APEA Pharmacology Review Questions and Answers Flashcards

A patient is prescribed levothyroxine. The NP should instruct the patient to take this medication:

Answer: 30-60 minutes before breakfast on an empty stomach

Levothyroxine absorption is significantly impaired by food, calcium, and iron; it must be taken on an empty stomach 30-60 minutes before eating.

Which medication requires monitoring for hyperkalemia when combined with an ACE inhibitor in a heart failure patient?

Answer: Spironolactone

Spironolactone is a potassium-sparing diuretic; combining it with an ACE inhibitor (which also raises potassium) significantly increases hyperkalemia risk.

A patient with asthma requires an antihypertensive. Which class is contraindicated due to risk of bronchospasm?

Answer: Non-selective beta-blockers

Non-selective beta-blockers block both beta-1 and beta-2 receptors, causing bronchospasm in patients with reactive airway disease.

Which drug-drug interaction occurs when a patient takes sildenafil with a nitrate, requiring the NP to avoid co-prescription?

Answer: Severe hypotension

Both sildenafil and nitrates cause vasodilation; their combination produces additive nitric oxide effects resulting in profound, potentially fatal hypotension.

A patient on lithium therapy presents with tremor, polyuria, and confusion. These signs suggest which complication?

Answer: Lithium toxicity

Coarse tremor, cognitive changes, and polyuria in a lithium patient indicate toxicity, which can occur with therapeutic doses if fluid/sodium intake changes.

When prescribing clindamycin, the NP must counsel the patient about which potentially life-threatening adverse effect?

Answer: Clostridioides difficile colitis

Clindamycin has a high risk of disrupting colonic flora and promoting C. difficile overgrowth, leading to pseudomembranous colitis.