Pharmacotherapeutics for Advanced Practice Nurse Prescribers 5th Edition Questions &answer, Exams of Nursing

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Pharmacotherapeutics for Advanced Practice

Nurse Prescribers 5th Edition Woo Robinson

Test Bank

A 45-year-old patient presents with hypertension and is prescribed an angiotensin- converting enzyme (ACE) inhibitor. Which of the following is a common adverse effect of ACE inhibitors? A. Hyperkalemia B. Bradycardia C. Hypoglycemia D. Constipation Answer: A. Hyperkalemia Which medication is the first-line treatment for a newly diagnosed patient with type 2 diabetes mellitus? A. Metformin B. Insulin glargine C. Glipizide D. Pioglitazone Answer: A. Metformin A patient with chronic asthma is being prescribed an inhaled corticosteroid. What is an important patient education point regarding the use of inhaled corticosteroids? A. Rinse the mouth with water after each use B. Use the inhaler only when experiencing acute symptoms C. Expect to see immediate results within minutes D. Increase the dose if symptoms do not improve within one day Answer: A. Rinse the mouth with water after each use A patient with a history of myocardial infarction is started on a beta-blocker. Which of the following is a contraindication for beta-blocker therapy? A. Asthma B. Diabetes mellitus C. Hypertension D. Hyperlipidemia Answer: A. Asthma Which of the following antibiotics is appropriate for treating a patient with a urinary tract infection caused by Escherichia coli? A. Amoxicillin B. Ciprofloxacin

C. Azithromycin D. Doxycycline Answer: B. Ciprofloxacin A patient with severe pain is prescribed morphine. What is a major concern when using opioid analgesics like morphine? A. Hypertension B. Respiratory depression C. Increased urination D. Hyperactivity Answer: B. Respiratory depression Which of the following medications is used as a first-line treatment for generalized anxiety disorder? A. Sertraline B. Methylphenidate C. Haloperidol D. Diazepam Answer: A. Sertraline A patient is prescribed warfarin for anticoagulation. What is a key aspect of patient education for those taking warfarin? A. Avoid all green leafy vegetables B. Routine blood monitoring is necessary C. Expect increased bruising and bleeding as normal D. Double the dose if a dose is missed Answer: B. Routine blood monitoring is necessary A patient taking simvastatin for hyperlipidemia complains of muscle pain. What should be the nurse practitioner's next step? A. Discontinue the medication immediately B. Advise the patient to increase exercise C. Recommend taking the medication with food D. Suggest taking the medication at bedtime Answer: A. Discontinue the medication immediately Which of the following is an appropriate use of a proton pump inhibitor (PPI)? A. Treatment of acute myocardial infarction B. Management of gastroesophageal reflux disease (GERD) C. Prophylaxis for bacterial infections D. Long-term use for indigestion without further evaluation

Answer: B. Management of gastroesophageal reflux disease (GERD) Nurse practitioner prescriptive authority is regulated by who? The State Board of Nursing for Each State What is the benefits of having an APRN prescriber? APRN's care for patients more holistically and include patients in making decisions regarding their care What does clinical judgement in prescribing include? Factoring in the cost of the particular What is included in the criteria for choosing and effective drug for a disorder? Consulting nationally recognized guidelines for disease management NP's thrive under the new health-care reform because of what? NP's have the ability to control care cost and improve patient outcome Nutritional intake and lab results reflect hypoalbuminemia; why is this important for prescribers? The Distribution of drugs to target tissues may be affected Drugs that have an significant first-pass effect what? they are rapidly metabolized by the liver and may have little if any desired action The route of excretion of a volatile drug will likely be? Lungs Medroxyprogesterone (Depo Provera) is prescribed IM to create storage reservoir of the drug. What are storage reserviors> Increased the length of time a drug is available and active Why is Cephalexin given every 8 hours? What knowledge of the drug does the NP know? Half Life

