NAPLEX QBANK Therapeutic Plan Assessment Questions and Answers

Question 1

A 68-year-old male with a history of type 2 diabetes, hypertension, and a previous myocardial infarction presents to the pharmacy with a new prescription for sitagliptin 100 mg daily.
His current medication list includes metformin 1000 mg BID, lisinopril 20 mg daily, metoprolol succinate 100 mg daily, aspirin 81 mg daily, and atorvastatin 40 mg daily.
His most recent lab results show a SCr of 1.7 mg/dL and an eGFR of 38 mL/min/1.73m².
Which of the following represents the most significant drug therapy problem?

Accepted Answer

The sitagliptin dose is too high for the patient's renal function.

Answer

There is a therapeutic duplication with metformin and sitagliptin.

Answer

Atorvastatin is contraindicated in patients with diabetes.

Answer

Metoprolol may mask signs of hypoglycemia.

Question 2

A pharmacist is conducting a medication therapy review (MTR) for a 75-year-old female patient with osteoporosis, GERD, and insomnia. Her profile includes alendronate 70 mg weekly, calcium/vitamin D supplement daily, omeprazole 20 mg daily, and zolpidem 5 mg at bedtime as needed. The patient reports experiencing increased mid-back pain over the last month. When assessing the therapeutic plan, which is the most critical parameter for the pharmacist to evaluate further?

Accepted Answer

The risk of falls associated with zolpidem use.

Answer

Long-term use of a proton pump inhibitor.

Answer

The potential for esophagitis with alendronate.

Answer

The timing of the calcium supplement administration.

Question 3

When assessing a patient's therapeutic plan, which of the following is the primary goal of evaluating the 'effectiveness' of a medication?

Accepted Answer

To determine if the medication is achieving its desired therapeutic goals.

Answer

To determine if the medication is causing any adverse effects.

Answer

To verify that the patient is taking the medication as prescribed.

Answer

To ensure the medication has an appropriate indication for the patient's condition.

Question 4

A patient stabilized on warfarin for atrial fibrillation (target INR 2.0-3.0) is prescribed a new medication. Two weeks later, their INR is 1.3. Which of the following newly prescribed medications is the most likely cause of this subtherapeutic INR?

Accepted Answer

Carbamazepine

Answer

Amiodarone

Answer

Metronidazole

Answer

Fluconazole

Question 5

A pharmacist is developing a therapeutic monitoring plan for a patient starting therapy with lithium for bipolar disorder. In addition to monitoring the lithium serum concentration, which of the following sets of laboratory parameters is MOST important to monitor at baseline and periodically thereafter?

Accepted Answer

Thyroid function tests (TFTs) and renal function tests (BUN, SCr)

Answer

Complete blood count (CBC) and liver function tests (LFTs)

Answer

Serum electrolytes, lipid panel, and uric acid

Answer

Fasting blood glucose and hemoglobin A1c

Question 6

During a prospective drug utilization review (DUR), a pharmacist notes a prescription for rosuvastatin for a patient currently taking gemfibrozil. Which of the following drug therapy problems should the pharmacist identify?

Accepted Answer

A significant drug-drug interaction increasing the risk of myopathy

Answer

Unnecessary drug therapy

Answer

Therapeutic duplication

Answer

A dose that is too low to be effective