CPJE Clinical Prep Exam Questions and Answers 2025

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CPJE Clinical Prep Exam Questions and
Answers 2025
Tylenol (I,D,Overdose) -Correct Answer ✔Acetaminophen
I: fever/pain
D: 325-650mg, max < 4000mg/day from all sources
*OD = liver damage, use NAC for antidote
no anti platelet activity
DOC for pain in pregnancy or use with warfarin

Ofirmev (IV) (I,D,Overdose) -Correct Answer ✔Acetaminophen
I: fever/pain
D: < 4000mg/day from all sources
*Can treat more severe pain
*OD = liver damage, use NAC for antidote
no anti platelet activity

NAC (I) -Correct Answer ✔N-acetylcysteine
I: APAP overdose
Compatible with: D5W, ½ NS, and Water for Injection
Stable for 24h at room temp

COX-1 selective NSAIDs -Correct Answer ✔indomethacin, ketorlac

COX-1 selective = higher risk for GI bleeding

COX-2 selective NSAIDs -Correct Answer ✔Celecoxib
Diclofenac
Meloxicam
Etodolac
Nabumetone

COX-2 selective = higher risk of CV events (MI, stroke)

COX 1 and COX 2 non-selective NSAIDs -Correct Answer ✔ibuprofen, naproxen,
piroxicam, sulindac

COX-1 = higher risk for GI bleeding
COX-2 = higher risk of CV events (MI, stroke)

Daypro (I,D, BBW) -Correct Answer ✔Oxaprozin
I: fever/pain/inflammation
*Similar caution to piroxicam: high risk for GI tox and severe SJS


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Dose: 1200 mg once daily w/ max of 1800 mg if >50 kg
BBW: COX non-selective: GI bleeding and CV thrombotic event risk
SE: anemia, skin rash, asthma exacerbation, renal (NSAID + diuretic + ACE/ARB) /
hepatic tox (least risk with ibuprofen / celecoxib)

**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus
CI: for use in patients w/ CABG surgery
requires med guide to be dispensed

Ascriptin, Bufferin, Ecotrin (I,D,CI,OD,BBW) -Correct Answer ✔Aspirin (Bayer)
I: fever/pain/inflammation
D: 81-325mg qd
CI: pregnancy (esp 3rd trimester), OD = tinnitis
*BBW: COX-1 selectivity NSAID = GI bleed
Avoid in children < 16 with any vial infection due to potential risk of Reye's syndrome
irreversible antiplatelet, GI toxicity

Naprosyn (I,D,BBW) -Correct Answer ✔Naproxen, Aleve
I: fever/pain/inflammation
-OTC: 220mg qd
-Rx: 250-550mg bid
*Higher GI side effects
*BBW: COX-1/2 selectivity NSAID = GI bleed and CV tox
SE: anemia, skin rash, asthma exacerbation, renal (NSAID + diuretic + ACE/ARB) /
hepatic tox (least risk with ibuprofen / celecoxib)
CI: for use in patients w/ CABG surgery
requires med guide to be dispensed

Motrin, Advil (I,D,BBW, SE, CI) -Correct Answer ✔Ibuprofen
I: fever/pain/inflammation
Dose
-OTC: 200-400mg q 4-6 hrs
-Rx: 600-800 mg tid, max 3200mg/d
child: 10mg/kg/dose with max 40mg/kg/day
COX non-selective: GI bleeding and CV thrombotic event risk
SE: anemia, skin rash, asthma exacerbation, renal (NSAID + diuretic + ACE/ARB) /
hepatic tox (least risk with ibuprofen / celecoxib)
**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus
CI: for use in patients w/ CABG surgery
requires med-guide to be dispensed

