Common Registration Assessment: 2026 Free Preparation Guide Study Guide

Apply it

A person collecting apixaban asks for ibuprofen for new knee pain. Identify the increased bleeding risk, assess the pain and any bleeding symptoms, and agree an appropriate alternative or clinical review rather than supplying automatically.

Apply it

A person starting apixaban says their dentist already knows their usual medicines. Explain that they should still carry the alert card and tell the dental team about apixaban whenever treatment is being considered.

Apply it

An asymptomatic adult reports a clinic reading of 148/94 mmHg and asks whether this proves hypertension. Explain that further assessment, often including ambulatory or home readings, helps determine whether the elevation persists outside the clinic.

Apply it

A person's home monitoring average is 138/87 mmHg. They dismiss it because it is below 140/90 mmHg. Explain that the usual home threshold is lower and that this average warrants discussion with their healthcare professional.

Apply it

A lithium-treated patient develops diarrhoea, marked tremor and difficulty walking after becoming unwell. Treat this as suspected toxicity: withhold lithium and arrange urgent assessment, lithium measurement and renal/electrolyte testing rather than waiting for routine monitoring.

Apply it

A patient takes lithium at 10 pm. A routine 12-hour sample is due at 10 am the next morning; an 8 am sample represents ten hours. Document the actual interval and clarify interpretation before changing the dose. Do not move the next evening dose to the morning to create a pre-dose sample.

Apply it

A patient admitted to hospital normally takes Parkinson's medicines at specific times that differ from ward rounds. Communicate the established schedule promptly and ensure the administration plan preserves those times while any swallowing concerns are assessed.

Apply it

A patient taking immediate-release Sinemet can safely swallow water but cannot manage tablets. Use the authorised off-label dispersion instructions to give the full dose at its established time while arranging specialist review. The same approach must not be applied to Sinemet CR.

Apply it

A person taking an SGLT2 inhibitor has vomiting, abdominal pain and deep breathing but reports a glucose reading close to their usual range. Arrange immediate medical assessment for possible ketoacidosis rather than recommending home observation based on glucose.

Apply it

A patient takes levothyroxine with breakfast and coffee because this is easiest to remember. Explain the absorption issue and agree a morning routine that allows the recommended interval before food and caffeine, then communicate the change during follow-up.

Apply it

A person taking Eltroxin 100 microgram tablets plans to take newly purchased ferrous sulfate with the morning tablet. Explain the absorption interaction and agree the 7 am levothyroxine and noon iron schedule, checking that other doses and interactions also fit.

Apply it

A person taking amoxicillin reports frequent diarrhoea with visible blood. Tell them to stop amoxicillin and call a doctor or NHS 111 now. Communicate the antibiotic exposure and symptoms rather than offering symptomatic treatment as the complete response.

Apply it

An adult asks for heartburn treatment but describes food repeatedly sticking and coughing when drinking. Identify possible dysphagia and arrange urgent clinical review instead of assuming uncomplicated reflux and managing the complaint entirely through a medicine sale.

Apply it

A person requests salbutamol earlier than expected and has not collected prescribed corticosteroid treatment. Assess current symptoms and arrange urgent asthma review. If worsening symptoms are not relieved by the prescribed attack treatment, obtain urgent medical assistance.

Apply it

A person says they stopped their corticosteroid inhaler because salbutamol works faster. Explain the different treatment roles, check the prescribed regimen and arrange review so that rapid relief is not mistaken for adequate anti-inflammatory asthma treatment.

Apply it

A patient starting methotrexate for rheumatoid arthritis believes it belongs with their daily morning tablets. Establish the prescribed weekly day, demonstrate the schedule and ask the patient to describe it back before the first dose is taken.

Apply it

A patient receiving chemotherapy phones about shivering and feeling acutely unwell. Direct them to contact their cancer team's emergency service immediately using their treatment instructions, rather than advising them to wait overnight or first try routine cold remedies.

Apply it

A patient thinks betamethasone valerate 0.1% is weaker than hydrocortisone 1% and plans to use it on the face for longer. Explain the mild-versus-potent comparison and check the prescribed body site and duration before use.

Apply it

A person requests drops for a red eye and then mentions blurred vision and discomfort in bright light. Arrange emergency assessment rather than beginning an over-the-counter treatment trial and asking them to return if it fails.

Apply it

A person woke with markedly reduced hearing in one ear and asks for wax drops. Recognise the sudden onset and arrange urgent medical assessment rather than recommending several days of wax treatment before considering another explanation.

