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NABP NAPLEX Exam Questions
- Topic 1: Foundational Knowledge for Pharmacy Practice: This section of the exam measures skills of Pharmacists and covers essential pharmaceutical sciences that support safe and effective patient care. It includes principles of pharmacology, pharmacokinetics, pharmacodynamics, and pharmaceutics. Candidates must understand pharmaceutical compounding for both sterile and nonsterile preparations, perform accurate calculations for doses and concentrations, and interpret biostatistical and pharmacoeconomic data. Additionally, knowledge of drug development, clinical trials, and critical evaluation of medical literature is assessed.
- Topic 2: Medication Use Process (Prescribing, Transcribing, Documenting, Dispensing, Administering, and Monitoring): This section of the exam measures skills of Clinical Pharmacists and evaluates their ability to manage the complete medication use process. It focuses on interpreting prescriptions, understanding drug indications and dosing, ensuring compliance with regulations, and monitoring patient safety and drug effectiveness. It also assesses the ability to handle therapeutic substitutions, immunization protocols, and proper drug storage, stability, and disposal. Mastery of safety measures in managing hazardous substances is essential.
- Topic 3: Person-Centered Assessment and Treatment Planning: This section of the exam measures skills of Clinical Pharmacy Practitioners and covers patient-centered care, including collecting and evaluating medication and health histories. It requires understanding disease pathophysiology, identifying medication-related problems, and ensuring therapy appropriateness. Candidates must demonstrate ability to monitor therapy outcomes, detect drug interactions and adverse effects, and modify treatment plans based on clinical goals. This section also includes patient counseling, health education, adherence support, and proper use of devices for self-monitoring.
- Topic 4: Professional Practice: This section of the exam measures skills of Pharmacy Professionals and emphasizes ethical and regulatory responsibilities within pharmacy practice. It includes adverse event and medication error reporting, participation in public health initiatives like antimicrobial and opioid stewardship, and understanding social determinants of health. Candidates must demonstrate ethical decision-making, patient confidentiality, and adherence to professional conduct standards when delivering pharmaceutical care.
- Topic 5: Pharmacy Management and Leadership: This section of the exam measures the skills of Pharmacy Managers and focuses on operational leadership in pharmacy practice. It includes topics like workflow planning, risk management, quality improvement, and medication safety systems. Candidates are assessed on managing inventory, handling drug recalls, and implementing continuous improvement processes. Leadership skills such as mentoring, delegation, and fostering professional development within teams are also evaluated to ensure effective pharmacy operations.
Free NABP NAPLEX Exam Actual Questions
Note: Premium Questions for NAPLEX were last updated On Mar. 14, 2026 (see below)
An order is received to start Milrinone at 0.75mcg/kg/min, Milrinone comes as 20mg/100ml D5W. What is the infusion rate in mL/hr? Patient weighs 115kg.
Patient dose: 0.75mcg 115kg = 86.25mcg/min (100mL/20mg) (86.25mcg/1hr) (60min/1hr) (1mg/1000mcg) = 25.875mL/hr Rate of infusion of Milrinone
Which of the following is/are nominal data?
Nominal data is considered unordered categories. Sex answers fall into male or female which is unordered. Race can be multiple answers such as Caucasian, African American, Asian, etc which is unordered. Blood group can only have blood type O, A, B, or AB which is also unordered. Ordered, or ordinal data would have categories that are in some sort of order
http://www.bmj.com/about-bmj/resources-readers/publications/statistics-square-one
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?
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.
JM is a 32-year-old women who comes to your diabetic clinic with complain of several episodes of hypoglycemi
a. She is on Insulin NPH/regular 70/30, 22 units twice a day with breakfast and dinner. 8 units with lunch.
After discussing with physician you decide to decrease the total daily insulin by 10% and change to insulin glargine once a day and Insulin Lispro three time a day at ratio of 50:50 -- 50 % of long and 50 % of short acting insulin.
What is her new insulin regimen? Round down to the nearest 1 unit.
22 2 + 7 = 51 units of total insulin per day. Decrease by 10% 51 units 0.9 = 45.9 units per day round up to 46 units. 46 units 0.50 = 23 units, administer 23 units of insulin glargine once daily. 46 units 0.50 = 23 units total Insulin Lispro. Round down, divided by three times a day, 7 units 3 times a day with meals.
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.
What is the reason for holding metformin in patients with reduced renal function?
Metformin is held in patients with reduced renal function due to an increased risk of lactic acidosis. Metformin has a Boxed Warning for lactic acidosis, which is a rare but serious metabolic complication. Lactic acidosis can occurs due to an accumulation of metformin (5 mcg/mL or more). It is fatal in about 50% of cases. Lactic acidosis has also been reported to occur in those with diabetes who have significant renal function impairment. Lactic acidosis occurs when there are elevated blood lactate levels of 5 mmol/L or more, decreased blood pH, electrolyte disturbances with an increased anion gap, and an increased lactate/pyruvate ratio. Normal lactic acid level <2.0 mmol/L.
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