NAPLEX QBANK Practice Test 1 — Questions and Answers
Question 1: Jen is an 75-year-old woman who is undergoing back surgery. Her height is 5 feet 4 inches, her weight is 85 kg, and NKDA. Hypertension, diabetes, serious depression, hypothyroidism, and persistent back pain are among her former medical conditions. Jen's post-op medications include Dexamethasone 8mg iv q6h with taper dose, Ondansetron 4mg iv q6h prn for N/V, and Ondansetron 4mg iv q6h prn for N/V. Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, 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 20m, D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dosage 0.1mg, 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 Lockout every 6 minutes, with a one-hour limit of 2.2 mg/hr. Morning labs include serum creatinine 1.4 mg/dl, magnesium 1.5 mg/dl, potassium 5.0 mmol/L, and sodium 135 mmol/L. <br/> Which of the following medications has the potential to raise Jen's blood glucose levels?
- Dexamethasone (Correct answer)
- Lisinopril
- Metoclopramide
- Hydromorphone
Correct answer: Dexamethasone
Dexamethasone is a corticosteroid, and a well-known adverse effect of corticosteroids is their ability to increase blood glucose levels. This occurs through various mechanisms, including increased gluconeogenesis and insulin resistance. For a patient with a history of diabetes, like Jen, this effect is particularly significant and requires close monitoring of blood glucose.
Question 2: Jen is an 75-year-old woman who is undergoing back surgery. Her height is 5 feet 4 inches, her weight is 85 kg, and NKDA. Hypertension, diabetes, serious depression, hypothyroidism, and persistent back pain are among her former medical conditions. Jen's post-op medications include Dexamethasone 8mg iv q6h with taper dose, Ondansetron 4mg iv q6h prn for N/V, and Ondansetron 4mg iv q6h prn for N/V. Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, 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 20m, D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dosage 0.1mg, 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 Lockout every 6 minutes, with a one-hour limit of 2.2 mg/hr. Morning labs include serum creatinine 1.4 mg/dl, magnesium 1.5 mg/dl, potassium 5.0 mmol/L, and sodium 135 mmol/L. <br/> When given at a larger dose and over a longer period of time, which of the following medications may cause tardive dyskinesia?
- Dexamethasone
- Famotidine
- Metoclopramide (Correct answer)
- Lisinopril
Correct answer: Metoclopramide
Metoclopramide is a dopamine D2 receptor antagonist used as an antiemetic and prokinetic agent. A significant and serious adverse effect associated with its long-term or high-dose use is tardive dyskinesia, a movement disorder characterized by involuntary, repetitive body movements. Due to this risk, metoclopramide carries a black box warning, and its use is generally limited to short durations.
Question 3: Jen is an 75-year-old woman who is undergoing back surgery. Her height is 5 feet 4 inches, her weight is 85 kg, and NKDA. Hypertension, diabetes, serious depression, hypothyroidism, and persistent back pain are among her former medical conditions. Jen's post-op medications include Dexamethasone 8mg iv q6h with taper dose, Ondansetron 4mg iv q6h prn for N/V, and Ondansetron 4mg iv q6h prn for N/V. Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, 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 20m, D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dosage 0.1mg, 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 Lockout every 6 minutes, with a one-hour limit of 2.2 mg/hr. Morning labs include serum creatinine 1.4 mg/dl, magnesium 1.5 mg/dl, potassium 5.0 mmol/L, and sodium 135 mmol/L. <br/> Which of the following medications has the potential to produce psychotic symptoms such as emotional lability, hallucinations, mania, mood swings, and schizophrenic symptoms?
- Famotidine
- Metoclopramide
- Dexamethasone (Correct answer)
- Hydromorphone
Correct answer: Dexamethasone
Dexamethasone, a corticosteroid, is known to cause a range of neuropsychiatric side effects, including mood disturbances, anxiety, insomnia, and in some cases, more severe psychotic symptoms such as emotional lability, hallucinations, mania, and schizophrenic-like symptoms. These effects can occur even with standard doses and are a significant consideration when prescribing corticosteroids.
