North American Pharmacist Licensure
Examination (NAPLEX) Comprehensive
Practice Examination
1. A patient with atrial fibrillation is taking warfarin. Which laboratory test is
routinely used to monitor therapy?
A. aPTT
B. Bleeding time
C. Platelet count
D. INR
Answer: INR
Rationale: INR standardizes prothrombin time and is the recommended test for
monitoring warfarin anticoagulation.
2. Which medication is considered first-line therapy for anaphylaxis?
A. Diphenhydramine
B. Albuterol
C. Epinephrine
D. Prednisone
Answer: Epinephrine
,Rationale: Intramuscular epinephrine rapidly reverses airway edema,
hypotension, and bronchospasm, making it the treatment of choice.
3. Which insulin has the fastest onset of action?
A. NPH insulin
B. Insulin glargine
C. Insulin lispro
D. Insulin detemir
Answer: Insulin lispro
Rationale: Insulin lispro is a rapid-acting insulin with an onset of approximately
15 minutes.
4. Which electrolyte abnormality is most commonly associated with loop
diuretics?
A. Hyperkalemia
B. Hypercalcemia
C. Hypokalemia
D. Hypermagnesemia
Answer: Hypokalemia
Rationale: Loop diuretics increase urinary potassium excretion, frequently
leading to hypokalemia.
5. Which antibiotic should generally be avoided during pregnancy because of
tooth discoloration in the fetus?
A. Penicillin V
B. Cephalexin
,C. Azithromycin
D. Doxycycline
Answer: Doxycycline
Rationale: Tetracyclines can impair bone growth and permanently discolor
developing teeth.
6. Which drug is a proton pump inhibitor?
A. Famotidine
B. Calcium carbonate
C. Sucralfate
D. Pantoprazole
Answer: Pantoprazole
Rationale: Pantoprazole irreversibly inhibits gastric H+/K+-ATPase pumps,
reducing gastric acid secretion.
7. A patient develops a persistent dry cough after starting lisinopril. What is
the most likely cause?
A. Histamine release
B. Bradykinin accumulation
C. Increased aldosterone
D. Serotonin release
Answer: Bradykinin accumulation
Rationale: ACE inhibition decreases bradykinin breakdown, causing cough in
susceptible patients.
, 8. Which medication requires routine liver function monitoring?
A. Amoxicillin
B. Statins
C. Acetaminophen at recommended doses
D. Cetirizine
Answer: Statins
Rationale: Statins can rarely cause hepatotoxicity, making liver assessment
appropriate when clinically indicated.
9. Which vaccine is administered annually?
A. MMR
B. Varicella
C. HPV
D. Influenza vaccine
Answer: Influenza vaccine
Rationale: Influenza viruses change frequently, requiring annual vaccination.
10.Which medication is an antidote for opioid overdose?
A. Flumazenil
B. Vitamin K
C. Protamine sulfate
D. Naloxone
Answer: Naloxone
Rationale: Naloxone rapidly displaces opioids from receptors and reverses
respiratory depression.
Examination (NAPLEX) Comprehensive
Practice Examination
1. A patient with atrial fibrillation is taking warfarin. Which laboratory test is
routinely used to monitor therapy?
A. aPTT
B. Bleeding time
C. Platelet count
D. INR
Answer: INR
Rationale: INR standardizes prothrombin time and is the recommended test for
monitoring warfarin anticoagulation.
2. Which medication is considered first-line therapy for anaphylaxis?
A. Diphenhydramine
B. Albuterol
C. Epinephrine
D. Prednisone
Answer: Epinephrine
,Rationale: Intramuscular epinephrine rapidly reverses airway edema,
hypotension, and bronchospasm, making it the treatment of choice.
3. Which insulin has the fastest onset of action?
A. NPH insulin
B. Insulin glargine
C. Insulin lispro
D. Insulin detemir
Answer: Insulin lispro
Rationale: Insulin lispro is a rapid-acting insulin with an onset of approximately
15 minutes.
4. Which electrolyte abnormality is most commonly associated with loop
diuretics?
A. Hyperkalemia
B. Hypercalcemia
C. Hypokalemia
D. Hypermagnesemia
Answer: Hypokalemia
Rationale: Loop diuretics increase urinary potassium excretion, frequently
leading to hypokalemia.
5. Which antibiotic should generally be avoided during pregnancy because of
tooth discoloration in the fetus?
A. Penicillin V
B. Cephalexin
,C. Azithromycin
D. Doxycycline
Answer: Doxycycline
Rationale: Tetracyclines can impair bone growth and permanently discolor
developing teeth.
6. Which drug is a proton pump inhibitor?
A. Famotidine
B. Calcium carbonate
C. Sucralfate
D. Pantoprazole
Answer: Pantoprazole
Rationale: Pantoprazole irreversibly inhibits gastric H+/K+-ATPase pumps,
reducing gastric acid secretion.
7. A patient develops a persistent dry cough after starting lisinopril. What is
the most likely cause?
A. Histamine release
B. Bradykinin accumulation
C. Increased aldosterone
D. Serotonin release
Answer: Bradykinin accumulation
Rationale: ACE inhibition decreases bradykinin breakdown, causing cough in
susceptible patients.
, 8. Which medication requires routine liver function monitoring?
A. Amoxicillin
B. Statins
C. Acetaminophen at recommended doses
D. Cetirizine
Answer: Statins
Rationale: Statins can rarely cause hepatotoxicity, making liver assessment
appropriate when clinically indicated.
9. Which vaccine is administered annually?
A. MMR
B. Varicella
C. HPV
D. Influenza vaccine
Answer: Influenza vaccine
Rationale: Influenza viruses change frequently, requiring annual vaccination.
10.Which medication is an antidote for opioid overdose?
A. Flumazenil
B. Vitamin K
C. Protamine sulfate
D. Naloxone
Answer: Naloxone
Rationale: Naloxone rapidly displaces opioids from receptors and reverses
respiratory depression.
