NABP NAPLEX Exam Questions Instant Access

Question 1

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?

AAdd ciclesonide to current regimen

BAdd salmeterol to current regimen

CDiscontinue fluticasone and instead use salmeterol

DAdd cromolyn to current regimen

EDiscontinue fluticasone and add ipratropium to 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 2

A 22-year-old woman adopted a cat. Shortly thereafter, she developed itchy eyes and persistent rhinorrhe

a. She was clearly allergic to the pet, but desperately wanted to keep it. She tried taking diphenhydramine, but it had intolerable side effects.

Which of the following is a common effect of this type of medication?

ADecreased intraocular pressure

BBradycardia

CXerostomia

DDiarrhea

EExcessive sweating

Answer : C

Diphenhydramine possesses anticholinergic properties. Xerostomia, or dry mouth, is a common side effect of anti-cholinergic medications, due to anti-muscarinic, parasympatholytic effects. Other adverse reactions may include: * Mydriasis with blurred vision, photophobia * Urinary retention * Constipation * Anhidrosis * Hyperthermia * Tachycardia * Altered mental status

A commonly referenced mnemonic for anti-cholinergic toxicity is ''mad as a hatter, red as a beet, dry as a bone, hot as a hare, blind as a bat'' to reflect confusion, flushing, dry mouth, hyperthermia and mydriasis, respectively.

Question 3

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

AHydration status

BBlood pressure

CBlood glucose

DRenal function

EAll of the above

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).

Question 4

According to the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to ReduceAtherosclerotic Cardiovascular Risk in Adults, which of the following LDL cholesterol thresholds is an indication for high- intensity statin therapy?

A 100 mg/dL

B 130 mg/dL

C 190 mg/dL

D 200 mg/dL

E 150 mg/dL

Answer : C

Statin therapy should be used as treatment in adults with primary LDL--C 190 mg/dL and age over 21 years. Unless contraindicated, high-intensity statin therapy should be used.

Question 5

Which of the following medication can lower seizures threshold?

ABupropion

BTramadol

CClozapine

DThiothixene

EAll of the above can lower seizure threshold

Answer : E

Seizure threshold can be lowered by bupropion, chlorpromazine, clozapine, maprotiline, olanzapine, thioridazine, thiothixene, and tramadol.

Question 6

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

ABile acid sequestrant

BGLP-1 agonist

CThiazolidinediones

DSGLT2 Inhibitor

EAlpha-glucosidase inhibitors

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 7

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?

ALidocaine/Hydrocortisone 2%/1.25%

BLidocaine/Hydrocortisone 0.375%/0.15%

CLidocaine/Hydrocortisone 1.25 %/ 0.15%

DLidocaine/Hydrocortisone 2% /0.25%

ELidocaine/Hydrocortisone 1.25% /0.375%

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.

NABP North American Pharmacist Licensure Examination NAPLEX Exam Questions