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NAPLEX Sample Questions Answers

Questions 4

CJ is a 69-year-old male with a history of diabetes, hypertension and hypercholesterolemia. His fasting lipid profile is TC 530 mg/dL; LDL-C 125; HDL-C 48 mg/dL; and TG 640 mg/dL. His A1c 8.1, calculate creatinine clearance is 65mls/hr, BP 135/80 mm Hg, HR 70 beats /min.

His current medications include metformin 1000mg po bid, lisinopril 20mg daily, sitagliptin 50mg bid and atorvastatin 40mg daily.

What is the best pharmacological agent to initiate on CJ?

Options:

A.

Increase atorvastatin to 80mg

B.

Niacin 500mg twice daily

C.

Fenofibrate 162mg daily

D.

Gemfibrozil 600mg twice daily

E.

Fish oil 500mg twice daily

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Questions 5

Select the class of Anti-diabetic medication that works in the specified organ to prevent hyperglycemia. Select all that applies. Pancreases (A)

Options:

A.

Sulfonylureas

B.

Alpha- Glucosidase Inhibitors

C.

DPP4 Inhibitors

D.

Glucagon-like peptide-1 receptor agonists

E.

Thiazolidinediones

F.

Biguanide

G.

SGLT2 inhibitors

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Questions 6

JT is a 58-year-old women who is on vancomycin empirically for pyomyositis confirmed by MRI. Surgical debridement has successfully removed infected tissue and pus. C&S of the infected tissue comes back MSSA sensitive to everything on the panel. JT is allergic to PCN (rash), she has had cephalosporin for her UTI in the past with no problem.

What would be the most appropriate antibiotics to switch to while JT is still in the hospital?

Options:

A.

Oxacillin

B.

Doxycycline

C.

Ceftaroline

D.

Daptomycin

E.

Cefazolin

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Questions 7

Which of the following NSAIDs is an Enolic acid derivative?

Options:

A.

Ibuprofen

B.

Piroxicam

C.

Naproxen

D.

Oxaprozin

E.

Fenoprofen

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Questions 8

Which of these drugs is used to promote fetal lung maturation?

Options:

A.

Dexamethasone

B.

Nifedipine

C.

Misoprostol

D.

Methotrexate

E.

Prednisolone

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Questions 9

A patient with multibacillary leprosy is on dapsone, clofazimine, and rifampin. Which of the following is true regarding the mechanism of action of the medications listed?

Options:

A.

Dapsone is bacteriostatic because of its inhibitory effects on dihydrofolate reductase

B.

Dapsone is bacteriostatic because of its inhibitory effects on myeloperoxidase

C.

Clofazimine is bactericidal by directly inhibiting bacterial DNA polymerase

D.

Rifampin is bacteriostatic by inhibiting RNA synthesis by blocking DNA-dependent RNA polymerase

E.

Rifampin is bactericidal by inhibiting RNA synthesis by blocking DNA-dependent RNA polymerase

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Questions 10

LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA. His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain.

Post-op day 1, LN’s medication includes Dexamethasone 8 mg iv q6h with taper dosing, Ondansetron 4 mg iv q6h prn for N/V, Levothyroxine 0.075 mg po daily, Lisinopril 10 mg po daily, Citalopram 20 mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10 mg suppository daily prn for constipation, Famotidine 20 mg iv q12hr, Metoclopramide 10 mg iv q6h, Metformin 500 mg po bid, D51/2NS with 20 K at 125 mls/hour and Hydromorphone PCA at 0.2 mg/hour of basal rate, demand dose 0.1 mg. lock-out every 6 min, one hour limit 2.2 mg/hour. Pertinent morning labs includes serum creatinine 1.4 mg/dl, Mg 1.5 mg/dl, K

5.0 mmol/L, Na 135 mmol/L.

Which of the following medication may increase LN’s Blood glucose?

Options:

A.

Lisinopril

B.

Dexamethasone

C.

Famotidine

D.

Metoclopramide

E.

Hydromorphone

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Questions 11

Select the class of Anti-diabetic medication that works in the specified organto prevent hyperglycemia. Select all that applies. Fat Tissue (H)

Options:

A.

Sulfonylureas

B.

Alpha- Glucosidase Inhibitors

C.

DPP4 Inhibitors

D.

Glucagon-like peptide-1 receptor agonists

E.

Thiazolidinediones

F.

Biguanide

G.

SGLT2 inhibitors

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Questions 12

LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.

