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NAPLEX North American Pharmacist Licensure Examination Questions and Answers

Questions 4

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 5

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 4mg iv q6h prn for N/V, Levothyroxine 0.075 mg 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 135 mmol/L.

Which of the following medication may cause psychotic episode such as emotional lability, hallucinations, mania, mood swings and schizophrenic reasons?

Options:

A.

Lisinopril

B.

Dexamethasone

C.

Famotidine

D.

Metoclopramide

E.

Hydromorphone

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Questions 6

What is the standard oral weekly dose of alendronate given to treat osteoporosis?

Options:

A.

10mg

B.

70mg

C.

140mg

D.

200mg

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Questions 7

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.

What is LN’s creatinine clearance using Cockcroft and Gault equation based on IBW?

Options:

A.

43 mls/min

B.

53 mls/min

C.

63 mls/min

D.

33 mls/min

E.

23 mls/min

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Questions 8

Which of the following is true regarding extent of absorption of drugs?

Options:

A.

After oral ingestion of drugs, the absorption of drug may be incomplete

B.

Drugs which are too lipophilic cannot cross the lipid cell membrane

C.

Drugs which are too hydrophilic are not soluble enough to cross the water layer adjacent to the cell

D.

P-glycoprotein is an efflux transporter which is present in the enterocytes and it enhances the absorption of drug

E.

Grape juice activates P-glycoprotein leading to substantial inhibition of absorption of drugs

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Questions 9

An order is received for 0.03 units /min of vasopressin for Sepsis to maintain MAP >65. The standard mixed in your hospital for vasopressin is 40 units in 100ml NS.

What is the rate in mLs/hr should the vasopressin be infused at?

Options:

A.

4.0 ml/hr

B.

4.9ml/hr

C.

4.5ml/hr

D.

3.5ml/hr

E.

6ml/hr

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Questions 10

You receive an order for 40mg/kg/dose of Amoxicillin every 12 hours. Pt’s weight is 18 lbs. You have 250mg/5ml of amoxicillin suspension.

Calculate the total amount in milliliters needed for 10-day supply. Round up your answer to the nearest 1.

Options:

A.

14 mls

B.

132 mls

C.

96 mls

D.

86 mls

E.

36 mls

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Questions 11

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 12

A patient with acute pharyngitis caused by group A Streptococcus (strep throat) is allergic to penicillins (non- immediate type), which of the following is NOT recommended as treatment?

Options:

A.

Clindamycin

B.

Amoxicillin

C.

Cefalexin

D.

Clarithromycin

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Questions 13

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 14

FT is a 23-year-old newly diagnosed type I diabetes admitted to the hospital due to diabetes ketoacidosis. 2 days after being on insulin drip, anion gap is closed. Physician would like your help in transitioning her to subcutaneous insulin. She suggests using insulin glargine once a day and Insulin lispro three time a day at ratio of 70:30. 70 % of long and 30 % of short acting insulin. FT received average of 70 units of insulin in 24hrs.

Which of the following would be the best insulin regimen?

Options:

A.

49 units of Insulin Glargine subcutaneous daily and 7 units of Insulin Lispro subcutaneous three times a day with meals

B.

25 units of Insulin Glargine subcutaneous daily and 15 units of Insulin Lispro subcutaneous three times a day with meals

C.

40 units of Insulin Glargine subcutaneous daily and 10 units of Insulin Lispro subcutaneous three times a day with meals

D.

46 units of Insulin Glargine subcutaneous daily and 8 units of Insulin Lispro subcutaneous three times a day with meals

E.

52 units of Insulin Glargine subcutaneous daily and 6 units of Insulin Lispro subcutaneous three times a day with meals

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Questions 15

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 20 mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500mg po bid, D51/2NS

with 20K at 125 mls/hour and Hydromorphone PCA at 0.2 mg/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. Day 3 post-operation LN’s pain was much better and only used 3 mg of hydromorphone in the 24hrs.

Physician wants to change to oral morphine. What would be your best recommendation?

Options:

A.

Morphine SR 10mg po daily and morphine 5mg po q6h prn for breakthrough pain

B.

Morphine 60mg ER po daily and morphine 15mg po q6h prn breakthrough pain

C.

Morphine 30mg ER po q6hr and morphine 5mg q6h prn for breakthrough pain

D.

Morphine 15mg ER po q12hr and morphine 15mg po q6h prn for breakthrough pain

E.

Morphine 15mg ER po q12hr and morphine 5mg po q6h prn breakthrough pain

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Questions 16

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 17

Which of the following medication may increase LDL?

Options:

A.

Amiodarone

B.

Lisinopril

C.

Hydrochlorothiazide

D.

Acetaminophen

E.

Cyclosporine

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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. Liver (D)

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

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 20

What vitamin should the a patient receive to avoid Wernicke- Korsakoff syndrome?

Options:

A.

Thiamine

B.

Cyanocobalamin

C.

Folic Acid

D.

Nicotinic Acid

E.

Magnesium

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Questions 21

Which of the following class of antidiabetic medication may cause fluid retention?

Options:

A.

Bile acid sequestrant

B.

GLP-1 agonist

C.

Thiazolidinediones

D.

SGLT2 Inhibitor

E.

Alpha-glucosidase inhibitor

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Questions 22

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 20K at 125mls/hour and Hydromorphone PCA at 0.2 mg/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 may significantly cause QT prolongation?

Options:

A.

Lisinopril

B.

Levothyroxine

C.

Metformin

D.

Hydromorphone

E.

Citalopram

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Questions 23

What is the best anti-thyroid regimen in a pregnant woman who has clinically significant hyperthyroidism?

Options:

A.

Stop treatment and resume post-partum

B.

Propylthiouracil

C.

Methimazole

D.

Propylthiouracil first trimester followed by methimazole for the remainder of pregnancy

E.

Methimazole first trimester followed by propylthiouracil for the remainder of pregnancy

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Exam Code: NAPLEX
Exam Name: North American Pharmacist Licensure Examination
Last Update: May 18, 2024
Questions: 154
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