Pharmacy-focused MCQs — 100 questions (antipyretics: dosing, safety, contraindications, counseling) using Nehad J. Ahmed *ChatGPT can make mistakes. Check important info.

 

Pharmacy-focused MCQs — 100 questions (antipyretics: dosing, safety, contraindications, counseling) using

 

Nehad J. Ahmed

 

*ChatGPT can make mistakes. Check important info.

 

Questions (1–100) — choose the best answer (A–E)

  1. Fever is best defined as:
    A. Uncontrolled rise of body temperature not responsive to antipyretics
    B. A controlled elevation of body temperature above normal due to a higher hypothalamic set point
    C. Any body temperature above 37.0°C measured orally
    D. The same physiologic process as hyperthermia
    E. A dangerous condition that always requires emergency care
  2. The hypothalamic mediator primarily responsible for increasing the set point during fever is:
    A. Bradykinin
    B. Prostaglandins
    C. Histamine
    D. Dopamine
    E. Epinephrine
  3. Which site typically reads about 0.6°C higher than an oral temperature?
    A. Axillary
    B. Tympanic
    C. Rectal
    D. Temporal
    E. Forehead touch
  4. Rectal temperature that defines fever is approximately:
    A. 37.0°C (98.6°F)
    B. 37.4°C (99.4°F)
    C. 37.6°C (99.6°F)
    D. 38.0°C (100.4°F)
    E. 38.5°C (101.3°F)
  5. Which of the following is NOT a common cause of fever listed in the chapter?
    A. Infection
    B. Malignancy
    C. Autoimmune disease
    D. Environmental exposure
    E. Hyperthyroidism (as a primary chapter focus)
  6. Drug-induced fever is characterized by:
    A. Immediate fever at first dose in every patient
    B. Fever that persists without infection and resolves after withdrawal of offending agent
    C. Fever always accompanied by rash
    D. Fever caused only by antibiotics
    E. Fever that never resolves with stopping the drug
  7. Which of these medications is specifically included in the chapter’s list as often implicated in drug-induced fever?
    A. Metformin
    B. Carbamazepine
    C. Furosemide
    D. Metoprolol
    E. Insulin
  8. Which nonpharmacologic method is recommended for fever (per chapter)?
    A. Alcohol/ethanol sponge baths
    B. Ice baths
    C. Tepid sponge baths (after antipyretic effect begins)
    D. Heavy layering of clothing
    E. Cold-water immersion followed by vigorous exercise
  9. Cooling blankets should be used:
    A. Alone, without medications
    B. Only in hyperthermia
    C. Along with antipyretics if used for fever
    D. Only for children under 2 years
    E. Only when temperature exceeds 41.5°C
  10. The antipyretic of choice for most patients (preferred agent) is:
    A. Aspirin
    B. Naproxen
    C. Ibuprofen
    D. Acetaminophen
    E. Magnesium salicylate
  11. Acetaminophen adult dosing options listed in the chapter include (choose best):
    A. 650 mg every 4–6 h, max 3,250 mg/24 h OR 1,000 mg every 6 h, max 3,000 mg/24 h
    B. 325 mg every 12 h, max 650 mg/24 h
    C. 2,000 mg single dose only
    D. 500 mg every 2 h, no max given
    E. 5,000 mg/day routine
  12. The U.S. product labeling warns against which maximum daily acetaminophen use (general warning cited)?
    A. >1,000 mg/day
    B. >2,000 mg/day
    C. >3,000 mg/day for all patients
    D. >4,000 mg/day (be cautious because combination products exist)
    E. >6,000 mg/day
  13. In children, recommended acetaminophen dosing is:
    A. 1–2 mg/kg every 6–8 h
    B. 10–15 mg/kg every 4–6 h as needed (weight-based)
    C. 50 mg/kg every 2 h
    D. Fixed 500 mg dose regardless of weight
    E. Acetaminophen is contraindicated in children
  14. Ibuprofen adult dosing for fever noted in the chapter (typical OTC range) is:
    A. 50–100 mg every 12 h
    B. 200–400 mg every 4–6 h with a maximum of 1,200 mg/day (OTC guidance)
    C. 800–1,200 mg every hour
    D. 5,000 mg/day routinely recommended
    E. Not recommended at all for adults
