ANCC Adult NP Board Exam Prep Questions with 100% Correct Answers

Potent Inhibitors: CYP450 System Correct Answer Macrolides (erythromycin, clarithromycin, telithromycin) Antifungals (ketoconazole, fluconazole, itraconazole) Cimetidine (Tagamet) Citalopram (Celexa) Protease inhibitors (saquinavir, indinavir, nelfinavir) Grapefruit juice Narrow Therapeutic Index Drugs Correct Answer ■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 Correct Answer 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 Correct Answer 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 Correct Answer 0.5-2 mg Warfarin INR range issues Correct Answer Consistently Stable INR Check every 2 to 4 weeks up to every 12 weeks.