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How to Prepare for North American Pharmacist Licensure Examination
Preparation Guide for North American Pharmacist Licensure Examination
Introduction
In many careers, certification or a license is required to practice a career; for many careers in healthcare, a license is required to practice a career in health care. According to the Labor Bureau of Statistics in order to obtain a license in pharmacy, a person must graduate froma college of pharmacy that is accredited by the Accreditation Council for Pharmacy Education,and pass exams. The pharmacy license will be hard to obtain, and if I follow rules and regulations so that you will be able to retain your license.
To practice pharmacy in the United States, you must pass the NAPLEX exam. It's not enough to have a pharmacy degree. Though a necessity, a pharmacy degree is just the first stage of becoming a pharmacist. The degree prepares and equips you with the knowledge needed to progress onto the next stage. The NAPLEX exam takes your knowledge of pharmacy one step further. The NAPLEX exam has 250 questions. Some of these questions require a single answer, whilst other questions require you to select more than one correct answer. Some questions focus on the fundamental science of medicines, whereas other case study, or “scenario”, questions require you to understand, interpret and evaluate patient / clinical data.
To succeed at the NAPLEX test, candidates must possess exceptional knowledge of drug therapy and practice, dispensing and formulation science, and promoting public health and safe counselling procedure. As always, there are legal dimensions that candidates are expected to have a comprehensive knowledge of.
The opportunity benefits of becoming a pharmacist are immense. There are so many opportunities to succeed in this career and there is always a chance for change within it. For instance, the demand for pharmacists is expected to increase. The demand for pharmacists is expected to be higher through the year 2010, due to the increased needs for pharmaceuticals by a large and aging population. As society's health care needs have changed and expanded. There has been an increased emphasis on provision of care settings. As a result, an increased number of pharmacists now practice in hospitals, nursing homes, extended care facilities, neighborhood health care centers and health maintenance organization. These are many areas where pharmacists are needed and that it is why the demand is increasing.
There are many opportunities in a career in pharmacy because there is such a demand for pharmacists and the field has a variety of areas to venture into. Then there are a great number of challenges that go along with this career. School, training and certifications are all examples of the challenges. And the last thing is why pharmacy is the best career choice. The reason this is an excellent career choice is because of its opportunities, benefits and the challenges. This is a great choice because it reflects hard work and dedication.
In this guide, we will cover the NAPLEX exam dumps pdf and all aspects of the North American Pharmacist Licensure Examination.
Certification-question confirms eligibility to test for Colorado, Kentucky, Maine, Michigan, Nebraska, Oregon, Rhode Island, and Utah. There is an additional $85 fee for these states during the application process, and candidates may be approved to purchase the exam after meeting all application requirements.
Understanding function and technical aspects of Preparation, Compounding, Dispensing, and Administration of Medications and Provision of Health Care Products
The following will be discussed in NAPLEX exam dumps:
- Physiochemical properties of drugs that affect solubility and stability
- Packaging, labeling, storage, handling, and disposal of medications
- Rates of administration
- Identifying the presence of, and the cause of, product incompatibilities or degradation and methods for achieving stability
- Review, Dispense, and Administer Drugs and Drug Products
- Patients' nutritional needs and the content of nutrient sources
- Specific instructions and techniques for administration
- Physical attributes of drug products
- Compound Sterile and Nonsterile Products
- Drug concentrations, ratio strengths, and/or extent of ionization
- Commercial availability, identification, and ingredients of prescription and non-prescription drugs
- Quantities of medication to be compounded, dispensed, or administered
- Quantities of ingredients needed to compound preparations
NEW QUESTION 47
LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4mg iv q6h prn for N/V, Levothyroxine 0.075mg po daily, Lisinopril 10mg po daily, Citalopram
20mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500mg po bid, D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dose 0.1mg. lock-out every 6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg 1.5mg/ dl, K 5.0mmol/L, Na 135mmol/L.
Which of the following medication's dose are adjusted for poor renal function?
- A. Citalopram
- B. Ondansetron
- C. Metoclopramide
- D. Lisinopril
- E. Famotidine
Answer: C
Explanation:
Explanation
Famotidine and Metoclopramide would need to be adjusted for poor renal function. Since his CrCl is less than
50, famotidine would need to be adjusted by decreasing the dose by 50% or increasing the interval to every 36 to 48 hours. Metoclopramide would also need to be adjusted by 50% of the normal dose since his CrCl is less than 40. ACEInhibitors and ARBs should be held if serum K is greater than 5.6 or there is a rise in serum creatinine greater than 30% after initiation.
