Here’s the 10 free NAPLEX practice questions that I created:

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Answer the following 3 questions based on the case presented: 38 year old female is coming in to pick up her husband’s prescription. Her husband’s current medication list includes: Acetaminophen, Labetolol, Sertraline, Omeprazole, Flomax, Levothyroxine, and Proscar. His current diagnoses include osteoarthritis, hypertension, BPH, depression, hypothyroidism, and Psoriasis (which he is currently not taking anything). She states that her husband is having trouble with sinus congestion and has started to take pseudoephedrine to help relieve the symptoms.

1. Which disease state would most likely be exacerbated by pseudoephedrine?
   • Psoriasis
   • BPH
   • Depression
   • Hypothyroidism

2.  Upon further discussion with this patient, you discover that she may be pregnant. Which medication should you counsel her on that she should avoid touching broken or crushed pills?

• Labetolol
• Acetamionophen
• Flomax
• Proscar

3.  What is the primary mechanism of action for Flomax?

• Blocks Beta receptors
• Blocks Alpha receptors
• Blocks muscarinic receptors
• 5-alpha reductase inhibitor

4.  An ICU patient with a history of diabetes is currently experiencing significant hyperglycemia. Her current labs reveal creatinine = 1.2, potassium = 3.5, sodium = 134, LFT’s = Within normal limits, and BNP is stable. Which lab would you most closely monitor with aggressive insulin therapy?

• Potassium
• Sodium
• BNP
• Creatinine

5.  77 year old male with a history of CHF, anxiety, atrial fibrillation, GERD, gout, and CKD is receiving the current medications. Aspirin, Ativan, Zantac, Digoxin, allopurinol, and metoprolol – Which medication would be least likely to be affected by changes in kidney function?

• Ativan
• Zantac
• Digoxin
• Allopurinol

Answer question 6 and 7 based on the following information: A patient and her mother brings in a prescription for treatment of some congestion/upper respiratory symptoms. The patient is 12 years old and weighs 74 pounds. The prescription is written for 8mg/kg of Ibuprofen per dose, guaifenesin 100 mg per dose, and 5% alcohol. QS AD 240 mls. Take 1 teaspoon by mouth three times daily as needed.

6.  How much alcohol USP do you need to fill the prescription?

Fill In the Blank_______________

7.  How much Ibuprofen do you need to fill the entire prescription? Round to the nearest thousand.

Fill in the Blank_______________

8.  What is the primary mechanism of action of Glyset?

• Stimulates Beta Cells to produce insulin and causes a decrease in blood sugar
• Increases peripheral uptake of glucose into muscle cells resulting in a reduction of hyperglycemia
• Increases hepatic reuptake of glucose resulting in lower blood sugar
• Inhibits alpha glucosidase and reduces postprandial hyperglycemia

9.  Which of the following would be an appropriate treatment for H. Pylori?

• Omeprazole, Oral Vancomycin, Metronidazole
• Protonix, Omeprazole, High Dose Amoxicillin
• Prilosec, Macrobid, Clarithromycin
• Omeprazole, Amoxicillin, Clarithromycin

10.  65 year old male with a history of CHF, hypertension, and diabetes is having higher blood pressure of late. His current medications include: Clonidine, Acetaminophen, and Baby Aspirin. Which is the most appropriate medication to initiate?

• Altace
• Hydrochlorothiazide
• Norvasc
• Inderal

 

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ANSWERS:

Answer the following 3 questions based on the case presented: 38 year old female is coming in to pick up her husband’s prescription. Her husband’s current medication list includes: Acetaminophen, Labetolol, Sertraline, Omeprazole, Flomax, Levothyroxine, and Proscar. His current diagnoses include osteoarthritis, hypertension, BPH, depression, hypothyroidism, and Psoriasis (which he is currently not taking anything. She states that her husband is having trouble with sinus congestion and has started to take pseudoephedrine to help relieve the symptoms.

1. Which disease state would most likely be exacerbated by pseudoephedrine?
   • Psoriasis
   • BPH
   • Depression
   • Hypothyroidism

Answer: Remember that Sudafed (pseudoephedrine) has alpha agonist activity which can contribute to problems in BPH and hypertension. (hint – remember that alpha blockers are used to treat BPH symptoms as well as hypertension)

2.  Upon further discussion with this patient, you discover that she may be pregnant. Which medication should you counsel her on that she should avoid touching broken or crushed pills?