Apply it

A person with diabetes is planning pregnancy. Explain that the higher-risk recommendation is prescribed folic acid 5 mg daily, rather than relying on the usual 400 microgram dose, and arrange the prescription before conception.

Apply it

A pregnant adult with uncertain MMR history asks to receive the vaccine today. Explain why MMR is deferred during pregnancy and help arrange follow-up after pregnancy rather than administering it or suggesting that all future vaccination is unsafe.

Apply it

A lithium-treated patient has had diarrhoea and has barely drunk for a day. Assess for toxicity symptoms and arrange appropriate urgent advice, explaining why reduced intake and fluid loss matter instead of treating hydration as an unrelated issue.

Apply it

A patient taking apixaban reports black stools and asks whether bruising is simply expected with anticoagulation. Recognise the possible serious bleeding symptom and arrange urgent medical advice rather than grouping it with minor bruising and offering reassurance alone.

Apply it

In a Great Britain pharmacy, a patient avoids a prescribed medicine after a relative experienced side effects. Explore the specific fear, explain the patient's own treatment context and agree how questions will be resolved with the prescriber.

Apply it

After explaining weekly methotrexate in a Great Britain pharmacy, ask the patient which day they will take it and what they will do on other days. Use their response to identify and correct any remaining daily-dosing misunderstanding.

Apply it

In a Great Britain pharmacy, someone agrees to discuss a medicine but appears surprised when an additional service is proposed. Explain the separate activity and seek their agreement before proceeding rather than treating their attendance as blanket consent.

Apply it

A patient begins discussing a sensitive medicine at a crowded Great Britain pharmacy counter. Offer a private consultation space and ask whether they want their companion involved before exploring details that other customers could otherwise overhear.

Apply it

When referring possible lithium toxicity, communicate the symptoms, recent illness, lithium regimen, available dose timings and action already taken. State that urgent assessment is required and confirm how the patient will reach the receiving service.

Apply it

An older patient in a Great Britain pharmacy struggles to hear instructions in a noisy area. Move to a suitable space, ask how they prefer information presented and check their understanding rather than simply speaking faster or addressing a companion.

Apply it

A hypothetical 1.5% w/v preparation is required in a 200 mL final volume. Interpret this as 1.5 g per 100 mL, so 3 g of solute is needed, with the preparation made up to 200 mL.

Apply it

An exercise requires 75 g of a 4% w/w mixture from pure ingredient and base. Calculate 3 g of ingredient and, assuming no losses and additive masses, 72 g of base to achieve the required final mass.

Apply it

A hypothetical preparation requires 250 mL at 8% v/v using a pure liquid ingredient. Calculate 20 mL of ingredient, then make up to the specified final volume according to the stated preparation assumptions and instructions.

Apply it

To prepare 200 mL of a hypothetical 2 mg/mL solution from 10 mg/mL stock, calculate 40 mL of stock. Make this up to 200 mL; under additive-volume assumptions, this requires 160 mL of diluent.

Apply it

An exercise asks for 100 mL at 6 mg/mL from 10 mg/mL and 2 mg/mL solutions, assuming additive volumes. Equal 50 mL portions contribute 500 mg and 100 mg, producing 600 mg in 100 mL.

Apply it

A hypothetical 1 g powder displaces 0.8 mL and must yield 10 mL of final solution. Add 9.2 mL solvent under the stated model. The resulting 100 mg/mL concentration means a 250 mg portion occupies 2.5 mL.

Apply it

A hypothetical exercise specifies 24 mg/kg/day in three equal doses for a 20 kg patient. Calculate 480 mg daily and 160 mg per dose, then use the supplied product concentration to calculate the administration volume.

Apply it

A hypothetical course uses three tablets daily for four days, then two daily for three days, then one daily for two days. Calculate 12, 6 and 2 tablets respectively, giving a total requirement of 20 tablets.

Apply it

An exercise requires 31 tablets, available only in sealed packs of 14 with no splitting permitted. Calculate 31 divided by 14, then round upward to three packs, providing enough tablets under the stated supply constraint.

Apply it

A hypothetical liquid course uses 7.5 mL three times daily for seven days. The treatment volume is 157.5 mL. If only whole 100 mL bottles may be supplied, the exercise requires two bottles rather than one.

