Here’s a sample of 5 questions (with the answers below) right from the 250 Question NAPLEX Practice Exam.
MT is a 61 year old male who is starting chemotherapy treatment for metastatic colon cancer.
Wt= 165 lbs, Ht= 6’1’’.
- Oxaliplatin 85 mg/m2 IV over 2 hours, day 1
- Leucovorin 400 mg/m2 IV over 2 hours, day 1
- 5-FU 400 mg/m2 IV bolus on day 1, then 1200mg/m2/day for 2 days
- Avastin 5 mg/kg IV, day 1
- Zofran 8 mg PO every 6 hours PRN
- Decadron 8 mg PO on day 1 of chemotherapy
- Emend 125 mg 1 hour before chemo
1. The physician calls and would like the pharmacist to dose MT’s chemotherapy. For the first day of chemotherapy, what are the correct doses that MT should receive for Oxaliplatin and 5-Fluorouracil?
A. Oxaliplatin: 167 mg; 5-FU: 788 mg
B. Oxaliplatin: 167 mg; 5-FU: 2.4 grams
C. Oxaliplatin: 6.4 grams; 5-FU: 30 grams
D. Oxaliplatin: 105 mg; 5-FU: 482 mg
Answer: A – Oxaliplatin 167 mg and 5-Fluorouracil 788 mg. Based on the Mosteller equation for BSA, MT’s BSA is 1.97m2. The Dubois and Dubois equation gives a BSA of 1.98 m2. Either way, Option A is the best choice.
2. Leucovorin is given in combination with which of the following medications for the purpose of counteracting toxic effects and/or increasing the efficacy of treatment? (Select ALL that apply)
Answer: B, D – Leucovorin is the active form of folic acid. It is given with the pyrimidine analog antimetabolite, 5-FU, to increase its efficacy. It is also given with high-dose Methotrexate to decrease toxicity.
3. What is the mechanism of action of Emend?
A. A corticosteroid with potent anti-inflammatory effects
B. Dopamine receptor blocker in the CNS
C. 5-HT2 receptor antagonist
D. Substance P/Neurokinin-1 receptor antagonist
Answer: D – Emend is the brand name for Aprepitant, a medication used for acute and delayed nausea.
4. Which of the following are side effects of Avastin? (Select ALL that apply)
A. Impaired Wound Healing
D. Acne-like rash
E. Hot flashes
Answer: A,B, C – Avastin binds to VEG-F and inhibits angiogenesis. Therefore, it can cause bleeding and impaired wound healing. Hypertension is a common side effect that occurs in 19-34% of patients.
5. Patients that are deficient in what enzyme have increased risk of severe toxicity when treated with Xeloda?
Answer: C – A deficiency in dihydropyridine dehydrogenase can increase the toxicity of Xeloda.