NABP NABP-NAPLEX Online Practice Questions and Exam Preparation

NABP NABP-NAPLEX Online Questions & Answers

• Question 41:

  Which of the following antidiabetic medication works by inhibiting carbohydrate breakdown?

  A. Acarbose
  B. Metformin
  C. Dapagliflozin
  D. Pioglitazone
  E. Sitagliptin
  A. Acarbose

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  Acarbose is an alpha glucosidase inhibitor that inhibits carbohydrate breakdown. Metformin is a biguanide that decreases hepatic glucose production. Dapagliflozin is a SGLT2 inhibitor to decrease glucose reabsorption in the kidney. Pioglitazone is a TZD that increases insulin sensitivity. Sitagliptin is a DPP-4 inhibitor that works on incretins/increase insulin secretion/decrease glucagon secretion.

• Question 42:

  If LN receives Dextrose 5% half Normal Saline with 20 meq of Potassium as IVF at 125mls/hour. How much dextrose is he getting in 24hrs?

  A. 300gm
  B. 500gm
  C. 50gm
  D. 150gm
  E. 200gm
  D. 150gm

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  0.05 (1000 mL) = 50 g 1000 mL × (1 hour/125 mL) = 8 hours 50 × 3 = 150 g

• Question 43:

  Which of the following medication should be avoided if a patient is on lithium to avoid lithium toxicity?

  A. Lisinopril
  B. Furosemide
  C. Naproxen
  D. Amiodarone
  E. Warfarin
  C. Naproxen

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  ACE-inhibitors (such as lisinopril), NSAIDs (such as naproxen) and loop diuretics (furosemide) can all increase the risk of lithium toxicity.

• Question 44:

  Which of the following is/are ordinal data?

  A. NYHA I-IV
  B. Grade of breast cancer
  C. Sex
  D. Improvement Yes/No
  E. Alive or Dead
  B. Grade of breast cancer

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  Categorical data includes ordinal (ordered categories) and nominal (unordered categories). NYHA I-IV and grade of breast cancer are considered ordinal data because the categories for the answer choice are in order, you can have NYHA class I, II, III, or IV. Grade of breast cancers are also in order, grade 1, 2, or 3. Sex, Improvemnet Yes/No, Alive or Dead is considered nominal, unordered data because the answer choices are female or male, and do not have a set order.

  http://www.bmj.com/about-bmj/resources-readers/publications/statistics-square-one

• Question 45:

  A 50-year-old female has been receiving a diuretic for the treatment of essential hypertension. This drug acts by increasing the calcium content of urine and is the drug of choice for reducing acute pulmonary edema in congestive heart failure. Its side effects include ototoxicity and hyperuricemia. What is the most likely mechanism of action of this drug?

  A. Aldosterone receptor antagonist
  B. Inhibition of the Na/K/2Cl cotransporter
  C. Inhibition of carbonic anhydrase
  D. Acts as osmotic diuretic
  E. Blocking of the NACL cotransporter
  B. Inhibition of the Na/K/2Cl cotransporter

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  B: Loop diuretics inhibit the Na/K/2Cl cotransporter of the luminal membrane in the ascending limb of the loop of Henle. Therefore, reabsorption of Na, K, and CL is decreased. The loop diuretics are the most efficacious of the diuretic drugs because the ascending limb accounts for the reabsorption of 25

• Question 46:

  Which of the following is dichotomous variable?

  A. Sex
  B. Pain yes/ Pain no
  C. alive / dead
  D. Grade of Breast Cancer
  E. NYHA I-IV
  C. alive / dead

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  Dichotomous data is considered categorical data that only has two categories, or two answer choices. All 3 answer choices have only 2 categories: sex has male or female, pain is yes or no, and alive or dead is only two options also.

  http://www.bmj.com/about-bmj/resources-readers/publications/statistics-square-one

• Question 47:

  A 27-year-old female with ovarian cancer is undergoing chemotherapy. She develops subsequent renal failure.

  Which of the following drugs is most likely responsible for this?

  A. Cyclophosphamide
  B. Bleomycin
  C. Cisplatin
  D. Vinblastine
  E. Vincristine
  C. Cisplatin

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  Cisplatin. All chemotherapeutics have similar generalized side effects related to their effects on rapidly growing cells. These include hair loss, nausea, and fatigue. However, many chemotherapeutics have unique toxicities as well which are often tested. Cisplatin (C) is notable for its nephrotoxicity and ototoxicity. Cyclophosphamide (A) is known to cause hemorrhagic cystitis. This is a distinct process from nephrotoxicity. The most noteworthy side effect of bleomycin (B) is pulmonary toxicity that can lead to pulmonary fibrosis. Vinblastine (D) is known for bone marrow suppression. Vincristine (E) causes neuropathy.

• Question 48:

  When does the newer chronic kidney disease (CKD) guidelines recommend stopping metformin?

  A. when the estimated glomerular filtration (eGFR) is
  B. when estimated glomerular filtration (eGFR) is
  C. when creatinine clearance
  D. when creatinine clearance
  E. when serum creatinine is
  A. when the estimated glomerular filtration (eGFR) is

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  Metformin should be stopped when eGFR falls below 30. This is the only cutoff that is recommended for absolute discontinuing. If the eGFR falls between 30-44 while ontherapy, benefits and risks of discontinuing should be evaluated. New initiation is only recommended when eGFR >45.

• Question 49:

  Which of the following statements is true regarding Drug-receptor bonds?

  A. Covalent bonds of drugs with receptors are strong and mostly reversible
  B. Covalent bonding is much more common than electrostatic bonding in drug-receptor interactions
  C. Electrostatic bonds are stronger than covalent bonds
  D. Hydrophobic bonds are weak bonds and they are important in the interactions of highly water soluble drugs with the lipids of cell membranes
  E. Bond formation of between the acetyl group of aspirin and cyclo-oxygenase enzyme is a covalent bond
  E. Bond formation of between the acetyl group of aspirin and cyclo-oxygenase enzyme is a covalent bond

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  Drugs mainly interact with the receptors by means of chemical forces or bonds. There are three major types of drug receptor bonds: - Covalent - Electrostatic - Hydrophobic Covalent bonds are very strong bonds and in most of the cases they are irreversible under biologic conditions. For example, the covalent bond between the acetyl group of aspirin and cyclo-oxygenase enzyme (target enzyme present on the platelets) does not breaks easily. The platelet aggregation effect of aspirin lasts long after free acetyl-salicylic acid has disappeared from the blood (about 15 minutes) and it is reversed only by the synthesis of new cyclo-oxygenase enzyme in new platelets which takes a long time. Hence the effect of aspirin is seen after the drug is stopped. Among the drug receptor interactions, electrostatic bond is much more commonly found than covalent bond. The electrostatic bonds vary from relatively strong linkages between permanently charged ionic molecules to weaker hydrogen bonds and very weak induced dipole interactions such as van der Waals force. The electrostatic bonds are weaker than covalent bonds. Hydrophobic bonds are usually very weak bonds and probably important in the interactions of highly lipid soluble drugs with the lipids of cell membranes and perhaps in the interactions of the drugs with the internal walls of receptor "pockets".

• Question 50:

  A patient takes 1gm of Calcium Carbonate salt three times a day. How much elemental calcium, in grams, is he getting in 24hrs? (MW of Ca: 40.078 g/mol, MW of CaCO3: 100.087 g/mol)

  A. 3 g
  B. 1.8g
  C. 1.2g
  D. 0.8gm
  E. 1.8mg
  C. 1.2g

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