NAPLEX 試験問題を無料オンラインアクセス

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?

• A.Metformin can cause hyperkalemia
• B.Metformin can cause lactic acidosis
• C.Metformin can build up neurotoxin
• D.Metformin can cause hyperglycemia
• E.Metformin can cause acute renal failure

A 55-year-old female is receiving chemotherapy for metastatic carcinoma. She threatens to stop her treatment because of severe nausea and vomiting. The oncologist plans to use prochlorperazine to reduce the nausea and vomiting associated with chemotherapeutic agents. What is the mechanism of action of prochlorperazine?

• A.Cannabinoids related
• B.Blockage of prostaglandins
• C.Blocking dopamine receptors
• D.Serotonin 5-HT3 antagonist
• E.H2 receptor antagonist

A 23-year-old female presents to your clinic complaining of intermittent throbbing headaches that usually last for several hours and are made worse by the presence of light. She endorses occasional nausea without vomiting during the most severe episodes. Physical examination is unrevealing, and she has no significant past medical history.
Which of the following treatments is considered an abortive therapy for this patient's underlying condition?

• A.Sumatriptan
• B.Gabapentin
• C.Propranolol
• D.Diltiazam
• E.Amitriptyline

WM did not receive influenza vaccine prior to the start of this season, it's now December. He did get influenza vaccine last year. Which of the following is correct course of action?

• A.Skip influenza vaccine for this year since he received vaccine last year.
• B.Skip influenza vaccine for this year since it's too late.
• C.Start WM on Tamiflu to prevent him from getting influenza.
• D.Start Amantadine 200mg daily
• E.Vaccinate him with influenza vaccine since influenza season lasts until March in your community.

Which of the following is/are a risk factor for myopathy with statin therapy?

• A.Hepatic dysfunction
• B.Vitamin D deficiency
• C.Renal impairment
• D.Hypothyroidism
• E.Vitamin C deficiency