NAPLEX Practice Questions

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.

Ribavirin is not indicated for hepatitis B; this combo is for hepatitis C.

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.

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.

Transderm Scop is a 72-hour patch; change every 3 days and apply in advance of expected motion sickness.

Triamcinolone for asthma is marketed as Azmacort; Nasacort AQ is for allergic rhinitis.

10% Intralipid = 1.1 kcal/mL --> 400×1.1 = 440 kcal/week --> 440/7 ~ 62.9 kcal/day

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

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.

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.