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NAPLEX
North American Pharmacist Licensure Examination
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Question #143 Section 1
A. Nifedipine
B. Adalimumab
C. Digoxin
D. Simvastatin
Answer: A
The dihydropyridine drug "" nifedipine "" is the active ingredient found in the medicine Adalat. Nifedipine is used
to treat angina, Reynaud's phenomenon and hypertension. It is also used as a tocolytic agent in premature labor.
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
In the management of acute ischemic stroke, alteplase should be administered within 3 hours of symptom onset.
A. Methyldopa
B. Labetalol
C. Hydralazine
D. Nifedipine
Answer: A
The direct Coombs test is used to test for autoimmune hemolyticanemia "" a condition in which the body attacks
red blood cells, leading to anemia. Some drugs can cause a positive direct Coombs test "" methyldopa being one of
the most well-known (via IgG-mediated type II hypersensitivity reaction). Other drugs that can cause this effect
include quinidine (IgM-mediated activation) and penicillins (at very high doses).
Which H2-receptor blocker may cause gynecomastia in men due to its antiandrogenic effects?
A. Ranitidine
B. Nizatidine
C. Cimetidine
D. Famotidine
Answer: C
Cimetidine has multiple drug interactions due to its inhibitory effects on CYP1A2, 2C9, 2D6, and 3A4. Inhibition
of these enzymes can cause an increase in the serum concentrations of drugs metabolized by these enzymes,
leading to toxicity.
A patient presents in the pharmacy in a delirious state with pinpoint pupils. Which of the following toxicity states
does the patient most likely have?
A. Alcohol
B. Opioid
C. Benzodiazepine
D. Amphetamine
Answer: B
Signs of opioid overdose include pinpoint pupils, delirious state, nausea / vomiting, respiratory depression and
sleepiness or loss of consciousness. Naloxone may be used to reverse the effects of opioid overdose.
The administration of dapsone gel for the topical treatment of acne vulgaris in patients with G6PD deficiency may
produce which of these?
A. Anaphylaxis
B. Fungal infections
C. Hemolysis
D. Immunosuppression
Answer: C
Dapsone treatment has produced dose-related hemolysis and hemolytic anemia. Individuals with glucose-6¬
phosphate dehydrogenase (G6PD) deficiency are more prone to hemolysis.
A 51-year-old patient, who takes a calcium channel blocker (CCB), reports that he is experiencing constipation.
Which CCB is the patient most likely to be taking?
A. Nifedipine
B. Amlodipine
C. Verapamil
D. Diltiazem
Answer: C
Non-dihydropyridine calcium channel blockers "" which are diltiazem and verapamil "" are statistically more likely
to cause constipation. Of these two, verapamil has a higher probability of causing this side effect.
A. 90 millimoles
B. 99 millimoles
C. 145 millimoles
D. 154 millimoles
Answer: D
0.9% = 9 grams per every 1,000mL Molecular weight of NaCl = 58.5 9 / 58.5 = 0.154 moles 0.154 moles is the
same as 154 millimoles There are 154 millimoles of sodium ions and 154 millimoles of chloride ions in 0.9%
sodium chloride.
A 49-year-old's blood test results have come back from the lab. Their chloride level currently measures 99 mEq/L.
How should you interpret this result?
Answer: C
Serum chloride levels should ideally fall between 96-106 mEq/L. For this reason, the patient's chloride level has
come back as normal.
Before use, which of the following products should be used to clean surfaces of a laminar flow hood?
Answer: B
Before each use, 70% isopropyl alcohol should be used to clean surfaces of a laminar flow hood.
A. Tramadol
B. Digoxin
C. Valproate
D. Pregabalin
Answer: D
Pregabalin is the active ingredient of the medicine Lyrica; a drug used to treat epilepsy, neuropathic pain,
fibromyalgia and generalized anxiety disorder (GAD).
Answer: A
Benign prostatic hyperplasia (BPH) is an example of postrenal acute kidney injury (AKI). Postrenal AKI, as the
name suggests, involves an effect "Ëœpost' or "Ëœbeyond' the kidney, to problems that emerge downstream from
the kidney. BPH is one such example of that. Other examples include kidney stones, bladder stones and bladder
cancer.
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