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100+ Free GPhC CRA Part 2 Practice Questions

Pass your GPhC Registration Assessment (Common Registration Assessment) Part 2 - Clinical (SBA/EMQ) exam on the first try — instant access, no signup required.

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A patient newly started on levothyroxine for hypothyroidism asks when they should take it. Which is the most appropriate counselling advice?

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GPhC Registration Assessment (Common Registration Assessment) Part 1 - Calculations

Practice Questions

Sample GPhC CRA Part 2 Practice Questions

Try these sample questions to test your GPhC CRA Part 2 exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 58-year-old man with type 2 diabetes and an eGFR of 72 mL/min/1.73m2 has a clinic blood pressure of 158/96 mmHg confirmed on ambulatory monitoring. He is of white European origin and takes metformin only. Which is the most appropriate first-line antihypertensive to add?
A.Amlodipine
B.Doxazosin
C.Indapamide
D.Ramipril
Explanation: NICE NG136 recommends an ACE inhibitor (or ARB) as first-line for hypertension in any adult with type 2 diabetes regardless of age or ethnicity, because of additional renoprotective benefit. Ramipril is the appropriate choice here.
2A 70-year-old woman with newly diagnosed non-valvular atrial fibrillation has a CHA2DS2-VASc score of 4 and an eGFR of 55 mL/min/1.73m2. She has no contraindication to anticoagulation. Which is the most appropriate management to prevent stroke?
A.Aspirin 75 mg daily
B.No antithrombotic therapy
C.Clopidogrel 75 mg daily
D.Apixaban
Explanation: NICE NG196 recommends a direct-acting oral anticoagulant (DOAC) such as apixaban as first-line for stroke prevention in non-valvular AF when the CHA2DS2-VASc score indicates anticoagulation is warranted (here a score of 4). Apixaban does not require routine INR monitoring.
3A 62-year-old man is started on atorvastatin 80 mg for secondary prevention after an NSTEMI. Three months later his liver function should be checked. At what threshold of serum transaminase elevation does the BNF advise stopping the statin?
A.Above the upper limit of normal
B.Greater than 2 times the upper limit of normal
C.Greater than 3 times the upper limit of normal
D.Greater than 5 times the upper limit of normal
Explanation: The BNF advises that statins should be discontinued if serum transaminases rise to and persist above 3 times the upper limit of normal. Mild, transient rises below this do not usually require cessation.
4A 75-year-old woman taking warfarin presents with an INR of 8.2 but no bleeding. Her target INR range is 2.0-3.0. Which is the most appropriate immediate management according to the BNF?
A.Continue warfarin and recheck INR in one week
B.Stop warfarin and give intravenous vitamin K 5 mg
C.Stop warfarin and give oral phytomenadione 1-5 mg, restarting when INR is below 5.0
D.Give prothrombin complex concentrate immediately
Explanation: For a major INR rise (5.0-8.0 with no bleeding the BNF advises withholding 1-2 doses; for INR above 8.0 with no bleeding, stop warfarin and give small oral doses of phytomenadione (vitamin K1) 1-5 mg, restarting warfarin once the INR falls below 5.0.
5A patient with chronic heart failure with reduced ejection fraction (HFrEF) is already taking ramipril and bisoprolol but remains symptomatic. Spironolactone is being considered. Which monitoring parameter is most important before and after starting spironolactone?
A.Serum potassium and renal function
B.Full blood count
C.Liver function tests
D.Thyroid function tests
Explanation: Adding a mineralocorticoid receptor antagonist such as spironolactone to an ACE inhibitor risks hyperkalaemia and worsening renal function. The BNF and NICE advise checking serum potassium and renal function before starting and during treatment.
6A 60-year-old man presents to the pharmacy with central crushing chest pain radiating to his left arm for the last 20 minutes, sweating and breathlessness. He has a GTN spray but no relief after two doses. Which is the most appropriate immediate action?
A.Advise him to use a third dose of GTN and wait
B.Give 75 mg aspirin and advise rest at home
C.Refer him to make a routine GP appointment
D.Give 300 mg aspirin to chew and call 999 for an emergency ambulance
Explanation: This presentation is consistent with an acute coronary syndrome. UK practice is to call 999 immediately and give aspirin 300 mg (chewed or dispersed) unless contraindicated, as early aspirin reduces mortality in suspected MI.
7A patient on amlodipine for hypertension reports troublesome ankle swelling. Examination confirms bilateral peripheral oedema with no signs of heart failure. Which is the most appropriate advice?
A.This is a recognised dose-related side effect of amlodipine and the prescriber should review the dose or switch class
B.Stop all antihypertensive treatment immediately
C.Add furosemide to relieve the oedema
D.Reassure that this is an allergic reaction requiring antihistamines
Explanation: Peripheral (ankle) oedema is a common, dose-related side effect of dihydropyridine calcium-channel blockers such as amlodipine, caused by precapillary vasodilation. The appropriate action is prescriber review to reduce the dose or change antihypertensive class.
8A 55-year-old patient is prescribed bisoprolol for angina. He also has a history of asthma with frequent exacerbations. Which is the most appropriate advice to communicate to the prescriber?
A.Bisoprolol is contraindicated in asthma and an alternative anti-anginal should be considered
B.The dose of bisoprolol should simply be halved
C.Add a long-acting beta2 agonist to counteract the beta-blocker
D.Bisoprolol is fully cardioselective so asthma is not a concern
Explanation: Beta-blockers, including relatively cardioselective agents like bisoprolol, can cause bronchospasm and the BNF advises they should be avoided in patients with a history of asthma; where unavoidable, only under specialist supervision. An alternative anti-anginal such as a CCB should be considered.
9A patient taking simvastatin 40 mg at night is started on clarithromycin for a chest infection. Which is the most appropriate action regarding the statin?
A.Continue simvastatin unchanged
B.Increase simvastatin to 80 mg
C.Temporarily stop simvastatin during the clarithromycin course
D.Switch simvastatin to a once-weekly dose
Explanation: Clarithromycin is a potent CYP3A4 inhibitor and markedly increases simvastatin exposure, raising the risk of myopathy and rhabdomyolysis. The BNF advises avoiding the combination; simvastatin should be temporarily withheld during the clarithromycin course.
10Which of the following best describes the correct counselling point for a patient newly prescribed sublingual glyceryl trinitrate (GTN) spray for angina?
A.Swallow the spray with water for best effect
B.Store the spray in the refrigerator at all times
C.Use the spray every morning to prevent attacks
D.Use one to two sprays under the tongue when chest pain occurs and call 999 if pain persists after a second dose 5 minutes later
Explanation: GTN spray is taken sublingually at the onset of an angina attack. Patients are advised to repeat the dose after 5 minutes if pain persists and to call 999 if pain continues after the second dose, as this may indicate a myocardial infarction.

