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100 Cards in this Set
- Front
- Back
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Esther has NYHA functional class III systolic heart failure. The cardiologist is considering beginning Inspra, in addition to her other medications. He checks her lab values and finds the following: Na+ 151 mEq/L, K+ 5.6 mEq/L, Cl 99 mEq/L, C02 mEq/L 20, BUN 39 mg/dL and serum creatinine 1.8 mg/dL. Can Inspra be initiated? Answer AYes, once she is classified as NYHA IV. BYes, once she has trouble breathing without exertion. CNo, Inspra is contraindicated. DYes, but it will require sodium monitoring. EYes, but it will require potassium monitoring. |
CNo, Inspra is contraindicated |
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A patient with heart failure comes to the community pharmacy asking for help choosing a medicine to treat her mild pain. Which agent is the safest over-the-counter oral analgesic to treat mild pain in this patient? Answer AAcetaminophen BNaproxen CIbuprofen DHydrocortisone ointment EFlector patch |
AAcetaminophen |
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Albert has been prescribed Lasix. He should be counseled regarding the following side effects from the use of this drug: (Select ALL that apply.) Answer AHypercalcemia BHypokalemia CPhotosensitivity DOrthostatic hypotension EHypouricemia |
BHypokalemia CPhotosensitivity DOrthostatic hypotension |
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A patient gave the pharmacist a prescription for BiDil 20 mg TID. Which of the following is an appropriate generic substitution for BiDil? Answer AIsosorbide dinitrate/hydralazine BSpironolactone CIsosorbide mononitrate/hydralazine DDigoxin ETriamterene/Hydrochlorothiazide |
AIsosorbide dinitrate/hydralazine |
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A patient gave the pharmacist a prescription for Lasix 20 mg daily in the morning. Which of the following is an appropriate generic substitution for Lasix? Answer AEthacrynic acid BTorsemide CBumetanide DNesiritide EFurosemide |
EFurosemide |
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A patient with heart failure has been given a prescription for BiDil. He has been using ramipril, metoprolol, furosemide and potassium extended-release for heart failure, ferrous sulfate for anemia, methotrexate for rheumatoid arthritis, a multivitamin complex, sildenafil for erectile dysfunction and coenzyme Q 10. Which of the following statements is correct? Answer ADo not fill the new prescription; the physician must be contacted. BBiDil must be separated from the dosing of the ferrous sulfate and the multivitamin complex. CBiDil is contraindicated in patients with rheumatoid arthritis. DThe patient is at heightened risk for rhabdomyolysis. EThe drugs prescribed are fine to use together if taken as-directed.
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ADo not fill the new prescription; the physician must be contacted. |
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The most effective diuretics for controlling fluid volume in patients with heart failure are: Answer ACarbonic anhydrase inhibitors BThiazide-type diuretics CLoop diuretics DPotassium-sparing diuretics EOsmotic diuretics
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CLoop diuretics |
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Esther has NYHA functional class III systolic heart failure. She needs to use an additional drug to lower her blood pressure. She is currently taking Altace and hydrochlorothiazide. Which of the following medications should be added for her blood pressure? Answer ADiltiazem BMonopril CCarvedilol DAmlodipine ECandesartan
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CCarvedilol |
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A patient with New York Heart Association (NYHA) functional class III heart failure is diagnosed with diabetes. She is started on metformin but has diarrhea and discontinues the drug. The physician must choose an alternative agent for treatment of her diabetes. Which of the following diabetes medications is contraindicated in this patient? Answer AAmaryl BGlucotrol XL CInvokana DActos EJanuvia |
DActos |
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Max is hospitalized with a MRSA infection and is receiving vancomycin. This antibiotic carries a risk of ototoxicity. The physician is trying to adjust his other medications and asks the pharmacist which loop diuretic has the highest risk of ototoxicity. Which of the loop diuretics has the highest risk for ototoxicity? Answer ALasix BBumex CDemadex DEdecrin EAll loops have equal risk of ototoxicity
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DEdecrin |
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Frank has been diagnosed with heart failure and was told to begin Toprol XL 12.5 mg daily. The pharmacist dispensed a 25 mg tablet with instructions to the patient to cut at the score line. Which of the following statements are true regardingToprol XL? (Select ALL that apply.) Answer AThis is an extended-release formulation and cannot be cut. BThis medication can be taken without regard to food. CThe dose is likely to be titrated every 2 weeks, if tolerated. DThis medication should be stored in the refrigerator. EToprol XL can be cut at the score line; they should use a tablet cutter.
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BThis medication can be taken without regard to food. CThe dose is likely to be titrated every 2 weeks, if tolerated.
