Discuss NABP NAPLEX Exam Topic 4 Question 83

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

AHis past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain.
Post-op day 1, LN's medication includes Dexamethasone 8 mg 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 10 mg suppository daily prn for constipation, Famotidine 20 mg iv q12hr, Metoclopramide 10 mg iv q6h, Metformin 500 mg po bid, D51/2NS with 20 K at 125 mls/hour and Hydromorphone PCA at 0.2 mg/hour of basal rate, demand dose 0.1 mg. lock-out every 6 min, 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 cause tardive dyskinesia when given at a higher dose and for a long duration?

ALisinopril

BDexamethasone

CFamotidine

DMetoclopramide

EHydromorphone

Suggested Answer: C

Serum chloride levels should ideally fall between 96-106 mEq/L. For this reason, the patient's chloride level has come back as normal.

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34 comments · newest first

Sabra 10 months ago

Surprised to see Metoclopramide on this list!

Lai 11 months ago

Wait, really? I thought it was just for nausea.

Lou 11 months ago

Lisinopril? No way, that's not it.

Dylan 11 months ago

Totally agree, it's known for that side effect.

Mirta 11 months ago

I think Metoclopramide is the one that can cause tardive dyskinesia.

Ollie 12 months ago

I’m leaning towards Metoclopramide as the answer, but I wish I had reviewed the side effects more thoroughly. It’s tricky when you have multiple medications involved.

Loreen 12 months ago

I’m a bit confused about the options. I know Dexamethasone is a steroid and doesn’t typically cause tardive dyskinesia, but I can’t remember if Famotidine has any related risks.

Carmen 12 months ago

I think Metoclopramide can cause tardive dyskinesia if used for a long time, especially at higher doses. I feel like I saw a practice question about that recently.

Erasmo 1 year ago

I remember studying about tardive dyskinesia and how it’s often associated with long-term use of certain antipsychotics, but I’m not sure if Metoclopramide falls into that category.

Alpha 1 year ago

This is a good opportunity to apply my knowledge of medication side effects. I'll carefully consider each option and eliminate the ones that don't fit the criteria.

Royal 1 year ago

I'm a bit confused by all the details in the question. I'll need to read through it a few times to make sure I understand the key information needed to answer this.

Chana 1 year ago

Okay, I think I've got this. Metoclopramide is known to cause tardive dyskinesia, especially with prolonged use. I'm going to go with that as my answer.

Micheal 1 year ago

Hmm, there are a lot of medications listed here. I'll need to carefully review each one and their potential side effects to determine which one fits the criteria.

Annalee 1 year ago

This looks like a pretty straightforward medication question. I'll focus on identifying the drug that can cause tardive dyskinesia when given at higher doses and for longer durations.

Jody 1 year ago

I'm a bit unsure about this one. Option C seems to suggest starting on the testnet, which could work, but I'm not sure if that's the best approach. I think I'll go with option B to be on the safe side.

Charlena 1 year ago

I'm not totally sure about this one. I know Calm has a lot of different features, and it's not always easy to remember which one does what. I'll make an educated guess, but I'm not 100% certain.

Coral 1 year ago

Wait, is this a trick question? I'm gonna go with the wild card, D. Metoclopramide. No one expects the anti-nausea meds to be the ones spiking the blood sugar!

Laila 1 year ago

Oof, this patient is on a whole cocktail of meds. I'm gonna have to go with the classic culprit, B. Dexamethasone. Can't go wrong with the steroid!

Doretha 1 year ago

↳ replying to Laila

User1: It's important to monitor LN closely for any changes in his glucose levels while on Dexamethasone.

Malika 1 year ago

↳ replying to Laila

User2: Yeah, that steroid can definitely cause some spikes in blood sugar.

Alysa 1 year ago

↳ replying to Laila

User1: I agree, Dexamethasone is known to increase blood glucose levels.

Nelida 1 year ago

Haha, this question is a real head-scratcher. You know what they say, 'When in doubt, choose the corticosteroid!' B. Dexamethasone is my pick.

Jacqueline 1 year ago

Oh, man, this is a tough one. I'm gonna go with C. Famotidine. It can't be Lisinopril, right? That's an antihypertensive, not a blood sugar raiser.

Tiffiny 1 year ago

↳ replying to Jacqueline

You could be right. Let's wait for more input before making a final decision.

Elenora 1 year ago

↳ replying to Jacqueline

I see your point, but I still think it's C. Famotidine. It's always good to consider all possibilities.

Alva 1 year ago

↳ replying to Jacqueline

I'm not sure about that. I'm leaning towards E. Hydromorphone. Pain medications can sometimes affect blood glucose.

Jill 1 year ago

↳ replying to Jacqueline

I think it might be B. Dexamethasone. Steroids can definitely raise blood sugar levels.

Apolonia 1 year ago

Hmm, I think the answer is B. Dexamethasone is a corticosteroid, and it's well known to raise blood glucose levels. Gotta watch out for those side effects!

Dahlia 1 year ago

↳ replying to Apolonia

Yes, B. Dexamethasone is a corticosteroid that can raise blood glucose levels.

Dierdre 1 year ago

↳ replying to Apolonia

I think you're right, B. Dexamethasone is known for causing hyperglycemia.

Luis 1 year ago

↳ replying to Apolonia

I agree with you, B. Dexamethasone can definitely increase blood glucose levels.

Edgar 2 years ago

I'm not sure, but I think Dexamethasone is a steroid which can cause hyperglycemia.

Shawana 2 years ago

I agree with Brock, Dexamethasone can increase LN's blood glucose levels.

Brock 2 years ago

I think the answer is B) Dexamethasone.

NABP NAPLEX Exam - Topic 4 Question 83 Discussion