About the GPhC CRA Part 2 Exam

Part 2 of the GPhC Common Registration Assessment assesses safe and effective pharmacy care of the public through 120 SBA and EMQ questions in 150 minutes. It prioritises application of clinical, legal and calculation knowledge to realistic UK patient scenarios over factual recall, aligned to the BNF, BNFC and IETP 2021 standards.

Assessment

Computer-based Part 2 of the CRA: 120 multiple-choice questions comprising 90 Single Best Answer (SBA, five options each) and 30 Extended Matching Questions (15 EMQ sets of two, eight options each).

Time Limit

150 minutes (2.5 hours)

Passing Score

Varies by sitting; set using a modified Angoff method plus one Standard Error of Measurement and maintained via Item Response Theory. Both Part 1 and Part 2 must be passed in the same sitting with no compensation. Example: June 2025 Part 2 pass mark 79/120.

Exam Fee

GBP 208 application fee per attempt (non-refundable), covering both parts of the assessment in one sitting. (General Pharmaceutical Council (GPhC), UK)

GPhC CRA Part 2 Exam Content Outline

70%

Clinical therapeutics

Applied SBA/EMQ scenarios across 15 BNF/BNFC therapeutic areas, ordered by prevalence from cardiovascular to drug toxicity, including high-risk drug classes and special patient populations.

20%

Law, governance and regulation

UK pharmacy law and ethics: controlled drugs, prescription requirements, supply mechanisms, MHRA safety alerts and recalls, consent, safeguarding, confidentiality and professional standards.

10%

Pharmacy and healthcare calculations

Multi-step calculations embedded in Part 2 scenarios: doses, infusion and drip rates, concentrations, dilutions, pharmacokinetics and medical statistics.

How to Pass the GPhC CRA Part 2 Exam

What You Need to Know

  • Passing score: Varies by sitting; set using a modified Angoff method plus one Standard Error of Measurement and maintained via Item Response Theory. Both Part 1 and Part 2 must be passed in the same sitting with no compensation. Example: June 2025 Part 2 pass mark 79/120.
  • Assessment: Computer-based Part 2 of the CRA: 120 multiple-choice questions comprising 90 Single Best Answer (SBA, five options each) and 30 Extended Matching Questions (15 EMQ sets of two, eight options each).
  • Time limit: 150 minutes (2.5 hours)
  • Exam fee: GBP 208 application fee per attempt (non-refundable), covering both parts of the assessment in one sitting.

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

GPhC CRA Part 2 Study Tips from Top Performers

1Practise applying the BNF and BNFC to patient scenarios rather than memorising isolated facts - most Part 2 questions test clinical judgement and decision-making.
2Know the high-risk drug classes (anticoagulants, insulins, opioids, methotrexate, valproate, narrow therapeutic index drugs) and the relevant MHRA safety alerts and monitoring requirements.
3Be confident with embedded calculations (doses, infusion rates, concentrations, NNT) and core UK pharmacy law such as controlled-drug schedules, prescription validity, and emergency supply.

Frequently Asked Questions

How many questions are in GPhC CRA Part 2 and how long is it?

Part 2 has 120 multiple-choice questions - 90 Single Best Answer and 30 Extended Matching Questions - to be completed in 150 minutes (2.5 hours).

What is the pass mark for the GPhC Registration Assessment?

There is no fixed percentage; the pass mark is set per sitting using a modified Angoff method plus one Standard Error of Measurement. Candidates must pass both Part 1 and Part 2 in the same sitting, with no compensation. In June 2025 the Part 2 pass mark was 79 of 120.

What changed for the 2026 sittings?

From 2026, learning outcome 37 on independent prescribing (the act of prescribing) is not assessed in the CRA and is overseen by the Statutory Education Body instead. The exam format and content otherwise remain the same for all trainees.

Where and how is the exam delivered?

The CRA is a computer-based assessment delivered at test centres across the UK on the Surpass Assessment platform, jointly administered by the GPhC and the Pharmaceutical Society of Northern Ireland.