NP NP Pharmacology & Prescribing

Question 1

A nurse practitioner prescribes metformin for a patient with type 2 diabetes. Which condition is an absolute contraindication to metformin use?

Accepted Answer

eGFR < 30 mL/min/1.73m²

Answer

BMI > 35 kg/m²

Answer

Age > 65 years

Answer

HbA1c > 9%

Question 2

When prescribing warfarin, which INR target range is appropriate for a patient with atrial fibrillation and no mechanical heart valve?

Accepted Answer

2.0–3.0

Answer

1.0–1.5

Answer

2.5–3.5

Answer

3.0–4.0

Question 3

A patient is started on lisinopril and develops a dry, persistent cough. What is the most appropriate next step?

Accepted Answer

Switch to an ARB such as losartan

Answer

Add a cough suppressant and continue lisinopril

Answer

Reduce the lisinopril dose by half

Answer

Order pulmonary function tests before changing therapy

Question 4

Which schedule II controlled substance requires a new written or electronic prescription for each fill in most US states and cannot be called in by phone?

Accepted Answer

Oxycodone

Answer

Tramadol

Answer

Gabapentin

Answer

Alprazolam

Question 5

An NP prescribes azithromycin for a patient already taking amiodarone. What is the primary safety concern?

Accepted Answer

Prolonged QT interval and risk of torsades de pointes

Answer

Increased risk of hepatotoxicity

Answer

Reduced bioavailability of amiodarone

Answer

Serotonin syndrome

Question 6

Which drug class is first-line therapy for newly diagnosed hypertension in a non-Black patient without compelling indications, per JNC guidelines?

Accepted Answer

Thiazide diuretics, ACE inhibitors, ARBs, or CCBs

Answer

Beta-blockers

Answer

Alpha-blockers

Answer

Direct vasodilators