EToprol XL can be cut at the score line; they should use a tablet cutter. |
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Hamid has been prescribed Lasix. The following may occur from the use of this drug: (Select ALL that apply.) Answer AIncreased magnesium BIncreased blood glucose CIncreased potassium DIncreased chloride EIncreased triglycerides
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BIncreased blood glucose
EIncreased triglycerides |
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Karl has been diagnosed with heart failure and is beginning carvedilol immediate-release. Karl is 5 feet, 7 inches and weighs 78 kg. Assuming he tolerates the dose titrations, what is the maximum dose of carvedilol immediate-release that Karl may be given? Answer A12.5 mg BID B25 mg BID C50 mg BID D75 mg BID E100 mg BID
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B25 mg BID |
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Jamal has systolic heart failure with an ejection fraction of 33%. He gets short of breath while reaching down to tie his shoes and getting dressed. Which of the following ACC/AHA stages and NYHA functional class for heart failure best describe this patient? Answer AACC/AHA Stage A BACC/AHA Stage B, NYHA Class I CACC/AHA Stage C, NYHA Class II DACC/AHA Stage C, NYHA Class III EACC/AHA Stage D, NYHA Class IV |
DACC/AHA Stage C, NYHA Class III |
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Which of the following are common causes of heart failure? (Select ALL that apply.) Answer ABipolar disease BStroke CMyocardial Infarction DHypertension EUse of levothyroxine therapy |
CMyocardial Infarction DHypertension |
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Which of the following potassium chloride formulations can be opened and sprinkled on food? Answer AMicro-K BKlor-Con CKlor-Con M10 DK-tab EKlor-Con M15 |
AMicro-K |
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GT is a systolic heart failure patient on carvedilol 12.5 mg twice daily. To improve medication adherence, the primary physician wants to convert him to the once daily Coreg CR. What is the equivalent daily dose of Coreg CR for GT? Answer A10 mg B20 mg C40 mg D80 mg E160 mg |
C40 mg |
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Choose the correct mechanism of action for carvedilol: Answer ABeta-1 and beta-2 blocker and dopamine blocker BBeta-1 and beta-2 blocker and norepinephrine reuptake inhibitor CBeta-1 and beta-2 blocker and alpha-1 blocker DBeta-2 and alpha-2 selective blocker EBeta-1 and alpha-1 selective blocker |
CBeta-1 and beta-2 blocker and alpha-1 blocker |
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Select the correct generic name for Demadex: Answer ADolasetron BTorsemide CDexamethasone DMeperidine EDocetaxel |
BTorsemide |
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A patient gave the pharmacist a prescription for Aldactone 25 mg daily. Which of the following is an appropriate generic substitution for Aldactone? Answer ATraimterene/Hydrochlorothiazide BSpironolactone CEplerenone DAlendronate EAlfuzosin |
BSpironolactone |
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An elderly patient with NYHA functional class IV heart failure is using 120 mg of furosemide twice daily. He takes his furosemide at 8 am and 12 noon. He has several conditions and takes a lot of pills. The prescriber requests that you calculate the dose of bumetanide that would be equivalent to the patient’s furosemide therapy. Choose the correct equivalent bumetanide dose: Answer ABumetanide 2 mg daily BBumetanide 4 mg daily CBumetanide 6 mg daily DBumetanide 8 mg daily EBumetanide 10 mg daily |
CBumetanide 6 mg daily |
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Select the correct mechanism of action for Zestril: Answer ABinds to the Na+/K+ ATPase pump and decreases its action BAldosterone receptor antagonist CBlocks the conversion of angiotensin I to angiotensin II DBlocks angiotensin II by binding directly to the AT1 receptor EBinds to beta-adrenergic receptors and blocks epinephrine and norepinephrine |
CBlocks the conversion of angiotensin I to angiotensin II |
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A patient with systolic heart failure and atrial fibrillation uses lisinopril, carvedilol, spironolactone, amiodarone, furosemide, clopidogrel, digoxin, cholestyramine and potassium. Which drug is likely to lower the digoxin level via a gut binding interaction? Answer AAmiodarone BClopidogrel CLisinopril DCarvedilol ECholestyramine
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ECholestyramine |
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Which of the following agents is associated with a risk of cyanide toxicity? Answer ANitrogylcerin BNitroprusside CNesiritide DEplerenone EEnalaprilat |
BNitroprusside |
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John went to see a cardiologist at his doctor’s request. John does not understand why he should see a heart doctor. He has no heart failure symptoms or signs that the doctor has noticed, but his primary care physician wants a specialist to look at his heart. His past medical history is significant for high cholesterol, hypertension and type 2 diabetes. Which of the following ACC/AHA categories for heart failure best describe this patient? Answer AACC/AHA Stage A BACC/AHA Stage B CACC/AHA Stage C DACC/AHA Stage D EJohn does not match any of ACC/AHA staging categories |
AACC/AHA Stage A |
