NABP_NAPLEX Actual Exam Questions and Answers (2024 / 2025) | 100% Correct Verified Graded A+
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Course
NAPLEX
Institution
NAPLEX
NABP_NAPLEX Actual Exam Questions and Answers (2024 / 2025) | 100% Correct Verified Graded A+
1.Which of the following represents the major route of metabolism for acetaminophen?
A. Glucuronidation
B. Sulfation
C. Cytochrome P-450 oxidation
D. Direct renal excretion
E. Plasma breakdown An...
NABP
NAPLEX
North American Pharmacist Licensure
Examination
,1.Which of the following represents the major route of metabolism for
acetaminophen?
A. Glucuronidation
B. Sulfation
C. Cytochrome P-450 oxidation
D. Direct renal excretion
E. Plasma breakdown
Answer: A
Explanation:
Acetaminophen is metabolized by choices A through D. The major route is
glucuronidation catalyzed by UDP-glucuronyl transferase in the liver. Sulfation is the
next most common route and is the target mechanism for NAC therapy. Oxidation by
cytochrome P-450 results in the formation of N-acetyl-pbenzoquinone imine, which is
responsible for the hepatic necrosis caused by acetaminophen overdose. Direct renal
excretion represents approximately 5% of the metabolism of acetaminophen. Plasma
metabolism of acetaminophen does not generally occur.
2.A 15-year-old presents with 6 days of nasal congestion with thin, clear rhinorrhea.
She notes mild facial pain but has had no fevers. She feels her symptoms are
improving.
What is the most likely cause of her symptoms?
A. Streptococcus pneumoniae
B. Viral
C. Moraxella catarrhalis
D. Haemophilus influenzae
E. Staphylococcus aureus
Answer: B
Explanation:
This patient shows symptoms of acute sinusitis. The most common etiology of which
is viruses. Indications that an infection is viral as opposed to bacterial included a
shorter infection tie (less than 10 days) and no purulent discharge (hers is watery).
She does not show any evidence of a complication developing and even notes that
her symptoms are improving. If her symptoms were attributed to a bacterium, then the
most common cause of acute sinusitis is Streptococcus pneumoniae followed by
Haemophilus influenza, then Moraxella catarrhalis. Anaerobic species such as
Bacteroides fragilis and Staphylococcus aureus are more commonly found in patients
with chronic sinusitis (sinusitis lasting longer than 12 weeks). This is important to
realize before indiscriminately providing antibiotics for these patients.
3.A 72-year-old woman suffers from a major depressive episode. She has a history of
coronary artery disease, atrial fibrillation on anticoagulation therapy, sick sinus
, syndrome, glaucoma, and chronic obstructive pulmonary disease.
Which of the following medications is most appropriate for the treatment of her
depression?
A. Amitriptyline
B. Nortriptyline
C. Doxepin
D. Fluvoxamine
E. Escitalopram
Answer: E
Explanation:
In older adults, selection of antidepressant medication should be done with various
considerations in mind, most notably side effects and risk of drug-drug interactions.
The tricyclic antidepressants (TCAs), as discussed on question 50, have various side
effects including cardiac conduction abnormalities and drug-drug interactions that
make them undesirable for the treatment of depression in older adults. A selective
serotonin reuptake inhibitor is more favorable than a TCA in this patient. Fluvoxamine
has a high risk for drug-drug interactions, whereas escitalopram does not.
Fluvoxamine also has high protein binding, and can therefore interact with
anticoagulant medications, such a warfarin. Therefore, of the medications listed,
escitalopram is the most appropriate in this patient. In older adults, psychotropic
medications should be started at a low dose and titrated up slowly to the lowest
effective dose.
4.A 20-year-old student came to the emergency department with primary complaints
of palpitations, low-grade fever, and anxiety for 2 months. She reports that she is
irritable and suffers severe mood swings that is interfering with her sleep and
relationships (she admits to crying spells and frequent fights with friends and family).
She has also lost 12 pounds in the past 2 months with no apparent alteration in her
diet or physical activity (though she is happy with her weight loss). She denies any
past medical problems, though her friends have always been worried that she eats
too little.
Her temperature is 38.0 C (100.4 F), blood pressure is 148/62 mm Hg, pulse is
122/min and regular, and respiratory rate is 28/min. Examination reveals a bruit heard
over the anterior neck, fine tremor of the hands, and warm, moist skin. Her eyes and
eyelids do not move together during finger following test (with steady head).
Laboratory work is sent, including a thyroid panel, but will not be available until
tomorrow morning.
Which of the following is the most appropriate initial management at this time?
A. Diltiazem therapy
B. Iodine therapy
C. Methimazole therapy
D. Propranolol therapy
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