  15. In children 6 months–12 years, ibuprofen dosing for fever is:
    A. 25 mg/kg once daily
    B. 5–10 mg/kg every 6–8 h as needed, max 4 doses/day
    C. 50–100 mg/kg every 2 h
    D. 200–400 mg fixed dose regardless of weight
    E. Contraindicated under 12 years
  16. Aspirin for fever should be avoided in:
    A. Adults with hypertension only
    B. Children and teenagers with flu-like illness or chickenpox (due to Reye’s syndrome risk)
    C. Anyone with a headache
    D. All adults over 30 years old
    E. Patients with no history of allergy only
  17. Which statement about NSAIDs and fever is TRUE (per chapter)?
    A. NSAIDs are free of GI and platelet effects.
    B. NSAIDs reduce fever but can adversely affect GI tract and platelets; acetaminophen is preferred in many patients.
    C. NSAIDs have no contraindications in pregnancy.
    D. NSAIDs increase renal blood flow and are safe in renal impairment.
    E. NSAIDs are first-line in pregnancy for fever.
  18. Which patients should seek medical evaluation if fever does not resolve after OTC treatment for the time specified in the chapter?
    A. Children <2 yrs if no change within 24 h; other children within 48 h; adults within 3 days
    B. Adults only after 7 days
    C. Children only after 1 week
    D. Anyone immediately after 2 hours of OTC therapy
    E. Never — OTC is always sufficient
  19. Hyperthermia differs from fever in that:
    A. Hyperthermia is mediated by an elevated hypothalamic set point.
    B. Hyperthermia responds well to antipyretics.
    C. Hyperthermia is an uncontrolled rise in body temperature where the set point is NOT altered and antipyretics are ineffective.
    D. Hyperthermia is identical to hyperpyrexia.
    E. Hyperthermia is always due to infection.
  20. Hyperpyrexia is defined in the chapter as a temperature greater than approximately:
    A. 38°C (100.4°F)
    B. 39°C (102.2°F)
    C. 40°C (104°F)
    D. 41.5°C (106.7°F)
    E. 45°C (113°F)
  21. A fever diary recommendation includes measuring temperature every:
    A. 2 hours
    B. 4 hours only at night
    C. Every 8 hours and recording symptoms to help follow-up evaluation
    D. Once per week
    E. Only after medications
  22. Which of these is an important part of the “Collect” step of the patient care process for fever?
    A. Ignoring immunization status
    B. Collecting medication history (Rx and OTC) and adherence
    C. Only recording the current temperature without context
    D. Assuming no travel history is relevant
    E. Avoiding questions about allergy history
  23. For a returning traveler, the chapter suggests most fever-causing illnesses appear within what time period after exposure (general guidance)?
    A. Within 1 week only
    B. Usually within 21 days; majority within 1 month of exposure (varies by disease)
    C. After 2 years
    D. Only if they visited Europe
    E. Incubation time is always > 6 months
  24. Which of the following is a red-flag symptom that should prompt immediate physician evaluation in a child with fever?
    A. Slight cough but eating normally
    B. Refusing oral fluids
    C. Mild runny nose only
    D. Low-grade fever without other signs
    E. Playing well without symptoms
  25. Infants younger than 3 months with a temperature above which threshold should be seen by a physician irrespective of other symptoms?
    A. 37.0°C (98.6°F)
    B. 37.5°C (99.5°F)
    C. 38.0°C (100.4°F)
    D. 39.0°C (102.2°F)
    E. 40.0°C (104°F)
  26. The chapter recommends that sponging be performed:
    A. Before giving any antipyretic
    B. Always with cold water immediately
    C. After oral antipyretic therapy by about 1 hour so the hypothalamic set point can fall first
    D. Only in infants under 3 months
    E. As the sole therapy for fever
  27. Which of the following is a correct normal temperature/febrile threshold pairing for axillary measurement from the chapter?