Azithromycin doing requires that the first day's doing be twice those of the other four day; This is considered a loading does. What is a loading dose? Rapidly actives drug levels in the therapeutic range The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the: Onset of action Phenytoin required that a trough level be drawn. When and why are peak and trough levels are done To determine if a d rug is in the therapeutic range Drugs that are receptor agonists may demonstrate what property? Concentrations will produce an adverse effect Factors that affect gastric drug absorption include Lipid solubility of the drug Drugs that are receptors antagonists, such as beta-blockers, may cause what? An exaggerated response if abrupt discontinues Drug administration via IV:

1. need to be lipid soluble in order to absorb easily
2. Begin distribution in the body immediately
3. Are easily absorbed if they are nonionized
4. May use pinocytosis to be absorbed Are easily absorbed if they are nonionized What is the combination effect when a medication is added to a regimen for a synergistic effect? Greater than the sum of the effects of each drug individually Which of the following statements about bioavailability is true?
5. Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained-release mechanisms.
6. brands of a drug have the same bioavailability.
7. Drugs that are administered more than once a day have greater bioavailability than drugs given once daily.
8. Combining an active drug with an inert substance does not affect bioavailability.

Bioavailability issues are especially important for drugs with narrow therapeutic Which of the following statements about the major distribution barriers (blood-brain or fetal-placental) is true?

1. Water soluble and ionized drugs cross these barriers rapidly.
2. The blood-brain barrier slows the entry of many drugs into and from brain cells.
3. The fetal-placental barrier protects the fetus from drugs taken by the mother.
4. Lipid-soluble drugs do not pass these barriers and are safe for pregnant women The blood-brain barrier slows the entry of many drugs into and from brain cells. What is the purpose of phase I and phase II of metabolism in the liver? Change drug molecules to a form that an excretory organ can excrete What happens to the metabolites after they are metabolized in the liver? the metabolite may or may not be more active than the parent drug and they are totally deactivated so they are excreted without and effect; it depends on the medication being given What causes the body to increased the excretion of a drug through the renal system Unbinding a nonvolatile drug from plasma proteins. What is "steady state"? When the amount of the drug in the body remains constant When two pain medications are given together to treat pain, what kind of drug-to- drug interaction occurs? Additive Actions taken to reduce drug—drug interaction problems include all of the following EXCEPT:
5. Reducing the dosage of one of the drugs
6. Scheduling their administration at different times
7. Prescribing a third drug to counteract the adverse reaction of the combination
8. Reducing the dosage of both drugs Prescribing a third drug to counteract the adverse reaction of the combination What reduces the inhibition properties of Phase 1 Oxidative reductive process of drug metabolism?

What is the period of time called that it takes for a drug too decreased by 50% in the body? Half Life Drug antagonism is best defined as an effect of a drug that:

1. Leads to major physiological and psychological dependence
2. Is modified by the concurrent administration of another drug
3. Cannot be metabolized before another dose is administered
4. Leads to a decreased physiological response when combined with another drug Is modified by the concurrent administration of another drug What happens when a drug antagonist is given regularly? Down regulated the number of specific receptors What should be included in the education fo those who are prescribed oral enteric coated tables To achieve best effect, take the tablet with at least 8 oz of fluids What is the main reason for not crushing a sustained-released. capsule? It can cause toxicity What medication in the follow is mostly absorbed in the intestines rather than the stomach?

1. Sodium bicarb
2. ascorbic acid
3. salicylic acid
4. glucose Sodium Bicarb Which of the following variables is a factor in drug absorption?
5. The smaller the surface area for absorption, the more rapidly the drug is absorbed.
6. A rich blood supply to the area of absorption leads to better absorption.
7. The less soluble the drug, the more easily it is absorbed.
8. Ionized drugs are easily absorbed across the cell membrane. A rich blood supply of the are of absorption leads to better absorption What is an advantage of prescribing a sublingual medication? Absorbed rapidly

Drugs that use CYP 3A4 isoenzymes for metabolism may? Induced and inhibit the metabolism of another drug When do drugs reach steady state? After four or give half lives Ppregulation or hyper sensitization may lead to An exaggerated response if the drug is withdrawn Why do prescribers often use liquid medications such as liquid ibuprofen for children? Children often able to swallow pills In deciding which of multiple drugs used to treat a condition, the NPO chooses Drug A because it:

1. Has serious side effects and it is being used for a life-threatening condition
2. Will be taken twice daily and will be taken at home
3. Is expensive, but covered by health insurance
4. Non of these are important in choosing a drug Will be taken twice daily and will be taken at home What is known about the differences between the pharmacokinetics of men and women. Percentage of fat differs between genders What is the first step of the prescribing process according to WHO? Diagnosis the problem Treatment goals in prescribing should: be patient-centered The therapeutic goals when prescribing include curative, palliative, and preventative When determining drug treatment, what should an NP always do? Individualize the drug choice for the specific patient

What should patient education include when prescribing a medication? Discussion on adverse effects of the medication Passive monitoring of drug effectiveness includes:

1. Therapeutic drug levels
2. Adding or subtracting medications from the treatment regimen
3. Ongoing provider visits
4. Instructing the patient to report if the drug is not effective Instructing the patient to report if the drug is not effective Pharmacokinetic factors that affect prescribing include Bioavailability What recommendations bu the Institute of Medicine were made to address the impact of pharmaceutical promotion Conflicts of interest and financial relationships should be disclosed by those providing education Under new U.S. FDA labeling, Pregnancy Categories will be: Changed to incorporate a pregnancy risk summary and clinical considerations on the drug label What does the US FDA Regulate? The official labeling of all prescriptions and over the counter drugs What is approval of the FDA required for? Medical devices, including artificial joints When is an investigational new drug filed with the FDA? Prior to human testing of any new drug entity Phase IV clinical trials in the US are also known as Postmarketing research trials Is off-label prescribing legal? yes if there is scientific evidence for the use

What does the US Drug Enforcement Administration Regulate? Registers manufacturers and prescribers of controlled substances Are drugs that are disgnedated Schedule II by the DEA refillable No. A new prescription needs to be written What are some precautions when prescribing a controlled substance? Using tamper-proof paper for all prescriptions written for controlled drugs. What are some strategies for prescribers to use to prevent the misuse of controlled prescriptions? Use a chemical dependency screening tool; fir limit-setting regarding controlled substances; and practicing saying no to deal with patients who are push overs What are some behaviors that predict addition to controlled substances Stealing and borrowing another patients drugs When are medications agreements/pain medication contracts recommended? Universally for all medications prescribed for chronic pain When and what do prescriptions needs to be written Medical devices, controlled drugs, and legend drugs Based on the patients below, who is at high risk for experiencing an adverse drug reaction?

1. 32-year old male
2. 22- year told female
3. 3 month old female 4)48 year old male 3 month old Why are infants and babies are a higher risk of adverse drug reactions? lack of safety and efficacy studies in pediatric populations Why are elderly at high risk of adverse drug reactions? Age-related decrease in renal function

The type of adverse drug reaction that is idiosyncratic when a drug is given in the usual therapeutic dose is type Type B Digoxin may cause a type A adverse drug reaction due to:

1. Idiosyncratic effects
2. Its narrow therapeutic index
3. Being a teratogen
4. Being a carcinogen Its narrow therapeutic index What type of reaction occurs after a medication is used? Type IV If neutropenia occurs after the use of a topical medication, what type of reaction is neutropenia characterized as Cytotoxic hypersensitivyt reaction What type of reaction is anaphylactic shock? Type 1 Reaction; Also known as an immediate hypersensitivity reaction What time of reaction is someone using a corticosteroid at risk for? Type C Why do immunomodulators such as azathioprine cause a delayed reaction (type D reaction) because they are carcinogens An example of a first-dose reaction that may occur includes:
5. Orthostatic hypotension that does not occur with repeated doses
6. Purple glove syndrome with phenytoin use
7. Hemolytic anemia from ceftriaxone use
8. Contact dermatitis from neomycin use Orthostatic hypotension that does not occur with repeated doses Drugs that are prone to cause adverse drug reactions include Insulins

