Student Resources

Guidelines that Conflict

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Which Should I Use to Prepare for the NAPLEX?

Practice guidelines change frequently.

Guidelines updates that may be relevant for NAPLEX are reviewed on the Errata and Updates page, under the Student Resources tab.

Many guidelines are now updated throughout the year, as needed, to address rapidly changing information. Examples include the American Diabetes Association's Standards of Medical Care in Diabetes, Guidelines for Use of Antiretroviral Agents from the U.S. Department of Health and Human Services and many others.


This can make NAPLEX preparation seem confusing!

NABP writes the NAPLEX questions, and NABP states that the current guideline (for any condition) should be used to respond to questions.

You can follow this recommendation even when a new guideline is released a week before your exam date.

How can that be true? Because the questions are largely guideline-version independent. The quantity of pre-test questions helps, too. New questions do not count towards the NAPLEX score until they make their way through NABP's question validation process. This takes time. A question based on information that changed recently is unlikely to count until several months later.

Here are two examples of common question types. The response would stay the same, regardless of the guideline version:

HIV Guidelines
Atripla was a recommended initial treatment option for HIV infection until 2015. The specific drug information (what is in the drug, the side effects, warnings, monitoring) has not changed substantially, though Atripla is no longer recommended as first-line treatment for most patients with HIV.

HIV Question Example
A patient is taking Atripla 1 tablet daily to treat HIV infection. Select the components of Atripla (Select ALL that apply.)

  1. Tenofovir
  2. Abacavir
  3. Efavirenz
  4. Emtricitabine
  5. Maraviroc

Hypertension Guidelines
Most pharmacists have been taught to treat blood pressure to a goal of < 140/90 mmHg. JNC 8 recommended a goal of < 150/90 mmHg for patients ≥ 60 years old who do not have diabetes or renal disease. Recently, the ACC/AHA guidelines recommended a goal of < 130/80 mmHg for all patients.

Hypertension Question Example
JT is a 51-year-old Hispanic male taking aspirin 81 mg daily, simvastatin 20 mg QHS and Lantus 16 units QHS. He presents to the clinic for medication refills. JT has recorded his blood pressure readings since his last clinic visit. They ranged from 164-182/96-108 mmHg. His blood pressure is 168/110 mmHg today. Select the most appropriate treatment for the patient's blood pressure:

  1. Diovan HCT 160/12.5 mg once daily
  2. Catapres 0.1 mg twice daily
  3. Verapamil 120 mg three times daily
  4. Tenoretic 50/25 mg once daily
  5. Maxzide-25 once daily


RxPREP helps students preparing for pharmacist licensure. It's what we do best.

We have found that students who have difficulty when testing have lapses in drug knowledge rather than lapses in knowledge of guideline details. It is best to focus your study time on becoming a drug therapy expert.

Feel confident using the material in the current RxPrep Course Book and any updates we have posted under the Student Resources tab on the RxPrep website at www.rxprep.com and your studies will proceed nicely.

Best wishes from our Pharmacist team for your successful preparation!

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