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1. A 66-year-old woman presents to clinic with a chief complaint of constipation. She is a retired nurse, exercises 3 to 4 times a week, and tries to eat a balanced diet. Which of her characteristics places her at risk for CIC?

A. Gender and age B. Sedentary lifestyle and age C. Diet and gender D. Socioeconomic status

2. For the past 9 months, a patient has experienced straining during most bowel movements, hard and lumpy stool, and the feeling that bowel movements are not fully evacuated. The patient rarely has a loose stool and when he does, it is typically associated with laxative use. The patient has been evaluated for multiple gastrointestinal and endocrine conditions, but has not met criteria for diagnosis. Based upon this information, does the patient meet Rome IV criteria for CIC?

A. Yes, the patient has had symptoms for at least 9 months and has at least 2 criteria B. Yes, the patient has had symptoms for at least 6 months and other disorders were eliminated C. No, the patient has not had symptoms long enough and all causes were not eliminated D. No, the patient has not had symptoms long enough, even though they have at least 2 criteria

3. Prucalopride is selective for and exerts its mechanism of action as an agonist at which of the following receptors?

A. 5-HT₁ B. 5-HT₄ C. Na⁺/H⁺ exchanger-3 D. GHS 1a

4. Which of the following adverse effects is uniquely associated with relamorelin therapy?

A. Headache B. Diarrhea C. Vomiting D. Increased appetite

5. A patient with CIC has been instructed by her physician to begin taking an OTC laxative. Which of the following recommendations is accurate to convey to the patient?

A. Soluble fibers such as psyllium will cause more cramping and bloating than insoluble fiber B. Polyethylene glycol is more effective than other osmotic laxatives C. Stimulant laxatives cause more diarrhea and are therefore preferred for long-term treatment D. Just drink water as studies did not show any difference between OTC laxatives and placebo

6. LD presents to clinic with worsening CIC. He previously has been able to treat his symptoms with OTC laxatives, but they are not working as well anymore. He additionally has developed mild pain. Which of the following treatment options may be more effective for LD?

A. PEG 17 gm daily plus bisacodyl 10 mg daily B. Linaclotide 145 mcg daily C. Plecanatide 3 mg daily D. Both B and C are correct

7. Dyspnea has been associated with which of the following medications?

A. Plecanatide B. Lubiprostone C. Linaclotide D. Tenapanor

8. MC presents to the pharmacy with a prescription for linaclotide. During initial counseling, you learn that he takes no other medications to treat his CIC. Which of the following interventions below would be appropriate to recommend as daily add-on therapy to help with symptom control?

A. Docusate sodium B. Bran fiber C. Bisacodyl D. Senna

9. The absence of which symptom as the predominant symptom is a primary distinction between CIC and IBS-C?

A. Fewer than 3 bowel movements/week B. Straining C. Incomplete evacuation D. Pain