NABP NABP-NAPLEX Online Practice Questions and Exam Preparation

NABP NABP-NAPLEX Online Questions & Answers

• Question 21:

  What indication usually requires higher dose of proton pump inhibitor?

  A. Helicobacter pylori
  B. Esophagitis
  C. Duodenal ulcer
  D. Stress ulcer prophylaxis
  E. Zollinger-Ellison syndrome
  E. Zollinger-Ellison syndrome

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  The diagnosis of Zollinger-Ellison syndrome is suggested when plasma gastrin is > 1000 pg/ml and the basal acid output is > 15 mEq/h or when associated with a pH andlt; 2. The treatment is focused on controlling gastric acid hypersecretion and localisation of the tumour and its metastases. Proton pump inhibitors are the most effective antisecretory drugs and can be administered at high dosages

• Question 22:

  All of the following may increase triglycerides except:

  A. Protease inhibitor
  B. Bile acid sequestrants
  C. Fish oil
  D. Oral estrogens
  E. Glucocorticoids
  C. Fish oil

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  Agents that can cause elevated triglycerides: oral estrogens, glucocorticoids, bile acid sequestrants, protease inhibitors, retinoic acid, anabolic steroids, sirolimus, raloxifene, tamoxifen, beta blockers (not carvedilol), and thiazides.

• Question 23:

  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?

  A. 43 mls/min
  B. 53 mls/min
  C. 63 mls/min
  D. 33 mls/min
  E. 23 mls/min
  D. 33 mls/min

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  ABW = 85 kg IBW = 50 kg + 2.3 kg (4) = 59.2 kg 85/59.2 = 1.44 AdjBW = 59.2 kg + 0.4(85 kg-59.2 kg) = 69.52 kg CrCl (IBW) = [(140-84) 59.2]/(72 × 1.4) = 32.8 CrCl (AdjBW) = [(140-84) 69.52]/(72 × 1.4) = 38.6

• Question 24:

  What is the weight of 1000 ml of serum protein whose specific gravity is 1.27?

  A. 1270 gm
  B. 127mg
  C. 12.7mg
  D. 12.7gm
  E. 1.27gm
  A. 1270 gm

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  SG= weight/mL, 1.27 = x/1000ml, x = 1270gm

• Question 25:

  Which of the following Anti-epileptic medication can cause pancreatitis?

  A. Carbamazepine
  B. Gabapentin
  C. Valproic acid
  D. Levetiracetam
  E. Phenobarbital
  C. Valproic acid

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  Cases of life-threatening pancreatitis have been reported in both pediatric and adult patients receiving valproic acid or its analogs. Patients should be warned that abdominal pain, nausea, vomiting, and/or anorexia can be symptoms of pancreatitis that require prompt medical evaluation. If pancreatitis is diagnosed, valproate should be discontinued.

  http://www.clinicalpharmacology-ip.com/Forms/Monograph/monograph.aspx?cpnum=637andsec=moncontrandt=0

• Question 26:

  An 11-year-old male presents with his mother to your clinic with 5 days of frequent diarrhea, occasionally with streaks of blood mixed in. Stool cultures are pending, but preliminary stool samples demonstrate fecal WBC and RBC.

  Assuming the patient is stable enough for outpatient management, what would be the optimal treatment assuming the underlying pathogen is Shigella?

  A. Oral Erythromycin
  B. Oral Metronidazole
  C. Oral Vancomycin
  D. An oral quinolone
  E. Oral TMP-SMX
  E. Oral TMP-SMX

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  Correct: E. Shigella can cause bloody diarrhea, and frequently affects young children and institutionalized patients. The pathogen is highly contagious, and is spread via fecal-oral transmission. The pathogen can lead to severe dehydration, and even cause febrile seizures in young patients. For clinically stable patients who can be managed via outpatient therapy, the optimal treatment is via PO TMP-SMX to decrease the risk of person-to-person transmission. Choice A ?Erythromycin is the first line treatment for bloody diarrhea caused by the pathogen campylobacter. However, for the purposes of decreasing transmissibility of suspected Shigella, TMP-SMX remains the mainstay of therapy. Choices B + C ?Oral metronidazole and oral vancomycin can both be used in the treatment of Clostridium deficile. Alternatively, intravenous metronidazole can be given if the patient is unable to tolerate oral medications. Choice D ?Oral quinolones can be used in cases of bloody diarrhea in which salmonella is the suspected pathogen. Salmonella is caused by the ingestion of contaminated poultry and/or eggs, and can ultimately lead to bacteremia in 5-10% of cases.

• Question 27:

  You get an order for 5% amino acid 15% dextrose premixed parenteral nutrition solution, 2 L at 83mls/hr. Your pharmacy technician tells you there is manufacture's backorder on those. How many ml of 20% dextrose would you need to provide the same amount of dextrose in 24 hrs?

  A. 1000ml
  B. 1400ml
  C. 1500ml
  D. 200ml
  E. 2500ml
  C. 1500ml

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  15% dextrose = 15gm/100ml = 300gm/2000ml. Patient needs 300gm. 300gm/Xml = 20gm/100ml = 1500ml

• Question 28:

  Calculate the Osmolarity of 3% hypertonic saline?

  A. 1026 mOsmol/L
  B. 76.9mOsmol/L
  C. 287 mOsm/L
  D. 565 mOsm/L
  E. 327 mOsm/L
  A. 1026 mOsmol/L

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• Question 29:

  What is the mEq/ml (Milliequivalents) of 50% Magnesium Sulfate? (Molecular weight of MgSO4 is 120.4g/mol.)

  A. 8.3mEq/ml
  B. 4.11mEq/ml
  C. 62mEq/ml
  D. 50mEq/ml
  E. 2.06mEq/ml
  B. 4.11mEq/ml

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  50gm/100ml × 1equiv/120.4gm × 1000meq/1equiv = 4.16meq/ml

• Question 30:

  Mesna is typically administered alongside which of these chemotherapeutic agents?

  A. Busulfan
  B. Paclitaxel
  C. Ifosfamide
  D. Doxorubicin
  C. Ifosfamide

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  Mesna is administered to patients taking either ifosfamide or cyclophoshamide to conjugate toxic acrolein and therefore prevent hemorrhagic cystitis (bladder bleeding).