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NAPLEX Dumps
North American Pharmacist Licensure
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NABP - NAPLEX
Question #:1
Which of the following would be most appropriate to treat infections associated with stenotrophomonas
maltophilia?
A.  Meropenem
B.  Vancomycin
C.  Ciprofloxacin
D.  Sulfamethoxazole/trimethoprim
E.  Ampicillin
Answer: D
Explanation
Primary treatment for stenotrophomonas maltophilia is SMX-TMP. Meropenem, ciprofloxacin, Ampicillin and
vancomycin have no coverage.
Question #:2
Which of the following is recommended to be monitored in patients on Divalproex Sodium?
A.  CBC
B.  Serum ammonia
C.  LFT’s
D.  Pulmonary function
E.  Serum creatinine
Answer: C
Explanation
A, B, C. Hepatotoxicity, including hepatic failure, has been fatal and may more commonly occur in the first 6
months of treatment. Valproic acid and its analogs are contraindicated in patients with known urea cycle
disorders. Patients with urea cycle disorders have a genetic enzyme defect leading to an impaired ability to
produce urea. Hyperammonemic encephalopathy has been reported following initiation of valproate therapy.
Because of, inhibition of the secondary phase of platelet aggregation, and abnormal coagulation parameters
complete blood counts and coagulation tests are recommended before initiating valproic acid therapy and at
periodic intervals.
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Question #:3
LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and
NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and
chronic back pain. Post-op day 1, LN’s medication includes Dexamethasone 8mg iv q6h with taper dosing,
Ondansetron 4mg iv q6h prn for N/V, Levothyroxine 0.075mg po daily, Lisinopril 10mg po daily, Citalopram
20mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for
constipation, Famotidine 20mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500mg po bid, D51/2NS
with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dose 0.1mg. lock-out
every 6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg 1.5mg/
dl, K 5.0mmol/L, Na 135mmol/L.
LN used 5 on-demand bolus doses from the hydromorphone PCA, how much hydromorphone did the patient
get in 24 hours?
A.  10mg
B.  5.3mg
C.  4.8mg
D.  0.5mg
E.  52.8mg
Answer: B
Explanation
0.2 mg/hour basal rate = 0.2mg/hour (24 hours) = 4.8 mg Demand dose of 0.1 mg × 5 = 0.5 mg 4.8 mg + 0.5
mg = 5.3 mg
Question #:4
In the management of acute ischemic stroke, within how many minutes from symptom onset should alteplase
be administered?
A.  3 hours
B.  6 hours
C.  12 hours
D.  24 hours
Answer: A
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Explanation
In the management of acute ischemic stroke, alteplase should be administered within 3 hours of symptom
onset.
Question #:5
A patient with multibacillary leprosy is on dapsone, clofazimine, and rifampin. Which of the following is true
regarding the mechanism of action of the medications listed?
A.  Dapsone is bacteriostatic because of its inhibitory effects on dihydrofolate reductase
B.  Dapsone is bacteriostatic because of its inhibitory effects on myeloperoxidase
C.  Clofazimine is bactericidal by directly inhibiting bacterial DNA polymerase
D.  Rifampin is bacteriostatic by inhibiting RNA synthesis by blocking DNA-dependent RNA polymerase
E.  Rifampin is bactericidal by inhibiting RNA synthesis by blocking DNA-dependent RNA polymerase
Answer: E
Explanation
A, B – false – dapsone inhibits bacterial synthesis of dihydrofolic acid, via competition with para-
aminobenzoate for the active site of dihydropteroate synthetase. Dapsone is both bacteriostatic and weakly
bactericidal against M. leprae. Neither of the listed mechanisms are the cause of these effects. C – False – A
substance with both anti-leprosy and anti-inflammatory activity, clofazimine is weakly bactericidal against M.
leprae by binding to the guanine bases of bacterial DNA, not DNA polymerase directly. D – False – See
below. E – True – Rifampin is bactericidal by inhibiting RNA synthesis by blocking DNA-dependent RNA
polymerase.
Question #:6
Which of the following represents the major route of metabolism for acetaminophen?
A.  Glucuronidation
B.  Sulfation
C.  Cytochrome P-450 oxidation
D.  Direct renal excretion
E.  Plasma breakdown
Answer: A
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Explanation
Acetaminophen is metabolized by choices A through D. The major route is glucuronidation catalyzed by
UDP- glucuronyl transferase in the liver. Sulfation is the next most common route and is the target mechanism
for NAC therapy. Oxidation by cytochrome P-450 results in the formation of N-acetyl-p-benzoquinone imine,
which is responsible for the hepatic necrosis caused by acetaminophen overdose. Direct renal excretion
represents approximately 5% of the metabolism of acetaminophen. Plasma metabolism of acetaminophen does
not generally occur.
Question #:7
Which of the following medication may increase LDL?
A.  Amiodarone
B.  Lisinopril
C.  Hydrochlorothiazide
D.  Acetaminophen
E.  Cyclosporine
Answer: E
Explanation
LDL can be elevated by diuretics, cyclosporine, glucocorticoids, and amiodarone.
Question #:8
Which of the following medication should be avoided if a patient is on lithium to avoid lithium toxicity?
A.  Lisinopril
B.  Furosemide
C.  Naproxen
D.  Amiodarone
E.  Warfarin
Answer: C
Explanation
ACE-inhibitors (such as lisinopril), NSAIDs (such as naproxen) and loop diuretics (furosemide) can all
increase the risk of lithium toxicity.
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Question #:9
Mesna is typically administered alongside which of these chemotherapeutic agents?
A.  Busulfan
B.  Paclitaxel
C.  Ifosfamide
D.  Doxorubicin
Answer: C
Explanation
Mesna is administered to patients taking either ifosfamide or cyclophoshamide to conjugate toxic acrolein and
therefore prevent hemorrhagic cystitis (bladder bleeding).
Question #:10
What vitamin should the a patient receive to avoid Wernicke- Korsakoff syndrome?
A.  Thiamine
B.  Cyanocobalamin
C.  Folic Acid
D.  Nicotinic Acid
E.  Magnesium
Answer: A
Explanation
Thiamine should be administered to prevent Wernicke’s encephalopathy.
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