NABP NABP-NAPLEX Online Practice Questions and Exam Preparation

NABP NABP-NAPLEX Online Questions & Answers

• Question 31:

  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?

  A. 10mg
  B. 5.3mg
  C. 4.8mg
  D. 0.5mg
  E. 52.8mg
  B. 5.3mg

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  0.2 mg/hour basal rate = 0.2mg/hour (24 hours) = 4.8 mg Demand dose of 0.1 mg ?5 = 0.5 mg 4.8 mg + 0.5 mg = 5.3 mg

• Question 32:

  How does pregabalin work in the treatment of seizures?

  A. Sodium channel blocker
  B. 2 ligand
  C. AMPA receptor antagonist
  D. GABA agonist
  E. SV2A binder
  B. 2 ligand

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  Pregabalin works as a ligand of the auxiliary 2 subunit site of certain voltage-dependent calcium channels (VDCCs), and thereby acts as an inhibitor of 2 subunit-containing VDCCs.

• Question 33:

  What is the active ingredient found in the medicine Adalat?

  A. Nifedipine
  B. Adalimumab
  C. Digoxin
  D. Simvastatin
  A. Nifedipine

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• Question 34:

  The administration of dapsone gel for the topical treatment of acne vulgaris in patients with G6PD deficiency may produce which of these?

  A. Anaphylaxis
  B. Fungal infections
  C. Hemolysis
  D. Immunosuppression
  C. Hemolysis

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• Question 35:

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

  A. Dexamethasone
  B. Nifedipine
  C. Misoprostol
  D. Methotrexate
  E. Prednisolone
  A. Dexamethasone

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  Dexamethasone is used to promote fetal lung maturation. This may be necessary in cases of women who need to deliver prematurely. A tocolytic drug, such as nifedipine, may be used to suppress labor whilst dexamethasone works to accelerate fetal lung development.

• Question 36:

  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?

  A. 5mg
  B. 10mg
  C. 7mg
  D. 13mg
  E. 9.7mg
  E. 9.7mg

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• Question 37:

  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?

  A. CYP3A4
  B. CYP2C9
  C. CYP2C19
  D. CYP2D9
  E. CYP1A2
  C. CYP2C19

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  Omeprazole is CYP2C19 inhibitor which can prolong the elimination of warfarin, particularly R-warfarin. R-warfarin is partially metabolized by CYP2C19. The combined use of omeprazole and warfarin has been associated with reports of increased INR and prothrombin time (PT).

• Question 38:

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

  A. Miglitol
  B. Linagliptin
  C. Pioglitazone
  D. Exenatide
  E. Empagliflozin
  E. Empagliflozin

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  Empagliflozin is a SGLT2 inhibitor to decrease glucose reabsorption in the kidney. Linagliptin is a DPP-4 inhibitor that works on incretins/increase insulin secretion/decrease glucagon secretion. Pioglitazone is a TZD that increases insulin sensitivity. Exenatide is a GLP-1 agonist which increase insulin secretion/decrease glucagon secretion/increase satiety.

• Question 39:

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

  A. Benign prostatic hyperplasia
  B. Heart failure
  C. Dehydration
  D. Renal vein thrombosis
  A. Benign prostatic hyperplasia

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  Benign prostatic hyperplasia (BPH) is an example of postrenal acute kidney injury (AKI). Postrenal AKI, as the name suggests, involves an effect `post' or `beyond' the kidney, to problems that emerge downstream from the kidney. BPH is one such example of that. Other examples include kidney stones, bladder stones and bladder cancer.

• Question 40:

  Your patient is a 43-year-old male who is experiencing post-operative voiding difficulty after an elective inguinal hernia repair. His post void residual volume was 280 cc.

  Which of the following medications is the most appropriate choice of therapy for this patient?

  A. Bethanechol
  B. Oxybutynin
  C. Phenylephrine
  D. Finasteride
  E. Imipramine
  A. Bethanechol

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  The patient is experiencing a common complication of low abdominal surgery. Post-operative urinary retention occurs in almost 25% of patients after low abdominal surgical procedures. A normal post-void residual volume is less than 50 cc or urine. The effects of anesthesia and analgesia both contribute to bladder distension, decreased micturition reflex, reduction of contractility of the detrusor muscle of the bladder, and incomplete voiding. The detrusor muscle of the bladder is stimulated to contract by muscarinic cholinergic agonists. Bethanechol is a muscarinic agonist and is frequently used in this setting to improve bladder emptying. Finasteride is a drug that is a 5 alpha reductase inhibitor indicated for use in patients with bladder outlet obstruction as a result of prostatic hypertrophy. The inhibition of 5 alpha reductase decreases local conversion of testosterone to dihydrotestosterone in the prostate gland, which results in gradual shrinkage over a period of six to twelve months. Phenylephrine is an alphaadrenergic agonist that is selective for alpha-1 receptors. Activation of the alpha 1 receptors in the bladder results in contraction of the trigone muscle and sphincter. This promotes urinary retention. Oxybutynin is an antimuscarinic agent that is useful for treatment of urge incontinence, and would have a detrimental effect on this patient's bladder disorder. Imipramine is a medication with anticholinergic properties that would also cause worsening of the patient's condition. Take home message: Post-operative urinary retention with concomitant incomplete voiding is a complication that results from a decreased micturition reflex, increased vesical sphincter tone, or decreased contractility of the detrusor muscle of the bladder. It can be successfully treated with a muscarinic agonist, such as bethanechol, or with an alpha-1 adrenergic antagonist.