CPJE Clinical Exam Questions &
Answers (Grade A+)
Paul is a patient in the step-down unit. A basal metabolic panel is
taken and Paul is found to have a sodium level of 132 mEq/L. His
medications include levothyroxine, losartan, fluticasone,
chlorthalidone, Lamictal, Trileptal and Celexa. Which of the
patient's medications could be contributing to the low serum
sodium level? -
correct answer ✅Chlorthalidone, trileptal and celexa.
Patients taking either carbamazepine, oxcarbazepine, SSRIs or SNRIs
and thiazide diuretics should have sodium checked, especially if
symptoms of hyponatremia are present. Hypothyroidism can cause
hyponatremia, but not levothyroxine. The most likely cause of low
sodium levels is fluid loss.
Maureen is a 45 year-old female who takes the following
medications: clopidogrel 75 mg once daily, aspirin EC 81 mg once
daily, Toprol XL 50 mg once daily and Nitrostat 0.4 mg 1 tablet SL
PRN. Maureen has a long history of schizoaffective disorder. She is
not currently taking any medication for this condition. Which of the
following options represents the safest choice in this patient? -
correct answer ✅Seroquel because in this patient, it is best to
avoid drugs with higher QT prolongation risk due to the presence of
co-existing coronary artery disease.
,CPJE Clinical Exam Questions &
Answers (Grade A+)
Which of the following antifungal agents is limited to one dose
intravenous (followed by oral dosing) with reduced renal function
due to the accumulation of a renally-cleared component in the IV
formulation? -
correct answer ✅Voriconazole, CrCl cutoff is 50 ml/min
Manuel has been discharged on linezolid 600 mg twice daily, to be
taken at home for 6 weeks. He should be counseled on the risk of
this adverse effect, which can occur with long-term use of linezolid:
-
correct answer ✅Myelosuppression and neuropathy
A 19 year-old female patient has begun therapy with Atripla. This
medication contains tenofovir. Which of the following statements
concerning tenofovir is correct? -
correct answer ✅Tenofovir can damage the kidneys and it requires
a reduced dosage with renal insufficiency. It can cause Fanconi
syndrome, weaken bone, and can damage kidneys; it is necessary
to monitor renal function when using this drug.
Manuel is admitted to the orthopedic unit with an infected toe. The
toe is amputated. The surgeon reports that he is not sure how far
up the bone the infection has spread. He suggests that the patient
be discharged on six weeks of antibiotic therapy. He has been
, CPJE Clinical Exam Questions &
Answers (Grade A+)
receiving linezolid 600 mg twice daily, given by intravenous
administration. Which of the following statements are correct?
I. The patient can be discharged on the same oral dose as he has
been using in an intravenous formulation.
II. The patient is using linezolid long-term and this will put him at
risk for a low platelet count.
III. Linezolid has good gram positive and good gram negative
coverage, with some coverage of anaerobes.
IV. The primary side effects the may experience are headache and
diarrhea. -
correct answer ✅I, II & IV
A 44 year-old female presented to the Emergency Department with
oliguria x 4 days. She was admitted and diagnosed with a Staph
aureus bacteremia. She was initially treated with vancomycin,
which was changed to daptomycin (Cubicin) after four days due to a
lack of clinical progress. Which of the following statements
concerning daptomycin are correct?
Answers (Grade A+)
Paul is a patient in the step-down unit. A basal metabolic panel is
taken and Paul is found to have a sodium level of 132 mEq/L. His
medications include levothyroxine, losartan, fluticasone,
chlorthalidone, Lamictal, Trileptal and Celexa. Which of the
patient's medications could be contributing to the low serum
sodium level? -
correct answer ✅Chlorthalidone, trileptal and celexa.
Patients taking either carbamazepine, oxcarbazepine, SSRIs or SNRIs
and thiazide diuretics should have sodium checked, especially if
symptoms of hyponatremia are present. Hypothyroidism can cause
hyponatremia, but not levothyroxine. The most likely cause of low
sodium levels is fluid loss.
Maureen is a 45 year-old female who takes the following
medications: clopidogrel 75 mg once daily, aspirin EC 81 mg once
daily, Toprol XL 50 mg once daily and Nitrostat 0.4 mg 1 tablet SL
PRN. Maureen has a long history of schizoaffective disorder. She is
not currently taking any medication for this condition. Which of the
following options represents the safest choice in this patient? -
correct answer ✅Seroquel because in this patient, it is best to
avoid drugs with higher QT prolongation risk due to the presence of
co-existing coronary artery disease.
,CPJE Clinical Exam Questions &
Answers (Grade A+)
Which of the following antifungal agents is limited to one dose
intravenous (followed by oral dosing) with reduced renal function
due to the accumulation of a renally-cleared component in the IV
formulation? -
correct answer ✅Voriconazole, CrCl cutoff is 50 ml/min
Manuel has been discharged on linezolid 600 mg twice daily, to be
taken at home for 6 weeks. He should be counseled on the risk of
this adverse effect, which can occur with long-term use of linezolid:
-
correct answer ✅Myelosuppression and neuropathy
A 19 year-old female patient has begun therapy with Atripla. This
medication contains tenofovir. Which of the following statements
concerning tenofovir is correct? -
correct answer ✅Tenofovir can damage the kidneys and it requires
a reduced dosage with renal insufficiency. It can cause Fanconi
syndrome, weaken bone, and can damage kidneys; it is necessary
to monitor renal function when using this drug.
Manuel is admitted to the orthopedic unit with an infected toe. The
toe is amputated. The surgeon reports that he is not sure how far
up the bone the infection has spread. He suggests that the patient
be discharged on six weeks of antibiotic therapy. He has been
, CPJE Clinical Exam Questions &
Answers (Grade A+)
receiving linezolid 600 mg twice daily, given by intravenous
administration. Which of the following statements are correct?
I. The patient can be discharged on the same oral dose as he has
been using in an intravenous formulation.
II. The patient is using linezolid long-term and this will put him at
risk for a low platelet count.
III. Linezolid has good gram positive and good gram negative
coverage, with some coverage of anaerobes.
IV. The primary side effects the may experience are headache and
diarrhea. -
correct answer ✅I, II & IV
A 44 year-old female presented to the Emergency Department with
oliguria x 4 days. She was admitted and diagnosed with a Staph
aureus bacteremia. She was initially treated with vancomycin,
which was changed to daptomycin (Cubicin) after four days due to a
lack of clinical progress. Which of the following statements
concerning daptomycin are correct?
