NAPLEX Practice Questions: Special Populations

Studying and being prepared for special populations’ questions on the NAPLEX is crucial for pharmacists to provide safe and effective medication therapy to patients. Special populations, such as pediatric patients, elderly patients, pregnant patients, patients with liver disease, and patients with renal impairment, have unique physiological, pharmacokinetic, and pharmacodynamic characteristics that require special consideration when choosing and dosing medications. Ignoring these differences can result in harm to the patient and negative outcomes. By studying and being prepared for special populations’ questions on the NAPLEX, pharmacists can demonstrate their knowledge and understanding of the complexities involved in caring for these patients, ultimately improving patient outcomes and enhancing public health.

Here are 5 NAPLEX practice questions. Please scroll to the end for answers and explanations.

Content accurate at the time of publishing 2/6/2023

NAPLEX Question 1

A pediatric patient is prescribed a commonly used medication for their condition. The patient's healthcare provider is considering adjusting the dose based on the patient's weight. What is the appropriate weight-based dosing formula for this medication in pediatric patients?

A. Body Surface Area

B. Body Mass Index

C. Ideal Body Weight

D. Actual Body Weight

NAPLEX Question 2

An elderly patient is prescribed a commonly used medication for their condition. The patient's healthcare provider is considering adjusting the dose based on the patient's age.

What is the appropriate age-based dosing formula for this medication in elderly patients?

A. Geriatric Dosage Handbooks

B. Creatinine Clearance

C. Body Surface Area

D. Ideal Body Weight

NAPLEX Question 3

A 60-year-old male patient with end-stage renal disease (ESRD) and hypertension is started on lisinopril 20mg daily. What dosing considerations should be made for this patient, and what should be the target blood pressure?

A. Increase the dose of lisinopril to 40mg daily and aim for a blood pressure of 140/90 mmHg

B. Decrease the dose of lisinopril to 10mg daily and aim for a blood pressure of 140/90 mmHg

C. Maintain the dose of lisinopril at 20mg daily and aim for a blood pressure of 160/100 mmHg

D. Maintain the dose of lisinopril at 20mg daily and aim for a blood pressure of 130/80 mmHg

NAPLEX Question 4

A 28-year-old female patient in her second trimester of pregnancy presents with migraine headaches. What is the best medication option for her?

A. Sumatriptan 100mg orally as needed

B. Naproxen 500mg twice daily

C. Acetaminophen 1000mg every 4 hours as needed

D. Diclofenac 50mg twice daily

NAPLEX Question 5

A patient with liver disease is prescribed a commonly used medication for their condition. The patient's healthcare provider is considering adjusting the dose based on the patient's liver function.

What is the appropriate liver function-based dosing formula for this medication in patients with liver disease?

A. Creatinine Clearance

B. Total Liver Function

C. Model for End-Stage Liver Disease (MELD) Score

D. Body Mass Index

 Answers and Explanation:

NAPLEX question 1- Correct Answer: A. Body Surface Area

Explanation: In pediatrics, dosing is often based on Body Surface Area (BSA), which takes into account the patient's height and weight. This formula provides a more accurate representation of the patient's size and ensures that the dose is appropriate for the patient's age and weight. Body Mass Index (BMI), Ideal Body Weight (IBW), and Actual Body Weight (ABW) are not commonly used for weight-based dosing in pediatric patients.

The BSA equation is: BSA = √((height x weight)/3600) where height is in cm (height (in cm) = 2.54 x height (in inches)) and weight is in Kg

NAPLEX Question 2- Correct Answer: A. Geriatric Dosage Handbooks

Explanation: In geriatrics, dosing is often based on Geriatric Dosage Handbooks, which provide guidelines for adjusting dosing in elderly patients based on factors such as age, kidney function, and liver function. Creatinine Clearance, Body Surface Area, and Ideal Body Weight are not commonly used for age-based dosing in elderly patients.

NAPLEX Question 3- Correct Answer: D. Maintain the dose of lisinopril at 20mg daily and aim for a blood pressure of 130/80 mmHg

Explanation: Patients with ESRD have impaired elimination of medications and may experience greater exposure to medications, which can increase the risk of adverse effects. The American College of Cardiology and the American Heart Association recommend a lower blood pressure target of 130/80 mmHg for patients with chronic kidney disease, including those with ESRD. The dose of lisinopril should be maintained at 20mg daily as a starting dose, and the blood pressure target should be 130/80 mmHg. This helps ensure that the patient's blood pressure is controlled while minimizing the risk of adverse effects related to the medication.

NAPLEX Question 4- Correct Answer: C. Acetaminophen 1000mg every 4 hours as needed

Explanation: Migraine headaches during pregnancy require careful consideration of medication options due to the potential for adverse effects on the developing fetus. Acetaminophen is considered the safest pain reliever for use during pregnancy and is recommended as the first-line treatment for migraine headaches. Sumatriptan, naproxen, and diclofenac are not recommended during pregnancy due to their potential to cause harm to the fetus, including an increased risk of birth defects, premature birth, or low birth weight. In this case, acetaminophen is the best option because it is considered safe during pregnancy and has a well-established role in the treatment of mild to moderate pain.

NAPLEX Question 5- Correct Answer: C. Model for End-Stage Liver Disease (MELD) Score

Explanation: In patients with liver disease, dosing is often based on the Model for End-Stage Liver Disease (MELD) Score, which provides an estimate of a patient's liver function and helps to determine the appropriate dose of a medication. Creatinine Clearance, Total Liver Function, and Body Mass Index are not commonly used for liver function-based dosing in patients with liver disease.

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