02 NAPLEX Practice Test | quiz | NABP | North American Pharmacist Licensure Examination

02 NAPLEX Practice Test | quiz | NABP | North American Pharmacist Licensure Examination

1 >>Which of the following species is most likely to cause purulent boils on the skin? ?

• (A) Streptococcus
• (B) Staphylococcus
• (C) Candida
• (D) Aspergillus

Solution Staph infections most commonly result in skin infections that usually result in a localized collection of puss, known as a boil. Strep infections commonly result in sore throats and pneumonia. Candida infection commonly results in oral thrust, yeast infections, and jock itch. Aspergillus commonly causes lung infections. Pseudomonas infection commonly causes pneumonia, urinary tract infections, and bacteremia.

2 >>Which of the following is the most appropriate treatment for conjunctival herpes simplex virus (HSV) infection? ?

• (A) Mupirocin
• (B) Idoxuridine
• (C) Bacitracin
• (D) Amphotericin B

Solution Idoxuridine is an antiviral agent that has demonstrated efficacy against HSV infections and is available in an ophthalmic form. Mupirocin and bacitracin are antibacterial agents that would not be effective against a virus. Amphotericin B is an anti-fungal agent that would not be effective against a virus. Thiabendazole is an anthelmintic agent that has activity against parasitic infections, but not viral infections.

3 >>Which of the following should NOT be used to treat candidal infections? ?

• (A) Terconazole
• (B) Miconazole
• (C) Nystatin
• (D) Tolnaftate

Solution Tolnaftate is an anti-fungal used for the treatment of tinea pedis, tinea cruris, and tinea corporis. Miconazole, nystatin, and clotrimazole are all used to treat Candidal infections.

4 >>Which of the following is an indication for methotrexate? ?

• (A) Warts
• (B) Tinea infection
• (C) Psoriasis
• (D) Acne

Solution Methotrexate is used to treat psoriasis. The dose is 2.5 mg/dose every 12 hours for 3 doses given weekly.

5 >>Which of the following may occur with corticosteroid ingestion? ?

• (A) Disseminated infection
• (B) Immunosuppression
• (C) Increased risk of infection
• (D) All of the above

Solution Corticosteroids block prostaglandin activity as well as interfere with enzymes involved in inflammation, thereby reducing inflammation. Corticosteroids suppress the immune system, therefore making the patient more susceptible to infection and masking infectious symptoms.

6 >>Compared with other NSAIDs, which of the following is a benefit associated with the use of piroxicam? ?

• (A) Once-daily dosing
• (B) No gastric side effects
• (C) Cytoprotective effects
• (D) Inexpensive

Solution Piroxicam is dosed once daily, compared to ibuprofen and naproxen that are dosed 2-4 times daily. Piroxicam may cause GI side effects and does not demonstrate cytoprotective effects. Compared to other NSAIDs, piroxicam has the same mechanism of action and is more expensive.

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7 >>Which of the following is an indication for clomiphene citrate? ?

• (A) Dysmenorrhea
• (B) Nausea
• (C) Depression
• (D) Infertility

Solution Clomiphene citrate is used for the treatment of ovulatory failure, which can cause infertility. Clomiphene stimulates ovulation.

8 >>Which of the following is detected by the e.p.t. home pregnancy test? ?

• (A) Human chorionic gonadotropin
• (B) Prolactin
• (C) Progestin
• (D) Progesterone

Solution E.P.T. home pregnancy test detects levels of human chorionic gonadotropin, which is produced in pregnancy, soon after conception.

9 >>Which of the following is/are the mechanism of action of nitric oxide (NO)? ?

• (A) Increased smooth muscle activity
• (B) Stimulation of nucleotide c-GMP
• (C) Smooth muscle relaxation
• (D) b and c

Solution NO is a biologic messenger that lines blood vessels and signals smooth muscle relaxation. NO also binds and activates guanylyl cyclase in the vascular smooth muscle, which is an enzyme that catalyzes the activation of c-GMP.

10 >>Which of the following drug combinations are found in Advair? ?

