NAPLEX QBANK Practice Test 3 — Questions and Answers
Question 1: Which vaccine is contraindicated in a severely immunocompromised patient?
- Inactivated influenza
- Pneumococcal (PCV15)
- Live attenuated zoster (Zostavax) (Correct answer)
- Tdap
Correct answer: Live attenuated zoster (Zostavax)
Live vaccines like the older zoster vaccine are contraindicated in severe immunosuppression.
Question 2: A patient on lithium starts an NSAID. What is the expected effect?
- Decreased lithium levels
- Increased lithium levels (Correct answer)
- No change
- Increased lithium renal clearance
Correct answer: Increased lithium levels
NSAIDs reduce renal lithium clearance, raising serum lithium and toxicity risk.
Question 3: Which electrolyte abnormality predisposes to digoxin toxicity?
- Hyperkalemia
- Hypokalemia (Correct answer)
- Hypernatremia
- Hypochloremia
Correct answer: Hypokalemia
Hypokalemia increases digoxin binding to Na/K-ATPase, enhancing toxicity.
Question 4: What is the preferred treatment for a pregnant patient with a UTI in the first trimester?
- Ciprofloxacin
- Nitrofurantoin
- Cephalexin (Correct answer)
- Doxycycline
Correct answer: Cephalexin
Cephalexin is a safe first-line choice; nitrofurantoin and sulfa are avoided near term, and fluoroquinolones/tetracyclines are contraindicated.
Question 5: Which monitoring parameter is most important for a patient starting amiodarone long term?
- Thyroid and pulmonary function (Correct answer)
- Serum amylase
- Folate level
- Uric acid
Correct answer: Thyroid and pulmonary function
Amiodarone can cause thyroid dysfunction and pulmonary fibrosis, requiring baseline and periodic monitoring.
Question 6: A patient taking an SSRI is started on tramadol. What is the primary concern?
- Hypoglycemia
- Serotonin syndrome (Correct answer)
- QT shortening
- Hyperkalemia
Correct answer: Serotonin syndrome
Tramadol has serotonergic activity, and combining it with an SSRI raises serotonin syndrome risk.
Question 7: Which agent is first-line for acute anaphylaxis?
- IV diphenhydramine
- IM epinephrine (Correct answer)
- Oral prednisone
- Nebulized albuterol
Correct answer: IM epinephrine
Intramuscular epinephrine into the anterolateral thigh is the immediate first-line treatment for anaphylaxis.
NAPLEX QBANK Practice Test 3
Which vaccine is contraindicated in a severely immunocompromised patient?