Therapeutic Treatment Planning 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 Treatment Planning flashcards as text
A 58-year-old with type 2 diabetes, eGFR 28 mL/min, and HbA1c 8.9% is on metformin. What is the most appropriate change to the treatment plan?
Answer: Discontinue metformin and add a GLP-1 receptor agonist or insulin
Metformin is contraindicated when eGFR is below 30 mL/min due to lactic acidosis risk, so it should be stopped and replaced with an agent safe in renal impairment.
A patient with newly diagnosed stage 2 hypertension and no compelling indications has a blood pressure of 162/98 mmHg. What is the preferred initial pharmacologic approach?
Answer: Two first-line agents from different classes
Stage 2 hypertension generally warrants initiating two first-line antihypertensives of different classes to reach goal blood pressure.
Which monitoring parameter is most important to establish at baseline before starting amiodarone for chronic atrial fibrillation?
Answer: Thyroid, liver, and pulmonary function tests
Amiodarone can cause thyroid, hepatic, and pulmonary toxicity, so baseline TFTs, LFTs, and pulmonary function are required.
A patient with heart failure with reduced ejection fraction (HFrEF) is on lisinopril and metoprolol succinate. Which addition best aligns with guideline-directed medical therapy?
Answer: A mineralocorticoid receptor antagonist such as spironolactone
Adding an MRA improves survival in HFrEF and is a core pillar of guideline-directed therapy.
A patient on warfarin presents with an INR of 6.5 and no bleeding. What is the most appropriate management?
Answer: Hold warfarin and consider low-dose oral vitamin K
For an elevated INR without bleeding, holding warfarin with possible low-dose oral vitamin K is appropriate; aggressive reversal is reserved for serious bleeding.
Which agent is the preferred first-line pharmacotherapy for a pregnant patient with newly diagnosed chronic hypertension?
Answer: Labetalol
Labetalol is a preferred antihypertensive in pregnancy, while ACE inhibitors and ARBs are contraindicated due to fetal toxicity.
A patient with osteoporosis and a history of esophageal stricture needs treatment. Which option best fits the treatment plan?
Answer: IV zoledronic acid annually
Oral bisphosphonates are contraindicated with esophageal abnormalities, so IV zoledronic acid is preferred.