NABP NAPLEX Exam - Topic 1 Question 106 Discussion

Actual exam question for NABP's NAPLEX exam

Question #: 106
Topic #: 1

LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.

His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4 mg iv q6h prn for N/V, Levothyroxine 0.075 mg po daily, Lisinopril 10 mg po daily, Citalopram 20 mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20 mg iv q12hr, Metoclopramide 10 mg iv q6h, Metformin 500 mg po bid, D51/2NS with 20K at 125 mls/hour and Hydromorphone PCA at 0.2 mg/hour of basal rate, demand dose 0.1 mg. lock- out every 6min, one hour limit 2.2 mg/hour. Pertinent morning labs includes serum creatinine 1.4 mg/dl, Mg 1.5 mg/dl, K 5.0 mmol/L, Na 135 mmol/L.

Which of the following medication may increase LN's potassium?

AOndansetron

BMetoclopramide

CMetformin

DLisinopril

EHydromorphone

Show Suggested Answer

Suggested Answer: D

Lisinopril may increase LN's potassium. One of the warnings/precautions of lisinopril is hyperkalemia. ACE inhibitors block the formation of circulating angiotensin II, which can lead to a decrease in aldosterone secretion that can result in an increase in potassium. Risk factors for hyperkalemia while taking lisinopril include renal impairment, diabetes, and concomitant use of potassium-sparing diuretics, potassium

supplements and/or potassium containing salts. Potassium should be monitored closely when taking any of the other agents listed. Hyperkalemia is not listed in the warnings/precautions section for the other medications.

by Joye at Jun 16, 2025, 04:19 AM

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Lawrence

4 months ago

Wait, really? I didn't know Lisinopril did that!

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Kirby

4 months ago

I thought Metformin could too, but not really.

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Alica

4 months ago

Totally agree, it's a common side effect!

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Burma

4 months ago

Ondansetron is safe for potassium, right?

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Anissa

4 months ago

Lisinopril can increase potassium levels.

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Joseph

5 months ago

Ondansetron and Metoclopramide are antiemetics, but I don't recall them affecting potassium. I guess I should lean towards Lisinopril.

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Roxane

5 months ago

I practiced a similar question about potassium levels and medications. I think Lisinopril was mentioned in that one too.

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Staci

5 months ago

I'm not entirely sure, but I feel like Metformin doesn't really affect potassium. I might be mixing it up with something else.

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Shanda

5 months ago

I remember that Lisinopril is an ACE inhibitor, and it can increase potassium levels. I think that might be the answer.

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Christiane

5 months ago

I feel pretty confident about this one. Lisinopril is an ACE inhibitor, and those are known to increase potassium levels, so that's my answer.

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Breana

6 months ago

I'm a little unsure about this one. There are a lot of different medications here, and I want to make sure I don't overlook something. I'll double-check my work before submitting my answer.

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Fabiola

6 months ago

Okay, I think I've got this. Based on the patient's medication list, the drug that is most likely to increase potassium is Lisinopril, which is an ACE inhibitor.

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Ressie

6 months ago

Hmm, this is a lot of information to take in. I'm going to need to carefully read through the details to make sure I don't miss anything important.

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Samira

6 months ago

This looks like a pretty straightforward medication question. I'll start by reviewing the patient's medication list and looking for any drugs that are known to affect potassium levels.

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Antonio

8 months ago

I'm just gonna guess D) Lisinopril. Seems like the obvious choice, unless the answer is actually 'all of the above'!

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Sharee

9 months ago

This patient has a lot going on! I bet the answer is D) Lisinopril. Gotta keep an eye on those ACE inhibitors.

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Judy

7 months ago

It's important to monitor LN's potassium levels while he's on Lisinopril.

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Ashton

7 months ago

Yeah, ACE inhibitors like Lisinopril can cause hyperkalemia.

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Jovita

8 months ago

I agree, D) Lisinopril can definitely increase potassium levels.

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Tamala

9 months ago

Hold up, is this a trick question? I'm gonna go with E) Hydromorphone. Opioids can mess with electrolyte balance, right?

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Aracelis

7 months ago

Yeah, opioids like Hydromorphone can definitely affect electrolyte balance.

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Rutha

8 months ago

I think you're right, E) Hydromorphone can increase potassium levels.

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Catalina

9 months ago

I'm going with C) Metformin. Isn't that known to cause hyperkalemia in some cases?

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Olive

7 months ago

Yes, you're correct. Metformin can indeed increase potassium levels in some patients.

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Marjory

7 months ago

I'm going with C) Metformin. Isn't that known to cause hyperkalemia in some cases?

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Terrilyn

8 months ago

E) Hydromorphone

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Lisbeth

8 months ago

D) Lisinopril

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Hayley

8 months ago

C) Metformin

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Dorethea

8 months ago

B) Metoclopramide

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Lezlie

8 months ago

A) Ondansetron

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Izetta

9 months ago

Definitely D) Lisinopril. That's an important medication to watch out for in patients with kidney issues.

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Aimee

9 months ago

Yes, Lisinopril is known to cause hyperkalemia in patients with kidney problems.

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Joni

9 months ago

It's important to monitor LN's labs closely while on Lisinopril.

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Alpha

9 months ago

I agree, Lisinopril can definitely increase potassium levels.

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Lettie

9 months ago

But what about Metformin? I heard it can also increase potassium levels.

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Brandon

10 months ago

I agree with Timothy, ACE inhibitors like Lisinopril can cause hyperkalemia.

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Timothy

10 months ago

I think Lisinopril may increase LN's potassium because it's an ACE inhibitor.

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Noelia

10 months ago

Hmm, this is a tricky one. I think the answer is D) Lisinopril, since it's an ACE inhibitor and can increase potassium levels.

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Rory

9 months ago

User 2

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Loreta

9 months ago

User 1

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