North American Pharmacist Licensure
Examination (NAPLEX) Practice Exam
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. A 65-year-old patient with hypertension and chronic kidney disease
(CKD) is prescribed lisinopril. Which monitoring parameter is most
important initially?
A. Blood glucose
B. Serum creatinine and potassium
C. Liver function tests
D. Complete blood count
Answer: B. Serum creatinine and potassium
Rationale: ACE inhibitors like lisinopril can increase serum creatinine and
,potassium, especially in patients with CKD. Monitoring these parameters is
crucial to prevent hyperkalemia and worsening renal function.
2. Which antibiotic is considered first-line therapy for an uncomplicated
urinary tract infection (UTI) in a non-pregnant adult?
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin
D. Doxycycline
Answer: B. Nitrofurantoin
Rationale: Nitrofurantoin is effective against common uropathogens like E.
coli and is recommended as first-line therapy for uncomplicated UTIs due to
its efficacy and low resistance risk.
3. A patient presents with a new diagnosis of type 2 diabetes. Which class
of medications is recommended to reduce cardiovascular risk in patients
with atherosclerotic cardiovascular disease (ASCVD)?
A. Sulfonylureas
B. SGLT2 inhibitors or GLP-1 receptor agonists
C. Thiazolidinediones
D. DPP-4 inhibitors
,Answer: B. SGLT2 inhibitors or GLP-1 receptor agonists
Rationale: Guidelines recommend SGLT2 inhibitors or GLP-1 receptor
agonists for patients with type 2 diabetes and ASCVD due to proven
cardiovascular risk reduction.
4. Which of the following medications requires monitoring of the
international normalized ratio (INR)?
A. Dabigatran
B. Apixaban
C. Warfarin
D. Rivaroxaban
Answer: C. Warfarin
Rationale: Warfarin therapy requires INR monitoring to ensure therapeutic
anticoagulation and reduce the risk of bleeding or thrombosis.
5. A patient on metformin reports gastrointestinal discomfort. What is the
most appropriate intervention?
A. Discontinue therapy immediately
B. Switch to insulin
C. Take with meals or use extended-release formulation
D. Increase dose gradually
, Answer: C. Take with meals or use extended-release formulation
Rationale: Metformin commonly causes GI upset. Taking with food or
switching to an extended-release form can improve tolerability without
compromising efficacy.
6. Which class of antihypertensive drugs is preferred in a patient with
chronic kidney disease and proteinuria?
A. Calcium channel blockers
B. Beta-blockers
C. Diuretics
D. ACE inhibitors or ARBs
Answer: D. ACE inhibitors or ARBs
Rationale: ACE inhibitors and ARBs reduce proteinuria and slow the
progression of CKD, making them first-line therapy for hypertensive patients
with CKD.
7. What is the recommended treatment for an acute gout flare?
A. Allopurinol
B. Febuxostat
C. Colchicine, NSAIDs, or corticosteroids
D. Probenecid
Examination (NAPLEX) Practice Exam
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. A 65-year-old patient with hypertension and chronic kidney disease
(CKD) is prescribed lisinopril. Which monitoring parameter is most
important initially?
A. Blood glucose
B. Serum creatinine and potassium
C. Liver function tests
D. Complete blood count
Answer: B. Serum creatinine and potassium
Rationale: ACE inhibitors like lisinopril can increase serum creatinine and
,potassium, especially in patients with CKD. Monitoring these parameters is
crucial to prevent hyperkalemia and worsening renal function.
2. Which antibiotic is considered first-line therapy for an uncomplicated
urinary tract infection (UTI) in a non-pregnant adult?
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin
D. Doxycycline
Answer: B. Nitrofurantoin
Rationale: Nitrofurantoin is effective against common uropathogens like E.
coli and is recommended as first-line therapy for uncomplicated UTIs due to
its efficacy and low resistance risk.
3. A patient presents with a new diagnosis of type 2 diabetes. Which class
of medications is recommended to reduce cardiovascular risk in patients
with atherosclerotic cardiovascular disease (ASCVD)?
A. Sulfonylureas
B. SGLT2 inhibitors or GLP-1 receptor agonists
C. Thiazolidinediones
D. DPP-4 inhibitors
,Answer: B. SGLT2 inhibitors or GLP-1 receptor agonists
Rationale: Guidelines recommend SGLT2 inhibitors or GLP-1 receptor
agonists for patients with type 2 diabetes and ASCVD due to proven
cardiovascular risk reduction.
4. Which of the following medications requires monitoring of the
international normalized ratio (INR)?
A. Dabigatran
B. Apixaban
C. Warfarin
D. Rivaroxaban
Answer: C. Warfarin
Rationale: Warfarin therapy requires INR monitoring to ensure therapeutic
anticoagulation and reduce the risk of bleeding or thrombosis.
5. A patient on metformin reports gastrointestinal discomfort. What is the
most appropriate intervention?
A. Discontinue therapy immediately
B. Switch to insulin
C. Take with meals or use extended-release formulation
D. Increase dose gradually
, Answer: C. Take with meals or use extended-release formulation
Rationale: Metformin commonly causes GI upset. Taking with food or
switching to an extended-release form can improve tolerability without
compromising efficacy.
6. Which class of antihypertensive drugs is preferred in a patient with
chronic kidney disease and proteinuria?
A. Calcium channel blockers
B. Beta-blockers
C. Diuretics
D. ACE inhibitors or ARBs
Answer: D. ACE inhibitors or ARBs
Rationale: ACE inhibitors and ARBs reduce proteinuria and slow the
progression of CKD, making them first-line therapy for hypertensive patients
with CKD.
7. What is the recommended treatment for an acute gout flare?
A. Allopurinol
B. Febuxostat
C. Colchicine, NSAIDs, or corticosteroids
D. Probenecid
