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A 60-year-old man had a cardiac stent placed 2 months ago for NSTEMI. He takes aspirin and clopidogrel. His dentist wants to do an elective tooth extraction, and he asks if he can stop clopidogrel. What should the NP recommend? 

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

A 48-year-old man with a 30–pack-year smoking history presents for help with quitting. He has no history of depression, seizures, or cardiovascular disease. He has attempted to quit twice in the past using willpower alone but relapsed within weeks due to strong cravings. He expresses high motivation to stop now, stating, “I’ll try whatever works best.” Which first-line pharmacologic intervention is most appropriate to recommend? 

A 69-year-old man with persistent atrial fibrillation has been maintained on amiodarone for rhythm control for the past 18 months. He presents to clinic for follow-up and reports mild dyspnea on exertion but no chest pain or palpitations. He is otherwise stable on warfarin and carvedilol. Which organ systems require routine baseline and ongoing monitoring in patients treated chronically with amiodarone? 

A 58-year-old man had a heart attack (STEMI) treated with stent placement 3 months ago. He now has frequent premature ventricular contractions (PVCs) on Holter monitoring. He asks if there is a medicine to “stop the extra beats.” Which drug class improves survival in this setting? 

After 5 years on levodopa, a patient develops involuntary writhing movements. This is most likely: 

A 55-year-old man with long-standing hypertension and ischemic cardiomyopathy presents to your clinic with exertional dyspnea and palpitations. He has persistent atrial fibrillation. Current medications include carvedilol, lisinopril, spironolactone, and furosemide. Due to continued symptoms and inadequate rate control, digoxin is added.  What is the primary therapeutic role of digoxin in this clinical context? 

A patient with low literacy struggles with instructions. What is the best approach to providing this patient’s education? 

A 63-year-old woman on hydrochlorothiazide, citalopram, and omeprazole presents with dizziness and near fainting. ECG shows polymorphic ventricular tachycardia with prolonged QT (torsades de pointes). Which medication should be given immediately? 

A 52-year-old with alcohol dependence is prescribed naltrexone. How does naltrexone work?