NABP NAPLEX Exam - Topic 4 Question 83 Discussion

Actual exam question for NABP's NAPLEX exam

Question #: 83
Topic #: 4

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

Show Suggested Answer

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.

by Teddy at May 29, 2024, 08:55 AM

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Sabra

3 months ago

Surprised to see Metoclopramide on this list!

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Lai

3 months ago

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

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Lou

3 months ago

Lisinopril? No way, that's not it.

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Dylan

4 months ago

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

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Mirta

4 months ago

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

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Ollie

4 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.

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Loreen

4 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.

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Carmen

4 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.

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Erasmo

5 months 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.

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Alpha

5 months 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.

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Royal

5 months 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.

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Chana

5 months 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.

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Micheal

5 months 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.

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Annalee

5 months 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.

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Jody

5 months 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.

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Charlena

5 months 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.

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Coral

9 months 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!

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Laila

9 months 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!

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Doretha

8 months ago

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

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Malika

8 months ago

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

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Alysa

9 months ago

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

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Nelida

9 months 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.

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Jacqueline

9 months 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.

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Tiffiny

8 months ago

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

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Elenora

8 months ago

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

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Alva

8 months ago

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

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Jill

9 months ago

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

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Apolonia

9 months 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!

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