NAPLEX PREP 2024 Questions with 100%
Correct Answers
Name three examples of at-home tests that can be purchased OTC?
pregnancy, ovulation, HIV, herpes, fecal occult blood, drug tests
lifespan of platelets?
7-10 days -- reason you have to hold aspirin 10 days prior to surgery
When would a CMP be helpful?
getting baseline electrolyte labs and liver function tests in one blood draw
These are the three white blood cells (leukocytes) classified further as granulocytes
neutrophils, basophils, eosinophils
Drug-induced agranulocytosis caused by what drugs?
clozapine, propylthiouracil, methimazole, procainamide, carbamazepine, bactrim, isoniazid
For what lab values does JCO require a specific institution protocol?
critical lab values and in that protocol, physicians are required to have a time frame to manage them
Define "myelosuppression"
a reduction in all hematopoietic cells (RBCs, platelets, leukocytes)
What medications increase serum calcium ?
vitamin D, thiazides
What medications DECREASE serum calcium?
corticosteroids, long-term heparin, loops, bisphosphonates, cinacalcet, topiramate, calcitonin
T/F You must correct calcium every time you get a value for serum calcium.
False, ionized calcium does not need to be corrected.
Corrected Ca = Reported Ca + [(4-albumin) x 0.8]
What medications / disease states lower serum magnesium?
normal 1.3-2.1 mEq/L
PPIs, diuretics, amphoB, echinocandins
Diarrhea, chronic alcohol use disorder
What medications elevate serum magnesium?
normal 1.3-2.1 mEq/L
Mg-containing antacids, laxatives in renal impairment
,Phosphate levels (normal 2.3-4.7 mg/L) in the blood can be lowered by...
phosphate binders, oral Calcium
Role of PO4 in the body...
in bone metabolism, helps to buffer acid-base balance
Electrolyte imbalances/ changes resulting from renal impairment are:
increased phosphate
increased BUN
increased Scr
Main intracellular cation that's normal range is 3.5-5mEq/L?
potassium
Elevate or reduce serum concentrations of potassium?
A. Corticosteroids
B. ACEi/ARBs/aliskerin
C. Canagliflozin
D. Albuterol
E. Loops
F. Insulin
G. Bactrim
H. Immunosuppressives (cyclosporine/ tacrolimus)
A. lower
B. elevate
C. elevate
D. lower
E. lower
F. lower
G. elevate
H. elevate
Medications that reduce extracellular sodium concentrations (normal 135-145mEq/L)
carbamazepine, oxcarbazepine, SSRIs, diuretics
How does a salicylate overdose affect the body's acid-base balance?
body enters alkalosis
When the anion gap is elevated above 5-12 normal range, what is the body's metabolic state?
metabolic acidosis
A 4 year old gets a new prescription for an antibiotic and her mother is asking you if it's appropriately
dosed. What references could you refer to check?
Harriet Lane Handbook
Red Book by AAP
,You get a call from a Dr. about to discharge a patient from the hospital who just had a GI ulcer bleed.
The doctor is asking what formulations are available for this patient's maintenance medications
because he is afraid oral tablets will be too harsh. What references do you check?
Package inserts
Any drug monograph - Lexi, Micromedex, ClinPharm, Facts and Comparisons
A very concerned father rushes into your pharmacy after finding a small white pill on his daughter's
bedroom floor. He asks you to identify the medication. How would you go about doing this if you
didn't recognize the tablet?
Use the Drug ID tool on Micromedex, Lexicomp, Pillbox, Ident-A-Drug
**only source without pill ID = AHFS
Which of the following are included in the package insert?
A. Indications
B. Black box warnings
C. Drug cost
D. Major changes in safety
E. Dosing administration
F. Drug strengths and formulations
G. ADRs and DDIs
H. Mechanism of Action
I. Contraindications
J. Specific trial results from clinical trials
All of the above EXCEPT C.
Drug cost and off-label indications not on package insert --it is an FDA-approved item part of the drug
labeling. only FDA-approved indications included
There are four locations to find the package insert. List 2
Daily Med
Drugs@FDA
manufacturer website
attached to box/printed
Which resource would you go to first if doing an in-depth research paper on off-label indications of
duloxetine?