    A. Normal 36.7–37.0°C; fever point 39.0°C
    B. Normal 34.7–37.4°C; fever point ~37.4°C (99.4°F)
    C. Axillary and rectal measure exactly the same
    D. Axillary fever point 38.5°C
    E. Axillary cannot be used to detect fever
  28. Which population is specifically noted as higher risk and needing immediate medical attention for fever?
    A. Healthy teenagers only
    B. Immunocompromised patients (eg, on steroids, cancer, sickle cell)
    C. People who never travel
    D. Only athletes with fever
    E. All adults over 20
  29. Which antipyretic mechanism is attributed to acetaminophen in the chapter?
    A. Peripheral inhibition of cyclooxygenase only
    B. Increasing hypothalamic set point
    C. Inhibiting production/release of prostaglandins in the CNS and inhibiting endogenous pyrogens at the hypothalamus
    D. Directly cooling the skin via evaporation
    E. Blocking histamine-1 receptors
  30. For patients with liver disease, acetaminophen use should be:
    A. Unrestricted at any dose
    B. Avoided entirely in all cases
    C. Used with caution and medical consultation (contraindicated in active/severe hepatic impairment)
    D. Doubled as needed
    E. Replaced with aspirin routinely
  31. Ibuprofen should be avoided in pregnancy because:
    A. It is ineffective for fever in pregnancy
    B. It may cause fetal risks in the second half of pregnancy (FDA warning) and is contraindicated in pregnancy/breastfeeding per chapter guidance
    C. It always causes birth defects
    D. It is the preferred agent in pregnancy
    E. It causes immediate miscarriage in all cases
  32. Which of these is a documented adverse effect concern for NSAIDs noted in the chapter?
    A. Platelet dysfunction and gastrointestinal bleeding/ulceration
    B. Hypoglycemia risk only
    C. Complete immunity to infection
    D. Hair loss only
    E. Hearing improvement
  33. The chapter’s guidance for older adults regarding ibuprofen includes:
    A. No concerns — NSAIDs are always safe
    B. Avoid ibuprofen in older adults with heart failure due to possible fluid retention and exacerbation of heart failure
    C. Ibuprofen cures heart failure
    D. Ibuprofen is preferred for chronic kidney disease stage 4–5
    E. Ibuprofen must be given at double dose in older adults
  34. Combination therapy (alternating or combining acetaminophen and NSAIDs) is:
    A. Never recommended
    B. Possible in many but not all patients — should be individualized and used cautiously
    C. Required for all fevers >38°C
    D. The only safe strategy in children
    E. Always harmful
  35. Which of the following statements about fever in children is emphasized?
    A. Fever alone equals severe illness always
    B. Fever often causes dehydration — encourage appropriate hydration and monitoring of fluid intake
    C. Children do not get febrile seizures
    D. Antipyretics prevent all febrile seizures
    E. Children should always receive aspirin for fever
  36. Fever with severe headache and stiff neck may indicate:
    A. Otitis media only
    B. Meningitis — consider immediate evaluation and possible lumbar puncture
    C. Simple viral cough
    D. Typical food poisoning only
    E. Seasonal allergies
  37. Which antipyretic is contraindicated in children recovering from chickenpox or influenza?
    A. Acetaminophen
    B. Ibuprofen
    C. Aspirin (due to Reye’s syndrome risk)
    D. Diphenhydramine
    E. Pseudoephedrine
  38. The chapter suggests that fever evaluation should include which social factor?
    A. Patient’s favorite color
    B. Barriers to care (eg, ability to access medications, cost, cultural considerations)
    C. Whether the patient likes sports
    D. None — social factors are irrelevant
    E. Only travel history matters
  39. For adults, if antipyretic therapy is ineffective, at what point should they seek further evaluation?
    A. Immediately after first dose
    B. After 3 days with no improvement (per chapter recommendations)
    C. After 14 days
    D. Never — self-care should continue regardless
    E. Only if temperature exceeds 50°C
  40. Fever from environmental exposure (eg, closed car) is most consistent with:
    A. Fever caused by prostaglandin-mediated hypothalamic set-point change
    B. Hyperthermia — uncontrolled heat gain not responsive to antipyretics
    C. Viral infection exclusively
    D. Always mild and not dangerous
    E. Drug-induced fever always
  41. Which of the following is TRUE regarding measurement sites and their relative readings?
    A. Rectal readings are approximately 0.6°C higher than oral; axillary approx 0.6°C lower.
    B. All sites read exactly the same.
    C. Tympanic readings are always 2°C higher than rectal.
    D. Temporal temperature is unreliable and not used.
    E. Oral readings are 1°C higher than rectal.
  42. Which of these is emphasized as an important counseling point when recommending OTC antipyretics?
    A. Use different thermometers each time to compare
    B. Ensure the patient understands dosing schedule, max daily dose, and potential interactions with other products (eg, combination products containing acetaminophen)
    C. Never read the product label
    D. Double doses are acceptable if symptoms are severe
    E. Ignore liver/renal disease status
  43. Which of the following drug classes is associated with fever but was specifically mentioned among the offenders in the chapter?