NEW QUESTION 48
Which of the following class of antidiabetic medications can increase triglycerides?
- A. Thiazolidinediones
- B. Alpha-glucosidase inhibitors
- C. Bile acid sequestrant
- D. SGLT2 Inhibitor
- E. GLP-1 agonist
Answer: C
Explanation:
Explanation
The only bile acid sequestrant, colesevelam (Welchol), has been shown to increase triglycerides through mechanism of: activation of phosphatidic acid phosphatase with promotes triglyceride synthesis. GLP-1 agonists work on GLP 1 receptors to increase insulin secretion, decrease glucagon secretion, and increase satiety. Thiazolidinediones activate nuclear transcription factor PPAR gamma to increase insulin sensitivity.
SGLT2 inhibitors inhibit glucose reabsorption in the kidney. Alpha-glucosidase inhibitors slow down digestion and absorptions of carbs in the gut.
NEW QUESTION 49
After talking to the patient you find out LT has been incompliant with her three times a day Valproic acid, level came back at 35 mmol/L.
What is the most appropriate course of action?
- A. Valproic acid level is within normal limit, no adjustment is needed.
- B. Notify the physician to increse the dose of Valproic acid.
- C. Albumin needs to be obtained to calculate corrected Valproic acid level
- D. Notify the physician to decrease the dose of Valproic acid.
Answer: A
Explanation:
Explanation
The delayed-release action of divalproex allows for less frequent dosing than valproic acid in some patients.
Divalproex sodium contains sodium valproate and valproic acid in a 1:1 molar stable co-ordination compound.
Valproic acid, sodium valproate, and divalproex share the same pharmacology; however, there are pharmacokinetic differences among products.
NEW QUESTION 50
Which of these drugs is used to prevent contrast-induced nephropathy?
- A. N-acetylcysteine
- B. Metformin
- C. Activated charcoal
- D. Mannitol
- E. Spironolactone
Answer: A
Explanation:
Explanation
N-acetylcysteine can be used to prevent contrast-induced nephropathy. Whilst evidence is not overwhelming for use in favor, it does appear to have a clinical impact. N-acetylcysteine is typically given the day before treatment and the day when treatment commences. Other means to prevent contrast-induced nephropathy include adequate hydration, while some studied recommend ascorbic acid.
NEW QUESTION 51
A CD4 count of 180 cells per cubic meter may be evaluated as which of these?
- A. High
- B. Very low
- C. Low
- D. Severely high
Answer: B
Explanation:
Explanation
A CD4 count of 180 cells per cubic meter is considered very low - typically an indicator that the patient has an immunocompromised state, such as AIDS. CD4 counts are a measure of healthy T-cell levels. The lower the count, the more susceptible the patient is to opportunistic infections. A normal range is between 500 and 1,500 cells.
NEW QUESTION 52
What is the Osmolarity of NS with KCL 40 meq/L? (MW of KCl: 74.55 g/mol) (MW of NaCl: 58.44 g/mol)
- A. 800 mOsm/L
- B. 830 mOsm/L
- C. 388 mOsm/L
- D. 308 mOm/L
- E. 1108 mOsm/L
Answer: C
Explanation:
KCl: Osmoles = number of particles in solution Convert 40meq to weight in g: 40meq × 1equiv/1000 mEq ×
74.5g/1 equiv = 2.98g of KCL. Calculate mOsm/L: 2.98g/L × 1mol/74.5g × 2Osm/1 mol × 1000mOsm/1 Osm
80mOsm/L. NaCl: 0.9g/100ml × 1mol/58.5 g × 2 Osm/1mol × 1000 mOsm/ 1Osm × 1000ml/1L = 308 mOsm/L
80 mOsm/L + 308 mOsm/L = 388 mOsm/L
NEW QUESTION 53
A patient presents in the pharmacy in a delirious state with pinpoint pupils. Which of the following toxicity states does the patient most likely have?
- A. Benzodiazepine
- B. Amphetamine
- C. Alcohol
- D. Opioid
Answer: D
Explanation:
Explanation
Signs of opioid overdose include pinpoint pupils, delirious state, nausea / vomiting, respiratory depression and sleepiness or loss of consciousness. Naloxone may be used to reverse the effects of opioid overdose.
NEW QUESTION 54
Your patient is a 58-year-old male who presents with onset of severe substernal chest pain and shortness of breath. An ECG reveals an acute STEMI, and he is on his way to the cardiac catheterization suite for percutaneous coronary intervention.