Question 4: Jen is an 75-year-old woman who is undergoing back surgery. Her height is 5 feet 4 inches, her weight is 85 kg, and NKDA. Hypertension, diabetes, serious depression, hypothyroidism, and persistent back pain are among her former medical conditions. Jen's post-op medications include Dexamethasone 8mg iv q6h with taper dose, Ondansetron 4mg iv q6h prn for N/V, and Ondansetron 4mg iv q6h prn for N/V. Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, 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 20m, D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dosage 0.1mg, 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 Lockout every 6 minutes, with a one-hour limit of 2.2 mg/hr. Morning labs include serum creatinine 1.4 mg/dl, magnesium 1.5 mg/dl, potassium 5.0 mmol/L, and sodium 135 mmol/L. <br/> To avoid the most prevalent adverse effect of hydromorphone, which of the following medications should Jen be taking?
- Insulin Sliding scale for hyperglycemia
- Ondansetron for N/V
- Docusate sodium / Senna for Constipation and ondansetron for N/V (Correct answer)
- Dexamethasone for N/V
Correct answer: Docusate sodium / Senna for Constipation and ondansetron for N/V
The most prevalent adverse effects of opioid analgesics like hydromorphone are constipation and nausea/vomiting. To prevent and manage these common side effects, a bowel regimen including a stool softener (docusate sodium) and a stimulant laxative (senna) is typically prescribed for opioid-induced constipation. Additionally, an antiemetic like ondansetron is used to address nausea and vomiting, ensuring comprehensive management of opioid side effects.
Question 5: Jen is an 75-year-old woman who is undergoing back surgery. Her height is 5 feet 4 inches, her weight is 85 kg, and NKDA. Hypertension, diabetes, serious depression, hypothyroidism, and persistent back pain are among her former medical conditions. Jen's post-op medications include Dexamethasone 8mg iv q6h with taper dose, Ondansetron 4mg iv q6h prn for N/V, and Ondansetron 4mg iv q6h prn for N/V. Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, 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 20m, D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dosage 0.1mg, 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 Lockout every 6 minutes, with a one-hour limit of 2.2 mg/hr. Morning labs include serum creatinine 1.4 mg/dl, magnesium 1.5 mg/dl, potassium 5.0 mmol/L, and sodium 135 mmol/L. <br/> Which of the following medications has the potential to induce substantial QT prolongation?
- Hydromorphone
- Lisinopril
- Citalopram (Correct answer)
- Metformin
Correct answer: Citalopram
Citalopram, an antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) class, is known to cause dose-dependent QT prolongation. This effect can increase the risk of serious ventricular arrhythmias, including Torsades de Pointes. Due to this cardiac risk, citalopram has specific dosing recommendations and precautions, especially in patients with pre-existing cardiac conditions or those taking other QT-prolonging drugs.
Question 6: Jen is an 75-year-old woman who is undergoing back surgery. Her height is 5 feet 4 inches, her weight is 85 kg, and NKDA. Hypertension, diabetes, serious depression, hypothyroidism, and persistent back pain are among her former medical conditions. Jen's post-op medications include Dexamethasone 8mg iv q6h with taper dose, Ondansetron 4mg iv q6h prn for N/V, and Ondansetron 4mg iv q6h prn for N/V. Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, 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 20m, D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dosage 0.1mg, 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 Lockout every 6 minutes, with a one-hour limit of 2.2 mg/hr. Morning labs include serum creatinine 1.4 mg/dl, magnesium 1.5 mg/dl, potassium 5.0 mmol/L, and sodium 135 mmol/L. <br/> Why is it suggested that people using chronic metformin have their total blood count monitored?
