Leik - FNP Review(2024 Latest Update)accurate 100%

Leik - FNP Review(2024 Latest Update)accurate 100% Which of the following drugs interact with warfarin/coumadin? a. Imodium (loperamide) b. Diltiazem Hydrochloride SR (diltiazem) c. trimethoporim-sulfamethoxazole (Bactrim) d. sumatriptan (Imitrex) - ANSWER c Sulfa drugs will interact with warfarin (increases the blood level), which results in an elevation of the INR and the risk of bleeding. The following drugs are potent inhibitors of the CYP450 system except: a. Erythromycin (Erythrocin) b. Cimetidine (Tagamet) c. Ceftazidime (Tazicef) d. Diltiazem (Cardizem) - ANSWER a Erythromycin acts as inhibitors slow down drug clearance, increasing drug concentration. This may lead to drug overdose. A 57 year old patient comes to the clinic for her routine physical. She has no new complaints. The only medication that she takes is digoxin (Lanoxin) for her atrial fibrillation. Which of the following electrolyte levels should be monitored in this patient? a. potassium, calcium, chloride b. magnesium, calcium, chloride c. potassium, calcium, magnesium d. magnesium, calcium, phosphate - ANSWER c Monitor digoxin level, EKG, electrolytes (potassium, magnesium, and calcium) A 48 year old female patient comes to the clinic today to discuss her ongoing use off Lithium. She states that she has begun feeling very tired and feels cold during the day. She thinks that her increase in Lithium dose is causing her symptoms. What should the nurse practitioner order? a. TSH b. CBC c. LFT d. BUN - ANSWER a Patients taking lithium have an increased risk of developing hypothyroidism by decreasing the production of T4. Levothyroxine replacement therapy concurrently with lithium administration especially in the presence of clinically overt hypothyroidism. A patient has recently been prescribed omeprazole (Prilosec) for GERD. He also takes lisinopril (Zestril). His PMH includes migraines, hypertension, and chronic kidney disease. The nurse practitioner notes: a. The patient should stop taking the omeprazole (Prilosec) due his diagnosis of chronic kidney disease. b. The patient should stop taking omeprazole (Prilosec) due to drug interaction with lisinopril (Zestril). c. The patient may continue taking the omeprazole (Prilosec) but should monitor blood pressure. d. The patient may continue taking omeprazole (Prilosec) as prescribed. - ANSWER a Studies suggest that PPIs may increase the risk of kidney disease. Using PPIs may also cause acute interstitial nephritis. A patient that has already been diagnosed with CKD should not take PPIs. A patient taking Warfarin (Coumadin) is having abdominal surgery in one month. She wants to know when she should stop taking her Warfarin (Coumadin). The nurse practitioner advises: a. The day before scheduled surgery. b. Do not stop taking Warfarin (Coumadin) c. 3 days before surgery. d. 7 days before surgery. - ANSWER d Patients should discontinue warfarin 7 days before surgery. A 71 year old patient has been diagnosed with stage III congestive heart failure. Which of the following class of medications may cause an exacerbation of congestive heart failure> a. Thiazolidinediones b. Narcotics c. NSAIDs d. ACE Inhibitors - ANSWER a