Which of the following drugs used in acute coronary syndromes treated with PCI must undergo oxidation by hepatic P450 enzymes to an active form?
- A. Aspirin
- B. Clopidogrel
- C. Eptifibatide
- D. Ticlopidine
- E. Warfarin
Answer: B
Explanation:
Explanation
Clopidogrel and ticlopidine are ADP receptor pathway inhibitors. The irreversible inhibition of the ADP- dependent pathway of platelet activation is thought to be the result of covalent modification and inactivation of the platelet P2Y ADP receptor. This receptor is coupled to the inhibition of adenylyl cyclase. Both drugs are prodrugs and undergo conversion to active metabolites in the liver. However, clopidogrel must undergo oxidation by hepatic P450 enzymes to its active form. This is significant because many drugs are metabolized the hepatic P450 enzymes, including statins, and clopidogrel may interact with these medications. Clopidogrel is a second-generation thienopyridine and ticlopidine is a first-generation thienopyridine. Both drugs are indicated in combination with aspirin to prevent stent thrombosis. Eptifibatide is a GPIIb-IIIa receptor antagonist that is used to treat unstable angina and non-ST segment elevation myocardial infarction.
Eptifibatide is also used to reduce ischemic events in patients who are undergoing percutaneous coronary intervention. The drug is a synthetic peptide that directly antagonizes the GPIIb-IIIa receptor on the platelet.
Aspirin is an antiplatelet drug that works by inhibition of synthesis of prostaglandins. Prostaglandin G2 is the result of a synthesis pathway that is activated by platelets and endothelial cells, and results in localized vasoconstriction and induction of platelet aggregation, as well as causing release of platelet granules. Warfarin is an anticoagulant that acts on vitamin K-dependent reactions in the coagulation pathway. Vitamin K is necessary for hepatic synthesis of coagulation factors II, VII, IX and X, protein C and protein S.
Vitamin K- dependent carboxylation is necessary for induction of enzymatic activity of these coagulation factors. Take- home message: Clopidogrel, a second-generation thienopyridine ADP receptor pathway inhibitor, is indicated in combination with aspirin to prevent stent thrombosis in patients who undergo percutaneous coronary intervention after myocardial infarction. Clopidogrel is a prodrug that must undergo oxidation by hepatic P450 enzymes, and therefore may affect the activity of statins and other drugs dependent on the hepatic P450 enzymes.
NEW QUESTION 55
Which of the following medication can lower seizures threshold?
- A. Bupropion
- B. Clozapine
- C. Thiothixene
- D. All of the above can lower seizure threshold
- E. Tramadol
Answer: D
Explanation:
Seizure threshold can be lowered by bupropion, chlorpromazine, clozapine, maprotiline, olanzapine, thioridazine, thiothixene, and tramadol.
NEW QUESTION 56
LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain.
Post-op day 1, LN's medication includes Dexamethasone 8 mg iv q6h with taper dosing, Ondansetron 4 mg iv q6h prn for N/V, Levothyroxine 0.075 mg po daily, Lisinopril 10 mg po daily, Citalopram 20 mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10 mg suppository daily prn for constipation, Famotidine 20 mg iv q12hr, Metoclopramide 10 mg iv q6h, Metformin 500 mg po bid, D51/2NS with 20 K at
125 mls/hour and Hydromorphone PCA at 0.2 mg/hour of basal rate, demand dose 0.1 mg. lock-out every 6 min, one hour limit 2.2 mg/hour. Pertinent morning labs includes serum creatinine 1.4 mg/dl, Mg 1.5 mg/dl, K
5.0 mmol/L, Na 135 mmol/L.
Which of the following medication may cause tardive dyskinesia when given at a higher dose and for a long duration?
- A. Metoclopramide
- B. Hydromorphone
- C. Lisinopril
- D. Famotidine
- E. Dexamethasone
Answer: A
Explanation:
Metoclopramide may cause tardive dyskinesia when given at a higher dose and for a long duration of time of more than 3 months. Tardive dyskinesia is also listed as a Boxed Warning for metoclopramide. Tardive dyskinesia is a serious movement disorder that is irreversible. The risk increases with duration of treatment and the total cumulative dose. If signs or symptoms of tardive dyskinesia develop, then metoclopramide should be discontinued. There is currently no known treatment for it, but symptoms can lessen or resolve after metoclopramide is stopped. Treatment should not be more than 12 weeks unless the benefits outweigh the risks of developing tardive dyskinesia.