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A patient with systolic heart failure has been given a prescription for BiDil. Which of the following side effects is most common with BiDil therapy? Answer ARash BHeadache CHair growth DSore, painful joints EIncreased appetite |
BHeadache |
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Select the correct generic name for Natrecor: Answer ANitroprusside BNebivolol CEplerenone DNaloxone ENesiritide |
ENesiritide |
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Which of the following statements are correct regarding the monitoring of potassium levels in heart failure patients? (SelectALL that apply.) Answer APotassium should be monitored at baseline BPotassium should be monitored quarterly CPotassium should be monitored a few days after the initiation of an ACE inhibitor, ARB, aldosterone antagonist or diuretic DPotassium should be monitored a few days after the up titration of an ACE inhibitor, ARB, aldosterone antagonist or diuretic EPotassium should be monitored when a patient's renal function changes |
APotassium should be monitored at baseline
CPotassium should be monitored a few days after the initiation of an ACE inhibitor, ARB, aldosterone antagonist or diuretic DPotassium should be monitored a few days after the up titration of an ACE inhibitor, ARB, aldosterone antagonist or diuretic EPotassium should be monitored when a patient's renal function changes |
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Which of the following beta-adrenergic blocking agents has been shown to reduce mortality in patients with systolic heart failure? Answer ACarvedilol BMetoprolol tartrate CAtenolol DPropranolol ELabetalol |
ACarvedilol |
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A 71 year-old male patient with heart failure was receiving standard therapy, however, he remained symptomatic. He has an appointment with the cardiologist in six weeks. To try and help him out, his primary care physician initiated digoxin 0.25 mg once daily and increased his carvedilol dose from 3.125 mg BID to 6.25 mg BID. Recent lab work includes an ALT 78 units/L, BUN 40 mg/dL, SCr 2.1 mg/dL, and K+ 4.5 mEq/L. The patient took the new medications for a couple of weeks and began to notice nausea and a reduced appetite. He felt confused and disoriented. He went back to the physician for help. What is the likely cause of the patient's symptoms? Answer ADigoxin toxicity BThe increased carvedilol dose CLiver failure DDecompensated heart failure EThe potassium level |
ADigoxin toxicity |
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Frank has been diagnosed with heart failure and is beginning metoprolol extended-release. The pharmacist should provide the following counseling points: (Select ALL that apply.) Answer AIf you miss a dose, take your dose as soon as you remember, unless it is time to take your next dose. Do not double the dose. BDo not drive a car, use machinery, or do anything that requires you to be alert until you adjust to the medication and the symptoms subside. CThis medication may make your feel more tired and dizzy at first. These effects will go away in a few days. However, call your doctor if the symptoms feel severe or you have weight gain or increased shortness of breath. DThis medication must be taken with food. EThis medication should not be stopped abruptly. |
AIf you miss a dose, take your dose as soon as you remember, unless it is time to take your next dose. Do not double the dose. BDo not drive a car, use machinery, or do anything that requires you to be alert until you adjust to the medication and the symptoms subside. CThis medication may make your feel more tired and dizzy at first. These effects will go away in a few days. However, call your doctor if the symptoms feel severe or you have weight gain or increased shortness of breath.
EThis medication should not be stopped abruptly. |
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A patient gave the pharmacist a prescription for Edecrin 25 mg daily. Which of the following is an appropriate generic substitution for Edecrin? Answer AEthacrynic acid BTorsemide CBumetanide DNesiritide EFurosemide |
AEthacrynic acid |
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A heart failure patient is receiving furosemide 80 mg intravenously twice daily for the treatment of acute pulmonary edema. After two days, the patient is negative 5 liters of urine output. The patient is noted to have an increasing serum bicarbonate concentration of 36 mEq/L. Which of the following agents can be prescribed to prevent development of a metabolic alkalosis? Answer AHydrochlorothiazide BTriamterene CAcetazolamide DMannitol EMetolazone |
CAcetazolamide |
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Select the correct mechanism of action for Diovan: Answer ABinds to the Na+/K+ ATPase pump and decreases its action BAldosterone receptor antagonist CBinds to beta-adrenergic receptors and blocks epinephrine and norepinephrine DBlocks angiotensin II by binding directly to the AT1 receptor EBlocks the conversion of angiotensin I to angiotensin II |
DBlocks angiotensin II by binding directly to the AT1 receptor |
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A patient with systolic heart failure and paroxysmal atrial fibrillation is prescribed lisinopril, carvedilol, spironolactone, amiodarone, furosemide, clopidogrel, digoxin, cholestyramine and potassium. The patient forgot to refill his potassium tablets. His potassium level decreased to 2.1 mEq/L. Hypokalemia could potentiate which of the following in this patient? (Select ALL that apply.) Answer ACholestyramine toxicity BIncreased risk of recurrent atrial fibrillation CBleeding DDigoxin toxicity EDiarrhea |
