Sudden withdrawal of beta blockers may precipitate: 

A 60-year-old woman with diabetes and hyperlipidemia has been on rosuvastatin 40 mg for 8 months. She presents to clinic with severe muscle pain, weakness, and dark urine. Exam shows diffuse muscle tenderness. Which statin-associated adverse effect mandates immediate discontinuation of therapy? 

A 71-year-old man with HFrEF presents with nausea, yellow-green visual halos, and new-onset ventricular ectopy. He has been compliant with his digoxin therapy and recently had his furosemide dose increased for volume overload. Labs: K⁺ = 2.8 mEq/L, Cr = 1.0 mg/dL. Which factor most likely precipitated his digoxin toxicity? 

A 54-year-old African American with HTN and no CKD/DM is starting therapy. According to guidelines, which is most appropriate? 

A patient with moderate Alzheimer’s is prescribed memantine. Its mechanism is: 

A 52-year-old man with severe alcohol use disorder is interested in medication-assisted treatment after completing inpatient detoxification. He has normal renal function. He expresses strong motivation to remain abstinent but admits that cravings are high when he is around friends who drink. He wants “something that will stop me from drinking if I slip.” Which pharmacologic agent is most appropriate for this treatment goal? 

A 74-year-old man with ischemic cardiomyopathy and chronic atrial fibrillation presents to clinic with complaints of fatigue, anorexia, and intermittent visual blurring. He takes digoxin, furosemide, lisinopril, and warfarin. Exam: HR 48 bpm, irregular; BP 102/60 mmHg. Labs: K⁺ = 2.7 mEq/L, Cr = 1.0 mg/dL. Which medication combination most likely precipitated this presentation? 

Physical dependence is best defined as: 

A term neonate is admitted to the NICU with suspected sepsis and is started on IV gentamicin. The NP notes that the dosing interval is significantly longer than in adults. Which physiologic difference in neonates best explains this adjustment? 

A 72-year-old woman with insomnia is prescribed zolpidem. She reports improvement in sleep but experiences morning drowsiness and an episode of sleepwalking. What should the NP do next?