NABP NABP-NAPLEX Online Practice Questions and Exam Preparation

NABP NABP-NAPLEX Online Questions & Answers

• Question 91:

  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.

  It is recommended to monitor complete blood count in patients on chronic metformin because of what reason?

  A. Metformin may decrease erythropoietin level
  B. Metformin may decrease platelet count
  C. Metformin may decrease vitamin B12 levels
  D. Metformin may cause leukocytosis
  E. Metformin may decrease iron absorption
  C. Metformin may decrease vitamin B12 levels

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  Metformin may impair the absorption of vitamin B12, especially in those with inadequate vitamin b12 or calcium intake/absorption. Vitamin b12 deficiency can be treated with discontinuation of therapy or supplementation. Vitamin b12 serum concentrations should be monitored periodically with long-term therapy.

• Question 92:

  A physician orders 300gms of albumin post paracentesis, how many milliliters of 25% albumin do you need to give 300gms?

  A. 300ml
  B. 25ml
  C. 100ml
  D. 1200ml
  E. 1000ml
  D. 1200ml

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  25g/100ml = 300g/Xml Xml = 1200mL

• Question 93:

  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?

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

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  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 94:

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

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

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  It is not necessary that all the drugs get completely absorbed after oral administration. Most of them are incompletely absorbed. The extent of absorption varies from 5 to less than 100 % with oral ingestion of drugs. Drugs which are too hydrophilic like atenolol are incompletely absorbed because the drug cannot cross the lipid membrane due to high hydrophilic nature of the drug. Similarly, drugs which are too lipophilic like acyclovir are not soluble enough to cross the water layer adjacent to the cell. Pglycoprotein is an efflux transporter which is present in the enterocytes and it inhibits absorption of drug. It is also known as export transporter or reverse transporter. It has many drugs as its substrate. Grape juice in fact inhibits P-glycoprotein in the intestine thereby decreasing the efflux of drug from the cells by P-glycoprotein. Thus ingestion of grape juice may lead to significantly increased absorption of the drug.

• Question 95:

  In a study where Rivaroxaban was compared to enoxaparin to find total VTE following HIP replacement surgery, there were 17 total VTE out of 1513 patients in the Rivaraoaban group and 57 total VTE out of 1473 patient in the enoxaparin group. What is the relative risk reduction of using Rivaroxaban over Enoxaparin?

  A. 39%
  B. 71%
  C. 29%
  D. 14%
  E. 42%
  B. 71%

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  Relative risk reduction: 0.71 = 71% Relative risk: (Event rate in rivaroxaban group)/(Event rate in enoxaparin group) = (17/1513)/(57/1473) = 0.2903 Relative risk reduction: 1

• Question 96:

  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.

  A. 14 mls
  B. 132 mls
  C. 96 mls
  D. 86 mls
  E. 36 mls
  B. 132 mls

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  If 40mg of amoxicillin are needed per kg of body weight, then the dose of amoxicillin is 40mg multiplied by the patient's body weight. This patient weighs 18 lbs, based on the conversion of 2.2 lbs = 1 kg, the patient weighs 8.2 kg. 40 mg multiplied by 8.2 kg is equal to 328 mg, this is one dose of amoxicillin. If the amoxicillin comes in 250 mg/5 mL, then it needs to be determined how many mLs it will take to get 328 mg of amoxicillin. In order to do this 328 mg needs to be divided by 250 mg to get a ratio. This comes out to be 1.312. This ratio can be multiplied by the number of mLs it takes to make up 250 mg, which is 5 mLs. 1.312 multiplied by 5 mLs is 6.56 mL, this is how many mLs it will take to have 328 mg. This volume is for 1 single dose of amoxicillin. The patient is receiving 2 doses per day and for a total of 10 days, this means the patient will be receiving 20 doses. 20 doses multiplied by 6.56 mL doses equals the total volume the patient will be receiving, which is 131.2 mL.

• Question 97:

  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?

  A. Lisinopril
  B. Dexamethasone
  C. Famotidine
  D. Metoclopramide
  E. Hydromorphone
  B. Dexamethasone

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  Dexamethasone is associated with psychiatric disturbances. Corticosteroids may exacerbate pre-existing psychiatric conditions.

• Question 98:

  A physician orders Dopamine 5 mcg/kg/min. The concentration of the Dopamine IV bag is 400 mg in 250 D5W. The patient's weight is 168 lbs. Calculate the infusion rate in mL/hr.

  A. 10.2mls/hr
  B. 5.2mls/hr
  C. 14.29mls/hr
  D. 22.4mls/hr
  E. 0.17mls/hr
  C. 14.29mls/hr

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• Question 99:

  MT is 47-year-old man who presents to the ER with painful, red, swollen area on his left leg. His temperature is 38.4, respiratory rate 30 and heart rate 95. He has been taking cephalexin day 4 today, as prescribed by his primary care physician. His CMP is normal a CBC shows elevated WBC of 16,000/mm3. What would be the most appropriate antibiotic/s to initiate on MT empirically?

  A. Vancomycin IV and Piperacillin/Tazobactam
  B. IV Doxycycline and Ceftazidime
  C. Nafcillin
  D. Vancomycin IV.
  E. Ceftriaxone
  A. Vancomycin IV and Piperacillin/Tazobactam

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  This patient is displaying signs of a severe case of cellulitis. Severe cellulitis is defined as having one of the following: failed oral antibiotic treatment, immunocompromised, clinical signs of deeper infection, or meeting the SIRS criteria. Based on this patient's presentation they have failed antibiotic treatment and meet SIRS criteria. For severe cellulitis, IDSA SSTI guidelines recommend using Vancomycin along with Zosyn.

  https://academic.oup.com/cid/article/59/2/e10/2895845/Practice-Guidelines-for-the-Diagnosis-and

• Question 100:

  A Physician orders amiodarone 1 mg/min for six hours, then 0.5 mg/min thereafter. The patient's weight is 156 lbs. The concentration of the IV bag comes as 1.8 mg per ml. Calculate the infusion rate in mL/hr.

  A. 33.33mls/hr then /16.67mls/hr
  B. 60mls/hr then 30mls/hr
  C. 30mls/hr then 15mls/hr
  D. 16.67mls/hr then 8.3mls/hr
  E. 8.3mls/hr then 4.15mls/hr
  A. 33.33mls/hr then /16.67mls/hr

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