BIncreased risk of recurrent atrial fibrillation
DDigoxin toxicity |
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Select the correct mechanism of action for metoprolol: Answer ABinds to the Na+/K+ ATPase pump and decreases its action BAldosterone receptor antagonist CBinds to beta-adrenergic receptors and blocks epinephrine and norepinephrine DBlocks angiotensin II by binding directly to the AT1 receptor EBlocks the conversion of angiotensin I to angiotensin II |
CBinds to beta-adrenergic receptors and blocks epinephrine and norepinephrine |
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Which of the following antiarrhythmics should be avoided in patients with systolic heart failure? (Select ALL that apply.) Answer AFlecainide BMexiletine CPropafenone DProcainamide EQuinidine |
AFlecainide BMexiletine CPropafenone DProcainamide EQuinidine |
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Select the correct mechanism of action for Aldactone: Answer ABinds to beta-adrenergic receptors and blocks epinephrine and norepinephrine BBlocks angiotensin II by binding directly to the AT1 receptor CBlocks the conversion of angiotensin I to angiotensin II DBinds to the Na+/K+ ATPase pump and decreases its action EAldosterone receptor antagonist
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EAldosterone receptor antagonist |
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A patient has NYHA functional class II heart failure. All patients with heart failure should follow these recommendations: (Select ALL that apply.) Answer AExercise 30 minutes/day, 3-5 days/week as tolerated. BDo not use NSAIDs or COX-2 inhibitors without the doctor's authorization. CMonitor body weight daily, in the morning before eating and after using the restroom. Weight should be documented. DGet a hepatitis vaccine and annual flu shot. EFluid restriction of < 2 L/day is recommended. |
AExercise 30 minutes/day, 3-5 days/week as tolerated. BDo not use NSAIDs or COX-2 inhibitors without the doctor's authorization. CMonitor body weight daily, in the morning before eating and after using the restroom. Weight should be documented. |
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A patient with New York Heart Association (NYHA) functional class III heart failure is diagnosed with rheumatoid arthritis (RA). The physician must choose an agent to treat the RA. Which of the following medications would be most appropriate in this patient? Answer ACertolizumab BInfliximab CMethotrexate DEtanercept ERituximab |
CMethotrexate |
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Which of the following chemotherapeutic agents have lifetime maximum doses due to risk of cardiotoxicity? Answer AAnthracyclines, such as doxorubicin and daunorubicin BVinca alkaloids, such as vincristine and vinblastine CAntimetabolites, such as fluorouracil DTaxanes, such as paclitaxel ETopoisomerase inhibitors, such as irinotecan
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AAnthracyclines, such as doxorubicin and daunorubicin |
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A patient gave the pharmacist a prescription for Inspra 25 mg daily. Which of the following is the generic name for Inspra? Answer AIsosorbide Dinitrate/Hydralazine BSpironolactone CEplerenone DNesiritide EFurosemide |
CEplerenone |
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A patient with systolic heart failure on digoxin has developed an upper respiratory tract infection. He has been prescribed clarithromycin. Choose the correct statement: Answer AThe digoxin level will decrease; it is best not to use a P450 3A4 enzyme inducer such as clarithromycin. BThe digoxin level will increase; it is best not to use a P-glycoprotein and 3A4 inhibitor such as clarithromycin. CDigoxin levels are not affected by hepatic inducers or inhibitors. DClarithromycin will bind to digoxin in the gut and reduce absorption. EDigoxin will cause the clarithromycin level to increase. |
BThe digoxin level will increase; it is best not to use a P-glycoprotein and 3A4 inhibitor such as clarithromycin. |
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Which of the following statements is correct regarding digoxin? Answer ADigoxin is a positive inotrope and a negative chronotrope. BDigoxin is a positive inotrope and a positive chronotrope. CDigoxin is a negative inotrope and a negative chronotrope. DDigoxin is a negative inotrope and a positive chronotrope. EDigoxin has no effects on these hemodynamic parameters. |
ADigoxin is a positive inotrope and a negative chronotrope. |
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A patient is using furosemide 20 mg QHS and has a reported potassium level of 2.8 mEq/L. The patient reports she has to get up at night more often to use the bathroom. Which of the following statements are correct? (Select ALL that apply.) Answer ALoop diuretics should be taken in the morning (or, if divided, the second dose is taken at noon or early afternoon). BPotassium supplementation is often required when loop diuretics are taken. CThe potassium level is within normal range. DThe dose of furosemide is too high for a patient with heart failure. EThe patient should have her serum magnesium level checked.
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ALoop diuretics should be taken in the morning (or, if divided, the second dose is taken at noon or early afternoon). BPotassium supplementation is often required when loop diuretics are taken.
