NAPLEX Practice Questions

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

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

Volume = 44 ÷ 4 = 11 mL

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.

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.

Dornase alfa (Pulmozyme) is refrigerated, nebulized, breaks down DNA in mucus to reduce viscosity. It's dosed as 2.5mg ampules given in neublizer once daily for 6 months.

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.

Calcium and phosphate can precipitate in TPN if not carefully managed. Best practices include using calcium gluconate (less dissociation than calcium chloride), adding phosphate first and calcium last, using lower final concentrations, and ensuring proper refrigeration. Calcium and phosphate added should not exceed 45 mEq/L. Maintain proper pH (lower pH = less risk of precipitation). Refrigerate the bag once prepared.

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

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