NEW QUESTION 57
Injectable Sulfamethoxazole/Trimethoprim comes as 400mg/80mg/5ml. Physician requests you to dose a Sulfamethoxazole/Trimethoprim intravenously for PCP. You know the dose is 15mg/kg/day (based on TMP component) divided q6h.
How many milliliters of Sulfamethoxazole/Trimethoprim of 400mg/80mg/5ml would you need for single dose? Patient weighs 80kg.
- A. 75 mL
- B. 50 mL
- C. 16.5 mL
- D. 15 mL
- E. 18.75 mL
Answer: E
Explanation:
Explanation
80kg person = 15mg/kg/day = 1200mg/day 80mg /5ml = 1200mg/X X= 75mL/day / 4 doses = 18.75 mL per dose
NEW QUESTION 58
In the US Nurses' Health Study (NHS) cohort study, where they looked at association of regular aspirin use (≥two 325 mg tablets/week) and colorectal cancer in 82,911 women found (RR, 0.77; 95% CI, 0.67-0.88) over
20 years of follow-up.
In an another analysis of the NHS, regular aspirin use, investigator also found (hazard ratio [HR]=0.72, 95% CI
0.56-0.92), what does this say about the mortality from colorectal cancer? How can this data best be interpreted?
- A. Those who takes aspirin ≥2 times/week have 28% lower risk of colorectal cancer
- B. Those who takes aspirin ≥2 times/week have 0.77% lower risk of colorectal cancer
- C. Those who takes aspirin ≥2 times/week have 23% reduction in death from colorectal cancer
- D. None of the above is correct
- E. Those who takes aspirin ≥2 times/week have 23% lower risk of colorectal cancer
Answer: E
Explanation:
Explanation/Reference:
Explanation:
Relative risk can be stated as 0.77 times as likely or 0.77 times the risk, but it could also be illustrated as a relative risk reduction and stated as a 23% risk reduction or 23% lower risk by taking the medication.
Reference:
https://www.ncbi.nlm.nih.gov/books/NBK63647/
NEW QUESTION 59
Which of the following antidiabetic medication may cause cyanocobalamin deficiency?
- A. Glimepiride
- B. Metformin
- C. Canagliflozin
- D. Pioglitazone
- E. Saxagliptin
Answer: B
Explanation:
Metformin is associated with vitamin B12 deficiency because it affects the calcium dependent membrane uptake of it. All other drug classes are not associated with this.
NEW QUESTION 60
If a patient is getting NS IVF at 120mls/hr, how much Sodium Chloride in grams is this patient getting in 24 hours? NS is 0.9% sodium chloride.
- A. 90mg
- B. 25.92mg
- C. 25.92kg
- D. 90gm
- E. 25.92gm
Answer: E
Explanation:
0.9%= 0.9g/100mL, 120mL/h × 24hrs = 2880mL. 0.9g/100ml = x/2880ml, x = 25.92g of NaCl.
NEW QUESTION 61
If a patient takes 0.5mg of intravenous hydromorphone every 4hrs what would be the equivalent orals total daily dose? Hydromorphone oral to parenteral ratio 7.5:1.5.
- A. 7.5mg
- B. 15mg
- C. 5mg
- D. 10mg
- E. 20mg
Answer: B
Explanation:
To determine the dose conversion IV to PO, the ratio of PO to IV needs to be determined, this is 7.5 / 1.5 which is 5. This number means that the PO dose is 5 times more than the IV dose to get the same amount of drug into the bloodstream. If the patient is taking 0.5 mg IV then the PO dose would be 0.5 mg multiplied by 5, which is 2.5 mg. Since the patient is taking the medication every 4 hours the patient is receiving 6 doses, 24hrs/4hrs
= 6. Since the patient is receiving 2.5 mg every dose and is receiving 6 doses a day, the patient is receiving 15 mg, 2.5 mg multiplied by 6 doses.
NEW QUESTION 62
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Benefits of Getting the North American Pharmacist Licensure Examination
Getting licensed early will help to put you at ease as you begin your job and to join a professional pharmacy organization.
The score transfer program saves time and allows you to move ahead with licensure in more than one state as soon as you pass the NAPLEX.
Score transfer can be added to your NAPLEX application in your e-Profile. You may select states in addition to the primary state where you are seeking licensure, and we will transmit your score to those boards of pharmacy.
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