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NAPLEX Practice Exam A

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NAPLEX Practice Questions

1 / 10

1. A woman presents prescriptions for PegIntron once weekly and ribavirin for hepatitis B. What should the pharmacist do?

A. Fill as written.

B. Do not fill; the patient should not be taking this combination for hepatits B

C. Do not fill; triple therapy is needed for hepatitis B

D. Do not fill; dangerous drug interaction between PegIntron and ribavirin

E. Do not fill; PegIntron should be given daily

Ribavirin is not indicated for hepatitis B; this combo is for hepatitis C.

2 / 10

2. Which Alzheimer medication comes in oral disintegrating tablet form for dysphagia patients?

A. Tacrine

B. Donepezil

C. Rivastigmine

D. Galantamine

E. Memantine

Donepezil (Aricept) is the only one available as an ODT.

3 / 10

3. A 45-year-old male on warfarin, digoxin, carvedilol and amiodarone wants to use Pepto-Bismol for diarrhea. What is the pharmacist’s primary concern?

A. Risk of arrhythmia

B. Risk of bradycardia

C. Risk of digoxin toxicity

D. Risk of bleeding

E. Risk of heart block

Bismuth subsalicylate contains salicylate, which can increase bleeding risk—especially in those taking anticoagulants like warfarin.

4 / 10

4. A patient is admitted with ataxia, dizziness, and slurred speech. Phenytoin toxicity is suspected. Laboratory values show: phenytoin level 12.6 mcg/mL (therapeutic 10-20 mcg/mL) and albumin 1.6 g/dL (normal range 3.6-5.1 g/dL). What is the most appropriate interpretation of these findings?

A. Albumin level is actually higher

B. Albumin level is actually lower

C. Phenytoin level is actually higher

D. Phenytoin level is actually lower

E. None of the above

Low albumin means more free (active) phenytoin, making the effective level higher than what appears in labs.

5 / 10

5. A glaucoma patient with COPD requires a beta blocker eye drop. Which is the safest option?

A. Timolol

B. Levobunolol

C. Carteolol

D. Nadolol

E. Betaxolol

Betaxolol is beta-1 selective and less likely to exacerbate respiratory conditions. The others are non-selective.

6 / 10

6. Emily has a long-standing history of psychosis and anxiety. She presents to the clinic with an involuntary, rhythmic movement of the neck that is painful. Which of her current medications is the most likely cause of this drug-induced movement disorder?

A. Lorazepam

B. Chlorpromazine

C. Carvedilol

D. Albuterol

E. Pregabalin

Chlorpromazine is a dopamine-blocking agent, which can cause movement disorders like tardive dyskinesia.

7 / 10

7. A patient has a prolonged QT interval. Which antiarrhythmic poses the least additional QT risk?

A. Quinidine

B. Procainamide

C. Dofetilide

D. Diltiazem

E. Amiodarone

Diltiazem (a non-dihydropyridine CCB) does not significantly prolong QT, while most antiarrhythmics, especially Class IA (eg, quinidine, procainamide) and III (eg, dofetilide, sotalol, amiodarone), do.

8 / 10

8. James is a 65-year-old male newly prescribed tamsulosin for benign prostatic hyperplasia. Which of the following statements is correct?

A. The correct dose is 4 mg daily

B. Tamsulosin is a dopamine agonist

C. Tamsulosin blocks alpha-1 receptors in prostate tissue

D. It causes frequent erectile dysfunction

E. It is only used for prostate cancer

Tamsulosin blocks alpha-1 receptors in the prostate to improve urinary flow. The standard dose is 0.4 mg daily.

9 / 10

9. Travis smokes 1.5–2 packs/day. What is the correct starting dose of nicotine gum?

A. 8 mg gum

B. 6 mg gum

C. 4 mg gum

D. 2 mg gum

E. 1 mg gum

Smokers >25 cigarettes/day should start with 4 mg gum. 2 mg is for lighter smokers. There are 20 cigarettes in 1 pack.

10 / 10

10. Paul a 45 year-old male has diabetes and no prior adult vaccines. It’s October. Which vaccines should be recommended?

A. Pneumovax 23 + Fluvarin

B. Prevnar 20 + Fluvarin

C. Pneumovax 23 + Flumist

D. Prevnar 13 + Flumist

E. Shingles vaccine

Paul is under 65 but has diabetes, which places him in a high-risk group for pneumococcal disease. Current ACIP guidelines recommend: Pneumococcal vaccination: Patients aged 19–64 with diabetes should receive either: PCV20 alone, or PCV15 followed by PPSV23 (at least 1 year apart, or 8 weeks in immunocompromised).
Annual influenza vaccination: He should receive an inactivated influenza vaccine like Fluvarin. FluMist is not recommended in high-risk patients (e.g., diabetes, chronic conditions). Shingles vaccine (Shingrix) is approved for immunocompetent adults ?50 years or ?19 if immunocompromised, so Peter does not yet qualify based on age alone.

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