    A. Anticonvulsants (eg, phenytoin, carbamazepine)
    B. Statins only
    C. Oral contraceptives only
    D. Topical emollients only
    E. Antacids only
  44. The chapter recommends advising patients with suspected COVID-19 symptoms to:
    A. Ignore public health guidance
    B. Follow CDC guidance for testing/isolation and treat symptoms including antipyretic therapy as appropriate
    C. Take antibiotics empirically always
    D. Avoid antipyretics entirely
    E. Seek surgery immediately
  45. Fever accompanied by vomiting and inability to keep fluids down is:
    A. A benign sign always
    B. A red-flag symptom warranting immediate physician evaluation (especially in children)
    C. Only seen in adults
    D. Best treated by decreasing fluid intake further
    E. Indicative of overhydration
  46. Which statement is correct about fever patterns (etiology)?
    A. Infections, malignancies, autoimmune disorders, and medications can all cause fever.
    B. Fever is only caused by bacterial infections.
    C. Malignancy never causes fever.
    D. Vaccines never cause fever.
    E. Environmental causes are the only relevant cause.
  47. Which of the following is an appropriate at-home nonpharmacologic recommendation for fever management?
    A. Heavy blankets and bundling to induce shivering
    B. Tepid water sponging after antipyretic effect starts, loose clothing, and ensure adequate hydration
    C. Alcohol rubs to cool skin quickly
    D. Ice bath for 30 minutes
    E. Immediate exercise to normalize temperature
  48. Which group is highlighted as having increasing prevalence for fever of unknown origin over time?
    A. Children only
    B. Patients with inflammatory diseases and complex patients with many potential causes
    C. Only healthy adults with no comorbidities
    D. No group — FUO is decreasing overall
    E. Tourists only
  49. When evaluating fever, which lab values (if available) can assist the clinician per chapter?
    A. None — labs are never helpful
    B. CBC, kidney function, liver function, and basic metabolic panel to look for clues and safety concerns
    C. Only cholesterol levels
    D. Only pregnancy tests are relevant
    E. Only genetic testing is relevant
  50. Which is TRUE about sponging and shivering?
    A. Shivering during sponging indicates improved cooling benefits — continue the sponge bath.
    B. If shivering starts when sponging with tepid water, the intervention should be stopped to avoid increased heat production.
    C. Shivering is unrelated to changes in hypothalamic set point.
    D. Shivering indicates hyperthermia only.
    E. Shivering should be induced intentionally.
  51. For children older than 2 years — if symptoms do not change with OTC therapy — seek medical evaluation after:
    A. 12 hours
    B. 24 hours
    C. 48 hours
    D. 5 days
    E. 7 days
  52. The chapter states that temporal (infrared) fever thresholds vary — which of the following approximate thresholds is listed?
    A. 38.1°C (100.6°F) for 0–2 months; 37.9°C (100.2°F) for 3–47 months; 37.8°C (100.0°F) for >4 years
    B. 39.5°C for all ages
    C. No age differences exist for temporal readings
    D. Temporal readings are always lower than axillary by 2°C
    E. Temporal method is not described
  53. Which of these is NOT recommended for fever management per chapter?
    A. Encouraging hydration
    B. Tepid sponging after antipyretic effect initiates
    C. Alcohol sponge baths and ice baths
    D. Using same thermometer/site consistently
    E. Educating caregivers on red-flag symptoms
  54. When considering drug interactions for fever therapy, the pharmacist should:
    A. Ignore OTC products the patient uses
    B. Consider interactions between current OTC, prescription, and herbal medications that may alter therapy options
    C. Assume no interactions exist with antipyretics
    D. Disregard the patient’s other medical history
    E. Recommend combination opioid/acetaminophen products without checking other acetaminophen sources
  55. In the context of fever in returning travelers, which region is described as more commonly associated with fever?
    A. Sub-Saharan Africa, South and Central Asia, Southeast Asia, Latin America and the Caribbean (higher risk)
    B. Antarctica only
    C. Northern Europe only
    D. No regions are associated with fever risk
    E. Outer space
  56. Which of the following is an accurate statement about fever and COVID-19 per the chapter?
    A. Fever is never a symptom of COVID-19.
    B. Fever, cough, or shortness of breath were reported by ~70% of patients with COVID-19; symptom overlap with other infections makes testing/evaluation necessary.
