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NAPLEX Practice Exam A

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NAPLEX Practice Questions

1 / 10

1. What is the likely cause of flushing and dizziness in a patient recently started on ritonavir for HIV. Currently the patient is on nifedipine SR, atenolol and linisopril?

A. Decreased atenolol levels due to enzyme induction

B. Elevated atenolol levels due to enzyme inhibition

C. Decreased nifedipine levels due to enzyme induction

D. Elevated nifedipine levels due to enzyme inhibition

E. Ritonavir-induced flushing syndrome

Ritonavir inhibits metabolism of nifedipine, increasing drug levels and side effects.

2 / 10

2. Which symptoms are expected with lithium levels 1.5–3 mEq/L?

A. Coarse hand tremor

B. Diarrhea/nausea

C. Arrhythmia

D. A and B only

E. All of the above

Toxic symptoms include coarse tremor, GI upset, and ataxia at this level. Toxicity at lithium levels > 3mEq/L can result in CNS depression, seizures, irreversible brain damage, coma, arrhythmia.

3 / 10

3. A woman with ESRD due to lupus is taking the following medicaitons: erythropoeitin, CellCept, Prograf, carvedilol, prednisone, and Norco. She begins to develop elevated fasting glucose. Which drug(s) most likely contributed to her increased blood sugar?

A. Prednisone, erythropoietin, Norco

B. Prednisone, erythropoietin, CellCept

C. Prednisone, CellCept, Prograf

D. Prednisone, CellCept, hydrocodone

E. Prednisone, CellCept, carvedilol

Corticosteroids like prednisone are well-known to cause hyperglycemia. Mycophenolate may also contribute, although less commonly.

4 / 10

4. Aurora has monthly migraines triggered by her menstrual cycle which is accompanied by heavy bleeding. Which option would be appropriate to prevent migraines in her case?

A. Sumatriptan

B. Propranolol to reduce migraines

C. Oral contraceptives

D. A migraine patch

E. Fioricet for pain management

Oral contraceptives are a reasonable option for managing both pre-menstrual migraines and heavy menstrual bleeding, addressing both issues simultaneously.

5 / 10

5. A 45-year-old patient is diagnosed with diabetes. The patient has past medical history of chronic kidney disease (eGFR 25) and heartfailure. What is the most appropriate first line therapy for the patient?

A. exenatide

B. lixisenatide

C. canagliflozin

D. empagliflozin

E. B or D

In patients with type 2 diabetes and established CVD or heart failure, SGLT2 inhibitors have shown both cardiovascular and renal benefit. Empagliflozin specifically is indicated for use in patients with HFrEF and CKD, including those with eGFR ?20, depending on the specific agent and FDA label. Canagliflozin should be avoided in eGFR <30. Exenatide and lixisenatide (GLP-1 receptor agonists) primarily show benefit in reducing atherosclerotic cardiovascular disease (ASCVD) events, like stroke or myocardial infarction, but not heart failure–specific outcomes.

6 / 10

6. Which medications are used in the initial 2-month phase for tuberculosis?

A. Rifampin, Isoniazid, Linezolid, Ethambutol

B. Isoniazid, Ethambutol, Levofloxacin, Pyrazinamide

C. Rifampin, Isoniazid, Pyrazinamide, Ethambutol

D. Rifampin, Amikacin, Pyrazinamide, Moxifloxacin

E. Isoniazid, Rifampin, Bedaquiline, Ethionamide

The initial treatment for wild-type TB includes four first-line drugs known as the RIPE regimen: Rifampin, Isoniazid, Pyrazinamide, and Ethambutol. These drugs are used together in the intensive phase to reduce bacterial load and prevent resistance.

7 / 10

7. What controlled category is Sonata?

A. C I

B. C II

C. C III

D. C IV

E. C V

Sonata (zaleplon) is a C IV controlled substance like other non-BZDs.

8 / 10

8. A patient taking levothyroxine also uses OTC medications for heartburn. Which of the following is least likely to interfere with thyroid hormone absorption?

A. Magnesium hydroxide

B. Calcium carbonate

C. Famotidine

D. Pepcid Complete

E. C and D only

Calcium and magnesium-based antacids can impair levothyroxine absorption. Famotidine, an H2 blocker, does not affect absorption, but combination products may. Pepcid Complete contains famotidine and antacids.

9 / 10

9. A patient presents a prescription for Cozaar she needed filled. Her other medication is Yasmin contraceptive pills. The pharmacy is in a supermarket, and the pharmacist notices the patient has Morton Salt Balance in her shopping cart, which contains potassium chloride. The following are correct counseling statements:

A. Your new medication, and the salt substitute, can increase your potassium.

B. Yasmin can increase potassium.

C. Cozaar is not safe in pregnancy.

D. A and B.

E. All of the above

Both Cozaar (losartan) and Yasmin (ethinyl estradiol/drospirenone) can increase potassium levels. Additionally, potassium-containing salt substitutes can further increase potassium levels when taken with Cozaar. It's also important to note that Cozaar is contraindicated in pregnancy. Therefore, statements A and B are correct counseling points.

10 / 10

10. A patient needs long-term prophylaxis to reduce gout flare frequency. Which of the following are appropriate options?

A. Allopurinol

B. Febuxostat

C. Prednisone

D. A and B only

E. All of the above

Allopurinol and febuxostat are used for prevention, not corticosteroids like prednisone, which are for acute flares.

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