Illinois Pharmacist Licensing Examination
(NAPLEX) Practice Questions and Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A
1. A patient with HFrEF (EF 30%) should receive which medication to reduce
mortality?
A. Diltiazem
B. Lisinopril
C. Digoxin
D. Furosemide
Answer: B — Lisinopril
Rationale: ACE inhibitors reduce mortality in heart failure with reduced ejection fraction
(HFrEF). Diltiazem (a non-DHP CCB) may worsen HF. Digoxin improves symptoms but does
not reduce mortality. Furosemide improves fluid status only.
2. First-line treatment for uncomplicated cystitis in a nonpregnant female:
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin
D. Levofloxacin
Answer: B — Nitrofurantoin
Rationale: Nitrofurantoin (5 days) is first-line per guidelines. Fluoroquinolones are reserved due
to resistance and adverse effects.
3. Which statin is high-intensity at 40–80 mg?
A. Pravastatin
B. Simvastatin
C. Atorvastatin
D. Lovastatin
,Answer: C — Atorvastatin
Rationale: Atorvastatin 40–80 mg is high-intensity (≥50% LDL reduction).
4. A diabetic patient on metformin has eGFR 25 mL/min. What is appropriate?
A. Increase dose
B. Continue same dose
C. Discontinue metformin
D. Add glyburide
Answer: C — Discontinue metformin
Rationale: Metformin is contraindicated if eGFR <30 mL/min due to lactic acidosis risk.
5. Which inhaler must be shaken before use?
A. Tiotropium
B. Fluticasone/salmeterol DPI
C. Albuterol HFA
D. Umeclidinium
Answer: C — Albuterol HFA
Rationale: Metered-dose inhalers (HFA) require shaking; dry powder inhalers do not.
6. Drug of choice for anaphylaxis:
A. Diphenhydramine
B. Epinephrine IM
C. Prednisone
D. Albuterol
Answer: B — Epinephrine IM
Rationale: IM epinephrine (lateral thigh) is first-line.
7. Which drug can cause cough as a common adverse effect?
A. Losartan
B. Lisinopril
, C. Amlodipine
D. Hydrochlorothiazide
Answer: B — Lisinopril
Rationale: ACE inhibitors increase bradykinin → dry cough.
8. Preferred anticoagulant in pregnancy:
A. Warfarin
B. Apixaban
C. Heparin
D. Rivaroxaban
Answer: C — Heparin
Rationale: Heparin does not cross the placenta; warfarin is teratogenic.
9. First-line therapy for hypothyroidism:
A. Methimazole
B. Levothyroxine
C. Liothyronine
D. Propranolol
Answer: B — Levothyroxine
Rationale: Synthetic T4 is standard replacement therapy.
10. Which medication is contraindicated in asthma?
A. Metoprolol
B. Propranolol
C. Lisinopril
D. Montelukast
Answer: B — Propranolol
Rationale: Nonselective beta-blockers can trigger bronchospasm.
Infectious Disease
(NAPLEX) Practice Questions and Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A
1. A patient with HFrEF (EF 30%) should receive which medication to reduce
mortality?
A. Diltiazem
B. Lisinopril
C. Digoxin
D. Furosemide
Answer: B — Lisinopril
Rationale: ACE inhibitors reduce mortality in heart failure with reduced ejection fraction
(HFrEF). Diltiazem (a non-DHP CCB) may worsen HF. Digoxin improves symptoms but does
not reduce mortality. Furosemide improves fluid status only.
2. First-line treatment for uncomplicated cystitis in a nonpregnant female:
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin
D. Levofloxacin
Answer: B — Nitrofurantoin
Rationale: Nitrofurantoin (5 days) is first-line per guidelines. Fluoroquinolones are reserved due
to resistance and adverse effects.
3. Which statin is high-intensity at 40–80 mg?
A. Pravastatin
B. Simvastatin
C. Atorvastatin
D. Lovastatin
,Answer: C — Atorvastatin
Rationale: Atorvastatin 40–80 mg is high-intensity (≥50% LDL reduction).
4. A diabetic patient on metformin has eGFR 25 mL/min. What is appropriate?
A. Increase dose
B. Continue same dose
C. Discontinue metformin
D. Add glyburide
Answer: C — Discontinue metformin
Rationale: Metformin is contraindicated if eGFR <30 mL/min due to lactic acidosis risk.
5. Which inhaler must be shaken before use?
A. Tiotropium
B. Fluticasone/salmeterol DPI
C. Albuterol HFA
D. Umeclidinium
Answer: C — Albuterol HFA
Rationale: Metered-dose inhalers (HFA) require shaking; dry powder inhalers do not.
6. Drug of choice for anaphylaxis:
A. Diphenhydramine
B. Epinephrine IM
C. Prednisone
D. Albuterol
Answer: B — Epinephrine IM
Rationale: IM epinephrine (lateral thigh) is first-line.
7. Which drug can cause cough as a common adverse effect?
A. Losartan
B. Lisinopril
, C. Amlodipine
D. Hydrochlorothiazide
Answer: B — Lisinopril
Rationale: ACE inhibitors increase bradykinin → dry cough.
8. Preferred anticoagulant in pregnancy:
A. Warfarin
B. Apixaban
C. Heparin
D. Rivaroxaban
Answer: C — Heparin
Rationale: Heparin does not cross the placenta; warfarin is teratogenic.
9. First-line therapy for hypothyroidism:
A. Methimazole
B. Levothyroxine
C. Liothyronine
D. Propranolol
Answer: B — Levothyroxine
Rationale: Synthetic T4 is standard replacement therapy.
10. Which medication is contraindicated in asthma?
A. Metoprolol
B. Propranolol
C. Lisinopril
D. Montelukast
Answer: B — Propranolol
Rationale: Nonselective beta-blockers can trigger bronchospasm.
Infectious Disease