    C. COVID-19 always presents with unique rash distinguishing it from other infections.
    D. Antipyretics are contraindicated in suspected COVID-19.
    E. Only severe COVID-19 causes fever.
  57. A patient taking several medication products that contain acetaminophen should be counseled to:
    A. Add them together liberally to improve effect
    B. Be aware of total daily acetaminophen intake and avoid exceeding recommended limits because combination products can cause unintentional overdose
    C. Ignore labels — OTCs are always safe
    D. Double their usual single dose if fever persists
    E. Substitute with aspirin without consideration
  58. Which of the following is a stated goal of therapy for fever?
    A. Always normalize temperature within 1 hour
    B. Relieve discomfort and reduce body temperature, and when appropriate, treat the underlying cause
    C. Only give antibiotics to every patient with fever
    D. Prevent all future infections by antipyretic use
    E. Hospitalize all febrile patients
  59. Which of the following is an example of a red-flag sign in adults with fever that requires immediate medical attention?
    A. Mild congestion only
    B. Shortness of breath or chest pain
    C. Slight sore throat only
    D. Occasional sneezing
    E. Mild fatigue only
  60. Which statement best reflects the chapter’s take on antipyretic dosing frequency?
    A. Antipyretics are dosed on an as-needed basis for fever; follow recommended intervals and max doses.
    B. Antipyretics should be taken continuously every hour regardless of response.
    C. Once a single dose is given, no follow up needed.
    D. Only one dose of antipyretic is ever safe.
    E. Antipyretics should be alternated every 15 minutes.
  61. Which of the following is TRUE about fever in malignancy per the chapter?
    A. Malignancies cannot cause fever.
    B. Certain malignancies such as lymphoma, leukemia, renal cell carcinoma, and hepatocellular carcinoma can present with fever.
    C. Fever rules out malignancy.
    D. Fever in malignancy is always bacterial infection.
    E. Malignancy-related fever always resolves without therapy.
  62. For patients with suspected hyperthermia, what is an important distinguishing feature from fever?
    A. Hyperthermia is expected to respond to acetaminophen readily.
    B. Hyperthermia occurs when heat gain exceeds heat loss with no change in hypothalamic set point and will not respond to antipyretics.
    C. Hyperthermia is the same as fever and requires the same workup.
    D. Hyperthermia is always due to infection.
    E. Hyperthermia never causes dehydration.
  63. Which of the following medications should be used with caution in patients with renal complications (per chapter guidance)?
    A. Ibuprofen (NSAIDs) — consult physician in renal dysfunction; dose adjustments may be required.
    B. Acetaminophen — always nephrotoxic only
    C. Aspirin — safe in severe renal impairment without caution
    D. All antipyretics are safe without modifications
    E. Antipyretics are not discussed with renal disease
  64. Which of the following is an appropriate counseling point when giving acetaminophen to patients who consume alcohol regularly?
    A. No concerns — alcohol has no interaction with acetaminophen.
    B. Advise caution because chronic heavy alcohol use increases hepatic risk; consult physician; labels warn about alcohol consumption with acetaminophen.
    C. Tell them to drink more alcohol to reduce fever.
    D. Recommend doubling acetaminophen dose if alcohol is used.
    E. Say acetaminophen is totally contraindicated in anyone who drinks any alcohol.
  65. For children, why is weight preferred over age when dosing antipyretics?
    A. Age is always more accurate than weight.
    B. Weight-based dosing more accurately reflects pharmacokinetic needs and reduces risk of under/overdosing.
    C. Weight is irrelevant to dosing.
    D. Age always underestimates dosing needs.
    E. Age and weight never correlate.
  66. Which is a correct adult aspirin dosing regimen for fever cited in the chapter?
    A. 325–650 mg orally every 4–6 h as needed, max 4 g/24 h
    B. 50 mg once daily only
    C. 2 g every hour unlimited
    D. Aspirin is contraindicated in all adults always
    E. Aspirin is the only safe antipyretic in pregnancy
  67. Which statement is accurate about fever follow-up?
    A. If fever and associated symptoms have not changed within 3 days of starting antipyretic therapy in adults, they should seek further evaluation.
