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Leik - FNP Review questions with answers
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Leik - FNP Review questions withanswers
Which |of |the |following |drugs |interact |with |warfarin/coumadin?
a. |Imodium |(loperamide)
b. |Diltiazem |Hydrochloride |SR |(diltiazem)
c. |trimethoporim-sulfamethoxazole |(Bactrim)
d. |sumatriptan |(Imitrex) |- |ANSWERS✔✔ |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) |- |ANSWERS✔✔ |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
d. |magnesium, |calcium, |phosphate |- |ANSWERS✔✔ |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 |- |ANSWERS✔✔ |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).
c. |The |patient |may |continue |taking |the |omeprazole |(Prilosec) |but |should |monitor
|blood |pressure.
d. |The |patient |may |continue |taking |omeprazole |(Prilosec) |as |prescribed. |-
|ANSWERS✔✔ |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. |- |ANSWERS✔✔ |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 |- |ANSWERS✔✔ |a
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) |- |ANSWERS✔✔ |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.
d. |Take |the |medication |30 |minutes |after |eating. |- |ANSWERS✔✔ |b
Risedronate |(actonel) |is |a |bisphosphonate |that |is |use |to |treat |osteoporisis/penia.
|Patients |should |be |advised |to |take |risedronate |(actonel) |upon |awakening |with |a
|glass |of |water, |before |breakfast. |They |should |not |lie |down |for |30 |minutes |afterward.
|Should |not |mix |with |other |drugs.
Bisphosphonates |are |contraindicated |in |which |of |the |following |conditions |except:
a. |CKD
b. |GERD
c. |Celiac |Disease
d. |Espohageal |Stricture |- |ANSWERS✔✔ |c
Osteoporosis |is |a |complication |of |untreated |celiac |disease. |Bisphosphonates, |such
|as |fosamax |and |actonel, |are |used |to |prevent |or |treat |osteoporisis/penia.
A |patient |has |been |taking |simvastatin |(Zocor), |40 |mg, |two |times |per |day |for |the
|past |2 |weeks. |He |returns |to |the |clinic |with |complaints |of |muscle |pain |and
|tenderness. |Which |of |the |following |should |the |nurse |practitioner |do?
a. |Tell |the |patient |that |it |is |normal |to |have |these |side |effects |when |taking |a |new
|medication |and |they |should |resolve |within |4 |weeks.
b. |Prescribe |600 |mg/day |of |ibuprofen |to |improve |pain.
c. |Prescribe |physical |therapy |for |4 |weeks.
d. |Send |the |patient |to |the |emergency |room |for |immediate |evaluation. |-
|ANSWERS✔✔ |d
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