Sample Questions from our NAPLEX Q-Bank

The sample questions below were taken directly from the NAPLEX Q-Bank & Flashcard Database.  They represent over a 1,800 other practice test questions you will encounter with the use of our NAPLEX Q-Bank.  We believe our NAPLEX practice test questions and flashcards system will prepare you to pass the NAPLEX exam the first time.  Each question comes with a concise rationale supporting the right answer or concept being tested.   



Sample Flashcard  1

What type of study design can be affected most by "recall bias"?

Answer Provided:   Case-controlled studies

Note: Case-controlled studies are retrospective in design and thus are dependent on either previously collected information in the medical charts or from patient's recall of information that had already occurred. The ability of the patient to recall specific information will decline with time from the event, especially if the event(s) were not apparently important to them at the time.

 

Sample Question  2

Which of the following antibiotics are known to have bactericidal activity due to its ability to inhibit cell wall synthesis?

     a.     Piperacillin/tazobactam (Zosyn)
     b.     Ciprofloxacin (Cipro)
     c.     Minocycline (Dynacin, Minocin, Solodyn)
     d.     Azithromycin (Zithromax)

Correct Answer = a

Rationale Provided:

Piperacillin/tazobactam is the only antibiotic listed that can inhibit cell synthesis. Remember it is a beta-lactam antibiotic that is known to inhibit the transpeptidation (or cross linking) of the disaccharide units that make up the peptidoglycan cell wall. Ciprofloxacin is a fluoroquinolone that inhibits DNA replication via inhibition of DNA gyrase or topoisomerase II. Minocycline is a tetracycline antibiotic that inhibits protein synthesis and is also bacteriostatic. Azithromycin is a macrolide antibiotic that inhibits protein synthesis via inhibition of 50S ribosome.

 

Sample Question  3

When starting an HIV infected patient on highly active antiretroviral therapy (HAART) that contains efavirenz (Sustiva), which of the following would be most important to counsel the patient on? 

     a.     Efavirenz should not be taken with a high fat meal as it can increase its absorption in the GI tract and cause some CNS side effects
     b.     Efavirenz is associated with the development of painful peripheral neuropathy in some patients
     c.     Efavirenz is a strong inhibitor of enzymes needed by other medications, thereby increasing the risk for drug-drug interactions
     d.     Efavirenz can cause a yellow of the skin in about 10% of patients but is not harmful

Correct Answer = a

Rationale Provided:

Efavirenz (Sustiva) is recommended to not be taken with a high fat meals as it can increase the absorption of the efavirenz thereby putting the patient at increased risk for CNS side effects including vivid dreams, nightmares, and/or psychosis.  In most cases these side effects are worse early on in the initiation of efavirenz and decrease in severity over the first 2 weeks.  Peripheral neuropathies are associated with the "d-drugs" in the nucleoside reverse transcriptase class of medications not non-nucleoside reverse transcriptase inhibitors.  Answer option c is wrong because efavirenz has a net effect of inducing enzymes (i.e., CYP450) involved in drug metabolism, not inhibiting them.  The last answer choice is more common with atazanavir and/or indinavir due to their inhibition of UGT mediated conjugation of bilirubin in the liver.  

 

Sample Question  4

What can occur if a patient were to continuously use nasal spray topical decongestants for beyond 3-5 days? 

     a.     Bradycardia
     b.     Nose bleeds (epistaxis)
     c.     Increased sensitivity to smell
     d.     Rebound congestion

Correct Answer = d

Rationale Provided:

It is well known that too much use of nasal decongestants can cause or result in rebound congestion or a condition called, rhinitis medicamentosa.  This is due to the over stimulation of the alpha receptors resulting in their down-regulation.   When this occurs the nasal congestion worsens, sometimes more than baseline or before starting the decongestant.  

 

Sample Question  5

Which of following best reflect the mechanism of action of memantine (Namenda) used in the treatment of Alzheimer's disease? 

     a.     Inhibitor of acetylcholinesterase enzyme
     b.     Agonist to the D2 receptor in the central nervous system
     c.     Antagonizes the NMDA receptor
     d.     Inhibitor of monoamine oxidase enzyme

Correct Answer = c

Rationale Provided:

Agonists of the D2 receptor are options for the treatment of Parkinson's disease and include pramipexole (Mirapex) and ropinirole (Requip).  Inhibitors of monoamine oxidase enzyme are normally used in the treatment of depression and Parkinson's disease.  Memantine (Namenda) is the only antagonist to the NMDA receptor, which blocks glutamates over activation of this receptor that may contribute to neuronal cell death.  Donepezil (Aricept), galantamine (Razadyne), and rivastigamine (Exelon) are inhibitors of acetylcholinesterase and are known to increase the concentrations of acetylcholine in the synaptic cleft. 

 

Sample Question 6

Which of the following is a long-acting beta-2 receptor agonist (bronchodilator) that can be given by nebulization and as well as a dry powder inhaler (DPI) for the treatment of COPD? 

     a.     Formoterol
     b.     Albuterol
     c.     Pulmicort
     d.     Fluticasone

Correct answer = a

Rational Provided:

The key words are "long-acting" and "bronchodilator".  Albuterol is a short acting bronchodilator (beta-2 agonist) and is available in a metered dose inhaler, solution for nebulization, and syrup for oral ingestion).  Budesonide and fluticasone are both inhaled steroids with budesonide being the only one that can be given as an inhaler and nebulizer route.