NP Review Extra Questions
A 15-year-old female patient presents to the clinic with a classic presentation
of strep throat. When the nurse practitioner prescribes the patient antibiotics,
the patient states that penicillin makes her itchy. Which of the following
medications would be the most appropriate alternative for this patient? -
correct answer ✔Cephalexin / Keflex
The first-line drug treatment for strep throat related to group A streptococcus
is penicillin or amoxicillin. However, since the patient reported an non-
anaphylactic allergy to this medication class, an alternative medication from
the cephalosporin drug class would be appropriate. Other alternative options
include medications from the macrolide drug class, such as azithromycin and
clarithromycin
A middle-aged man calls into the clinic today stating that he recently started
an antibiotic, and today he received a first degree sunburn while gardening for
a couple of hours outside. Which of the following antibiotics is he likely taking
based on this finding? - correct answer ✔Doxycycline
This side effect may last up to several months after cessation of tetracycline
use so patient education is imperative.
Metronidazole (Flagyl) can be used to treat all of the following conditions
except:
Trich, Diverticulitis, Liver abscess, Erysipelas. - correct answer ✔Erysipelas
= treatment is PCN
A 24-year-old female patient presents to the clinic reporting purulent, green,
frothy vaginal discharge. Upon further assessment, the nurse practitioner
,obtains a vaginal swab and visualizes flagella under the microscope. The
nurse practitioner knows to treat this condition with which of the following
antibiotics? - correct answer ✔Flagyl
flagella is indicative of trichomoniasis, which is treated with metronidazole
(Flagyl). Penicillin G (Bicillin) is used to treat syphilis, ceftriaxone (Rocephin)
is used to treat gonorrhea, and azithromycin (Zithromax) is used to treat
chlamydia.
A 26-year-old female patient presents to the clinic for her four week
postpartum visit. The patient reports a painful and tender right breast. Upon
further assessment, the nurse practitioner palpates a warm and boggy breast
and diagnoses the patient with mastitis. The patient has a history of an
anaphylactic reaction to penicillin. Which of the following would be the best
option to treat her mastitis? - correct answer ✔clindamycin (Cleocin)
A patient has been diagnosed with tuberculosis and will need to be on
rifampin (Rifadin) for 9 months. Which of the following lab tests should be
obtained routinely while the patient is taking this medication? - correct answer
✔Liver Function tests
Rifampin (Rifadin) is metabolized in the liver and is a drug that can be
severely hepatotoxic. Patients on long-term rifampin (Rifadin) will need serial
liver function panels.
A 40-year-old patient presents to the office to review the results of their most
recent lipid panel. The results are shown below. The nurse practitioner
informs the patient that the triglyceride levels are extremely high and should
be treated right away with a fenofibrate to avoid what condition?
Total cholesterol: 200
LDL: 104
,HDL: 45
Triglycerides: 687 - correct answer ✔acute pancreatitis
A 85-year-old female patient has been diagnosed with hypothyroidism and is
receiving a prescription for levothyroxine (Synthroid). The nurse practitioner
starts the levothyroxine (Synthroid) at a dose of 12.5 mcg by mouth daily. Why
would the nurse practitioner start the patient at this dose? - correct answer
✔The correct answer is due to the cardiac side effects that can occur with this
medication. Levothyroxine can lower the threshold fat which cardiac
arrhythmias occur, and should be started at lower doses in the elderly or
those with a previous cardiac history.
Which lab result is most sensitive and specific to overall kidney function? -
correct answer ✔GFR
A 54-year-old patient presents to the office after three months of lifestyle
modifications due to his recent diagnosis of stage 1 hypertension. The patient
has a history of hyperlipidemia and diabetes. The nurse practitioner knows
that thiazide diuretics increase all of the following lab levels except: - correct
answer ✔Potassium
A good way to remember this is thinking of (HCTz) H-hyperglycemia, C-
crystals for uric acid, T-triglycerides.
An ACE inhibitor, such as lisinopril (Zestril), should be discontinued in which
of the following patients? - correct answer ✔GFR 29
A 60-year-old female patient has just been diagnosed with heart failure. She
has been noticing swelling in her ankles lately, despite taking her diuretics.
Which of the following medications may be responsible for this symptom? -
correct answer ✔Verapamil
, Non-dihydropyridine calcium channel blockers like verapamil (Verelan) may
have the side effect of ankle edema and should not be given to patients with a
history of heart failure
A 47-year-old male patient presents to the clinic today after recently being
treated for a heart failure exacerbation. He states that his chest feels more
enlarged than normal and there appears to be an increase in the amount of
breast tissue upon physical exam. The nurse practitioner is aware that which
of the following medications can lead to this side effect? - correct answer
✔Spirinolactone
A known side effect of spironolactone use in men is the potential for
gynecomastia
Your 63-year-old male patient was recently diagnosed with heart failure.
When doing a medication reconciliation, which medication would be most
appropriate to discontinue? - correct answer ✔Volteran
NSAIDS are known to cause potential fluid retention and edema. Heart failure
patients commonly have issues with excess fluid volume, so taking NSAIDs
increases their risk for a potential exacerbation.