• (A) Flunisolide and salmeterol
• (B) Fluticasone and salmeterol
• (C) Beclomethasone and formoterol
• (D) Fluticasone and formoterol

Solution Advair is a combination of a long-acting beta2-adrenergic agonist, salmeterol, and a corticosteroid, fluticasone

11 >>Which of the following is the preferred method to evaluate the efficacy of warfarin therapy? ?

• (A) Prothrombin time (PT)
• (B) Partial Thromboplastin Time (PTT)
• (C) Bleeding time
• (D) International Normalized Ration (INR)

Solution INR is an internationally standardized ratio for reporting results of blood coagulation tests and standardizes variations in PT values. PT is prothrombin time, which can be highly variable from one institution to the next, and can yield different results if a patient has his or her blood tested at multiple sites. The PT can be used to monitor warfarin treatment but the PT has been largely replaced by INR monitoring. PTT is a partial thromboplastin time test used to monitor heparin, and as with the PT test, results are highly variable. Bleeding time measures platelet function, but is also highly variable due to variations in methods used.

12 >>InnoPran XL™ is available as: ?

• (A) 80 mg
• (B) 120 mg
• (C) 180 mg
• (D) a and b

Solution InnoPran XL is available as 80 mg and 120 mg capsules that contain sustained-release beads.

13 >>Which of the following is NOT a common symptom of antipsychotic medications? ?

• (A) Akathisia
• (B) Anhedonia
• (C) Diabetes
• (D) Weight gain

Solution Anhedonia is a symptom of major depressive disorder, as well as schizophrenia and other mental disorders. First generations antipsychotics commonly cause movement disorders, such as akithesia and tardive dyskinesia. Second generation antipsychotics commonly cause endocrine side effects, such as weight gain and diabetes.

14 >>A 65-year-old woman with congestive heart failure and atrial fibrillation is diagnosed with glaucoma. What is the most appropriate topical treatment? ?

• (A) Timolol
• (B) Timolol plus dorzolamide
• (C) Latanoprost
• (D) Epinephrine

Solution Latanoprost is a prostaglandin F2-alpha analog that will not impact the patient's CHF and atrial fibrilation. Timolol blocks beta-adrenergic receptors and ocular administration can result in some systemic absorption. Beta blockers are used with caution in patients with CHF, and may worsen CHF symptoms. Epinephrine is rarely used for the treatment of glaucoma due to side effects, including high blood pressure and disturbances in heart rhythm.

15 >>What is the rationale for the preferred use of inhaled corticosteroids over oral corticosteroids in the treatment of asthma? ?

• (A) Increased efficacy
• (B) Decreased systemic side effects
• (C) Increased ease of use
• (D) a and b

Solution Oral corticosteroids can cause a variety of systemic side effects when used long term including osteoporosis, muscle wasting, hyperglycemia and mood changes. These side effects are not seen with inhaled corticosteroids. There is no improvement in efficacy or ease of use with inhaled corticosteroids.

16 >>Lisinopril is a: ?

• (A) b blocker.
• (B) a1 blocker.
• (C) angiotensin-recepter blocker.
• (D) angiotensin-converting enzyme inhibitor.

Solution Lisinopril is an angiotensin converting enzyme inhibitor. Metoprolol is a beta blocker, doxazosin is an alpha-1 blocker, losartan is an angiotensin receptor blocker and furosemide is a diuretic.

17 >>Bicitra is the U.S. brand name for: ?

• (A) Sodium citrate and citric acid
• (B) Dibasic sodium phosphate
• (C) Bismuth subsalicylate
• (D) Magaldrate and simethicone

Solution Bicitra , a medication that makes the urine less acidic, is the US brand name for sodium citrate and citric acid.

18 >>Aprepitant (Emend) is: I. Available as capsules II. A substance P antagonist III. Used to prevent acute and delayed nausea and vomiting associated with cancer chemotherapy ?

• (A) I only
• (B) III only
• (C) I and II only
• (D) I, II, and III

Solution Aprepitant (Emend ) is available as capsule and as an injection. The drug is a selective antagonist of human substance P/neurokinin 1 receptors. It is used to prevent nausea and vomiting associated with chemotherapy.

19 >>Which of the following is the most appropriate initial treatment for a patient with newly diagnosed type 2 diabetes? ?

