Pharmacology Flashcards

A patient with heart failure and hypertension is started on lisinopril. The FNP should monitor for which MOST common side effect?

Answer: Dry, nonproductive cough

ACE inhibitors like lisinopril commonly cause a dry cough due to accumulation of bradykinin in the airways.

The FNP prescribes metformin for a newly diagnosed type 2 diabetic. Which contraindication should be screened for FIRST?

Answer: eGFR <30 mL/min/1.73 m²

Metformin is contraindicated with significant renal impairment (eGFR <30) due to risk of lactic acidosis from drug accumulation.

A patient taking warfarin reports adding daily vitamin K supplements. The FNP anticipates which effect on INR?

Answer: Decreased INR due to increased clotting factor synthesis

Vitamin K is a cofactor for clotting factor synthesis; supplementing it antagonizes warfarin's anticoagulant effect, lowering the INR.

Which antibiotic class is MOST appropriate for treating community-acquired pneumonia in a healthy adult without comorbidities?

Answer: Macrolides (e.g., azithromycin)

IDSA/ATS guidelines recommend macrolide monotherapy as first-line for outpatient CAP in previously healthy patients with no antibiotic use in the past 3 months.

A patient on fluoxetine is prescribed tramadol for pain. The FNP's GREATEST concern is:

Answer: Serotonin syndrome

Tramadol inhibits serotonin reuptake; combined with SSRIs like fluoxetine, this dramatically increases the risk of serotonin syndrome.

The FNP is initiating a statin in a patient. Which laboratory test should be checked at baseline and periodically?

Answer: Liver function tests (ALT/AST)

Statins can rarely cause hepatotoxicity, so baseline and periodic liver function monitoring is recommended per guidelines.