Disease State Management Practice Test

An 82-year-old woman (60 kg, 155 cm) presents for regimen simplification. PMH: atrial fibrillation, HFpEF, hypertension, GERD, chronic pain. Current meds: warfarin (INR goal 2–3; last INR 3.4), amiodarone 200 mg PO daily, omeprazole 20 mg PO daily, tramadol 50 mg PO q6h PRN, acetaminophen 1000 mg PO TID, furosemide 20 mg PO daily. Labs: SCr 1.0 mg/dL (eGFR 52), AST/ALT WNL. She reports frequent bruising and missed INR appointments. Allergies: none. Which monitoring parameter is crucial for this patient?

A 65-year-old woman (90 kg, 167 cm) with type 2 diabetes presents for follow-up. Current meds: metformin 1000 mg PO BID, insulin glargine 20 units SC nightly. Labs: A1c 10.8%; fasting SMBG 210–260 mg/dL. She reports taking insulin "only when sugar is high" and often skips injections due to fear of hypoglycemia. SCr 0.9 mg/dL. Allergies: none. What counseling advice should be prioritized for this therapy?