    B. Follow-up is unnecessary for any patient.
    C. Adults should wait 2 weeks before re-evaluation.
    D. Children never require follow up.
    E. Fever follow up is only for immunocompromised patients.
  68. Which is an example of a symptom that might indicate dengue fever in a returning traveler (mentioned as an example)?
    A. Sore throat only
    B. Rash, myalgias, GI upset, or headaches after travel to tropical/subtropical areas — consider dengue among differentials
    C. Exclusively joint deformities
    D. Skin cancer lesions only
    E. Only cough and sinus congestion
  69. A patient reports they have taken acetaminophen but temperature did not decrease — this finding may help you differentiate:
    A. Hyperthermia (antipyretics are ineffective in hyperthermia) vs fever (which often responds) — but note hyperpyrexia responds to antipyretics despite high temperatures
    B. That acetaminophen is always ineffective
    C. Only indicates the thermometer is broken
    D. That ibuprofen is also guaranteed to be ineffective
    E. That they have no fever
  70. Which of the following patients should be advised to see a physician immediately regardless of temperature (per chapter’s red flags)?
    A. A patient with unexplained dermatologic spots or rash and fever
    B. A patient with mild seasonal allergies only
    C. A patient who slept poorly last night only
    D. A person with a small scrape and no systemic signs
    E. A patient on regular vitamins only
  71. For a child weighing 10 kg, an appropriate single dose range of acetaminophen (10–15 mg/kg) would be approximately:
    A. 10–20 mg total
    B. 50–75 mg total
    C. 100–150 mg total
    D. 500–650 mg total
    E. 1,000–1,500 mg total
  72. Which of these is emphasized regarding antipyretic use in pregnancy?
    A. Ibuprofen and other NSAIDs should be avoided in pregnancy (especially later stages); acetaminophen is generally considered safe in pregnancy and lactation (FDA category B).
    B. Aspirin is preferred throughout pregnancy.
    C. All antipyretics are contraindicated in pregnancy.
    D. High-dose ibuprofen is recommended in third trimester.
    E. Antipyretic safety is not discussed in the chapter.
  73. Which of the following is recommended when counseling caregivers about thermometry?
    A. Use the same thermometer and measurement site consistently during a febrile illness for accuracy.
    B. Switch thermometers and sites frequently to see differences.
    C. Only use touch (hand) to determine fever.
    D. Thermometer accuracy does not matter.
    E. Use only oral readings for infants.
  74. Which symptom cluster in a child would be most concerning for immediate evaluation?
    A. Low fever, playing, eating well
    B. Fever >38°C with vomiting without ability to keep down fluids and sustained diarrhea
    C. Slight runny nose only
    D. Mild fussiness but normal hydration
    E. Sleeping a little more than usual
  75. Which of the following is an accurate statement about aspirin use in adults in febrile illness?
    A. Aspirin is first-line for pediatric fever.
    B. At febrile doses it should be avoided in pregnancy and lactation; use in severe hepatic/renal impairment is contraindicated; Reye’s risk in children prohibits pediatric use after chickenpox/flu.
    C. Aspirin has no toxicity concerns.
    D. Aspirin is required for all febrile patients.
    E. Aspirin is always safe in children.
  76. What is the maximum number of ibuprofen doses per day recommended for children 6 months–12 years per the chapter?
    A. 0 doses/day
    B. 1 dose/day only
    C. 2 doses/day only
    D. 4 doses/day (per typical OTC guidance)
    E. 10 doses/day
  77. Which of following is TRUE about distinguishing fever vs hyperpyrexia vs hyperthermia?
    A. Hyperpyrexia is an extremely high fever (>41.5°C) that does respond to antipyretics; hyperthermia does not respond to antipyretics.
