NAPLEX Comprehensive Exam Questions
and correct Answers (Verified Answers)
2025
1. A patient with atrial fibrillation is prescribed warfarin. Which of the following
lab values is most important to monitor for therapeutic efficacy?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Prothrombin Time (PT)
Rationale: The INR is the standardized lab value used to monitor warfarin
therapy. It reflects the prothrombin time (PT) but is adjusted for variability
between labs.
2. Which antibiotic should be avoided in children due to the risk of tooth
discoloration?
A. Amoxicillin
B. Cephalexin
C. Doxycycline
D. Azithromycin
,Rationale: Doxycycline, a tetracycline antibiotic, can bind to calcium in teeth and
bones, leading to permanent discoloration. It should be avoided in children under
8 years old.
3. A 70-year-old female is taking lisinopril. She develops a persistent dry cough.
What is the most appropriate alternative medication?
A. Amlodipine
B. Furosemide
C. Losartan
D. Spironolactone
Rationale: Losartan, an angiotensin receptor blocker (ARB), does not inhibit
bradykinin breakdown, so it is a good alternative when ACE inhibitors cause
cough.
4. Which insulin has the fastest onset of action?
A. Insulin lispro
B. Insulin glargine
C. Insulin detemir
D. Regular insulin
Rationale: Insulin lispro is a rapid-acting insulin analog that begins to work within
15 minutes, making it the fastest-acting among the choices.
5. A pharmacy receives a prescription for Suboxone®. What is it used to treat?
, A. Chronic pain
B. Opioid dependence
C. Depression
D. Neuropathic pain
Rationale: Suboxone® (buprenorphine/naloxone) is FDA-approved for the
treatment of opioid dependence, helping to reduce cravings and withdrawal
symptoms.
6. A patient is taking simvastatin 40 mg and is prescribed clarithromycin. What
is the most appropriate pharmacist action?
A. Fill the prescription as written
B. Lower simvastatin dose to 20 mg
C. Contact the prescriber to change simvastatin or antibiotic
D. Tell the patient to monitor for muscle pain
Rationale: Clarithromycin is a strong CYP3A4 inhibitor that can significantly
increase simvastatin levels, increasing the risk of rhabdomyolysis. Avoid
concurrent use.
7. Which medication is most likely to cause hyperkalemia?
A. Hydrochlorothiazide
B. Furosemide
C. Spironolactone
D. Atenolol
and correct Answers (Verified Answers)
2025
1. A patient with atrial fibrillation is prescribed warfarin. Which of the following
lab values is most important to monitor for therapeutic efficacy?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Prothrombin Time (PT)
Rationale: The INR is the standardized lab value used to monitor warfarin
therapy. It reflects the prothrombin time (PT) but is adjusted for variability
between labs.
2. Which antibiotic should be avoided in children due to the risk of tooth
discoloration?
A. Amoxicillin
B. Cephalexin
C. Doxycycline
D. Azithromycin
,Rationale: Doxycycline, a tetracycline antibiotic, can bind to calcium in teeth and
bones, leading to permanent discoloration. It should be avoided in children under
8 years old.
3. A 70-year-old female is taking lisinopril. She develops a persistent dry cough.
What is the most appropriate alternative medication?
A. Amlodipine
B. Furosemide
C. Losartan
D. Spironolactone
Rationale: Losartan, an angiotensin receptor blocker (ARB), does not inhibit
bradykinin breakdown, so it is a good alternative when ACE inhibitors cause
cough.
4. Which insulin has the fastest onset of action?
A. Insulin lispro
B. Insulin glargine
C. Insulin detemir
D. Regular insulin
Rationale: Insulin lispro is a rapid-acting insulin analog that begins to work within
15 minutes, making it the fastest-acting among the choices.
5. A pharmacy receives a prescription for Suboxone®. What is it used to treat?
, A. Chronic pain
B. Opioid dependence
C. Depression
D. Neuropathic pain
Rationale: Suboxone® (buprenorphine/naloxone) is FDA-approved for the
treatment of opioid dependence, helping to reduce cravings and withdrawal
symptoms.
6. A patient is taking simvastatin 40 mg and is prescribed clarithromycin. What
is the most appropriate pharmacist action?
A. Fill the prescription as written
B. Lower simvastatin dose to 20 mg
C. Contact the prescriber to change simvastatin or antibiotic
D. Tell the patient to monitor for muscle pain
Rationale: Clarithromycin is a strong CYP3A4 inhibitor that can significantly
increase simvastatin levels, increasing the risk of rhabdomyolysis. Avoid
concurrent use.
7. Which medication is most likely to cause hyperkalemia?
A. Hydrochlorothiazide
B. Furosemide
C. Spironolactone
D. Atenolol