EThe patient should have her serum magnesium level checked. |
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Select the correct indication for BiDil: Answer AFor the treatment of heart failure as initial therapy in self-identified black patients. BFor the treatment of heart failure as an adjunct to standard therapy in self-identified black patients. CFor the treatment of hypertension as an adjunct to standard therapy in self-identified black patients. DFor the treatment of hypertension as initial therapy in self-identified black patients. EFor the treatment of benign prostatic hyperplasia in self-identified black patients. |
BFor the treatment of heart failure as an adjunct to standard therapy in self-identified black patients. |
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JY has a past medical history significant for systolic heart failure and hypertension. He is being seen in clinic for routine follow up. He is on lisinopril 20 mg daily, Toprol XL 200 mg daily, furosemide 20 mg twice daily, and spironolactone 25 mg daily. His blood pressure has been averaging 154/94 mmHg and his heart rate is averaging 65 beats/minute. Which of the following agents would be best to add to provide better control of his blood pressure? Answer AAmlodipine BDiltiazem CLosartan DEplerenone ECarvedilol
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AAmlodipine |
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A patient has been using digoxin 0.125 mg daily for several years. During this time the renal function has declined from an estimated 55 mL/min to 24 mL/min. The patient is unable to stand and has vomited. The heart rate is taken and found to be 45 BPM and the heart rhythm is unstable. The cardiologist is paged, but in the meantime the attending physician asks if there are any products that can lower the digoxin level quickly. What is the antidote for digoxin toxicity? Answer APhenytek BFabior CDigiFab DLanoxin EFerriprox |
CDigiFab |
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A patient presents to the hospital with increasing shortness of breath, fatigue, and lower extremity edema. The patient is diagnosed with acute decompensated heart failure. His blood pressure is 105/60 mmHg and his heart rate is 80 beats/minute. His serum creatinine is 1.4 mg/dL. In addition to furosemide, which of the following intravenous vasodilators are appropriate for this patient? (Select ALL that apply.) Answer ANitrogylcerin BNesiritide CMilrinone DDopamine EPhenylephrine |
ANitrogylcerin BNesiritide |
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A 45 year-old female patient has gone to see her primary care physician. The doctor is looking at her blood work, which includes the following parameters: total cholesterol 202 mg/dL, HDL 52 mg/dL, LDL 130 mg/dL, TG 96 mg/dL, BUN 18 mg/dL, SCr 0.8 mg/dL, hCG+, with a blood pressure of 148/88 mmHg. Which of the following medications can be safely administered? Answer AHydrochlorothiazide BLipitor CZestril DAtenolol ETekturna
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AHydrochlorothiazide |
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A patient gave the pharmacist a prescription for Norvasc 10 mg daily #90. Which of the following is an appropriate generic substitution for Norvasc? Answer AAmlodipine BLisinopril CNicardipine DCarvedilol EDiltiazem
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AAmlodipine |
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A patient gave the pharmacist a prescription for Catapres 0.1 mg 1 tablet BID #60. Which of the following is an appropriate generic substitution for Catapres? Answer AMinoxidil BHydralazine CDoxazosin DClonidine EClonazepam |
DClonidine |
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Thomas, a 48 year old white male, is being treated at your clinic for hypertension. Today his BP is 147/93. His PMH is significant for GERD, diabetes and gout. Thomas is currently taking Janumet XR, Motrin, Prinzide and Zantac. Which of the following medications would be appropriate to add for better BP control according to JNC 8? (Select ALL that apply.) Answer ACozaar BAltace CAdalat CC DNorvasc EHydrochlorothiazide |
CAdalat CC DNorvasc |
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In 2012, a contraindication was added to the labeling of aliskiren. This contraindication warns not to use aliskiren in combination with ACE inhibitors or ARBs in patients with: Answer ADiabetes BHepatitis CRaynaud's syndrome DMyocardial infarction EStroke |
ADiabetes |
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A patient is using chlorthalidone 25 mg daily and has a reported potassium level of 4.6 mEq/L. Which of the following statements is correct? Answer AThe patient needs an agent to lower her potassium level. BChlorthalidone works by blocking Na+ reabsorption in the distal convoluted tubules. CSupplementation with prescription oral potassium is often required when thiazide diuretics are taken. DThis is not an effective dose of chlorthalidone to lower BP. EChlorthalidone has been shown to be less effective than other thiazide-type diuretics.
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BChlorthalidone works by blocking Na+ reabsorption in the distal convoluted tubules. |
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A patient is prescribed Inspra. What is the labeled indications for Inspra? (Select ALL that apply.) Answer AHypertension BHeart failure CAsthma DCOPD EPAH |
AHypertension BHeart failure |
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A patient gave the pharmacist a prescription for Cardizem CD 120 mg 1 PO daily #30. Which of the following is an appropriate generic substitution for Cardizem CD? Answer AAmlodipine extended-release capsule BCarteolol extended-release capsule CVerapamil extended-release capsule DCarvedilol extended-release capsule EDiltiazem extended-release capsule
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EDiltiazem extended-release capsule |
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A hospitalized patient was given sodium polystyrene sulfonate this morning. The pharmacist is reviewing her medications. Which of the following medications most likely should be discontinued in this patient? Answer AMetoprolol BClopidogrel COlmesartan DClonidine EPiperacillin-Tazobactam
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COlmesartan |
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Jack is a white male patient who presents with high blood pressure on several visits. He works in construction. According to the JNC 8 guidelines, which class of medications are appropriate at initial therapy for Jack? (Select ALL that apply.) Answer ABeta-blockers BACE Inhibitors CAngiotensin Receptor Blockers DCalcium channel blockers EThiazide-type diuretics
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BACE Inhibitors CAngiotensin Receptor Blockers DCalcium channel blockers EThiazide-type diuretics |
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Jackie presents to her doctor's office with hypertension. She is prescribed Lotrel. This medication contains: Answer ABenazepril and amlodipine BOlmesartan and amlodipine CValsartan and aliskiren DValsartan and amlodipine EIrbesartan and hydrochlorothiazide |
ABenazepril and amlodipine |
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Paula lives in Florida. She has been started on hydrochlorothiazide 25 mg daily. Which of the following statements are correct? (Select ALL that apply.) Answer AShe should use protective clothing and sunscreen while in the sun. BShe has an increased risk for low bone density; calcium and vitamin D intake should be optimized. CShe has an increased risk for hyperkalemia. DShe has an increased risk for an allergic-type reaction. EAlthough she is not an at increased risk, this medication can cause dizziness, rash, and rarely hypochloremic alkalosis. |
AShe should use protective clothing and sunscreen while in the sun.
