Download Leik FNP Review – 100+ Detailed Practice Questions for Nurse Practitioner Exam Prep2025 and more Exams Nursing in PDF only on Docsity!
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- 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 concen- tration. 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 Answer>: c
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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 de- creasing the production of T4. Levothyroxine replacement therapy concurrently with lithium administration especially in the presence of clinically overt hypothyroidism.
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a. Thiazolidinediones b. Narcotics c. NSAIDs d. ACE Inhibitors Answer>: 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
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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. d. Take the medication 30 minutes after eating. Answer>: 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
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The patient is presenting with signs of potential rhabdomyolysis. The risk of rhab- domyolysis increases with high dose Zocor (80 mg). Rhabdomyolysis can be life-threatening and the patient needs prompt emergent evaluation.
- A patient has been diagnosed with atrial fibrillation. The nurse practitioner knows that which of the following medication is not considered first-line drug for heart rate control: a. Digoxin b. Atenolol (Tenormin) c. Verapamil hydrochloride (Calan SR) d. Metoprolol (Toprol) Answer>: A
Digoxin is not considered first-line drug for heart rate control in patients with atrial fibrillation. Digoxin has a very narrow therapeutic range.
- A 41 year old patient has been presribed Digoxin (Lanoxin) following a diagnosis of heart failure due to left ventricular systolic dysfunction. The patient presents to the clinic today with nausea and vomiting, abdominal pain, and visual changes. What does the nurse practitioner suspect? a. The patient is presenting with a potential allergy to Digoxin (Lanoxin) and tells the patient to follow-up with his cardiologist. b. Send the patient to get an upper endoscopy and prescribe Zofran until symptoms resolve. c. Tell the patient to follow-up with their cardiologist for a new medication. d. Send the patient to the emergency room for immediate evaluation. Answer>: D
The patient is presenting with signs and symptoms of acute digoxin overdose and needs detailed evaluation. Initial symptoms are typical GI complaints,
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arrhythmias, confusion, and visual changes. Labs the should be ordered in suspected digoxin toxicity are electrolytes, creatinine, and serial EKGs.
- The nurse practitioner knows that Warfarin/Coumadin has a duration of action for: a. 1-2 days b. 2-5 days c. 5-7 days d. 7-10 days Answer>: B
2-5 days for a single dose
- Which of the following should a patient avoid when taking an ACE in- hibitor? a. Calcium
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c. Ibuprofen D. Benazepril (Lotensin) Answer>: B
Valsartain (diovan) is a ARB and Benazepril (lotensin) is an ACE. Both of which should not be taken with a potassium-sparing medication. There is a higher risk of hyperkalemia. NSAID use may also contribute to hyperkalemia.
- A 66 year old male comes to the clinic with concerns about erectile dis- function. He is extremely distressed and would like to discuss using Tadalafil (Cialis) since that is what his brother recommended. Which of the following in the patients PMH is a contraindication for using Tadalafil (Cialis)? a. The patient had a MI 3 months ago. b. The patient had nephrolithiasis one month ago. c. The patient complains of nasal congestion.
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d. The patient takes calcium supplements. Answer>: A
Using cialis (or viagra, levitra) is contraindicated in patients that have had an MI or stroke within 3-6 months. While cialis can cause nasal congestion, it is not a contraindication.
- Which of the following foods should a patient avoid when taking warfarin (coumadin)? a. kale, spinach, broccoli b. liver, beans c. fish, beef, pork d. carrots, corn, peas Answer>: A
Patients should avoid foods high in vitamin K when taking warfarin as it may reduce anticoagulant effects of warfarin (decrease INR). Mayonnaise, canola oil, and soybean oil also have high levels of vitamin K
- Which of the following ethnicities may require a lower starting dose of Warfarin (Coumadin)? a. African Americans b. Asians c. Caucasians d. Hispanic Answer>: B
may require a lower starting and maintenance doses of warfarin.
- Which of the following blood pressure medication is most useful in a patient with osteoporosis?
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BB should never be given to patients with AV blocks other than type 1. They are also contraindicated in shock, hypotension, severe bradycardia, and chronic pulmonary disease
- Which of the following beta blockers are considered cardioselective? a. Propranolol b. Carvedilol (Coreg) c. Nadolol d. Metoprolol Answer>: D
Metoprolol is considered cardioselective because it blocks beta-1 receptors, which are found mainly in the heart. They are also more potent.
