NAPLEX Exam Prep FREE Sample Exam — Fixed Set

A patient stabilized on 100 mg of a drug given intravenously is being converted to the oral formulation. The oral bioavailability of the drug is 0.5, and clearance is unchanged. What oral dose provides the same systemic exposure?

50 mg

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100 mg

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400 mg

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200 mg

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A water-quality report expresses a contaminant limit as 0.05%. Express this concentration in parts per million (ppm).

50 ppm

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5,000 ppm

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5 ppm

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500 ppm

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Rate control in atrial fibrillation with verapamil is explained by which action?

Blocking beta-1 receptors in the sinoatrial node

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Inhibiting the sodium-potassium ATPase pump in cardiac tissue

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Blocking L-type calcium channels in the atrioventricular node, slowing conduction

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Opening potassium channels to shorten the cardiac action potential

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Coordination difficulty leads a pharmacist to recommend a valved holding chamber for a patient’s metered-dose inhaler. Which technique instruction is correct with a spacer?

Inhale as rapidly and forcefully as possible

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Exhale fully into the chamber before each dose to prime it

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Inhale slowly and deeply after actuating the inhaler into the chamber

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Remove the inhaler canister and pour the dose into the chamber

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Maintenance therapy is planned to delay recurrence of mood episodes in bipolar I disorder, using an agent that must be titrated slowly because rapid escalation increases the risk of a serious rash. Which drug fits?

Lamotrigine

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Lithium used with no titration or level monitoring

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Carbamazepine started at full maintenance dose on day one

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Haloperidol used as long-term mood-episode prophylaxis

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Counseling a patient newly prescribed sildenafil for erectile dysfunction, the pharmacist emphasizes the key administration and safety points. Which statement is correct?

Take it daily at the same time as sublingual nitroglycerin for best effect

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Take it as needed roughly 30 to 60 minutes before sexual activity, and never combine it with any nitrate

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Take two tablets if the first has no effect within 10 minutes

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It must be taken with a high-fat meal to be absorbed

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A 78-year-old man taking chlorthalidone for 6 months reports fatigue. Laboratory results show sodium 124 mEq/L and potassium 3.0 mEq/L. Which adverse drug effect best explains these findings?

Thiazide-type diuretic therapy causing hyponatremia and hypokalemia

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Thiazide-type diuretic therapy causing hypernatremia and hyperkalemia

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Potassium-sparing diuretic therapy causing hyperkalemia and hypernatremia

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Loop diuretic therapy causing hypocalcemia as the sole electrolyte abnormality

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Rate control is ordered as diltiazem for an 81-year-old woman with atrial fibrillation (rate 132/min) admitted with decompensated heart failure and an ejection fraction of 25%. What should the pharmacist do?

Verify the order, because diltiazem is ideal in decompensated HFrEF

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Recommend replacing diltiazem with verapamil at an equivalent dose

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Add diltiazem to her existing verapamil for stronger effect

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Intervene — nondihydropyridine calcium channel blockers can worsen decompensated HFrEF, so a cautious beta-blocker/digoxin strategy should be discussed instead

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Foot-care teaching is scheduled for a 71-year-old man with diabetes and reduced sensation in both feet. Which self-care practice should be emphasized?

Walk barefoot indoors to improve circulation

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Cut corns deeply with a clean blade

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Soak both feet in very hot water each night

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Inspect his feet daily, including the soles, and seek care promptly for any sore that is not healing

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During therapy with dapsone, a patient reports unusual fatigue and shortness of breath, and the pharmacist considers the drug’s hematologic toxicities. Which adverse effects must dapsone monitoring anticipate, especially in glucose-6-phosphate dehydrogenase deficiency?

Hemolysis and methemoglobinemia, tracked with blood counts and clinical signs of cyanosis or dyspnea

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QT prolongation tracked with serial ECGs

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Pulmonary fibrosis tracked with chest imaging

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Crystalluria tracked with urine pH

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Anemia of chronic kidney disease is being evaluated in a 60-year-old man with hemoglobin 9.4 g/dL, ferritin 60 ng/mL, and transferrin saturation 15%. Which step precedes erythropoiesis-stimulating therapy?

Start epoetin today without further testing

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Replete iron first, then reassess the need for an erythropoiesis-stimulating agent

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Transfuse 2 units routinely at this hemoglobin

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Start oral vitamin B12 regardless of levels

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A healthy 45-year-old woman at a pharmacy health fair says she will start colorectal cancer screening at 60 because that is what her parents did. What current guidance should she hear?

Screening is no longer recommended for anyone

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She should wait for rectal bleeding before any testing

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Her parents' schedule is still the standard

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Average-risk screening now begins at age 45, so she should arrange it now

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NAPLEX Exam Prep FREE Sample Exam — Fixed Set

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