    B. Hyperpyrexia and hyperthermia are identical.
    C. Hyperpyrexia never responds to antipyretics.
    D. Fever and hyperthermia are identical and interchangeable terms.
    E. None of these distinctions matter clinically.
  78. Fever in neutropenic patients (eg, post-chemotherapy) often requires:
    A. Only OTC therapy at home
    B. Immediate medical attention and a specialized approach (eg, initial management of fever and neutropenia)
    C. Ignoring fever until it resolves
    D. Only prescribing herbal remedies
    E. Delaying care
  79. Which of these antipyretic adverse-effect concerns is especially notable in NSAIDs but not a main concern with acetaminophen?
    A. Hepatotoxicity at normal doses
    B. Platelet dysfunction and GI ulceration/bleeding risk
    C. None — NSAIDs are identical to acetaminophen in adverse effects
    D. Profound sedation specific to NSAIDs only
    E. Severe hyperkalemia routinely
  80. For patients with severe hepatic impairment, which antipyretic is contraindicated per chapter guidance?
    A. Ibuprofen
    B. Aspirin
    C. Acetaminophen (contraindicated in active, severe hepatic impairment)
    D. Diphenhydramine
    E. All antipyretics are safe
  81. Which of the following is recommended to help reduce fever-related dehydration?
    A. Reduce fluid intake to stop sweating
    B. Encourage appropriate hydration and oral fluids
    C. Force solids only — no fluids
    D. IV fluids for all patients at home
    E. No fluids if antipyretics are given
  82. Which method is recommended to reduce fever quickly but safely (chapter guidance)?
    A. Alcohol or ice baths to rapidly drop temperature
    B. Tepid sponge bath after antipyretic effect begins, fans, and cool blankets used with antipyretics — alcohol/ice baths discouraged
    C. Cold water immersion for children under 2
    D. Always use ice packs on the chest for 6 hours
    E. Sponging before antipyretic administration
  83. The chapter’s approach to recommending OTC agents includes assessing:
    A. Indication, safety, adherence, and effectiveness of each medication the patient is taking
    B. Only the cost of the medication
    C. Random selection without review
    D. Choosing the most expensive product always
    E. Never discussing adverse effects
  84. In which situation should a pharmacist refer a febrile patient immediately to a physician?
    A. Any fever in a well-appearing adult with no other symptoms
    B. A child of any age with a temperature above 40°C (104°F) (one of the chapter’s immediate referral criteria)
    C. A minor cough and thirst only
    D. A single low reading of 37.1°C with no symptoms
    E. A small bruise
  85. What is the maximum pediatric acetaminophen per-day limit described for infants?
    A. No limit given
    B. 20 mg/kg/day
    C. 75 mg/kg/day for infants (chapter gives maximum guidance)
    D. 500 mg/day regardless of weight
    E. 200 mg/kg/day
  86. Which of the following is TRUE about patient education per the chapter?
    A. Education is unnecessary for fever — patients always know what to do.
    B. Provide personalized education on checking temperature consistently, nonpharmacologic approaches, goals of therapy, adverse effects, and monitoring parameters.
    C. Advise everyone to use alcohol baths.
    D. Tell caregivers to stop giving fluids when fever is present.
    E. Only advise patients to take antibiotics.
  87. Which agent should be avoided in older adults with Stage 4–5 chronic kidney disease?
    A. Acetaminophen — always avoid in CKD
    B. Ibuprofen — avoid as NSAIDs may cause renal injury in severe CKD (chapter cautions)
    C. Aspirin — no concerns in CKD
    D. Antipyretics are not discussed for CKD
    E. All antipyretics are safe without adjustments
  88. Which of the following is an important consideration when selecting an OTC antipyretic for a patient?
    A. Mechanism of action only
    B. Age, pregnancy status, renal/hepatic function, other meds (interactions), and patient preferences/affordability
    C. Only the cost per package
    D. Manufacturer’s logo color only
    E. None — all patients should get the same drug
  89. Which of these statements about fever in adults is consistent with the chapter?
    A. Adults with fever should always self-treat for at least 2 weeks.
    B. If fever lasts >3 days without improvement with OTC therapy, further evaluation is recommended.
    C. Adults should never take antipyretics.
    D. Fever is always harmless in adults.
    E. Adult fever is only due to travel.
  90. Which of the following is a correct pediatric ibuprofen formulation guidance per the chapter?
    A. Children <2 years should use 50 mg/1.25 mL suspension; children ≥2 years may use 100 mg/5 mL formulations — caregivers must pay attention to formulation to avoid overdose.