American Hospital Formulary Service (AHFS)
- can find on Lexicomp
- no pill ID, no pricing, no natural products
There are many free resources that can be accessed. These are:
Drug info portal (National Library of Medicine - includes DailyMed, LactMed, Pillbox)
Epocrates (Plus offers ICD codes for billing at a fee)
Prescriber's Digital reference (drugs, vaccines, biologics)
Drugs.com
RxList
, You are working in the pharmacy basement when a doctor calls and asks roughly how much a
medication will cost for a patient as she wants to make sure the patient can afford it before
prescribing. What two resources offer drug pricing?
Redbook (Micromedex)
Medi-Span Price Rx
You are volunteering at a refugee community center in your city to do a brown bag event with
individuals. A lot of the medications being taken are from Venezuela, Peru, Colombia and your
Spanish is not helping you out today. How can you be sure which medications patients are taking?
International drug names compendia
Index Nominum
Martindale's
USAN (USP Dictionary)
Lexicomp
When marketing a new OTC product, a manufacturer has two possible pathways to go through for
approval.
1. NDA - through FDA CDER and this will then be an FDA-approved drug
2. OTC monograph process - labeling can be on the container itself (ie. vitamins)
Match the organization to the population/ disease state guidelines
A. CHEST guidelines
B. ADA guidelines/ AACE
C. COPD
D/ HIV and CAP guidelines
E. ACOG
F. GINA
G. ACIP
H. AAP
I. Renal guidelines
J. STIs
A. stroke prevention and VTE
B. diabetes
C. GOLD
D. IDSA
E. Women's health
F. Asthma guidelines
G. Immunization recommendations (via CDC)
H. Pediatrics
I. KDIGO
J. CDC
Where do I find information on drug adverse reactions?
- ASHP drug-induced Dx
- FDAble
- MedWatch (FAERS = FDA Safety Info + AE Reporting)
- VAERS (vaccines)
Correct Answers
Name three examples of at-home tests that can be purchased OTC?
pregnancy, ovulation, HIV, herpes, fecal occult blood, drug tests
lifespan of platelets?
7-10 days -- reason you have to hold aspirin 10 days prior to surgery
When would a CMP be helpful?
getting baseline electrolyte labs and liver function tests in one blood draw
These are the three white blood cells (leukocytes) classified further as granulocytes
neutrophils, basophils, eosinophils
Drug-induced agranulocytosis caused by what drugs?
clozapine, propylthiouracil, methimazole, procainamide, carbamazepine, bactrim, isoniazid
For what lab values does JCO require a specific institution protocol?
critical lab values and in that protocol, physicians are required to have a time frame to manage them
Define "myelosuppression"
a reduction in all hematopoietic cells (RBCs, platelets, leukocytes)
What medications increase serum calcium ?
vitamin D, thiazides
What medications DECREASE serum calcium?
corticosteroids, long-term heparin, loops, bisphosphonates, cinacalcet, topiramate, calcitonin
T/F You must correct calcium every time you get a value for serum calcium.
False, ionized calcium does not need to be corrected.
Corrected Ca = Reported Ca + [(4-albumin) x 0.8]
What medications / disease states lower serum magnesium?
normal 1.3-2.1 mEq/L
PPIs, diuretics, amphoB, echinocandins
Diarrhea, chronic alcohol use disorder
What medications elevate serum magnesium?
normal 1.3-2.1 mEq/L
Mg-containing antacids, laxatives in renal impairment
,Phosphate levels (normal 2.3-4.7 mg/L) in the blood can be lowered by...
phosphate binders, oral Calcium
Role of PO4 in the body...
in bone metabolism, helps to buffer acid-base balance
Electrolyte imbalances/ changes resulting from renal impairment are:
increased phosphate
increased BUN
increased Scr
Main intracellular cation that's normal range is 3.5-5mEq/L?
potassium
Elevate or reduce serum concentrations of potassium?
