APEA APEA Pharmacology Review Questions and Answers 3 — Questions and Answers
Question 1: A nurse practitioner prescribes methotrexate for rheumatoid arthritis. Which supplement should be co-prescribed to reduce mucosal and hematologic toxicity?
- Folic acid (Correct answer)
- Vitamin B12
- Vitamin D
- Zinc
Correct answer: Folic acid
Methotrexate inhibits folate metabolism; supplementing with folic acid reduces side effects such as oral ulcers, nausea, and cytopenias without reducing efficacy.
Question 2: Which medication used for type 2 diabetes increases the risk of urinary tract infections and genital mycotic infections due to its mechanism of action?
- SGLT-2 inhibitors (Correct answer)
- GLP-1 agonists
- DPP-4 inhibitors
- Sulfonylureas
Correct answer: SGLT-2 inhibitors
SGLT-2 inhibitors increase urinary glucose excretion, creating a favorable environment for bacterial and fungal growth in the genitourinary tract.
Question 3: A patient taking amiodarone for atrial fibrillation requires monitoring for which thyroid-related adverse effect?
- Both hypothyroidism and hyperthyroidism (Correct answer)
- Hypothyroidism only
- Hyperthyroidism only
- Thyroid cancer
Correct answer: Both hypothyroidism and hyperthyroidism
Amiodarone contains high iodine content and can cause both hypo- and hyperthyroidism; thyroid function must be monitored every 6 months.
Question 4: Which analgesic is most appropriate for mild-to-moderate pain in a patient with chronic kidney disease to avoid nephrotoxicity?
- Acetaminophen (Correct answer)
- Ibuprofen
- Naproxen
- Ketorolac
Correct answer: Acetaminophen
Acetaminophen is the preferred analgesic in CKD patients because it is not nephrotoxic at standard doses, unlike NSAIDs which reduce renal prostaglandin-mediated blood flow.
Question 5: A patient with a penicillin allergy documented as anaphylaxis requires treatment for a serious infection. What is the cross-reactivity risk with cephalosporins?
- 1-2% (Correct answer)
- 10-15%
- 25-30%
- 50%
Correct answer: 1-2%
Cross-reactivity between penicillins and cephalosporins is approximately 1-2%, much lower than previously thought, though caution is still warranted with severe allergies.
Question 6: Which medication used in COPD management is associated with the adverse effect of oral candidiasis and requires rinsing the mouth after use?
- Inhaled corticosteroids (Correct answer)
- Long-acting beta agonists
- Long-acting muscarinic antagonists
- Short-acting beta agonists
Correct answer: Inhaled corticosteroids
Inhaled corticosteroids can deposit in the oropharynx and suppress local immunity, promoting Candida overgrowth; rinsing the mouth after use reduces this risk.
APEA APEA Pharmacology Review Questions and Answers 3
A nurse practitioner prescribes methotrexate for rheumatoid arthritis.
Which supplement should be co-prescribed to reduce mucosal and hematologic toxicity?