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  1. Home
  2. NABP Certification
  3. NAPLEX Exam
  4. NABP.NAPLEX.v2023-10-31.q78 Dumps
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Question 51

Which of the following antidiabetic medication works by inhibiting carbohydrate breakdown?

Correct Answer: A
Explanation
Acarbose is an alpha glucosidase inhibitor that inhibits carbohydrate breakdown. Metformin is a biguanide that decreases hepatic glucose production. Dapagliflozin is a SGLT2 inhibitor to decrease glucose reabsorption in the kidney. Pioglitazone is a TZD that increases insulin sensitivity. Sitagliptin is a DPP-4 inhibitor that works on incretins/increase insulin secretion/decrease glucagon secretion.
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Question 52

Which of the following beta-blocker is NOT proven to reduce mortality in patients with Systolic CHF?

Correct Answer: E
Nadolol is not proven to reduce mortality in patients with systolic CHF. The efficacy of nadolol in HF has not been determined. For patients taking nadolol, it should be used with caution in those with compensated heart failure and patients should be monitored for a worsening of the condition. Bisoprolol, carvedilol, and sustained- release metoprolol succinate are the beta-blockers that have been proven to reduce mortality in patients with systolic CHF. These 3 beta-blockers have been effective in reducing the risk of death in patients with chronic HFrEF. Other beta-blockers were found to be less effective. Bucindolol did not exhibit uniform effectiveness across different populations. Metoprolol tartrate was found to be less effective in HF clinical trials.
Reference:
http://circ.ahajournals.org/content/128/16/e240
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Question 53

JK is a 67 years old African American man who presents to your clinic for his blood pressure management. His past medical history includes Peptic ulcer disease and hypertension. His two BP readings are 160/98, 159/96 and HR 85. He says he has been adherent to his medication and lifestyle. He currently takes 12.5mg Chlorthalidone and Prilosec 20mg daily.
Which of the following is the best strategy to manage his blood pressure?

Correct Answer: B
As the patient is over the age of 60 and he does not have CKD or diabetes, his goal BP should be SBP < 150 mmHg or DBP < 90 mmHg, and he is not currently at this goal with his medication regimen. Options are to maximize the current medication dosage (option A), or to add a second agent. Since calcium channel blockers like Norvasc are recommended as initial treatment options in African Americans, choosing Norvasc over lisinopril would probably be the more effective option.
Reference:
http://jamanetwork.com/journals/jama/fullarticle/1791497
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Question 54

In a study where Rivaroxaban was compared to Enoxaparin to find total VTE following HIP replacement surgery, there were 17 total VTE out of 1513 patients in the Rivaraoaban group and 57 total VTE out of 1473 patient in the enoxaparin group.
What is the absolute risk reduction of using Rivaroxaban over Enoxaparin?

Correct Answer: D
Explanation
Absolute risk reduction: 0.027 = 2.7% (Event rate in enoxaparin group) - (Event rate in rivaroxaban group) = (57/1473) - (17/1513) = 0.02746
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Question 55

An 11-year-old male presents with his mother to your clinic with 5 days of frequent diarrhea, occasionally with streaks of blood mixed in. Stool cultures are pending, but preliminary stool samples demonstrate fecal WBC and RBC.
Assuming the patient is stable enough for outpatient management, what would be the optimal treatment assuming the underlying pathogen is Shigella?

Correct Answer: E
Explanation
Shigella can cause bloody diarrhea, and frequently affects young children and institutionalized patients. The pathogen is highly contagious, and is spread via fecal-oral transmission. The pathogen can lead to severe dehydration, and even cause febrile seizures in young patients. For clinically stable patients who can be managed via outpatient therapy, the optimal treatment is via PO TMP-SMX to decrease the risk of person- to-person transmission. Choice A - Erythromycin is the first line treatment for bloody diarrhea caused by the pathogen campylobacter. However, for the purposes of decreasing transmissibility of suspected Shigella, TMP-SMX remains the mainstay of therapy. Choices B + C - Oral metronidazole and oral vancomycin can both be used in the treatment of Clostridium deficile. Alternatively, intravenous metronidazole can be given if the patient is unable to tolerate oral medications. Choice D - Oral quinolones can be used in cases of bloody diarrhea in which salmonella is the suspected pathogen. Salmonella is caused by the ingestion of contaminated poultry and/or eggs, and can ultimately lead to bacteremia in 5-10% of cases.
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