, not independently changed. What is the most appropriate CRAS-level action?

   Choose one answer

   AContinue apixaban 5 mg by mouth twice daily and document that no clinically relevant interaction exists.BDocument both medications accurately and promptly escalate the interaction concern to the supervising pharmacist or licensed clinician.CReduce apixaban to 2.5 mg by mouth twice daily because clarithromycin can increase apixaban exposure.DRecommend switching to rivaroxaban 20 mg by mouth daily to avoid the interaction.
2. Question 2 of 10

   A CRAS working under a pharmacist-approved dispensing protocol reviews apixaban 5 mg by mouth twice daily for atrial fibrillation. The medication profile also lists ketoconazole 400 mg by mouth daily. The protocol states: “Immediate: verify interacting medications and report strong CYP3A4/P-gp inhibitors before dispensing.” Which response best identifies the task cue and required action?

   Choose one answer

   A

   Change apixaban to 2.5 mg twice daily because dose reduction is a common apixaban strategy.

   B

   Recommend switching to rivaroxaban because it is another oral factor Xa inhibitor used for atrial fibrillation.

   C

   Document the profile as a routine refill because apixaban 5 mg twice daily is a standard atrial fibrillation dose.

   D

   Verify the ketoconazole interaction and report the order for pharmacist or prescriber review before dispensing.

3. Question 3 of 10

   A CRAS candidate is reviewing a pharmacist-supervised practice case: warfarin 5 mg by mouth once daily. The study note asks the candidate to verify that yesterday’s INR value, dose, prescriber callback time, and patient education handout were entered in the correct record fields per protocol. Which inferred study domain best labels this review task?

   Choose one answer

   A

   Documentation, because the task centers on accurate, complete, protocol-aligned recording of results and actions.

   B

   Terminology, because the task centers on recognizing anticoagulation terms such as INR and warfarin.

   C

   Prioritization, because the task centers on deciding which patient-care issue must be addressed first.

   D

   Procedure, because the task centers on selecting the next operational step in a standing workflow.

4. Question 4 of 10

   During medication reconciliation under pharmacist-approved workflow, a CRAS candidate reviews a patient taking metformin 500 mg by mouth twice daily. The patient says, “I feel dizzy,” and the measured blood pressure is 88/54 mm Hg. Which documentation best uses common clinical terminology by separating subjective report from objective finding?

   Choose one answer

   A

   Patient appears unstable and probably needs medication discontinued.

   B

   Metformin 500 mg by mouth twice daily is contraindicated due to low blood pressure.

   C

   Patient reports dizziness; blood pressure measured at 88/54 mm Hg.

   D

   Patient is hypotensive because metformin is causing dizziness.

5. Question 5 of 10

   In a pharmacist-supervised medication reconciliation workflow, an order reads: warfarin 2.5 mg by mouth once daily. Available tablets are warfarin 5 mg. The patient also reports taking trimethoprim-sulfamethoxazole 160/800 mg by mouth twice daily. Which CRAS documentation entry is safest before pharmacist review?

   Choose one answer

   A

   Document warfarin 2.5 mg as 0.5 tablet daily and flag trimethoprim-sulfamethoxazole for pharmacist clarification.

   B

   Document warfarin 2.5 mg as .5 tablet daily and note that no interaction clarification is needed.

   C

   Document warfarin 0.25 mg as 0.5 tablet daily and flag trimethoprim-sulfamethoxazole for routine refill review.

   D

   Document warfarin 2.50 mg as 0.5 tablet daily and flag only if bleeding symptoms are present.

6. Question 6 of 10

   In a clinic pharmacy workflow, a CRAS candidate supporting the pharmacist reviews an electronic medication order for fictional patient Mara Lee: apixaban 5 mg by mouth twice daily, entered today. The chart shows the drug, dose, route, frequency, and patient name, but no second patient identifier and no prescriber signature/authentication. Under record-component protocol, what is the best next step before filing the order?

   Choose one answer

   AFlag a possible apixaban-amiodarone interaction but file the order because interaction review is separate from record validity.BHold filing and clarify per protocol: verify two patient identifiers and obtain prescriber authentication before treating the order as valid.CFile the order because the drug, dose, route, and frequency are present, then note the missing elements later.DChange the order to rivaroxaban 15 mg by mouth once daily if renal function is reduced, then file the corrected anticoagulant order.
7. Question 7 of 10

   A CRAS candidate in an outpatient infusion area is asked, within protocol, to help prepare a station before a nurse administers cefazolin 1 g IV every 8 hours. After touching a shared workstation and before entering the patient care area, the candidate plans to put on clean gloves. What is the best next step?

   Choose one answer

   APut on clean gloves now because gloves replace hand hygiene when no visible soil is present.BDelay hand hygiene until after leaving the patient care area if no direct patient contact occurs.CPerform hand hygiene first, then don clean gloves before patient-area contact.DDon gloves first, then apply alcohol-based hand rub over the gloves before contact.
8. Question 8 of 10

   A CRAS is checking an infusion pump before a licensed nurse starts potassium chloride 20 mEq in 1,000 mL normal saline IV at 75 mL/hr continuous. The pump powers on, but the calibration sticker expired last month and the casing has a crack. What is the most appropriate next step?

   Choose one answer

   A

   Remove the pump from service per policy, label it as unsafe, document the defect, and notify the appropriate person.

   B

   Clean the pump, document that it powered on, and allow use because the ordered infusion rate is routine.

   C

   Reset the pump, cover the crack with tape, and ask the nurse to monitor the site more frequently during infusion.

   D

   Use the pump only after comparing its displayed rate with the medication order and confirming the IV tubing fits.

9. Question 9 of 10

   A CRAS candidate is supporting a pharmacist-verified medication delivery for cefazolin 2 g IV every 8 hours. The room sign states: Contact Precautions—gown and gloves before entry; use dedicated equipment; clean hands before leaving. Under protocol, which workflow best matches the posted isolation category?

   Choose one answer

   A

   Wear a surgical mask only, enter with the medication, and document that droplet precautions were followed.

   B

   Enter without PPE if the medication is urgent, then clean hands and report that standard precautions were sufficient.

   C

   Perform hand hygiene, don gown and gloves before entry, use dedicated equipment when available, and do not infer a diagnosis from the sign.

   D

   Wear an N95 respirator, keep the door closed, and delay medication delivery until airborne precautions are discontinued.

10. Question 10 of 10

    Under pharmacist-supervised protocol, a CRAS candidate is setting up materials for an order: apixaban 5 mg by mouth twice daily for nonvalvular atrial fibrillation. The profile shows age 82 years, weight 58 kg, serum creatinine 1.6 mg/dL, and ketoconazole 400 mg by mouth daily. Before preparing the medication, which next step best fits safe preparation and set-up?

    Choose one answer

    AStop set-up and clarify with the supervising pharmacist because renal, weight, age, and interaction factors may require order review.BSubstitute rivaroxaban 15 mg once daily because it is another oral factor Xa inhibitor with renal dosing.CPrepare apixaban 2.5 mg twice daily because the patient meets dose-reduction criteria for atrial fibrillation.DPrepare apixaban 5 mg twice daily because it matches the active order and usual atrial fibrillation dose.

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