Pharmacy PEBC Practice Exam

PB is a 70 year old female who is on the final day of a 10-day course of cotrimoxazole DS, i po bid for mild pyelonephritis. PB’s medical conditions include hypertension and osteoarthritis, for which she takes enalapril 5 mg po bid and acetaminophen 650 mg po qid. PB has been feeling unwell for the past two days, complaining of abdominal pain, diarrhea, and muscle weakness. She presents to the emergency department, where it is discovered that her serum potassium level is 5.9 mmol/L (normal: 3.5-5.0 mmol/L) and her estimated creatinine clearance is 70 mL/min. PB’s hyperkalemia puts her at risk for developing which of the following?

1. Arrhythmias

2. Renal failure

3. Rhabdomyolysis

4. Metabolic alkalosis

The correct answer is: Arrhythmias

PB's current medication regimen includes enalapril, which is known to increase potassium levels in the body. Therefore, option A is the correct answer as PB's hyperkalemia puts her at risk for developing arrhythmias. Option B, renal failure, is incorrect because PB's estimated creatinine clearance is still within normal range. Renal failure is a condition where the kidneys are unable to filter waste products from the blood. Option C, rhabdomyolysis, is incorrect because PB's muscle weakness is most likely due to her pyelonephritis and can be attributed to her current medication regimen as well. Rhabdomyolysis is a serious condition where damaged muscle tissue breaks down and releases substances that can damage the kidneys. Option D, metabolic alkalosis, is incorrect because PB's hyperkalemia would most likely result in metabolic acidosis rather than