- Metformin may decreases vitamin B12 levels (Correct answer)
- Metformin may cause leukocytosis
- Metformin may decreases erythropoietin level
- Metformin may decrease iron absorption
Correct answer: Metformin may decreases vitamin B12 levels
Long-term use of metformin, a medication for type 2 diabetes, can interfere with the absorption of vitamin B12 in the gastrointestinal tract. This can lead to vitamin B12 deficiency, which is crucial for red blood cell formation. Consequently, monitoring a patient's total blood count (CBC) is recommended to detect potential megaloblastic anemia, a hematological manifestation of B12 deficiency, allowing for timely supplementation if needed.
Question 7: Jen is an 75-year-old woman who is undergoing back surgery. Her height is 5 feet 4 inches, her weight is 85 kg, and NKDA. Hypertension, diabetes, serious depression, hypothyroidism, and persistent back pain are among her former medical conditions. Jen's post-op medications include Dexamethasone 8mg iv q6h with taper dose, Ondansetron 4mg iv q6h prn for N/V, and Ondansetron 4mg iv q6h prn for N/V. Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, 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 20m, D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dosage 0.1mg, 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 Lockout every 6 minutes, with a one-hour limit of 2.2 mg/hr. Morning labs include serum creatinine 1.4 mg/dl, magnesium 1.5 mg/dl, potassium 5.0 mmol/L, and sodium 135 mmol/L. <br/> What is the rationale behind delaying metformin treatment in patients with impaired renal function?
- Metformin can build up neurotoxin
- Metformin can cause hyperglycemia
- Metformin can cause hyperkalemia
- Metformin can cause lactic acidosis (Correct answer)
Correct answer: Metformin can cause lactic acidosis
Metformin is primarily excreted by the kidneys, and in patients with impaired renal function, it can accumulate to toxic levels. This accumulation significantly increases the risk of lactic acidosis, a rare but severe and potentially fatal metabolic complication. Therefore, metformin is contraindicated or requires dose adjustment in patients with significant renal impairment to prevent this life-threatening adverse effect.
Question 8: Jen is an 75-year-old woman who is undergoing back surgery. Her height is 5 feet 4 inches, her weight is 85 kg, and NKDA. Hypertension, diabetes, serious depression, hypothyroidism, and persistent back pain are among her former medical conditions. Jen's post-op medications include Dexamethasone 8mg iv q6h with taper dose, Ondansetron 4mg iv q6h prn for N/V, and Ondansetron 4mg iv q6h prn for N/V. Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, 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 20m, D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dosage 0.1mg, 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 Lockout every 6 minutes, with a one-hour limit of 2.2 mg/hr. Morning labs include serum creatinine 1.4 mg/dl, magnesium 1.5 mg/dl, potassium 5.0 mmol/L, and sodium 135 mmol/L. <br/> Which of the following medications has the potential to raise Jen's potassium levels?
- Lisinopril (Correct answer)
- Ondansetron
- Hydromorphone
- Metoclopramide
Correct answer: Lisinopril
Lisinopril is an ACE inhibitor, and a known side effect of this class of medications is hyperkalemia (elevated potassium levels). ACE inhibitors block the production of angiotensin II, which in turn reduces aldosterone secretion. Aldosterone normally promotes potassium excretion, so its reduction leads to decreased potassium elimination by the kidneys, increasing serum potassium levels.
Question 9: To create 1/3 NS 1 liter bag, you'll need 51.3 mEq of NaCl. How much 23.4 percent NaCl would you require? (Na has a molecular weight of 23 while Cl has a molecular weight of 35.5)
- 23.4ml
- 58.5ml
- 10ml
- 12.82ml (Correct answer)
Correct answer: 12.82ml
To determine the volume of 23.4% NaCl needed, first calculate the total grams of NaCl required: 51.3 mEq of NaCl is equivalent to 51.3 mmol, and with a molecular weight of 58.5 g/mol (23+35.5), this is 2.99955 grams. Since 23.4% NaCl means 23.4 grams of NaCl per 100 mL of solution, you would need (2.99955 g / 23.4 g) * 100 mL, which equals approximately 12.82 mL.
