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NAPLEX Practice Exam A

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NAPLEX Practice Questions

1 / 10

1. A patient on chronic omeprazole therapy is concerned about nutrient absorption. Which of the following agents may have reduced absorption with acid suppression?

A. Iron

B. Itraconazole

C. Acetaminophen

D. Tetracycline

E. A and B only

Many drugs require an acidic environment for optimal absorption, including iron, azole antifungals, and certain antibiotics. Chronic acid suppression can impair this.

2 / 10

2. 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.

3 / 10

3. 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.

4 / 10

4. An 72-year-old female has T-scores of -4.2 in her spine and -3.4 in her right hip without history of fractures. What condition is indicated?

A. More testing is needed to make a diagnosis.

B. These results indicate osteopenia.

C. These results indicate osteoporosis.

D. The patient does not have osteopenia or osteoporosis.

A T-score below -2.5 is diagnostic for osteoporosis.

5 / 10

5. How can the incorrect use of antithrombotics be minimized in hospitalized patients?

A. Use dosing protocols

B. Monitor INRs as scheduled

C. Educate patients and involve dietitians

D. A and B only

E. All of the above

A multi-faceted approach including protocols, education, monitoring, and use of technology like programmable pumps can reduce risks.

6 / 10

6. A patient reports ankle swelling after starting pregabalin. Where should this adverse effect be reported?

A. The Red Book

B. The Orange Book

C. The Pink Sheet

D. MedWatch

E. CMS

Adverse drug reactions are reported to the FDA MedWatch program.

7 / 10

7. A prescription calls for 54 grams of polyethylene glycol 400. If the specific gravity is 1.13, how many milliliters are required?

A. 58.3 mL

B. 20 mL

C. 47.8 mL

D. 50 mL

E. 46.29 mL

Volume = weight ÷ SG (g/mL) = 54 ÷ 1.13 = ~47.8 mL.

8 / 10

8. A patient begins Plaquenil for lupus. What are important counseling points?
I. The drug is dosed three times per day.
II. Visual and auditory changes should be monitored.
III. Lab tests should monitor for increased platelets.
IV. Take with meals to reduce GI upset.

A. 1 and 2

B. 2 and 3

C. 3 and 4

D. 2 and 4

E. 1, 2, 3 and 4

Hydroxychloroquine may cause retinal toxicity. It should be taken with food and monitored with labs for blood dyscrasias. It is dosed once to twice daily for SLE and may cause DECREASE in platelets.

9 / 10

9. 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.

10 / 10

10. 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.

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