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NABP-NAPLEX Real Exam Questions

North American Pharmacist Licensure

154 questions available · Page 1 of 16

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Question 1 Single choice

Which of these ranges reflects normal serum creatinine levels?

  1. A

    0.2 - 0.5 mg/dL

  2. B

    0.6 - 1.2 mg/dL

  3. C

    1.5 - 2.0 mg/dL

  4. D

    2.4 - 3.2 mg/dL

  5. E

    3.5 - 5.0 mg/dL

Show answer and explanation

Correct answer: B

Question 2 Single choice

Before use, which of the following products should be used to clean surfaces of a laminar flow hood?

  1. A

    95% ethyl alcohol

  2. B

    70% isopropyl alcohol

  3. C

    Purified water

  4. D

    Purified WFI

Show answer and explanation

Correct answer: B

Explanation

Before each use, 70% isopropyl alcohol should be used to clean surfaces of a laminar flow hood.

Question 3 Single choice

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?

  1. A

    Dapsone is bacteriostatic because of its inhibitory effects on dihydrofolate reductase

  2. B

    Dapsone is bacteriostatic because of its inhibitory effects on myeloperoxidase

  3. C

    Clofazimine is bactericidal by directly inhibiting bacterial DNA polymerase

  4. D

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

  5. E

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

Show answer and explanation

Correct answer: E

Explanation

A, B ?false ?dapsone inhibits bacterial synthesis of dihydrofolic acid, via competition with para-aminobenzoate for the active site of dihydropteroate synthetase. Dapsone is both bacteriostatic and weakly bactericidal against M. leprae. Neither of the listed mechanisms are the cause of these effects. C ?
False ?A substance with both anti-leprosy and anti-inflammatory activity, clofazimine is weakly bactericidal against M. leprae by binding to the guanine bases of bacterial DNA, not DNA polymerase directly. D ?
False ?See below. E ?True ?Rifampin is bactericidal by inhibiting RNA synthesis by blocking DNA-dependent RNA polymerase.

Question 4 Single choice

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?

  1. A

    Clindamycin

  2. B

    Amoxicillin

  3. C

    Cefalexin

  4. D

    Clarithromycin

Show answer and explanation

Correct answer: B

Explanation

Amoxicillin is a penicillin and so should be avoided in patients even with a non-immediate allergy. Acute treatment should be administered with one of the other listed options.

Question 5 Single choice

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?

  1. A

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

  2. B

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

  3. C

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

  4. D

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

  5. E

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

Show answer and explanation

Correct answer: E

Explanation

Since LN used 3 mg of hydromorphone, this would be equivalent to a total of morphine 60 mg po daily.
Since you would start with 70-80% of that dose, Morphine 15mg ER po q12hr and morphine 5mg po q6h prn breakthrough pain would be appropriate regimen.

Question 6 Single choice

A fasting blood glucose level greater than what value is an indicator of type 2 diabetes?

  1. A

    5 mmol/L

  2. B

    6 mmol/L

  3. C

    7 mmol/L

  4. D

    8 mmol/L

  5. E

    9 mmol/L

Show answer and explanation

Correct answer: C

Explanation

A fasting blood glucose level of greater than 7 mmol/L (or greater than 126mg/dL) is an indicator of type 2 diabetes.

Question 7 Single choice

What is the Osmolarity of NS with KCL 40 meq/L? (MW of KCl: 74.55 g/mol) (MW of NaCl: 58.44 g/mol)

  1. A

    800 mOsm/L

  2. B

    308 mOm/L

  3. C

    1108 mOsm/L

  4. D

    830 mOsm/L

  5. E

    388 mOsm/L

Show answer and explanation

Correct answer: E

Question 8 Single choice

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?

  1. A

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

  2. B

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

  3. C

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

  4. D

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

  5. E

    None of the above are correct

Show answer and explanation

Correct answer: D

Explanation

Odds ratio of 0.44 (44%) means that this group was associated with an event happening 44% of the time, compared to 1 (an event happening 100% of the time if unexposed), therefore 100 - 44 = 56%, which is the reduction caused by the exposure. Exposure is the use of ascorbic acid.

References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1112884/

Question 9 Single choice

What is the standard loading dose for clopidogrel in the treatment of ACS?

  1. A

    75mg

  2. B

    100mg

  3. C

    150mg

  4. D

    200mg

  5. E

    300mg

Show answer and explanation

Correct answer: E

Explanation

300mg is the standard loading dose of clopidogrel ?an antiplatelet drug ?in the treatment of acute coronary syndrome (ACS).

Question 10 Single choice

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

  1. A

    Metformin

  2. B

    Activated charcoal

  3. C

    N-acetylcysteine

  4. D

    Spironolactone

  5. E

    Mannitol

Show answer and explanation

Correct answer: C

Explanation

N-acetylcysteine can be used to prevent contrast-induced nephropathy. Whilst evidence is not overwhelming for use in favor, it does appear to have a clinical impact. N-acetylcysteine is typically given the day before treatment and the day when treatment commences. Other means to prevent contrast-induced nephropathy include adequate hydration, while some studied recommend ascorbic acid.