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Therapeutic Plan Assessment Flashcards

7 cards from real NAPLEX QBANK practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Therapeutic Plan Assessment flashcards as text

  1. A 68-year-old with heart failure (EF 30%) and a serum potassium of 5.6 mEq/L is on lisinopril and spironolactone. Which intervention is most appropriate?

    Answer: Hold the spironolactone and recheck potassium

    Hyperkalemia (>5.5 mEq/L) from combined ACE inhibitor and aldosterone antagonist therapy warrants holding the spironolactone and rechecking potassium.

  2. A patient on warfarin presents with an INR of 6.8 and no bleeding. What is the most appropriate action?

    Answer: Hold warfarin and consider low-dose oral vitamin K

    For INR 4.5-10 without bleeding, guidelines recommend holding warfarin with possible low-dose oral vitamin K rather than aggressive reversal.

  3. Which lab parameter is most important to monitor when initiating allopurinol in a patient with gout and CKD?

    Answer: Serum creatinine and CBC

    Allopurinol requires renal dose adjustment and can cause hypersensitivity/marrow effects, so renal function and CBC are monitored.

  4. A type 2 diabetic with an A1c of 9.2% on metformin alone and a history of heart failure should add which agent for best cardiovascular benefit?

    Answer: Empagliflozin

    SGLT2 inhibitors like empagliflozin reduce heart failure hospitalizations and are preferred in diabetics with HF.

  5. A patient on simvastatin 40 mg is started on which medication that requires lowering the simvastatin dose due to interaction?

    Answer: Amlodipine

    Amlodipine inhibits simvastatin metabolism, so simvastatin should not exceed 20 mg daily when combined.

  6. An asthmatic patient using a rescue albuterol inhaler more than twice weekly indicates the need for which therapy adjustment?

    Answer: Add an inhaled corticosteroid

    Frequent rescue inhaler use signals inadequate control, requiring a controller such as an inhaled corticosteroid.

  7. Which therapeutic change is appropriate for a patient on amiodarone who develops elevated TSH and low free T4?

    Answer: Add levothyroxine and continue monitoring

    Amiodarone-induced hypothyroidism is treated with levothyroxine while continuing thyroid monitoring.