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NAPLEX Practice Exam A

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NAPLEX Practice Questions

1 / 10

1. 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.

2 / 10

2. A 67-year-old man presents to the emergency department 1 hour after the sudden onset of right-sided weakness and slurred speech which occured 1 hr ago. A non-contrast CT scan of the head shows no evidence of hemorrhage. His blood pressure is 190/92 mmHg, and blood glucose is 110 mg/dL. His past medical history includes hypertension, type 2 diabetes, and peptic ulcer disease. His current medications include lisinopril, metformin, enoxaparin, and aspirin. Further review of the electronic medical record reveals that he underwent a lumbar laminectomy 10 days ago.

Which of the following is the most appropriate next step regarding administration of alteplase (tPA)?

A. Administer alteplase within the next 2 hours.

B. Do not administer alteplase due to recent surgery.

C. Administer alteplase after administering a loading dose of aspirin.

D. Administer alteplase only if blood pressure is lowered to below 185/110 mmHg.

E. Administer alteplase after discontinuing enoxaparin for 24 hours

Alteplase is contraindicated in recent intracranial or intraspinal surgery. Alteplase must be initiated within 3 hours (and possibly up to 4.5 hours) of symptom onset. Prior anticoag use (LMWH within 24 hrs, NOACs within 48 hrs) is contraindicated. If BP >185/110, may attempt to lower BP to under cutoff before consider tPA.

3 / 10

3. A patient hospitalized with acute myocardial infarction. What statin should they be started on to reduce risk of recurrent ischemia?

A. Simvastatin 40 mg

B. Lovastatin 80 mg

C. Rosuvastatin 10 mg

D. Atorvastatin 80 mg

E. Pravastatin 40 mg

High-intensity statins like atorvastatin 80 mg improve outcomes post-MI when started promptly.

4 / 10

4. 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.

5 / 10

5. 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.

6 / 10

6. A patient using erythropoietin for eight months. She woke up today having pain and swelling below the knees. What is the most likely complication?

A. Arthralgia

B. Myalgia

C. Deep vein thrombosis

D. Osteosarcoma

E. Peripheral neuropathy

ESAs increase the risk of thrombotic events like DVT; patients should be monitored for signs of clots.

7 / 10

7. 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.

8 / 10

8. A 17-year-old female is picking up her oral contraceptive pills. The pharmacist wants to ensure she is maintaining an adequate intake of which B vitamin, which may be depleted with oral contraceptive use?

A. Folic acid

B. Pyridoxine

C. Riboflavin

D. Thiamine

E. Cobalamin

All women of childbearing age should get folic acid to prevent neural tube defects in case of pregnancy. It’s recommended regardless of birth control use.

9 / 10

9. An 75-year-old male with end stage renal disease is currently on venlafaxine, warfarin, lisinopril, and potassium. He had a recent serious bleed. What is the most likely cause?

A. Bleeding risk from warfarin and lisinopril

B. Increased bleed risk from warfarin and venlafaxine

C. Fall risk due to end stage renal disease and venlafaxine

D. A and B

E. None of the above

SSRIs/SNRIs like venlafaxine increase bleeding risk when used with anticoagulants such as warfarin.

10 / 10

10. Which auxiliary labels should accompany a benzodiazepine prescription?

A. Controlled substance warning

B. May cause drowsiness

C. Avoid alcohol

D. May impair driving