• Labetolol
• Acetamionophen
• Flomax
• Proscar

Answer – Proscar and Avodart are two 5 alpha reductase inhibitors that can cause serious birth defects. Finasteride is also used for hair loss.

3.  What is the primary mechanism of action for Flomax?

• Blocks Beta receptors
• Blocks Alpha receptors
• Blocks muscarinic receptors
• 5-alpha reductase inhibitor

Flomax is an alpha blocker or antagonist used in the treatment of BPH.

4.  An ICU patient with a history of diabetes is currently experiencing significant hyperglycemia. Her current labs reveal creatinine = 1.2, potassium = 3.5, sodium = 134, LFT’s = Within normal limits, and BNP is stable. Which lab would you most closely monitor with aggressive insulin therapy?

• Potassium
• Sodium
• BNP
• Creatinine

Answer – We need to be very careful with insulin therapy and make sure potassium stores are adequate. Insulin can cause hypokalemia.

5.  77 year old male with a history of CHF, anxiety, atrial fibrillation, GERD, gout, and CKD is receiving the current medications. Aspirin, Ativan, Zantac, Digoxin, allopurinol, and metoprolol.  Which medication would be least likely to be affected by changes in kidney function?

• Ativan
• Zantac
• Digoxin
• Allopurinol

Ativan is the only medication of the ones listed that is not primarily eliminated by the kidney. The others could accumulate and cause issues with worsening renal function.

Answer question 6 and 7 based on the following information: A patient and her mother brings in a prescription for treatment of some congestion/upper respiratory symptoms. The patient is 12 years old and weighs 74 pounds. The prescription is written for 8mg/kg of Ibuprofen per dose, guaifenesin 100 mg per dose, and 5% alcohol. QS AD 240 mls. Take 1 teaspoon by mouth three times daily as needed.

6.  How much alcohol USP do you need to fill the prescription?

Fill In the Blank_______________

5% is 5mls of pure ETOH per 100 mls

5 X (240mls/100mls) = 12 mls of pure ETOH – Remember that Alcohol USP is 95% ethanol. The final answer will be 12 mls/0.95 = 12.63 mls of alcohol USP

7.  How much Ibuprofen do you need to fill the entire prescription? Round to the nearest thousand.

Fill in the Blank_______________

Take weight in kg – 33.5658kg X 8mg/kg = 268.5 mg per dose.

Each dose is 5 mls and within 240 mls, there is 48 doses.

48 doses X 268.5mg = 12,888 mg of Ibuprofen or rounding to the nearest thousand, 13,000mg

8.  What is the primary mechanism of action of Glyset?

• Stimulates Beta Cells to produce insulin and causes a decrease in blood sugar
• Increases peripheral uptake of glucose into muscle cells resulting in a reduction of hyperglycemia
• Increases hepatic reuptake of glucose resulting in lower blood sugar
• Inhibits alpha glucosidase and reduces postprandial hyperglycemia

Alpha glucosidase is in the gut and essential breaks down sugars, by inhibiting this enzyme, you reduce absorption of glucose. The major side effect of GI complaints also makes sense (flatulence etc.) as there is more sugar in the gut.

9.  Which of the following would be an appropriate treatment for H. Pylori?

• Omeprazole, Oral Vancomycin, Metronidazole
• Protonix, Omeprazole, High Dose Amoxicillin
• Prilosec, Macrobid, Clarithromycin
• Omeprazole, Amoxicillin, Clarithromycin

Flagyl (metronidazole) can be used as well, but not with oral vancomycin. Two PPI’s doesn’t make much sense, and macrobid isn’t an appropriate selection for H Pylori.

10.  65 year old male with a history of CHF, hypertension, and diabetes is having higher blood pressure of late. His current medications include: Clonidine, Acetaminophen, and Baby Aspirin. Which is the most appropriate recommendation?

• Altace
• Hydrochlorothiazide
• Norvasc
• Inderal

Altace (Ramipril) would be most appropriate given his comorbid conditions. A beta blocker could be a consideration with CHF history, but you would not pick a non-selective agent like Inderal first line in this case.

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