- A 60 year old patient comes to the clinic with complaints of dizziness and near-syncopal events. Which of the following medications does the nurse practitioner suspects may be causing her symptoms? a. Metoprolol b. Lisionopril (Zestril) c. Losartan (Cozaar) d. Aliskiren (Tekturna) Answer>: A
Beta blockers can cause bradycardia, which can lead to near-syncopal events.
- A 33 year old, obese patient with a history of diabetes, hypertension, and migraines comes to the clinic for a check-up. She recently found out that she was 12 weeks pregnant with her third child. What medications would the nurse practitioner discontinue immediatly? a. Metformin b. Methyldopa
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c. Losartan (Cozaar) d. Sumatriptan (Imatrex) Answer>: c
ACE/ARBS contraindicated in pregnancy. Usage of ACE inhibitors and ARBs during the second and third trimesters of pregnancy also causes serious problems, though of a different type. Used later in pregnancy, these drugs cause serious kidney problems in the baby, including impaired renal function or kidney failure
- Which of the following are preferred hypertensive drug treatments in pa- tients with diabetes except? a. Losartan (Cozaar) b. Benazepril (Lotensin) c. Atenolol
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a. Beta-blockers b. CCB c. Alpha-blockers d. ACEI Answer>: c
Alpha blockers are the initial therapy for symptomatic BPH. (Terazosin/hytrin or Doxazosin/cardura)
- Which class of medications may cause permanent discoloration of teeth and skeletal defects if taken by children younger than 9? a. Macrolides b. Tetracyclines c. Fluoroquinolones c. Cephlasporins Answer>: B
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Skeletal defects can occur if taken during last half of pregnancy, in infancy, or children less than 9. May be used after the age of 13, as all permanent teeth have erupted.
- A patient is beginning treatment with Doxycycline for Lyme disease. The nurse practitioner know that: a. Severe sunburns can occur. b. Safe to use in pregnancy. c. Should be taken with food. d. Does not interfere with oral contraceptive pills. Answer>: A
Photosensitivity reaction occurs with minimal sunlight exposure; avoid or mini- mize sunlight exposure; use sunblock, wide-brim hats, and sunglasses. AVOID in pregnancy, should be taken on an EMPTY stomach, and can interfere with oral contraceptive pills.
- What category are most macrolides considered in pregnancy? a. A b. B c. C d. D Answer>: B
Most macrolides are category B EXCEPT clarithyromycin and telithromycin (both are C - AVOID IN PREGNANCY).
- A patient has been diagnosed with pharyngitis. She has had a severe reac- tion penicillin, which required hospitalization. Which of the following antibiotic should also be avoided as a result of this reaction except? a. Augmentin (Amoxicillin/clavulanic acid) b. Cephalexin (Keflex)
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Patients are at an increased risk of achilles tendon rupture when taking fluoro- quinolones. Avoid strenuous activity while on the drug. Patient should be advised to stop drug if tendon pain/swelling develops.
- Fluoroquinolones should be avoided in patients that are/have all of the following except: a. Pregnant b. Younger than 18 years of age c. Myasthenia gravis d. Ulcerative colitis Answer>: D
Patients with ulcerative colitis are allowed to take most fluoroquinolones. Studies have shown that they may improve symptoms in the digestive tract.
- A patient with type one diabetes comes to the clinic for acute exacerbation of chronic bronchitis. Which of the following antibiotics should be avoided for this patient due to their increased risk of hypoglycemia? a. Levofloxacin (Levaquin) b. Ciprofloxacin (Cipro) c. Amoxicillin d. Erythromycin Answer>: A
Levofloxacin can increase risk of hypoglycemia, which may have serious affects on type one diabetics.
- A patient is taking a tricyclic antidepressant for their depression. Quinolones should be avoided in these patients due to their risk of: a. Potential suicidal ideations b. Worsening depressive symptoms
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c. Sudden death from arrhythmias d. Extreme fatigue Answer>: c
Patients should avoid taking quinolones with other QT-prolonging drugs or with electrolyte imblances (HYPOmagnesium, HYPOkalemia) because there will elevate the risk of sudden death from torsades de pointes.
- A 44 year old patient comes to the clinic today with complaints of ongoing diarrhea for the past 3 days. He recently returned from a vacation with his family from the Caribbean. He is not taking any other medications. Which of the following medications are best given for traveler's diarrhea? a. Cipro 500 mg BID for 3 days b. Cipro 500 mg BID for 7 days c. Imodium 4 mg for one day
