NABP North American Pharmacist Licensure Examination NAPLEX Exam Questions

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Total 155 questions
Question 1

An order is received for heparin 18 units per kg per hour on a patient whose weight is 125lb. The IV bag comes as a concentration of 50 units /mL. Calculate the infusion rate in terms of mL/hr.



Answer : D

125 lb =56Kg, 56Kg [18 units/ 1 kg] = 1022.72 units/hr, 1022.72 units [1 mL/50 units] = 20.45 mL/hr


Question 2

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?



Answer : E

Lidocaine: 30g 0.05 = 1.5g. Hydrocortisone: 90g 0.005 = 0.45g. 90g + 30g = 120g. 1.5g/120g = 0.0125 100 = 1.25% Lidocaine. 0.45g/120g = 0.00375 100 = 0.375% Hydrocortisone.


Question 3

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



Answer : C

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


Question 4

A 54-year-old male with a long history of mild persistent asthma on daily fluticasone therapy has been using his albuterol inhaler every day for the past month, and presents requesting a refill. What changes should be made to his current regimen?



Answer : B

Add salmeterol to the current regimen. This patient had mild persistent asthma but was using his albuterol daily, which indicates that a step up in therapy is warranted. The preferred first line treatment regimen for moderate persistent asthma are low to medium dose inhaled corticosteroids plus a long acting beta2 agonist, as well as a short acting beta2 agonist as needed. A is incorrect. Ciclesonide is an inhaled corticosteroid. The patient in the case is already using fluticasone, so adding ciclesonide would be therapeutic duplication. C is incorrect. Long-acting beta2 agonists should only be used as adjunctive therapy in patients who are currently receiving but not adequately controlled on an inhaled corticosteroid. These medications should not be used as monotherapy, due to an increased risk of asthma related deaths. D is incorrect. Cromolyn prevents the release of vasoactive mediators from mast cell and is primarily used for exercise-induced asthma, it is not indicated as an alternative agent in patients with moderate persistent asthma. E is incorrect. Ipratropium is a short-acting anticholinergic, which is often used in COPD or in asthma exacerbations. It is not indicated for maintenance treatment of moderate persistent asthma.


Question 5

A 15-year-old presents with 6 days of nasal congestion with thin, clear rhinorrhe

a. She notes mild facial pain but has had no fevers. She feels her symptoms are improving.

What is the most likely cause of her symptoms?



Answer : B

This patient shows symptoms of acute sinusitis. The most common etiology of which is viruses. Indications that an infection is viral as opposed to bacterial included a shorter infection tie (less than 10 days) and no purulent discharge (hers is watery). She does not show any evidence of a complication developing and even notes that her symptoms are improving. If her symptoms were attributed to a bacterium, then the most common cause of acute sinusitis is Streptococcus pneumoniae followed by Haemophilus influenza, then Moraxella catarrhalis. Anaerobic species such as Bacteroides fragilis and Staphylococcus aureus are more commonly found in patients with chronic sinusitis (sinusitis lasting longer than 12 weeks). This is important to realize before indiscriminately providing antibiotics for these patients.


Question 6

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.



Answer : A

68 kg [5 mcg/kg/min] = 340 mcg/min Bag concentration = 2 mg/ml or 2000 mcg/ml 340 mcg [1 mL/2000 mcg] = 0.17 mL/min 60 in [0.17 mL/min] = 10.2 mLs in one hour


Question 7

Which of the following should be monitored when a patient is on SGLT2 inhibitor?



Answer : E

Because SGLT2 inhibitors work by preventing reabsorption of glucose in the kidneys, this increases frequency of urination. All of the options are monitoring requirements since the hydration status, blood pressure, blood glucose, and renal function may all be changed from increased urination (from the mechanism of the drug).


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Total 155 questions