FPGEE Clinical Pharmacy 2

Question 1

A patient with CKD stage 4 is prescribed metformin. What is the most appropriate action?

Accepted Answer

Discontinue metformin

Answer

Metformin is contraindicated in CKD stage 4 (eGFR <30 mL/min/1.73m²) due to risk of lactic acidosis.

Question 2

Which parameter is most important to monitor in a patient receiving vancomycin for MRSA bacteremia?

Accepted Answer

AUC/MIC ratio

Answer

Current ASHP/IDSA guidelines recommend AUC/MIC-guided monitoring (target AUC 400–600 mg·h/L) for vancomycin efficacy and nephrotoxicity avoidance.

Question 3

A 68-year-old patient on warfarin for atrial fibrillation develops a UTI and is prescribed trimethoprim-sulfamethoxazole. What is the expected INR effect?

Accepted Answer

INR will increase

Answer

TMP-SMX inhibits CYP2C9, reducing warfarin metabolism and raising the INR.

Question 4

A patient presents with symptoms of serotonin syndrome. Which combination is the most likely cause?

Accepted Answer

Linezolid + sertraline

Answer

Linezolid has MAO-inhibitor activity; combining it with an SSRI like sertraline can precipitate serotonin syndrome.

Question 5

Which diuretic is most appropriate for a patient with heart failure and a serum potassium of 3.1 mEq/L?

Accepted Answer

Spironolactone

Answer

Spironolactone is a potassium-sparing diuretic that also reduces morbidity and mortality in heart failure.

FPGEE Exam Practice Test

FPGEE Exam Practice Test

FPGEE Clinical Pharmacy 2