Question 10: If Jen is given Dextrose 5% half-normal saline with 20 meq potassium as IVF at a rate of 125mls/hour. How much dextrose does she consume in a day?
- 50gm
- 300gm
- 150gm (Correct answer)
- 500gm
Correct answer: 150gm
The patient is receiving Dextrose 5% at a rate of 125 mL/hour. To find the total dextrose consumed in a day, first calculate the total volume infused: 125 mL/hour * 24 hours/day = 3000 mL/day. Since Dextrose 5% means there are 5 grams of dextrose per 100 mL of solution, the total dextrose consumed is (5 g / 100 mL) * 3000 mL = 150 grams.
Question 11: What percentage of lidocaine and hydrocortisone do you get when you mix 30 gm of 5% lidocaine cream with 90 gm of 0.5 percent hydrocortisone cream?
- Lidocaine/Hydrocortisone 1.25% /0.375% (Correct answer)
- Lidocaine/Hydrocortisone 2%/1.25%
- Lidocaine/Hydrocortisone 2% /0.25%
- Lidocaine/Hydrocortisone 0.375%/0.15%
Correct answer: Lidocaine/Hydrocortisone 1.25% /0.375%
To calculate the final percentages, first find the total weight of the mixture (30g + 90g = 120g). Then, calculate the amount of each active ingredient: 30g of 5% lidocaine contains 1.5g lidocaine (30 * 0.05), and 90g of 0.5% hydrocortisone contains 0.45g hydrocortisone (90 * 0.005). Finally, divide each amount by the total mixture weight and multiply by 100% to get the new concentrations: (1.5g lidocaine / 120g) * 100% = 1.25% lidocaine, and (0.45g hydrocortisone / 120g) * 100% = 0.375% hydrocortisone.
Question 12: On a patient weighing 125 pounds, an order for heparin 18 units per kg per hour is received. The IV bag has a 50-unit-per-milliliter concentration. Calculate the rate of infusion in mL/hr.
- 10.23 mls/hr
- 20.45 mls/hr (Correct answer)
- 18 mls/hr
- 40.9 mls/hr
Correct answer: 20.45 mls/hr
First, convert the patient's weight from pounds to kilograms: 125 lbs / 2.2 lbs/kg = 56.82 kg. Next, calculate the total heparin units needed per hour: 18 units/kg/hr * 56.82 kg = 1022.76 units/hr. Finally, divide the total units per hour by the concentration of the IV bag to find the infusion rate in mL/hr: 1022.76 units/hr / 50 units/mL = 20.4552 mL/hr, which rounds to 20.45 mL/hr.
Question 13: Which of the following is a first-line therapy for atherosclerotic cardiovascular disease (ASCVD) prevention?
- Bile acid resins
- Fibrates
- HMG Co-A reductase inhibitors (Correct answer)
- Fish oil
Correct answer: HMG Co-A reductase inhibitors
HMG Co-A reductase inhibitors, commonly known as statins, are the cornerstone of atherosclerotic cardiovascular disease (ASCVD) prevention. They work by inhibiting the rate-limiting enzyme in cholesterol synthesis, effectively lowering LDL-C levels and reducing the risk of cardiovascular events. Major guidelines consistently recommend statins as first-line therapy for both primary and secondary prevention due to their proven efficacy.
Question 14: Which of the following is/are appropriate for skin/soft tissue infections caused by pseudomonas?
- Cefepime (Correct answer)
- Cefazolin
- Vancomycin
- Ertapenem
Correct answer: Cefepime
Cefepime is a fourth-generation cephalosporin antibiotic known for its broad spectrum of activity, which includes excellent coverage against Pseudomonas aeruginosa. For skin and soft tissue infections where Pseudomonas is a suspected or confirmed pathogen, an agent with specific anti-pseudomonal activity is required. Cefepime is an appropriate choice due to its efficacy and ability to penetrate infected tissues.