A. Corticosteroids
B. ACEi/ARBs/aliskerin
C. Canagliflozin
D. Albuterol
E. Loops
F. Insulin
G. Bactrim
H. Immunosuppressives (cyclosporine/ tacrolimus)
A. lower
B. elevate
C. elevate
D. lower
E. lower
F. lower
G. elevate
H. elevate
Medications that reduce extracellular sodium concentrations (normal 135-145mEq/L)
carbamazepine, oxcarbazepine, SSRIs, diuretics
How does a salicylate overdose affect the body's acid-base balance?
body enters alkalosis
When the anion gap is elevated above 5-12 normal range, what is the body's metabolic state?
metabolic acidosis
A 4 year old gets a new prescription for an antibiotic and her mother is asking you if it's appropriately
dosed. What references could you refer to check?
Harriet Lane Handbook
Red Book by AAP
,You get a call from a Dr. about to discharge a patient from the hospital who just had a GI ulcer bleed.
The doctor is asking what formulations are available for this patient's maintenance medications
because he is afraid oral tablets will be too harsh. What references do you check?
Package inserts
Any drug monograph - Lexi, Micromedex, ClinPharm, Facts and Comparisons
A very concerned father rushes into your pharmacy after finding a small white pill on his daughter's
bedroom floor. He asks you to identify the medication. How would you go about doing this if you
didn't recognize the tablet?
Use the Drug ID tool on Micromedex, Lexicomp, Pillbox, Ident-A-Drug
**only source without pill ID = AHFS
Which of the following are included in the package insert?
A. Indications
B. Black box warnings
C. Drug cost
D. Major changes in safety
E. Dosing administration
F. Drug strengths and formulations
G. ADRs and DDIs
H. Mechanism of Action
I. Contraindications
J. Specific trial results from clinical trials
All of the above EXCEPT C.
Drug cost and off-label indications not on package insert --it is an FDA-approved item part of the drug
labeling. only FDA-approved indications included
There are four locations to find the package insert. List 2
Daily Med
Drugs@FDA
manufacturer website
attached to box/printed
Which resource would you go to first if doing an in-depth research paper on off-label indications of
duloxetine?
American Hospital Formulary Service (AHFS)
- can find on Lexicomp
- no pill ID, no pricing, no natural products
There are many free resources that can be accessed. These are:
Drug info portal (National Library of Medicine - includes DailyMed, LactMed, Pillbox)
Epocrates (Plus offers ICD codes for billing at a fee)
Prescriber's Digital reference (drugs, vaccines, biologics)
Drugs.com
RxList
, You are working in the pharmacy basement when a doctor calls and asks roughly how much a
medication will cost for a patient as she wants to make sure the patient can afford it before
prescribing. What two resources offer drug pricing?
Redbook (Micromedex)
Medi-Span Price Rx
You are volunteering at a refugee community center in your city to do a brown bag event with
individuals. A lot of the medications being taken are from Venezuela, Peru, Colombia and your
Spanish is not helping you out today. How can you be sure which medications patients are taking?
International drug names compendia
Index Nominum
Martindale's
USAN (USP Dictionary)
Lexicomp
When marketing a new OTC product, a manufacturer has two possible pathways to go through for
approval.
1. NDA - through FDA CDER and this will then be an FDA-approved drug
2. OTC monograph process - labeling can be on the container itself (ie. vitamins)
Match the organization to the population/ disease state guidelines
A. CHEST guidelines
B. ADA guidelines/ AACE
C. COPD
D/ HIV and CAP guidelines
E. ACOG
F. GINA
G. ACIP
H. AAP
I. Renal guidelines
J. STIs
A. stroke prevention and VTE
B. diabetes
C. GOLD
D. IDSA
E. Women's health
F. Asthma guidelines
G. Immunization recommendations (via CDC)
H. Pediatrics
I. KDIGO
J. CDC
Where do I find information on drug adverse reactions?
- ASHP drug-induced Dx
- FDAble
- MedWatch (FAERS = FDA Safety Info + AE Reporting)
- VAERS (vaccines)