    B. Children of any age should take the adult 400 mg tablet only.
    C. Ibuprofen formulations are identical regardless of age.
    D. No formulation guidance is provided.
    E. Ibuprofen is never used in children.
  91. Which of these is recommended in the plan/implement steps for fever management?
    A. Never reconcile patients’ medication lists
    B. Review and reconcile all medication lists to arrive at an accurate, updated medication list and discuss appropriate OTC therapy and monitoring with the patient
    C. Avoid discussing follow-up with the patient
    D. Recommend herbal remedies exclusively
    E. Provide only written instructions without discussion
  92. Which of these is a major difference between fever and hyperpyrexia as stated?
    A. Hyperpyrexia is a modest increase in temperature (≤38°C)
    B. Hyperpyrexia is extreme elevation (eg, >41.5°C) and is a medical emergency; fever refers to controlled elevations to a higher set point.
    C. Fever and hyperpyrexia are synonymous.
    D. Hyperpyrexia is always mild.
    E. Hyperpyrexia never requires medical attention.
  93. If a patient has suspected drug-fever coincidence with a new medication, the appropriate initial action is:
    A. Ignore the possibility and continue all meds
    B. Consider withdrawal of the offending agent and evaluate for resolution (drug fever often subsides after withdrawal)
    C. Immediately hospitalize without stopping the drug
    D. Double the new drug dose to test causality
    E. Prescribe another drug without evaluation
  94. For teaching purposes, what is one suggested “Beyond the Book” activity in the chapter for students?
    A. Create a drug treatment table of OTC products for fever including age, mechanism, dosing, interactions, and cost; compare and produce optimal situations for each agent.
    B. Ignore the evidence and recommend any drug randomly
    C. Only memorize drug brand names without details
    D. Refrain from patient education exercises
    E. Only study surgical therapies for fever
  95. Which of the following statements about antipyretic combinations is supported by the chapter?
    A. Combining acetaminophen and NSAIDs is never allowed.
    B. Combination therapy can be used in most but not all patients and should be individualized considering safety and interactions.
    C. Combinations always prevent hospitalizations.
    D. Combinations are only used in newborns.
    E. Alternating antipyretics every 15 minutes is standard.
  96. A patient with suspected severe infection and fever plus altered mental status should be:
    A. Managed at home with OTC therapy only
    B. Referred urgently for medical evaluation (red-flag — changes in mental status require immediate attention)
    C. Given ibuprofen and sent home without follow up
    D. Told to wait two weeks
    E. Given a cold drink only
  97. Which antipyretic is specifically noted as safe in pregnancy and lactation when used appropriately?
    A. Aspirin
    B. Ibuprofen in the 3rd trimester
    C. Acetaminophen (oral acetaminophen is safe and FDA pregnancy category B in the chapter’s discussion)
    D. Naproxen always safe
    E. No antipyretic is safe in pregnancy
  98. Which of the following is correct regarding use of cooling techniques for hyperthermia?
    A. Cooling techniques such as cool blankets and fans are useful but antipyretics are ineffective in hyperthermia; immediate evaluation required.
    B. Antipyretics are the only required treatment for hyperthermia.
    C. Hyperthermia resolves with bed rest alone always.
    D. Alcohol bath is recommended to treat hyperthermia.
    E. Cooling techniques are never helpful.
  99. The chapter emphasizes the importance of which of the following when counseling caregivers of a febrile child?
    A. Provide clear instructions on dosing (weight-based), when to seek care (red flags), hydration, and how to measure temperature consistently.
    B. Tell them to give adult doses to children.
    C. Avoid any instructions to reduce fever.
    D. Encourage alternating antipyretics every 15 minutes.
    E. Suggest ignoring the child’s symptoms.
  100. Finally, which of these best summarizes the chapter’s overall patient-centered approach to fever?
    A. Use a systematic patient care process: collect, assess, plan, implement, follow-up — include medication reconciliation, individualized education, and appropriate referral when red flags are present.
    B. Treat all fevers identically regardless of context.
    C. Refer every fever to surgery immediately.
    D. Use only herbal remedies for fever.
    E. Disregard patient preferences or barriers.

 

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