Question 15: What is the milliequivalents per milliliter (mEq/ml) of 50 percent Magnesium Sulfate? (MgSO4 has a molecular weight of 120.4g/mol.)
- 4.11mEq/ml (Correct answer)
- 62mEq/ml
- 50mEq/ml
- 2.06mEq/ml
Correct answer: 4.11mEq/ml
The term '50 percent Magnesium Sulfate' in pharmaceutical contexts typically refers to a solution containing 50 grams of Magnesium Sulfate heptahydrate (MgSO4·7H2O) per 100 mL. With a molecular weight of 246.4 g/mol for MgSO4·7H2O and a valence of 2, the equivalent weight is 123.2 g/Eq. Therefore, 0.5 g/mL divided by 0.1232 g/mEq yields approximately 4.06 mEq/mL, which is closest to 4.11 mEq/mL.
Question 16: What is the weight of 1000 mL of 1.27 specific gravity serum protein?
- 12.7gm
- 1270 gm (Correct answer)
- 1.27gm
- 127mg
Correct answer: 1270 gm
Specific gravity (SG) is a dimensionless quantity that represents the ratio of a substance's density to the density of water (approximately 1 g/mL). If the specific gravity of serum protein is 1.27, its density is 1.27 g/mL. To find the weight of 1000 mL, you multiply the density by the volume: 1.27 g/mL * 1000 mL = 1270 grams.
Question 17: Except for ____, all of the above could raise your triglycerides.
- Fish Oil (Correct answer)
- Oral estrogens
- Protease inhibitor
- Glucocorticoids
Correct answer: Fish Oil
Fish oil, particularly its omega-3 fatty acid components like EPA and DHA, is well-known for its ability to lower triglyceride levels, especially at higher doses. In contrast, oral estrogens, protease inhibitors, and glucocorticoids are all medication classes that are recognized to potentially increase triglyceride levels as a common adverse effect. Therefore, fish oil is the exception that would not raise triglycerides.
Question 18: In mOsm/L, what is the osmolarity of 40mEq KCl in 100mL sterile water? (KCl has a molecular weight of 74.5gm/mol.)
- 200mOsm/L
- 1600mOsm/L
- 800mOsm/L (Correct answer)
- 80mOsm/L
Correct answer: 800mOsm/L
To calculate the osmolarity, we first determine the total milliosmoles (mOsm) of solute. KCl dissociates into two particles (K+ and Cl-), so 40 mEq of KCl (which is 40 mmol) contributes 40 mmol * 2 osmoles/mmol = 80 mOsm. Since this is dissolved in 100 mL (0.1 L) of sterile water, the osmolarity is 80 mOsm / 0.1 L = 800 mOsm/L.
Question 19: Which of the following types of data are ordinal?
- Sex
- NYHA I-IV
- Improvement Yes/No
- Grade of breast cancer (Correct answer)
Correct answer: Grade of breast cancer
Ordinal data is a type of categorical data where the categories have a natural, meaningful order or ranking, but the differences between categories are not necessarily equal. The grade of breast cancer (e.g., Grade 1, 2, 3) exemplifies ordinal data because it represents increasing severity or aggressiveness in a ranked sequence. Other options like sex or improvement (yes/no) are nominal, lacking an inherent order.
Question 20: Which of the following medications has the potential to raise LDL?
- Metoprolol
- Lisinopril
- Amlodipine
- Hydrochlorothiazide (Correct answer)
Correct answer: Hydrochlorothiazide
Thiazide diuretics, such as hydrochlorothiazide, are known to have several metabolic side effects, including the potential to increase LDL cholesterol and triglyceride levels. While these effects are generally modest and dose-dependent, they are a recognized adverse effect, particularly with higher doses. The other listed medications (metoprolol, lisinopril, amlodipine) typically do not raise LDL cholesterol.