• (A) Glyburide
• (B) Insulin
• (C) Metformin
• (D) Acarboze

Solution Metformin works best in newly diagnosed type II diabetics and results in the greatest intial reduction of A1C of the oral medications available for diabetes. Insulin is usually initiated after metformin and other oral agents have been maximized. Acarbose is poorly tolerated due to GI side effects and most patients discontinue this medication due to the side effects. Pioglitazone may result in weight gain, and will not result in as much A1C lowering as metformin.

20 >>Which of the following agent(s) is/are classified as a sulfonylurea? I. Chlorpropamide II. Glipizide III. Tolterodine ?

• (A) I only
• (B) III only
• (C) I and II
• (D) II and III

Solution Chlorpropamide (Diabinese ) is a first-generation sulfonylurea, and glipizide (Glucotrol ) is a second generation sulfonylurea used in the management of type 2 diabetes. Tolterodine is a muscarinic receptor antagonist used for overactive bladder.

21 >>Type 1 diabetes mellitus: ?

• (A) may be due to autoimmune phenomena.
• (B) usually presents before puberty.
• (C) must be treated with insulin.
• (D) All of the above

Solution Type I diabetes is usually caused by an autoimmune disorder and is usually diagnosed in children and young adults. Patients with type I diabetes cannot produce their own insulin and must be take insulin. The most common symptoms of type I diabetes are polyuria, polydypsia, and polyphagia.

22 >>Type 2 diabetes mellitus: ?

• (A) does not have a genetic component.
• (B) requires insulin therapy.
• (C) is most likely to occur in thin, malnourished patients.
• (D) is a relative, not complete, lack of insulin.

Solution Type II patients may still produce some insulin on their own, but are resistant to the effects of insulin. Therapy for patients with type II diabetes includes medications that increase receptor sensitivity to insulin, and does not necessarily have to be insulin. Type II diabetes tends to occur in overweight patients.

23 >>Diabetes mellitus can be diagnosed in which of the following situations? ?

• (A) Fasting blood glucose greater than 126 mg/dL
• (B) Random plasma glucose greater than 200 mg/dL
• (C) Oral glucose challenge 2-hour plasma level greater than 200 mg/dL
• (D) Any of the above

Solution Diagnosis of diabetes is confirmed by a fasting blood glucose greater than 126 mg/dL, a random plasma glucose greater than 200 mg/dL, or an oral glucose challenge with a 2 hr plamsa glucose level greater than 200 mg/dL.

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24 >>Which of the following is classified as an NSAID? I. Celecoxib II. Ketorolac III. Acetaminophen ?

• (A) I only
• (B) III only
• (C) I and II
• (D) II and IIII

Solution Acetaminophen is not an NSAID; it reduces pain and fever but not inflammation. Celecoxib (Celebrex ) is an NSAID and selective COX-2 inhibitor. Ketorolac (Toradol ) is also an NSAID.

25 >>What are the active ingredients in Prempro ? ?

• (A) Conjugated estrogen and methyltestosterone
• (B) Conjugated estrogen and medroxyprogesterone
• (C) Ethinylestradiol and medroxyprogesterone
• (D) Drospirenone and ethinyl estradiol

Solution Prempro contains conjugated estrogen and medroxyprogesterone and is used to treat the symptoms of menopause such as hot flashes and vaginal dryness.

26 >>All of the following medications are protease inhibitors EXCEPT: ?

• (A) Reyataz
• (B) Lexiva
• (C) Viramune
• (D) Agenerase

Solution Viramune (nevirapine) is a non-nucleoside reverse transcriptase inhibitor (NNRTI) used to treat human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS).

27 >>Which of the following antiretroviral drugs are available as syrup or oral solution? ?

• (A) Epivir
• (B) Ziagen
• (C) Videx
• (D) All of the above

Solution Epivir (lamivudine), Ziagen (abacarin) (Retrovir), Videx (didanosine), and Norvir (ritonavir) are available as syrup or oral solution

28 >>Which of the following is/are considered rapidacting insulin? I. Apidra II. Humalog III. Novolog ?