US FDA MedWatch system is activated when: An adverse even or serious problem occurs with a medication that is not already identified on the label The Vaccine Adverse Events Reporting System is A voluntary reporting system that healthcare providers or consumers may use to report vaccine adverse events What is pharmacoeconomics? The analysis of the cost and consequences of any health-care related treatment or services The direct cost of drug therapy includes Pain and suffering due to inadequate drug therapy Indirect costs associated with drug therapy include? Loss of wages while undergoing drug therapy The intangible cost of drug therapy include? Inconvenience, pain, and suffering incurred with therapy What is it called when a pharmacoeconomic analysis takes place regarding two similar treatments for a disease? Cost-minimization analysis Cost-effectiveness analysis compares two or more treatments or programs that are: not necessarily therapeutically equivalent When the cost of a specific treatment or intervention are calculated and then compared with the dollar value of the benefit received it is referred to as Cost-benefit analysis What is a two-tiered prescription benefit plan? Higher co-pay for brand name drugs than for generic drugs When a provider proscribes a less expensive drug what does it increase and how?

Compliance & by decreasing the financial burden set on the patient When someone asks to explain what a coverage plan means, such as a Medicare plan, what should the NP do? Refer the patient to a Medicare Specialist at his insurance carrier to explain the benefits of his insurance Digoxin levels need to be monitored closely when the following medication is started:

1. Loratadine
2. Diphenhydramine
3. Ipratropium
4. Albuterol Albuterol Patients with pheochromocytoma should avoid what class of drug and why? Beta-2-Agonists as it causes hypertensive crisis What medications should be use cautiously with African American men with moderate persistent asthma? Salmeterol - It is an inhaled long-acting beta agonist; studies showed increase of respiratory and asthma related deaths in African Americans We have an expert-written solution to this problem! LTBA's received a black box warning due to? increased risk of asthma related deaths What is the bronchodilator of choice for those taking propranolol? Ipratropium Life-style management for those taking theophylline. self-monitoring of respiratory status w. peak flowmeter; stop smoking; voice environmental triggers for asthma What does Tiotropium bromide treat (Spiriva)? COPD the medication is an inhaled anticholinergic

How often should Beclomethasone be used for someone with asthma? Daily What are some side effects if montelukast (singular)? Aggression, anxiety, depression, and or suicidal thoughts Who can montelukast be prescribed for? a child with moderate persistent asthma Are there known drug reactions with Beclomethasone (QVAR) No What prescription of the following will someone with acute rhinitis benefit from?

1. Fluticasone
2. Cetirizine (Zyrtec)
3. OTC Cromolyn Nasap Spray (Nasalcrom)
4. Any of the Above? Any of the above What should be monitor for those who are taking diphenhydramine? Urinary retention Why are second generation antihistamines such as Claritin taking for seasonal allergies instead of first generation? They are less sedating then first generation antihistamines Who can be prescribed Sudafed? Anyone over the age of 4 years old In what populations should cough and cold medicines that contain sympathomimetic decongestion be used cautiously? Older adults, infects, and hypertensive patients What is the first line decongestant for someone who is hypertensive? Nasal Oxymetazoline What is the first line treatment for a 5 year old with a URI?

Fluids and symptomatic care What is an effective, cost effective treatment for impetigo form an insect bite? Bacitracin and Ploymixin B What are the instructions for applying a topical antibiotic or antiviral ointment? Was hands before and after the application of topical antimicrobials A patient with a known history of peptic ulcer disease presents with gastrointestinal bleeding. Which medication should be avoided in this patient? A. Ibuprofen B. Acetaminophen C. Omeprazole D. Ranitidine Answer: A. Ibuprofen A patient with atrial fibrillation is prescribed dabigatran. Which of the following is true regarding dabigatran? A. It requires routine INR monitoring B. It has a reversible agent available for bleeding C. It is taken once daily D. It is a vitamin K antagonist Answer: B. It has a reversible agent available for bleeding A 70-year-old male with benign prostatic hyperplasia (BPH) is prescribed tamsulosin. What is a common side effect associated with tamsulosin? A. Hypertension B. Orthostatic hypotension C. Bradycardia D. Dry cough Answer: B. Orthostatic hypotension A patient with chronic heart failure is prescribed spironolactone. Which electrolyte imbalance is most commonly associated with spironolactone? A. Hypokalemia B. Hyperkalemia C. Hyponatremia D. Hypernatremia Answer: B. Hyperkalemia

