ATI PHARMACOLOGY – FNP RETAKE EXAM/PHARMACOLOGY ATI FNP RETAKE EXAM

ATI PHARMACOLOGY – FNP RETAKE EXAM/PHARMACOLOGY ATI FNP RETAKE EXAM 68 year-old male of hispanic descent has recently been discharged from hospital with dx of stroke secondary to VTE, DVT, and type 2 DM. Medications are listed on dc note as warfarin 5mg every Mon/Wed/Fri/Sun. metformin 1g BID and ASA 325mg daily. Which is correct INR value for this pt? A. INR 1.5-2.5 B. INR 2.0- 3.0 C. INR 2.5-3.5 D. INR 3.0-4.0 -CORRECT ANSWER-- B. INR 2.0-3.0 Goal INR of stroke pt is 2.0-3.0. This is most common INR value and also true for AFIB Elderly pt with hx of severe mitral regurgitation has surgery for placement of a prosthetic mitral valve. Which is the correct IBR value? A. INR 1.5-2.5 B. INR 2.0-3.0 C. INR 2.5-3.5 D. INR 3.0-4.0 -CORRECT ANSWER-- C. INR 2.5-3.5 ACC/AHA guidelines for anticoagulation of pts with prosthetic valves suggest INR of 2.5-3.5. They are at higher risk of blood clots because of prosthetic valves Which of the following is an adverse effect from nondihydropyridine CCBs? A. Hyperkalemia B. Hypertriglyceridemia C. Hyperuricemia D. Constipation -CORRECT ANSWER-- D. Constipation Constipation affects up to 25% of pts on nondihydropyridine CCBs (verapamil, diltiazem). It can be severe in elderly. Important for pt to take a soluble fiber daily, increase fiber intake, walk daily, and ensure adequate fluid intake. When starting elderly pt on Synthroid, the NP must keep in mind the rationale for beginning with a lower dose because: A. CNS effects B. Cardiac effects C. Renal effects D. Hepatic effects -CORRECT ANSWER-- B. Cardiac effects Synthroid should be started on the lowest dose in the elderly because of cardiac effects including palpitations, tachycardia, anxiety, irritability, elevated BP, flushing and insomnia 55 yr old woman withRA sees NP. She has taken ibuprofen twice daily for many years. All of the following organ systems are at risk for damage from chronic NSAID use except: A. Cardiovascular B. MSK C. Hematopoietic D. Integumentary -CORRECT ANSWER-- B. MSK MSK is not damaged by NSAIDs. NSAIDs are used to treat muscle and joint pain. Systems adversely affects by NSAIDs includ CV, hematopoietic (because ASA affects platelets) and integumentary (e.g. Stevens-Johnson Syndrome) Pt newly diagnosed with DM reports severe hives and swollen lips after taking Bactrim for a bladder infection 2 months ago. Which of the following statements is correct? A. Pt cannot take any pills in the sulfonylurea class B. Pt can take some of the pills in the sulfonylurea class C. Pt can take any of the pills in the sulfonylurea class D. None of the above -CORRECT ANSWER-- C. Pt can take any of the pills in the sulfonylurea class Evidence does not support existence of cross-reactivity between sulfonamide antimicrobials (e.g. sulfamethoxazole) and nonantimicrobial sulfonamides (e.g. furosemide, thiazide diuretics, sulfonylurea hypoglycemics, protease inhibitors) This is due to the differences in their sulfa metabolites. The exception is sulfasalazine, a DMARD which can cause cross reaction Elderly pt presents with a new onset of sleepiness, weight gain of 10 lbs in a month, xerosis, and anomia. Free T4 is 0.8ng/dL, TSH is 7.2mU/L and MMSE has score of 28. Which medication will the NP prescribe? A. Levothyroxine (Synthroid) B. Propylthiouracil (Tapazole) C. Memantine (Namenda) D. Carbidopa-levadopa (Sinemet) -CORRECT ANSWER-- B. Levothyroxine (Synthroid) Pt presents with signs of subclinical hypothyroidism - free T4 is normal and the TSH is elevated. Normal free T4 ranges from 0.8 to 1.8 and a normal TSH range is 0.4- 4.0mU/L. Pt may be stated on a low dose of levothyroxine (usually 25mcg/day) Propylthiouracil (PTU) is used for HYPER thyroidism (signs include insomnia, tachycardia, increased BP and weight loss. Memantine - used for dementia in Alzheimer's disease. Carbidopa-levodopa (sinemet) is tx for Parkinson's disease Which of the following SSRIs is most likely to cause erectile dysfunction? A. Paroextine (Paxil) B. Escitalopram (Lexapro) C. Venlafaxine (Effexor) D. Amitriptyline (Elavil) -CORRECT ANSWER-- A. Paroxetine (Paxil) Ecsitalopram is also an SSRI but more likely to caused serotonin syndrome Venlafaxine (Effexor) is a SNRI Amitriptyline is a TCA A young adult with myasthenia gravis is diagnosed with pertussis. Which abx is contradindicated in a patient with this condition? A. Erythyromycin B. Doxycycline C. Clarithromycin D. Azithromycin -CORRECT ANSWER-- A. Erythromycin Erythromycin and teluithromycin are contraindicated in patients with myasthenia gravis because of potential respiratory collapse. ABX that are safe to prescribe for a patient