NABP NABP Certifications NAPLEX Questions & Answers

• Question 81:

  Which of the following antidiabetic medication may cause cyanocobalamin deficiency?

  A. Saxagliptin

  B. Canagliflozin

  C. Pioglitazone

  D. Glimepiride

  E. Metformin

  Correct Answer: E

  Metformin is associated with vitamin B12 deficiency because it affects the calcium dependent membrane uptake of it. All other drug classes are not associated with this.

• Question 82:

  A physician orders 300gms of albumin post paracentesis, how many milliliters of 25% albumin do you need to give 300gms?

  A. 300ml

  B. 25ml

  C. 100ml

  D. 1200ml

  E. 1000ml

  Correct Answer: D

  25g/100ml = 300g/Xml Xml = 1200mL

• Question 83:

  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

  Correct Answer: C

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

• Question 84:

  Which of the following would you use for aspiration pneumonia with an intention to cover anaerobes?

  A. Piperacillin-Tazobactam

  B. Cefepime

  C. Ampicillin-sulbactam

  D. Cefazolin

  E. Levofloxacin

  Correct Answer: C

  Cefepime, levofloxacin, cefazolin does not provide good coverage of anaerobes. Ampicillin-sulbactam and piperacillin-tazobactam provide anaerobic coverage.

• Question 85:

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

  A. Acarbose

  B. Metformin

  C. Dapagliflozin

  D. Pioglitazone

  E. Sitagliptin

  Correct Answer: A

  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 86:

  A physician orders Dopamine 5 mcg/kg/min. The concentration of the Dopamine IV bag is 400 mg in 250 D5W. The patient's weight is 168 lbs. Calculate the infusion rate in mL/hr.

  A. 10.2mls/hr

  B. 5.2mls/hr

  C. 14.29mls/hr

  D. 22.4mls/hr

  E. 0.17mls/hr

  Correct Answer: C

• Question 87:

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

  A. when the estimated glomerular filtration (eGFR) is <30 mL/min/1.73 m2

  B. when estimated glomerular filtration (eGFR) is <50 mL/min/1.73 m2

  C. when creatinine clearance <30 ml/min

  D. when creatinine clearance <50 ml/min

  E. when serum creatinine is <1.8 mg/dL

  Correct Answer: A

  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 88:

  A Physician orders Dobutamine HCl IV infusion at 5 mcg/kg/min. Dobutamine HCl is available as 500 mg in 250 mL of D5W. The patient weighs 68 kg. Calculate the infusion rate in mL/hr.

  A. 10.2mls/hr

  B. 5.2mls/hr

  C. 0.17mls/hr

  D. 22.4mls/hr

  E. 340mls/hr

  Correct Answer: A

• Question 89:

  Which of the following class of antidiabetic medications can increase triglycerides?

  A. Bile acid sequestrant

  B. GLP-1 agonist

  C. Thiazolidinediones

  D. SGLT2 Inhibitor

  E. Alpha-glucosidase inhibitors

  Correct Answer: A

  The only bile acid sequestrant, colesevelam (Welchol), has been shown to increase triglycerides through mechanism of: activation of phosphatidic acid phosphatase with promotes triglyceride synthesis. GLP-1 agonists work on GLP 1 receptors to increase insulin secretion, decrease glucagon secretion, and increase satiety. Thiazolidinediones activate nuclear transcription factor PPAR gamma to increase insulin sensitivity. SGLT2 inhibitors inhibit glucose reabsorption in the kidney. Alpha-glucosidase inhibitors slow down digestion and absorptions of carbs in the gut.

• Question 90:

  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

  Correct Answer: C

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