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100+ Free PSA Practice Questions

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2026 Statistics

Key Facts: PSA Exam

8 sections

Prescribing, Prescription Review, Planning Management, Providing Information, Calculation Skills, Adverse Drug Reactions, Drug Monitoring and Data Interpretation

PSA Blueprint, British Pharmacological Society and MSC Assessment

200 marks

Total marks available across about 60 items in the PSA

PSA Blueprint, British Pharmacological Society

2 hours

Time candidates are normally expected to complete the PSA in

PSA Item Writing Manual, British Pharmacological Society

80 marks

Prescribing section: eight items at 10 marks each (5 drug, 5 dose/route/frequency)

PSA Blueprint, British Pharmacological Society

Open-book

Full access to the BNF, BNF for Children and NICE interaction checker during the PSA

Prescribing Safety Assessment official site

Pass/fail

Criterion-referenced standard set to the competence of a new FY1 prescriber

Prescribing Safety Assessment official site

Final year

Sat by final-year UK medical students; a pass is required for full GMC registration

Prescribing Safety Assessment official site

100

Free original practice questions here

OpenExamPrep

The Prescribing Safety Assessment (PSA) is a national online pass/fail test of prescribing skills for final-year UK medical students and FY1 doctors, delivered by the British Pharmacological Society and MSC Assessment. It has eight sections - Prescribing, Prescription Review, Planning Management, Providing Information, Calculation Skills, Adverse Drug Reactions, Drug Monitoring and Data Interpretation - with about 60 items worth 200 marks total, completed within two hours. The Prescribing section is the heaviest, with eight items worth 10 marks each (80 marks). It is open-book with full BNF access, and the pass mark is criterion-referenced (commonly near 70%) to the standard of a new FY1 prescriber. This 100-question bank gives BNF-grounded single-best-answer practice across all eight sections.

