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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.

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

    Answer: eGFR < 30 mL/min/1.73m²

    Metformin is contraindicated when eGFR falls below 30 mL/min/1.73m² due to the risk of lactic acidosis from drug accumulation.

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

    Answer: 2.0–3.0

    For non-valvular atrial fibrillation, the target INR range is 2.0–3.0 to balance stroke prevention with bleeding risk.

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

    Answer: Switch to an ARB such as losartan

    ACE inhibitor–induced cough is a class effect caused by bradykinin accumulation; switching to an ARB eliminates this side effect.

  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?

    Answer: Oxycodone

    Oxycodone is a Schedule II opioid; federal law prohibits oral prescriptions for Schedule II substances, requiring a written or electronic prescription for each supply.

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

    Answer: Prolonged QT interval and risk of torsades de pointes

    Both azithromycin and amiodarone independently prolong the QT interval; combining them significantly increases the risk of potentially fatal arrhythmias.

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

    Answer: Thiazide diuretics, ACE inhibitors, ARBs, or CCBs

    Current guidelines recommend thiazide diuretics, ACE inhibitors, ARBs, or calcium channel blockers as first-line agents for most non-Black hypertensive patients.