A middle aged female patient presents to the clinic with increasing cough and
peripheral edema. Based on her past medical history of heart failure, which of
the following interventions would be LEAST appropriate to order at this time? -
correct answer ✔Initiate Lanoxin
Based on the patient's presentation, it is likely that she is currently
experiencing a heart failure exacerbation. A chest x-ray is appropriate given
the patient's cough and likely pulmonary congestion. Furosemide is
A 15-year-old female patient presents to the clinic with a classic presentation
of strep throat. When the nurse practitioner prescribes the patient antibiotics,
the patient states that penicillin makes her itchy. Which of the following
medications would be the most appropriate alternative for this patient? -
correct answer ✔Cephalexin / Keflex
The first-line drug treatment for strep throat related to group A streptococcus
is penicillin or amoxicillin. However, since the patient reported an non-
anaphylactic allergy to this medication class, an alternative medication from
the cephalosporin drug class would be appropriate. Other alternative options
include medications from the macrolide drug class, such as azithromycin and
clarithromycin
A middle-aged man calls into the clinic today stating that he recently started
an antibiotic, and today he received a first degree sunburn while gardening for
a couple of hours outside. Which of the following antibiotics is he likely taking
based on this finding? - correct answer ✔Doxycycline
This side effect may last up to several months after cessation of tetracycline
use so patient education is imperative.
Metronidazole (Flagyl) can be used to treat all of the following conditions
except:
Trich, Diverticulitis, Liver abscess, Erysipelas. - correct answer ✔Erysipelas
= treatment is PCN
A 24-year-old female patient presents to the clinic reporting purulent, green,
frothy vaginal discharge. Upon further assessment, the nurse practitioner
,obtains a vaginal swab and visualizes flagella under the microscope. The
nurse practitioner knows to treat this condition with which of the following
antibiotics? - correct answer ✔Flagyl
flagella is indicative of trichomoniasis, which is treated with metronidazole
(Flagyl). Penicillin G (Bicillin) is used to treat syphilis, ceftriaxone (Rocephin)
is used to treat gonorrhea, and azithromycin (Zithromax) is used to treat
chlamydia.
A 26-year-old female patient presents to the clinic for her four week
postpartum visit. The patient reports a painful and tender right breast. Upon
further assessment, the nurse practitioner palpates a warm and boggy breast
and diagnoses the patient with mastitis. The patient has a history of an
anaphylactic reaction to penicillin. Which of the following would be the best
option to treat her mastitis? - correct answer ✔clindamycin (Cleocin)
A patient has been diagnosed with tuberculosis and will need to be on
rifampin (Rifadin) for 9 months. Which of the following lab tests should be
obtained routinely while the patient is taking this medication? - correct answer
✔Liver Function tests
Rifampin (Rifadin) is metabolized in the liver and is a drug that can be
severely hepatotoxic. Patients on long-term rifampin (Rifadin) will need serial
liver function panels.
A 40-year-old patient presents to the office to review the results of their most
recent lipid panel. The results are shown below. The nurse practitioner
informs the patient that the triglyceride levels are extremely high and should
be treated right away with a fenofibrate to avoid what condition?
Total cholesterol: 200
LDL: 104
,HDL: 45
Triglycerides: 687 - correct answer ✔acute pancreatitis
A 85-year-old female patient has been diagnosed with hypothyroidism and is
receiving a prescription for levothyroxine (Synthroid). The nurse practitioner
starts the levothyroxine (Synthroid) at a dose of 12.5 mcg by mouth daily. Why
would the nurse practitioner start the patient at this dose? - correct answer
✔The correct answer is due to the cardiac side effects that can occur with this
medication. Levothyroxine can lower the threshold fat which cardiac
arrhythmias occur, and should be started at lower doses in the elderly or
those with a previous cardiac history.
Which lab result is most sensitive and specific to overall kidney function? -
correct answer ✔GFR
A 54-year-old patient presents to the office after three months of lifestyle
modifications due to his recent diagnosis of stage 1 hypertension. The patient
has a history of hyperlipidemia and diabetes. The nurse practitioner knows
that thiazide diuretics increase all of the following lab levels except: - correct
answer ✔Potassium
A good way to remember this is thinking of (HCTz) H-hyperglycemia, C-
crystals for uric acid, T-triglycerides.
An ACE inhibitor, such as lisinopril (Zestril), should be discontinued in which
of the following patients? - correct answer ✔GFR 29
A 60-year-old female patient has just been diagnosed with heart failure. She
has been noticing swelling in her ankles lately, despite taking her diuretics.
Which of the following medications may be responsible for this symptom? -
correct answer ✔Verapamil
, Non-dihydropyridine calcium channel blockers like verapamil (Verelan) may
have the side effect of ankle edema and should not be given to patients with a
history of heart failure
A 47-year-old male patient presents to the clinic today after recently being
treated for a heart failure exacerbation. He states that his chest feels more
enlarged than normal and there appears to be an increase in the amount of
breast tissue upon physical exam. The nurse practitioner is aware that which
of the following medications can lead to this side effect? - correct answer
✔Spirinolactone
A known side effect of spironolactone use in men is the potential for
gynecomastia
Your 63-year-old male patient was recently diagnosed with heart failure.
When doing a medication reconciliation, which medication would be most
appropriate to discontinue? - correct answer ✔Volteran
NSAIDS are known to cause potential fluid retention and edema. Heart failure
patients commonly have issues with excess fluid volume, so taking NSAIDs
increases their risk for a potential exacerbation.
A middle aged female patient presents to the clinic with increasing cough and
peripheral edema. Based on her past medical history of heart failure, which of
the following interventions would be LEAST appropriate to order at this time? -
correct answer ✔Initiate Lanoxin
Based on the patient's presentation, it is likely that she is currently
experiencing a heart failure exacerbation. A chest x-ray is appropriate given
the patient's cough and likely pulmonary congestion. Furosemide is
