NP NP Pharmacology & Prescribing 2

Question 1

A patient taking SSRIs is prescribed tramadol. Which serious drug interaction should the NP counsel the patient about?

Accepted Answer

Serotonin syndrome

Answer

Tramadol inhibits serotonin reuptake and, when combined with SSRIs, can precipitate serotonin syndrome, which is potentially life-threatening.

Question 2

Which medication requires baseline and periodic monitoring of serum creatinine and potassium when prescribed for heart failure?

Accepted Answer

Spironolactone

Answer

Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia and nephrotoxicity, necessitating regular renal function and electrolyte monitoring.

Question 3

When prescribing fluoroquinolones, the NP should warn patients about which rare but serious adverse effect?

Accepted Answer

Tendon rupture

Answer

Fluoroquinolones carry an FDA black box warning for tendinitis and tendon rupture, particularly of the Achilles tendon, especially in patients over 60 on corticosteroids.

Question 4

A patient with a penicillin allergy documented as 'hives and swelling' needs antibiotic coverage for a skin infection. The safest approach is to:

Accepted Answer

Use clindamycin or TMP-SMX as an alternative antibiotic class

Answer

For patients with documented IgE-mediated penicillin allergy, using an unrelated antibiotic class such as clindamycin or trimethoprim-sulfamethoxazole avoids cross-reactivity risk.

Question 5

Which analgesic is contraindicated in elderly patients due to increased risk of GI bleeding, renal impairment, and falls per the Beers Criteria?

Accepted Answer

Indomethacin

Answer

Indomethacin is listed on the Beers Criteria as a potentially inappropriate medication for older adults due to its high risk for GI toxicity and CNS adverse effects.

NP - Nurse Practitioner Practice Test

NP - Nurse Practitioner Practice Test

NP NP Pharmacology & Prescribing 2