NAPLEX QBANK Therapeutic Plan Assessment 2

Question 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?

Accepted Answer

Hold the spironolactone and recheck potassium

Answer

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

Question 2

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

Accepted Answer

Hold warfarin and consider low-dose oral vitamin K

Answer

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

Question 3

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

Accepted Answer

Serum creatinine and CBC

Answer

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

Question 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?

Accepted Answer

Empagliflozin

Answer

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

Question 5

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

Accepted Answer

Amlodipine

Answer

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

NAPLEX QBANK Practice Test

NAPLEX QBANK Practice Test

NAPLEX QBANK Therapeutic Plan Assessment 2