A patient presents with a fungal infection and is prescribed fluconazole. Which of the following statements is correct regarding fluconazole? A. It is a broad-spectrum antibiotic B. It requires renal dose adjustment C. It is used to treat viral infections D. It is contraindicated in liver disease Answer: B. It requires renal dose adjustment A patient with rheumatoid arthritis is started on methotrexate. What is an important consideration for patients taking methotrexate? A. It should be taken with a high-fat meal B. Regular liver function tests are necessary C. It is safe during pregnancy D. Increase sun exposure while taking the medication Answer: B. Regular liver function tests are necessary A patient with hyperthyroidism is prescribed propylthiouracil (PTU). Which of the following is a potential adverse effect of PTU? A. Hypoglycemia B. Agranulocytosis C. Hypertension D. Weight gain Answer: B. Agranulocytosis A patient with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium. What is the mechanism of action of tiotropium? A. Beta-2 adrenergic agonist B. Leukotriene receptor antagonist C. Anticholinergic agent D. Corticosteroid Answer: C. Anticholinergic agent A patient is started on lisinopril for hypertension. What is a common side effect of ACE inhibitors like lisinopril? A. Dry cough B. Weight gain C. Diarrhea D. Insomnia Answer: A. Dry cough A patient with a history of deep vein thrombosis (DVT) is on warfarin therapy. What dietary advice should be provided to this patient?

A. Avoid grapefruit juice B. Maintain a consistent intake of vitamin K C. Increase the intake of green leafy vegetables D. Avoid all dairy products Answer: B. Maintain a consistent intake of vitamin K A 55-year-old patient is prescribed atorvastatin for hypercholesterolemia. Which of the following should be monitored periodically while on atorvastatin therapy? A. Serum potassium levels B. Liver function tests C. Blood glucose levels D. Thyroid function tests Answer: B. Liver function tests A patient with a new diagnosis of depression is started on fluoxetine. Which class of medications does fluoxetine belong to? A. Tricyclic antidepressants (TCAs) B. Selective serotonin reuptake inhibitors (SSRIs) C. Monoamine oxidase inhibitors (MAOIs) D. Benzodiazepines Answer: B. Selective serotonin reuptake inhibitors (SSRIs) A patient with chronic kidney disease (CKD) is prescribed erythropoietin. What is the primary indication for erythropoietin in CKD patients? A. To reduce proteinuria B. To manage hyperkalemia C. To treat anemia D. To control hypertension Answer: C. To treat anemia A patient is prescribed amlodipine for hypertension. What is a common adverse effect of amlodipine? A. Peripheral edema B. Cough C. Bradycardia D. Hyperkalemia Answer: A. Peripheral edema A patient with osteoporosis is prescribed alendronate. How should alendronate be taken to ensure proper absorption and reduce the risk of esophageal irritation? A. With a high-calcium meal B. At bedtime with a glass of milk

