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NP Pharmacology & Prescribing Flashcards

6 cards from real NP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 6 NP Pharmacology & Prescribing flashcards as text

  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:

    Answer: Hold lithium and refer to the emergency department immediately

    A lithium level above 2.0 mEq/L with neurologic symptoms indicates serious toxicity requiring immediate hospitalization and supportive care or hemodialysis.

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

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

    Starting buprenorphine before moderate withdrawal risks precipitating acute withdrawal; a COWS score of 8–12 indicates the patient is ready for induction.

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

    Answer: Apixaban

    Apixaban is a direct oral anticoagulant (DOAC) that does not require INR monitoring and is FDA-approved for stroke prevention in non-valvular atrial fibrillation.

  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?

    Answer: Nitrates

    Combining PDE-5 inhibitors like sildenafil with nitrates causes profound, potentially fatal hypotension and is an absolute contraindication.

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

    Answer: REMS: iPLEDGE

    iPLEDGE is the FDA-mandated REMS program for isotretinoin requiring monthly pregnancy tests and counseling due to the drug's severe teratogenicity.

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

    Answer: Labetalol

    Labetalol (along with nifedipine and methyldopa) is considered safe in pregnancy; ACE inhibitors and ARBs are teratogenic and strictly contraindicated.