Sample PSA Practice Questions

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

1A 60 kg adult is admitted with community-acquired pneumonia (CURB-65 score 1) and no penicillin allergy. Following local and BNF guidance for low-severity community-acquired pneumonia, which oral antibiotic regimen is the most appropriate first-line choice?
A.Amoxicillin 500 mg three times daily
B.Co-amoxiclav 625 mg three times daily plus clarithromycin
C.Ciprofloxacin 500 mg twice daily
D.Vancomycin 1 g twice daily
Explanation: For low-severity community-acquired pneumonia in a patient who is not penicillin-allergic, the BNF and NICE recommend oral amoxicillin 500 mg three times daily as first-line treatment, typically for 5 days. A macrolide is the alternative in penicillin allergy.
2A 45 kg woman in diabetic ketoacidosis needs a fixed-rate intravenous insulin infusion. According to standard UK DKA protocols, which insulin and starting rate is most appropriate?
A.Soluble human insulin (Actrapid) at 0.1 units/kg/hour
B.Insulin glargine at 0.1 units/kg/hour
C.Soluble human insulin at 1 unit/kg/hour
D.Isophane insulin as a stat subcutaneous dose
Explanation: DKA is managed with a fixed-rate intravenous infusion of soluble (short-acting) human insulin such as Actrapid at 0.1 units/kg/hour. For a 45 kg patient that is about 4.5 units/hour, alongside IV fluids and potassium replacement.
3A previously well 70 kg adult presents with anaphylaxis after a wasp sting, with stridor and hypotension. Which is the correct first-line drug, dose and route?
A.Adrenaline 500 micrograms (0.5 mL of 1 in 1000) intramuscularly
B.Adrenaline 1 mg (10 mL of 1 in 10000) intravenously
C.Chlorphenamine 10 mg intramuscularly
D.Hydrocortisone 200 mg intravenously
Explanation: The first-line treatment for anaphylaxis in an adult is intramuscular adrenaline 500 micrograms (0.5 mL of 1 in 1000), repeated after 5 minutes if needed. IM into the anterolateral thigh is the correct route.
4A hypovolaemic adult needs an initial fluid bolus for resuscitation. Which prescription is most appropriate as a first bolus?
A.Sodium chloride 0.9% 500 mL intravenously over 15 minutes
B.Glucose 5% 1 litre intravenously over 8 hours
C.Sodium chloride 0.9% 50 mL intravenously over 1 hour
D.Glucose 50% 500 mL intravenously as a bolus
Explanation: For fluid resuscitation of a hypovolaemic adult, a crystalloid bolus of 500 mL of sodium chloride 0.9% (or balanced crystalloid) given over about 15 minutes is the standard initial prescription, then reassess.
5An adult with no contraindications has moderate post-operative pain not controlled by regular paracetamol. Following the WHO analgesic ladder, which is the most appropriate next step to add?
A.Codeine 30-60 mg up to four times daily orally
B.Morphine 10 mg intravenously as required
C.Diclofenac 150 mg three times daily orally
D.Tramadol 200 mg four times daily orally
Explanation: When regular paracetamol is insufficient for moderate pain, the next step on the analgesic ladder is a weak opioid such as codeine 30-60 mg up to four times daily, continuing the paracetamol. Stronger opioids are reserved for severe pain.
6A patient with confirmed proximal deep vein thrombosis and normal renal function is to start a direct oral anticoagulant. Which initial apixaban regimen is correct for treatment of acute VTE?
A.10 mg twice daily for 7 days, then 5 mg twice daily
B.5 mg twice daily continuously from day 1
C.2.5 mg twice daily continuously
D.10 mg once daily for 21 days, then 5 mg once daily
Explanation: For treatment of DVT or PE, apixaban is started at 10 mg twice daily for the first 7 days, then reduced to 5 mg twice daily. (Rivaroxaban uses 15 mg twice daily for 21 days then 20 mg once daily, which is a common distractor.)
7An adult with an acute exacerbation of asthma requires a systemic corticosteroid. Which is the most appropriate prescription?
A.Prednisolone 40 mg orally once daily for 5 days
B.Hydrocortisone 10 mg orally once daily for 5 days
C.Dexamethasone 0.5 mg orally once daily long-term
D.Beclometasone 200 micrograms inhaled twice daily only
Explanation: An acute asthma exacerbation is treated with oral prednisolone 40-50 mg once daily for at least 5 days (or until recovery), alongside bronchodilators. A short course does not usually need tapering.
8A patient with confirmed Helicobacter pylori infection and no penicillin allergy needs first-line eradication therapy. Which 7-day regimen is most appropriate?
A.A PPI plus amoxicillin plus clarithromycin or metronidazole
B.A PPI alone for 7 days
C.Amoxicillin alone for 14 days
D.A PPI plus ciprofloxacin plus rifampicin
Explanation: First-line H. pylori eradication is a 7-day triple regimen of a proton pump inhibitor plus two antibiotics: amoxicillin and either clarithromycin or metronidazole, in a patient with no penicillin allergy.
9A 25-year-old man has a first uncomplicated tonic-clonic seizure and an epilepsy diagnosis is made; he wishes to drive in future. Which is generally the most appropriate first-line antiepileptic monotherapy for generalised seizures in a young man?
A.Lamotrigine or levetiracetam
B.Sodium valproate
C.Phenytoin
D.Carbamazepine
Explanation: For generalised tonic-clonic seizures, first-line options include lamotrigine or levetiracetam. In a young man, valproate's teratogenicity makes it a less favoured choice and it is contraindicated in women of childbearing potential without strict conditions.
10An adult with newly diagnosed type 2 diabetes, eGFR 80 mL/min/1.73m2 and no contraindications needs first-line glucose-lowering therapy alongside lifestyle measures. Which drug is most appropriate?
A.Metformin 500 mg once daily, titrated with meals
B.Gliclazide 80 mg twice daily
C.Insulin glargine at night
D.Pioglitazone 30 mg once daily
Explanation: Metformin is first-line pharmacotherapy for type 2 diabetes in a patient with adequate renal function and no contraindications. It is started low (e.g. 500 mg once daily with food) and titrated to limit GI side effects.

About the PSA Exam

The Prescribing Safety Assessment (PSA) is a national, online, pass/fail assessment of the prescribing skills, judgement and supporting knowledge expected of a newly qualified Foundation Year 1 doctor in the NHS. Developed and delivered by the British Pharmacological Society and MSC Assessment, it is based on the General Medical Council's Outcomes for graduates. Final-year UK medical students sit the PSA before graduation, and a pass is required for full GMC registration. The assessment has eight sections, each with a distinct item style: Prescribing, Prescription Review, Planning Management, Providing Information, Calculation Skills, Adverse Drug Reactions, Drug Monitoring and Data Interpretation. It is open-book, with full access to the BNF, BNF for Children and the NICE interaction checker, and offers 200 marks across about 60 items completed within two hours.

Assessment

Eight sections, each with six or eight items: Prescribing (8 items, 80 marks), Prescription Review (8 items, 32 marks), Planning Management, Providing Information, Calculation Skills, Adverse Drug Reactions, Drug Monitoring and Data Interpretation. About 60 items in total offering 200 marks.

Time Limit

Candidates are normally expected to finish within a total of two hours (120 minutes) of examination time.

Passing Score

Pass/fail and criterion-referenced. There is no fixed published pass mark; the standard is set per sitting (modified Angoff) to reflect the competence of a new FY1 prescriber, with pass marks commonly around 70%.

Exam Fee

No individual sitting fee for final-year UK medical students; the PSA is funded through participating medical schools. International or independent sittings via BPS Assessment may carry a provider-set fee. (British Pharmacological Society and MSC Assessment)

PSA Exam Content Outline

20%

Prescribing

Choose the most appropriate single drug or IV fluid with the correct dose, route and frequency for a clinical scenario. Practice here covers analgesia, antibiotics, anticoagulation, IV fluids, insulin, antiemetics and emergency prescribing, with attention to safe, legal and effective prescriptions.

