NAPLEX Exam V2 | North American
Pharmacist Licensure Examination
(NAPLEX) | Q&A with Rationale (NAPLEX
Exam) | National Association of Boards of
Pharmacy (NABP)
1. A 65-year-old male with a history of HTN and Stage 3 CKD (eGFR 42 mL/min/1.73m2) is
diagnosed with Stage 2 Hypertension. Which of the following is the most appropriate first-
line antihypertensive therapy based on current clinical guidelines?
A. Lisinopril
B. Amlodipine
C. Hydrochlorothiazide
D. Metoprolol Succinate
Correct Answer: A
Rationale: ACE inhibitors such as lisinopril are recommended as first-line therapy for
patients with chronic kidney disease and hypertension. They provide significant
renoprotective benefits by reducing intraglomerular pressure and proteinuria. Serum
creatinine and potassium levels should be monitored within 1-2 weeks of starting therapy
to ensure safety.
,2. Which of the following describes the most appropriate counseling point for a patient
beginning therapy with Alendronate for osteoporosis?
A. Take the medication at least 30 minutes before the first food or drink of the day.
B. Take the medication at bedtime with a full glass of milk.
C. Lie down for 30 minutes after taking the dose to prevent dizziness.
D. Take the medication with a high-fat meal to increase absorption.
Correct Answer: A
Rationale: Alendronate must be taken on an empty stomach with plain water at least 30
minutes before any food, beverages, or other medications. Patients must remain upright for
at least 30 minutes to reduce the risk of esophageal irritation or ulceration. Taking the
medication with anything other than plain water significantly reduces its bioavailability.
3. A patient is admitted to the hospital with a suspected Methicillin-resistant Staphylococcus
aureus (MRSA) infection. Which of the following medications is a first-line treatment option
for MRSA bacteremia?
A. Cefazolin
B. Linezolid
C. Vancomycin
D. Piperacillin/Tazobactam
Correct Answer: C
, Rationale: Vancomycin is considered the standard of care for MRSA bacteremia according
to IDSA guidelines. Daptomycin is also a first-line alternative, whereas Linezolid is typically
reserved for pneumonia or skin infections due to its bacteriostatic nature in certain
contexts. Cefazolin and Piperacillin/Tazobactam lack activity against MRSA.
4. A pharmacist is reviewing a lab report for a patient on Warfarin therapy. The patient’s INR
is 5.5, and there is no evidence of bleeding. What is the most appropriate action according to
CHEST guidelines?
A. Administer Vitamin K 10mg IV.
B. Administer Vitamin K 2.5mg PO.
C. Hold 1-2 doses of Warfarin and monitor closely.
D. Continue the current dose and recheck INR in 24 hours.
Correct Answer: C
Rationale: For patients with an INR between 4.5 and 10 without bleeding, the
recommendation is to omit 1-2 doses of warfarin. Routine use of Vitamin K is not
recommended for INRs in this range unless there is a high risk of bleeding. The INR should
be monitored more frequently until it returns to the therapeutic range.
5. A 52-year-old female patient with a history of Type 2 Diabetes and Heart Failure with
Reduced Ejection Fraction (HFrEF) requires an additional agent to lower her A1c. Which of the
following is most appropriate?
A. Pioglitazone
Pharmacist Licensure Examination
(NAPLEX) | Q&A with Rationale (NAPLEX
Exam) | National Association of Boards of
Pharmacy (NABP)
1. A 65-year-old male with a history of HTN and Stage 3 CKD (eGFR 42 mL/min/1.73m2) is
diagnosed with Stage 2 Hypertension. Which of the following is the most appropriate first-
line antihypertensive therapy based on current clinical guidelines?
A. Lisinopril
B. Amlodipine
C. Hydrochlorothiazide
D. Metoprolol Succinate
Correct Answer: A
Rationale: ACE inhibitors such as lisinopril are recommended as first-line therapy for
patients with chronic kidney disease and hypertension. They provide significant
renoprotective benefits by reducing intraglomerular pressure and proteinuria. Serum
creatinine and potassium levels should be monitored within 1-2 weeks of starting therapy
to ensure safety.
,2. Which of the following describes the most appropriate counseling point for a patient
beginning therapy with Alendronate for osteoporosis?
A. Take the medication at least 30 minutes before the first food or drink of the day.
B. Take the medication at bedtime with a full glass of milk.
C. Lie down for 30 minutes after taking the dose to prevent dizziness.
D. Take the medication with a high-fat meal to increase absorption.
Correct Answer: A
Rationale: Alendronate must be taken on an empty stomach with plain water at least 30
minutes before any food, beverages, or other medications. Patients must remain upright for
at least 30 minutes to reduce the risk of esophageal irritation or ulceration. Taking the
medication with anything other than plain water significantly reduces its bioavailability.
3. A patient is admitted to the hospital with a suspected Methicillin-resistant Staphylococcus
aureus (MRSA) infection. Which of the following medications is a first-line treatment option
for MRSA bacteremia?
A. Cefazolin
B. Linezolid
C. Vancomycin
D. Piperacillin/Tazobactam
Correct Answer: C
, Rationale: Vancomycin is considered the standard of care for MRSA bacteremia according
to IDSA guidelines. Daptomycin is also a first-line alternative, whereas Linezolid is typically
reserved for pneumonia or skin infections due to its bacteriostatic nature in certain
contexts. Cefazolin and Piperacillin/Tazobactam lack activity against MRSA.
4. A pharmacist is reviewing a lab report for a patient on Warfarin therapy. The patient’s INR
is 5.5, and there is no evidence of bleeding. What is the most appropriate action according to
CHEST guidelines?
A. Administer Vitamin K 10mg IV.
B. Administer Vitamin K 2.5mg PO.
C. Hold 1-2 doses of Warfarin and monitor closely.
D. Continue the current dose and recheck INR in 24 hours.
Correct Answer: C
Rationale: For patients with an INR between 4.5 and 10 without bleeding, the
recommendation is to omit 1-2 doses of warfarin. Routine use of Vitamin K is not
recommended for INRs in this range unless there is a high risk of bleeding. The INR should
be monitored more frequently until it returns to the therapeutic range.
5. A 52-year-old female patient with a history of Type 2 Diabetes and Heart Failure with
Reduced Ejection Fraction (HFrEF) requires an additional agent to lower her A1c. Which of the
following is most appropriate?
A. Pioglitazone