Question 21: When a patient is taking an SGLT2 inhibitor, which of the following should be monitored?
- Blood pressure
- Blood glucose
- Hydration status
- All of the above (Correct answer)
Correct answer: All of the above
SGLT2 inhibitors increase glucose excretion in the urine, which can lead to several physiological changes requiring comprehensive monitoring. Blood glucose must be monitored for efficacy, blood pressure should be checked due to their diuretic effect, and hydration status is crucial to prevent dehydration and acute kidney injury. Therefore, monitoring all these parameters is essential for patient safety and optimal management.
Question 22: Which of the following anti-diabetic drugs acts by reducing glucose absorption?
- Linagliptin
- Pioglitazone
- Exenatide
- Empagliflozin (Correct answer)
Correct answer: Empagliflozin
Empagliflozin is an SGLT2 inhibitor, a class of drugs that specifically target the sodium-glucose co-transporter 2 in the renal tubules. By inhibiting this transporter, SGLT2 inhibitors reduce the reabsorption of glucose back into the bloodstream, thereby increasing glucose excretion in the urine. This mechanism directly reduces glucose absorption (reabsorption) by the kidneys.
Question 23: In patients with heart failure, which of the following medications should be avoided?
- Pioglitazone
- Naproxen
- Celebrex
- All of the above (Correct answer)
Correct answer: All of the above
All the listed medications should be avoided or used with extreme caution in patients with heart failure. Pioglitazone (a thiazolidinedione) can cause significant fluid retention, exacerbating heart failure symptoms. Naproxen and Celebrex (NSAIDs) can also lead to fluid retention, increased blood pressure, and impaired renal function, all of which can worsen heart failure. Thus, all these drugs pose risks in this patient population.
Question 24: What proportion of the sample is found within two standard deviations of the mean in a normal distribution?
- 95% (Correct answer)
- 100%
- 78%
- 95%
Correct answer: 95%
In a normal distribution, also known as a Gaussian distribution, a specific proportion of data falls within certain standard deviations from the mean. According to the empirical rule (or 68-95-99.7 rule), approximately 68% of data falls within one standard deviation, and approximately 95% of the data falls within two standard deviations of the mean. This is a fundamental concept in statistics.
Question 25: Which of the following medications can reduce the severity of seizures?
- Tramadol
- Bupropion
- Thiothixene
- All of the above (Correct answer)
Correct answer: All of the above
All the listed medications have the potential to lower the seizure threshold, thereby increasing the risk or severity of seizures. Tramadol is an opioid that can induce seizures, especially at higher doses. Bupropion is an antidepressant well-known for its dose-dependent seizure risk. Thiothixene, an antipsychotic, can also lower the seizure threshold. Therefore, caution is warranted when these drugs are used in patients prone to seizures.
NAPLEX QBANK Practice Test 1
Jen is an 75-year-old woman who is undergoing back surgery.
Her height is 5 feet 4 inches, her weight is 85 kg,
and NKDA.
Hypertension, diabetes, serious depression, hypothyroidism, and persistent back pain are
among her former medical conditions.
Jen's post-op medications include Dexamethasone 8mg iv q6h with taper dose,
Ondansetron 4mg iv q6h prn for N/V, and Ondansetron 4mg iv q6h prn for N/V.
Bisacodyl 10mg suppository daily prn
for constipation, Famotidine 20mg iv q12hr, 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 20m,
D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dosage 0.1mg, 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 Lockout every 6 minutes, with a one-hour limit of 2.2 mg/hr.
Morning labs include serum creatinine 1.4 mg/dl,
magnesium 1.5 mg/dl, potassium 5.0 mmol/L, and sodium 135 mmol/L.
Which of the following medications has the potential to raise Jen's blood glucose levels?