NAPLEX QBANK Therapeutic Plan Assessment 3

Question 1

A patient with stage 4 CKD (eGFR 22) and atrial fibrillation needs anticoagulation. Which agent requires the most caution or avoidance?

Accepted Answer

Dabigatran standard dose

Answer

Dabigatran is heavily renally cleared and standard dosing is inappropriate in severe CKD.

Question 2

A patient taking metformin is scheduled for a contrast CT scan. What is the appropriate plan?

Accepted Answer

Hold metformin around contrast and reassess renal function

Answer

Metformin is held around iodinated contrast to reduce the risk of lactic acidosis if renal function declines.

Question 3

Which monitoring is essential when a patient begins long-term oral corticosteroid therapy?

Accepted Answer

Blood glucose and bone density

Answer

Chronic corticosteroids cause hyperglycemia and osteoporosis, so glucose and bone health are monitored.

Question 4

A patient on lithium develops a tremor, confusion, and a level of 1.9 mEq/L. What is the priority action?

Accepted Answer

Hold lithium and ensure hydration

Answer

A lithium level near or above 1.5 mEq/L with symptoms is toxicity, requiring drug cessation and hydration.

Question 5

Which antihypertensive is preferred in a pregnant patient with chronic hypertension?

Accepted Answer

Labetalol

Answer

Labetalol is considered safe in pregnancy, whereas ACE inhibitors and ARBs are contraindicated.

NAPLEX QBANK Practice Test