How To Breakdown and Analyze A NAPLEX Exam Question

Pharmacist Consult

The North American Pharmacist Licensure Examination (NAPLEX) is designed to test prospective pharmacists on different skills needed to make sound decisions in optimizing therapeutic outcomes for their patients. This exam tests abilities to identify and determine safe methods to prepare and dispense medications and supply accurate health care information to provide optimal health care.

Rest assured that you are ready for your exam. You have learned and studied all the material that will appear on it, so it just takes practice to know where to recall all the information hosted in your brain.

Read. When first analyzing a question, read the entire question first without looking at the answers. The first answer that pops into your head is usually correct. If your initial answer is a listed option – go with that and don’t second guess yourself.

Break it down. Now, if your initial guess is not listed then you have some more work to do. You have to pull all of the information you have about each answer. From that base knowledge, you can start analyzing the answers and either eliminate or keep answers around. If you have no idea about the answer, then break it down.

Try this sample question taken from the BoardVitals NAPLEX board review question bank.

Which of the following medications do not cause drug-induced hypertension?

  1. Prednisone
  2. Meloxicam
  3. Cocaine
  4. Pioglitazone
  5. Cyclosporine

Which answers are definitely wrong? Prednisone can cause hypernatremia and fluid retention, potentially raising blood pressure (eliminate A). NSAIDS can block COX-1 and COX-2 leading to decreased prostagladin formation. These changes affect the kidneys potentially leading to increased blood pressure, fluid retention and sodium retention (eliminate B). Cocaine stimulates alpha and beta receptors leading to increased heart rate and blood pressure (eliminate C). Pioglitazone is a diabetic medication to control blood sugar. Pioglitazone does not seem to be a medication that would affect blood pressure at first thought. I would mark this answer and read the rest because I am unsure if it causes drug-induced hypertension. Cyclosporine has a huge risk of drug-induced hypertension, but it is an uncommon drug so let’s say you cannot recall much about it.

Down to 2. We have eliminated answers A, B, and C. We are choosing between answers D and E. Now we need to think of everything we know about these two drugs. I can tell you for sure that pioglitazone is a TZD to treat diabetes. It is contraindicated in heart failure, but you cannot recall anything about hypertension. Fluid retention is a potential side effect potentially leading to heart failure and also a risk of bladder cancer. Then you move on to cyclosporine and a drawing a blank. I would tell myself that I know a lot about pioglitazone and could not remember anything about hypertension. I cannot remember anything about cyclosporine so answer E has the highest probability of causing drug-induced hypertension. I would pick and answer D, pioglitazone, as the medication that does not cause drug-induced hypertension.

This NAPLEX board review question bank has 1700+ review questions written and reviewed by licensed pharmacists who have recently taken the exam. Start studying with a free trial. Each question comes with detailed explanations, like the one featured above.

Calculations. A portion of the exam is dedicated to just calculations — but don’t fret, if you know what to expect, you can prepare for these calculations so they won’t slow you down on the timed test. Personal calculators are not permitted during the NAPLEX. Depending on where you are taking it, however, you will be supplied with a simple function hand-held calculator or a built in computer calculator on the exam.

A recent pharmacist took the NAPLEX exam and broke down the calculation questions. In 2013, the exam was not heavy in calculations. The pharmacist didn’t have calculations in any suppository, troche or making capsule questions. Compounding calculation questions were rare to nonexistent on that exam. Many calculations included converting pounds to kilograms, mg/kg/day dosing when given a patient’s weight; calculating day supplies, drip rates; and calculating how much medication may be needed when only given directions or determining how many milligrams or milliliters may be needed for a single dose. Don’t make a simple error by not answering the direct question. If the question asks for the answer in KG, make sure you convert it so that it is as such.

Now that you know how to break down a NAPLEX exam question, you can practice on these free NAPLEX practice questions.

Take your time with the exam, and don’t forget to “prescribe” yourself some restful sleep and nutrition leading up to the exam. If you have any questions about the BoardVitals NAPLEX Question Bank, feel free to reach out to us on Twitter.