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NAPLEX Practice Exam A

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NAPLEX Practice Questions

1 / 10

1. 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.

2 / 10

2. 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.

3 / 10

3. What is the correct way to use the Daytrana patch?

A. Apply to the hip 2 hours before the medication is needed

B. Replace weekly

C. Switch application site on opposite hip every week

D. Press patch for 5 seconds when applying

E. Remove during bathing or showering

Daytrana is applied daily, to the hip, 2 hours before effect is desired, and held for 30 seconds. Alternate hips daily. It is water-resistant.

4 / 10

4. Which chemotherapy drugs have restricted lifetime dosing due to cumulative toxicity risks?

A. Idarubicin

B. Epirubicin

C. Daunorubicin

D. Doxorubicin

E. All of the above

Anthracyclines like doxorubicin, daunorubicin, idarubicin, and epirubicin have lifetime dose limits due to risk of cardiotoxicity.

5 / 10

5. Maria is a 30-year-old woman with lupus nephritis. Her renal function has progressively declined, and her estimated creatinine clearance is 23 mL/min. Her serum potassium is 4.8 mEq/L. Current medications include enalapril, hydroxychloroquine, a vitamin D supplement, and atorvastatin. Maria is seeking a reliable form of contraception. Which of the following contraceptive methods would be inappropriate for Maria given her current clinical status?

A. Yasmin

B. Yaz

C. IUD

D. A and B

E. All of the above

Maria is taking lisinopril and has CKD. Combined oral contraceptives like Yaz and Yasmin contain drospirenone, which is potassium-sparing. Her renal impairment and ACE inhibitor use increase the risk of hyperkalemia.

6 / 10

6. A patient with ulcerative colitis is prescribed sulfasalazine. What is an appropriate counseling point?

A. Common side effects include nausea and headache

B. This medication may cause red/orange discoloration of urine and skin.

C. This drug is well-tolerated in patients with sulfa allergies.

D. Take this medication on an empty stomach to enhance absorption.

E. A and B only

Sulfasalazine often causes nausea, headache, and reduced appetite. It's not the same as Asacol, and penicillin allergy is not a contraindication.

7 / 10

7. 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.

8 / 10

8. 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.

9 / 10

9. Calculate the body mass index (BMI) for a male who is 6'2" tall and weighs 215 lbs.

A. 27.6

B. 24.8

C. 25.3

D. 25.9

E. 29.4

Height = 74 in --> BMI = (215 / 74²) × 703 ~ 27.6

10 / 10

10. Proper EpiPen instructions include all EXCEPT:

A. Hold injector tip down; pull off the cap

B. Remove pants prior to injection

C. Rub area after removing the injector. Look at the tip: If the needle is showing, the dose was received. If not, repeat dose.

D. After the shot, press the needle against a hard surface to bend the needle back. Put the injector back in its case, needle first. Do not put the cap back on the injector.

The pen can go through clothes; removing pants is not required and may delay use.

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