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Leik - FNP Review With Verified Answers
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Leik - FNP Review 2023-2024 WithVerified Answers
Which of the following drugs interact with warfarin/coumadin?
a. Imodium (loperamide)
b. Diltiazem Hydrochloride SR (diltiazem)
c. trimethoporim-sulfamethoxazole (Bactrim)
d. sumatriptan (Imitrex) - ANSWER-c
Sulfa drugs will interact with warfarin (increases the blood level), which results in
an elevation of the INR and the risk of bleeding.
The following drugs are potent inhibitors of the CYP450 system except:
a. Erythromycin (Erythrocin)
b. Cimetidine (Tagamet)
c. Ceftazidime (Tazicef)
d. Diltiazem (Cardizem) - ANSWER-a
Erythromycin acts as inhibitors slow down drug clearance, increasing drug
concentration. This may lead to drug overdose.
A 57 year old patient comes to the clinic for her routine physical. She has no new
complaints. The only medication that she takes is digoxin (Lanoxin) for her atrial
fibrillation. Which of the following electrolyte levels should be monitored in this
patient?
a. potassium, calcium, chloride
b. magnesium, calcium, chloride
c. potassium, calcium, magnesium
,Leik - FNP Review 2023-2024 With
Verified Answers
d. magnesium, calcium, phosphate - ANSWER-c
Monitor digoxin level, EKG, electrolytes (potassium, magnesium, and calcium)
A 48 year old female patient comes to the clinic today to discuss her ongoing use
off Lithium. She states that she has begun feeling very tired and feels cold during
the day. She thinks that her increase in Lithium dose is causing her symptoms.
What should the nurse practitioner order?
a. TSH
b. CBC
c. LFT
d. BUN - ANSWER-a
Patients taking lithium have an increased risk of developing hypothyroidism by
decreasing the production of T4. Levothyroxine replacement therapy concurrently
with lithium administration especially in the presence of clinically overt
hypothyroidism.
A patient has recently been prescribed omeprazole (Prilosec) for GERD. He also
takes lisinopril (Zestril). His PMH includes migraines, hypertension, and chronic
kidney disease. The nurse practitioner notes:
a. The patient should stop taking the omeprazole (Prilosec) due his diagnosis of
chronic kidney disease.
b. The patient should stop taking omeprazole (Prilosec) due to drug interaction
with lisinopril (Zestril).
,Leik - FNP Review 2023-2024 With
Verified Answers
c. The patient may continue taking the omeprazole (Prilosec) but should monitor
blood pressure.
d. The patient may continue taking omeprazole (Prilosec) as prescribed. -
ANSWER-a
Studies suggest that PPIs may increase the risk of kidney disease. Using PPIs may
also cause acute interstitial nephritis. A patient that has already been diagnosed
with CKD should not take PPIs.
A patient taking Warfarin (Coumadin) is having abdominal surgery in one month.
She wants to know when she should stop taking her Warfarin (Coumadin). The
nurse practitioner advises:
a. The day before scheduled surgery.
b. Do not stop taking Warfarin (Coumadin)
c. 3 days before surgery.
d. 7 days before surgery. - ANSWER-d
Patients should discontinue warfarin 7 days before surgery.
A 71 year old patient has been diagnosed with stage III congestive heart failure.
Which of the following class of medications may cause an exacerbation of
congestive heart failure>
a. Thiazolidinediones
b. Narcotics
c. NSAIDs
d. ACE Inhibitors - ANSWER-a
, Leik - FNP Review 2023-2024 With
Verified Answers
Improved glycemic control decreases the risk of end organ damage and heart
failure in patients with diabetes. Thiazolidinediones are very useful drugs,
particularly for patients with marked insulin resistance and hyperlipidemia.
However, they do precipitate edema and heart failure. The edema can be severe
enough to lead to discontinuation of the drug, and the risk of heart failure limits
the population in which they can be used. They can be used safely in some cardiac
patients but, as noted in the article, they should be avoided or used with caution
in patients with CHF. Patients taking a TZD who subsequently develop edema
should be carefully evaluated for CHF. NY Health Association Class III or IV heart
failure should not use TZDs.
Which of the following medications may have a high risk of weight gain?
a. Bupropion (Wellbutrin)
b. Metformin (Glucophage)
c. Quetiapine (Seroquel)
d. Topiramate (Topamax) - ANSWER-c
High risk of weight gain, higher mortality in elderly patients. Weight should be
monitored every 3 months, monitor TSH and lipids.
A patient is newly prescribed risedronate (actonel). What should the nurse
practitioner include in patient education regarding this medication?
a. Take the medication in the evening with a large glass of water.
b. Take the medication upon wakening with a large glass of water.
c. Take the medication with a meal.
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