APEA APEA Pharmacology Review Questions and Answers 1

Question 1

A patient with type 2 diabetes and CKD stage 3 needs a second oral antidiabetic agent. Which medication should be avoided due to risk of lactic acidosis?

Accepted Answer

Metformin

Answer

Metformin is contraindicated when eGFR falls below 30 mL/min and should be used cautiously below 45 mL/min due to lactic acidosis risk.

Question 2

Which antibiotic class requires counseling about increased risk of tendon rupture, particularly in patients over 60 taking corticosteroids?

Accepted Answer

Fluoroquinolones

Answer

Fluoroquinolones carry a black box warning for tendinopathy and tendon rupture, with risk amplified in elderly patients on corticosteroids.

Question 3

A patient on warfarin starts taking trimethoprim-sulfamethoxazole for a UTI. The NP should anticipate which effect on the INR?

Accepted Answer

INR will increase

Answer

TMP-SMX inhibits CYP2C9, reducing warfarin metabolism and increasing its anticoagulant effect, thereby raising the INR.

Question 4

Which antihypertensive medication is contraindicated in pregnancy due to teratogenic effects including renal dysgenesis and skull hypoplasia?

Accepted Answer

ACE inhibitors

Answer

ACE inhibitors are absolutely contraindicated in pregnancy (FDA category D/X in 2nd-3rd trimester) due to fetal renal toxicity and hypotension.

Question 5

A patient taking a statin develops new-onset muscle pain and brown urine. The NP's priority action is to:

Accepted Answer

Stop the statin and check CK level

Answer

Myalgias with dark urine suggest rhabdomyolysis, a rare but serious statin complication; the statin must be stopped and CK checked urgently.

APEA - Advanced Practice Education Associates Practice Test

APEA - Advanced Practice Education Associates Practice Test

APEA APEA Pharmacology Review Questions and Answers 1