APEA APEA Pharmacology Review Questions and Answers 2 — Questions and Answers
Question 1: A patient is prescribed levothyroxine. The NP should instruct the patient to take this medication:
- 30-60 minutes before breakfast on an empty stomach (Correct answer)
- With breakfast to improve absorption
- At bedtime with a snack
- With calcium supplements for best absorption
Correct 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.
Question 2: Which medication requires monitoring for hyperkalemia when combined with an ACE inhibitor in a heart failure patient?
- Spironolactone (Correct answer)
- Furosemide
- Carvedilol
- Digoxin
Correct answer: Spironolactone
Spironolactone is a potassium-sparing diuretic; combining it with an ACE inhibitor (which also raises potassium) significantly increases hyperkalemia risk.
Question 3: A patient with asthma requires an antihypertensive. Which class is contraindicated due to risk of bronchospasm?
- Non-selective beta-blockers (Correct answer)
- ACE inhibitors
- Thiazide diuretics
- Calcium channel blockers
Correct 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.
Question 4: Which drug-drug interaction occurs when a patient takes sildenafil with a nitrate, requiring the NP to avoid co-prescription?
- Severe hypotension (Correct answer)
- Increased nitrate toxicity
- Reduced erectile efficacy
- Cardiac arrhythmia
Correct answer: Severe hypotension
Both sildenafil and nitrates cause vasodilation; their combination produces additive nitric oxide effects resulting in profound, potentially fatal hypotension.
Question 5: A patient on lithium therapy presents with tremor, polyuria, and confusion. These signs suggest which complication?
- Lithium toxicity (Correct answer)
- Lithium-induced hypothyroidism
- Nephrogenic diabetes insipidus only
- Serotonin syndrome
Correct 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.
Question 6: When prescribing clindamycin, the NP must counsel the patient about which potentially life-threatening adverse effect?
- Clostridioides difficile colitis (Correct answer)
- Stevens-Johnson syndrome
- Agranulocytosis
- Anaphylaxis
Correct answer: Clostridioides difficile colitis
Clindamycin has a high risk of disrupting colonic flora and promoting C. difficile overgrowth, leading to pseudomembranous colitis.
APEA APEA Pharmacology Review Questions and Answers 2
A patient is prescribed levothyroxine.
The NP should instruct the patient to take this medication: