NABP NABP Certifications NAPLEX Questions & Answers

• Question 111:

  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%

  Correct Answer: B

  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 – (relative risk) = 1 – 0.2903 = 0.7097 = 0.71.

• Question 112:

  If you mix 30 gm 5% lidocaine cream and 90gm of 0.5% hydrocortisone cream, what percent of lidocaine and hydrocortisone do you have as the end product?

  A. Lidocaine/Hydrocortisone 2%/1.25%

  B. Lidocaine/Hydrocortisone 0.375%/0.15%

  C. Lidocaine/Hydrocortisone 1.25 %/ 0.15%

  D. Lidocaine/Hydrocortisone 2% /0.25%

  E. Lidocaine/Hydrocortisone 1.25% /0.375%

  Correct Answer: E

• Question 113:

  Which of the following is considered first-line therapy for reducing the risk of atherosclerotic cardiovascular disease (ASCVD)?

  A. HMG Co-A reductase inhibitors

  B. Bile acid resins

  C. Nicotinic Acid

  D. Fibrates

  E. Fish oil

  Correct Answer: A

  ATP4 found that the use of statins for prevention of ASCVD is extensive and consistent. Statin therapy is recommended for patients at a higher risk of ASCVD who are most likely to experience a net benefit in terms of the potential for risk reduction vs the potential for adverse effects. Non-statin therapies do not provide sufficient benefits in the reduction of ASCVD risk in regards to their potential for adverse effects.

• Question 114:

  Which of the following is/are a risk factor for myopathy with statin therapy?

  A. Hypothyroidism

  B. Vitamin D deficiency

  C. Renal impairment

  D. Hepatic dysfunction

  E. Vitamin C deficiency

  Correct Answer: D

  Risk factors for myopathy are hypothyroidism, reduced renal or hepatic function, rheumatologic disorders such as polymyalgia rheumatica, steroid myopathy, vitamin D deficiency, or primary muscle diseases.

• Question 115:

  You need 51.3 mEq of NaCl to make 1/3 NS 1 liter bag. How many ml of 23.4% NaCl would you need? (Molecular weight of Na is 23 and Cl is 35.5)

  A. 12.82ml

  B. 16.82ml

  C. 23.4ml

  D. 58.5ml

  E. 10ml

  Correct Answer: A

• Question 116:

  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

  Correct Answer: D

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

• Question 117:

  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. lockout 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

  Correct Answer: D

  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 118:

  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?

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

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

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

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

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

  Correct Answer: E

  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 119:

  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. lockout 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. The bioavailability of levothyroxine is roughly 50%.

  The physician requests you for a dose recommendation to convert her home dose of 75mcg po daily to intravenous.

  What would be the appropriate intravenous dose?

  A. 37.5mcg

  B. 75mcg

  C. 75mg

  D. 150mcg

  E. 37.5mg

  Correct Answer: A

  Since the bioavailability of levothyroxine is roughly 50% (given in the question). To convert the home dose to intravenous, it would be 50% of the oral dose. So 50% of oral 75 mcg would be 37.5 mcg intravenously.

• Question 120:

  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. lockout 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.

  Which of the following medication's dose are adjusted for poor renal function?

  A. Famotidine

  B. Metoclopramide

  C. Lisinopril

  D. Citalopram

  E. Ondansetron

  Correct Answer: B

  Famotidine and Metoclopramide would need to be adjusted for poor renal function. Since his CrCl is less than 50, famotidine would need to be adjusted by decreasing the dose by 50% or increasing the interval to every 36 to 48 hours. Metoclopramide would also need to be adjusted by 50% of the normal dose since his CrCl is less than 40. ACEInhibitors and ARBs should be held if serum K is greater than 5.6 or there is a rise in serum creatinine greater than 30% after initiation.