NP NP Pharmacology & Prescribing 3

Question 1

A patient on lithium therapy presents with coarse tremor, polyuria, and confusion. Serum lithium level is 2.4 mEq/L. The NP's priority action is:

Accepted Answer

Hold lithium and refer to the emergency department immediately

Answer

Reduce the dose and recheck in one week

Answer

Switch to valproate and monitor

Answer

Increase fluid intake and recheck in 48 hours

Question 2

When initiating buprenorphine/naloxone (Suboxone) for opioid use disorder, the NP should begin induction only after the patient is in:

Accepted Answer

Mild to moderate opioid withdrawal (COWS score ≥ 8–12)

Answer

A comfortable, non-withdrawing state

Answer

Severe opioid withdrawal for maximum effect

Answer

A supervised hospital setting exclusively

Question 3

Which anticoagulant does NOT require routine INR monitoring and is approved for stroke prevention in non-valvular atrial fibrillation?

Accepted Answer

Apixaban

Answer

Warfarin

Answer

Heparin infusion

Answer

Low-molecular-weight heparin

Question 4

A patient is prescribed sildenafil for pulmonary hypertension. The NP must ensure the patient is not concurrently using which drug class due to life-threatening hypotension?

Accepted Answer

Nitrates

Answer

Beta-blockers

Answer

Statins

Answer

Proton pump inhibitors

Question 5

The NP prescribes isotretinoin for severe acne. Which mandatory program must the patient be enrolled in before dispensing?

Accepted Answer

REMS: iPLEDGE

Answer

MedWatch reporting system

Answer

VAERS registry

Answer

FDA Sentinel network

Question 6

Which antihypertensive medication is preferred during pregnancy for the management of chronic hypertension?

Accepted Answer

Labetalol

Answer

Lisinopril

Answer

Valsartan

Answer

Hydrochlorothiazide