NAPLEX QBANK Patient Counseling and Education 2 — Questions and Answers
Question 1: A patient starting warfarin asks about diet. What is the most appropriate counseling point?
- Avoid all foods containing vitamin K entirely
- Keep vitamin K intake consistent rather than eliminating it (Correct answer)
- Double the dose on days you eat leafy greens
- Take warfarin with grapefruit juice to boost effect
Correct answer: Keep vitamin K intake consistent rather than eliminating it
Consistency of vitamin K intake matters more than avoidance, since sudden changes alter INR.
Question 2: Which counseling point is correct for a patient prescribed alendronate for osteoporosis?
- Take at bedtime with a snack
- Take with a full glass of water and remain upright for 30 minutes (Correct answer)
- Lie down immediately after dosing
- Take with calcium supplement simultaneously
Correct answer: Take with a full glass of water and remain upright for 30 minutes
Alendronate must be taken with water on an empty stomach, staying upright to prevent esophageal irritation.
Question 3: A patient using a metered-dose inhaler with an inhaled corticosteroid should be counseled to do what after each use?
- Hold breath for 1 second only
- Rinse the mouth and spit to prevent oral thrush (Correct answer)
- Swallow extra water with the medication
- Use the inhaler only when symptoms occur
Correct answer: Rinse the mouth and spit to prevent oral thrush
Rinsing the mouth after an inhaled corticosteroid reduces the risk of oral candidiasis.
Question 4: Which statement about metformin counseling is most accurate?
- It commonly causes hypoglycemia as monotherapy
- GI upset is common and improves by taking it with meals (Correct answer)
- It must be taken on an empty stomach
- It causes significant weight gain
Correct answer: GI upset is common and improves by taking it with meals
Metformin frequently causes GI side effects that are minimized by taking it with food.
Question 5: A patient on a transdermal fentanyl patch should be told to do what when applying a new patch?
- Apply heat over the patch to speed absorption
- Rotate application sites and avoid external heat (Correct answer)
- Cut the patch to adjust the dose
- Apply to broken or irritated skin
Correct answer: Rotate application sites and avoid external heat
Heat increases fentanyl release and risk of overdose, and sites should be rotated to prevent irritation.
Question 6: What is the best counseling for a patient prescribed oral tetracycline?
- Take with milk for better tolerability
- Avoid dairy, antacids, and iron near dosing time (Correct answer)
- Take immediately after a calcium supplement
- Always take with an antacid
Correct answer: Avoid dairy, antacids, and iron near dosing time
Divalent and trivalent cations chelate tetracyclines and reduce absorption.
Question 7: A patient newly started on a statin reports muscle aches. What is the appropriate counseling response?
- Ignore it as statins never cause muscle problems
- Report muscle pain, tenderness, or dark urine to the provider (Correct answer)
- Stop drinking all fluids
- Double the statin dose immediately
Correct answer: Report muscle pain, tenderness, or dark urine to the provider
Muscle pain with dark urine may signal myopathy or rhabdomyolysis and should be reported.
NAPLEX QBANK Patient Counseling and Education 2
A patient starting warfarin asks about diet.
What is the most appropriate counseling point?