C. First thing in the morning with a full glass of water D. With an antacid to reduce stomach upset Answer: C. First thing in the morning with a full glass of water A patient with newly diagnosed Parkinson's disease is prescribed carbidopa- levodopa. What is the primary purpose of carbidopa in this combination? A. To reduce peripheral metabolism of levodopa B. To act as a dopamine agonist C. To increase the half-life of levodopa D. To prevent dopamine reuptake Answer: A. To reduce peripheral metabolism of levodopa A patient is prescribed clopidogrel after a recent myocardial infarction. What is the primary mechanism of action of clopidogrel? A. Inhibition of platelet aggregation B. Reduction of myocardial oxygen demand C. Decrease in blood pressure D. Vasodilation of coronary arteries Answer: A. Inhibition of platelet aggregation A patient with a history of bipolar disorder is prescribed lithium. Which of the following is a critical aspect of monitoring for patients on lithium therapy? A. Thyroid function tests B. Complete blood count C. Renal function tests D. Liver function tests Answer: C. Renal function tests A patient with type 1 diabetes mellitus is using insulin lispro. When should insulin lispro be administered in relation to meals? A. 30 minutes before meals B. 1 hour before meals C. Immediately after meals D. Immediately before meals Answer: D. Immediately before meals A patient with chronic migraines is prescribed topiramate. What is a common side effect of topiramate that the patient should be aware of? A. Weight gain B. Cognitive impairment C. Hypertension D. Constipation

Answer: B. Cognitive impairment A patient with hyperlipidemia is prescribed gemfibrozil. What is the primary effect of gemfibrozil on lipid levels? A. Reduction in LDL cholesterol B. Increase in HDL cholesterol C. Reduction in triglycerides D. Increase in total cholesterol Answer: C. Reduction in triglycerides A patient with generalized tonic-clonic seizures is prescribed phenytoin. What is a common adverse effect associated with phenytoin? A. Gingival hyperplasia B. Weight loss C. Hyperkalemia D. Alopecia Answer: A. Gingival hyperplasia A patient with chronic hepatitis C is started on ledipasvir-sofosbuvir. What is the primary goal of this antiviral therapy? A. To cure the hepatitis C infection B. To alleviate symptoms of hepatitis C C. To prevent the progression to hepatitis B D. To suppress viral replication temporarily Answer: A. To cure the hepatitis C infection A patient is prescribed digoxin for heart failure. What is an important sign of digoxin toxicity that patients should be educated about? A. Hypertension B. Visual disturbances C. Increased appetite D. Constipation Answer: B. Visual disturbances A patient with osteoarthritis is started on celecoxib. What is a major advantage of celecoxib compared to traditional nonsteroidal anti-inflammatory drugs (NSAIDs)? A. It has a longer half-life B. It is less likely to cause gastrointestinal ulcers C. It does not require renal dose adjustment D. It is more effective for acute pain Answer: B. It is less likely to cause gastrointestinal ulcers

A patient with severe psoriasis is prescribed methotrexate. Which of the following laboratory tests should be monitored regularly in this patient? A. Serum creatinine B. Complete blood count C. Lipid profile D. Blood glucose Answer: B. Complete blood count A patient with schizophrenia is prescribed risperidone. Which of the following is a potential adverse effect of risperidone that should be monitored? A. Hyperprolactinemia B. Hypotension C. Diarrhea D. Weight loss Answer: A. Hyperprolactinemia A patient with a recent kidney transplant is on cyclosporine. What is a common adverse effect of cyclosporine that requires monitoring? A. Hyperglycemia B. Hypotension C. Nephrotoxicity D. Hypokalemia Answer: C. Nephrotoxicity A patient with severe allergic rhinitis is prescribed fluticasone nasal spray. What is the primary mechanism of action of fluticasone in treating allergic rhinitis? A. Antihistamine effect B. Leukotriene inhibition C. Corticosteroid effect D. Mast cell stabilization Answer: C. Corticosteroid effect A patient with gout is started on allopurinol. What is the primary therapeutic action of allopurinol? A. Increasing renal excretion of uric acid B. Decreasing uric acid production C. Reducing inflammation D. Inhibiting the formation of uric acid crystals Answer: B. Decreasing uric acid production

