NAPLEX QBANK Cheat Sheet 2026

The 30 highest-yield NAPLEX QBANK facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which counseling point is correct for a patient prescribed levothyroxine? → Take on an empty stomach, typically 30-60 minutes before breakfast
2. What is the appropriate needle gauge consideration when administering an intramuscular vaccine to an adult? → A 1 to 1.5 inch needle into the deltoid
3. A patient with stage 4 CKD (eGFR 22) and atrial fibrillation needs anticoagulation. Which agent requires the most caution or avoidance? → Dabigatran standard dose
4. Which monitoring parameter is most important for a patient starting amiodarone long term? → Thyroid and pulmonary function
5. A patient develops a severe egg allergy with anaphylaxis. Which influenza vaccine is preferred? → Cell-based or recombinant influenza vaccine
6. Which mechanism explains the antiplatelet effect of clopidogrel? → Irreversible P2Y12 ADP receptor blockade
7. Which counseling point is correct regarding the recombinant zoster vaccine schedule? → Two doses given 2 to 6 months apart
8. Which electrolyte abnormality predisposes to digoxin toxicity? → Hypokalemia
9. A patient with stable angina remains symptomatic on maximally tolerated metoprolol. Which addition is most appropriate? → A dihydropyridine calcium channel blocker
10. Which drug combination is most likely responsible for a patient developing a prolonged QTc interval on ECG? → Azithromycin and haloperidol
11. If Jen is given Dextrose 5% half-normal saline with 20 meq potassium as IVF at a rate of 125mls/hour. How much dextrose does she consume in a day? → 150gm
12. Which is appropriate counseling for a patient prescribed sumatriptan for migraines? → Take at the onset of a migraine; do not exceed recommended doses
13. A patient taking a nonselective MAOI consumes aged cheese. What mechanism underlies the resulting hypertensive crisis? → Tyramine accumulation triggers massive norepinephrine release
14. Beta-blockers reduce heart rate primarily by antagonizing which receptor? → Beta-1 adrenergic receptors
15. Which medication is first-line for opioid-induced constipation prophylaxis? → A stimulant laxative such as senna
16. A patient taking an ACE inhibitor develops a persistent dry cough without angioedema. What is the best alternative? → Switch to an ARB
17. A patient with major depression has failed an adequate trial of one SSRI. What is the most appropriate next step? → Switch to another antidepressant or augment
18. Under USP , what is the ISO class requirement for the primary engineering control (PEC) where sterile compounding is performed? → ISO Class 5
19. A patient on phenazopyridine for urinary discomfort should be told to expect what? → Reddish-orange discoloration of urine
20. A patient with rheumatoid arthritis has inadequate control on methotrexate monotherapy. What is an appropriate next step? → Add a TNF inhibitor or other biologic DMARD
21. Under USP , how often must media-fill testing be performed for personnel compounding low- and medium-risk preparations? → At least annually
22. A patient with newly diagnosed HIV is to start an integrase inhibitor regimen. Which baseline test guides whether abacavir can be safely used? → HLA-B*5701 testing
23. Which mechanism underlies the action of sulfamethoxazole/trimethoprim? → Sequential inhibition of folate synthesis pathway
24. Geometric dilution is a technique used primarily to achieve what during non-sterile compounding? → Uniform mixing of a small amount of potent drug with a larger amount of diluent
25. A 58-year-old with type 2 diabetes, eGFR 28 mL/min, and HbA1c 8.9% is on metformin. What is the most appropriate change to the treatment plan? → Discontinue metformin and add a GLP-1 receptor agonist or insulin
26. What is the weight of 1000 mL of 1.27 specific gravity serum protein? → 1270 gm
27. An asthmatic patient using a rescue albuterol inhaler more than twice weekly indicates the need for which therapy adjustment? → Add an inhaled corticosteroid
28. A laminar airflow workbench (LAFW) directs HEPA-filtered air in which primary direction during sterile compounding? → Horizontally toward the compounder
29. Which of the following types of data are ordinal? → Grade of breast cancer
30. A patient with generalized anxiety disorder needs long-term pharmacotherapy. Which is the preferred first-line option? → An SSRI such as escitalopram