His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN’s medication includes Dexamethasone 8mg iv q6h with taper dosing,

Ondansetron 4mg iv q6h prn for N/V, Levothyroxine 0.075mg po daily, Lisinopril 10mg po daily, Citalopram 20mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500mg po bid, D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dose 0.1mg. lock-out

every 6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg 1.5mg/ dl, K 5.0mmol/L, Na 135mmol/L.

LN used 5 on-demand bolus doses from the hydromorphone PCA, how much hydromorphone did the patient get in 24 hours?

Options:

A.

10mg

B.

5.3mg

C.

4.8mg

D.

0.5mg

E.

52.8mg

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Questions 13

After talking to the patient you find out LT has been incompliant with her three times a day Valproic acid, level came back at 35 mmol/L.

What is the most appropriate course of action?

Options:

A.

Notify the physician to decrease the dose of Valproic acid.

B.

Notify the physician to increse the dose of Valproic acid.

C.

Albumin needs to be obtained to calculate corrected Valproic acid level

D.

Valproic acid level is within normal limit, no adjustment is needed.

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Questions 14

When does the newer chronic kidney disease (CKD) guidelines recommend stopping metformin?

Options:

A.

when the estimated glomerular filtration (eGFR) is <30 mL/min/1.73 m2

B.

when estimated glomerular filtration (eGFR) is <50 mL/min/1.73 m2

C.

when creatinine clearance <30 ml/min

D.

when creatinine clearance <50 ml/min

E.

when serum creatinine is <1.8 mg/dL

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Questions 15

Concomitant use of warfarin and omeprazole is associated with increased INR and prothrombin time(PT). What enzyme dose the omeprazole inhibits that is metabolized by warfarin?

Options:

A.

CYP3A4

B.

CYP2C9

C.

CYP2C19

D.

CYP2D9

E.

CYP1A2

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Questions 16

Which of the following antidiabetic medication works by decreasing glucose reabsorption?

Options:

A.

Miglitol

B.

Linagliptin

C.

Pioglitazone

D.

Exenatide

E.

Empagliflozin

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Questions 17

Results from a Meta-analysis where they looked at frequency of postoperative arterial fibrillation in patients on Ascorbic acid after cardiac surgery found odds ratio, 0.44 (95% CI, 0.32 to 0.61). How can you interpret this data?

Options:

A.

Ascorbic acid increased frequency of postoperative arterial fibrillation after cardiac surgery by 44%

B.

Ascorbic acid decreased frequency of postoperative arterial fibrillation after cardiac surgery by 44%

C.

There was no statistically significant difference in frequency of postoperative arterial fibrillation after cardiac surgery

D.

Ascorbic acid decreased frequency of postoperative arterial fibrillation after cardiac surgery by 56%

E.

None of the above are correct

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Questions 18

Select the class of Anti-diabetic medication that works in the specified organ to prevent hyperglycemia. Select all that applies. Muscle (F)

Options:

A.

Sulfonylureas

B.

Alpha- Glucosidase Inhibitors

C.

DPP4 Inhibitors

D.

Glucagon-like peptide-1 receptor agonists

E.

Thiazolidinediones

F.

Biguanide

G.

SGLT2 inhibitors

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Questions 19

Which of these cardiovascular drug classes is most associated with tachyphylaxis?

Options:

A.

ACE inhibitors

B.

Angiotensin-receptor blockers

C.

Direct renin inhibitors

D.

Calcium channel blockers

E.

Nitrates

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Questions 20

A patient presents in the pharmacy in a delirious state with pinpoint pupils. Which of the following toxicity states does the patient most likely have?

Options:

A.

Alcohol

B.

Opioid

C.

Benzodiazepine

D.

Amphetamine

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Questions 21

You need 51.3 mEq of NaCl to make 1/3 NS 1 liter bag. How many ml of 23.4% NaCl would you need? (Molecular weight of Na is 23 and Cl is 35.5)

Options:

A.

12.82ml B. 16.82ml

B.

23.4ml

C.

58.5ml

D.

10ml

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Questions 22

A 27-year-old female with ovarian cancer is undergoing chemotherapy. She develops subsequent renal failure.

Which of the following drugs is most likely responsible for this?

Options:

A.

Cyclophosphamide

B.

Bleomycin

C.

Cisplatin

D.

Vinblastine

E.

Vincristine

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Questions 23

Which of the following would be most appropriate to treat infections associated with stenotrophomonas maltophilia?

