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2024 NAPLEX PRACTICE EXAM QUESTIONS WITH CORRECT ANSWERS
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2024 NAPLEX PRACTICE EXAM QUESTIONS WITH CORRECT ANSWERS
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2024 NAPLEX PRACTICE EXAMQUESTIONS WITH CORRECT
ANSWERS
What is the range for acute manic episode treatment with lithium? -
CORRECT-ANSWERS0.8-1.2 mEq/L
higher than maintenance treatment
Which medication may potentially interact with and raise lithium levels?
A. metoprolol
B. lisinopril
C. Tenormin
D. APAP - CORRECT-ANSWERSlisinopril
affects the kidneys!!
Which is a side effect of lithium that commonly occurs in patients taking long
term?
A. ataxia
B. constipation
C. hypothyroidism
D. neuropathy - CORRECT-ANSWERSC. hypothyroidism
sometimes, diabetes insipidius
what is the most concerning ADR of MTX? - CORRECT-ANSWERSbone marrow
suppression
Which of the following causes infusion-related reactions?
A. Infliximab (Remicade)
B. Anakinra (Kineret)
C. Tofacitinib (Xeljanz)
D. Sulfasalazine - CORRECT-ANSWERSA. Infliximab (Remicade) only infusion
med
Kineret = subQ
sulfasalazine /xeljanz = oral
,Pneumonitis is a potential adverse effect of which of the following DMARDs?
A. Methotrexate
B. Sulfasalazine
C. Leflunomide
D. Minocycline - CORRECT-ANSWERSMethotrexate
Which of these medications is associated with elevations in cholesterol?
A. Tofacitinib (Xeljanz)
B. Tocilizumab (Actemra)
C. Methotrexate
D. Rituximab (Rituxan) - CORRECT-ANSWERSB. Tocilizumab (Actemra)
Which biologic DMARD is available in an oral formulation?
A. Infliximab (Remicade)
B. Certolizumab pegol (Cimzia)
C. Abatacept (Orencia)
D. Tofacitinib (Xeljanz) - CORRECT-ANSWERSD. Tofacitinib (Xeljanz)
Which of the following best describes the definition of ischemic stroke?
A. Abrupt onset focal neurologic deficit lasting at least 24 hours, and is of
presumed vascular origin.
B. Attack caused by focal brain, spinal cord, or retinal ischemia without acute
infarction and lasts less than 24 hours and usually less than 30 minutes.
C. Subarachnoid hemorrhage, intracerebral hemorrhage, and subdural
hematomas
D. Increased intracranial pressure - CORRECT-ANSWERSA. Abrupt onset
focal neurologic deficit lasting at least 24 hours, and is of presumed vascular
origin.
B = TIA
C = HEMORRHAGIC stroke
49-year-old man who presents to ED for new onset left-sided weakness that
began 5 hours ago. He has a history of HTN and CAD. MEDS: metoprolol 50
mg/day orally, HCTZ 25 mg/day orally, and aspirin 325 mg/day orally.
Vitals: BP 159/91 mm Hg, HR 91bpm, RR 13 breaths/minute, temperature
37.9°C.
The treatment team assesses this patient for treatment with TPA and asks
for your opinion. Given this information, which reply is the best?
A. He needs to be treated with tissue plasminogen activator.
B. He should not be treated with tissue plasminogen activator because the
onset of his stroke symptoms was 5 hours ago.
C. He should not be treated with tissue plasminogen activator because he
has hypertension.
D. He should not be treated with tissue plasminogen activator because he
takes aspirin - CORRECT-ANSWERSB. He should not be treated with tissue
,plasminogen activator because the onset of his stroke symptoms was 5
hours ago.
onset of symptoms is outside 4.5 hour treatment window
A patient survives a stroke. As part of his discharge treatment plan, you
evaluate his risk factors for a second stroke. His aspirin therapy is
discontinued.
Which medication for secondary stroke prevention is best to initiate at this
time?
A. Dipyridamole.
B. Enoxaparin.
C. Heparin.
D. Clopidogrel - CORRECT-ANSWERSClopidogrel
L.S. is an 81-year-old woman with a medical history of HTN, T2DM, renal
failure, and atrial fibrillation. She presents to ED for symptoms of right-sided
paralysis. She states that these symptoms began about 2.5 hours ago and
have not improved since then. The physician asks if she is a candidate for
tPA. How do you respond?
A. No, tPA must be given within 4.5 hours of onset of stroke symptoms
B. Yes, L.S. is in the patient population who can be treated within a 3-hour
window
C. Yes, everyone with stroke symptoms should be given tPA
D. No, she should receive a statin - CORRECT-ANSWERSB. Yes, L.S. is in the
patient population who can be treated within a 3-hour window
Class I recommendations from ASA/ACCP include:
A. tPA administered within 3 hours of onset regardless of age
B. Aspirin within 48 hours of onset
C. tPA administered within 4.5 hours unless patient excluded in this window
D. B and C - CORRECT-ANSWERSB. Aspirin within 48 hours of onset
C. tPA administered within 4.5 hours unless patient excluded in this window
Which of the following is considered a relative contraindication to receiving
tPA?
A. Pregnancy
B. Acute internal bleeding
C. Acute bleeding diathesis
D. Aneurysm - CORRECT-ANSWERSPregnancy
all other answers are ABSOLUTE CIs
Which secondary prevention medication is best to avoid in patients with a
known history of headaches?
, A. Aspirin
B. Aggrenox
C. Plavix
D. Lipitor - CORRECT-ANSWERSB. Aggrenox
has 20% incidence of headaches
Dr. Z asks if his patient with an acute stroke requires immediate
hypertension treatment for a BP 180/90. The patient has no evidence of
aortic dissection, acute MI, pulmonary edema, or hypertensive
encephalopathy. What blood pressure parameter do you recognize for
patient to remain untreated for hypertension?
A. < 220/120 mm Hg
B. > 220/120 mm Hg
C. < 180/90 mm Hg
D. > 180/90 mm Hg - CORRECT-ANSWERSA. < 220/120 mm Hg
What time frame should aspirin be administered after the onset symptoms of
a stroke?
A. Within 48 hours of onset
B. Within 36 hours of onset
C. Within 24 hours of onset
D. Within 12 hours of onset - CORRECT-ANSWERSA. Within 48 hours of onset
which of following is true regarding MAO inhibitors for depression?
A. potential for severe side effects of hypertensive crisis precipitated by
certain foods
B. considered 1st line
C. good choice because few drug interactions - CORRECT-ANSWERSA.
tyramine -containing foods can precipitate Serotonin syndrome and
hypertensive crises
Which of the following agents may be considered 1st line for treatment of
major depression?
A. Buspar
B. lithium
C. fluoxetine (Prozac)
D. Doxepin (Silenor) - CORRECT-ANSWERSC fluoxetine
SSRIs and SNRIs are first line for depression.
Silenor = insomnia
What is an advantage of using bupropion for tx of MDD?
A. action is specific to serotonin unlike SSRIs
B. fairly sedating so can also treat insomnia
C. free from effect of lowering seizure threshold
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