EAlthough she is not an at increased risk, this medication can cause dizziness, rash, and rarely hypochloremic alkalosis. |
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A patient gave the pharmacist a prescription for clonidine tablets for initial treatment of hypertension. The patient's other medications include polyethylene glycol, fluoxetine and olanzapine (for treatment-resistant depression) and modafinil. The pharmacist should contact the physician to offer the following correct recommendations: (Select ALL that apply.) Answer AClonidine will worsen constipation. BClonidine could worsen depression. CClonidine could worsen fatigue. DThere is a major drug interaction between clonidine and polyethylene glycol. EClonidine can increase the risk of serotonergic syndrome. |
AClonidine will worsen constipation. BClonidine could worsen depression. CClonidine could worsen fatigue. |
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A patient gave the pharmacist a prescription for Altace 10 mg PO daily. Which of the following is an appropriate generic substitution for Altace? Answer AMinoxidil BRamipril CTriamterene DSpironolactone EMoexipril |
BRamipril |
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A patient gave the pharmacist a prescription for Tenormin 50 mg daily #30. Which of the following is an appropriate generic substitution for Tenormin? Answer AAmiloride BEplerenone CAtenolol DTerazosin ENisoldipine |
CAtenolol |
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Which beta-blocker also confers alpha-1 receptor antagonistic activity? Answer AAtenolol BPropranolol CLabetolol DNebivolol EEsmolol |
CLabetolol |
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Which of the following statements are true regarding enalapril? (Select ALL that apply.) Answer AEnalapril can retain potassium; potassium levels must be monitored. BEnalapril is an angiotensin-converting enzyme inhibitor. CEnalapril comes in an oral formulation only. DEnalapril can cause a dry, hacking cough. EEnalapril has been shown to be beneficial in heart failure and renal protection in diabetes. |
AEnalapril can retain potassium; potassium levels must be monitored. BEnalapril is an angiotensin-converting enzyme inhibitor.
DEnalapril can cause a dry, hacking cough. EEnalapril has been shown to be beneficial in heart failure and renal protection in diabetes. |
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Charles presents to the emergency room after a motor vehicle accident. He is found to have a blood pressure of 192/112 mmHg. He has no acute organ damage and is diagnosed as having hypertensive urgency. Which of the following medications would not be an appropriate option to treat this condition: Answer ACaptopril BNifedipine sublingual CClonidine DLabetalol ELosartan |
BNifedipine sublingual |
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Charles presents to the emergency room after a motor vehicle accident. He is found to have a blood pressure of 192/112 mmHg. He has no acute organ damage and is diagnosed as having hypertensive urgency. Which of the following medications would not be an appropriate option to treat this condition: Answer ACaptopril BNifedipine sublingual CClonidine DLabetalol ELosartan |
look up |
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A patient is using furosemide 20 mg QHS and has a reported potassium level of 2.9 mEq/L. Which of the following statements are correct regarding furosemide therapy? (Select ALL that apply.) Answer AThis medication can cause ototoxicity. BThis medication is safe in patients with a severe sulfa allergy. CFurosemide should be taken in the morning, not at bedtime. DPotassium supplementation is often required when loop diuretics are taken. EThe patient should be told to restrict calcium intake. |
AThis medication can cause ototoxicity.
