NABP NABP Certifications NAPLEX Questions & Answers

• Question 31:

  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

  Correct Answer: A

  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.

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

• Question 32:

  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

  Correct Answer: A

• Question 33:

  Which of the following would be most appropriate to treat stenotrophomonas maltophilia?

  A. Meropenem

  B. Vancomycin

  C. Ciprofloxacin

  D. Sulfamethoxazole/trimethoprim

  E. Cefepime

  Correct Answer: D

  Primary treatment for stenotrophomonas maltophilia is SMX-TMP. Meropenem, ciprofloxacin, and vancomycin have no coverage.

• Question 34:

  An order is received to start Milrinone at 0.75mcg/kg/min, Milrinone comes as 20mg/100ml D5W. What is the infusion rate in mL/hr? Patient weighs 115kg.

  A. 86 mls/hr

  B. 13 mls/hr

  C. 25.9 mls/hr

  D. 43 mls/hr

  E. 7 mls/hr

  Correct Answer: C

• Question 35:

  JT is a 58-year-old women who is on vancomycin empirically for pyomyositis confirmed by MRI. Surgical debridement has successfully removed infected tissue and pus. CandS of the infected tissue comes back MSSA sensitive to everything on the panel. JT is allergic to PCN (rash), she has had cephalosporin for her UTI in the past with no problem.

  What would be the most appropriate antibiotics to switch to while JT is still in the hospital?

  A. Oxacillin

  B. Doxycycline

  C. Ceftaroline

  D. Daptomycin

  E. Cefazolin

  Correct Answer: E

  Cefazolin or an antistaphylococcal penicillin (oxacillin or nafcillin) is recommended for this patient because the CandS results indicate MSSA. Since the patient develops a rash to penicillins, it would be acceptable to use cefazolin in this case.

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

• Question 36:

  According to the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults, which of the following medications and dosing regimens is considered moderate-intensity statin therapy?

  A. Atorvastatin 80 mg PO QHS

  B. Lovastatin 20 mg PO QHS

  C. Simvastatin 40 mg PO QHS

  D. Rosuvastatin 40 mg PO QHS

  E. Atorvastatin 20mg PO QHS

  Correct Answer: E

• Question 37:

  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 absolute risk reduction of using Rivaroxaban over Enoxaparin?

  A. 17

  B. 57

  C. 71

  D. 2.7

  E. 0.27

  Correct Answer: D

• Question 38:

  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

  Correct Answer: E

• Question 39:

  Which of the following are non-pharmacological measure that may control symptoms of gastroesophageal reflux disease?

  A. Remain upright after a meal

  B. Increase fat intake to reduce gastric emptying time Reduce intake of food or beverage that may reduce

  C. lower esophageal sphincter tone

  D. Wear tight fitted cloths to increase intra-abdominal pressure.

  E. Discontinue nicotine use in patients that uses tobacco product.

  Correct Answer: E

  Non-pharmacological measure that may control symptoms of gastroesophageal reflux disease are: Avoid aggravating foods/beverages that may reduce LES pressure alcohol, citrus juices caffeine, garlic, onions or cause direct irritation such as spicy foods or tomato juice should be avoided. Reduce fat intake, remain upright after meals, avoid meal before bedtime. Avoid tight fitted cloths, decrease intra-abdominal pressure. Discontinue nicotine use. Reduce intake of food or beverage that may reduce lower esophageal sphincter tone.

• Question 40:

  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

  Correct Answer: C

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