Options:

A.

Meropenem

B.

Vancomycin

C.

Ciprofloxacin

D.

Sulfamethoxazole/trimethoprim

E.

Ampicillin

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Questions 24

A 54-year-old male with a long history of mild persistent asthma on daily fluticasone therapy has been using his albuterol inhaler every day for the past month, and presents requesting a refill. What changes should be made to his current regimen?

Options:

A.

Add ciclesonide to current regimen

B.

Add salmeterol to current regimen

C.

Discontinue fluticasone and instead use salmeterol

D.

Add cromolyn to current regimen

E.

Discontinue fluticasone and add ipratropium to current regimen

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Questions 25

Which of the following antidiabetic medication may cause cyanocobalamin deficiency?

Options:

A.

Saxagliptin

B.

Canagliflozin

C.

Pioglitazone

D.

Glimepiride

E.

Metformin

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Questions 26

Octreotide 50mcg/hr is ordered for a patient with esophageal varices, nurses prepared by mixing 1ml of concentration 0.5mg/ml of octreotide in 50mls NS. What rate should the bag be infused?

Options:

A.

50ml/hr

B.

5ml/hr

C.

5ml/min

D.

0.5ml/min

E.

7ml/hr

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Questions 27

Which of these drugs is used to prevent contrast-induced nephropathy?

Options:

A.

Metformin

B.

Activated charcoal

C.

N-acetylcysteine

D.

Spironolactone

E.

Mannitol

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Questions 28

JK is a 67 years old African American man who presents to your clinic for his blood pressure management. His past medical history includes Peptic ulcer disease and hypertension. His two BP readings are 160/98, 159/96 and HR 85. He says he has been adherent to his medication and lifestyle. He currently takes 12.5mg Chlorthalidone and Prilosec 20mg daily.

Which of the following is the best strategy to manage his blood pressure?

Options:

A.

Increase chlorthalidone to 25mg daily

B.

Add Norvasc 2.5 daily

C.

Add Lisinopril 5mg daily

D.

Add hydrochlorothiazide 25mg daily

E.

Add Lisinopril 20mg daily

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Questions 29

Proportion of people in a population who have a particular disease at a specified point in time or over a specified period of time is definition as which of the following?

Options:

A.

Incidence rate

B.

Prevalence rate

C.

Mortality rate

D.

Relative risk

E.

Odds ratio

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Questions 30

LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.

His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN’s medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4 mg iv q6h prn for N/V, Levothyroxine 0.075 mg po daily, Lisinopril 10 mg po daily, Citalopram 20 mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10 mg suppository daily prn for constipation, Famotidine 20 mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500 mg po bid, D51/2NS with 20K at 125 mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dose 0.1 mg. lock-out every 6min, one hour limit 2.2 mg/hour. Pertinent morning labs includes serum creatinine 1.4 mg/dl, Mg 1.5 mg/dl, K 5.0 mmol/L, Na 135 mmol/L.

Which of the following medication/s should LN be on to prevent the most common side effect of hydromorphone?

Options:

A.

Ondansetron for N/V

B.

Dexamethasone for N/V

C.

Insulin Sliding scale for hyperglycemia

D.

Docusate sodium / Senna for Constipation

E.

Docusate sodium / Senna for Constipation and ondansetron for N/V

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Questions 31

What indication usually requires higher dose of proton pump inhibitor?

Options:

A.

Helicobacter pylori

B.

Esophagitis

C.

Duodenal ulcer

D.

Stress ulcer prophylaxis

E.

Zollinger-Ellison syndrome

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Questions 32

Which of the following side effects should LT be made aware of while on Divalproex Sodium?

Options:

A.

Weight gain

B.

Oligomenorrhea

C.

Alopecia

D.

Gynecomastia

E.

Gingival hyperplasia

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Questions 33

How does pregabalin work in the treatment of seizures?

Options:

A.

Sodium channel blocker

B.

α2δ ligand

C.

AMPA receptor antagonist

D.

GABA agonist

E.

SV2A binder

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Questions 34

Aluminum levels may rise to toxic levels in patients with renal failure if administered with which of these medicines?

Options:

A.

Sucralfate

B.

Bismuth subgallate

C.

Docusate sodium

D.

Lactulose

E.

Alginates

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Questions 35

Which of the following medication may increase LDL?

Options:

A.

Amiodarone

B.

Lisinopril

C.

Hydrochlorothiazide

D.

