Comprehensive Pharmacy Review for NAPLEX Practice Exams, Cases, and Test Prep

Comprehensive Pharmacy Review for NAPLEX Practice Exams, Cases, and Test Prep

Th is practice exam book is a companion to Comprehen-sive Pharmacy Review. Whereas Comprehensive Pharmacy  Review presents most of the subjects in the pharmacy cur-riculum in outline form with review questions interspersed, this booklet off ers two examinations that are similar in for-mat and coverage to those in the licensing examination re-quired of all pharmacists.

Both patient profi le–based and free-standing test items are included in the examinations. Th e questions are of two general types. In the fi rst type (Example 1), the correct re-sponse most accurately completes a statement or answers a question. In the second type (Example 2), three state-ments are given. Th e correct answer may include one, two, or all three of these statements; these questions are to be answered according to the direction block that accompa-nies them.


Drugs that demonstrate nonlinear pharmacokinetics show which of the following properties?

A. A constant ratio of drug metabolites is formed as the  administered dose increases.

B. Th e elimination half-life increases as the administered dose is increased.

C. Th e area under the curve (AUC) increases in direct pro-portion to an increase in the administered dose.

D. Both low and high doses follow fi rst-order elimination kinetics.

E. Th e steady-state drug concentration increases in direct proportion to the dosing rate.


Antimuscarinic agents are used in the treatment of Parkin-son disease and in the control of some neuroleptic-induced extrapyramidal disorders. Th ese agents include which of the following?

I. ipratropium

II. benztropine

 III. trihexyphenidyl

I only

III only

I and II

II and III

I, II, and III

Allow a maximum of 4 hours for each examination.

Answers, with explanations, are given at the end of each test. Additional cases, questions, and calculations exercises are included following the two practice tests. Also, several ap-pendices are included at the back of the book for reference.

One of the least attractive aspects of pursuing an education is the necessity of being examined on the material that has been presented. Instructors do not like to prepare tests, and students do not like to take them.

However, students are required to take many exami-nations during their learning careers, and little if any time is spent acquainting them with the positive aspects of tests and with systematic and successful methods for approach-ing them. Students perceive tests as punitive and sometimes feel as if they were merely opportunities for the instructor to discover what the student has forgotten or has never learned. Students need to view tests as opportunities to display their knowledge and to use them as tools for developing prescrip-tions for further study and learning.

While preparing for any exam, class and board exams as well as practice exams, it is important that students learn as much as they can about the subject they will be tested and are prepared to discover just how much they may not know. Students should study to acquire knowledge, not just to pre-pare for tests. For the well-prepared student, the chances of passing far exceed the chances of failing.


In preparing for a test, most students collect far too much study material, only to fi nd that they simply do not have time to go through all of it. Th ey are defeated before they begin because either they cannot get through all the material, leav-ing areas unstudied, or they race through the material so quickly that they cannot benefi t from the activity.

It is generally more effi  cient for the student to use ma-terials already at hand—that is, class notes, one good outline to cover and strengthen all areas and to quickly review the whole topic, and one good text as a reference for complex material that requires further explanation.

Also, many students attempt to memorize far too much information, rather than learning and  understanding less material and then relying on that learned information to determine the answers to questions at the time of the  examination. Relying too heavily on memorized material causes anxiety, and the more anxious students become dur-ing a test, the less learned knowledge they are likely to use.


A positive attitude and a realistic approach are essential to successful test taking. If the student concentrates on the neg-ative aspects of tests or on the potential for failure, anxiety increases and performance decreases. A negative attitude generally develops if the student concentrates on “I must pass” rather than on “I can pass.” “What if I fail?” becomes the major factor motivating the student to run from failure rather than toward success. Th is results from placing too much emphasis on scores. Th e score received is only one  aspect of test performance. Test performance also indicates the student’s ability to use diff erential reasoning.

In each question with fi ve alternatives, of which one is correct, there are four alternatives that are incorrect. If de-ductive reasoning is used, the choices can be viewed as hav-ing possibilities of being correct. Th e elimination of wrong choices increases the odds that a student will be able to rec-ognize the correct choice. Even if the correct choice does not become evident, the probability of guessing correctly  increases. Eliminating incorrect choices on a test can result in choosing the correct answer.

Answering questions based on what is incorrect is diffi  -cult for many students because they have had nearly 20 years of experience taking tests with the implied assertion that knowledge can be displayed only by knowing what is correct. It must be remembered, however, that students can display knowledge by knowing something is wrong, just as they can display it by knowing something is right.


1. Study for yourself. Although some of the material may seem irrelevant, the more you learn now, the less you will have to learn later. Also, do not let the fear of the test rob you of an important part of your education. If you study

Introduction  to the NAPLEX

Aft er graduation from an accredited pharmacy program, the prospective pharmacist must demonstrate the competency to practice pharmacy. Th e standards of competence for the practice of pharmacy are set by each state board of  pharmacy.  NAPLEX—Th e North American Pharmacist  Licensure  Examination—is the principal instrument used by the state board of pharmacy to assess the knowledge and profi ciency necessary for a candidate to practice pharmacy. Th e National Association of Boards of Pharmacy (NABP) is an independent, international, and impartial association that assists member boards and jurisdictions in developing,  implementing, and enforcing uniform standards for the purpose of protecting the public health. NABP develops examinations that enable boards of pharmacy to assess the  competence of candidates seeking licensure to practice pharmacy. Each state board of pharmacy may impose additional examinations. Th e two ma-jor examinations developed by NABP are

Th e North American Pharmacist Licensure Examination (NAPLEX)

Multistate Pharmacy Jurisprudence Examination (MPJE) Foreign pharmacy graduates must pass the Foreign

Pharmacy Graduate Equivalency Examination (FPGEE) as part of the Foreign Pharmacy Graduate Equivalency Cer-tifi cation process. Foreign-educated pharmacists  awarded  FPGEC Certifi cation are considered to have partially ful-fi lled eligibility requirements for licensure in those states that accept the certifi cation.

A description of these computerized examinations and registration information may be found on the NABP  website 

online at Before submitting registration  materials, the pharmacy candidate should contact the board of pharmacy for additional information regarding proce-dures, deadline dates, and required documentation.

The NAPLEX is a computer-adaptive test. Th ese ques-tions measure the prospective pharmacist’s ability to measure pharmacotherapy and therapeutic outcomes, prepare and dis-pense medications, and implement and evaluate information for optimal health care. Th e computer adaptive exam tests a candidate’s knowledge and ability by assessing the answers before presenting the next test question. If the answer is cor-rect, the computer will select a more diffi  cult question from the test item pool in an appropriate content area; if the an-swer is incorrect, an easier question will be selected by the computer. Th e NAPLEX score is based on the diffi  culty level of the questions answered correctly.

NAPLEX consists of 185 multiple-choice test questions. 150 questions are used to calculate the test score. Th e remain-ing 35 items served as pretest questions and do not aff ect the NAPLEX score. Pretest questions are administered to evalu-ate the item’s diffi  culty level for possible inclusion as a scored question in future exams. Th ese pretest questions are dis-persed throughout the exam and cannot be identifi ed by the candidate. A majority of the questions on the NAPLEX are asked in a scenario-based format (i.e., patient profi les with accompanying test questions). To properly analyze and an-swer the questions presented, the candidate must refer to the information provided in the patient profi le. Some questions appear in a standalone format and should be answered solely from the information provided in the question.


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