14%

Prescription Review

Review a drug chart and identify the most or least appropriate item, an interaction, contraindication or prescribing error. Practice here covers polypharmacy in the elderly, renal and hepatic dose adjustment, duplicate therapy and high-risk combinations.

14%

Planning Management

Select the most appropriate initial management or treatment for a clinical situation from a list of options. Practice here covers acute presentations across medicine, surgery, psychiatry, O&G and general practice.

10%

Providing Information

Give the best counselling or safety advice to a patient about a medicine. Practice here covers how to take a drug, side effects to expect or report, monitoring and lifestyle interactions such as warfarin, methotrexate, inhalers and oral contraceptives.

14%

Calculation Skills

Perform drug dose, infusion-rate and unit-conversion calculations accurately. Practice here covers weight-based paediatric dosing, mL/hour and drops/min infusion rates, concentration conversions and dose adjustments.

12%

Adverse Drug Reactions

Recognise likely adverse reactions, identify the drug causing an effect, spot interactions and choose the best management. Practice here covers NSAIDs, diuretics, opioids, anticoagulants, antibiotics and common high-risk medicines.

8%

Drug Monitoring

Choose the most appropriate monitoring test or parameter and frequency for a medicine. Practice here covers warfarin/INR, gentamicin and vancomycin levels, lithium, methotrexate, digoxin, amiodarone and statins.

8%

Data Interpretation

Interpret results such as INR, U&Es, drug levels, blood glucose and blood gases to guide a prescribing decision. Practice here links abnormal results to the correct change in therapy.

How to Pass the PSA Exam

What You Need to Know

  • Passing score: Pass/fail and criterion-referenced. There is no fixed published pass mark; the standard is set per sitting (modified Angoff) to reflect the competence of a new FY1 prescriber, with pass marks commonly around 70%.
  • Assessment: Eight sections, each with six or eight items: Prescribing (8 items, 80 marks), Prescription Review (8 items, 32 marks), Planning Management, Providing Information, Calculation Skills, Adverse Drug Reactions, Drug Monitoring and Data Interpretation. About 60 items in total offering 200 marks.
  • Time limit: Candidates are normally expected to finish within a total of two hours (120 minutes) of examination time.
  • Exam fee: No individual sitting fee for final-year UK medical students; the PSA is funded through participating medical schools. International or independent sittings via BPS Assessment may carry a provider-set fee.

Keys to Passing

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

PSA Study Tips from Top Performers

1Practise navigating the BNF quickly: learn where interactions, monitoring, renal and hepatic dosing and pregnancy advice sit, because the PSA is open-book but time-pressured.
2Master high-yield monitoring pairs early - warfarin/INR, gentamicin and vancomycin levels, lithium, methotrexate FBC/LFTs, digoxin and amiodarone TFTs/LFTs come up repeatedly.
3For Calculation Skills, write out units at every step (mg, micrograms, mL, mL/hour) and double-check decimal places, since a single tenfold error can change a safe dose into a fatal one.
4For Prescribing items, always confirm drug, dose, route AND frequency, and remember that the marks for dose/route/frequency are capped by getting the drug right first.
5Learn the classic dangerous combinations - NSAIDs plus ACE inhibitor plus diuretic, warfarin plus antibiotics, methotrexate plus trimethoprim - so Prescription Review and ADR items are fast.
6Use timing discipline: the Prescribing section is the longest, so do not let calculations or data interpretation items eat the time you need to write eight safe prescriptions.

Frequently Asked Questions

How many sections are on the PSA?

There are eight sections: Prescribing, Prescription Review, Planning Management, Providing Information, Calculation Skills, Adverse Drug Reactions, Drug Monitoring and Data Interpretation. Each has a distinct item style and either six or eight items.

How long is the PSA and how many marks is it worth?

The PSA is completed within two hours (120 minutes) and offers a total of 200 marks across about 60 items. The Prescribing section carries the most marks, with eight items worth 10 marks each (80 marks).

Is the PSA open-book?

Yes. The PSA is an open-book online assessment with full access to the BNF, the BNF for Children and the NICE interaction checker throughout. You are expected to use them efficiently rather than memorise every detail.

What is the pass mark for the PSA?

The PSA is pass/fail and criterion-referenced. There is no fixed published pass mark; the standard is set per sitting by panel review to reflect the competence of a new FY1 prescriber, and pass marks commonly settle around 70%.

Who has to sit the PSA?

Final-year UK medical students sit the PSA before graduation, and a pass is required for full GMC registration. FY1 doctors who did not pass at medical school can resit through their deanery.

Are these official PSA questions?

No. These are original OpenExamPrep questions modelled on the eight PSA item styles and grounded in BNF prescribing practice. The British Pharmacological Society and MSC Assessment provide official practice papers separately.