NABP NAPLEX North American Pharmacist Licensure Examination Exam Practice Test

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Total 155 questions
Question 1

An order is received to start Milrinone at 0.75mcg/kg/min, Milrinone comes as 20mg/100ml D5W. What is the infusion rate in mL/hr? Patient weighs 115kg.



Answer : C

Patient dose: 0.75mcg 115kg = 86.25mcg/min (100mL/20mg) (86.25mcg/1hr) (60min/1hr) (1mg/1000mcg) = 25.875mL/hr Rate of infusion of Milrinone


Question 2

Which of the following is/are ordinal data?



Answer : B

Categorical data includes ordinal (ordered categories) and nominal (unordered categories). NYHA I-IV and grade of breast cancer are considered ordinal data because the categories for the answer choice are in order, you can have NYHA class I, II, III, or IV. Grade of breast cancers are also in order, grade 1, 2, or 3. Sex, Improvemnet Yes/No, Alive or Dead is considered nominal, unordered data because the answer choices are female or male, and do not have a set order.


http://www.bmj.com/about-bmj/resources-readers/publications/statistics-square-one

Question 3

Your patient, a 25-year-old G1P0 female at 26 weeks gestation presents due to an abnormal glucose tolerance test. One week prior, she was given 50 g of oral glucose and demonstrate a venous plasma glucose level of 156 mg/dL one hour later.

Which of the following is the most appropriate next step of management?



Answer : B

Gestational diabetes is typically asymptomatic but identified via a 1-hour 50g oral glucose challenge administered at 24--28 weeks of gestation. A venous plasma glucose blood level of > 140 mg/dL is suggestive, and must be confirmed with a 3-hour 100g oral glucose tolerance test. After administration of the 100g glucose challenge, at least two of the following are required for diagnosis: (1) fasting glucose > 95 mg/dL, (2) one-hour glucose >180 mg/dL, (3) two hour glucose >155 mg/dL, and (4) three hour glucose > 140 mg/dL. Choice A --

To diagnose gestational diabetes, a positive 1-hour 50g oral glucose challenge must be followed up by a three-hour 100g oral glucose challenge. The diagnosis is only confirmed after both challenges are completed and the thresholds are met. Choice C -- Following the diagnosis of gestational diabetes, the first step is strict glycemic control (fasting glucose).


Question 4

Which of the following should be monitored when a patient is on SGLT2 inhibitor?



Answer : E

Because SGLT2 inhibitors work by preventing reabsorption of glucose in the kidneys, this increases frequency of urination. All of the options are monitoring requirements since the hydration status, blood pressure, blood glucose, and renal function may all be changed from increased urination (from the mechanism of the drug).


Question 5

FT is a 23-year-old newly diagnosed type I diabetes admitted to the hospital due to diabetes ketoacidosis. 2 days after being on insulin drip, anion gap is closed. Physician would like your help in transitioning her to subcutaneous insulin. She suggests using insulin glargine once a day and Insulin lispro three time a day at ratio of 70:30. 70 % of long and 30 % of short acting insulin. FT received average of 70 units of insulin in 24hrs.

Which of the following would be the best insulin regimen?



Answer : A

70% of 70 units = 49 units of Insulin Glargine daily 30% of 70 units = 21 units of Insulin Lispro daily. Dived in 3 doses would be 7 units three times a day. FT's Insulin regimen should be 49 units of Insulin Glargine subcutaneous daily and 7 units of Insulin Lispro subcutaneous three times a day with meals


Question 6

You get an order for 5% amino acid 15% dextrose premixed parenteral nutrition solution, 2 L at 83mls/hr. Your pharmacy technician tells you there is manufacture's backorder on those. How many ml of 20% dextrose would you need to provide the same amount of dextrose in 24 hrs?



Answer : C

15% dextrose = 15gm/100ml = 300gm/2000ml. Patient needs 300gm. 300gm/Xml = 20gm/100ml = 1500ml


Question 7

A 72-year-old woman suffers from a major depressive episode. She has a history of coronary artery disease, atrial fibrillation on anticoagulation therapy, sick sinus syndrome, glaucoma, and chronic obstructive pulmonary disease.

Which of the following medications is most appropriate for the treatment of her depression?



Answer : E

In older adults, selection of antidepressant medication should be done with various considerations in mind, most notably side effects and risk of drug-drug interactions. The tricyclic antidepressants (TCAs), as discussed on Question: 4

interactions that make them undesirable for the treatment of depression in older adults. A selective serotonin reuptake inhibitor is more favorable than a TCA in this patient. Fluvoxamine has a high risk for drug-drug interactions, whereas escitalopram does not. Fluvoxamine also has high protein binding, and can therefore interact with anticoagulant medications, such a warfarin. Therefore, of the medications listed, escitalopram is the most appropriate in this patient. In older adults, psychotropic medications should be started at a low dose and titrated up slowly to the lowest effective dose.


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Total 155 questions