A patient with a history of chronic kidney disease is prescribed losartan for hypertension. What is the primary advantage of losartan over ACE inhibitors in this patient population? A. Reduced risk of hyperkalemia B. Lower incidence of cough C. Greater reduction in blood pressure D. Improved kidney function Answer: B. Lower incidence of cough A patient with depression is prescribed bupropion. Which of the following is a unique characteristic of bupropion compared to other antidepressants? A. Increased risk of weight gain B. High potential for sexual side effects C. Risk of seizure at high doses D. Significant sedative effect Answer: C. Risk of seizure at high doses A patient with acute pain is prescribed ketorolac. For how many days is ketorolac typically prescribed due to its risk profile? A. 3 days B. 5 days C. 7 days D. 10 days Answer: B. 5 days A patient is prescribed sildenafil for erectile dysfunction. Which of the following is an important contraindication to the use of sildenafil? A. Use of nitrates B. History of hypertension C. History of depression D. Use of beta-blockers Answer: A. Use of nitrates A patient with a history of epilepsy is prescribed valproic acid. Which of the following laboratory tests should be monitored regularly in this patient? A. Liver function tests B. Thyroid function tests C. Renal function tests D. Complete blood count Answer: A. Liver function tests

A patient with hyperthyroidism is started on methimazole. Which of the following adverse effects should the patient be monitored for? A. Agranulocytosis B. Hypoglycemia C. Hypertension D. Weight gain Answer: A. Agranulocytosis A patient with a history of deep vein thrombosis (DVT) is prescribed rivaroxaban. Which of the following is an advantage of rivaroxaban over warfarin? A. No dietary restrictions B. Lower cost C. Requires frequent INR monitoring D. Longer half-life Answer: A. No dietary restrictions A patient with chronic heart failure is started on sacubitril/valsartan. What is the primary mechanism of action of this combination? A. Beta-blockade and ACE inhibition B. Angiotensin receptor blockade and neprilysin inhibition C. Diuretic and vasodilator effect D. Calcium channel blockade and ACE inhibition Answer: B. Angiotensin receptor blockade and neprilysin inhibition A patient with asthma is prescribed montelukast. What is the primary therapeutic action of montelukast? A. Bronchodilation B. Anti-inflammatory effect C. Inhibition of leukotriene receptors D. Mast cell stabilization Answer: C. Inhibition of leukotriene receptors A patient with rheumatoid arthritis is prescribed etanercept. Which of the following is an important consideration regarding etanercept therapy? A. It is taken orally once daily B. It requires regular monitoring for tuberculosis C. It is a first-line therapy for mild RA D. It does not affect the immune system Answer: B. It requires regular monitoring for tuberculosis

A patient with hypertension and diabetes mellitus is started on an SGLT2 inhibitor. Which of the following is a known benefit of SGLT2 inhibitors in this patient population? A. Reduction in blood glucose levels B. Increase in renal function C. Reduction in blood pressure D. Weight gain Answer: A. Reduction in blood glucose levels A patient with atrial fibrillation is prescribed amiodarone. What is a critical adverse effect of amiodarone that requires monitoring? A. Pulmonary toxicity B. Hypotension C. Hyperglycemia D. Renal dysfunction Answer: A. Pulmonary toxicity A patient with osteoporosis is started on denosumab. How is denosumab administered? A. Oral tablet daily B. Intravenous infusion monthly C. Subcutaneous injection every six months D. Intramuscular injection weekly Answer: C. Subcutaneous injection every six months A patient with hypertension is prescribed hydrochlorothiazide. What is a common side effect of hydrochlorothiazide that should be monitored? A. Hyperkalemia B. Hypokalemia C. Hyponatremia D. Hypercalcemia Answer: B. Hypokalemia A patient with type 2 diabetes is started on exenatide. Which of the following is a common side effect of exenatide? A. Weight gain B. Nausea C. Hyperglycemia D. Constipation Answer: B. Nausea

A patient with chronic pain is prescribed gabapentin. What is the primary mechanism of action of gabapentin in treating neuropathic pain? A. Inhibition of voltage-gated calcium channels B. Blockade of NMDA receptors C. Inhibition of serotonin reuptake D. Activation of opioid receptors Answer: A. Inhibition of voltage-gated calcium channels A patient with schizophrenia is prescribed clozapine. Which of the following is a serious adverse effect of clozapine that requires regular monitoring? A. Agranulocytosis B. Hypertension C. Weight loss D. Renal failure Answer: A. Agranulocytosis