• (A) I only
• (B) III only
• (C) I and II only
• (D) I, II, and III

Solution Apidra (insulin glulisine), Humalog (insulin lispro), and Novolog (insulin aspart) are rapidacting insulins.

29 >>All of the following drugs are prostaglandin analogs EXCEPT: ?

• (A) Xalatan
• (B) Lumigan
• (C) Azopt
• (D) Travatan

Solution Azopt (brinzolamide) is a carbonic anhydrase inhibitor.

30 >>Which HMG-CoA reductase inhibitor is least likely to have drug interactions? ?

• (A) Pravastatin
• (B) Lovastatin
• (C) Fluvastatin
• (D) Atorvastatin

Solution Pravastatin (Pravachol ) is not metabolized by the cytochrome P450 system and is least likely to have drug interactions.

31 >>What is the brand name for levalbuterol? ?

• (A) Ventolin
• (B) Serevent
• (C) Xopenex
• (D) Flovent

Solution Xopenex is the brand name for levalbuterol. Ventolin is brand name albuterol, Serevent is salmeterol, and Flovent is fluticasone.

32 >>What is the dose of trazodone for depression? ?

• (A) 10 mg per day
• (B) 25-50 mg per day
• (C) 1-2 grams per day
• (D) 150 mg per day

Solution The dose of trazodone (Desyrel ) for depression is 150 mg per day in divided doses. The maximum dose of trazodone is 600 mg per day.

33 >>Axert is available as: I. 6.25 mg II. 12.5 mg III. 30 mg ?

• (A) I only
• (B) III only
• (C) I and II only
• (D) II and III only

Solution Almotriptan (Axert ) belongs to a class of drugs called triptans and is available in two doses, 6.25 mg and 12.5 mg.

34 >>Imitrex is available as: I. Nasal spray II. Tablets III. Injection ?

• (A) I only
• (B) III only
• (C) I and II only
• (D) I, II, and III

Solution Imitrex belongs to a class of drugs called triptans and is available as a nasal spray, tablets, and injection.

35 >>Ketorolac is a(n): ?

• (A) salicylate.
• (B) NSAID.
• (C) corticosteroid.
• (D) opioid.

Solution Ketorolac is an NSAID, aspirin is a salicylate, prednisone is a corticosteroid, morphine is an opioid, and diazepam is a benzodiazepine.

36 >>What is the maximum oral daily dose of ketorolac? ?

• (A) 20 mg
• (B) 40 mg
• (C) 50 mg
• (D) 100 mg

Solution The maximum daily dose of oral ketorolac for pain management is 40 mg.

37 >>Which of the following conditions is NOT a contraindication for ketorolac? ?

• (A) Hemorrhagic diathesis
• (B) Gastrointestinal perforation
• (C) Epilepsy
• (D) Renal failure

Solution Ketorolac is not contraindicated in epilepsy. Ketorolac is contraindicated in renal failure due to volume depletion, in hemorrhagic diathesis due to possible inhibition of platelet functioning by ketorolac, in gastrointestinal peroforation due to increased risk of GI perforation and in breast feeding since ketorolac enters the milk and could inhibit prostaglandin synthesis in neonates.

38 >>What is the brand name for latanoprost? ?

• (A) Toradol
• (B) Accuset
• (C) Xalatan
• (D) Conista

Solution Xalatan is latanoprost. Toradol is ketorolac. Accuset, Conista and Zerolast are all made up drug names.

39 >>What is the correct daily topical dose of latanoprost for the treatment of glaucoma? ?

• (A) 15 mcg
• (B) 15 mg
• (C) 1.5 mcg
• (D) 1.5 mg

Solution The correct daily dose of latanoprost for the treatment of glaucoma is 1.5 mcg (1 drop).

40 >>Latanoprost: ?

• (A) has an onset of action of 1-2 hours.
• (B) has a peak effect at 8-12 hours.
• (C) has a volume of distribution of 1 L/kg.
• (D) is excreted unchanged in the urine.

Solution Latanoprost has a peak effect at 8-12 hours. It has an onset of action of 3-4 hours, a volume of distribution of 0.16 L/kg, is excreted in the urine as metabolites, and has a half-life elimination of 17 minutes.

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