NAPLEX® Competency Statements
NAPLEX stands for the North American Pharmacist Licensure Examination®. It is a high-stakes exam that pharmacy graduates must take and pass to be licensed to practice pharmacy in the United States. Understanding what is covered on the NAPLEX (or any exam for that matter) is the first step in preparation. The NAPLEX Competency Statements provide a blueprint (or a detailed plan) of testable items.
NAPLEX Competency Statements
The National Association of Boards of Pharmacy® (NABP®) developed the NAPLEX Competency Statements (eg, blueprint) through pharmacists’ surveys identifying critical areas of pharmacy practice. The NAPLEX Competency Statements are divided into six “areas” reflecting the knowledge, skills, and abilities required of an entry-level pharmacist. The following table gives you a broad overview of the six competency areas tested and the proportion of questions to expect in each area.
|Area||Topic||% of Test|
|Area 1||Obtain, Interpret, or Assess Data,
Medical, or Patient Information
|Area 2||Identify Drug Characteristics||14%|
|Area 3||Develop or Manage Treatment Plans||35%|
|Area 4||Perform Calculations||14%|
|Area 5||Compound, Dispense, or Administer Drugs,
or Manage Delivery Systems
|Area 6||Develop or Manage Practice or Medication-Use
Systems to Ensure Safety and Quality
Answering case-based questions correctly on the exam may require integration of knowledge from multiple content areas simultaneously.
1.1 – From instruments, screening tools, laboratory, genomic or genetic information, or diagnostic findings
1.2 – From patients: treatment adherence, or medication-taking behavior; chief complaint, medication history, medical history, family history, social history, lifestyle habits, socioeconomic background
1.3 – From practitioners: treatment adherence, or medication-taking behavior; chief complaint, medication history, medical history, family history, social history, lifestyle habits, socioeconomic background
1.4 – From medical records: treatment adherence, or medication-taking behavior; chief complaint, medication history, medical history, family history, social history, lifestyle habits, socioeconomic background
1.5 – Signs or symptoms of medical conditions, healthy physiology, etiology of diseases, or pathophysiology
1.6 – Risk factors or maintenance of health and wellness
1.7 – Evidence-based literature or studies using primary, secondary, and tertiary references
Area 1 comprises approximately 18% of the exam and tests the ability to identify and assess pertinent case-based information (eg, abnormal labs, disease risk factors and symptoms, medication use history, diagnostic test results). The ability to review clinical trial data and make appropriate conclusions is also tested in this area.
2.1 – Pharmacology, mechanism of action, or therapeutic class
2.2 – Commercial availability; prescription or non-prescription status; brand, generic, or biosimilar names; physical descriptions; or how supplied
2.3 – Boxed warnings or REMS
2.4 – Pregnancy or lactation
Approximately 14% of the exam is dedicated to Area 2. This area tests the understanding of medications, including mechanism of action, brand and generic drug names, availability (eg, prescription vs. OTC), and pertinent safety issues (eg, boxed warnings, use in pregnancy).
3.1 – Triage or medical referral
3.2 – Therapeutic goals or outcomes and clinical endpoints
3.3 – Medication reconciliation; indication or therapeutic uses; lack of indication; inappropriate indication; duplication of therapy; omissions
3.4 – Drug dosing or dosing adjustments; duration of therapy
3.5 – Drug route of administration, dosage forms, or delivery systems
3.6 – Drug contraindications, allergies, or precautions
3.7 – Adverse drug effects, toxicology, or overdose
3.8 – Drug interactions
3.9 – Therapeutic monitoring parameters, monitoring techniques, monitoring tools, or monitoring frequency
3.10 – Drug pharmacokinetics or pharmacodynamics
3.11 – Evidence-based practice
3.12 – Non-drug therapy: lifestyle, self-care, first-aid, complementary and alternative medicine, or medical equipment
Area 3 represents the largest portion of the exam (approximately 35%) and reflects the patient-centered focus of routine pharmacy practice in multiple settings (eg, hospital, community). This includes the core elements of pharmacotherapy: guideline-directed treatments, therapeutic goals, safe use of drugs (eg, appropriate dosing, contraindications, adverse effects, interactions), and pharmacokinetics. Common interventions made by pharmacists during medication profile review, such as therapy duplications or omissions, are also tested.
