NURS 5463 Advanced Pharmacology Practice
Exam 3 Question and Answers with
Rationales Top rated Latest Version
## *Question 1*
A 67-year-old man with non-valvular atrial fibrillation is prescribed
*apixaban*. Which patient characteristic would most likely warrant a
dose reduction according to prescribing recommendations?
A. Age 45 years and weight 90 kg
B. Age 82 years, weight 58 kg, serum creatinine 1.7 mg/dL
C. Hypertension controlled with lisinopril
D. Type 2 diabetes with HbA1c 7.2%
### *Correct Answer: B. Age 82 years, weight 58 kg, serum creatinine
1.7 mg/dL*
,### *Rationale*
For many patients with non-valvular atrial fibrillation, apixaban dose
reduction is recommended when *at least two* of the following are
present:
* Age ≥80 years
* Body weight ≤60 kg
* Serum creatinine ≥1.5 mg/dL
This patient meets all three criteria.
---
## *Question 2*
A 72-year-old patient with heart failure develops symptomatic
*hyperkalemia (K⁺ = 6.8 mEq/L)* with ECG changes.
Which medication provides the *fastest temporary intracellular shift*
of potassium?
A. Sodium polystyrene sulfonate
,B. Regular insulin with intravenous dextrose
C. Furosemide
D. Patiromer
### *Correct Answer: B. Regular insulin with intravenous dextrose*
### *Rationale*
Regular insulin rapidly shifts potassium into cells. Dextrose is
administered to reduce the risk of hypoglycemia unless the patient is
significantly hyperglycemic. Definitive potassium removal strategies
should also be implemented as appropriate.
---
## *Question 3*
A patient taking *lithium* develops coarse tremors, confusion,
vomiting, and ataxia.
Which medication is most likely contributing to lithium toxicity?
A. Hydrochlorothiazide
, B. Calcium carbonate
C. Famotidine
D. Acetaminophen
### *Correct Answer: A. Hydrochlorothiazide*
### *Rationale*
Thiazide diuretics reduce renal lithium clearance, increasing lithium
concentrations and the risk of toxicity. Other medications that may
increase lithium levels include ACE inhibitors, ARBs, and NSAIDs.
---
## *Question 4*
A patient taking *clozapine* reports fever and a sore throat.
What is the priority action?
A. Continue therapy.
B. Obtain an immediate complete blood count with absolute neutrophil
count (ANC).
Exam 3 Question and Answers with
Rationales Top rated Latest Version
## *Question 1*
A 67-year-old man with non-valvular atrial fibrillation is prescribed
*apixaban*. Which patient characteristic would most likely warrant a
dose reduction according to prescribing recommendations?
A. Age 45 years and weight 90 kg
B. Age 82 years, weight 58 kg, serum creatinine 1.7 mg/dL
C. Hypertension controlled with lisinopril
D. Type 2 diabetes with HbA1c 7.2%
### *Correct Answer: B. Age 82 years, weight 58 kg, serum creatinine
1.7 mg/dL*
,### *Rationale*
For many patients with non-valvular atrial fibrillation, apixaban dose
reduction is recommended when *at least two* of the following are
present:
* Age ≥80 years
* Body weight ≤60 kg
* Serum creatinine ≥1.5 mg/dL
This patient meets all three criteria.
---
## *Question 2*
A 72-year-old patient with heart failure develops symptomatic
*hyperkalemia (K⁺ = 6.8 mEq/L)* with ECG changes.
Which medication provides the *fastest temporary intracellular shift*
of potassium?
A. Sodium polystyrene sulfonate
,B. Regular insulin with intravenous dextrose
C. Furosemide
D. Patiromer
### *Correct Answer: B. Regular insulin with intravenous dextrose*
### *Rationale*
Regular insulin rapidly shifts potassium into cells. Dextrose is
administered to reduce the risk of hypoglycemia unless the patient is
significantly hyperglycemic. Definitive potassium removal strategies
should also be implemented as appropriate.
---
## *Question 3*
A patient taking *lithium* develops coarse tremors, confusion,
vomiting, and ataxia.
Which medication is most likely contributing to lithium toxicity?
A. Hydrochlorothiazide
, B. Calcium carbonate
C. Famotidine
D. Acetaminophen
### *Correct Answer: A. Hydrochlorothiazide*
### *Rationale*
Thiazide diuretics reduce renal lithium clearance, increasing lithium
concentrations and the risk of toxicity. Other medications that may
increase lithium levels include ACE inhibitors, ARBs, and NSAIDs.
---
## *Question 4*
A patient taking *clozapine* reports fever and a sore throat.
What is the priority action?
A. Continue therapy.
B. Obtain an immediate complete blood count with absolute neutrophil
count (ANC).
