Common Registration Assessment, Part 1

Fluticasone inhaler puffs, nebule doses and steroid cards for the GPhC assessment

Three original practice questions, with the working shown. Read the stated prescription or plan before calculating.

Published 30 October 2026. Independent revision material, not GPhC questions, not for patient care.

Person holding and using an inhaler indoors
Photo from Pexels, used under the Pexels licence. It is a stock image and does not show the exercise.

The NHS lists the usual dose of inhaled fluticasone as 1 or 2 puffs taken twice a day, and the usual nebuliser dose as 0.5mg to 2mg breathed in from the nebuliser machine twice a day.

The NHS advises that anyone taking more than 400 micrograms of fluticasone a day, for example 250 micrograms twice a day, should ask their doctor, nurse or pharmacist whether they need to carry a blue steroid treatment card, a red steroid emergency card, or both.

The NHS states that inhalers come in different strengths and that a prescriber may advise more than 2 puffs at a time depending on symptoms and the inhaler used.

Each question fixes the values needed for its arithmetic. Write the unit beside every step and distinguish a single dose from a daily total or course supply. All prescriptions and patients here are fictional; these are revision materials, not for patient care.

The method

  1. Identify the formulation (inhaler puffs or nebuliser) and the stated strength.
  2. Calculate one occasion first, then scale to the stated frequency and duration.
  3. Add morning and evening doses to get a daily total before comparing with the 400 micrograms threshold.
  4. Keep puffs, micrograms and mg as separate units; convert mg to micrograms by multiplying by 1,000 only when asked.
  5. Apply the steroid card threshold exactly as stated: more than 400 micrograms a day.

Three practice questions

Work each one on paper first, then open the answer. All patients and prescriptions are fictional.

Question 1

A fictional patient uses 2 puffs of a fluticasone inhaler twice a day. How many puffs is that per week?

Show the answer

Answer: 28 puffs

Working: 2 puffs x 2 times a day = 4 puffs a day; 4 x 7 days = 28 puffs per week.

Question 2

A fictional patient uses a 1mg nebule twice a day for 5 days. How many mg of fluticasone is that in total?

Show the answer

Answer: 10mg

Working: 1mg x 2 times a day = 2mg a day; 2mg x 5 days = 10mg.

Question 3

A fictional prescription is 250 micrograms twice a day. Is the daily total above the 400 micrograms a day threshold the NHS gives for asking about a steroid card?

Show the answer

Answer: Yes, 500 micrograms a day

Working: 250 micrograms x 2 = 500 micrograms a day; 500 is more than 400, so the stated threshold is passed.

NHS: How and when to use inhaled fluticasone

https://www.nhs.uk/medicines/fluticasone-inhalers/how-and-when-to-use-inhaled-fluticasone/

Where marks are lost

  • Comparing a single dose with the 400 micrograms daily threshold instead of the daily total.
  • Mixing nebule mg with inhaler micrograms without converting.
  • Treating arithmetic as evidence that a real prescription is clinically suitable.

Frequently asked questions

Are these official assessment questions?

No. They are original revision exercises, not official GPhC questions and not for patient care.

Does passing the threshold mean a card is always needed?

The NHS says to ask a doctor, nurse or pharmacist. The arithmetic only checks the stated daily total against the stated threshold.

How should I check the answer?

Check the requested unit, then work backwards from the quantity to the stated dose and duration.

Sources

The questions above are original and use fictional patients and prescriptions. PreRegExamPrep is not affiliated with or endorsed by the General Pharmaceutical Council.

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More calculation topics

See also the formula sheet, the eight sample questions and the approved calculator page.