ANCC Adult NP Board Exam prep Questions with solutions 2023

ANCC Adult NP Board Exam prep Questions with solutions 2023 Potent Inhibitors: CYP450 System - ANS ️️ Macrolides (erythromycin, clarithromycin, telithromycin) Antifungals (ketoconazole, fluconazole, itraconazole) Cimetidine (Tagamet) Citalopram (Celexa) Protease inhibitors (saquinavir, indinavir, nelfinavir) Grapefruit juice Narrow Therapeutic Index Drugs - ANS ️️ ■Warfarin sodium (Coumadin): monitor INR. ■ Digoxin (Lanoxin): monitor digoxin level, EKG, electrolytes (potassium, magnesium, calcium). ■ Theophylline: monitor blood levels. ■ Carbamezapine (Tegretol) and phenytoin (Dilantin): monitor blood levels. ■ Levothyroxine: monitor TSH. ■ Lithium: monitor blood levels, TSH (risk of HYPOthyroidism). Beers Criteria - ANS ️️ Antipsychotics: Quetiapine, clozapine, and pimavanserin may be used with caution. Rivaroxaban and dabigatran: Higher bleeding risk than warfarin and other direct oral anticoagulants. Tramadol: Risk of hyponatremia from syndrome of inappropriate antidiuretic hormone secretion. Opioids: Do not combine with benzodiazepines or gabapentinoids, as they increase the risk of severe respiratory depression. s/sx of digoxin toxicity - ANS ️️ Initial symptoms are GI (nausea/vomiting), hyperkalemia, and bradydysrhythmias (atrioventricular [AV] blocks) or tachydysrhythmias (ventricular tachycardia/fibrillation or atrial tachycardia with 2:1 block). Others include confusion and visual changes (yellowish-green-tinged color vision). Digoxin therapeutic range - ANS ️️ 0.5-2 mg Warfarin INR range issues - ANS ️️ Consistently Stable INR Check every 2 to 4 weeks up to every 12 weeks. Single Out-of-Range INR If patient has stable INR and has a single out-of-range INR ≤0.5 below or above therapeutic INR (2-3), experts suggest continuing current warfarin dose; retest INR within 1 to 2 weeks. INR <5 With No Significant Bleeding Risk Omit one dose and/or reduce maintenance dose slightly; recheck INR. DOACs: Antidotes - ANS ️️ idarucizumab and andexanet alfa: reverse the anticoagulant effects of dabigatran and FXa inhibitors, respectively. Fresh frozen plasma and prothrombin complex concentrate can also be used for rapid reversa 2017 ACC/AHA stages of hypertension - ANS ️️ Normal BP: Systolic <120 mmHg and diastolic <80 mmHg Elevated BP: Systolic 120 to 129 mmHg and diastolic <80 mmHg Stage 1: Systolic 130 to 139 mmHg or diastolic 80 to 89 mmHg Stage 2: Systolic ≥140 mmHg or diastolic ≥90 mmHg Thiazide diuretics contraindication - ANS ️️ Sulfa aller