Acetaminophen

E.

Cyclosporine

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Questions 36

Which of these is an example of postrenal acute kidney injury (AKI)?

Options:

A.

Benign prostatic hyperplasia

B.

Heart failure

C.

Dehydration

D.

Renal vein thrombosis

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Questions 37

Which of the following is dichotomous variable?

Options:

A.

Sex

B.

Pain yes/ Pain no

C.

alive / dead

D.

Grade of Breast Cancer

E.

NYHA I-IV

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Questions 38

Which of the following is/are ordinal data?

Options:

A.

NYHA I-IV

B.

Grade of breast cancer

C.

Sex

D.

Improvement Yes/No

E.

Alive or Dead

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Questions 39

LT is a 42-year-old white female with past medical history of epilepsy, gastroesophageal reflux disease and seasonal allergies. She weighs 86 kg, height 5’6” and allergic to Aspirin (rash) and Phenobarbital (difficulty breathing).

Her medications include Omeprazole 40mg daily, Phenytoin 200mg twice daily, Valproic acid 500mg four times daily, Loratadine 10mg daily. She comes to your community pharmacy to pick up prescription for Primidone 250mg twice daily.

Pertaining to Primidone what is the most appropriate action to take?

Options:

A.

Notify the physician, Primidone dose is too low.

B.

Notify the physician, Primidone in contraindicated in patient with phenobarbital allergy.

C.

Notify the physician, Primidone in contraindicated in patient with Aspirin allergy.

D.

Notify the physician, patient is already on three anti-seizure medication and primidone is not needed.

E.

Notify the physician, Primidone in contraindicated in patient with gastroesophageal reflux disease.

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Questions 40

A physician needs your help to calculate the protamine dose on a patient who started hemorrhaging while on heparin. Patient has been receiving heparin at a dose of 13mls/hr for 2 hrs when the physician decides to use protamine to reverse the heparin. Heparin bag says concentration of 50 units/ml. The half-life of heparin is 60 minutes. 1 mg of protamine reverses 100 units of heparin.

How much protamine should be given to this patient?

Options:

A.

5mg

B.

10mg

C.

7mg

D.

13mg

E.

9.7mg

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Questions 41

Which of the following class of antidiabetic medications can increase triglycerides?

Options:

A.

Bile acid sequestrant

B.

GLP-1 agonist

C.

Thiazolidinediones

D.

SGLT2 Inhibitor

E.

Alpha-glucosidase inhibitors

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Questions 42

LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.

His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN’s medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4mg iv q6h prn for N/V, Levothyroxine 0.075mg po daily, Lisinopril 10mg po daily, Citalopram 20mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500mg po bid, D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dose 0.1mg. lock-out

every 6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg 1.5mg/ dl, K 5.0mmol/L, Na 135mmol/L.

Which of the following medication’s dose are adjusted for poor renal function?

Options:

A.

Famotidine

B.

Metoclopramide

C.

Lisinopril

D.

Citalopram

E.

Ondansetron

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Questions 43

RL is a 54 YOM who’s calculated 10-year atherosclerotic cardiovascular disease (ASCVD) risk is 18 %.

Which of the following is the most appropriate pharmacotherapy recommendation for CR?

Options:

A.

Rosuvastatin 10 mg PO QHS

B.

Atorvastatin 80 mg PO QHS

C.

Lovastatin 10 mg PO QHS

D.

Pravastatin 20 mg PO QHS

E.

Atorvastatin 20mg PO QHS

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Questions 44

A CD4 count of 180 cells per cubic meter may be evaluated as which of these?

Options:

A.

Very low

B.

Low

C.

High

D.

Severely high

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Questions 45

According to the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to ReduceAtherosclerotic Cardiovascular Risk in Adults, which of the following LDL cholesterol thresholds is an indication for high- intensity statin therapy?

Options:

A.

≥ 100 mg/dL

B.

≥ 130 mg/dL

C.

≥ 190 mg/dL

D.

≥ 200 mg/dL

E.

≥ 150 mg/dL

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Questions 46

Which of the following illnesses is an example of a type III hypersensitivity reaction?

Options:

A.

Lupus

B.

Graves disease

C.

Hashiomoto’s thyroiditis

D.

Allergic rhinitis

E.

Myasthenia gravis

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Exam Code: NAPLEX
Exam Name: North American Pharmacist Licensure Examination
Last Update: May 17, 2024
Questions: 154
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