CFurosemide should be taken in the morning, not at bedtime. DPotassium supplementation is often required when loop diuretics are taken. |
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A patient gave the pharmacist a prescription for Lopressor 50 mg BID #60. Which of the following is an appropriate generic substitution for Lopressor? Answer AMetoprolol BBumetanide CTriamterene DClonidine EOlmesartan |
AMetoprolol |
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A patient gave the pharmacist a prescription for Zestril 5 mg daily #30. Which of the following is an appropriate generic substitution for Zestril? Answer AQuinapril BLisinopril CBenazepril DFosinopril EMoexipril |
BLisinopril |
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A patient gave the pharmacist a prescription for Benicar 20 mg by mouth daily #30. Which of the following is an appropriate generic substitution for Benicar? Answer AOlmesartan BTelmisartan CIrbesartan DEprosartan ECandesartan |
AOlmesartan |
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What is the mechanism of action of clonidine? Answer AActs as an alpha-1 agonist, resulting in a decrease in norepinephrine release BActs as an alpha-1 antagonist, resulting in an increase in norepinephrine release CActs as an alpha-2 agonist, resulting in a decrease in norepinephrine release DActs as an alpha-2 antagonist, resulting in a decrease in norepinephrine release EActs as an alpha-1 and alpha-2 antagonist, resulting in an increase in norepinephrine release |
CActs as an alpha-2 agonist, resulting in a decrease in norepinephrine release |
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A patient has been started on hydrochlorothiazide 25 mg daily. Which of the following statements are correct? (Select ALLthat apply.) Answer APotassium can decrease BCalcium can decrease CUric acid can increase DSodium can increase EMagnesium can decrease |
APotassium can decrease
CUric acid can increase
EMagnesium can decrease |
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Roger has just been diagnosed with hypertension. His past medical history is significant for BPH and bilateral renal artery stenosis. Which of the following medications should not be used for treatment of his hypertension? Answer ACalcium channel blockers BAngiotensin receptor blockers CDirect renin inhibitors DAngiotensin converting enzyme inhibitors EBeta-blockers |
BAngiotensin receptor blockers CDirect renin inhibitors DAngiotensin converting enzyme inhibitors |
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A patient gave the pharmacist a prescription for Avapro 150 mg by mouth daily #30. Which of the following is an appropriate generic substitution for Avapro? Answer AAmlodipine BIrbesartan CVerapamil DValsartan ECandesartan |
BIrbesartan |
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Which of the following agents is a beta-1 and beta-2 adrenergic antagonist that readily penetrates the CNS blood-brain barrier? Answer AMetoprolol BAtenolol CPropranolol DLisinopril EAmlodipine
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CPropranolol |
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A patient gave the pharmacist a prescription for Dyazide 37.5-25 mg 1 tablet daily #30. Which of the following is an appropriate generic substitution for Dyazide? Answer ASpironolactone and hydrochlorothiazide BAmiloride and hydrochlorothiazide CTriamterene and hydrochlorothiazide DIndapamide and hydrochlorothiazide EAzilsartan and chlorthalidone
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CTriamterene and hydrochlorothiazide |
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Jamal is a black male patient who presents with high blood pressure on several visits. He works as an attorney. According to the JNC 8 guidelines, which class of medications is appropriate at initial therapy for Jamal? (Select ALL that apply.) Answer ABeta-blockers BACE Inhibitors CAngiotensin Receptor Blockers DCalcium channel blockers EThiazide-type diuretics |
DCalcium channel blockers EThiazide-type diuretics |
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A 55 year-old male patient with hypertension was started on lisinopril. He developed severe swelling of his mouth, with trouble breathing. Choose the correct statement: Answer AThe patient should be switched to Vasotec therapy. BThe patient should be switched to Atacand therapy. CThe patient should be switched to Lotrel therapy. DThe patient should be switched to Exforge therapy. ENone of the above. |
ENone of the above. |
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A patient gave the pharmacist a prescription for Diovan 80 mg by mouth daily #30. Which of the following is an appropriate generic substitution for Diovan? Answer ACandesartan BIrbesartan COlmesartan DValsartan ELosartan |
DValsartan |
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A patient gave the pharmacist a prescription for Cozaar she needed filled. Her other medication is Yaz contraceptive pills. The pharmacy is in a supermarket and the pharmacist notices the patient has Morton Salt Balance in her shopping cart, which contains potassium chloride. Which of the following are correct counseling statements for this patient? (Select ALLthat apply.) Answer AYour new medication is safe in pregnancy. BYaz can increase potassium. CYour new medication can cause a dry, hacking cough. DYour new medication, and the salt substitute, can increase your potassium. EYour new medication can decrease the effectiveness of Yaz. |
BYaz can increase potassium.
DYour new medication, and the salt substitute, can increase your potassium. |
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Frank comes to the clinic for a follow up visit for his hypertension and diabetes management. He has been taking four medications to control his blood pressure for a long time. Today, the pharmacist notices a butterfly rash across Frank's nose and upper cheeks. Which of the following medications is most likely to cause this side effect? Answer AHydrochlorothiazide BEnalapril CHydralazine DEplerenone EVerapamil
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CHydralazine |
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A patient gave the pharmacist a prescription for Exforge. Which of the following is the generic of Exforge? Answer AAmlodipine and benazepril BAmlodipine and valsartan CAmlodipine, valsartan and hydrochlorothiazide DAmlodipine and olmesartan EAliskiren and amlodipine
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BAmlodipine and valsartan |
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A patient gave the pharmacist a prescription for Cozaar 50 mg by mouth daily #30. Which of the following is an appropriate generic substitution for Cozaar? Answer AOlmesartan BValsartan CIrbesartan DLosartan ECandesartan
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DLosartan |
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Loop diuretics, such as furosemide, work on this part of the nephron: Answer AThe proximal, convoluted tubule BThe distal, convoluted tubule CThe descending limb of the Loop of Henle DThe ascending limb of the Loop of Henle EThe afferent and efferent arterioles |
DThe ascending limb of the Loop of Henle |
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A patient has high blood pressure, but a slow heart rate. The patient occasionally suffers from orthostatic hypotension and syncope. The physician is concerned and does not wish to use a blood pressure medication which can lower heart rate. Choose an agent that does not significantly lower heart rate: Answer ANadolol BAmlodipine CDiltiazem DVerapamil EAtenolol |
BAmlodipine |
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Choose the correct statements concerning Cleviprex: (Select ALL that apply.) Answer AIt comes in a milky white emulsion. BIt is contraindicated in a soy or egg allergy. CIt is an intravenous non-dihydropyridine calcium channel blocker. DThe medication needs to be discarded after 4 hours of use. EThe tubing for Cleviprex should be changed every 12 hours. |
AIt comes in a milky white emulsion. BIt is contraindicated in a soy or egg allergy.