Apply it

A hypothetical infusion requires 180 mL over 90 minutes. Convert 90 minutes to 1.5 hours, then calculate 180 divided by 1.5, giving 120 mL/hour. Check that this rate delivers 180 mL over the specified period.

Apply it

An exercise states that 240 mg is made up to 120 mL and must deliver 12 mg/hour. The concentration is 2 mg/mL, so the pump rate is 6 mL/hour. Multiplication confirms delivery of 12 mg each hour.

Apply it

A hypothetical exercise specifies 2 micrograms/kg/minute for 50 kg using 1 mg/mL solution. This is 100 micrograms/minute, 6,000 micrograms/hour or 6 mg/hour, requiring 6 mL/hour. The calculation supplies no treatment recommendation.

Apply it

In a hypothetical one-year study, an event occurs in 12% of controls and 8% of treated participants. The absolute reduction is four percentage points, or 0.04, giving an NNT of 25 over one year.

Apply it

A hypothetical intervention reduces one-year event risk from 2% to 1%. The relative risk is 0.5 and relative reduction 50%, but the absolute reduction is one percentage point. Explain both rather than presenting only the larger percentage.

Apply it

An exercise states equal outcomes and asks for annual provider costs. Treatment A costs £100 plus £80 monitoring; treatment B costs £140 plus £20 monitoring. Their totals are £180 and £160, making B cheaper within the stated perspective.

Apply it

A hypothetical option costs £300 more and yields 0.02 additional quality-adjusted life years per patient. Dividing £300 by 0.02 gives £15,000 per additional quality-adjusted life year, before applying any separately specified decision threshold.

Apply it

An exercise specifies an initial concentration of 80 mg/L, a four-hour half-life and no further dosing under first-order elimination. After twelve hours, three half-lives have elapsed, leaving 10 mg/L rather than subtracting a fixed amount each hour.

Apply it

A hypothetical model gives clearance of 3 L/hour and a target of 4 mg/L. The maintenance input is 12 mg/hour. If the exercise supplies a 2 mg/mL infusion, the corresponding pump rate is 6 mL/hour.

Apply it

A hypothetical formula gives a target of 2 mg/L, volume of distribution of 40 L and bioavailability of 0.5. The modelled loading dose is 160 mg because 80 mg systemically requires twice that administered amount.

Apply it

A hypothetical calculation produces 1.276 mL and explicitly requests an answer to two decimal places. Report 1.28 mL after completing the calculation, rather than rounding an earlier concentration and obtaining a materially different final result.

Apply it

An established patient requests 56 days of a non-controlled maintenance tablet during an emergency. Even if the other conditions are met, that quantity exceeds the ordinary 30-day limit. Select a justified quantity within the limit and arrange ongoing access.

Apply it

A patient is admitted to hospital with a recognised reaction suspected to involve an established medicine. Report the serious suspected reaction even though it is already listed in the product information and another cause remains possible.

Apply it

A patient notices a black triangle beside a medicine name and fears it means the product has been banned. Explain additional monitoring and the request to report suspected reactions, while addressing any symptoms and the person's treatment concerns.

Apply it

A Great Britain pharmacist confirms that a patient received the wrong strength. Assess possible harm promptly, explain the confirmed error and apologise, arrange corrective care and document events rather than waiting for a management meeting before contacting the patient.

Apply it

In a Great Britain pharmacy, repeated interruptions lead to several selection near misses. Record concrete examples, raise the patient-safety concern with the responsible person and seek practical controls rather than waiting until an incorrect medicine reaches a patient.

Apply it

A Great Britain pharmacist is asked to convert an unfamiliar Parkinson's regimen after swallowing deteriorates. Identify the exact products and timing needs, consult suitable specialist guidance or expertise and communicate a clear interim plan that avoids unreviewed manipulation or omission.

Apply it

In England, an adult has run out of amlodipine 5 mg daily. Records confirm previous prescribing by their UK GP; interview confirms immediate need, an appropriate unchanged dose and inability to obtain a prescription without undue delay. A justified seven-day supply can meet the patient-request route when the remaining legal requirements are completed.

Apply it

A hospital list and a patient's account show different Parkinson's medicine times. Establish the actual pre-admission regimen, clarify the intended current plan with the care team and communicate the reconciled schedule to the people administering the medicines.

Apply it

For seven amlodipine 5 mg tablets supplied after the required interview, record the patient's address and why a prescription could not be obtained in time. Label the actual quantity, confirmed daily instructions and required particulars, including 'Emergency Supply'.