Vimovo (I,D,BBW) -Correct Answer ✔Naproxen + esomeprazole


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I: osteoarthritis, rheumatoid arthritis, pain
D: naproxen 375/ esomeprazole 20mg or naproxen 500 mg/esomeprazole 20mg twice
daily
*less GI side effects since combo with PPI
COX non-selective: GI bleeding and CV thrombotic event risk
SE: C-diff (PPI), anemia, skin rash, asthma exacerbation, renal
**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus
CI: for use in patients w/ CABG surgery
requires med-guide to be dispensed

Voltaren (I,D) -Correct Answer ✔Diclofenac (gel)
I: pain/inflammation
Dose: 1% gel, apply 2 (hand) - 4g (knee) up to 4x daily per joint. max per joint 16g/day,
max total body use is 32g/day. Does come as 3% for actinic keratosis (scaly patch of
skin) where 0.5g is used
Comes as solution 1.5 (Klofensaid II) - 2% (Pennsaid), patch 1.3% (Flecor, Licart)

COX-2 selectivity (CV events)
SE: anemia, skin rash, asthma exacerbation, renal (NSAID + diuretic + ACE/ARB) /
hepatic tox (least risk with ibuprofen / celecoxib)
**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus
CI: for use in patients w/ CABG surgery
requires med guide to be dispensed

Cataflam, Cambia, Zipsor, Zorvolex (I,D, BBW, SE) -Correct Answer ✔Diclofenac oral
I: Gout, dysmenorrhea, ankylosing spondylitis, migraine, arthritis, pain
D: 100 - 150mg per day in divided doses (50-75mg BID)

COX-2 selectivity (CV events)
SE: edema, constipation, nausea, rash, HTN, anemia
**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus
CI: for use in patients w/ CABG surgery
Requires med guide to be dispensed

Flector / Licart -Correct Answer ✔diclofenac patch 1.3%

Flector: 1 patch (180mg) placed to most painful area BID
Licart: 1 patch daily
COX-2 selectivity (CV events)



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Toradol (I,D -IV/PO/Max-,BBW, SE) -Correct Answer ✔Ketorolac
I: analgesia
-IV/IM 30mg x 1, or 30mg QID (max 120mg/d)
-PO: 20mg once after IV or IM, then 10mg q4-6hr (max: 40mg/d)
*Max = 5 days of treatment
*Most GI toxic w/ piroxicam
*BBW: COX-1 selectivity NSAID = GI bleed
SE: bleeding, acute renal failure, liver failure, anaphylactic shock

**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus
CI: for use in patients w/ CABG surgery
Requires a med-guide to be dispensed

Indocin, Tivorbex (I,D,BBW,SE,CI) -Correct Answer ✔Indomethacin
-I: fever/pain/inflammation, gout
- arthritis: 25-50mg IR B-TID, 75mg BID CR max 150mg daily
- Gout tx (acute flare): 50mg TID w/in 24-48h of flare, d/c 2-3 days after resolution of
clinical signs, usual duration of 5-7 days
*High risk for CNS SE (avoid in psych conditions) and GI toxicity
*BBW: COX-1 selectivity NSAID = GI bleed
CI: CABG, hx of asthma, use in neonates

**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus
SE: vomiting, post hemorrhage, HA, CNS**
Requires a med-guide to be dispensed

Clinoril (D,BBW) -Correct Answer ✔Sulindac
*less common NSAID that may be better w/ reduced renal function or patients on lithium
*BBW: COX-1 selectivity NSAID = GI bleed
- OA/RA: 150-200 mg BID, max 400mg
- Acute gouty arthritis: 200 mg twice daily for 7 days (maximum: 400 mg/day)

**FDA safety alert: Caution with use in pregnancy after 20 weeks, can cause fetal renal
tox / oligohydroaminos, avoid use after 30 weeks due to risk of premature closure of
fetal ductus arteriosus

Relafen (I,D) -Correct Answer ✔Nabumetone
I: fever/pain/inflammation
D: 1000-200mg qd or bid

*COX-2 selectivity NSAID: CV event (MI, stroke



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