AANP Pharmacology 2

Question 1

Which opioid analgesic has active metabolites that can accumulate in renal failure, causing CNS toxicity?

Accepted Answer

Morphine

Answer

Morphine-6-glucuronide, an active metabolite of morphine, accumulates in renal failure and can cause prolonged sedation and respiratory depression.

Question 2

A nurse practitioner prescribes trimethoprim-sulfamethoxazole to a patient on methotrexate. What serious risk exists?

Accepted Answer

Bone marrow suppression and pancytopenia

Answer

TMP-SMX inhibits dihydrofolate reductase and can potentiate methotrexate toxicity, leading to severe bone marrow suppression and pancytopenia.

Question 3

What is the antidote for acetaminophen overdose?

Accepted Answer

N-acetylcysteine

Answer

N-acetylcysteine replenishes glutathione stores in the liver, neutralizing the toxic metabolite NAPQI that causes hepatotoxicity in acetaminophen overdose.

Question 4

Which SSRI has the longest half-life and is least likely to cause discontinuation syndrome?

Accepted Answer

Fluoxetine

Answer

Fluoxetine has a half-life of 2–6 days (with active metabolite norfluoxetine at 4–16 days), which effectively tapers itself and minimizes discontinuation symptoms.

Question 5

A patient prescribed a fluoroquinolone antibiotic reports new-onset tendon pain. What should the NP do?

Accepted Answer

Discontinue the fluoroquinolone and switch to an alternative antibiotic

Answer

Fluoroquinolones carry a black box warning for tendinopathy and tendon rupture; the drug should be discontinued immediately and an alternative antibiotic selected.

AANP - American Association of Nurse Practitioners Practice Test

AANP - American Association of Nurse Practitioners Practice Test

AANP Pharmacology 2