4.1 – Patient parameters or laboratory measures
4.2 – Quantities of drugs to be dispensed or administered
4.3 – Rates of administration
4.4 – Dose conversions
4.5 – Drug concentrations, ratio strengths, osmolarity, osmolality, or extent of ionization
4.6 – Quantities of drugs or ingredients to be compounded
4.7 – Nutritional needs and the content of nutrient sources
4.8 – Biostatistics, epidemiological, or pharmacoeconomic measures
4.9 – Pharmacokinetic parameters
Approximately 14% of the exam tests on the ability to perform calculations, which is a critical component of pharmacy practice. Pharmacists must be skilled in calculating drip rates, drug quantities and concentrations to be compounded or dispensed, creatinine clearance, and pharmacokinetic parameters such as half-life. Biostatistics calculations (eg, number needed to treat) are also tested in this area.
5.1 – Physicochemical properties of drug products affecting compatibility, stability, delivery, absorption, onset, duration, distribution, metabolism, or elimination
5.2 – Techniques, procedures, or equipment for hazardous or non-hazardous sterile products
5.3 – Techniques, procedures, or equipment for hazardous or non-hazardous non-sterile products
5.4 – Equipment or delivery systems
5.5 – Instructions or techniques for drug administration
5.6 – Packaging, storage, handling, or disposal
Area 5 comprises approximately 11% of the exam. Knowledge of sterile, non-sterile, and hazardous drug compounding is essential. This area may examine concepts such as compounding equipment, beyond-use dates, proper storage of medications (eg, refrigeration or non-refrigeration), and instructions for drug administration (eg, injection or inhaler technique, filter requirements).
6.1 – Interdisciplinary practice, collaborative practice, or expanded practice responsibilities
6.2 – Continuity of care or transitions of care
6.3 – Disease prevention or screening programs; or stewardship
6.4 – Vulnerable populations, special populations, or risk prevention programs
6.5 – Pharmacy informatics
Approximately 7% of the exam covers assurance of safety and quality in medication-use systems. The expanded role of the pharmacist is tested (eg, collaborative practice, stewardship, health screenings, vaccinations). This area also focuses on clinical decision support, bar coding, and other core elements of medication safety and pharmacy informatics.
How Competency Statements are tested in NAPLEX
The NAPLEX Competency Statements provide a general overview of testable content but do not provide specifics on which disease states to study or which formulas to learn. That’s where UWorld RxPrep comes in; we’ve done the work for you. The UWorld RxPrep study materials provide you with the must-know content.
Here is a sample question from the UWorld RxPrep QBank. This question is focused on Area 3: Develop or Manage Treatment plans. But look closer… you won’t be able to answer this question correctly without integrating knowledge from Area 1, Area 2, and Area 4.
|Skills required to answer this question and their location in the UWorld RxPrep Course Book|
A 53-year-old female arrives at the emergency department with a severe headache, vomiting, and muscle weakness. She is found to have a right hemisphere hemorrhagic stroke.
Past Medical History: hypertension, obesity
Vital Signs: BP 185/105 mmHg, HR 110 bpm, RR 24 bpm, O2 sat 90% on room air, T 100.4°F (38°C), Ht 5'9", Wt 130 kg
Hemoglobin 12 g/dL
Platelets 200,000 cells/mm3
Serum creatinine 1.4 mg/dL
What is the best option to prevent a deep vein thrombosis in this patient during the initial period of hospitalization?
Knowledge of medical terms
Medical Terms Quick Guide
Ability to interpret laboratory values
Chapter: Lab Values & Drug Monitoring
Knowledge of evidence-based guideline recommendations for treating deep vein thrombosis
Ability to calculate creatinine clearance
Chapter: Calculations IV - Clinical
Knowledge of contraindications and warnings related to anticoagulants
Use our NAPLEX Study Guide to stay on track and maximize your chances of success.
NAPLEX Competency Statement Changes
NABP’s Executive Committee reviews and approves standard-setting exercises every five years to evaluate the minimum standards for licensure. The standard-setting exercises may or may not change the exam blueprint. However, specific exam questions are updated as needed to reflect changes in clinical practice (eg, when a new “blockbuster” medication is approved).