NAPLEX QBANK Practice Test 3

Question 1

Which vaccine is contraindicated in a severely immunocompromised patient?

Accepted Answer

Live attenuated zoster (Zostavax)

Answer

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?

Accepted Answer

Increased lithium levels

Answer

NSAIDs reduce renal lithium clearance, raising serum lithium and toxicity risk.

Question 3

Which electrolyte abnormality predisposes to digoxin toxicity?

Accepted Answer

Hypokalemia

Answer

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?

Accepted Answer

Cephalexin

Answer

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?

Accepted Answer

Thyroid and pulmonary function

Answer

Amiodarone can cause thyroid dysfunction and pulmonary fibrosis, requiring baseline and periodic monitoring.