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
A patient with stage 4 CKD (eGFR 22) and atrial fibrillation needs anticoagulation. Which agent requires the most caution or avoidance?
Answer: Dabigatran standard dose
Dabigatran is heavily renally cleared and standard dosing is inappropriate in severe CKD.
A patient taking metformin is scheduled for a contrast CT scan. What is the appropriate plan?
Answer: Hold metformin around contrast and reassess renal function
Metformin is held around iodinated contrast to reduce the risk of lactic acidosis if renal function declines.
Which monitoring is essential when a patient begins long-term oral corticosteroid therapy?
Answer: Blood glucose and bone density
Chronic corticosteroids cause hyperglycemia and osteoporosis, so glucose and bone health are monitored.
A patient on lithium develops a tremor, confusion, and a level of 1.9 mEq/L. What is the priority action?
Answer: Hold lithium and ensure hydration
A lithium level near or above 1.5 mEq/L with symptoms is toxicity, requiring drug cessation and hydration.
Which antihypertensive is preferred in a pregnant patient with chronic hypertension?
Answer: Labetalol
Labetalol is considered safe in pregnancy, whereas ACE inhibitors and ARBs are contraindicated.
A patient on phenytoin reports gait instability and the level is 28 mcg/mL. What is the appropriate response?
Answer: Reduce or hold the dose given supratherapeutic level
Phenytoin therapeutic range is 10-20 mcg/mL, and ataxia at 28 indicates toxicity requiring dose reduction.
A patient with depression on an SSRI is started on tramadol for pain. What risk should be communicated?
Answer: Serotonin syndrome
Combining serotonergic agents like SSRIs and tramadol increases the risk of serotonin syndrome.