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NABP North American Pharmacist Licensure Examination Sample Questions (Q54-Q59):

NEW QUESTION # 54
LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4mg iv q6h prn for N/V, 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 20mg iv q12hr, 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. lock-out every
6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg 1.5mg/dl, K
5.0mmol/L, Na 135mmol/L.
It is recommended to monitor complete blood count in patients on chronic metformin because of what reason?

A. Metformin may cause leukocytosis
B. Metformin may decrease iron absorption
C. Metformin may decrease vitamin B12 levels
D. Metformin may decrease platelet count
E. Metformin may decrease erythropoietin level

Answer: C

Explanation:
Metformin may impair the absorption of vitamin B12, especially in those with inadequate vitamin b12 or calcium intake/absorption. Vitamin b12 deficiency can be treated with discontinuation of therapy or supplementation.
Vitamin b12 serum concentrations should be monitored periodically with long-term therapy.

NEW QUESTION # 55
Which of the following would be most appropriate to treat stenotrophomonas maltophilia?

A. Sulfamethoxazole/trimethoprim
B. Meropenem
C. Ciprofloxacin
D. Vancomycin
E. Cefepime

Answer: A

Explanation:
Explanation
Primary treatment for stenotrophomonas maltophilia is SMX-TMP. Meropenem, ciprofloxacin, and vancomycin have no coverage.

NEW QUESTION # 56
A 50-year-old female has been receiving a diuretic for the treatment of essential hypertension. This drug acts by increasing the calcium content of urine and is the drug of choice for reducing acute pulmonary edema in congestive heart failure. Its side effects include ototoxicity and hyperuricemia. What is the most likely mechanism of action of this drug?

A. Acts as osmotic diuretic
B. Inhibition of the Na/K/2Cl cotransporter
C. Inhibition of carbonic anhydrase
D. Aldosterone receptor antagonist
E. Blocking of the NACL cotransporter

Answer: B

Explanation:
B: Loop diuretics inhibit the Na/K/2Cl cotransporter of the luminal membrane in the ascending limb of the loop of Henle. Therefore, reabsorption of Na, K, and CL is decreased. The loop diuretics are the most efficacious of the diuretic drugs because the ascending limb accounts for the reabsorption of 25-30 % of filtered NaCl and downstream sites are not able to compensate for this increased Na load. Loop diuretics are the drugs of choice for reducing acute pulmonary edema in congestive heart failure. Loop diuretics act promptly, even among patients who have poor function or who have not responded to thiazides or other diuretics. Adverse side effects include ototoxicity, particularly when used in conjunction with the aminoglycoside antibiotics. Furosemide and ethacrynic acid compete with uric acid for the renal and biliary secretary system, thus blocking its secretion, and thereby causing or exacerbating gouty attacks. A: Aldosterone receptor antagonist is incorrect.
Spironolactone is a synthetic aldosterone antagonist that competes with aldosterone for intracellular cytoplasmic receptor sites. Because spironolactone chemically resembles some of the sex steroids, it does have minimal hormonal activity and may induce gynecomastia in males and menstrual irregularities in females.
C: Inhibition of carbonic anhydrase is incorrect. Acetazolamide inhibits carbonic anhydrase, which is located intracellulary and on the apical membrane of the proximal tubular epithelium. The decreased ability to exchange NA for H in the presence of acetazolamide results in a mild diuresis. The adverse side effects of acetazolamide include metabolic acidosis (mild), potassium depletion, renal stone formation, drowsiness, and paresthesia. D: Acts as osmotic diuretic is incorrect. A number of simple, hydrophilic, chemical substances that are filtered through the glomerulus, such as mannitol and urea, result in some degree of diuresis. This is due to their ability to carry water with them into tubular fluid. Osmotic diuretics are a mainstay of treatment for patients with increased intracranial pressure or acute renal failure due to shock, drug toxicities, or trauma. E: Blocking of the NaCl cotransporter is incorrect. The thiazide derivatives act mainly in the distal tubule to decrease the reabsorption of Na by inhibition of an Na/Cl cotransporter on the luminal membrane. As a result, these drugs increase the concentration of NA and CL in the tubular fluid. Hypokalemia is the most frequent problem encountered with the thiazide diuretics and can predispose patients on digitalis to ventricular arrhythmias.
Thiazides increase serum uric acid by decreasing the amount of acid excreted by the organic acid secretory system. The thiazides inhibit the secretion of calcium, sometimes leading to elevated levels of Ca in the blood.

NEW QUESTION # 57
Which of the following antidiabetic medication may cause cyanocobalamin deficiency?

A. Glimepiride
B. Canagliflozin
C. Pioglitazone
D. Saxagliptin
E. Metformin

Answer: E

Explanation:
Explanation
Metformin is associated with vitamin B12 deficiency because it affects the calcium dependent membrane uptake of it. All other drug classes are not associated with this.

NEW QUESTION # 58
LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4mg iv q6h prn for N/V, 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 20mg iv q12hr, 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. lock-out every
6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg 1.5mg/dl, K
5.0mmol/L, Na 135mmol/L. The bioavailability of levothyroxine is roughly 50%.
The physician requests you for a dose recommendation to convert her home dose of 75mcg po daily to intravenous.
What would be the appropriate intravenous dose?

A. 75mcg
B. 75mg
C. 37.5mcg
D. 37.5mg
E. 150mcg

Answer: C

Explanation:
Since the bioavailability of levothyroxine is roughly 50% (given in the question). To convert the home dose to intravenous, it would be 50% of the oral dose. So 50% of oral 75 mcg would be 37.5 mcg intravenously.

NEW QUESTION # 59
......

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Jerry Thomas Jerry Thomas

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Customized NAPLEX Lab Simulation & Valid Exam NAPLEX Book

Valid Exam NABP NAPLEX Book | Exam NAPLEX Score

NABP North American Pharmacist Licensure Examination Sample Questions (Q54-Q59):

North American Pharmacist Licensure Examination Latest Materials are Highly Effective to Make Use of - SurePassExams

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Jerry Thomas Jerry Thomas

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Customized NAPLEX Lab Simulation & Valid Exam NAPLEX Book

Valid Exam NABP NAPLEX Book | Exam NAPLEX Score

NABP North American Pharmacist Licensure Examination Sample Questions (Q54-Q59):

North American Pharmacist Licensure Examination Latest Materials are Highly Effective to Make Use of - SurePassExams