EThe tubing for Cleviprex should be changed every 12 hours. |
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A patient gave the pharmacist a prescription for Catapres TTS-1 #4. Choose the correct counseling statements for this medication. (Select ALL that apply.) Answer ATake this medication by mouth four times daily. BThis medication can be disposed of in the trash container with a lid. CReplace the patch every morning. DRotate the site where you place the patch. EThis is the highest dose available of this medication.
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BThis medication can be disposed of in the trash container with a lid.
DRotate the site where you place the patch. |
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Alex, a 68 year old white male, is being treated at your clinic for hypertension. Today his BP is 147/93. His PMH is significant for GERD, diabetes and gout. Alex is currently taking Janumet XR, Motrin, Hyzaar and Zantac. Which of the following medications would be appropriate to add for better BP control according to JNC 8? Answer AHydrochlorothiazide BProcardia XL CCardura DCoreg EAlex does not need additional BP lowering.
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BProcardia XL |
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A patient gave the pharmacist a prescription for Accupril 40 mg PO daily. Which of the following is an appropriate generic substitution for Accupril? Answer AFosinopril BRamipril CTriamterene DClonidine EQuinapril
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EQuinapril |
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A 30 year-old female has hypertension and asthma. She is already using hydrochlorothiazide 25 mg daily, but her blood pressure remains elevated at a range of 142-154/84-92 mmHg. She will be started on beta blocker therapy. Which of the following agents is most appropriate? Answer ACarteolol BCarvedilol CPropranolol DMetoprolol ETimolol
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DMetoprolol |
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Which of the following antihypertensives should not be taken with grapefruit or grapefruit juice? (Select ALL that apply.) Answer ALopressor BCardizem LA CCoreg DCalan SR EDilt-XR |
BCardizem LA
DCalan SR EDilt-XR |
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Jerry has hypertension that is difficult to control. He uses chlorthalidone, lisinopril, magnesium, amlodipine and clonidine daily. With this regimen, his blood pressure stays within the range of 122-144/84-98 mmHg. His heart rate averages 60 beats per minute (BPM). Jerry ran out of one of these medications last week. His blood pressure increased to 192/110 mmHg, with a heart rate of 90 BPM. Which of Jerry's medications would most likely cause this acute rise in blood pressure if suddenly discontinued? Answer AChlorthalidone BLisinopril CAmlodipine DClonidine EMagnesium
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DClonidine |
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What is the mechanism of action of Diovan? Answer AAngiotensin-converting enzyme inhibitor BBeta1-selective adrenergic antagonist CAngiotensin receptor blocker DCalcium channel blocker EAlpha 2-receptor agonist |
CAngiotensin receptor blocker |
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A patient with diabetes, hypertension, and peptic ulcer disease is on aspirin, glyburide, enalapril, metoprolol, chlorthalidone, and famotidine. Which of the patient's medications may block signs and symptoms of hypoglycemia? Answer AEnalapril BMetoprolol CAspirin DChlorthalidone EFamotidine |
BMetoprolol |
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Choose the correct statement regarding carvedilol to carvedilol CR dosing: Answer ACarvedilol 25 mg BID is equivalent to Coreg CR 40 mg daily. BCarvedilol 6.25 mg BID is equivalent to Coreg CR 20 mg daily. CCarvedilol 12.5 mg BID is equivalent to Coreg CR 30 mg daily. DCarvedilol 3.125 mg BID is equivalent to Coreg CR 5 mg daily. ENone of the above. |
BCarvedilol 6.25 mg BID is equivalent to Coreg CR 20 mg daily. |
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Jackson has systolic heart failure with an ejection fraction of 33%. Which of the following medications could potentially worsen his heart failure condition? Answer AAmlodipine BVerapamil CRamipril DLabetalol ECandesartan |
BVerapamil |
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A patient gave the pharmacist a prescription for Atacand 8 mg 1 tablet by mouth daily #30. Which of the following is an appropriate generic substitution for Atacand? Answer AValsartan BCandasartan CIrbesartan DPerindopril ELabetalol |
BCandasartan |
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A 62 year-old female patient comes to the clinic for follow-up evaluation of her osteoporosis. Her BP last vist was 158/92 mmHg and 154/95 mmHg this visit. According to the JNC 8 guidelines, what is this patient's goal BP given she has no other medical conditions? Answer A< 140/90 mmHg B< 120/80 mmHg C< 150/90 mmHg D< 140/80 mmHg E< 150/80 mmHg
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C< 150/90 mmHg |
