Ambulatory Care Test Ambulatory Care Ambulatory Care Pharmacology 4

Question 1

A patient with type 2 diabetes on metformin has an A1C of 8.5%. Which add-on agent would be most appropriate for a patient who also has established ASCVD?

Accepted Answer

GLP-1 receptor agonist (semaglutide)

Answer

GLP-1 receptor agonists like semaglutide have proven cardiovascular benefit in patients with established ASCVD per ADA guidelines.

Question 2

A patient prescribed spironolactone for heart failure should avoid concurrent use of which over-the-counter medication?

Accepted Answer

NSAIDs (ibuprofen)

Answer

NSAIDs reduce renal prostaglandins, decrease GFR, and worsen hyperkalemia risk in patients on spironolactone.

Question 3

Which opioid analgesic is contraindicated in patients with renal failure due to accumulation of a toxic metabolite?

Accepted Answer

Morphine

Answer

Morphine-6-glucuronide, an active metabolite, accumulates in renal failure causing prolonged CNS and respiratory depression.

Question 4

A patient taking lithium develops polyuria and polydipsia. Which drug is most likely responsible for this adverse effect?

Accepted Answer

Lithium itself causing nephrogenic DI

Answer

Long-term lithium therapy can cause nephrogenic diabetes insipidus by interfering with vasopressin-mediated water reabsorption.

Question 5

Which medication used for osteoporosis must the patient remain upright for at least 30 minutes after taking to prevent esophageal injury?

Accepted Answer

Alendronate

Answer

Oral bisphosphonates like alendronate can cause esophagitis or esophageal ulcers if the patient lies down after taking the tablet.

Ambulatory Care Test Practice Test

Ambulatory Care Test Practice Test

Ambulatory Care Test Ambulatory Care Ambulatory Care Pharmacology 4